International development of methods of analysis for the presence of products of modern biotechnology

Methods of analysis for products of modern biotechnology are required for national and international trade in seeds, grain and food in order to meet the labeling or import/export requirements of different nations and trading blocks. Although many methods were developed by the originators of transgenic events, governments, universities, and testing laboratories, trade is less complicated if there exists a set of international consensus-derived analytical standards. In any analytical situation, multiple methods may exist for testing for the same analyte. These methods may be supported by regional preferences and regulatory requirements. However, tests need to be sensitive enough to determine low levels of these traits in commodity grain for regulatory purposes and also to indicate purity of seeds containing these traits. The International Organization for Standardization (ISO) and its European counterpart have worked to produce a suite of standards through open, balanced and consensus-driven processes. Presently, these standards are approaching the time for their first review. In fact, ISO 21572, the "protein standard" has already been circulated for systematic review. In order to expedite the review and revision of the nucleic acid standards an ISO Technical Specification (ISO/TS 21098) was drafted to set the criteria for the inclusion of precision data from collaborative studies into the annexes of these standards.     

农村公共卫生体系的现状分析及对策构想

在医疗服务机构实行市场导向化改革的背景下，城乡医疗服务行为模式发生了重大变化。广大农民尤其是贫困地区的农民对于医疗服务的可及性下降，“因病致贫、因病返贫”凸显出农村公共卫生体系的脆弱。文章在肯定既有成就的同时，认为投入不足、利用能力下降、资源配置不均、结构不合理是农村公共卫生体系建设中面临的困境与挑战。在此基础上，提出预防、保障与外部参与共同发力的对策构想。     

中国疾病预防控制中心公共职能的界定

目的　明确中国疾病预防控制中心公共职能的落实程度。方法　采用分层随机抽样法,在全国范围内抽取16 1个疾病预防控制中心,调查样本机构公共职能项目开展比例以及开展项目的操作程度。结果　(1)疾病预防控制中心公共职能项目的平均落实程度为4 2. 9% ,其中省级为5 6. 0 % ,市级为4 3. 7% ,县级为4 1. 3% ;东部地区为4 9. 3% ,中部地区为4 5 . 4 % ,西部地区为35. 3%。(2 )疾病预防控制中心七项公共职能中,疾病预防与控制落实程度职能落实程度为5 4 3%、突发公共卫生事件应急处置为6 5 . 8%、疫情报告及健康相关因素信息管理为35 . 0 %、健康危害因素监测与控制为31 .3%、实验室检测与评价39 .1%、健康教育与健康促进为36 .4 %、技术指导与应用研究为5 6 . 7%。结论　中国疾病预防控制中心各项公共职能落实程度普遍不高,并随地区和级别的变化而变化;各项公共职能中,突发公共卫生事件应急处置职能落实程度最高,健康危害因素监测与控制职能落实程度最低。     

我国现行的献血方式分析

无偿献血是各国血液事业的发展方向,我国目前正处于有偿献血向无偿献血转化的过渡时期,存在着无偿献血、有偿献血、计划献血和亲友互献血等多种献血方式,献血方式的发展趋势是：无偿献血膛步取代有偿献血,逐步清除亲友互助献血,计划献血也瘵自动退出历史舞台.     

商丘市睢阳区2009年手足口病流行病学分析

目的分析商丘市睢阳区2009年手足口病的流行病学特征,为制定手足口病防控措施提供科学依据。方法根据国家疾病监测报告管理信息系统2009年报告的手足口病例进行流行病学分析。结果 2009年全区报告手足口病1245例,全年均有发病,春末夏初高发,共发生858例(占68.92%),4月份为发病高峰456例(占36.63%),病例集中在市区和近郊乡镇,发生710例(占57.03%),男女性别比为1.74︰1,5岁以下儿童占94.94%,散居儿童占92.77%,病原体主要为EV71,占阳性标本的90.18%。结论搞好环境卫生,养成良好的卫生习惯,建立监测系统是防控手足口病的重要措施。     

The association of smoking with clinical indicators of altered sex steroids--a study of 50,145 women

This study was designed to test the association of smoking with four clinically apparent conditions that may be related to altered sex steroids: natural and induced menopause, infertility, oligomenorrhea, and hirsutism. Data were obtained from the personal inventories of 50,145 women ages 20-59 years in TOPS, a weight reduction program. The age-adjusted odds ratios of each condition for heavy smokers compared with nonsmokers were 1.59 for natural menopause, 1.49 for induced menopause, 1.35 for infertility, 1.30 for oligomenorrhea among women younger than 40 years, 1.63 for oligomenorrhea among women 40-49 years, and 1.54 for hirsutism (P less than .05 for oligomenorrhea and P less than .001 for all other risks). The odds ratios were not substantially changed after adjustment for obesity, parity, and husband's education level. These results suggest that smoking may affect the ovaries or hormone metabolism, or both, with medical and cosmetic consequences.     

