ABSTRACT
Described in the paper is the reform made at public hospitals in Zhejiang province,with analysis of its problems and causes. Based on such,the authors proposed the following actions:to accelerate the reform of public hospitals centering on health promotion, and encourage such hospitals to shoulder the health care responsibility on behalf of the government; to proceed with hierarchical medical system and contract-based service focusing on capacity building of general practitioners; to attract private capital into building the healthcare system; and to motivate non-governmental organizations to cater to diversified healthcare needs of the people.
ABSTRACT
The paper covered the initial success of Zhejiang province in furthering its development of a basic healthcare system in alignment of social and economic growth. Such progress has been achieved by adhering to the principles of coordinated arrangement,highlighting key points and step-by-step progress. Also presented are the methods and experiences of the province in its reform and perspectives for furthering the ongoing reform.
ABSTRACT
The article reviewed the current status, reform measures and progress of the tiered medical services in Zhejiang province, and analyzed main roadblocks in such a system.Proposals made in the paper include such reform measures as further expanding quality medical resources of better talents and equipments to enhance primary medical institutions;forming the gatekeeper practice featuring firstvisit at community health centers with enhanced primary capabilities;insisting on joint reform of medical treatment, medical insurance and drugs, promoting the development of tiered medical services and utilization efficiency of medical resources in the province.
ABSTRACT
Since the launch of the comprehensive public hospital reform in Zhejiang Province, the price of medical services has been adjusted, and the charging structure of medical services has been improved. Likewise, medical insurance policies have been optimized. Through several price adjustment strategies, such as the“loosen-re-strain” policy, the labor of medical personnel has been better valued, the operation of public medical institutions has been stabilized, and the allocation of medical resources has been optimized. Hence, this paper aims to measure the achievements and drawbacks of the medical service price adjustments by analyzing the various strategy. It is suggested that the comprehensive public hospital reform should be further intensified via the advancement of coordination of healthcare, medical insurance and medicine, the exploration of new procurement mechanisms for drugs and medical equipment, the establishment of dynamic adjustment mechanisms for medical service pricing, the exploration of new management mechanisms for medical services, and the strengthening of medical service supervision.
ABSTRACT
Covered in the paper are the policies and progress of the county-level public hospital reform in the province,and a summarized analysis of the self-appraisal reports and hospital reform statements submitted by the health authorities and up to 300 hospitals in 79 counties of the province.As found in the papers,the ongoing reform in Zhejiang is focused on reforming the business models in place,seeking breakthroughs from the zero mark-up policy on drug sales,in addition to such policies as reducing drug costs,adjusting medical service pricing,financial subsidies,and medical insurance payment reforms.Despite the initial success,further policy studies are needed in terms of internal management,upper and lower linkage,and personnel incentives.
ABSTRACT
Based on the ongoing health reform and Wenzhou's economic and social developments,this article made a complete analysis on the policy packages initiated by Wenzhou government in August 2012,in an effort to encourage and involve private capital to launch medical institutions.These policies and measures released take into account the policy and legal environment for private capital in medical sector in China,and target the demands of deepening health reform and shortage of health development funding.Such efforts of Wenzhou are designed as breakthroughs in terms of market access,doctors mobility,return on investment,health insurance and fiscal policy.
ABSTRACT
Human cytomegalovirus glycoprotein B (gB) represents a target for diagnosis and treatment in view of the role it plays in virus entry and spread. Nevertheless, to our knowledge, rare detection of a gB antigen has been reported in transplant patients and limited information is available about diagnostic gB monoclonal antibodies (mAbs). Our aim was to develop gB mAbs with diagnostic potential. Hydrophilic gB peptides (ST: amino acids 27-40, SH: amino acids 81-94) of favorable immunogenicity were synthesized and used to immunize BALB/c mice. Two mAbs, named ZJU-FH6 and ZJU-FE6, were generated by the hybridoma technique and limited serial dilution and then characterized by indirect ELISA, Western blotting, immunoprecipitation, and immunohistochemical staining. The mAbs displayed high titers of specific binding affinities for the ST and SH synthetic peptides at an mAb dilution of 1:60,000 and 1:240,000, respectively. Western blotting and immunoprecipitation indicated that these mAbs recognized both denatured and native gB of the Towne and AD169 strains. The mAbs, when used as the primary antibody, showed positive staining in cells infected with both Towne and AD169 strains. The mAbs were then tested on patients submitted to allogeneic hematopoietic stem cell transplantation. The gB antigen positivity rates of the patients tested using ZJU-FH6 and ZJU-FE6 were 62.0 and 63.0%, respectively. The gB antigen showed a significant correlation with the level of pp65 antigen in peripheral blood leukocytes. In conclusion, two potential diagnostic gB mAbs were developed and were shown to be capable of recognizing gB in peripheral blood leukocytes in a reliable manner.
