积极推进公立医院改革的关键举措——《“十二五”期间深化医药卫生体制改革规划暨实施方案》评述

《“十二五”期间深化医药卫生体制改革规划暨实施方案》明确积极推进公立医院改革是3个重点突破的领域之一。公立医院作为医疗服务供给的主要单位,其改革的成功与否,最终将直接关系到深化医药卫生体制改革的成败。指出规划更具操作性,在公立医院改革方面具有3个显著特点,并提出在具体实施中要处理好3个关系,即改革优先顺序的关系、职能与资源的关系、基础环境与改革的关系。

     

新医改下我国农村居民就诊流向变化趋势与成因分析

目的 研究新医改前后我国农村居民就诊流向变化及其原因。方法 综合分析《中国卫生服务调查研究》、《中国卫生统计年鉴》和医改监测与评价相关数据,并结合典型地区调研和专家咨询。结果 新医改实施以来,患者的首诊机构选择变化不大,但农村居民就诊流向发生了重大变化。结论 基本医疗保障制度、基本药物制度、基本医疗卫生服务体系、基本公共卫生服务体系和乡镇卫生院综合改革对农村居民就医流向有着重要影响,同时存在着交互作用。应进一步明确农村医疗服务体系功能定位、优化农村医疗卫生网络布局、加强农村卫生服务制度建设、发挥新农合制度导向作用和推进乡镇卫生院综合改革。     

中国新疆天山山脉中部微孢衣属的研究

报道了天山山脉中部微孢衣属的3个种类,分别为被膜微孢衣(Acarospora molybdina)、疣微孢衣(Acarospora verruculosa)、戈壁微孢衣(Acarospora gobiensis)。其中被膜微孢衣为中国新记录种。该文对3种微孢衣属的地衣体和子囊盘的形态特征,以及子囊盘、子囊、子囊孢衣和侧丝等解剖特征进行了详细描述,并提供了相关彩色图片。     

七叶树繁育系统的研究

对七叶树的开花物候期、花部特征、单花开放动态、花粉活力、柱头可授性、花粉-胚珠比(P/O)和杂交指数(OCI)等有关生殖生物学特性进行了研究。结果表明:(1)在西安地区七叶树4月22日进入初花期,5月5日至13日为盛花期,5月14日进入终花期,整个群花期持续30d左右,单花花期持续5～8d。(2)七叶树的花有雄花和两性花两种形态,其在形态大小和生理上有显著差异,雄花小于两性花,其子房退化,雄花的花粉活力远远大于两性花的花粉活力,雄花开花当天花粉活力最强,达到75.69%,是七叶树授粉的最佳时间;两性花雌雄蕊发育正常,其柱头可授期持续8～9d,开花后3d柱头可授性达到最强。(3)P/O和OCI检测结果均表明,七叶树繁育系统为异交,需要传粉者,属于雄全同株植物。     

Enriching Our Views on Clinical Ethics: Results of a Qualitative Study of the Moral Psychology of Healthcare Ethics Committee Members

The contribution of healthcare ethics committee (HEC) members to HECs is fundamental. However, little is known about how HEC members view clinical ethics. We report results from a qualitative study of the moral psychology of HEC members. We found that contrary to the existing Kohlberg-based studies, HEC members hold a pragmatic non-expert view of clinical ethics based mainly on respect for persons and a commitment to the patient’s good. In general, HEC members hold deflationary views regarding moral theory. Ethical principles are not abstract foundations but the expression of moral commitments to patients that pre-exist awareness of moral theory. Emotions and proximity to patient sufferance fundamentally shape the views of HEC members on clinical ethics. Further work at the intersection of clinical ethics and qualitative research could bring to the foreground lay perspectives on moral problems that may differ from bioethics expert views.     

