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ObjectiveTo evaluate the implementation effect of the basic public health service project in Jiangbei District of Chongqing， so as to provide a basis for further improving the service content and social/economic benefits of the project. MethodsThe evaluation was conducted according to the “National Basic Public Health Service Regulations”， “National Basic Public Health Service Project Performance Evaluation Guidance Plan” and the assessment indicators， indicator requirements and weights of each project. The items were evaluated one by one， and each item was calculated and compared to obtain the trends in the three years from 2018 to 2020. ResultsThe evaluation results showed that the twelve contents of the basic public health service projects in Jiangbei District either met or exceeded the national requirements. The overall effect increased year by year， from 71.73 to 78.74 points. Eight of the twelve service contents have improved year by year， among which the report and processing of information related to infectious diseases and public health emergencies reached 100%， and the vaccination rate of “eight vaccines” reached 97%. Maternal and children （0-6 years old） health care increased significantly， rising by 39.89% and 36.62% respectively. Chronic disease health management was unsatisfactory. ConclusionThe effects of implementation of the basic public health service project is significant， and the service quality has improved year by year. The service content and assessment indicators are still imperfect and is worth of further research.
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【Objective】 To investigate the distribution frequency of RBC rare blood group among blood donors in Chongqing, so as to provide basic data for the establishment of regional rare blood group donor database. 【Methods】 A total of 14 805 voluntary blood donors of Chongqing Blood Center from December 2020 to May 2021 were screened for Jk(a-b-) phenotype of Kidd blood group system by urea hemolysis test and confirmed by saline agglutination test. The indirect anti-globulin test was used to screen the Fy(a-) phenotype of Duffy blood group system, s-phenotype of the MNS blood group system and k- phenotype of Kell blood group system in 1 466 O type blood donors. The polyamine test was used to screen the Di(b-) phenotype of Diego blood group system in 856 voluntary blood donors, and confirmed by anti-globulin test. 【Results】 Among the voluntary blood donors in Chongqing, the proportion of Jk(a-b-) phenotype was 0.0203% (3/14 805). The ratio of both Fy(a-b+ ) and S+ s- phenotype among type O blood donors was 0.136 4% (2/1 466), and k- phenotype was not seen. The proportion of Di(a+ b-) phenotype among 856 blood donors was 0.233 6% (2/826). 【Conclusion】 The distribution frequency of rare blood group antigens in the above five blood group systems in Chongqing voluntary blood donors presents regional characteristics.
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OBJECTIVES@#To understand the perceptions of doctors, patients and forensic examiners on the current situation of medical disputes and medical damage identification in China, and to explore the medical damage identification model that is more conducive for the resolution of medical disputes.@*METHODS@#A questionnaire was designed, and in-service clinicians, forensic examiners and inpatients in Sichuan Province and Chongqing City were randomly selected from April to November 2019. SPSS 22.0 software was used to analyze the data of various survey results.@*RESULTS@#Compared with patients (24.92%), doctors (61.72%) believed that the current doctor-patient relationship was more tense than before; both doctors and patients were more inclined to choose voluntary consultation and people's mediation to resolve medical disputes; forensic examiners have the highest level of cognition of medical and health-related laws and regulations, followed by doctors and patients; 66.72% of doctors and 78.41% of patients believed that medical damage identification was necessary, and they were more inclined to entrust forensic identification institutions; different groups all believed that forensic examiners and doctors should participate in the identification together, 80.94% of doctors believed that the appraisal institutions should be responsible for the forensic opinion, not the appraiser.@*CONCLUSIONS@#It is suggested that the Medical Association identification and forensic identification should learn from each other and formulate basic unified rules for the identification of medical damage. It is suggested to standardize the behavior of medical damage forensic identification institutions and appraisers, to improve their own appraisal level, actively invite clinical medical experts for consultation in identification, and promote the standardized, scientization of forensic identification.