西藏地区3岁以下儿童辅食添加状况调查

目的 了解西藏地区3岁以下儿童的辅食添加状况。方法 采用横断面调查设计与分层多阶段随机抽样法，获得1655对母与子，通过母亲回顾调查了儿童的辅食添加情况，并与1995年中国9市(城区和郊区)7岁以下儿童及同时期中国西部40个贫困县农村3岁以下儿童喂养状况比较。结果 西藏地区3岁以下儿童辅食添加中糌粑(熟青稞面和酥油茶的混合物)添加最早，平均在出生后1．98月龄，男童稍早于女童，但其他辅食的添加两者间差异无显著性。城市儿童添加辅食明显早于农村儿童，到4月龄时，城市中仅有10．6％的儿童尚未添加辅食，而农村却仍有21．7％的儿童尚未添加；农区儿童添加辅食早于牧区儿童，到4月龄尚未添加辅食的比例分别为14．2％和30．9％；鸡蛋和猪、牛、羊肉类的添加时间在8～9月龄之间，城市添加比例和频率高于农村；西藏儿童到6月龄时只有11．5％尚未添加任何辅食，明显低于西部40个贫困县(45．2％)。在动物性辅食的添加上，西藏儿童也较早，到6月龄尚未添加任何动物性辅食的儿童比例为49％，而西部40个县则为61．4％。到6月龄时下列各类辅食的添加比例分别为：糌粑89．1％、鸡蛋22．1％、鲜奶29．1％、猪牛羊肉23．5％、蔬菜17．5％、豆制品0．75％、鱼肉1．03％、鸡肉3．35％。结论 西藏地区3岁以下儿童的喂养方式较平原地区有很大的区别，其辅食结构以糌粑为主，辅以少数几种食品(奶、肉)，缺少蔬菜，特别是农牧区。豆制品、鸡、鱼肉类不是普遍添加的辅食。辅食添加早，种类单调是其喂养方面存在的一个突出特点，改善辅食添加是改善该地区儿童营养状况的一个重要环节。     

华南地区16家医院药品费用分析

药费比重过高在目前已成为一个较突出的问题。针对这一问题,对华南地区16家医院药费与医院级别、药费与费别、药费与处置费的关系及药费与病种进行了统计分析。查找原因,采取相应对策以降低药费比重,充分发挥医疗技术在诊治疾病中的作用。     

Future development of biological understanding of radiation protection: implications of nonstochastic effects

Radiation-protection standards are based on minimizing or preventing biological effects in exposed populations. Radiation-induced biological effects can be classified as stochastic--malignant and hereditary diseases for which the probability of an effect occurring is a function of dose without threshold--and nonstochastic--inflammatory and degenerative diseases for which the severity and frequency of the effect varies with the dose and for which a threshold is present. The current International Commission on Radiation Protection (ICRP) approach for setting limits for intakes of radionuclides by workers, which accounts for doses to significantly exposed organs of the body, is based on limitation of stochastic effects in most situations. When setting exposure limits, nonstochastic effects are generally considered to be unlikely at the limits for stochastic effects. In some situations, limits based on prevention of nonstochastic effects are lower than for stochastic effects. This review considers the threshold radiation doses for thyroid, bone, liver and lung and their relationship to the limits recommended by the ICRP and the cancer risks at the limits. This review indicates that the threshold dose for nonstochastic effects in thyroid and lung is much above the dose limit as advocated by ICRP. The threshold dose for nonstochastic effects in bone and liver is much closer to the dose limit, but protection from nonstochastic effects should still be afforded by the dose limits.     

