Identification and Genotypic Characterization of Potentially Pathogenic Acanthamoeba Isolated from Tap Water in Wuxi, China

Members of genus Acanthamoeba are widely distributed in the environment. Some are pathogenic and cause keratitis and fatal granulomatous amoebic encephalitis. In this study, we isolated an Acanthamoeba CJW/W1 strain from tap water in Wuxi, Jiangsu Province, China. Its 18S rDNA was sequenced and a phylogenetic tree was constructed. The isolated cysts belonged to morphologic group II. Comparison of 18S rDNA sequences of CJW/W1 strain and other isolates showed high similarity (99.7%) to a clinical isolate Asp, KA/E28. A phylogeny analysis confirmed this isolate belonged to the pathogenic genotype T4, the most common strain associated with Acanthamoeba-related diseases. This is the first report of an Acanthamoeba strain isolated from tap water in Wuxi, China. Acanthamoeba could be a public health threat to the contact lens wearers and, therefore, its prevalence should be monitored.

Study on the Implementation Status of Drug Procurement with Target Quantity of Public Hospitals in China / 中国药房

OBJECTIVE:To provide reference for improving the drug procurement system of public hospitals in China. METH-ODS:The drug collective procurement documents in each province were retrieved after publishing the document [2015] No.7 of the State Council and the document [2015] No.70 of the National Health and Family Planning Commission,the drug bidding data was collected,and form and implementation of drug procurement with target quantity were analyzed. RESULTS:Procurement with tar-get quantity included scattered procurement with target quantity,national centralized procurement with target quantity and provin-cial centralized procurement with target quantity. In scattered procurement with target quantity,actual purchase price was opaque, and the procurement was similar to"second negotiation"in individual province. National centralized procurement with target quanti-ty was implemented well. Provincial centralized procurement with target quantity was not fully implemented,only Shanghai carried out centralized procurement with target quantity,and the pilot had good effects. CONCLUSIONS:In order to promote procurement with target quantity,it's suggested that we should definite"procurement with target quantity"in the governmental document,pub-lish actual procurement price of scattered procurement with target quantity,try to implement centralized procurement with target quantity without quality levels distinguished,improve the centralized procurement with target quantity with quality levels distin-guished and improve supporting measures,such as hospital procurement system,provincial procurement platform, pre-payment mechanism by health-care funds,and so on.

Discussion on Medical Costs Control in China from the Perspective of the Relationship among Doctors, Hospitals and Health Insurance Institutions in the United States / 中国药房

OBJECTIVE:To provide reference for medical costs control in China. METHODS:Based on main characteristics of the United States health service system,information asymmetry,principal-agent theory and Freedman’s consumption theory were used to analyze the advantages of restrictive relationship among doctors,hospitals and health insurance institutions in control-ling medical costs and improving the quality of diagnosis and treatment. The growth rate of medical cost,the percentage of drug ex-penditure and other aspects were compared between China and the United States;the effect of restrictive relationship on medical cost control was demonstrated. RESULTS & CONCLUSIONS:In the United States,there are hierarchical medical system and two-way referral system;for-profit hospitals and non-profit hospitals are mutually complementary;different natures of health insur-ance system,different payment methods and strict“commercial bribe”monitoring system are carried out;doctors,hospitals and health insurance restrict each other. Not only there are many advantages in theory,but also in practice the growth rate of medical cost and the percentage of drug expenditure are superior to our country. Finally it controls the rapid growth of medical cost to a cer-tain extent. Combined with our national conditions,learning from the United States experience,restrictive relationship among doc-tors,hospitals and health insurance institutions is established to control the increase of medical cost in China through reducing infor-mation asymmetry and standardizing payment audit;establishing a scientific pattern of mixed payment;strengthening the indirect impact of the health insurance institutions on doctors and hospitals,etc.