何 维 免疫学教授，博士生导师。现任卫生部科教司司长，中国农工民主党中央委员会副主席，中国免疫学会副理事长兼秘书长，国际免疫学联盟教育委员会委员。主要研究方向是T细胞受体识别、肿瘤免疫机制、肿瘤免疫
治疗与诊断和老化免疫机制研究。
“十一五”期间，国家首次斥巨资支持16个国家科技重大专项研究。其中有两个涉及医药卫生领域，而“
艾滋病和病毒性肝炎等重大传染病防治”就占有一席之地。今年是“十二五”开局之年，回溯重大传染病防治在过去几年取得的重要研究成果，曙光频现，希望在前。
战胜甲流 应急能力通过大考
对甲型H1N1流感的成功防控，证实了建设传染病检测技术平台网络实验室的价值。而已经达到国际先进水平的病原体鉴别能力，则是这次战役中闪亮的一笔。
——何 维
抛却具体疾病对人类健康的威胁不谈，单讲强化突发传染病的应急处置能力建设对于传染病防控的科技支撑就提出了更高的要求，而这无疑是设立重大传染病防治专项要解决的首要问题之一。事实上，无论是早些年的SARS，还是新近发生的甲型H1N1流感、禽流感、
手足口病、发热伴血小板减少综合征（蜱虫感染）等突发传染性疾病，以及NDM－1耐药菌等随时可能威胁到人们的健康杀手，通常都没有城乡、种族、国度之分，常令各国的防治体系疲于应付。因此，只有通过建立完备的疫情监控系统、提高病原体检定水平、提升医疗系统整体应急处置能力，才能做到有备无患。
“十一五”期间我国卫生应急处置能力显著提升：形成了短时间内对多种病原体组合筛查的能力，突发疫情的病原体鉴别能力达到了国际先进水平；借助传染病监测技术平台网络实验室建设，促进了传染病监测与检测技术由国家级单位向省市级单位的有效转移，并在近年应对多个疾病的过程中得到了真刀真枪的检验。
当甲流在其他国家迅速流行之初，我国专家组根据甲流病毒的流行特点，判断它的传播特点将会呈三个高峰形态，其中第一个高峰峰值最高，感染率和死亡率也最高。而相比发达国家，我国的传染病防控体系并没有达到高度专业化，需要以高度的社会动员等形式进行弥补。因此，专家组最终决定在第一时间对甲流病毒进行围堵，尽可能减少病毒流入我国。
随后的实践证实，成功围堵不仅避开了病毒传播的第一个高峰，而且为国内学者迅速研制、生产针对性药物和疫苗赢得了宝贵的时间。最终，我国学者在72小时内，成功建立了病毒核酸检测方法，并将我们研发的检测试剂提供给14个发展中国家，国家流感中心还被WHO认定为发展中国家唯一的流感参比实验室。而之前建立的防控产品评价技术平台则用于甲流疫苗质量评定，使我国成为全球第一个研制成功并规模生产和使用甲流疫苗的国家，免疫方案也得到全世界的认可和采用。
科技支撑能力不仅在甲流防控这场“大考”中大显身手，在一些突发应急事件的“中考”猝然降临时也能迅速应对：在蜱虫感染事件发生后，在最短的时间内确定病原体，消解社会恐慌；而在全球性围追NDM－1耐药菌的科研热潮中，我国学者则很快锁定了本土的NDM－1病例，为及时应对争取先机。
总体思路 科技攻关先抓主要矛盾
在重大传染病防控这一专项中，我国学者最主要的努力目标就是降低“三病两率”（艾滋病、病毒性肝炎和结核病的发病率和病死率）和提高我们的应急处置能力。在降低“三病两率”方面，三大疾病防控的科研成果各有亮点。
——何 维
从我国现状来看，对百姓威胁最为严重的传染病是艾滋病、病毒性肝炎和结核病，因此专家团队认为控制这三种疾病将解决传染病的主要矛盾。
“十一五”期间主要任务是摸清底数、取得局部突破。其间，我国学者在15个省、自治区、直辖市建立了传染病综合防治试验区和单病种现场，覆盖人口逾2000万。开展了全球最大规模的流行病学研究，创建了传染病综合管理信息体系。
具体到艾滋病，国内学者成功研发适合国情且符合国际标准的核酸血筛检测体系及第四代检测试剂盒，将检测窗口期从三周缩短到两周以内，可更加及时地发现感染者。同时逐步确认了艾滋病传播模式的变化，为国家及时调整防治策略提供了依据。此外，还有优化的成人治疗方案，减轻了药物的毒副作用，使费用降低了79%。针对艾滋病疫苗难题，建立“政产学研用”相结合的中国艾滋病疫苗联盟，探索建立举国体制大兵团联合作战的攻关模式，初步验证了艾滋病疫苗的安全性。
在病毒性肝炎领域，一批
乙肝免疫治疗制剂临床研究取得进展，具有自主知识产权的治疗性疫苗将于近期完成Ⅲ期临床试验。通过建立慢性乙肝和重症乙肝临床治疗方案，使重症乙肝病死率进一步下降。国产乙肝、丙肝诊断试剂的性能也取得了进步，一系列质优价廉的检测试剂相继上市。
