康复医疗服务体系是全周期医疗卫生服务体系的重要组成部分,目前仍是我国医疗服务体系的短板.2021年12月31日,深圳市全面启动康复医疗服务体系建设,并设计了配套的医保支付体系,积极开展阶梯式付费、床日费用标准、监管考核等多项实践探索,为我国完善分阶段分层次的连续性康复医疗服务体系提供了实践思路.

介绍深圳市卫生行政许可工作中一名医师提出变更执业地点申请时,其所提交的《医师变更执业注册申请审核表》中的"原执业机构意见"一栏,未见该医师所在深圳某医院填写的意见和加盖公章;由于《医师执业注册暂行办法》未明确规定医师变更执业地点需要出具原执业机构意见,深圳市卫生和计划生育委员会审批窗口依法受理该申请,结合听证方式,作出给予行政许可决定.因此作者建议国家卫生行政部门应及时修订《医师执业注册暂行办法》,以适应新时期基层工作的需求.

为进一步激发作为特区的深圳经济发展活力,完善市场经济体制,构建法治化国际化营商环境,自2013年3月1日起,深圳市率全国之先实施以商事登记制度改革为主的系列制度改革,改革一年多以来,对商事主体和营商环境起到了积极的促进作用,也给政府相关执法部门带来了极大的影响.作者主要探讨作为政府执法部门之一的卫生监督部门,如何应对体制改革后续卫生监管,以期达到防范执法风险的同时,为营造特区未来发展新优势做出应尽的努力.

Health inspection departments belong to the administrative law enforcement branch of the government, which is entrusted by the government and the people with the sacred duty. To address the exising problems,such as health inspection system construction and administrative management system,this article was based on theories in public adminis-tration,used literature research,data analysis and empirical research methods,and learned from successful experiences in both vertical management in domestic government and foreign government management system on the relationship between central and local government,and recommendations were provided to the health inspection agencies below the provincial level for implementing integrated vertical management during the super ministry system reform.

In order to evaluate the health inspection enforcement in Shenzhen,we established the health inspection and law enforcement performance evaluation index system based on the situation of Shenzhen and the health administrative law enforcement evaluation published by MOH.And it is the first time that the system was used for the evaluation of health inspection agencies at the district-level.

目的 了解湖南省1～12岁儿童维生素A的营养状况及分布特点,为预防维生素A缺乏提供依据.方法 本调查样本由多阶段分层整群随机抽样法获得.利用高效液相色谱法测定520名3～12岁儿童血浆样品的视黄醇含量;家庭食物连续3日个人膳食回顾询问法收集375名1～13岁儿童维生素A摄入情况.结果 1～13岁儿童维生素A摄入量低于60%RNI的人达到74.7%.只有16.5%的人摄入量在80%RNI以上.被测儿童的血浆维生素A平均水平为30.5 μg/dl(城市36.6 μg/dl,农村28.6 μg/dl);维生素A缺乏率为6.9%(城市1.7%、农村8.5%);维生素A边缘缺乏率为46.0%(城市20.0%,农村53.8%).维生素A的缺乏和边缘缺乏男性明显高于女性(χ2=6.89,P＜0.01),3～7岁儿童明显高于8～12岁儿童(χ2=7.64,P＜0.01).结论 湖南省1～12岁儿童存在维生素A缺乏,特别是在农村地区,食物供给不足是造成维生素A缺乏病的直接原因.

大力发展卫生监督事业,必须对外争取有利政策,对内强壮机构自身建设。深圳市卫生监督所沿袭了深圳改革创新精神,在广东率先倡导卫生监督文化,并奠定了扎实的根底。作者从实践入手,深入探讨卫生监督文化建设及其对卫生监督事业的深远影响。

人类需要的营养物质来自于各种各样的食物,因此饮食行为直接影响着营养物质的获取,从而影响到营养素的摄入,对健康产生影响[1].笔者利用2002年中国居民营养与健康状况调查湖南省数据,对该省15岁以上居民的就餐行为进行分析.

