“时间银行”作为志愿服务领域的创新,不仅有利于满足老年人的健康养老需求,还有利于健康养老的持续发展,是推进健康养老的重要举措.文章对我国“时间银行”建立的合法性与合理性进行了分析,探讨其对健康养老可能造成的影响.结果 发现,我国“时间银行”的建立基本满足合法性以及实质合理性,但是在形式合法性方面存在缺陷;认为应通过建立健全相关的制度安排、完善运行管理机制、强化社会共识来推动“时间银行”的进一步实践与发展,以切实增强健康养老的可持续性,实现精准配置健康养老的资源,真正满足老年人健康养老的相关需求.

人口老龄化为我国医疗保险制度带来巨大挑战,医疗保险制度作为保障老年人医疗需要重要制度安排,是积极应对人口老龄化的重要途径.文章运用文献研究法、对比分析法、归纳总结法等方法,在分析我国医疗保险制度供给及实施现状的基础上,研究借鉴美国、日本、德国、澳大利亚关于老年人医疗保险制度的经验,提出建立老年人医疗保险制度,强化老年人医疗保险的政策保障;强调政府责任,重视老年人健康权益的保障;健全医疗保险体系,满足老年人多层次、多样化的医疗需求;统筹城乡发展,促进老年人医疗保险权益的公平正义等启示与思考.

随着老龄化社会的到来,我国失能、失智人口增长迅速,失能老人养老问题严峻,长期护理服务成为一种公共需要.公共产品以公共需要为导向,这种需要是不可或缺、必须满足的需要,因此公共产品的供给不可或缺.长期护理保险作为解决失能、半失能人群长期护理问题的一个新险种,该制度在保障失能、半失能老年人健康权益中发挥着重要作用.通过深入调研苏州市这一典型试点城市对长期护理保险制度的实施,系统总结苏州市所取得的成功经验,分析第一阶段制度运行过程中出现的问题和原因,探索第二阶段完善性施策和发展路径,为长期护理保险在全国的进一步推广提供参考和经验,为解决我国养老问题提供新思路.

Nitrogen (N) cycling is a critical pathway by which producer, consumer, and decomposer interact with each other and with environmental circumstances simultaneously. The natural abundance composition of N-15/N-14 in plants and soils (termed as delta N-15(plant) and delta N-15(soil)), as well as the difference between them (delta N-15(soil-to-plant) = delta N-15(plant)-delta N-15(soil)), is a useful tool for better understanding ecosystem N cycling. However, the drivers and mechanisms of ecosystem N cycling in alpine grasslands on the Tibetan Plateau are mostly unknown, especially across different grassland types at a regional scale. To fill this knowledge gap, we measured delta N-15(plant) (200 samples of top-dominant species) and delta N-15(soil) (85 samples of top-layer soils, 0-20 cm) at nine sites that represent zonal communities of alpine deserts, steppes, and meadows in North Tibet, and calculated the corresponding delta N-15(soil)-to-plant. Our results showed that delta N-15(plant), delta N-15(soil), and delta N-15(soil-to-plant) were significantly different among the three zonal grassland types (analysis of differences with non-parametric Kruskal Test, P < 0.05), with the lowest values in meadows and the highest values in deserts. Regression analyses showed that the delta N-15(plant), delta N-15(soil), and delta N-15(soil)-to-plant decreased with the increases of growing season precipitation (GSP) and habitat aridity index (Aridity), soil organic carbon (SOC) and soil total nitrogen (STN), plant species richness, Shannon diversity index, and plant community productivity, whereas increased with the increases of accumulated active temperature (AccT) and soil total phosphorus (STP) across alpine grassland types at the regional scale. Multiple linear models with analysis of covariance (ANCOVA) confirmed GSP to be the most critical driver, which alone explained most variances of delta N-15(plant) (56%), delta N-15(soil) (62%), and delta N-15(soil-to-plant) (35%). However, structural equation modeling performed better than multiple linear modeling in predicting delta N-15(plant) (76% vs. 66%) and worse in predicting delta N-15(soil) (79% vs. 84%) and delta N-15(soil-to-plant) (31% vs. 46%), likely due to the exclusion of collinear predictors and the removal of non-significant influencing paths. Overall, this study has highlighted the importance to uncover the complexity of climate, soil nutrients, and vegetation properties in networking to drive the different components of ecosystem N cycling in alpine grasslands on the Tibetan Plateau.