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Humanos , China , Disentimientos y Disputas , Medicina Legal , Relaciones Médico-Paciente , Encuestas y CuestionariosRESUMEN
Objective@#To investigate the current prevalence of latent tuberculosis infection (LTBI) among residents living in Nanchuan District, Chongqing Municipality, so as to provide the evidence for formulating LTBI control measures.@*Methods@#The residents living in one street and one township from Nanchuan District were randomly selected using the multistage cluster sampling method during the period between January and April, 2020, and their demographic information, smoking history, history of alcohol consumption, history of contacts with tuberculosis patients and Bacillus Calmette-Guérin ( BCG ) vaccination scars were collected. The infection of Mycobacterium tuberculosis was detected using interferon gamma release assay ( IGRA ), and a positive IGRA test and exclusion of active tuberculosis was defined as LTBI. The prevalence of LTBI was descriptively analyzed among the study subjects.@*Results@#Totally 1 000 residents were recruited, including 381 males and 619 females, with a male to female ratio of 0.62∶1. The mean age was ( 45.87±18.40 ) years. Among all participants, there were 222 smokers ( 22.20% ), 247 subjects consuming alcohol (24.70%), 62 subjects with a history of contacts with tuberculosis patients ( 6.20% ) and 904 subjects with BCG scars ( 90.40% ). A total of 198 residents were diagnosed with LTBI (19.80% prevalence), and a higher prevalence rate of LTBI was seen in men than in women ( 23.36% vs. 17.61%; χ2=4.911, P=0.027 ). The prevalence of LTBI was significantly higher in married/divorced/widowed residents than in unmarried residents ( 24.22% vs. 2.01%; χ2=49.514, P<0.001 ), and significantly greater prevalence was found in smokers than in non-smokers ( 27.93% vs. 17.48%; χ2=11.871, P=0.001 ). The prevalence of LTBI appeared a tendency towards a rise with age ( χ2trend=59.100, P<0.001 ) and body mass index ( χ2trend=9.479, P=0.002 ).@*Conclusions@#The prevalence of LTBI is high among residents living in Nanchuan District, notably among elder, male smokers with high body mass index. Risk monitoring and timely interventions are required.
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OBJECTIVE To provide reference for the safety of drug use in children and the rational drug use management strategies by health administration departments. METHODS A self-designed questionnaire was used to investigate the cognition of antibiotics and the parents ’behavior of children ’s use of antibiotics ，using online and offline questionnaires. Univariate analysis was carried out on the scores of respondents ’cognition，and multivariate Logistic regression analysis was carried out on the factors affecting parents ’behavior of children ’s use of antibiotics. RESULTS A total of 1 068 questionnaires were distributed ，and 993 valid questionnaires were recovered ，with the effective recovery rate of 93.0％. Among the respondents ，43.2％ of the parents ’ behavior of children ’s use of antibiotics in the past 6 months. The score of respondents ’cognition，high treatment cost and cumbersome treatment procedures ，easy access to antibiotics ，certain medication experience ，the recommendation of pharmacists in drug store ，the recommendation of relatives and friends and the publicity of mass media were positively correlated with parents ’ behavior of children ’s use of antibiotics （P＜0.05）. CONCLUSIONS The rate of the parents ’in Sichuan-Chongqing area is high ， which is the result of a combination of several factors. Reducing the risk of behavior of children ’s use of antibiotics requires the joint efforts of the government ，medical institutions and the public. The parents ’cognition towards antibiotics should be improved ，and the acquisition of antibiotics should be standardized so as to reduce unreasonable use of antibiotics.
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OBJECTIVE@#To investigate the hematological characteristics and genotype distribution of thalassemia among people at reproductive age in Chongqing.@*METHODS@#Hematology analysis and capillary electrophoresis were performed in 29 145 participants at reproductive age. The patients with positive results were confirmed by thalassemia genotyping. Genotype distribution and characteristics of mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and hba2 levels in thalassemia patients were analyzed.@*RESULTS@#--SEA/αα (45.10%), -α3.7/αα (39.31%) and -α4.2/αα (8.46%) were the most common genotypes of α-thalassemia, while CD17 (HBB: c. 52A>T) (31.67%), CD41-42 (HBB: c. 126-129 del TTCT) (26.87%) and IVS-Ⅱ-654 (HBB: c. 316-197 C>T) (24.21%) were the most common genotypes of β-thalassemia in Chongqing. In α-thalassemia ααCS/αα showed the lowest hba2 value (2.18±0.23)%, while --SEA/αα showed the lowest MCV (71.9±8.5) fl and MCH (22.7±3.3) pg value. The patients in βE (HBB: c. 79G>A) group showed comparatively higher values of MCV and MCH and significantly lower HbA and hba2 values than the other genotypes. There was no significant difference in HbA, hba2, MCV, MCH levels of the patients between pregnant group and non-pregnant group.@*CONCLUSIONS@#In Chongqing, there are differences in hematological characteristics among patients with different thalassemia genotypes. There is no significant effect of pregnancy on HbA, hba2, MCV and MCH has been found.