目的描述湖南省城乡居民食物消费现状及变化趋势。方法运用1982年、1992年和2002年湖南省营养调查的膳食调查数据进行比较分析。结果1982～1992年阶段的变化主要是热能的摄入维持稳定,全省热量营养素来源分布基本符合平衡膳食原则。1992～2002年阶段,谷物类食物的摄入迅速减少,猪肉和油脂类的摄入量迅速增加。农村居民膳食结构趋向合理,城市居民膳食失衡加重。结论20年来,湖南省城乡居民膳食质量有很大提高,动物性食物及油脂类的摄人量增加明显。农村居民膳食结构趋向合理,城市居民膳食失衡的现象严重。

[Objective] To analyze the malnutrition status of preschool children in Hunan province,and provide policy-making evidence for the health administrative department and other government departments.[Methods] The z score of height for age(HAZ),weight for age(WAZ)and weight for height(WHZ)were calculated by using the Anthro software.All the data were analysed by SPSS.[Results] The mean z scores of HAZ,WAZ and WHZ were-0.90,-0.55 and 0.06 respectively.In the urban areas the z scores were-0.11、0.29 and 0.52 respectively,in the rural areas the z scores were-1.23、-0.9 and-0.13 respectively.There were no case of low weight for age and wasting in the urban preschool children,while the rate of wast-ing and low weight for age in the rural were from 2.27% to 9.23%,and from 14.25% to 28% respectively.There were great dif-ferences of stunt between preschool children in rural and urban areas.The stunted rate was below 10% in urban,while it was from 20% to 39% in the rural.[Conclusion] The malnurtrition status of preschool children in rural and urban areas is differ-ent.Their physical status can be well developed by diet scientification and rationalization.

慢性非传染性疾病(以下简称"慢性病")由于常为终身性疾患,预后差,医疗费用昂贵,已成为威胁劳动力人口健康、影响社会经济发展的一个重要公共卫生问题.

Objective To study the distributional characteristics of plasma total cholesterol (TC), triglyceride(TG), high density lipoprotein cholesterol(HDLC)levels and dyslipidemia in people aged 18 years or over among the residents in urban and rural areas in Hunan Province. Methods The fasting plasma lipid profiles were determined with the enzymemethods in 1,684 subjects aged 18 years or older. Result The mean TC ,TG and HDI-C were 4.01mmoL/L, 0.94 mnoL/L, and 1.43 mmol/L respectively. The mean TC, TG and HDI-C in urban and rural areas were 4.61mmol/L, 1.11mmol/L, 1.5mmol/L and 3.86mmol/L, 0.91mmol/L, 1.41mmol/L respectively. The mean values in age groups of 18～44 years, 45～ 59 years and 60 years above were 3.78mmol/L, 4.15mmol/L, and 4.34mmol/L for TC; 0.88mmol/L, 0.94mmol/L, and 1.12 mmol/L for TG; and 1.42mmol/L, 1.48mmol/L, and 1.38mmol/L for HDI-C respectively. Conclusion These results provide the provincial representative data of plasma lipid level distribution. TC and TG levels of adults in urban area are higher than those of adults in rural areas. With increasing age, the plasma TC and TG levels show an increased trend. Hypertriglyceridemia is the most prominent type among those aged 18 or over. Prevalence of dyslipidemia is higher in the elderly. Dyslipidemia has become one of important risk factors threatening health of Chinese people, and early comprehensive prevention and control of dyslipidemia is urgently warranted. Key words: Cholesterol; TrigIyceride; High-density lipoprotein-cholesterol; Dyslipidemia

Objective Expression,purification and characterization of P35 recombinant antigen of Toxoplasma gondii in E.coli JM109. Methods The gene encoding P35 surface antigen was amplified by RT-PCR,from a Toxoplasma gondii cDNA libray,and cloned into plasmid pGEX-2TK to construct a recombinant plasmid P35/pGEX,Then transformed it into E.coli JM109.The positive recombinant clone was induced by IPTG to express target fusion protein GST-p35 which was easy to be purified with GSTrap TM column and Trombin Protease.The purified product was analyzed by SDS-PAGE and Western-blot. Results The fusion GST-P35 protein was about 54 kDa and P35 recombinant antigen protein about 28 kDa respectively.The purified GST-P35 protein can be recognized by anti-GST antibody and the serums of infected rabbits by Western-blot. Conclusion The recombinant plasmid P35/pGEX was constructed and expressed in E.coli JM109,and the purified fusion protein GST-P35a and P35 recombinant protein have good antigenicity.