纳洛酮治疗30例早产儿原发性呼吸暂停

目的 观察纳洛酮治疗早产儿原发性呼吸暂停的临床疗效.方法 将诊断为原发性呼吸暂停的60例早产儿随机分为治疗组30例,用纳洛酮注射液0.1mg·kg-1·次-1,1次/8h,静脉滴注;对照组30例常规用氨茶碱,首剂5mg/kg,12h后予维持量2mg/kg,静脉滴注,1次/8h.结果 治疗组显效25例,有效4例,无效1例,总有效率96.7%;对照组显效12例,有效9例,无效9例,总有效率70.0%.两组总有效率比较有显著差异(P＜0.05).结论 纳洛酮治疗早产儿原发性呼吸暂停疗效显著,且无明显不良反应,值得推广.     

Development of a measure of the health-related quality of life of children in public care

OBJECTIVES: To validate PedsQL for children in public care and develop an 'in-care' module. DESIGN AND SETTING: Questionnaire development and validation. Questionnaires were completed in placement. A total of 69 children in public care (aged 8-18 years) and their carers were recruited through routine paediatric assessments, and 662 children not in public care were recruited from local schools. MEASURES: Self- and proxy-report versions of PedsQL generic module and the 'in-care' module. RESULTS: Cronbach's alpha for the generic module ranged from 0.66 to 0.88 and from 0.74 to 0.90 for self- and proxy-report respectively. Lower scores were reported for children in care compared with peers living at home for proxy- and self-report. Proxy- and self-report correlation ranged from 0.43 to 0.60 (P < 0.001). Cronbach's alpha for the in-care module was 0.87 and 0.91 for self- and proxy-report respectively. Proxy- and self-report scores showed significant correlation with generic module scores. The highest correlations were seen with sub-scales measuring Psychosocial Functioning (e.g. Emotional Functioning: Pearson's r = 0.67 and 0.59, P < 0.001 for self- and proxy-report respectively). Proxy- and self-report correlation was 0.45 (P < 0.001). CONCLUSIONS: We found PedsQL generic module and the newly developed 'in-care' module to have excellent internal reliability for self- and proxy-report. Validity was established for both measures and significant correlation found between child and proxy ratings. Although further testing of the measures is recommended, both have potential value in assessing the success of placements and could provide a reliable and valid tool for individual patient analysis in clinical practice and for research with this group.     

昆明市农村居民肥胖相关高血压的直接经济负担研究

目的分析昆明市官渡区农村居民归因于肥胖的高血压的直接经济负担,为制定该地区心血管疾病的预防干预措施提供依据。方法采用按比例概率抽样方法（PPS）在昆明市官渡区对4595名18岁及以上村民通过问卷调查和体格检查获取高血压的患病、医疗费用资料及肥胖情况。结果该地区居民高血压患病率为32．9％（男性为32．5％,女性为33．4％）;标化患病率为31．8％（男性为30．7％,女性为32．9％）;知晓率为49．9％（男性为43．7％,女性为55．4％）,肥胖检出率为11．2％（男性为8．9％,女性为13．3％）,男性的肥胖检出率明显低于女性,差异有统计学意义（x^2=22．713,P〈0．05）,女性高血压的知晓率明显高于男性,差异有统计学意义（x^2=33．614,P〈0．01）。肥胖者患高血压的风险明显高于非肥胖者（OR=2．64,P〈0．01）。高血压的总直接疾病经济负担为265．67百万元,其中归因于肥胖的总直接疾病经济负担为41．23百万元,占高血压总直接经济负担的15．5％。结论肥胖相关高血压给当地造成了一定的经济负担,应采取措施降低肥胖的发生率,从而减轻患者的经济负担。     

Nosological coding of cause of death

Death certificates representing 766 decedents who had participated in the Hypertension Detection and Follow-up Program (1973-1979) at one of 14 US centers were given to three nosologists for purposes of coding underlying cause of death. Analyses examined interobserver variability among the three nosologists as well as intraobserver variability for each of the three nosologists. All three nosologists agreed on a three-digit International Classification of Diseases, Adapted (ICDA) code in 90.2% of the cases and at least two out of three agreed in 99.7% of the death certificates examined. Agreement rates improved when disease codes were collapsed into broader categories utilized in the Hypertension Detection and Follow-up Program. When particular disease classifications (e.g., cerebrovascular, ischemic heart disease, myocardial infarction, and neoplasms) were examined, three out of three agreement rates were highest for neoplasms (97.8%) and lowest for myocardial infarction (86.5%). Similarly, two out of three agreement was highest for neoplasms (98.5%) and lowest for myocardial infarction (88.0%). Intranosologist agreement rates were based on a recoded 20% sample of death certificates. Agreement rates for three-digit ICDA codes ranged from 94.8% to 96.1% for the three nosologists. The agreement rates for the general disease categories ranged from 96.7% to 97.4%.     