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Femenino , Humanos , Embarazo , China , Índices de Eritrocitos , Genotipo , Mutación , Talasemia alfa/genética , Talasemia betaRESUMEN
【Objective】 To explore the characteristics and prevalence of HBV infection among voluntary blood donors in Chongqing and analyze its epidemiological characteristics, so as to provide reference for effective selection of low-risk blood donors. 【Methods】 The test results of hepatitis B surface antigen (HBsAg) and viral nucleic acid (HBV DNA) of 314 442 voluntary blood donors from October 2017 to October 2020 in Chongqing Blood Center were retrospectively analyzed. The relationship between the total positive rate of HBV, HBsAg+ /HBV DNA-, HBsAg-/HBV DNA+, HBsAg+ /HBV DNA+ and gender, marriage, age, education background, occupation, firs-time blood donation and repeated blood donation was analyzed. 【Results】 Among the 314 442 voluntary blood donors, the total positive rate of HBV, HBsAg+ /HBV DNA-, HBsAg-/HBV DNA+ and HBsAg+ /HBV DNA+ was 0.88% (2 764/314 442), 0.28% (893/314 442), 0.18% (567/314 442) and 0.41% (1 304/314 442), respectively. The total positive rate of HBV, HBsAg-/HBV DNA+ and HBsAg+ /HBV DNA+ was different in gender, marriage, age, education background, occupation and firs-time/repeated blood donation. The positive rate of men was higher than that of women, and that of married higher than that of unmarried, and decreased as the education level elevated.The positive rate of farmers and workers was the highest and that of medical staff was the lowest, followed by students, military personnel, civil servants, and teachers. The positive rate of first-time blood donors was higher than that of repeated blood donors. The differences were statistically significant (P0.05). 【Conclusion】 The prevalence of HBV among voluntary blood donors in Chongqing is relatively high and is related to gender, marriage, age, education background, occupation, and first-time/repeated blood donation. It is necessary to strengthen effective consultation before blood donation, formulate guidelines for blood donation recruitment, select voluntary blood donors from low-risk groups to improve blood safety.
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Objective To understand the status of radiological diagnosis and radiotherapy in southeaster Chongqing area, and to provide evidence for health authorities to carry out radiological diagnosis and radiotherapy management. Methods The questionnaire survey was carried out in radiological diagnosis and radiotherapy institutions. Results In 2020 there are 224 radiological diagnosis and radiotherapy institutions, including 3 tertiary hospitals and 16 secondary hospitals. Three hospitals carried out radiotherapy, two hospitals carried out nuclear medicine, and seven hospitals carried out interventional radiology. There were 376 sets of radiological diagnosis and radiotherapy equipment, and the number of DR and CT machine was large (58.8% and 14.9% respectively). There were 786 radiological workers (66.9% male), and most of them were X-ray diagnostic workers (85.8%). There were 977, 043 cases of routine X-ray diagnosis(application frequency of 357.7 per 1000 population), mainly in the first level and below hospitals (accounting for 45.3%). There were 391, 067 cases of CT diagnosis (application frequency 143.8 per 1000 population), mainly in secondary hospitals (66.0%). 4860 patients received interventional therapy (application frequency 1.78 per 1000 population) and 781 patients received radiotherapy (application frequency 0.003 per 1000 population), mainly in tertiary hospitals (55.3% and 69.8% respectively). Conclusion Radiological diagnosis and radiotherapy resources in southeast Chongqing area backward and unevenly developed, and there are few hospitals carrying out radiotherapy, nuclear medicine and interventional radiology. Except for Qianjiang district, the level of radiological diagnosis and radiotherapy in the other five districts and counties (autonomous counties) is weak, it is necessary to further improve the level of radiological diagnosis and radiotherapy.
