条例原文能逐字核对,但它只说明到期换管是你的义务,不说明换了能少出多少事故。按年限换管能把燃气事故降多少,没找到官方统计数字,所以只给 C 级。有人以「安检」名义上门,检查完就推销自闭阀和报警器。条例第二十条第六项不许燃气公司要求你买它指定的产品,你可以拒绝,也可以投诉。闻到燃气味,先关燃气总阀,瓶装气关钢瓶阀门。再开门开窗通风,别开排气扇。电灯、抽油烟机这些电器一律别开也别关,打火机也别碰。然后人撤出去,离开现场再打燃气公司的报警电话。一氧化碳中毒是另一件事,见第 13 节。
Mushroom Poisoning Outbreaks — China, 2025. China CDC Weekly (2026):「In 2025, China CDC investigated 828 mushroom poisoning incidents across 27 provincial-level administrative divisions (PLADs), affecting 2,165 individuals and causing 13 deaths - a case fatality rate of 0.6%, the lowest of the past six years. In total, 138 poisonous mushroom species were identified, including 34 newly recorded in poisoning incidents in China.」「From 2019 to 2024, the annual number of incidents ranged from 276 to 676, and the case fatality rate ranged from 0.87% to 2.86%.」https://doi.org/10.46234/ccdcw2026.120;同刊 2024 年度报告 https://doi.org/10.46234/ccdcw2025.106
Ettehad D 等 (2016). Blood pressure lowering for prevention of cardiovascular disease and death: a systematic review and meta-analysis. Lancet. https://doi.org/10.1016/S0140-6736(15)01225-8 ; Lu J 等 (2017). Prevalence, awareness, treatment, and control of hypertension in China (China PEACE Million Persons Project). Lancet. https://doi.org/10.1016/S0140-6736(17)32478-9
Spiegel CN, Lindaman FC (1977). Children can't fly: a program to prevent childhood morbidity and mortality from window falls. American Journal of Public Health:「Significant reduction in falls resulted, particularly in the Bronx, where reported falls declined 50 percent from 1973 to 1975」,1976 年纽约市卫生法典修订「to require that landlords provide window guards in apartments where children ten years old and younger reside」. https://doi.org/10.2105/AJPH.67.12.1143;(2021). Unintentional Window Falls in Children and Adolescents. Academic Pediatrics:2007 年 1 月至 2017 年 8 月全国电子伤害监测系统 38,840 例急诊就诊,「The majority of falls occurred in children under the age of 6 and were related to falls from a second story or below」. https://doi.org/10.1016/j.acap.2020.07.008
Cummings P 等 (2011). Association between wearing a personal floatation device and death by drowning among recreational boaters. Injury Prevention. https://doi.org/10.1136/ip.2010.028688 ; Li Z 等 (2023). Unintentional Drowning Mortality Among Individuals Under Age 20 — China, 2013–2021. China CDC Weekly. https://doi.org/10.46234/ccdcw2023.198 ; Zhou J 等 (2024). Injury Mortality of Children and Adolescents Aged 0–19 Years — China, 2010–2021. China CDC Weekly. https://doi.org/10.46234/ccdcw2024.057
备注
A 级只对应救生衣这一半。「不离视线」是大家的共识,单算只有 C 级,没有随机试验,以后也不会有。中国的溺水死亡集中在农村、夏季,以及 15 到 19 岁的男性。冬天上冰面玩,见第 41 条(野外冰面先量厚度)。
Qu C 等 (2014). Efficacy of neonatal HBV vaccination on liver cancer and other liver diseases over 30-year follow-up of the Qidong hepatitis B intervention study. PLoS Medicine. https://doi.org/10.1371/journal.pmed.1001774 ; Cui F 等 (2017). Prevention of Chronic Hepatitis B after 3 Decades of Escalating Vaccination Policy, China. Emerging Infectious Diseases. https://doi.org/10.3201/eid2305.161477
美国疾病控制与预防中心. 破伤风:「Tetanus bacteria can get into someone's body through broken skin, usually through injuries.」「Tetanus can lead to death (1 in 10 cases in the United States are fatal).」「People who didn't complete the primary series or who aren't up to date with their 10-year tetanus booster shots are also at increased risk.」「Vaccination also helps prevent tetanus in people with wounds, depending on their tetanus vaccination history.」https://www.cdc.gov/tetanus/about/index.html;国家卫生健康委办公厅 (2024). 关于印发非新生儿破伤风诊疗规范(2024 年版)的通知(国卫办医急函〔2024〕381 号,风险分级见附件第 16 页,表 4 见第 20 页). https://www.gov.cn/zhengce/zhengceku/202410/content_6982262.htm;附件 PDF(扫描件). https://www.gov.cn/zhengce/zhengceku/202410/P020241023483425528555.pdf
