政府采购对中国经济的影响

从政府采购制度及其理论依据入手，从公共财政理论和新公共管理理论等方面分析了政府采购制度的利与弊。提出政府应利用行政、法律等手段加强对政府采购制度的宏观管理和监督，并逐步淡出微观管制。在政府采购制度与采购行为中，政府的作用不是取代市场，而是为市场保驾护航，让市场更好地发挥作用。     

超声处理对羊瘙痒病脑组织中PrPSc聚集状态的影响

目的 研究超声处理对感染羊瘙痒症仓鼠脑组织中PrP^Sc聚集状态的影响，寻找产生PrP^Sc低聚体的条件。方法 裂解液制备脑组织提取物，用各种超声条件处理不同阶段的脑组织提取物；以蛋白酶消化后的Western blot方法和图象分析系统观测PrP^Sc蛋白的分布和聚集状态。结果 适当的超声处理(15s共30次)可增加脑组织匀浆上清中PrP^Sc含量1．29～1．58倍；同样条件下超声处理可明显增加羊瘙痒因子263K感染仓鼠脑组织匀浆上清中PrP蛋白总量，而对正常对照仓鼠脑组织匀浆上清中PrP蛋白总量影响不大；对经常规高速离心获得的PrP^Sc的超声处理显示约90％的PrP^Sc存在于离心上清液中。结论 对感染动物脑组织进行超声处理可增加PrP^Sc的提取量，利于实验室检测。适当的超声处理可破碎大的相对分子质量的PrP^Sc聚集物，产生小的相对分子质量的PrP^Sc产物。     

900MHz微波电磁辐射对原代培养的大鼠脑皮质神经元能量代谢的影响

目的　研究 90 0MHz微波电磁辐射对原代培养的大鼠脑皮质神经元能量代谢的影响。方法　将大鼠脑皮质神经元暴露于 90 0MHz的连续性微波电磁辐射 (SAR =3 2 2mW g、PD =9mW cm2 ) ,每天暴露 2h ,连续 4d或 5d ,及一次性 1 2h暴露 ,以细胞色素氧化酶为观察指标 ,研究微波对神经元能量代谢的影响。结果　微波电磁辐射可使神经元细胞色素氧化酶活性降低。结论　神经元细胞色素氧化酶活性的改变并非“致热效应”所致 ;微波电磁辐射对神经元细胞色素氧化酶活性影响有蓄积毒性作用 ,其影响在一定程度上是可恢复的 ,并且与神经元接受微波辐射时细胞培养年龄关系不密切。     

子宫实验和E-SCREEN实验在检测雌激素活性中的相关性

目的　以 1 7β 雌二醇 (1 7β E2 )和四种植物提取物为受试物 ,研究子宫实验和E SCREEN实验在检测雌激素活性中的相关性。方法　断乳雌性小鼠 (1 0～ 1 2g)按体重分为 6组 ,分别给予小茴香、山豆根、补骨脂和川牛膝提取物 (1 0g kgBW ,ig)、1 7β E2 (0 5mg kgBW ,sc)和蒸馏水 (ig) ,持续 9天后处死动物剥离子宫称重。分别在人类乳腺癌MCF 7细胞培养液中加入四种植物提取物 (终浓度 1 0mg L)和 1 7β E2 (终浓度0 3μmol L) ,计算各组细胞在 1 2 0h内的平均群体倍增时间 ,分析小鼠子宫重量与细胞群体倍增时间的相关性。结果　 4种植物提取物均可使小鼠子宫重量增加 (P <0 0 5或P <0 0 1 ) ,细胞群体倍增时间缩短。子宫重量与群体倍增时间呈显著负相关 (r=- 0 96 7,P <0 0 1 )。结论　子宫实验和E SCREEN实验结果在检测雌激素活性物质时具有一致性     

Clinicians' perceptions of the problem of antimicrobial resistance in health care facilities

BACKGROUND: Many clinicians do not comply with guidelines regarding antimicrobial resistance (AR). In response, the Centers for Disease Control and Prevention developed a national Campaign to Prevent Antimicrobial Resistance in Healthcare Settings that presents 4 strategies and 12 evidence-based steps. METHODS: To assess clinicians' perceptions of AR, barriers and facilitators to preventing AR, and how best to reach clinicians, a questionnaire and 4 focus groups were conducted after presentation of the Campaign at 4 Pittsburgh Regional Healthcare Initiative hospitals. RESULTS: One hundred seventeen clinicians completed the questionnaire; 28 participated in the focus groups. Clinicians were significantly more likely to perceive that AR was a problem nationally than in their own institution (95% vs 77%; P<.001) or practice (95% vs 65%; P =.002), consistent with focus group results (93% nationally vs 46% institution or practice). The 3 Campaign steps with the most barriers to implementation were "Treat infection, not colonization" (35%), "Stop treatment when infection is cured or unlikely" (35%), and "Practice antimicrobial control" (33%). Clinicians in the focus groups cited the additional barriers of the health care culture, lack of knowledge, and the nursing shortage; facilitators included education, information technology, and consults. Computer programs, posters, and local data were suggested for reaching clinicians about AR. CONCLUSIONS: Clinicians perceive AR to be a complex national problem but less relevant to their own institution or practice. Providing clinicians with information and steps for preventing AR, as in the Campaign, may affect their perceptions of the problem and motivate them to take actions to ensure patient safety.     