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Chengdu-Chongqing economic circle is centered on Chengdu City and Chongqing Municipality, with aims to build the “fourth growth pole” of China’s economy. During this circle, elimination of schistosomiasis had been achieved in 82.5% of the endemic counties (districts) of Sichuan Province, and schistosomiasis is not historically endemic in Chongqing Municipality; however, there is still a risk of schistosmiasis transmission in Sichuan Province and Chongqing Municipality because the natural and social factors affecting schistosomiasis transmission have not been completely eliminated in these areas. Based on the endemic situation of schistosomiasis in Sichuan Province and Chongqing Municipality, we analyzed the opportunities and challenges of schistosomiasis control during the construction of Chengdu-Chongqing economic circle, and proposed the corresponding suggestions, so as to provide insights into the sustainable development of schistosomiasis control in the context of the Chengdu-Chongqing economic circle construction.
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OBJECTIVE：To provide reference for clinical treatment of Acinetobacter baumannii infection and rational use of antibiotics. METHODS ：By retrospective analysis ，64 500 strains of bacteria were isolated from the inpatients of our hospital during Jan. 2015 to Dec. 2018. WHONET 5.6 software was used to analyze the detection rate ，specimen type ，departments of A. baumannii. The resistance of A. baumannii to 18 commonly used antibiotics in 4 years was analyzed by RxC table χ 2 test. RESULTS：A total of 2 072，2 040，2 017 and 2 143 strains of A. baumannii were isolated during 2015-2018，accounting for 12.85％，13.38％，13.60％，11.71％ of positive specimens. The main specimen types of 8 272 strains of A. baumannii were sputum（4 368 strains，52.81％），pus（1 106 strains，13.37％），ascites（804 strains，9.72％）. The main departments were burn department（1 605 strains，19.40％），hepatobiliary department （1 200 strains，14.51％），brain surgery department （977 strains， 11.81％）. The drug resistance rate to 18 kinds of antibiotics showed a wave-like decreasing trend （P＜0.001）. In 2018，drug resistance rate to ampicillin and aztreonam was more than 80％，and that to ampicillin/sulbactam ，ceftazidime，levofloxacin， Compound sulfamethoxazole ，gentamicin，amikacin，tobramycin and tegacyclin was less than 50％ ，among which the drug resistance rate to amikacin and tegacyclin were 14.7％ and 0，respectively. CONCLUSIONS ：There is no significant change in the number of isolates and detection rate of A. baumannii in our hospital between 2015 and 2018. The bacteria mainly cause respiratory tract infection. Amikacin or tegacyclin are recommended for treatment.
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OBJECTIVES@#To analyze the causes of perinatal death and related factors from the perspective of forensic medicine, and to provide references for reducing perinatal mortality and guidance for forensic identification.@*METHODS@#A retrospective analysis was performed on 102 cases of perinatal autopsy with clinical data from the Department of Forensic Medicine of Chongqing Medical University in 2004-2016.@*RESULTS@#Of the 102 cases of perinatal deaths, 66 （64.71%） were neonatal deaths, 24 （23.53%） were stillborn foetuses, and 12 （11.76%） were stillbirths. Among the 66 neonatal death cases, 39 （59.09%） died within 1 d, 19 （28.79%） died within 1-3 d, and 8 （12.12%） died within >3-7 d of birth. The top 3 causes of neonatal death were pulmonary diseases, congenital malformation, umbilical cord and placental abnormalities. The causes of stillborn foetus and stillbirth were mainly umbilical cord and placental abnormalities, and intrauterine asphyxia.@*CONCLUSIONS@#Pulmonary diseases, umbilical cord and placental abnormalities, and congenital malformations are the main causes of perinatal death. In order to reduce the perinatal mortality, pre-pregnancy examination and prenatal care should be strengthened, and the knowledge of pregnancy care should be popularized.