Hewitson P 等 (2007). Screening for colorectal cancer using the faecal occult blood test, Hemoccult. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD001216.pub2 ; Bretthauer M 等 (2022). Effect of Colonoscopy Screening on Risks of Colorectal Cancer and Related Death. New England Journal of Medicine. https://doi.org/10.1056/NEJMoa2208375
Lal H, Cunningham AL, Godeaux O, et al. (2015). Efficacy of an adjuvanted herpes zoster subunit vaccine in older adults. New England Journal of Medicine, 372(22), 2087-2096. https://doi.org/10.1056/NEJMoa1501184
荷兰把 8.45 万名 65 岁以上老人随机分成两组来比。用的是 13 价肺炎球菌结合疫苗。它对疫苗覆盖型肺炎的效力是 45.6%。可信范围是 95.2% CI 21.8–62.5。疫苗覆盖型就是这支疫苗管得住的那几个菌型。对侵袭性肺炎球菌病的效力是 75.0%(95% CI 41.4–90.8),这是最凶险的那一类感染。对全部原因加在一起的肺炎,它没有效果
来源
Bonten MJ, Huijts SM, Bolkenbaas M, et al. (2015). Polysaccharide conjugate vaccine against pneumococcal pneumonia in adults. New England Journal of Medicine, 372(12), 1114-1125. https://doi.org/10.1056/NEJMoa1408544
山东临朐那项随机分组的试验跟踪了 22 年。做过幽门螺杆菌根除治疗的人,得胃癌的风险低约一半。原值 OR 0.48,可信范围 95% CI 0.32 到 0.71。死于胃癌的风险低约 38%(HR 0.62,95% CI 0.39 到 0.99)
来源
Li WQ 等 (2019). Effects of Helicobacter pylori treatment and vitamin and garlic supplementation on gastric cancer incidence and mortality: follow-up of a randomized intervention trial. BMJ. https://doi.org/10.1136/bmj.l5016
National Lung Screening Trial Research Team (2011). Reduced Lung-Cancer Mortality with Low-Dose Computed Tomographic Screening. New England Journal of Medicine. https://doi.org/10.1056/NEJMoa1102873
Price SJ, Shephard EA, Stapley SA, Barraclough K, Hamilton WT (2014). Non-visible versus visible haematuria and bladder cancer risk: a study of electronic records in primary care. British Journal of General Practice, 64(626), e584-e589. https://doi.org/10.3399/bjgp14X681409
Gupta BP, Murad MH, Clifton MM, Prokop L, Nehra A, Kopecky SL (2011). The effect of lifestyle modification and cardiovascular risk factor reduction on erectile dysfunction: a systematic review and meta-analysis. Archives of Internal Medicine, 171(20), 1797-1803. https://doi.org/10.1001/archinternmed.2011.440;Rosen RC, Cappelleri JC, Smith MD, Lipsky J, Peña BM (1999). Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. International Journal of Impotence Research, 11(6), 319-326. https://doi.org/10.1038/sj.ijir.3900472
一项研究把 25 项研究、10676 对异性伴侣合起来一起算。这些伴侣都是一方感染 HIV、一方没感染,学名叫血清不一致。和从来不用的人相比,坚持每次都用安全套的人,HIV 传播风险低约 71%。原值 RR 0.29,可信范围 95% CI 0.20 至 0.43。和用得断断续续的人相比,低约 77%(RR 0.23,95% CI 0.13 至 0.40)。作者的结论是,安全套虽然不完美,但「坚持使用可使 HIV 传播降低 70% 以上」。同一层保护还覆盖梅毒、淋病、衣原体等其他性传播感染
来源
Giannou FK, Tsiara CG, Nikolopoulos GK, et al. (2016). Condom effectiveness in reducing heterosexual HIV transmission: a systematic review and meta-analysis of studies on HIV serodiscordant couples. Expert Review of Pharmacoeconomics & Outcomes Research, 16(4), 489-499. https://doi.org/10.1586/14737167.2016.1102635;Fonner VA 等 (2016). Effectiveness and safety of oral HIV preexposure prophylaxis for all populations. AIDS. https://doi.org/10.1097/QAD.0000000000001145(暴露前预防 PrEP)
备注
「不规律使用」和「不用」的差距很小,要每次、全程都用才有效。共用针具是另一条独立的高效传播途径,和性行为无关,注射毒品、纹身、穿孔都算。高风险人群还可以用暴露前预防(PrEP),就是事先吃药挡住感染。把 18 项研究合起来算,凡是超过七成人按时吃药的试验,吃 PrEP 的人感染 HIV 的风险比吃安慰剂的低约七成。原值是风险比 0.30,可信范围 95% CI 0.21 至 0.45。按时吃药的人少的那些试验,则看不到保护效果。PrEP 是处方药,去感染科或者疾控问,别自己网购。已经暴露之后怎么办见第 13 节