Enhanced terminal room disinfection and acquisition and infection caused by multidrug-resistant organisms and Clostridium diffcile(the Benefits of Enhanced Terminal Room Disinfection study):a cluster-randomised,multicentre,crossover study

中文:背景患者入院后可从不当消毒的环境表面获得多药耐药菌和艰难梭菌。本文确定了3种强化的终末消毒(入住同一病房的两名患者之间的消毒)策略,对感染耐甲氧西林金黄色葡萄球菌(MRSA)、耐万古霉素肠球菌(VRE)、艰难梭菌(CD)和多重耐药不动杆菌的影响。方法本文在美国东南部的9家医院开展了一项务实的、集群-随机、交叉研究。凡曾有感染或定植目标细菌感染患者居住过的病房,患者出院后随机采取4种消毒策略中的一种方法进行终末消毒:对照(季胺盐类消毒剂消毒,但凡遇到CD采用含氯消毒剂);UV(季胺盐类+UV-C消毒,但凡遇到CD采用含氯消毒剂+UV-C);含氯消毒剂;含氯消毒剂+UV-C。凡入住目标病房的患者被列为暴露人群。这4种终末消毒方法分别在每家医院连续实施7个月的周期。本文随机设计这几种消毒策略在每家医院内的实施顺序(1:1:1:1)。主要产出的结果是,观察暴露患者中目标细菌的感染的发生或定植情况,以及ITT人群中暴露患者CD感染发生率。本研究ClinicalTrials.gov注册编号:NCT01579370。结果共有31 226名患者暴露,其中21 395(69%)符合标准,包括4 916名对照组,5 178名UV组,5 438名含氯消毒剂组,以及5 863名含氯消毒剂+UV组。在对照组中,22 426个暴露日中有115名患者发生目标细菌的感染(51.3/10000暴露日)。在标准清洁策略的基础上增加UV消毒的暴露患者,其目标细菌感染的发生率明显较低(n=76;33.9/10 000暴露日;RR:0.70,95%CI:0.50～0.988;P=0.036)。含氯消毒剂组(n=101;41.6/10 000暴露日;RR:0.85,95%CI:0.69～1.04;P=0.116),或含氯消毒剂+UV组患者(n=131;45.6/10 000暴露日;RR:0.91,95%CI:0.76～1.09;P=0.303)的目标细菌的感染率,其差异无统计学意义。同样,在含氯消毒剂的基础上增加UV消毒,暴露患者中CD感染率也没有发生改变((n=38 vs 36;30.4 vs 31.6/10 000暴露日;RR:1.0,95%CI:0.57-1.75;P=0.997)。解释污染的医疗机构环境是获得病原微生物的重要来源;强化终末消毒可以降低这一风险。     

Assessing motivation for physicians to prevent antimicrobial resistance in hospitalized children using the Health Belief Model as a framework

BACKGROUND: Antimicrobial resistance (AR) is a threat to hospitalized children, and more information is needed to motivate physicians to adopt evidence-based practices such as those in the Centers for Disease Control and Prevention's (CDC) Campaign to Prevent Antimicrobial Resistance. METHODS: The framework of the Health Belief Model (HBM) was used to assess personal perceptions and cues to action related to the prevention of AR in 3 national focus groups in August 2003. RESULTS: Twenty-five physicians who treat hospitalized children participated; all reported that they had cared for a patient with an antimicrobial-resistant organism. Physicians perceived that AR was more of a problem nationally (92%) than in their institution (76%) or practice (60%) and reported that issues such as nursing shortage, cost of health care, and lack of specialty services presented more of a challenge to the care of hospitalized children than AR. Reported preferences of cues to action included journal articles (80%), infectious disease experts (76%), and colleagues (52%). CONCLUSIONS: The HBM provides insight into physicians' perceptions about AR and preferred cues to action, which yield valuable information concerning the modes, methods, and messengers to intervene on problems such as antimicrobial resistance in hospitalized children.     

2006年2月份全国甲乙类传染病疫情动态简介

发病数 死亡数 病名 DISease Case number Death 本月 Feb 去年同月本年累计 Last Feb .CumZ《X拓 去年累计 CumZ(X)5 本月 Feb. 去年同月 Last Feb nUmber 本年累计 CUmZ《X场 去年用计 Cu几12(X)5 Plague Cholem 疫乱 鼠霍 传染性非曲型肺炎sARs-------- 艾滋病AIDS 366 186 699 442 41 40 75 92 肝炎viral HePatitis 1 10 462 72 750 209 010 166 092 79 74 168 158 甲肝Type A 4 643 3 956 8 857 9 149 4 1 84 乙肝TyPe B 92 876 59 788 176239 136989 58 56 129 121 丙肝Type C 5 039 2 758 9 805 6 539 6 7 10 14 戊…