关于我国发行文化彩票的思考

我国的彩票产业如今正处于高速发展的时期，15年来，全国累计发行的福利彩票和体育彩票约为500亿元人民币。笔者认为，发行文化彩票势在必行，不但可以丰富彩票市场的内容，也将给正处于资金短缺状况的公益文化事业募集资金，使彩票发挥更多的社会效益。     

硅凝胶假体隆乳安全性的争议问题探讨

目的：探讨硅凝胶假体隆乳安全性的争议问题。方法：查阅近年来有关硅凝胶假体隆乳的可能并发症之研究文献,并作综合分析、评价。结果：硅凝胶假体隆乳术后存在乳房假体破裂或渗漏、硅胶肉芽肿、包膜挛缩、假体移位、感染、蒙道尔病等已明确的并发症以及继发乳腺癌、自身免疫性疾病、结缔组织病、硅胶及铂的乳汁污染等尚存争议的安全性问题。结论：目前的研究认为硅凝胶假体隆乳术是相对安全的,既要重视已明确的并发症,又要重视尚存争议的安全性问题,并于术前充分告知选用硅凝胶假体隆乳的就医者。     

Introduction to the special issue on Ophthalmic Genetics: Vision in 2020

In this special issue of the American Journal of Medical Genetics, Part C, we explore the ever‐expanding field of Ophthalmic Genetics. The eye is unique among organs for its accessibility to physical examination, permitting exploration of every tissue by slit lamp microscopy, ophthalmoscopy, and imaging including color and autofluorescent photography, ultrasound, optical coherence tomography (OCT), electrophysiology, and adaptive optics confocal and scanning laser ophthalmoscopy. This accessibility permits a variety of surgical and nonsurgical treatments, including the first FDA‐approved gene therapy, voretigene neparvovec‐rzyl for RPE65‐associated Leber Congenital Amaurosis. In this issue, we sought to provide a survey highlighting how heritable ophthalmic disorders are recognizable and accessible to clinical geneticists as well as ophthalmologists.     

Comparison of Di-n-methyl Phthalate Biodegradation by Free and Immobilized Microbial Cells

Objective To compare the biodegradation of di-n-methyl pathalate by free and immobilized microbial cells. Methods The enrichment and isolation technique was used to isolate the microorganism. The PAV-entrapment method was utilized to immobilize the microorganisms. The scanning electron microscophy (SEM) was used to observe the growth and distribution of microbial cells immobilized inside the PVA bead gels. The GC/MS method was used to identify the main intermediates of DMP degradation. Results The microbial cells could grow quite well in PVA gel.The metabolic pathway did not change before and after immobilization of the microbial cells. The degradation rate of immobilized cells was higher than that of flee cells. Conclusion The immobilized microbial cells possess advantages than free cells when applied to the biodegradation of toxic organic pollutants.     

合同购买重点卫生服务试点研究

目的探讨合同购买重点卫生服务的适宜技术。方法应用社会学评估方法,对试行合同购买卫生Ⅷ项目重点卫生服务1年以上的某项目县运行情况进行现场调查分析。结果合同购买重点卫生服务在试点县3所县级卫生机构和11所乡镇卫生院得到有效实施；合同任务基本实现；合同购买方式不但可以规范直接面向需方提供服务的财务行为,而且是社区落实卫生干预活动行之有效的管理手段；基层实施合同购买重点卫生服务操作程序应简便,监管指导要到位。结论合同购买重点卫生服务试点是成功的,项目推行的购买程序和管理技术对于政府改变公共卫生的直接财政投入方式可提供借鉴。     

Priority-setting and rationing in healthcare: Evidence from the English experience

In a context of ever increasing demand, the recent economic downturn has placed further pressure on decision-makers to effectively target healthcare resources. Over recent years there has been a push to develop more explicit evidence-based priority-setting processes, which aim to be transparent and inclusive in their approach and a number of analytical tools and sources of evidence have been developed and utilised at national and local levels. This paper reports findings from a qualitative research study which investigated local priority-setting activity across five English Primary Care Trusts, between March and November 2012. Findings demonstrate the dual aims of local decision-making processes: to improve the overall effectiveness of priority-setting (i.e. reaching ‘correct’ resource allocation decisions); and to increase the acceptability of priority-setting processes for those involved in both decision-making and implementation. Respondents considered priority-setting processes to be compartmentalised and peripheral to resource planning and allocation. Further progress was required with regard to disinvestment and service redesign with respondents noting difficulty in implementing decisions. While local priority-setters had begun to develop more explicit processes, public awareness and input remained limited. The leadership behaviours required to navigate the political complexities of working within and across organisations with differing incentives systems and cultures remained similarly underdeveloped.     

What’s in a game? Future directions for the assessment and treatment of drinking games

This conclusion reviews the critical issues raised by the papers in this Special Issue on Drinking Games, with an eye toward directions for future research and the development of palliative interventions. In particular, this conclusion highlights the significance of individual-level characteristics that are associated with drinking game risk, the social context in which these games take place, and methodological considerations for studying both the individual and the context as they unfold as part of drinking game practices. Given both the ubiquity of these games in North American college drinking life, and the substantial hazards with which these games are associated, interventions that may reduce harmful outcomes are needed but have not yet been developed. Issues relevant to the development of such interventions are considered.     

Fifty years of newborn screening

Newborn screening has evolved fast following recent advances in diagnosis and treatment of disease, particularly the development of multiplex testing and applications of molecular testing. Formal evidence of benefit from newborn screening has been largely lacking, due to the rarity of individual disorders. There are wide international differences in the choice of disorders screened, and ethical issues in both screening and not screening are apparent. More evidence is needed about benefit and harm of screening for specific disorders and renewed discussion about the basic aims of newborn screening must be undertaken.     

2009-2010 novel influenza A (H1N1) vaccination coverage in the Republic of Korea

This study aimed to assess vaccination coverage for novel influenza A (H1N1) in Korea using a immunization registry system as the data source. Vaccination coverage was found to be 26.1% for the total population and 54.4% for priority groups targeted by a national vaccination campaign between October 27, 2009, to March 31, 2010. The factors associated with increased coverage were rapid vaccination and free vaccination; these factors may need to be considered in future pandemics.