The biodiversity-productivity relationship is critical for better predicting ecosystem responses to climate change and human disturbance. However, it remains unclear about the effects of climate change, land use shifts, plant diversity, and their interactions on productivity partitioning above- and below-ground components in alpine grasslands on the Tibetan Plateau. To answer this question, we conducted field surveys at 33 grazed vs. fenced paired sites that are distributed across the alpine meadow, steppe, and desert-steppe zones on the northern Tibetan Plateau in early August of 2010-2013. Generalized additive models (GAMs) showed that aboveground net primary productivity (ANPP) linearly increased with growing season precipitation (GSP) while belowground net primary productivity (BNPP) decreased with growing season temperature (GST). Compared to grazed sites, short-term fencing did not alter the patterns of ANPP along climatic gradients but tended to decrease BNPP at moderate precipitation levels of 200 mm < GSP < 450 mm. We also found that ANPP and BNPP linearly increased with species richness, ANPP decreased with Shannon diversity index, and BNPP did not correlate with the Shannon diversity index. Fencing did not alter the relationships between productivity components and plant diversity indices. Generalized additive mixed models furtherly confirmed that the interaction of localized plant diversity and climatic condition nonlinearly regulated productivity partitioning of alpine grasslands in this area. Finally, structural equation models (SEMs) revealed the direction and strength of causal links between biotic and abiotic variables within alpine grassland ecosystems. ANPP was controlled directly by GSP (0.53) and indirectly via species richness (0.41) and Shannon index (- 0.12). In contrast, BNPP was influenced directly by GST (- 0.43) and indirectly by GSP via species richness (0.05) and Shannon index (- 0.02). Therefore, we recommend using a joint approach of GAMs and SEMs for better understanding mechanisms behind the relationship between biodiversity and ecosystem function under climate change and human disturbance.

随着我国社会老龄化程度不断加深,老年人数量不断增大,老年人心理慰藉服务需求也随之不断扩大.但老年人心理慰藉服务供给却没有跟上急速增长的需求,造成问题不断累积,有可能会引起一系列社会问题.为此,本文针对老年人心理慰藉的服务供需矛盾对城市老年人心理慰藉供给路径做出相应探索和研究.

Water conservation is a comprehensive water resources regulatory function of forest ecosystems through various hydrological processes, including canopy interception, litter containment and soil retention. As a typical northern rocky mountain area, Taihang Mountain is characterized by low rainfall with uneven seasonal distribution, shallow soil, low soil water-holding capacity and fragile environment. In spite of this, Taihang Mountain is an important ecological security shelter for the water sources belt in the North China Plain. Water has become one of the key limiting factors for the protection and restoration of vegetation in the region. Therefore, comparative analysis of water conservation capacities of main forest vegetation types is needed for development of feasible measures for water conservation and sustainable water security in the region. In this paper, we selected 196 records of canopy interception, litter and soil water carrying capacity in the natural deciduous broad-leaved forest, artificial deciduous broad-leaved forest, mixed forest, natural coniferous forest, coniferous forest and shrubs in the mountain region. We integrated water storage capacity with canopy rainfall interception, litter and soil water-holding capacity and then analyze water carrying capacities of main forest vegetation types in the area. Forest integrated water conservation capacity was calculated using a water conservation function for forest ecosystems. The results showed that: 1) soil non-capillary porosity had positive correlation with integrated water holding capacity of the ecosystem and the maximum soil water-holding capacity accounted for over 90% of the total water capacity of forest ecosystems in the region. It was revealed that soil layer, as the main water reservoir, was the most important layer for hydrological processes in the forests. 2) Coniferous forests such asPinus tabuliformis andPlatycladus orientalis were more suitable for regional meteorological conditions. Redistribution capacity of precipitation by coniferous forest is significantly higher than that of other forest types. 3) Low canopy density of mixed forest was beneficial to shrub growth and its litter holding was also higher than that of pure forest. 4) Although comprehensive water storage capacity of natural forest was higher than that of plantation forest, water storage capacity ofP. orientalis plantation andP. tabuliformis plantation ranked inferior to that of natural forests ofRobinia psendoacacia,P. orientalis andP. tabuliformis. In summary, it was important to take afforestation measures for soil erosion, long-term forest enclosure and appropriate stand density in order to fulfill the goals of ecosystem restoration and ecological reconstruction. In order to increase water conservation capacity, plantation forest with tree species such asP. tabuliformis andP. orientalis was recommended in afforestation. This study provided the basis for the evaluation of water conservation capacity of vegetation along with rational management of forest and water resources. It laid the foundation for environmental protection and disaster prevention and mitigation in Taihang Mountain.

