TB: the leading infectious killer of adults and the single biggest killer of young women. Three million deaths; seven million new cases in 1997

This is an article on tuberculosis (TB) incidence among women in the reproductive age group and its therapeutic management. TB has become the leading cause of death among women of reproductive age, as reported by the WHO. This disease incidence counters perceptions in wealthy countries where the disease is most commonly found in elderly men. Women of reproductive age are more susceptible to other diseases once infected with TB than are men of the same age. Studies are being conducted on the biological, epidemiological, social, and cultural differences in TB occurrence among men and women and their access to the TB treatment strategy referred to as "directly observed treatment short-course" (DOTS). The WHO recommends DOTS, by which patients are observed and monitored while taking their medication. DOTS combines five elements: 1) political commitment, 2) case detection through sputum smear microscopy, 3) directly observed short-course treatment, 4) regular drugs and supplies, and 5) monitoring systems with evaluation treatment outcome for each and every patient. The WHO recognizes three factors which compound the problem of the TB epidemic: multi-drug resistant TB, HIV, and the economic crisis in Asia. To date, over 100 countries have been using DOTS. In at least one Asian country, Thailand, the government has committed to a 5-year plan to ensure DOTS accessibility.     

River blindness. Protection for 54 cents a year

Infection by onchocerca volvulus, a parasitic worm, causes onchocerciasis (river blindness), a debilitating and often blinding disease endemic to tropical areas of Africa and Central and South America. The adult onchocerca volvulus invades the human host where it lives and reproduces for up to 14 years, creating millions of infant worms which cause itching, loss of skin color, rapid aging, and disfiguring skin disease in the host. Onchocerciasis often causes blindness in the human host by approximately age 35 years, and is the third leading cause of blindness in Africa. Onchocerca volvulus is transmitted among humans through the bite of blackflies which breed in fast-flowing rivers. The Onchocerciasis Control Program (OCP) was formally launched in 1974 by the UN's Food and Agriculture Organization (FAO), the UN Development Program (UNDP), the World Bank, and the World Health Organization (WHO) in Benin, Burkina Faso, Ghana, Cote d'Ivoire, Mali, Niger, and Togo. Vector control is the central strategy of the OCP, consisting of weekly helicopter spraying of larvacide to prevent the blackfly from reproducing and transmitting the disease. In addition, Merck & Co. is providing drug therapy against the infant worms in the human host free of charge to 16 million people in endemic areas. Onchocerciasis has now almost been eradicated in the 7 original target countries. Also through the OCP, by 1996, more than 34 million people were protected against the disease, about 2 million who were seriously infected have fully recovered, and an estimated 600,000 people have been prevented from going blind. 12 million infants born since the launch of the OCP face no risk of contracting the disease, and approximately 25 million hectares of arable fertile riverine land has been opened for resettlement. Labor productivity has also increased.     

The history of gold therapy for tuberculosis

This is a historical study of the popularization of a medical therapy contrary to pertinent experimental findings. Presumably this circumstance reflects the desperation about tuberculosis: highly prevalent, highly fatal, and lacking any etiologically directed therapy. Gold compounds were introduced, based initially on the reputation of Robert Koch, who had found gold cyanide effective against M. tuberculosis in cultures, but not in experimentally infected animals. Treatment of pulmonary tuberculosis with these compounds was popularized, particularly by Danish physicians, in the mid-1920s, despite consistently negative experimental results, based on Paul Ehrlich's theories of antimicrobial drug effects. Difficulties in the design of interpretable clinical studies were soon recognized but also generally ignored, thus permitting data to be interpreted as favorable to antituberculous gold therapy. Eventually toxicity was considered to outweigh the alleged therapeutic benefit of all gold compounds. This resulted in their discard shortly before the introduction of streptomycin therapy.     

Malaria,in second place,sees fewer victims,but greater difficulty of control. With climate,including global warming,as complications

This is an article on malarial risks and prevention. Malaria is the deadliest tropical parasitic disease and one of the leading causes of death. The risk for this disease has been linked with changes in land use related to road building, mining, logging, and agricultural and irrigation projects. Global climatic change, disintegration of health services, armed conflicts, and mass movements of refugees also contribute to the increasing risk for malaria. Disease prevention includes a variety of measures that may protect against infection. They may be directed against the mosquito vector or against the development of disease in infected individuals. The WHO stresses the curability of malaria in spite of the occurrence of drug resistance. If the antimalarial drugs are used properly and targeted to those at risk, malarial disease and death can be reduced. Vaccines are also in development; an effective one could be available within the next 7-15 years.     