Grouping of the International Classification of Diseases for analysis of hospital readmissions

ICD chapters and three-digit categories are not always appropriate for epidemiological analysis; the former are too generic and the latter too numerous. When the epidemiological focus is not on a specific clinical diagnosis, an intermediate grouping proposal between these two possibilities becomes necessary. Such proposals are not frequent in the literature. We used a two-stage grouping proposal based on hospital admissions volume, internal clinical coherence in each group, and the results of a Cox multivariate model for real data. As a result, we obtained 26 groups for adults and 19 groups for children, among which we chose hernia as the reference category for adults and appendiceal disease for children. The grouping proved adequate for the analysis of readmissions in a large Brazilian general hospital. Procedures similar to those described in this research report can be used to analyze other health problems.     

FoodNet: overview of a decade of achievement

The Foodborne Diseases Active Surveillance Network (FoodNet) performs active, population-based laboratory surveillance for nine common foodborne pathogens and one syndrome in a catchment area of 44.5 million persons. FoodNet surveillance data are an important resource for examining trends in specific diseases over time. Population surveys and laboratory surveys have been used to estimate the burden of disease, for example that there are 38.6 cases of Salmonella infection for each reported case. FoodNet case-control studies have identified new risk factors for E. coli O157, Campylobacter, and several Salmonella serotypes. FoodNet sites have demonstrated the value of delivered stool kits for improving the rate of confirming an etiology in foodborne disease outbreaks. FoodNet helps build capacity for foodborne disease surveillance in participating sites and through close collaborations with PulseNet, EHS-Net, Global SalmSurv, and other partners.     

再论医院后勤服务社会化的可行性

目前，经济高速发展，服务体系和水准相对滞后，加上管理者素质的提高，现代管理技术的应用，以及后勤管理体制的改革，为医院后勤工作向社会分离提供了条件，也为推进医院后勤服务社会化提供了机遇。但规范卫生服务市场体系是后勤服务社会化的保障，故要建立：卫生物质流通、后勤人才流动、经济信息市场及卫生建设筹资机构。在推进后勤服务社会化时尚需解决：①支持条件；②实施集团联盟；③注意经营定位等问题。     

外科皮瓣修复先天性尿道下裂的临床观察

目的：探讨采用不同外科皮瓣修复先天性尿道下裂的临床疗效。方法：回顾性分析我院133例先天性尿道下裂患者采用不同外科皮瓣治疗的病例资料。结果：不同类型尿道下裂修复应用不同外科皮瓣：Ⅰ、Ⅱ、Ⅲ型尿道下裂修复主要应用阴茎阴囊皮瓣＋尿道板、尿道板，Ⅳ型尿道下裂修复主要应用阴茎阴囊皮瓣、阴茎阴囊皮瓣＋尿道板；阴茎阴囊皮瓣＋尿道板对Ⅰ、Ⅱ、Ⅲ型尿道下裂治愈率无明显差异（P〉0．05），尿道板对Ⅲ型尿道下裂的治愈率低于Ⅰ型和Ⅱ型尿道下裂（P〈0．05）；阴茎阴囊皮瓣＋尿道板、尿道板分别对Ⅰ型和Ⅱ型尿道下裂治愈率相似（P〉0．05），但阴茎阴囊皮瓣＋尿道板对Ⅲ型尿道下裂治愈率显著高于尿道板（P〈0．05）。阴茎阴囊皮瓣＋尿道板、尿道板治疗尿道下裂术后尿瘘发生率分别为23．0％和42．9％，阴茎阴囊皮瓣无并发症发生。结论：手术治疗不同类型尿道下裂应选择适宜的外科皮瓣；阴茎阴囊皮瓣＋尿道板较适用于各型尿道下裂的修复治疗，单独尿道板较适用于Ⅰ型和Ⅱ型尿道下裂的修复治疗。     