农村居民基本医疗保险是农村地区的一项"兜底性"的福利制安排,对于防范农村居民"因病致贫、因病返贫"意义重大.文章以制度变迁理论为视角,首先分析了我国农村居民基本医疗保险制度的变迁历程及当前运行现状.在此基础上,从现行城乡居民基本医疗保险制度交易费用高昂、原有制度路径依赖严重等角度分析了进一步推动农村居民基本医疗保险制度改革必然性.最后,从坚持循序渐进、恪守公平正义、防范民粹主义等角度提出了推进农村居民基本医疗保险制度改革的路径选择.

Nutrient cycling is one of the basic functions of forest ecosystems. As two of the main nutrition elements, nitrogen and phosphorus are critical for proper metabolism and growth processes of plants. In order to reduce the dependence on external nutrient, plants can resorb nutrients from senescing leaves prior to abscission and store them into other plant tissues for reuse. Resorption efficiency, defined as the percent nutrient reduction between live and senescent leaves, is used to quantify the resorption capacity of a plant. Nutrient resorption is a key process of plant nutrient utilization strategy. Through nutrient resorption, plants can reduce nutrient loss from the ecosystem and lower the dependence on the environment. This is crucial for the stability of plant population and community, and for ecosystem nutrient cycling. Based on published papers on forests in mountain regions of North China (including the Loess Plateau, Taihang Mountain, North Beijing Mountain Area, etc.), the systemization of nitrogen and phosphorus contents in mature and senescent leaves of forests was conducted depending on the life forms and management methods of forests. All in all, we collected data on nitrogen and phosphorus at 13 sites in the three regions and conducted a comprehensive assessment on nutrient resorption efficiencies. We compared nitrogen and phosphorus resorption efficiencies between trees and shrubs, as well as between natural and plantation forests. In order to explore the factors regulating nutrient resorption efficiency, we also analyzed the relationships between the contents of nitrogen and phosphorus against nutrient resorption efficiency. The results showed that the ranges of nitrogen and phosphorus resorption efficiencies for forests were respectively 24.5%–71.3% and 18.1%–75.4%, with averages of 45.5% and 47.4%, both slightly lower than global average. Average nitrogen content in mature leaves of plantation forests was 21.6 g·kg﹣1, significantly higher than that of natural forests (11.6 g·kg﹣1). This indicated that in the process of growth of plantation forests, there could be excessive consumption of nutrients. In Taihang Mountain, nitrogen content in mature and senescent leaves and nitrogen resorption efficiency for shrubs were significantly higher than those for trees. However, phosphorus resorption efficiency was relatively lower, demonstrating that plant growth in the region was mainly limited by nitrogen supply. Comparisons among different areas showed that nitrogen and phosphorus resorption efficiencies in North Beijing Mountain Area were higher than those in the Loess Plateau and Taihang Mountain. Correlation analysis showed that both nitrogen and phosphorus resorption efficiencies were significantly correlated with nitrogen content in senescent leaves, indicating that the nitrogen content of senescent forest leaves (also called nutrient resorption proficiency) in North China was the main limiting factor of nitrogen and phosphorus resorption efficiencies. Based on the comparison of nutrient resorption efficiencies of different vegetation species, nutrient resorption efficiencies were greater for conifer forests than that for broad-leaved species. This suggested that in nutrient-barren soils in mountain terrains, nutrient resorption in conifer forests was more efficient, and conifer trees were probably more adaptable to such barren soil environment. In the process of development of artificial plantations in mountain regions, it was recommended to consider high nutrient use efficiency of conifer forests.

运用文献研究法、对比分析法、归纳总结法等方法分析与研究我国长期护理服务需求现状和问题、我国试点城市长期护理保险制度供给与实施现状以及美日德韩等国长期护理保险制度经验,认为我国长期护理保险制度存在着制度设计公平性不足、过度依赖医保基金、年龄限制不符合权利义务对等原则、精神慰藉服务尚未被纳入服务项目、服务提供机构与专业人才短缺以及缺乏法律支持等问题,并提出逐步扩大制度覆盖范围,实现城乡统一;坚持社会化筹资模式,实行多层次的筹资比例;重视评估标准的制定,坚持权利义务对等原则;坚持老年人利益最大化,逐步扩大服务项目;鼓励社会力量全面参与,培养专业人才;建立长期护理保险法,强化政府责任等建议.

