病原微生物实验室生物安全标准体系框架研究

制定和实施病原微生物实验室生物安全标准是实现病原微生物实验室科学化、效率化、规范化管理和运行的重要手段。本文通过对国内外病原微生物实验室生物安全标准化建设的现状进行分析，提出病原微生物实验室生物安全标准体系框架，主要包含基础标准、管理标准、技术标准和行业应用4个部分，为病原微生物实验室生物安全标准化工作提供参考，助力我国生物安全事业的规范发展。     

湖北省医疗卫生机构生物安全实验室管理现状与对策

目的了解湖北省医疗卫生机构生物安全实验室管理现状,为提升生物安全实验室规范管理能力提供科学依据。方法全省各辖区选取657家医疗卫生机构的生物安全实验室进行辖区内监督检查,从中抽取48家进行省级现场抽查。对结果进行统计,分析生物安全实验室管理现状及存在的主要问题。结果各辖区实验室生物安全管理制度、组织结构、人员培训、设施设备配备符合率达95.00%以上,菌(毒)种及样本管理符合率仅68.95%。省级抽查显示高压灭菌器和生物安全柜定期检测符合率分别为62.50%和47.92%。实验活动准入、意外事故处置与演练、风险评估制度的实施符合率为72.92%。生物安全管理文件的更新、人员定期评价和技术档案建立、菌(毒)种及样本管理等制度的实施符合率分别为64.58%、62.50%和54.17%。结论各辖区监督检查与省级抽查结果基本一致。建议属地化管理关注生物安全制度的执行情况,加强对高压灭菌器和生物安全柜定期检测、实验活动准入、风险评估、意外事故处置与演练,尤其是菌(毒)种及样本管理工作的技术指导与监管力度。     

医疗卫生机构实验室生物安全的现状

<正>生物安全既是我国各级政府高度重视的问题,又是全社会普遍关注的热点。为了解金华市医疗卫生机构实验室生物安全现状,2011年开展了实验室生物安全调查工作,分析存在问题,为今后政府部门制定生物安全政策和管理措施提供科学依据。     

实验室生物安全管理研究进展

摘要：生物安全实验室是进行开展疾病控制、临床诊断、科学研究工作的基础设施和重要场所,其生物安 全管理工作关系到国家的安全稳定。本研究介绍了实验室生物安全管理的概念,研究了国内外实验室生物 安全管理现状,分析了我国在实验室生物安全管理方面存在的问题,并提出了完善实验室生物安全管理体 系、加强生物安全实验室的硬件建设、加强实验室人员生物安全培训等改进建议和措施。 关键词：病原微生物;实验室;生物安全;管理现状;问题;对策;研究进展 中图分类号：Ｒ ３３　　文献标识码：Ａ　　文章编号：１００９ ６６３９ （２０１８）０３ ０２３８ ０４     

河南省一级、二级生物安全实验室备案政策分析与探索

生物安全已成为国家安全的重要组成部分,一级、二级生物安全实验室备案是开展病原微生物实验室生物安全管理的基础,也是落实实验室生物安全相关法律法规的需要。本文以河南省为例,基于SWOT分析法,从优势、劣势、机遇、挑战四个维度对其备案政策进行分析并提出意见建议,以期对一级、二级生物安全实验室备案政策的有效施行提供有益借鉴。     

病原微生物实验室的生物安全和管理

依据国内外有关法规、标准对病原微生物实验室的生物安全和管理要求进行了分析和综述，提出了我国出入境检验检疫生物安全实验室需要进一步依法加强病原微生物实验室的安全管理，依法进行设立、分级、使用、管理，为我国从事病原微生物实验的科研工作者熟悉、了解、正确使用生物安全实验室提供技术保障。     

新增医疗服务价格项目管理探讨

以国家卫生健康委预算医院为研究对象,对其新增医疗服务价格项目管理现状及相关政策文件进行梳理发现:国家卫生健康委预算医院所在地区新增医疗服务价格管理存在缺乏国家层面系统性的管理文件、权限设置过渡下沉、定价基础不牢靠、监管不到位,转归问题未解决以及医院申报把关不严等问题。建议国家层面出台系统性的管理及指导文件,同时完善监管体系,医院加强院内申报审核、监督管理强化责任意识。     

病原生物学实验室的生物安全隐患与对策

医学院校病原生物学实验室一直存在着生物安全隐患问题,所谓的实验室生物安全（Laboratory Biosafety,LBS）指在从事病原微生物实验活动的实验室中避免病原微生物对工作人员和相关人员的危害。随着国家对实验室生物安全的重视,我们对医学院校病原生物学实验室生物安全隐患问题也要给予高度关注,并且针对其存在的问题提出对策。     

我国诊所发展历程研究

作为个体开业行医的主要承载机构和组织形式,诊所在我国的发展趋势,反映了我国医务人员自由执业的情况。建国以来,我国诊所机构经历了允许、限制、重新允许、支持和鼓励四个发展阶段。本文根据文献资料对建国后的诊所机构管理文件进行了系统梳理,分析其特征和社会影响,以期为现有管理政策的进一步完善提供参考。     

生物安全实验室备案管理现状分析

目的了解全国生物安全实验室备案管理现状,为规范化开展备案管理工作提供建议和依据。方法对省级卫生健康行政主管部门生物安全实验室备案管理现状进行问卷调查,并对部分已经发表的实验室备案相关文献进行分析。结果 20个省份的调查结果表明,截至2017年底,各省均出台了生物安全实验室备案管理要求,并开展了备案管理,但各省在备案对象、备案周期、途径方式、审查形式和备案证明材料反馈等方面存在差别。文献分析结果显示,部分地区的疾控中心和医疗机构备案比例较高,院校、科研院所和企业备案数量较少,且由于底数不清无法估计备案比例。结论生物安全实验室备案管理在实验室覆盖面、质量、管理方式和指标体系等方面存在亟须解决的问题,相关行政部门应加强联合监管,实验室建设单位应提高认识,共同完善备案管理。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.