Investigation of the population diversity of intermediate host snails and crabs of Paragonimus along Jiulong River, Zhangjiang River and Dongxi River basins in southern Fujian Province / 中国血吸虫病防治杂志

Objective To investigate the population distribution of intermediate host snails and crabs of Paragonimus along the Jiulongjiang River, Zhangjiang River, and Dongxi River basins in Bopingling Mountain, southern Fujian Province, so as to provide baseline data for researches on parasitic disease prevention and control and enlargement of samples in the parasitic resource bank. Methods A total of 23 villages in 8 counties (districts) along the Jiulong River, Zhangjiang River, and Dongxi River basins in Zhangzhou City, Fujian Province were selected as survey sites during the period from November 2020 through March 2023, and snail and freshwater crabs were sampled from 1 to 3 streams and ditches neighboring residential areas in each village. Morphological identification of snails was performed according to the external morphological characteristics of collected snail shells, and the unidentified snail species sampled from the natural foci of paragonimiasis in Yunxiao County were subjected to se-quence analysis of the mitochondrial cytochrome oxidase 1 (CO1) gene. The crab species was identified by observing the morphological characteristics of the terminal segment of the first pleopod of male crabs, and Paragonimus cercariae and metacercariae were detected in collected snails. Results The shells of the unidentified snails sampled from the natural foci of paragonimiasis in Yunxiao County were approximately 50 mm in height and 18 mm in width, thick and solid, long tower cone-shaped, and had 8 to 10 whorls. CO1 gene sequence analysis identified the snail species as Sulcospira hainanensis. A total of 6 freshwater snail species belonging to 5 genera within 3 families, identified 23 survey sites, including Semisulcospira libertina, Paludomus zhangchouensis and S. hainanensis that belonged to the Family Pleurceridae, Tricula fujianensis and T. huaanensis that belonged to the subfamily Triculinae, Family Pomatiopsidae, and Melanoides tuberculata (Family Thiaridae), and 11 species of freshwater crabs belonging to 5 genera within 2 families were identified, including Sinopotamon genus of S. jianglense, S. pinheense, and S. zhangzhouense, Huananpotamon genus of H. planopodum and H. zhangzhouense, Nanhaipotamon genus of N. huaanense and N. longhaiense, and Minpotamon genus of M. nasicum and M. auritum that belonged to the Family Potamidae, and Somanniathelphusa genus of S. huaanensis and S. zhangpuensis (Family Parathelphusidae). In addition, the prevalence of P. westermani cercariae infections was 0.08% (2/2 317) in P. zhangchouensis from Danyan Village in Changtai District and 0.09% (1/1 039) in S. hainanensis from Jinkeng Village in Yunxiao County, and the prevalence of P. westermani metacercariae infections was 25.81% (8/31) in S. jianglense from Danyan Village in Changtai District, and 26.31% (5/19) in S. zhangzhouense from Jinkeng Village in Yunxiao County, respectively. Conclusions There is a population diversity in the intermediate host snails and crabs along the Jiulongjiang River, Zhangjiang River, and Dongxi River basins in Bopingling Mountain, southern Fujian Province, and P. zhangzhouensis and S. hainanensis are, for the first time, confirmed as the first intermediate hosts of P. westermani.

Epidemiological characteristics of viral hepatitis E in Fujian Province from 2012 to 2021 / 中国热带医学