我国已成为世界第一大老龄人口国家.以全国第一、第二批90个试点城市为标志,我国医养结合养老服务体系建设已从各地自发探索跨入自觉的国家治理新阶段.在系统审察、分析、研究我国医养结合养老服务的进展现状、存在问题及其原因基础上,有针对性地提出解决问题的对策,提出全国医养结合养老服务体系建设的国家治理目标和建设规划的建议,旨在最终通过国家工程实施规划方案,有效保障我国老龄人口的生命健康.

我国大病医保制度运行试点,在显示公私合作的制度利于大病医疗保险基金有效利用金融业精算技术以提高效率的同时,也存在着若干不可忽视的问题:加重了我国社会基本医疗保险制度碎片化趋势;商业保险的逐利性导致制度基金安全风险增大,以及缺乏评估标准与退出机制,对商业保险监控不力等,已经直接或间接影响大病医疗保险制度的全面实施.据此,有必要在全面分析社会医疗保险与商业保险合作的方式、范围、程度以及社会医保与商业保险的异同点基础上,提出最佳模式和底线模式两种方案:大病医疗保险回归社会保障部门直接运行为最佳模式;底线模式为修正合作模式,即如果要引进商业医疗保险,继续推进社会医保与商业保险合作,则应保证大病医保的社会保障基本属性、强化政府社保管理服务职能、准确定位公私合作双方地位、合理规划公私合作项目与范围,健立健全保险基金运行评估及预警机制、加强医保基金征收管理、加强医疗保险费用控制和基金预决算管理等,建立符合国情的社会医保公私合作模式.

The commercial application of YN-1 catalyst in selective hydrogenation unit of pyrolysis gasoline C9+ cut of Xinjang Dushanzi Tianli Industrial Company was introduced. The results showed that YN-1 cata-lyst had high activity at low temperature,good stability and large amount of gum level for C9+ cut selective hydrogenation of the oil with gum level>100 mg·(100mL)-1 and bromine valence>95 gBr·(100g)-1. YN-1 catalyst could adapt to reaction temperature rise of >90 ℃.

某些城市实施的“先看病后付费”的诊疗模式曾引起社会强烈反应，通过分析该模式的可行性，讨论了实现该模式所需要具备的条件。

新型农村合作医疗制度是我国保障8亿农民健康具有地域性与身份性的公共产品,该制度实施9年来取得了阶段性重要成果,然而,应对城乡一体化发展必然趋势,该制度潜力已经基本耗尽,慎重考虑新型农村合作医疗的政策调整已是当务之急.因此,尊重差异性社会的现实格局,基于“基本公平与比例公平”的原则,将新型农村合作医疗并入全民社会基本医疗保险,在“全民社会基本医疗保险加多元补充医疗保险”的医疗保险模式中,让农民与职工、城镇居民均等获得基本医疗保险.这将是坚持科学发展观,走中国特色社会主义之路的理性选择.为此,本文将从政治、社会、经济与技术层面对新型农村合作医疗并入全民基本社会医疗保险体系进行了可行性分析.

Both fertilization and grazing exclosure are effective management measures for recovery of degraded grasslands. To better understand the effects of both measures and their interaction on restoration of degraded alpine grasslands, a longterm experiment of exclosure and addition of nitrogen(50 kg N hm-2 a-1, LN; 100 kg N hm-2 a-1, HN) combined with phosphorus((50 kg N + 50 kg P) hm-2 a-1, LN + P;(100 kg N + 50 kg P) hm-2 a-1, HN + P) was carried out in a degraded Kobresia pygeama alpine meadow on the Tibetan Plateau since 2008. The results showed that nitrogen(N) addition did not affect plant community coverage, while in grazing plots LN + P and HN + P treatments signifi cantly increased plant community coverage by 86% and 63%, respectively. Moreover, in grazing exclosure plots LN + P and HN + P treatments signif icantly increased 107% and 248% of plant community coverage respectively, compared with grazing plots under the same fertilization levels. N addition alone contributed to enhancing importance values(IV) of grass, and this effect was specifically improved by exclosure. However, sedge and Potentilla were much more responsive to combination of N and P addition. N addition alone under free grazing did not affect aboveground biomass for grass, sedge or herbs of Potentilla, while LN + P treatment significantly enhanced community aboveground biomass by 137%. Under exclosure conditions, N addition did not signif icantly change the aboveground biomass of sedge, but increased the aboveground biomass of grass by 8.4 times. However, N combined with Paddition in fencing plots signif icantly promoted aboveground biomass of grass, sedge and Potentilla herbs. For example, LN + P and HN + P treatments enhanced the aboveground biomass of herbs by 98% and 86%, respectively. Our results suggested that though N addition alone could not improve the condition of degraded alpine meadow, N combined with P fertilization and/or exclosure will contribute greatly to the restoration of degraded alpine meadow. Fig 3, Tab 4, Ref 54