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Femenino , Humanos , Lactante , Embarazo , Autopsia , Causas de Muerte , Mortalidad Infantil , Estudios Retrospectivos , MortinatoRESUMEN
Objective@#To analyze the prevalence of pneumoconiosis and civil aid and medical care among Xiangyang-Chongqing railway construction workers in Chongqing from 2011 to 2018, so as to provide scientific basis for prevention and control of pneumoconiosis.@*Methods@#The Chongqing database of Xiangyang-Chongqing railway construction workers cases from 2011 to 2018 were subjected to systematic collected. SPSS 18.0 was adopted for statistical description and analysis.@*Results@#From 2011 to 2018, a total of 7031 silicosis cases were diagnosed, and 5827 cases were existed, including 4056 cases of stage I, 1491 cases of stage II, and 280 cases of stage III. The cases were concentrated in the area along the southwest to northeast of Chongqing. The diagnosis age of silicosis patients was mainly 60~64 years old (69.73%) . Most silicosis cases were the drill workers and the stone workers. The exposure time of silicosis patients was short and concentrated in 3 years. The 5827 cases of pneumoconiosis in the Xiangyang-Chongqing railway were all treated with special civil aid and medical care for pneumoconiosis in the Xiangyang-Chongqing railway.@*Conclusion@#The prevalence of silicosis among workers who participated in Xiangyang-Chongqing railway construction remained serious. Civil aid and medical care covers all silicosis patients. Occupational health surveillance for silicosis and assistance should be carried out in these workers.
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Objective The purpose of this paper is to study the problems and challenges faced by the university in the management of science funds,in order to provide evidence for improving the management level of science funds at university,at the same time to provide possible reference for other universities.Methods Through retrospective analysis of the application and funding of the National Natural Science Foundation of China of Chongqing Medical University during the period of 2013 to 2018.Results In recent years,the funding level of science funds in our university has entered the bottleneck period,main influencing factors include policy,talents,management and so on.Conclusions It is suggested to strengthen the top-level design of scientific research management,strengthen the training of scientific research personnel,and ensure the capability of scientific research management.
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Objective To investigate the related factors of soil-transmitted nematode infections in Chongqing City, so as to provide the basis for scientific prevention and treatment of the infections. Methods From 2011 to 2015, the stool samples of residents of the surveillance sites in Chongqing City were collected every year, and the soil-transmitted nematode eggs were examined by the modified Kato-Katz thick smear method (three smears for a single stool sample). The respondents were surveyed by questionnaires, and the factors affecting soil-transmitted nematode infections were identified. Results The prevalence of human soil-transmitted nematode infections were 6.44%, 7.30%, 6.85%, 6.93% and 5.56% in Chongqing City from 2011 to 2015, respectively. The more unclean drinking water and the lower frequency of washing hands after using the toilet were the risk factors for Ascaris lumbricoides infection. The more harmless toilets, the higher level of fertilizer application, the lower frequency of drinking raw water, and the lower frequency of food without washing were the protective factors for A. lumbricoides infection. Conclusions The local soil-transmitted nematode infections are at a low epidemic level in Chongqing City, and it is necessary to ad-here to the classified guidance, comprehensive prevention and further monitoring on the basis of health education, water and toilet improvement, and environmental sanitation improvement in order to consolidate the prevention and control achievements.
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Objective To investigate the related factors of soil-transmitted nematode infections in Chongqing City, so as to provide the basis for scientific prevention and treatment of the infections. Methods From 2011 to 2015, the stool samples of residents of the surveillance sites in Chongqing City were collected every year, and the soil-transmitted nematode eggs were examined by the modified Kato-Katz thick smear method (three smears for a single stool sample). The respondents were surveyed by questionnaires, and the factors affecting soil-transmitted nematode infections were identified. Results The prevalence of human soil-transmitted nematode infections were 6.44%, 7.30%, 6.85%, 6.93% and 5.56% in Chongqing City from 2011 to 2015, respectively. The more unclean drinking water and the lower frequency of washing hands after using the toilet were the risk factors for Ascaris lumbricoides infection. The more harmless toilets, the higher level of fertilizer application, the lower frequency of drinking raw water, and the lower frequency of food without washing were the protective factors for A. lumbricoides infection. Conclusions The local soil-transmitted nematode infections are at a low epidemic level in Chongqing City, and it is necessary to ad-here to the classified guidance, comprehensive prevention and further monitoring on the basis of health education, water and toilet improvement, and environmental sanitation improvement in order to consolidate the prevention and control achievements.
