我国医疗技术管理中引入医疗技术评估的路径探讨

2015年以来,在简政放权的大环境下,我国医疗技术管理面临着从重审批的分级分类管理向重监管转型的挑战和机遇,亟需探索建立更加科学合理的医疗技术管理体系。使用医疗技术评估的科学工具和手段是在医疗技术管理领域国际通行的理念和做法。本文梳理了我国医疗技术管理政策沿革,介绍了国际典型代表英国医疗技术管理的过程和方法,并为完善我国医疗技术管理提供了几条政策建议。     

L.S. Vygotsky and the Theater

The article presents the analysis of L.S. Vygotsky's works dedicated to the theater arts and is organized according Vygotsky's different life and work stages. Meanwhile special attention is paid to the Gomel period during which a large number of reviews were written by Vygotsky and published in “Nash ponedel'nik” and “Polesskaia pravda” newspapers. Biographical facts are widely used in this analysis and help to clarify Vygotsky's interest in art. It is shown that even at the beginning of his oeuvre, he was interested not only in a range of problems in art, but also psychological problems related to art perception and creativeness. Vygotsky's usage of structural concept ideas about the peculiar properties of literary text composition are also explored. Vygotsky analyzes the socio-psychological mechanisms of theatrical art effect. Furthermore, those areas which are widely used by Vygotsky in determining the characteristics of cast reincarnation are examined. Special emphasis is placed on the different elements of the actor techniques (speech, movement, emotional expression, acting personality and etc.). Materials are widely used in this study and help identify the socio-cultural context that defined Vygotsky's values at different stages of his work, related to his drama criticism and his formation as a professional psychologist.     

iQPR法处理水对SD鼠生物安全性的研究

iQPR技术处理污水是一项新型尖端的技术,此技术可以成功降低污水乃至受到污染的地下水中的各种污染指标。但是,iQPR技术处理污水尤其是地下水是否存在潜在的生物安全性问题有待于进一步研究。因此,为评估iQPR技术对生物安全性的影响,本研究首先分析了三种不同iQPR法处理水的水质成分;其次系统研究了iQPR水对SD鼠在个体水平、组织水平和病理形态学损伤的研究。研究表明:iQPR处理的水质成分较对照组普通饮用水好,在个体组织水平检测未见异常,尽管其中一组iQPR处理水造成了SD鼠的脾小体增大,但是可能的原因是水处理环节存在微生物污染现象,因此,初步认定此技术未造成SD大鼠的个体损伤。本研究为揭示iQPR处理的水对生物体的安全性评价提供一个理论依据。     

金柑花蕾酵母双杂交cDNA文库构建及评价

为了探索金柑花发育的分子机制并研究与金柑花发育相关重要基因编码的蛋白质之间的相互作用,本研究以融安金柑不同生长时期的花蕾为材料,采用SMART技术构建了cDNA文库,对该文库进行了鉴定评价。经检测,所构建的cDNA文库滴度为2.83×10^8cfu/mL,文库库容为1.42×10^10cfu,重组率为97.91%,插入的双链cDNA片段长度主要分布在250~2 000 bp之间。结果表明,该文库达到了建库标准,理论上涵盖了全部与融安金柑花蕾发育相关的基因,为后续利用酵母双杂交技术筛选互作蛋白提供了物质基础。     

建立多重液相基因芯片方法快速检测狐狸、水貂成分

基于xMAP液相芯片新型生物技术平台,分别以狐狸线粒体DNA D-loop区序列、水貂线粒体DNA细胞色素b基因序列为模板设计特异扩增引物和探针,并对探针进行锁核酸修饰,建立了二重xMAP液相基因芯片方法,用于快速检测狐狸和水貂源性成分。该法能准确鉴定鉴别狐狸和水貂DNA,对其他18种动物物种DNA均呈检测阴性,对狐狸、水貂DNA的检测低限分别为2. 8pg/μl、0. 9pg/μl,对肉类混样检出限为0. 05%(m/m)。对目标源性DNA含量为1%(V/V)的32份饲料与食品核酸添加样本均呈对应目标检测阳性。结果表明,该方法特异性强、灵敏度高,适用于食品与饲料领域相关原料和产品的质量与安全检验。     

人源抗体制备及临床应用研究进展

与常规治疗药物相比,抗体药物具有靶向性强、特异性好等优点,其作为一类重要的治疗性药物,近年来在临床中的应用逐渐增多,为疾病的治疗提供了新的选择,应用范围逐渐从肿瘤、自身免疫性疾病及慢性炎症扩展到心血管和感染性等疾病中。人源抗体的全部结构是由人类抗体基因所编码的,因此避免了异种蛋白长期应用引起的不良反应,加之人源抗体制备技术的不断发展完善,使其逐渐成为治疗性抗体研发的首要选择。综述了近年来治疗性人源抗体的主要制备技术及其在临床中应用的最新进展,同时探讨了人源抗体制备技术的不足之处,以期为人源抗体的发展提供借鉴和思路。     