@#Abstract: Objective To analyze the epidemiological characteristics of viral hepatitis E in Fujian Province from 2012-2021, and to provide scientific evidence for the prevention and control of hepatitis E in the future. Methods Descriptive epidemiological method was used to analyze hepatitis E cases in Fujian Province from 2012 to 2021. Results From 2012 to 2021, a total of 8 877 cases of hepatitis E were reported in Fujian Province from 2012-2021. The overall incidence rate showed a decreasing trend (χ2trend =458.14, P<0.001), with the lowest incidence rate of 1.32/100 000 in 2020 and an annual average incidence rate of 2.29/100 000 per year. The incidence was higher in winter and spring, with the months of March and April having the highest number of reported cases (2 146, 24.17%) and the fewest cases were reported in September (571, 6.43%). The difference in reported incidence rates between cities was statistically significant (χ2=1 877.75, P<0.01). The comprehensive experimental zone of Pingtan had the highest average reported incidence rate of 6.03/100 000, while Zhangzhou had the lowest at 0.94/100 000. The number of male cases was higher than the number of female cases, with a male to female ratio of 2.04∶1. The disease was most prevalent among middle-aged and elderly individuals, with the age group of 40-<65 years having the highest number of reported cases, accounting for 57.44% (5 099/8 877) of all cases. The age group of 50-<55 years had the highest reported incidence, with the number of reported cases increasing with age below 50 years, but decreasing with age over 50 years. As for occupational distribution, peasants had the highest proportion of the disease, accounting for 34.49% (3 062 cases) of the total cases. Conclusions The reported incidence rate of hepatitis E in Fujian showed a downward from 2012 to 2021. Due to the impact of COVID-19, incidence of the lowest was 2020, but it did not reflect the true situation of the disease, which may have affected trend of hepatitis E. In order to control and reduce the incidence of hepatitis E, efforts should be made to increase publicity and education on health knowledge and vaccination among key areas and populations, strengthen monitoring and diagnostic capability, and implement comprehensive prevention and control measures.

Molecular epidemiological characteristics of newly diagnosed HIV-1 cases in Fujian Province in 2020 / 中国血吸虫病防治杂志

Objective To investigate the HIV-1 genotype and distribution of newly diagnosed HIV-1 cases in Fujian Province in 2020, so as to provide insights into formulation of the precise AIDS control strategy in the province. Methods Newly diagnosed HIV-1 cases without antiretroviral therapy (excluding AIDS patients) were randomly sampled from each city of Fujian Province in 2020 at a proportion of 50% of the mean number of HIV-infected cases reported across 9 cities of Fujian Province during the past three years. Subjects’ demographic and epidemiological data were collected and blood samples were collected. The HIV-1 pol gene was amplified using nested reverse-transcription PCR assay, and the gene sequences were used for HIV-1 genotyping and phylogenetic analysis. The gene sequences were uploaded to the HIV Drug Resistance Database (http://hivdb.stanford.edu) for genotypic drug resistance assays, and the scores and level of HIV drug resistance were estimated using the HIVDB Algorithm version 9.5. Results A total of 1 043 newly diagnosed HIV-1 cases were reported in Fujian Province in 2020, and 936 gene sequences were successfully obtained following sequencing of blood samples. There were 9 HIV-1 genotypes characterized in blood samples from 936 newly diagnosed HIV-1 cases, with CRF07_BC (52.1%) and CRF01_AE (30.4%) as predominant subtypes, followed by CRF08_BC (4.9%), CRF55_01B (3.0%), subtype C (2.5%), subtype B (2.1%), CRF85_BC (1.7%), CRF59_01B (0.3%) and CRF65_CPX (0.1%), and unidentified subtypes were found in 26 blood samples. HIV-1 drug resistance was detected in 43 out of the 936 newly diagnosed HIV-1 cases, with 4.6% prevalence of HIV-1 drug resistance prior to therapy, and the highest drug resistance was found in the HIV CRF59_01B subtype, followed by in CRF08_BC, B, C, CRF01_AE, CRF07_BC and other subtypes, with a significant difference in the genotype-specific prevalence of HIV-1 drug resistance (χ2 = 45.002, P < 0.05). Conclusions There was a HIV-1 genotype diversity in Fujian Province in 2020, and emerging recombinant and drug-resistant HIV-1 strains were detected and spread across patients and regions. Monitoring of HIV-1 genotypes is recommended to be reinforced for timely understanding of the transmission and spread of novel recombinant and drug-resistant HIV-1 strains.