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OBJECTIVE： To investigate the current status of pharmacists in public hospitals from Chongqing after the comprehensive reform of public hospitals， to put forward countermeasures and suggestions. METHODS： In questionnaire survey， pharmacists were selected from 33 public hospitals of secondary grade and above in Chongqing as survey objects. The current status of pharmacists in public hospitals of Chongqing from Sept. to Aug. 2018 was collected and surveyed in respects of the basic situation of pharmacists， the impact of medical reform policies， acceptance and professional development requirements of pharmacists. RESULTS： Totally 33 medical institutions included 13 third-grade hospitals and 20 secondary hospitals. A total of 838 questionnaires were distributed and 702 questionnaires were effectively recovered with effective recovery rate of 83.8％. According to the survey results， the majority of pharmacists in public hospitals of Chongqing were 25-35 years old （50.6％）； 8 （1.1％） had doctor’s degree， 86 （12.3％） had master’s degree， and 25.9％ had junior college and technical secondary schools. The number of master’s and doctor’s degrees in third-grade hospitals was higher than that of secondary hospitals， but there were still junior college and technical secondary school degrees in third-grade hospitals. Pharmacists were mainly referred to as middle and junior titles， 217 of which were middle-level titles （30.9％）， and 434 were primary titles（61.8％）； the majors were mainly pharmacy （64％）， followed by traditional Chinese pharmacology （18.7％）. Most of the working years were within 10 years （54.9％）. There were 274 people （39.0％） with an annual income of less than 50 000 yuan， 342 people （48.7％） with an annual income of 50 000- 100 000 yuan and only 86 people （12.3％） with an annual income of more than 100 000 yuan. After the implementation of new medical reform， 430 people （61.3％） thought that the workload had increased significantly or slightly， 99 people （14.1％） thought that the scope of work was significantly expanded， and 433 people thought that the annual income after medical reform was slightly reduced or significantly reduced （61.7％）； 253 people （36.0％） believed that hospital leaders did not pay attention to and did not pay much attention to pharmacists； 294 （41.9％） believed that medical staffs relatively accepted or highly accepted pharmacists. The reasons why pharmaceutical staffs thought that they were not valued mainly included five aspects， including that patients did not understand them； clinical medical staff did not agree with them； leaders did not pay attention to them； corresponding systems and regulations lacked； professional quality lacked. The main work content of pharmacists was mainly based on drug dispensing， and there were fewer people carrying out clinical pharmaceutical care， pharmacy management， pharmaceutical administration and quality control， preparation， pharmaceutical research. The jobs that they hoped to engage in were clinical pharmaceutical care， drug dispensing， pharmaceutical administration and quality monitoring， etc. Pharmacists believed that drug dispensing and delivery， reviewing medical orders， medication education guidance， consultation and medication counseling， drug management were important skills. The pharmaceutical staffs were good at skills， such as medical order review， medication education guidance， drug management. CONCLUSIONS： At present， the pharmacists in public hospitals of Chongqing have some problems， such as low education level， few clinical pharmaceutical professionals， low overall income and not recognized. It is suggested to protect the role and position of pharmacists in the medical treatment process from the perspective of introducing highly educated personnel of clinical pharmacy， improving the professional and educational structure of pharmacists， changing the pharmaceutical care mode， and improving their own ability and treatment.
