DNA指纹图在法医学鉴定中应用的研究(Ⅰ)

应用 MYO DNA 探针对中国人进行了 DNA 遗传指纹图检验。从两个家系16人及100个无关个体中取肘静脉血提取 DNA,用限制性内切酶 HinfⅠ或 HaeⅢ水解,1%琼脂糖凝胶电泳分离,经 Southern印迹转移,MYO DNA 探针杂交,获得了清晰可辨的 DNA 指纹图谱。结果每个个体在3.0Kb 以上均能检出10条以上杂交区带,个体间的相关概率<4×10~(-9),由杂交区带构成的图谱是个体特异的,杂交区带遵循孟德尔的显性遗传方式由亲代向子代遗传;具有 DNA Fingerprints 的特点。对两起亲子鉴定的案例进行指纹图检验,孩子所存在的杂交区带,除来自母亲外,其余可在嫌疑父亲带中找到,肯定了孩子与嫌疑人的父子关系。MYO DNA 探针在亲子鉴定与个人识别的法医学鉴定中有着重要的实用价值。     

根据Y-染色体特异DNA序列鉴定牙齿性别

人类牙齿的性别鉴定,是法医学个体识别中的一个重要部分。作者们应用限制性内切酶 HaeⅢ、Sau3A 水解60颗牙髓 DNA,琼脂糖凝胶电泳分离酶解片段,在紫外灯下直接观察。根据 Y-染色体特异 DNA 序列,3.4kb 长片段的有无,判断牙齿的性别。为牙齿性别的法医学鉴定提供了一种简单、准确的新方法。     

应用判别分析法判断胸骨性别的研究

本文测量了85例国人胸骨(男52,女33)的全长、柄长、体长、柄最大宽、体最大宽、柄最大厚及体最大厚七个项目,发现所有项目都具有非常显著的性别差异,但两性间重迭率较高,用单项难以准确判定性别。为此,采用 Fisher 判别分析法建立了判定胸骨性别的判别函数,判别率最高达90%。考虑到残缺胸骨的性别鉴定,亦建立了相应的判别函数。与国外研究相比,本文方法判别率较高且更具有实用价值。     

论企业核心竞争力

核心竞争力一词在 1990年《哈佛商业评论》出现以来便立即引起人们的广泛重视。企业核心竞争力是在市场竞争中一种能使企业长期持续发展、获得超额垄断利润并能为顾客带来更多独特价值的核心能力。这种竞争能力为企业创造的优势与一般竞争优势不同 ,它是建立在知识而非经验的基础上 ,具有价值优越性、模仿的高成本性、不可交易性、相对先进性、延伸性、整体关联性、阶段性、层次性与长期性等特性。如此多特性决定了企业核心竞争力的培育与获取不是一朝一夕之事。     

Medicare program; prospective payment system and consolidated billing for skilled nursing facilities--update. Final rule

This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs), for fiscal year (FY) 2004. Annual updates to the PPS rates are required by section 1888(e) of the Social Security Act (the Act), as amended by the Medicare, Medicaid, and SCHIP Balanced Budget Refinement Act of 1999 (BBRA), and the Medicare, Medicaid, and SCHIP Benefits Improvement and Protection Act of 2000 (BIPA), relating to Medicare payments and consolidated billing for SNFs.     

Medicare program; revisions to payment policies under the physician fee schedule for calendar year 2003 and inclusion of registered nurses in the personnel provision of the critical access hospital emergency services requirement for frontier areas and remote locations. Final rule with comment period