对于肝癌的早期诊断，由于我们自主发现了比现行肝癌筛查标志物甲胎蛋白特异性更高的新标志物GPC3/MXR7，将有效提高肝癌早期的诊断准确率。抗原致敏人树突状细胞瘤苗已完成Ⅱ期临床试验，与化疗结合对转移性肝癌的有效率达45%。包括外科手术在内的治疗手段不断发展，显著提高了乙肝相关性终末期肝病患者的存活率和生活质量。
在对抗结核病的研究中，一批常温、简便条件下即可使用的检测技术显著提升了基层单位的检测能力和水平。研发的菌体分离和富集材料与技术等，使痰液中结核分枝杆菌的检出率由25%提高到60%以上。菌种鉴定和耐药检测基因芯片等技术将检测时间由8周缩短到6小时。实现结核和非结核分枝杆菌快速鉴别，时间由2～3月缩短至1～2天，大大提高了结核病诊治水平。
迎接挑战 科技进步再成中流砥柱
尽管在减低“三病两率”方面取得了可喜进展，但这场与重大传染病的阵地战不可能一蹴而就，最终制胜的法宝依然要靠科技进步。
——何 维
目前确定的三大疾病防控策略分别是：艾滋病要阻断传播途径，肝炎要减少易感人群，结核要控制传染源。而这些策略都面临着严峻的挑战。据统计，我国HIV感染人数约74万，并且仍在升高。主要以性传播为主，特别是在局部地区传播态势比较严重（如四川凉山、新疆部分地区），出现了由高危人群向一般人群蔓延的危险苗头。尽管乙肝病毒携带者人数有所下降，但仍然高达9000万，慢性肝炎患者2300万，如此庞大的现患数量使得减少易感人群的努力异常艰难。结核病发病率连年居高不下，特别是耐药病例在全球位居前列，这给传染源的有效管理增加了诸多困难。
面对如此棘手的难题，归根到底还是要依靠科技
工作者的智慧和力量，运用现代科学技术手段和先进理念，找寻破解难题的金钥匙。从疾病诊断角度看，随着芯片、基因测序、纳米材料等的应用，新型诊断方法和材料的出现，将极大推动传染病诊断技术向组合、灵敏精确以及早期预测疗效等方向发展。同时，传染病疫苗的研制水平也将不断提升，新的疫苗研发生产时间有望进一步缩短。
“十二五”计划期间，卫生部和总后卫生部将进一步探索适合国情的传染病科技防控模式，突破一批关键核心技术和产品，解决一批传染病防控和产业发展的瓶颈问题，促进一批成果转化、转移和应用，确保降低“三病两率”目标的实现和传染病防控能力的大幅跃升，为保障人民健康和社会经济发展提供强大的科技支撑。
艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复 艾滋病不治会早死，早治才康复
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| 图示∶2010年12月即将出版的《中国特色医疗金鉴》登载的刘君主任及其机构 |
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Major infectious diseases would like to in front
ZHENG Ying Fan Luo Gang at 09:34 on April 21, 2011 Source: Health News Network
He Wei Immunology Professor. Science and Education Secretary, now the Ministry of Health, Peasants and Workers Democratic Central Committee Vice Chairman, Chinese Society for Immunology, Vice Chairman and Secretary General, International Union of Immunology Board of Education members. Main research direction is to identify the T cell receptor, tumor immune mechanisms, diagnosis and tumor immunotherapy and immune mechanisms of aging.
