营利性医院医疗服务自主定价政府监管的思考

营利性医院医疗服务自主定价是践行十八届三中全会“市场在资源配置中起决定性作用”在医疗服务领域的举措。对营利性医院医疗服务自主定价进行阐述,并通过分析营利性医院医疗服务自主定价出现的问题,提出完善其政府监管的具体途径：完善政府对营利性医院自主定价的引导措施,完善营利性医院自主定价信息公示,畅通政府监管的信息传输渠道以及政府监管部门加大对违规自主定价的处罚。     

Cytogenetic identification of genomic elements of brook trout (Salvelinus fontinalis) in the karyotype of Arctic char (Salvelinus alpinus) from the aquaculture broodstock

Growing interest of Arctic char (Salvelinus alpinus) aquaculture in Europe, and the fact that it can easily hybridize with brook trout (Salvelinus fontinalis) resulting in fertile progeny, led us to investigate fish from the farmed stocks. Chromosomes of sampled Arctic char were examined using conventional and molecular cytogenetic (FISH) techniques in order to determine possible contamination of genomic elements of brook trout. Investigated fish possessed karyotypes composed of 80–82 chromosomes and up to three chromosome fragments. Using staining methods and FISH approach enabled identification of the brook trout chromosomes in the eight out of twenty‐two examined Arctic char. Specific location of AT‐, GC‐ positive and NOR sites observed on chromosomes as well as chromosome fragments in the karyotypes of several individuals points on past chromosomal rearrangements in fish from examined broodstock. Based on our results, it may be assumed that individuals with the brook trout genomic elements, although phenotypically identified as Arctic chars, were hybrids. Our results highlights that special care should be taken to protect gene pools of brook trout and Arctic char in farms where both species are cultured.     

Chromosome evolution in the Salmonidae (Pisces): an update

The karyotypes of salmonid fishes including taxa in the three subfamilies Coregoninae, Thymallinae and Salmoninae are described. This review is an update of the (Hartley, 1987) review of the chromosomes of salmonid fishes. As described in the previous review, the karyotypes of salmonid fishes fall into two main categories based on chromosome numbers: the type A karyotypes have diploid numbers close to 80 with approximately 100 chromosome arms (2n = 80, NF = 100), and the type B karyotypes have diploid numbers close to 60 with approximately 100 chromosome arms (2n = 60, NF = 100). In this paper we have proposed additional sub categories based on variation in the number of chromosome arms: the A' type with NF = 110-120, the A" type with NF greater than 140, and the B' type with NF less than 80. Two modes of chromosome evolution are found in the salmonids: in the Coregoninae and the Salmoninae the chromosomes have evolved by centric fusions of the Robertsonian type decreasing chromosome numbers (2n) while retaining chromosome arm numbers (NF) close to that found in the hypothetical tetraploid ancestor so that most extant taxa have either type A or type B karyotypes. In the Thymallinae, the chromosomes have evolved by inversions so that chromosome arm numbers (NF) have increased but chromosome numbers (2n) close to the karyotype of the hypothetical tetraploid ancestor have been retained and all taxa have type A' karyotypes. Most of the taxa with type B karyotypes in the Coregoninae and Salmoninae are members of the genus Oncorhynchus, although at least one example of type B karyotypes is found in all of the other genera. These taxa either have an anadromous life history or are found in specialized lacustrine environments. Selection for increases or decreases in genetic recombination as proposed by Qumsiyeh, 1994 could have been involved in the evolution of chromosome number in salmonid fishes.     

Prehistorically modified soils of central Amazonia: a model for sustainable agriculture in the twenty-first century