Subject(s)
Animals , Humans , Mice , Antibodies, Monoclonal , Antibodies, Viral/immunology , Cytomegalovirus Infections/diagnosis , Cytomegalovirus/immunology , Viral Envelope Proteins/immunology , Antibodies, Monoclonal/immunology , Blotting, Western , Enzyme-Linked Immunosorbent Assay , Hematopoietic Stem Cell Transplantation , Immunohistochemistry , Immunoprecipitation , Mice, Inbred BALB C , Sensitivity and SpecificityABSTRACT
Medical science and technology are important as they concerns people's life. Innovation of medical science and technology is therefore significant for the development of the science and technology. This article discussed the current situation of medical science and technology in China,and analyszed its opportnities and challenges. In addition, strategies for its development during the Twelfth Five-year Plan period are proposed, namely, to develop HLS, construct the innovative systems of medical science and technology, and to promote the coordinated development of the medicine and science and technology.
ABSTRACT
Objective To study the correlation of HBV infection pretransplantation and posttrans-plantation and HCMV recurrence after liver transplantation (LT). Methods We reviewed historical patient medical records of LT patients in recent two years in our hospital. All the patients were divided into HBV in-fection group and a control group based on a peripheral blood HB antigen assay before LT. The HBV infec-tion group was divided into HBV reactive infection group and HBV non-relapse group. HCMV antigen pp~65 was detected by immunohistochemical methods. HB antigens and antibodies were detected by time-resolved fluorescence immunoassay, and liver enzyme levels were detected by conventional methods. Results Com-paring two groups of patients, pp65-positive rates of LT patients with HBV infection and control group pa-tients were 84.3% and 57.9% respectively (P=0.024). While in HBV recurrence infection group and non-recurrence infection group, the incidences of HCMV recurrence were 90.9% and 83.3% (P=0.843). The changes in the liver transaminases level in both groups have no statistical significance (P>0.05). Conclusion Pretransplantation HBV infection may increase the incidence of HCMV recurrence. Posttrans-plantation HBV reactive infection, however, may not increase the incidence of HCMV reactive infection. Meanwhile, compare with either HBV infection or HCMV infection alone, co-infection may not serious in liv-er enzymes levels.
ABSTRACT
Community Health Committee (CHC), an innovative public participation mechanism of grassroots health service management, established a bottom-up communication channel between the public and government to communicate health related problems and opinions, and set up a grassroots community health services supervision system. The rural residents were endowed with opportunities to take part in grassroots health care decision making and management by CHC. CHC changed the top-down model of traditional health management, improved the grassroots medical services, and increased governance capability of local government We introduced the CHC practice in Zhejiang project counties, exhibited the primary effects and experience of this pilot program, and explored new mechanism and model for rural community residents to participate in grassroots health service management
ABSTRACT
Objective To investigate JC virus(JCV) infection in kidney transplant recipients and its influence on graft function and also initially explore JCV infection factors. Methods A total of 49 kidney transplant recipients and 24 health examination persons were enrolled in our study, JCV DNA was measured using nested qualitative polymerase chain reaction assays of urine, while CMV DNA was measured by common qualitative polymerase chain reaction assays of urine. JCV infection factors, such as age, male, immunosuppressive therapy, cytomegalovirus(CMV) infection were analyzed by Binary Logistic Regression, and glomerular filtration rate(GFR) was selected as a index of kidney function and the difference of GFR between JCV-infected and non-infected patients was compared using t test. Results JCV was detected in 42.9% of kidney transplant patients and 4.2% health examination persons. CMV infection and Pred + MMF + CsA triple immunosuppressive regimen were found to be the risk factors of JCV infection. No difference of GFR was observed between JCV infected and non-infected patients (86.470 ± 29.990 and 84.060 ± 33. 729 for each; t =0. 259, P =0.797). Conclusion JCV is frequently detected in kidney transplant recipients. CMV infection and using of Pred + MMF + CsA triple immunosuppressive regimen can significantly increase the risk of JCV infection. While, graft function was not influenced by JCV infection in kidney transplant patients.