A phylogeographic study of the stoneplant Conophytum (Aizoaceae; Ruschioideae; Ruschieae) in the Bushmanland Inselberg Region (South Africa) suggests anemochory

The Bushmanland Inselberg Region (BIR) of South Africa provides an ideal system to study population interactions, as these inselbergs function as islands of Succulent Karoo surrounded by Nama Karoo vegetation. The population genetics of four Conophytum taxa endemic to the quartz-associated habitats of inselbergs in the BIR were investigated using amplified fragment length polymorphisms (AFLP), namely C. marginatum subsp. haramoepense, C. marginatum subsp. marginatum, C. maughanii, and C. ratum. Conophytum marginatum colonizes the quartz outcrops on the summits of the inselbergs, while C. maughanii and C. ratum occupy quartz patches at the summit and base of the inselbergs. A total of 24 populations were sampled to assess genetic differentiation between populations of each species, specifically between summit and base populations of C. ratum, eastern and western populations of C. maughanii and populations of the two subspecies of C. marginatum. Moderate levels of genetic differentiation were recovered between the summit and base populations of C. ratum, with an indication of some genetic connectivity between the populations. Slight differentiation between the eastern and western populations of C. maughanii was recovered, however, this was not reflected in the PCoA and STRUCTURE results. In C. marginatum, no significant genetic differentiation was recovered between populations of the subspecies. These results may reflect evidence of different dispersal mechanisms in the species, with the genetic connectivity between populations of C. ratum possibly indicating dispersal through hygrochastic capsules, while genetic connectivity between populations of C. maughanii and C. marginatum may, for the first time, suggest long-distance dispersal, i.e. anemochory. This study provides the first insights into population interactions across the BIR and highlights the importance of conservation in the region, particularly of the Gamsberg, in light of the recent mining activities.     

Efficient GFP‐labeling and analysis of spermatogenic cells using the IRG transgene and flow cytometry

Spermatogenesis is a highly ordered developmental program that produces haploid male germ cells. The study of male germ cell development in the mouse has provided unique perspectives into the molecular mechanisms that control cell development and differentiation in mammals, including tissue‐specific gene regulatory programs. An intrinsic challenge in spermatogenesis research is the heterogeneity of germ and somatic cell types present in the testis. Techniques to separate and isolate distinct mouse spermatogenic cell types have great potential to shed light on molecular mechanisms controlling mammalian cell development, while also providing new insights into cellular events important for human reproductive health. Here, we detail a versatile strategy that combines Cre‐lox technology to fluorescently label germ cells, with flow cytometry to discriminate and isolate germ cells in different stages of development for cellular and molecular analyses.     

The Middle/Later Stone Age transition and cultural dynamics of late Pleistocene East Africa

The Middle to Later Stone Age (MSA/LSA) transition is a prominent feature of the African archeological record that began in some places ~30,000–60,000 years ago, historically associated with the origin and/or dispersal of “modern” humans. Unlike the analogous Middle to Upper Paleolithic transition in Eurasia and associated Neanderthal extinction, the African MSA/LSA record remains poorly documented, with its potential role in explaining changes in the behavioral diversity and geographic range of Homo sapiens largely unexplored. I review archeological and biogeographic data from East Africa, show regionally diverse pathways to the MSA/LSA transition, and emphasize the need for analytical approaches that document potential ancestor‐descendent relationships visible in the archeological record, needed to assess independent invention, population interaction, dispersal, and other potential mechanisms for behavioral change. Diversity within East Africa underscores the need for regional, rather than continental‐scale narratives of the later evolutionary history of H. sapiens.     

青藏高原山水林田湖草生态保护修复模式——以拉萨河流域为例

山水林田湖草生态保护与修复是推进生态文明建设的必然要求。青藏高原是我国生态屏障区、水源涵养区和生态脆弱区,生态地位独特、生态保护责任重大。为此,中央及地方政府高度重视青藏高原生态文明建设,积极开展山水林田湖草生态保护修复试点工程。从青藏高原山水林田湖草生态保护与修复试点的特殊性出发,以拉萨河流域为例梳理了其主要的生态保护修复工程项目,提炼了青藏高原山水林田湖草生态保护与修复的技术路线,从参与主体、整合要素、运行保障、实施目标等方面总结了青藏高原多部门跨区、多要素综合、多渠道协作、多目标耦合的山水林田湖草联动治理模式,从山、水、林、田、湖、草六大生态要素出发归纳了青藏高原生态保护修复的分类指导-精准施策的实践框架,以期对青藏高原山水林田湖草生态建设情况有一个清晰的认识,并为全国其他地区系统开展山水林田湖草生态保护修复工作提供借鉴。