This final rule with comment period refines the resource-based practice expense relative value units (RVUs) and makes other changes to Medicare Part B payment policy. In addition, as required by statute, we are announcing the physician fee schedule update for CY 2003. The update to the physician fee schedule occurs as a result of a calculation methodology specified by law. That law required the Department to set annual updates based in part on estimates of several factors. Although subsequent after-the-fact data indicate that actual increases were different to some degree from earlier estimates, the law does not permit those estimates to be revised. A subsequent law required estimates to be revised for FY 2000 and beyond. Although we have exhaustively examined opportunities for a different interpretation of law that would allow us to correct the flaw in the formula administratively, current law does not permit such an interpretation. Accordingly, without Congressional action to address the current legal framework, the Department is compelled to announce herein a physician fee schedule update for CY 2003 of -4.4 percent. Because the Department would adopt a change in the formula that determines the physician update if the law permitted it, we have examined how proper adjustments to past data could result in a positive update. The Department believes that revisions of estimates used to establish the sustainable growth rates (SGR) for fiscal years (FY) 1998 and 1999 and Medicare volume performance standards (MVPS) for 1990-1996 would, under present calculations, result in a positive update. The Department intends to work closely with Congress to develop legislation that could permit a positive update, and hopes that such legislation can be passed before the negative update takes effect. Because the Department wishes to change the update promptly in the event that Congress provides the Department legal authority to do so, we are requesting comments regarding how physician fee schedule rates could and should be recalculated prospectively in the event that Congress provides the Department with legal authority to revise estimates used to establish the sustainable growth rates (SGR) and for 1998 and 1999 and the NVPS for 1990-1996. The other policy changes concern: the pricing of the technical component for positron emission tomography (PET) scans, Medicare qualifications for clinical nurse specialists, a process to add or delete services to the definition of telehealth, the definition for ZZZ global periods, global period for surface radiation, and an endoscopic base for urology codes. In addition, this rule updates the codes subject to physician self-referral prohibitions. We are expanding the definition of a screening fecal-occult blood test and are modifying our regulations to expand coverage for additional colorectal cancer screening tests through our national coverage determination process. We also make revisions to the sustainable growth rate, the anesthesia conversion factor, and the work values for some gastroenterologic services. We are making these changes to ensure that our payment systems are updated to reflect changes in medical practice and the relative value of services. This final rule also clarifies the enrollment of physical and occupational therapists as therapists in private practice and clarifies the policy regarding services and supplies incident to a physician's professional services. In addition, this final rule discusses physical and occupational therapy payment caps and makes technical changes to the definition of outpatient rehabilitation services. In addition, we are finalizing the calendar year (CY) 2002 interim RVUs and are issuing interim RVUs for new and revised procedure codes for calendar year (CY) 2003. As required by the statute, we are announcing that the physician fee schedule update for CY 2003 is -4.4 percent, the initial estimate of the sustainable growth rate for CY 2003 is 7.6 percent, and the conversion factor for CY 2003 is $34.5920. This final rule will also allow registered nurses (RNs) to provide emergency care in certain critical access hospitals (CAHs) in frontier areas (an area with fewer than six residents per square mile) or remote locations (locations designated in a State's rural health plan that we have approved.) This policy applies if the State, following consultation with the State Boards of Medicine and Nursing, and in accordance with State law, requests that RNs be included, along with a doctor of medicine or osteopathy, a physician's assistant, or a nurse practitioner with training or experience in emergency care, as personnel authorized to provide emergency services in CAHs in frontier areas or remote locations.     

Medical devices: reclassification and codification of the absorbable polydioxanone surgical suture. Final rule

The Food and Drug Administration (FDA) is announcing that it has issued an order in the form of a letter to Ethicon, Inc., reclassifying the absorbable polydioxanone surgical (PDS) suture intended for use in soft tissue approximation, including use in pediatric cardiovascular tissue where growth is expected to occur and ophthalmic surgery, from class III (premarket approval) to class II (special controls). Elsewhere in this issue of the Federal Register, FDA is announcing the availability of the guidance document entitled "Class II Special Controls Guidance Document: Surgical Sutures; Guidance for Industry and FDA," which is immediately in effect as the special control for the PDS suture, but remains subject to public comment and possible future revision under the agency's good guidance practices. The agency is reclassifying this device into class II because new information supplied by the petitioner indicates that special controls, in addition to general controls, will provide reasonable assurance of the safety and effectiveness of the device, and there is sufficient information to establish special controls. Accordingly, the order is being codified in the Code of Federal Regulations. Any firm submitting a premarket notification (510(k)) for a new PDS suture will need to address the issues covered in the special control guidance. However, the firm need only show that its device meets the recommendations of the guidance or in some other way provides equivalent assurances of safety and effectiveness.     

New drug and biological drug products; evidence needed to demonstrate effectiveness of new drugs when human efficacy studies are not ethical or feasible. Final rule

The Food and Drug Administration (FDA) is amending its new drug and biological product regulations to allow appropriate studies in animals in certain cases to provide substantial evidence of the effectiveness of new drug and biological products used to reduce or prevent the toxicity of chemical, biological, radiological, or nuclear substances. This rule will apply when adequate and well-controlled clinical studies in humans cannot be ethically conducted and field efficacy studies are not feasible. In these situations, certain new drug and biological products that are intended to reduce or prevent serious or life-threatening conditions may be approved for marketing based on evidence of effectiveness derived from appropriate studies in animals and any additional supporting data.     

Health insurance reform: standard unique employer indentifier. Final rule

This final rule establishes a standard for a unique employer identifier and requirements concerning its use by health plans, health care clearinghouses, and health care providers. The health plans, health care clearinghouses, and health care providers must use the identifier, among other uses, in connection with certain electronic transactions. The use of this identifier will improve the Medicare and Medicaid programs, and other Federal health programs and private health programs, and the effectiveness and efficiency of the health care industry in general, by simplifying the administration of the system and enabling the efficient electronic transmission of certain health information. It will implement some of the requirements of the Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act of 1996.