"Eleventh Five-Year" period, the country's first money in support of 16 major projects of national science and technology. Two of which involved medical and health fields, and "AIDS and viral hepatitis and other major infectious diseases," to place. This year is the "second five" first year, back major infectious diseases in the past few years, important research results obtained, the dawn of frequency is, hope the former.
A flow of emergency response capabilities by overcoming the College Entrance Examination
The success of prevention and control of swine influenza H1N1 confirmed infectious disease detection technology platform for building the value of the network laboratories. And has reached international advanced level ability to identify pathogens, it is a shining this battle.
- He Wei
Discard the specific disease threats to human health aside, one speaking to strengthen emergency outbreaks of infectious diseases of epidemic prevention and control of capacity building and technology support for the proposed higher requirements, and this is undoubtedly the establishment of major infectious diseases specific to One of the most important issue to resolve. In fact, both the early years of the SARS, or to the recent H1N1, avian flu, foot and mouth disease, fever and thrombocytopenia syndrome (tick worm infection) and other infectious disease emergencies, and the NDM-1 resistance drugs may pose a threat to people at any microorganisms in the health of killer, usually not urban and rural, race, country of points, often makes the control system for countries struggling to cope. Therefore, only through the establishment of a comprehensive disease surveillance system to improve the level of pathogen testing to enhance the overall emergency response capacity of health systems, can be prepared.
"Eleventh Five-Year" period of emergency response capacity of our health significantly improved: the formation of a short screening of the ability to mix a variety of pathogens, sudden ability to identify the causative agent of the epidemic has reached the international advanced level; technology platform for infectious disease surveillance network with experiment room building and promotion of the communicable disease surveillance and detection technology from the national to the provincial and municipal units of the effective transfer of units, and in recent years over the course of disease should have been a shooting test.
When a stream of rapidly popular in other countries, the beginning, our group of experts based on the popular features of a flow of the virus, its transmission characteristics to determine the three peak shape will be presented, including the highest peak of the first peak, the highest rate of infection and mortality. And compared to developed countries, China's disease prevention and control system and did not reach a high degree of specialization, the need for a high degree of social mobilization and other forms of make up. Therefore, the group finally decided on a flow for the first time the virus containment and minimize the virus into our country.
Confirmed by subsequent practice, successful transmission of the virus to contain not only to avoid the first peak, but also for the rapid development of domestic scholars, produce targeted drugs and vaccines has won valuable time. Finally, within 72 hours of academics, successful establishment of the virus nucleic acid detection methods, and we have developed test kit available to 14 developing countries, WHO National Influenza Centre has also been identified as the only developing experimental influenza reference room. And product evaluation prior to the establishment of prevention and control technology platform is used in the vaccine quality assessment, making China the world's first successful development and scale production and use of the vaccine in national immunization program has also been recognized and used around the world.
Scientific and technological support capabilities not only in the prevention and control of a flow of this "final exam" in their talents, in some sudden emergency event "in the test," when suddenly came quickly respond: worm infection in the ticks after the incident, in the shortest possible time to determine pathogen , digestion social panic; in global Weizhui NDM-1 resistant upsurge in scientific research, our scholars then quickly locked the local NDM-1 cases, for the timely response to fight the initiative.
Scientific and technological grasp the general idea first major contradictions
Prevention and control of major infectious diseases in this special, our scholars the most important goal is to reduce the "two-three disease rate" (AIDS, viral hepatitis and tuberculosis morbidity and mortality) and to improve our emergency response capabilities. Reducing the "three-two patients rate", the three diseases prevention and control of scientific research have highlights.
- He Wei
From our current situation of the people, the most serious infectious disease threat of AIDS, viral hepatitis and tuberculosis, so that control of the team of experts will address the three diseases, infectious diseases, the principal contradiction.
"During" the main task is to find out the real, made of local breakthrough. In the meantime, China scholars in the 15 provinces, autonomous regions and municipalities to establish comprehensive prevention and control of infectious disease testing area and a single disease site, covering a population of more than 20 million. Launched the world's largest epidemiological study to create a comprehensive management information system for infectious diseases.