上海市区有老人家庭居住需求与居住分异

上海是我国第一个进入老年型人口结构的城市。随着年龄的增长、生理心理状况的变化,老人对住宅的需求有一定的特殊性。居家养老模式下,老人的居住状况直接影响老人晚年的生活质量。以老人与子女居住空间距离为标准,可分为共居型、网络型和分离型三种居住类型。受经济、社会、文化及健康状况的影响,上海市区有老人家庭存在居住地段、住宅类型、住宅环境、社区为老服务等方面的分异。     

Les «Faits scientifiques» et leur public: l’histoire de la détection de la syphilis

In the 1910's and 1920', thanks to the conjunction of scientific views concerning the specificity of anti-bacterial antibodies, of lay ideas about the existence of anti-bacterial antibodies and of the perceived importance of developing a syphilis test for public health officials, the community of serologists collectively transformed a relatively inefficient diagnostic test described by Wassermann in 1906 into an "incontestable scientific fact". This "scientific fact" established the equivalence: Wassermann positive individual=person infected with the germ Treponema pallidum, the etiological agent of syphilis. It modified the boundaries of the nosologic entity "syphilis", medical practices, professional attitudes, lay perceptions of syphilis, and health policies. In the 1950's, however, discrepancies between Wassermann test data and epidemiological data and, on the other hand, the development of specific anti-treponemal tests, destabilized the previously stabilized "scientific fact". A high percentage of Wassermann positive individuals were redefined as "biological false positifs", that is persons who suffered from chronic affections able to induce positive results of the Wassermann test. The equivalence Wassermann positive person=individual infected by Treponema pallidum was replaced by the equation: Wassermann positive person=individual infected by Treponema pallidum or biological false positive. The new perception of the Wassermann test again changed scientific views, professional practices and lay beliefs. The history of the Wassermann reaction illustrates the complicated interaction between "scientific facts" and "social facts", and the mutual shaping of both.     

General Assembly pledges support for war against AIDS

At a special meeting held in October 1987, the World Health Organization called for a concerted, international response to acquired immunodeficiency syndrome (AIDS). Announced was the creation of a WHO Global Commission on AIDS comprised of experts in health, social, economic, legal, ethical, and biomedical fields who will advise WHO officials of developments in various aspects of the disease. Member States were united in terms of the need for open communication and support of WHO efforts to combat AIDS. By December 1987, 129 countries had reported 73,747 AIDS cases to WHO and another 3 million new cases are likely to develop by 1982. The WHO strategy is based on several concepts: 1) even in the absence of a vaccine, AIDS is controllable through widespread education; 2) longterm commitment to eradication is necessary; 3) AIDS prevention and control must be integrated into national health systems; and 4) international cooperation, coordination, and leadership is vital. National AIDS committees have been established in over 100 countries.     

20世纪80年代沿海地区经济发展战略的选择及其效应

沿海地区经济发展战略作为一个关系到整个国民经济全局的重大决策,是贯彻邓小平“部分先富带后富”思想的重大举措,也是基于改革开放新形势的正确选择。其基本内涵,不仅是沿海地区要发展外向型经济,而且更重要的是沿海地区要率先发展起来,影响和带动全国经济的发展。这一新战略的实施,有力地促进了改革和开放的有机结合,不仅开创了我国国民经济发展的新局面,也成为新时期中国工业化发展道路探索的新起点。     

Research on human subjects,exploitation, and global principles of ethics

Abstract

In 1997, 5.8 million people became infected with HIV, 30.6 million people were living with HIV/AIDS, and infection was running at about sixteen thousand new infections a day, of which more than 90% were in low income countries. Against this background the urgency and importance of the fight against HIV/AIDS can scarcely be exaggerated. While a cure for AIDS remains elusive research to discover more effective treatment and possible vaccines is vital. It is at this crucial moment that moral criticism has emerged of some of the most promising research towards treatments and vaccines for HIV/AIDS. This criticism has focused on, and purports to be justified by, the major current international principles and protocols on the ethics of research on human subjects. If this criticism is valid and no better ways of prosecuting successful research on AIDS can be found, the consequences, as the figures above indicate, are truly bleak. This paper will attempt to provide an appropriate framework for assessing the ethics of research on human subjects generally and in doing so will assess the relevance and force of the major ethical criticisms that have been levelled at current research on human subjects in the context of HIV/AIDS therapy and vaccines.     

北平和平接管时期的城市街道工作组

北平和平接管时期的街道工作组是人民政权的临时派出机关。工作组在短短的几个月时间里完成了摧毁保甲制度、发动和组织群众、建立群众拥护的街政府三项艰巨任务,为新中国定都北京奠定了初步的政权基础,并为以后中共接管其他城市提供了有益的历史经验。     

医院档案管理中存在的问题及应对策略

随着医疗制度改革的不断深入,医院档案管理工作如何更好地服务于医疗、教学、科研等工作,是新时期所要面对的新任务、新课题。由于医院档案工作具有广泛性的特点,它涉及医院的各个部门,融入了医院全方位的信息,因此,良好的档案管理是医院科学管理的基础。对此,笔者对医院档案管理中存在的问题及应对策略进行了初步的分析和阐述。     

The New Mental Health Programme of WHO

Abstract

Over 40 million persons are suffering from severe mental illness allover the world and their number will grow during the next decades. The reasons why their treatment is often neglected and of low priority are reviewed, and research in the subject is criticized as being insufficiently interdisciplinary. During the last three years WHO has developed a new approach to mental health, urging mental health professionals to reorient their philosophy of work. Suggestions for urgent interdisciplinary research projects conclude the review.     