Terra Preta soils of central Amazonia exhibit approximately three times more soil organic matter, nitrogen and phosphorus and 70 times more charcoal compared to adjacent infertile soils. The Terra Preta soils were generated by pre-Columbian native populations by chance or intentionally adding large amounts of charred residues (charcoal), organic wastes, excrements and bones. In this paper, it is argued that generating new Terra Preta sites ('Terra Preta nova') could be the basis for sustainable agriculture in the twenty-first century to produce food for billions of people, and could lead to attaining three Millennium Development Goals: (i) to combat desertification, (ii) to sequester atmospheric CO2 in the long term, and (iii) to maintain biodiversity hotspots such as tropical rainforests. Therefore, large-scale generation and utilization of Terra Preta soils would decrease the pressure on primary forests that are being extensively cleared for agricultural use with only limited fertility and sustainability and, hence, only providing a limited time for cropping. This would maintain biodiversity while mitigating both land degradation and climate change. However, it should not be overlooked that the infertility of most tropical soils (and associated low population density) is what could have prevented tropical forests undergoing large-scale clearance for agriculture. Increased fertility may increase the populations supported by shifting cultivation, thereby maintaining and increasing pressure on forests.     

Reptilian transferrins: evolution of disulphide bridges and conservation of iron-binding center

Transferrins, found in invertebrates and vertebrates, form a physiologically important family of proteins playing a major role in iron acquisition and transport, defense against microbial pathogens, growth and differentiation. These proteins are bilobal in structure and each lobe is composed of two domains divided by a cleft harboring an iron atom. Vertebrate transferrins comprise of serotransferrins, lactoferrins and ovotransferrins. In mammals serotransferrins transport iron in physiological fluids and deliver it to cells, while lactoferrins scavenge iron, limiting its availability to invading microbes. In oviparous vertebrates there is only one transferrin gene, expressed either in the liver to be delivered to physiological fluids as serotransferrin, or in the oviduct with a final localization in egg white as ovotransferrin. Being products of one gene sero- and ovotransferrin are identical at the amino-acid sequence level but with different, cell specific glycosylation patterns. Our knowledge of the mechanisms of transferrin iron binding and release is based on sequence and structural data obtained for human serotransferrin and hen and duck ovotransferrins. No sequence information about other ovotransferrins was available until our recent publication of turkey, ostrich, and red-eared turtle (TtrF) ovotransferrin mRNA sequences [Ciuraszkiewicz, J., Olczak, M., Watorek, W., 2006. Isolation, cloning and sequencing of transferrins from red-eared turtle, African ostrich and turkey. Comp. Biochem. Physiol. 143 B, 301-310]. In the present paper, ten new reptilian mRNA transferrin sequences obtained from the Nile crocodile (NtrF), bearded dragon (BtrF), Cuban brown anole (AtrF), veiled and Mediterranean chameleons (VtrF and KtrF), sand lizard (StrF), leopard gecko (LtrF), Burmese python (PtrF), African house snake (HtrF), and grass snake (GtrF) are presented and analyzed. Nile crocodile and red-eared turtle transferrins have a disulphide bridge pattern identical to known bird homologues. A partially different disulphide bridge pattern was found in the Squamata (snakes and lizards). The possibility of a unique interdomain disulphide bridge was predicted for LtrF. Differences were found in iron-binding centers from those of previously known transferrins. Substitutions were found in the iron-chelating residues of StrF and TtrF and in the synergistic anion-binding residues of NtrF. In snakes, the transferrin (PtrF, HtrF and GtrF) N-lobe "dilysine trigger" occurring in all other known transferrins was not found, which indicates a different mechanism of iron release.     

教学医院毕业实习教学管理模式的实践探索

目的 分析高校附属医院临床医学专业应届毕业生对毕业实习教学管理的满意度,为完善毕业实习教学管理模式提出对策。为提高毕业实习教学水平和学生整体素质教育提供参考。 方法 制定学生对教师、教师对学生、学生对教学资源的评价指标,对临床医学专业应届毕业生、实习带教老师进行问卷调查。 结果 教师对学生“学习态度”“独立完成操作”的满意度均高于95%;学生对教师教学纪律、教学准备、和教学能力的满意度均达到100%;学生对设备准备、耗材准备、毕业实习学时安排满意度均高于95%。发现了医学生毕业实习管理工作中存在的具体问题。结论 高校附属医院要建立完善毕业实习管理制度,加强毕业实习质量监督,科学制定考核制度。     

Comparison of the carbon-sequestering abilities of pineapple leaf residue chars produced by controlled combustion and by field burning

This study was undertaken to compare the chemical properties and yields of pineapple leaf residue (PLR) char produced by field burning (CF) with that produced by a partial combustion of air-dried PLR at 340 °C for 3 h in a furnace (CL). Higher total C, lignin content, and yield from CL as well as the presence of aromatic compounds in the Fourier Transform Infrared spectra of the char produced from CL suggest that the CL process was better in sequestering C than was the CF process. Although the C/N ratio of char produced from CL was low indicating a high N content of the char, the C in the char produced from CL was dominated by lignin suggesting that the decomposition of char produced from CL would be slow. To sequester C by char application, the PLR should be combusted in a controlled process rather than by burning in the field.     