Prevalence of Anisakise infections in marine fishes in Eastern Fujian Fishing Ground of Fujian Province / 中国血吸虫病防治杂志

Objective To investigate the prevalence of Anisakis infection in marine fishes in Eastern Fujian Fishing Ground of Fujian Province, so as to provide insights into the development of the anisakiasis control strategy.. Methods Marine fish samples were randomly collected from Jiaocheng District, Fuding City and Xiapu County around Eastern Fujian Fishing Ground in Fujian Province from September to December, 2021. All fishes were dissected, and the abdominal contents were collected. Parasites were sampled under a stereomicroscope and the Anisakis species were identified through morphology. The prevalence and intensity of Anisakis infections were calculated. Results A total of 177 marine fishes belonging to 24 species were dissected, and Anisakis was detected in 73 marine fishes (41.2%) belonging to 16 species (66.7%), with a mean infection intensity of 14.3 parasites per fish. High prevalence of Anisakis infection was found in Ilisha elongata (5/5), Miichthys miiuy (3/3), Plectorhynchus cinctus (2/2), Scomberomorus niphonius (12/13), Trichiurus lepturus (19/23), Pennahia argentata (6/11) and Ditrema temmincki (14/27), with mean infection intensities of 9.2, 2.7, 4.5, 10.9, 39.2, 4.5 parasites per fish and 2.1 parasites per fish. The Anisakis larvae were characterized as Anisakis and Hysterothylacium. Conclusions High prevalence of Anisakis infection is detected in marine fishes in Eastern Fujian Fishing Ground of Fujian Province. The health education pertaining to food health is required to be reinforced to prevent the development of human anisakiasis.

Prevalence of Angiostrongylus cantonensis infection in snails in Fujian Province from 2017 to 2021 / 中国血吸虫病防治杂志

Objective To investigate the prevalence of Angiostrongylus cantonensis infection in market-sold and field-captured snails in Fujian Province, so as to provide the scientific basis for the formulation of the angiostrongyliasis control measures. Methods In each month from May to October during the period from 2017 through 2021, Pomacea snails were collected from two field fixed surveillance sites and Bellamya aeruginosa collected from one agricultural product market in Fuzhou City, while Pomacea and B. aeruginosa snails were collected from two agricultural product markets and four restaurants in Xiamen City. At least 50 Pomacea snails and 500 g B. aeruginosa were sampled each time. A. cantonensis infection was detected in Pomacea snails using lung microscopy, and in B. aeruginosa using a tissue homogenate method. Results A total of 9 531 Pomacea snails were detected for A. cantonensis infection in two cities of Fuzhou and Xiamen, and the overall prevalence of A. cantonensis infection was 4.40%, with the highest prevalence in 2017 (6.82%, 116/1 701) and the lowest prevalence in 2019 (3.46%, 83/2 400). The prevalence of A. cantonensis infection was significantly higher in Pomacea snails sampled from Fuzhou City (11.23%, 326/2 903) than from Xiamen City (1.40%, 93/6 628) (χ2 = 461.48, P < 0.01). A. cantonensis larvae were detected in larval Pomacea snails in two cities of Fuzhou and Xiamen each month. The prevalence of A. cantonensis infection in Pomacea snails appeared an overall tendency towards a rise with month in Fuzhou City, with the highest prevalence in October (15.24%), and there was a significant difference among month (χ2 = 14.56, P < 0.05), while the prevalence of A. cantonensis infection in Pomacea snails was low in Pomacea snails sampled from Xiamen City each month, with the highest prevalence in June (2.64%), and there was a significant difference among month (χ2 = 23.17, P < 0.05). A total of 18 966 B. aeruginosa snails were detected for A. cantonensis infection in two cities of Fuzhou and Xiamen, and the overall prevalence of A. cantonensis infection was 0.01%. Conclusions A. cantonensis infection was identified in Pomacea and B. aeruginosa snails in Fujian Province from 2017 to 2021, and there is a potential risk of human A. cantonensis infection.