论唐代的配隶刑

配隶是流刑的一个变种,但重于普通流刑,两者之间的区别在于:普通流刑只居作一年,然后就可在当地附籍为民,而配隶则要长时间做苦役。配隶并不一定将犯人罚入军队,而是多将其发遣到边远的州郡服役,所以常被称为配州。配隶在唐代的出现主要有两方面的原因:首先是五刑制度本身存在的缺陷所致;其次是出于充实国防的目的。配隶刑对后世刑制产生了重要影响。     

《国语》观人记述简论

《国语》中有相当多的观人记述。结合当时的社会文化背景和相关的文献资料来看,《国语》观人记述较为全面而深入地反映了西周春秋时期的观人途径和手段,并包含着深刻的文化内蕴和明显的进步意义。就整部作品的文学性而言,《国语》观人记述也有着不可替代的重要功能,这主要表现为借一人之口刻画人物、直指人物内心的白描手法、赋予人物形象以深厚精警的意蕴等。     

改革人事档案“终身”制之我见

随着社会主义市场经济的发展和干部人事制度的改革,人事档案管理的“终身”制已越来越不适应新形势发展的需要。对此,笔者建议,可以借鉴法国《档案法》的有关规定,允许人事档案有一定的封闭期。同时,建立人事档案的多种形式,即一人一生可以只有一份人事档案,也可以有多份人事档案,也可以没有人事档案。     

Inter‐person Separation: A New Objective Standard for Evaluating the Spatial Fairness of Political Redistricting Plans

The fundamental basis for territorial political representation is the presumption that people share greater common interests with others in closer geographic proximity than with people farther away. This principle is found in U.S. legal requirements that districts for the House of Representatives and state legislatures should not needlessly divide “communities of interest” and should be “reasonably compact.” We propose a new objective standard to evaluate spatial fairness of redistricting plans: the extent to which a delineation minimizes total distance between all pairs of people assigned to the same district. To date, the legal standard of compactness has primarily been thought of in terms of the shapes of political districts, but boundary shape may have little correspondence with how populations are actually clustered and dispersed. Inter‐person separation, by contrast, provides a direct, intuitive metric for evaluating the congruence of districting plans with the territorial basis of political representation. To operationalize an inter‐person separation standard, we propose a model and present a heuristic method for delineating comparator districting schemes. We apply the standard to the current U.S. Congressional Districts in the states of Arizona and North Carolina to demonstrate how inter‐person separation could be used to develop and vet future redistricting plans.     

逻辑解构：从能动与受动关系看规律的主体性之维

在现代化进程中,人们为了满足日益膨胀的欲望,藐视客观规律,恣意夸大主体性,从某种程度上形成了一定的“反主体性效应”,导致人与自然关系的恶化、与社会关系的异化及与自身关系的二重化。强调能动性与受动性的协调统一,揭示客观规律所蕴含的主体性维度成为现时代赋予的历史使命。     

晚清教会医院慈善医疗演变述论

教会医院的慈善医疗是基督教在华慈善事业的重要组成部分。在晚清特殊的社会背景下,教会医院的慈善医疗经历了一个发展变化的过程。19世纪30—60年代,教会医院作为基督教适应中国社会的产物,从一开始即进行免费的慈善医疗,其经费依赖于外国,医学传教士是慈善医疗的主体。19世纪70—90年代,有的教会医院继续实行免费的慈善医疗,有的教会医院在收费制度下进行不同形式的慈善医疗,中国人对教会医院的资助开始增加,一些中国人在慈善医疗中发挥了一定的作用。20世纪初,实行收费制度是教会医院的通行办法,教会医院在此情况下进行了不同形式的慈善医疗,来自中国的经费日益增加,中国人在慈善医疗中发挥的作用不断增强。上述变化不仅是教会医院适应中国社会的产物,也是中国人对其态度变化的结果。     

草根英雄在孤独中坚守——电影《可可西里》观感

电影《可可西里》是一阙雄浑阳刚的壮烈纪实曲,是一部信仰与生命的挽歌,是一部草根英雄式的、充满悲壮苍凉的悲剧。这部以民间保护藏羚羊的巡山队故事为原型的电影,有许多“震撼”人心之处。以日泰队长为首的巡山队员们虽然是平凡的小人物,没有得到政治意义上的褒扬,更没有什么“英雄勋章”之类的表彰,但他们是我们朴实的百姓的英雄,是草根英雄!