Effect of bone char addition on the fractionation and bio-accessibility of Pb and Zn in combined contaminated soil

Effect of bone char addition on the fractionation and bio-accessibility of lead (Pb) and Zinc (Zn) in combined contaminated soil was studied by batch soil column incubation experiment. Four treatments were designed: control (without bone char), 1%, 2% and 5% bone char addition (by weight). The results showed that all treatments with bone char addition could significantly decrease the concentration of HOAc extractable Pb (P < 0.05). Compared with the control the concentration of HOAc extractable Pb was decreased by 66.85%, 83.69% and 97.40%, respectively, in 1%, 2% and 5% bone char amended soils after 3 months incubation. The treatment with 5% bone char addition significantly decreased (P < 0.05) the concentration of HOAc extractable Zn by 47.80%, 43.63% and 41.35%, respectively, after 1, 2 and 3 months incubation. All treatments, including 1%, 2% and 5% bone char addition, significantly decreased (P < 0.05) the concentration of bio-accessible Pb after 3 months incubation, however, only the treatment with 5% bone char addition significantly decreased (P < 0.05) the concentration of bio-accessible Zn after 3 months incubation. The results highlighted the potential of bone char amendments to reduce the bioavailability of Pb and Zn in contaminated soil.     

公立医院开展突发公共事件医疗应急救援的SWOT分析

采用SWOT分析方法对新形势下我国公立医院开展突发公共事件医疗应急救援工作的优势、劣势、机会与威胁进行系统分析,并提出我国公立医院开展突发公共事件医疗应急救援工作的发展策略,为更好地开展相关工作提供参考。     

The global pyrogenic carbon cycle and its impact on the level of atmospheric CO2 over past and future centuries

The incomplete combustion of vegetation and dead organic matter by landscape fires creates recalcitrant pyrogenic carbon (PyC), which could be consequential for the global carbon budget if changes in fire regime, climate, and atmospheric CO₂ were to substantially affect gains and losses of PyC on land and in oceans. Here, we included global PyC cycling in a coupled climate–carbon model to assess the role of PyC in historical and future simulations, accounting for uncertainties through five sets of parameter estimates. We obtained year‐2000 global stocks of (Central estimate, likely uncertainty range in parentheses) 86 (11–154), 47 (2–64), and 1129 (90–5892) Pg C for terrestrial residual PyC (RPyC), marine dissolved PyC, and marine particulate PyC, respectively. PyC cycling decreased atmospheric CO₂ only slightly between 1751 and 2000 (by 0.8 Pg C for the Central estimate) as PyC‐related fluxes changed little over the period. For 2000 to 2300, we combined Representative Concentration Pathways (RCPs) 4.5 and 8.5 with stable or continuously increasing future fire frequencies. For the increasing future fire regime, the production of new RPyC generally outpaced the warming‐induced accelerated loss of existing RPyC, so that PyC cycling decreased atmospheric CO₂ between 2000 and 2300 for most estimates (by 4–8 Pg C for Central). For the stable fire regime, however, PyC cycling usually increased atmospheric CO₂ (by 1–9 Pg C for Central), and only the most extreme choice of parameters maximizing PyC production and minimizing PyC decomposition led to atmospheric CO₂ decreases under RCPs 4.5 and 8.5 (by 5–8 Pg C). Our results suggest that PyC cycling will likely reduce the future increase in atmospheric CO₂ if landscape fires become much more frequent; however, in the absence of a substantial increase in fire frequency, PyC cycling might contribute to, rather than mitigate, the future increase in atmospheric CO₂.