虹口区居民伤害状况调查

[目的]了解上海市虹口区居民伤害发生情况、流行特征以及疾病负担,为创建安全社区提供决策支持。[方法]采用二阶段简单随机抽样的方法抽取到10400户共25153名常住居民对2010年6月1日至2011年5月31日期间的伤害发生情况进行回顾性调查,主要内容有性别、出生年月、文化程度、职业、伤害原因、发生时间、发生地点、伤害时的活动、伤害部位和性质。[结果]伤害粗发生率为3．10％,95％可信区间为2．79％～3．21％;标化发生率为2．50％;伤害次数发生率为3．30％,标化发生率为2．64％。前三位伤害原因是跌倒／坠落、交通事故、烧烫伤。发生地点以住所、街道公路、公共管理区域为多。伤害性质以浅表伤、脱位／扭伤／劳损、骨折为多。每例伤害患者治疗费用为3047元人民币。随着年龄的增长伤害发生率也提高（伤害发生率l～14岁组为1．45％,15～44岁组为1．54％,45～65岁组为3．18％,65岁及以上年龄组为6．48％）。伤害发生率有性别差异,男性伤害发生率为2．33％,女性为3．82％。随着文化程度的提高伤害发生率有下降的趋势（文盲为4．47％,小学为4．59％,初中为4．38％,高中／中专为3．27％,大专为1．89％,大学为1．57％）。伤害发生还与婚姻状况有关,未婚者伤害发生率为1．30％,已婚者为3．15％,离异或丧偶者为7．35％。[结论]安全社区建设应有针对性地开展伤害干预工作,重点干预女性、老人、文化程度低、离异独居的人员;干预重点场所应该为住所、街道公路、公共管理区域;减少因跌倒、交通事故造成的伤害的发生。     

Patterns of milk consumption and risk of cancer

The reported milk consumption habits of 3,334 cancer patients and 1,300 comparable control subjects seen at Roswell Park Memorial Institute were studied. The cancer patient group included persons diagnosed with cancers of the oral cavity, stomach, colon, rectum, lung, breast, uterus, cervix, prostate, or bladder. Data were obtained by means of a standardized admissions questionnaire. As a group, control patients were more likely to report never drinking whole milk; cancer patients more often reported frequent consumption of whole milk. Relative risks of different patterns of milk consumption for specific cancer diagnoses, adjusted for sex, age, smoking history, education, and county of residence, were calculated with multiple logistic regression analysis. Elevated risks for frequent consumption of whole milk relative to not drinking milk were observed for cancers of the oral cavity, stomach, colon, rectum, lung, bladder, breast, and cervix. Reduced risks for frequent consumption of 2% milk relative to not drinking milk were observed for cancers of the oral cavity, stomach, rectum, lung, and cervix. Preference for exclusive consumption of reduced-fat milk was linked to significant risk reduction for oral and cervical cancers, and drinking only whole milk was linked to significant risk increases for cancers of the oral cavity, stomach, rectum, lung, and breast. Some associations were observed for a computed index of milk fat intake, but the overall pattern of effects was not fully explained by variations in fat content. The effects observed for some sites may be confounded by other dietary or nondietary correlates of risk.     

边境地区鼠体外寄生虫重要种群的季节消长

目的调查我国东北中朝俄边境地区鼠体外寄生虫重要种群的季节消长。方法采用笼日法捕鼠,收集鼠体外寄生虫。结果东北边境吉林省的和龙、珲春市,黑龙江省密山市和东宁县12种鼠体寄生虫的季节消长观察结果。12种鼠体外寄生虫的活动季节分别为全沟硬蜱4.5个月;同源栉眼蚤指名亚种和二齿新蚤均为5.0个月;纳氏历螨、耶氏历螨和厩真历螨均为5.5个月;高丽新恙螨1.5个月,田宫新恙螨和虾夷五角恙螨均为2.0个月,田鼠新恙螨2.5个月,波氏新恙螨3.5个月,已纤恙螨4.5个月。在整个活动季节期间出现1次高峰的10种分别是:全沟硬蜱8月上旬,同源栉眼蚤指名亚种6月上旬,厩真历螨和耶氏历螨均为10月下旬,已纤恙螨5月上旬,虾夷五角新恙螨和田宫恙螨均为5月下旬,波氏新恙螨6月下旬,田鼠新恙螨和高丽新恙螨均为8上旬;出现2次高峰的2种依次为:二齿新蚤在4下旬和6上旬,纳氏历螨在6月下旬和10月上旬。结论东北中朝俄边境地区鼠体外寄生虫重要种群的季节消长调查结果为深入开展鼠体外寄生虫与疾病关系提供了参考依据。