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OBJECTIVE： To analyze the effect of the national designated production pilot policy for drug in shortage in China. METHODS： Taking 2 batches of drugs from 7 designated production manufacturers in Chongqing from Sept. 2012 to Sept. 2018 as an example， the overall supply situation of designated production （using the average satisfaction rate of medical institution’s order as index）， the changes of drug supply （average satisfaction rate of order） before and after the implementation of national designated production policy （during designated production period and non-designated production period） were all analyzed. According to the level of medical institutions and the order quantity of medical institutions （three sections： small amount， suitable， big amount）， the classification analysis was carried out. At the same time， telephone interview was conducted among the business personnel of related pharmaceutical production enterprises to understand and summarize the reasons for the supply problems of these drugs. RESULTS： Except for the average satisfaction rate of drug order was 0 in one designated production manufacturers， the satisfaction rate of drug order in the other 6 designated production manufacturers ranged from 58.05％ to 92.31％. During the designated production period， the satisfaction rate of drug order was increased significantly， compared with non-designated production period. However， after the expiration of the designated production of drugs， the order satisfaction rate mostly declined， and satisfaction rate of some drug orders were even lower than that before designated production. Average satisfaction rate of drug order in third level medical institution was higher than those of second level， first level or primary medical institutions. During designated production period， the average satisfaction rate of drug order in designated production manufacturers to medical institutions at all levels was higher than during non-designated production period or in non-designated production enterprises. There are 5 kinds of reasons for supply problem of designated production and drug with same specification： the limited price is lower than the cost； the production is stopped due to raw material； the production is stopped because of enterprise； the medical insurance payment price is far lower than the supply price； the hospital demand is small. CONCLUSIONS： The designated production pilot policy has played a significant role in improving the shortage of drug supply， but it still needs to be improved by establishing a dynamic adjustment mechanism for the scope， price and duration of designated drug production.
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Great achievements have been made in higher medical education in Chongqing, China. Among the western provinces and cities, Chongqing has relatively high quantity and quality indicators of medical education institutions . Within the whole country , Chongqing has a medium level of the key indicators of medical education, and there is still a gap between Chongqing and the economically developed provinces such as Zhejiang and Guangdong. Among the four centrally administered municipalities, Beijing and Shanghai have rich medical education resources, and there is a large gap between Chongqing and Beijing/Shanghai in the level of medical education, the number of academicians, and the number of hospitals included in the top hundred hospitals in China . Recently , Chongqing University started to establish a medical school, and University of Chinese Academy of Sciences started to construct an affiliated hospital named Chongqing Hospital in cooperation with Chongqing Municipal Health Planning Commission, which provided valuable opportunities for the development of higher medical education in Chongqing. Chongqing should increase the investment in basic research and development of medical science and technology, seize the strategic opportunity of"Internet+medicine", and gather the talents in medical science and technology, so as to promote the integration and development of military-civilian medical education and improve the level of higher medical education.
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Objective To understand the basic medical literacy status of Chongqing residents in 2016 and it’s influencing factors. Methods From August to December of 2016, multi-stage stratified cluster random sampling and PPS method were used to extract 15-69 years permanent residents from 34 counties in Chongqing to investigate residents' status and influencing factors of basic medical literacy by paper questionnaire survey, and SPSS 21.0 software was adopted for data analysis, and multi-factor logistic regression analysis was used for main result. Results The basic medical literacy level of Chongqing residents was 10.59% in 2016. 8 217 people were surveyed and 8 214 valid questionnaires for this analysis were completed. The ratio of urban and rural population was 0.43:1 and sex ratio was 1.02:1. Multi-factor logistic regression analysis showed that education level was an important factor affecting the basic medical literacy of residents. Conclusion The basic medical literacy level of Chongqing residents in 2016 is still at a low level, and the education and region are the main influencing factors, so it is necessary to carry out targeted health educational and health promotion activities.
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Objective To learn the command of basic theories, basic knowledge and basic skills, as well as strict requirement, strict attitude and strict behavior(three basics and three strictness)of clinicians at secondary and above public hospitals in Chongqing. Methods In this study, the examination scores of 1 650 clinicians from 55 such hospitals were assessed in terms of their three basics and three strictness performance during November 9-11 of 2016. The data were analyzed with t test and descriptive statistics. Results The theory scoring and skill scoring of all the clinicians averaged 61.25 ± 0.72 and 68.19 ± 21.12 respectively. Theory scoring and skill scoring of tertiary hospital clinicians were significantly higher than those at secondary(P＜0.05). The skill scoring of teaching hospital clinicians averaged 74.87 ± 20.67, higher than those at non-teaching hospitals(67.38 ± 21.07, P=0.045). Conclusions The basic medical quality lacks due attention by medical institutions at all levels, and the training and assessment of clinicians on three basics and three strictness fall far behind. The clinicians rely heavily on large medical equipments for their diagnoses, neglecting most basic diagnostic skills. Basic medical quality of the city can only be enhanced by strengthening the training and assessment of three basics and three strictness for clinicians.