Specific to AIDS, domestic scholars and successful development of international standards for conditions of nucleic acid blood screening test system and the fourth-generation test kit, the test window is shortened from three weeks to two weeks or less, can be found to be infected by a more timely manner. While gradually recognized the changing patterns of HIV transmission, prevention and control strategies to adjust for the state provided. In addition, optimization of the adult treatment programs, reducing the drug's side effects, so that 79% reduction in the cost. Challenges for AIDS vaccine, the establishment of "Education and Research as" a combination of China's AIDS vaccine Union, explore the establishment of nationwide system large formation of joint operations research model, a preliminary validation of the AIDS vaccine safety.
In the field of viral hepatitis, a number of clinical studies of hepatitis B immune therapeutic agents of progress, with independent intellectual property rights of therapeutic vaccines will be the recently completed Phase Ⅲ clinical trials. Through the establishment of chronic hepatitis B and clinical treatment of severe hepatitis, severe hepatitis B to a further decline in mortality. Domestic hepatitis B, hepatitis C diagnostic reagents has also made progress in performance, a series of reagent quality and cheap have listed.
For the early diagnosis of liver cancer, as we found a self-screening marker of HCC than the AFP present a new, more specific markers GPC3/MXR7, will effectively improve the diagnostic accuracy of early liver cancer. Human dendritic cells antigen vaccine has completed Phase Ⅱ clinical trial, metastatic liver cancer with chemotherapy combined with an effective rate of 45%. Including surgical treatment, including the continuous development of hepatitis B significantly improved end-stage liver disease related survival and quality of life.
Research in the fight against tuberculosis, a group of room temperature, easy to use under the conditions of the detection technology significantly improves the detection capability and grass-roots level. Research and development of cell separation and enrichment materials and technologies, so that the sputum Mycobacterium tuberculosis detection rate from 25% to 60%. Species identification and drug testing such as gene chip technology to reduce detection time from 8 weeks to 6 hours. TB and non-realization of rapid identification of Mycobacterium tuberculosis, the time reduced from 2 to 3 months to 1 to 2 days, greatly improving the diagnosis and treatment of tuberculosis.
The challenge again become the mainstay of scientific and technological progress
While reducing the "three-two patients rate" has made encouraging progress, but this trench warfare with the major infectious diseases can not be achieved, and ultimately winning the magic still rely on science and technology.
- He Wei
Current disease control strategy to determine the three were: to block the transmission of AIDS, hepatitis to reduce the susceptible population, tuberculosis should 控制传染源. These strategies are faced with severe challenges. According to statistics, the number of HIV infected about 74 million and still rising. Based mainly sexually transmitted, especially in the more serious situation in some areas spread (such as Sichuan Liangshan, some areas of Xinjiang), appeared in high-risk groups to the general population by the spread of dangerous sign. Despite the decline in the number of hepatitis B virus carriers, but still up to 90 million, 23 million patients with chronic hepatitis, are suffering from such a large number of efforts made to reduce the susceptible population extremely difficult. Successive years of high incidence of tuberculosis, especially in resistant cases the forefront in the world, which gives the source of infection increases the effective management of numerous difficulties.
Faced with such difficult problems, the final analysis, scientists still have to rely on the wisdom and strength, the use of modern scientific techniques and advanced concepts, to find the golden key to solve problems. From the perspective of disease diagnosis, with the chip, gene sequencing, the application of nano-materials, new diagnostic methods and materials, the emergence of infectious disease diagnostic technology will greatly promote the combination, sensitive, accurate and early prediction of efficacy of such direction. Meanwhile, the development of vaccines against infectious diseases will continue to enhance the level of the new vaccine research and development is expected to further reduce production time.
"Twelve Five-Year" Plan period, the Ministry of Health Ministry of Health and the General Logistics Department will further explore the science and technology for prevention and control of infectious conditions model to make breakthroughs in core technologies and products to address a number of infectious disease prevention and industrial development bottlenecks to promote a number of achievements, transfer and application, to ensure that reduce the "two-disease rates of the three" goals and infectious disease prevention and control capacity of a quantum leap, to protect people's health and socio-economic development of a strong scientific and technological support.