广西特有属——异裂菊属开花生物学及繁育系统特征

以异裂菊属5个种的实生苗为试验材料,通过田间观察,采用TTC法、联苯胺-过氧化氢法、杂交指数、花粉-胚珠比等方法,对异裂菊属的开花物候、花部特征、繁育系统及访花昆虫行为进行了研究。结果表明:(1)绢叶异裂菊的花期最早,为6~7月份;小花异裂菊和柳州异裂菊花期为6~8月份;凹脉异裂菊和异裂菊的花期为8~12月份,整个花期持续约5个多月,单花花期约为3d,单个花序花期约为5d。(2)异裂菊属的花粉在开花后1~18h具有活力,柱头的可授性持续约48h;杂交指数OCI为4,花粉/胚珠比(P/O)为1 450~2 250,繁育系统属于异交、部分自交亲和,需要传粉者。(3)传粉昆虫主要是食蚜蝇科灰带管食蚜蝇和胡蜂科黑尾胡蜂,昆虫访花高峰期在上午10:00~12:00,每次可连续访问多朵花,每朵花访问时间约为2~10s。     

Conserved Anterior Boundaries of Hox Gene Expression in the Central Nervous System of the LeechHelobdella

Molecular developmental studies of fly and mouse embryos have shown that the identity of individual body segments is controlled by a suite of homeobox-containing genes called the Hox cluster. To examine the conservation of this patterning mechanism in other segmented phyla, we here describe four Hox gene homologs isolated from glossiphoniid leeches of the genusHelobdella.Based on sequence similarity and phylogenetic analysis, the leech genesLox7, Lox6, Lox20,andLox5are deemed to be orthologs of theDrosophilageneslab, Dfd, Scr,andAntp,respectively. Sequence similarities betweenLox5andAntpoutside the homeodomain and phylogenetic reconstructions suggest that the Antennapedia family of Hox genes (as defined by Bürglin, 1994) had already expanded to include at least two discreteAntpandUbx/abdAprecursors prior to the annelid/arthropod divergence.In situhybridization reveals that the fourLoxgenes described in this study are all expressed at high levels within the segmented portion of the central nervous system (CNS), with variable levels of expression in the segmental mesoderm. Little or no expression was seen in peripheral ectoderm or endoderm, or in the unsegmented head region (prostomium). EachLoxgene has a distinct anterior expression boundary within one of the four rostral segments, and the anterior-posterior (AP) order of these expression boundaries is identical to that reported for the orthologous Hox gene products in fly and mouse. This finding supports the idea that the process of AP axis differentiation is conserved among the higher metazoan phyla with respect to the regional expression of individual Hox genes along that axis. One unusual feature of leech Hox genes is the observation that some genes are only expressed during later development -- beginning at the time of terminal cell differentiation -- whereas others begin expression at a much earlier stage, and their RNA ceases to be detectable shortly after the onset of expression of the ‘late’ Hox genes. The functional significance of this temporal disparity is unknown, but it is noteworthy that only the two ‘early’ Hox genes display high levels of mesodermal expression.     

扁玉螺中枢神经系统解剖及显微结构观察

对扁玉螺(Neverita didyma)中枢神经系统的大体解剖和显微结构进行了初步研究。结果表明,扁玉螺中枢神经系统包括一对口球神经节、一对脑神经节、一对侧神经节、一对足神经节及一个脏神经节。各神经节均由神经节被膜、胞体区及中央纤维网三部分组成。左右脑神经节之间和左右足神经节之间的联合以及脑-侧、脑-足和侧-足神经节之间的连索均较短。足神经节有明显的分区现象。     

连翘花柱二型的繁育系统特征研究

花柱二型是植物雌雄蕊交互异位的一种花多态现象.该研究以花柱二型植物连翘(Forsythia suspensa)为材料,通过检测其交配系统特征,比较两花型的胚珠产量、花粉质量及活力特性,以探讨花柱二型连翘两花型的功能性别分化及其进化意义.结果表明:连翘自交和型内异交坐果率均极低(<12.12％),主要以型间交配为主.长柱...