Deisenhammer EA, Ing CM, Strauss R, Kemmler G, Hinterhuber H, Weiss EM (2009). The duration of the suicidal process: how much time is left for intervention between consideration and accomplishment of a suicide attempt? Journal of Clinical Psychiatry, 70(1), 19-24. https://doi.org/10.4088/JCP.07m03904;Owens D, Horrocks J, House A (2002). Fatal and non-fatal repetition of self-harm: systematic review. British Journal of Psychiatry, 181, 193-199. https://doi.org/10.1192/bjp.181.3.193
Gawarammana IB, Buckley NA (2011). Medical management of paraquat ingestion. British Journal of Clinical Pharmacology, 72(5), 745-757. https://doi.org/10.1111/j.1365-2125.2011.04026.x;Chowdhury FR 等 (2026). Clinical and Laboratory Profile of Paraquat Poisoning: A Toxicological Crisis in Bangladesh. American Journal of Tropical Medicine and Hygiene, 115, 176-182. https://doi.org/10.4269/ajtmh.25-0719;Weaver LK, Hopkins RO, Chan KJ, et al. (2002). Hyperbaric oxygen for acute carbon monoxide poisoning. New England Journal of Medicine, 347(14), 1057-1067. https://doi.org/10.1056/NEJMoa013121;Parkinson RB, Hopkins RO, Cleavinger HB, et al. (2002). White matter hyperintensities and neuropsychological outcome following carbon monoxide poisoning. Neurology, 58(10), 1525-1532. https://doi.org/10.1212/wnl.58.10.1525;农业农村部办公厅 (2018). 关于切实加强百草枯监督管理的通知(农办农〔2018〕17 号). https://www.gov.cn/zhengce/zhengceku/2018-12/31/content_5442594.htm
Chen Y, Li W, Wang X, Zhong Q, Abudurexiti A, Qiu Q, Li J, Luo J (2025). Clinical features and prognostic predictors for patients admitted to trauma intensive care unit due to fall from height in South Xinjiang. International Journal of Emergency Medicine, 18, 142. https://doi.org/10.1186/s12245-025-00959-4;Simmel S, Wurm S, Drisch S, Woltmann A, Coenen M (2020). Prädiktion der Rückkehr zur Arbeit nach Polytrauma bei Patienten mit einem ISS von mindestens 25. Die Rehabilitation, 59(2), 95-103. https://doi.org/10.1055/a-0977-6853;国家卫生健康委 (2025). 2024 年我国卫生健康事业发展统计公报解读. https://www.gov.cn/zhengce/202512/content_7050025.htm
Muzaale AD, Massie AB, Wang MC, Montgomery RA, McBride MA, Wainright JL, Segev DL (2014). Risk of end-stage renal disease following live kidney donation. JAMA, 311(6), 579-586. https://doi.org/10.1001/jama.2013.285141;Mjøen G, Hallan S, Hartmann A, et al. (2014). Long-term risks for kidney donors. Kidney International, 86(1), 162-167. https://doi.org/10.1038/ki.2013.460;Ibrahim HN, Foley R, Tan L, et al. (2009). Long-term consequences of kidney donation. New England Journal of Medicine, 360(5), 459-469. https://doi.org/10.1056/NEJMoa0804883;Goyal M, Mehta RL, Schneiderman LJ, Sehgal AR (2002). Economic and health consequences of selling a kidney in India. JAMA, 288(13), 1589-1593. https://doi.org/10.1001/jama.288.13.1589
Karlsson A, Håkansson A. (2018). Gambling disorder, increased mortality, suicidality, and associated comorbidity: A longitudinal nationwide register study. Journal of Behavioral Addictions, 7(4), 1091–1099. https://doi.org/10.1556/2006.7.2018.112;Karlsson A, Håkansson A. (2023). Corrigendum to: Gambling disorder, increased mortality, suicidality, and associated comorbidity. Journal of Behavioral Addictions, 12(1), 302. https://doi.org/10.1556/2006.2023.10000;国家卫生健康委 (2024). 关于应用"12356"全国统一心理援助热线电话号码的通知(国卫医政函〔2024〕259 号). https://www.gov.cn/zhengce/zhengceku/202412/content_6994470.htm
备注
给 B 是因为只有一项研究,而且只算了去专科看过病的人。这些人病情偏重,所以 15 倍不能套到所有打牌的人身上。把钱交给家人管是经验做法,没有直接研究,单算是 C 级。赌博的法律红线见第 9 节第 13 条(不抽头、不玩网络赌博)。家里人欠了赌债该不该替他还,见第 8 节第 44 条(赌债不算夫妻共同债务)。自杀念头冒出来之后怎么办,见本节第 32 条(先告诉身边的一个人)。受益人主要是你自己,家人发现苗头时也可以拉着他照这条办。