Objective To understand the changes of residents' food consumption and nutrition situation in decade and describe the distribution of chronic non- communicable disease such as high blood pressure, diabetes and obese in Hunan Province. Methods 2 700 households from Changsha Furong district, Chaling, Lixian, Shimen and Baojing counties were sampled by stratified multi-stage cluster random sampling method. The questionnaires with interviewer, dietary survey , anthropometric assessment and biochemical test were adopted in this study. Results The result showed that the intake of percapita nutrients was sufficient and the change of dietary patterns was remark in decreases of cease food intake and increases of fat food intake, which caused dietary patterns imbalance. The prevalence of overweight and obese was 15.46% and 3.35% respectively. The prevalence of blood pressure was 15.38%, anemia rate was 19.11%. The rate of abnormal blood sugar was 3.54%, the rate of abnormal blood lipid was 13.5%. Conclusion The results of nutrition survey in 2002 remain that social economy develop quickly with rising of people's living level and changes in life style, but all society do not pay more a attention to the potential health problems caused by these changes. Since 1992, imbalance of dietary patterns had become more and more serious. Therefore, reasonable direction of food consumption, promotion of healthy life style, prevention and control of chronic non- communicable disease are serious challenge we are to face in the following 10 years.

目的:检测深圳市市售蜂蜜中氯霉素的残留量,以掌握蜂蜜中氯霉素污染的情况.方法:氯霉素定量酶联免疫检测法,利用抗体与抗原间免疫化学反应,酶标氯霉素结合体与样品检体中氯霉素残留物同时竞争固定在酶标孔的氯霉素抗体,待检体中氯霉素的含量愈高,显色反应愈浅,待检体中氯霉素的含量愈低,显色反应愈深.结果:经检测46个国内不同地方生产的在深圳销售的蜂蜜样品,检出含有氯霉素的有13个样品,有33个样品未检出.结论:此氯霉素残留量检测方法快速可靠、敏感性高、特异生强,对食品中氯霉素的筛查有重要的推广价值.

目的体外扩增间日疟原虫深圳株红内期小亚单位核糖体核糖核酸编码基因(SSUrDNA)片段,研究其结构与功能.方法设计一对特异性引物,采用聚合酶链反应(PCR)从间日疟原虫患者血样中扩增出间日疟原虫SSUrDNA片段,以PUC19质粒T载体构建重组子导入大肠杆菌JM109;阳性克隆双酶切鉴定后,双脱氧末端终止法测定序列.结果间日疟原虫SSUrDNA扩增片段大小为341bp;阳性克隆双酶切及PCR扩增均得到预期大小的片段;序列测定插入片段为341bp,与Sal Ⅰ株顺序相比,仅在第151位处缺失一个碱基C.结论成功克隆了间日疟原虫SSUrDNA片段,该序列在间日疟原虫虫株间高度保守.

Objective To evaluate the field application value of polymerase chain reaction(PCR) based method to detect and identify Plasmodium falciparum and Plasmodium vivax in mixed infection areas. Methods A total of 304 blood samples were collected in malaria mixed infection areas in Hainan Province. 3 primers were designed according to the plasmodium SSUrDNA sequence to detect the P. falciparum and P. vivax in a single tube by PCR and this PCR-based method was compared with the conventional microscopy method. Results Among 304 blood samples,15 samples were positive by PCR-based method(7 with P. vivax and 8 with P. falciparum ). However only 11 blood samples were positive (6 with P. vivax and 5 with P. falciparum ) by microscopy. The 4 blood samples,negative with microscopy but positive by PCR,were confirmed with plasmodium infection. Conclusion The PCR-based method was sensitive and specific. It’s useful in malaria field survey .

死因分析是评价人群健康状况、反映疾病危害程度的主要手段.为了解湖南省城乡居民病伤死亡现状、死因分布特点及变化趋势,现对2001年湖南省居民死因进行分析,并与1991年资料进行对比.

Aim To explore protection immunity and protection immune mechanism against infection of S japonicum,a calcium activated neutral proteinase(Calpain)as a vaccine candidate molecule Methods RNA was isolated from S japonicum adult,Calpain fragment which contain B and T epitopes was amplified by RT PCR,and PCR product was TA cloned and selected by PCR,then,subcloned into pVAC eukaryatic express vector,and pVAC Calpain express system was isolated from positive clone of culture,goal gene was identified by the way of enzyme digestion of BamHⅠ and EcoRⅠ and DNA sequence analysis from isolated pVAC Calpain Results A 453bp fragment of Calpain was amplified from S japonicum RNA,and the results of enzyme digestion and DNA sequence analysis showed Calpain gene was subcloned into pVAC eukaryatic express vector Conclusion Preparation for Calpain DNA vaccine of S japonicum will account for the protection immunity and protection immune mechanism of the Calpain vaccine candidate molecule