目的:了解流动儿童参加苏州市社会基本医疗保险制度的实施现状,着重分析苏州市流动儿童参加医疗保险制度运行特点、现状及反应性,进而对我国流动儿童基本医疗保险的发展提出建议.方法:综合各地相关政策文件,深入流动人口集宿地、市儿童医院、中小学校等地发放问卷,综合运用Epidate3.1统计录入、SPSS18.0、Excel等软件进行统计分析.结果:流动儿童基本医疗服务需求较高,但卫生服务利用率低；苏州儿童医疗保险制度的实施惠及了流动儿童家庭；政策宣传不到位,未参加社会基本医疗保险的流动儿童比例较高；部分流动儿童因制度规定无法参加儿童医疗保险.结论:政府应该确立保护流动儿童是政府的一种公共责任；优化社会医疗保障体系,关爱流动儿童健康；加大宣传力度,让利好于流动儿童的基本医疗保险制度具有普及性；加强对流动儿童在异地参保的管理,减少漏保与重复参保概率；利用高科技手段,提升居住证上信息识别功能等.

Implementation of national essential drugs system can not only in favour of residents’ essential pharmacy equity and lower their drug costs,but also regulates primary medical organization drugs using.This article discusses present situation of community health service institutions that carry out national essential drugs system and the problems by X community as an example in Suzhou.It puts forward some constructive suggestions,which includes wide the range of essential drugs list,add chronic disease and certain diseases drugs,enhance residents’ medication compliance,increase drug quality supervision,perfect the working and supporting measures of national essential drugs list policy adjustment.

Over the past decades, the Tibetan Plateau has experienced pronounced warming, yet the extent to which warming will affect alpine ecosystems depends on how warming interacts with other influential global change factors, such as nitrogen (N) deposition. A long-term warming and N manipulation experiment was established to investigate the interactive effects of warming and N deposition on alpine meadow. Open-top chambers were used to simulate warming. N addition, warming, N addition x warming, and a control were set up. In OTCs, daytime air and soil temperature were warmed by 2.0 degrees C and 1.6 degrees C above ambient conditions, but soil moisture was decreased by 4.95 m(3) m(-3). N addition enhanced ecosystem respiration (Reco); nevertheless, warming significantly decreased Reco. The decline of Reco resulting from warming was cancelled out by N addition in late growing season. Our results suggested that N addition enhanced Reco by increasing soil N availability and plant production, whereas warming decreased Reco through lowering soil moisture, soil N supply potential, and suppression of plant activity. Furthermore, season-specific responses of Reco indicated that warming and N deposition caused by future global change may have complicated influence on carbon cycles in alpine ecosystems.

在"以人为本"的科学发展观指导下,根据世界卫生组织"人人享有公平的健康保障"的卫生正义原则,我国在着力打破以身份、户籍和地区为特征的历史形成的城乡二元、地区分割的医疗保障体系,推进公共服务产品均等化,推进建立全国统一的居民基本医疗保险体系。然而,这一建设遭遇到俱乐部壁垒的严重阻碍。长期以来,由于区域间、城乡间、职业间经济发展水平和收入分配水平的严重差别,财税"分灶吃饭"的体制,造成了公共产品的俱乐部化。地方政府、单位、行业都在建立根据自己财力承受能力,确定本位利益最大化的基本医疗保险体系,因而形成了在俱乐部内部的外部性,在俱乐部外部的内部性,形成俱乐部之间难以互通的森严壁垒。以发达地区壁垒为例,一旦需要开放俱乐部,使公益外溢,那么就必然面临承担拯救全国流动人口的"耗散难题"。解决俱乐部壁垒难题,是科学推进我国基本医疗保险制度健康有序发展的关键。