US Preventive Services Task Force, Nicholson WK, Silverstein M, et al. (2025). Screening for Osteoporosis to Prevent Fractures: US Preventive Services Task Force Recommendation Statement. JAMA. https://doi.org/10.1001/jama.2024.27154 ; Kahwati LC, Kistler CE, Booth G, et al. (2025). Screening for Osteoporosis to Prevent Fractures: A Systematic Evidence Review for the US Preventive Services Task Force. JAMA. https://doi.org/10.1001/jama.2024.21653 ; Shepstone L, Lenaghan E, Cooper C, et al. (2018). Screening in the community to reduce fractures in older women (SCOOP): a randomised controlled trial. The Lancet. https://doi.org/10.1016/S0140-6736(17)32640-5 ; 中华医学会骨质疏松和骨矿盐疾病分会 (2017). 原发性骨质疏松症诊疗指南(2017). 中华骨质疏松和骨矿盐疾病杂志, 10(5), 413-443(表 5 骨密度测量的临床指征). https://html.rhhz.net/GUSS/html/cc825127-29a3-47c1-9a95-7a212fdcce55.htm ; Wang L, Yu W, Yin X, et al. (2021). Prevalence of Osteoporosis and Fracture in China: The China Osteoporosis Prevalence Study. JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2021.21106
中华医学会骨质疏松和骨矿盐疾病分会 (2017). 原发性骨质疏松症诊疗指南(2017). 中华骨质疏松和骨矿盐疾病杂志, 10(5), 413-443(表 10 抗骨质疏松症药物治疗适应证;钙剂一节;疗效监测一节). https://html.rhhz.net/GUSS/html/cc825127-29a3-47c1-9a95-7a212fdcce55.htm ; Wells GA, Hsieh SC, Peterson J, et al. (2025). Alendronate for the primary and secondary prevention of osteoporotic fractures in postmenopausal women. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.CD001155.pub3 ; Lyles KW, Colón-Emeric CS, Magaziner JS, et al. (2007). Zoledronic acid and clinical fractures and mortality after hip fracture. New England Journal of Medicine. https://doi.org/10.1056/NEJMoa074941 ; Cummings SR, Lui LY, Eastell R, Allen IE (2019). Association Between Drug Treatments for Patients With Osteoporosis and Overall Mortality Rates: A Meta-analysis. JAMA Internal Medicine. https://doi.org/10.1001/jamainternmed.2019.2779 ; Kahwati LC, Kistler CE, Booth G, et al. (2025). Screening for Osteoporosis to Prevent Fractures: A Systematic Evidence Review for the US Preventive Services Task Force. JAMA. https://doi.org/10.1001/jama.2024.21653 ; Wang L, Yu W, Yin X, et al. (2021). Prevalence of Osteoporosis and Fracture in China: The China Osteoporosis Prevalence Study. JAMA Network Open. https://doi.org/10.1001/jamanetworkopen.2021.21106
备注
争议:一篇合并了 38 项试验的荟萃分析没有看出这类药能降低总死亡率(RR 0.98,95% CI 0.91 到 1.05)。单看唑来膦酸也不显著(RR 0.88,95% CI 0.68 到 1.13)。作者的结论是,这类药只该为了少骨折而用。Cochrane 那几个数字的可信度也被评为低到中等。还没骨折、骨折风险较低的女性,阿仑膦酸钠对髋部骨折没看出明显作用(RR 0.76,95% CI 0.43 到 1.32)。下颌骨坏死、不典型股骨骨折这类少见的副作用,几年的试验看不全,所以要按时复查、不自己加药停药。有的人适合打针,有的人适合吃药,选哪种由医生定。怎么查出骨质疏松,见第 39 条(骨密度检查)。绝经激素治疗也能减少骨折,但一般只在不适合用别的药时才考虑。为了潮热盗汗用激素,见第 2 节第 43 条(绝经前后潮热去评估激素治疗)。受益人主要是你自己,也包括你的父母。
Gould MS, Marrocco FA, Kleinman M, Thomas JG, Mostkoff K, Cote J, Davies M (2005). Evaluating iatrogenic risk of youth suicide screening programs: a randomized controlled trial. JAMA, 293(13), 1635-1643. https://doi.org/10.1001/jama.293.13.1635;Polihronis C, Cloutier P, Kaur J, Skinner R, Cappelli M (2022). What's the harm in asking? A systematic review and meta-analysis on the risks of asking about suicide-related behaviors and self-harm with quality appraisal. Archives of Suicide Research, 26(2), 325-347. https://doi.org/10.1080/13811118.2020.1793857;Dazzi T, Gribble R, Wessely S, Fear NT (2014). Does asking about suicide and related behaviours induce suicidal ideation? What is the evidence? Psychological Medicine, 44(16), 3361-3363. https://doi.org/10.1017/S0033291714001299