Gene Polymorphisms of Patients with Lymphoma-Associated Hemophagocytic Syndrome in Longyan area, Fujian Province / 中国实验血液学杂志

OBJECTIVE@#To analyze the gene polymorphisms of patients with lymphoma-associated hemophagocytic syndrome in Longyan area, Fujian province.@*METHODS@#A total of 125 patients with lymphoma-associated hemophagocytic syndrome in Longyan, Fujian province, admitted to Longyan First Hospital from May 2017 to November 2020 were selected. Peripheral venous blood was collected from all the patients, and the genotypes of perforin 1 (PRF1) and interleukin-10 (IL-10) gene loci were detected by PCR-fluorescence probe method, and the correlation between PRF1 and IL-10 gene polymorphisms and lymphoma-associated hemophagocytic syndrome was analyzed.@*RESULTS@#The mutation frequencies of PRF1 gene loci rs885821 (C>T), rs885822 (C>T), rs1889490 (G>A) in patients with lymphoma-associated hemophagocytic syndrome were 10.40%, 78.8% and 64.4%, respectively. The mutation frequencies of rs1800872 (A>C), rs1800871 (C>T) and rs1800896 (G>A) of IL-10 loci were 56.0%, 45.2% and 77.6%, respectively.@*CONCLUSION@#PRF1 and IL-10 gene loci were polymorphic in patients with lymphoma-associated hemophagocytic syndrome in Longyan area, Fujian province. Alleles C and G of PRF1 and IL-10 were risk factors, and alleles T and A were protective factors.

Diagnosis and treatment of two imported cases with schistosomiasis haematobia in Fujian Province / 中国血吸虫病防治杂志

Objective To analyze the diagnosis and treatment of two imported cases with schistosomiasis haematobia, so as to provide insights into improving the diagnosis and treatment and avoiding misdiagnosis and mistreatment of imported schistosomiasis haematobia. Methods The medical records and epidemiological data pertaining to the two cases were collected. The stool and urine samples were collected for identification of Schistosoma eggs using the Kato-Katz technique and direct smear method after centrifugal precipitation, and blood samples were collected for detection of anti-Schistosoma antibody. Following definitive diagnosis, the patients were given praziquantel therapy. Results The patient 1, a Malagasy, was infected in Madagascar and returned to China for delivery. The case presented intermittent painless terminal hematuria symptoms, and showed no remarkable improvements following multiple-round treatments in several hospitals. In January 2017, she was found to be positive for anti-Schistosoma antibody, negative for feces test, and positive for S. haematobium eggs in urine test, and miracidia were hatched from eggs. Then, the case was diagnosed as schistosomiasis haematobia. Patient 2 worked in Republic of Malawi for many years, and presented intermittent painless terminal hematuria since October 2018; however, no definite diagnosis or effective treatment was received after admission to multiple hospitals. In March 2019, pathological examinations showed a number of eggs in the interstitium of the bladder mass, accompanied by a large number of eosinophils, which was consistent with schistosomiasis cystitis. In April 2019, he was tested positive for serum anti-Schistosoma antibody, negative for the fecal test, and had S. haematobium eggs in urine samples, with miracidia hatched from eggs. Then, the case was diagnosed as schistosomiasis haematobia. Following treatment with praziquantel at a dose of 60 mg/kg, all symptoms disappeared. Conclusions Overseas imported schistosomiasis haematobia is likely to be misdiagnosed. The training pertaining to schistosomiasis control knowledge requires to be improved among clinical professionals, in order to avoid misdiagnosis and mistreatment.

Study on Technological Innovation System of Pharmaceutical Industry in Fujian Province ：Based on System Causal Loop Diagram and Problem Basic Model Analysis / 中国药房

OBJECTIVE：To p rovide reference for improving the level of technological innovation and promoting the high-quality development of pharmaceutical industry in Fujian province. METHODS ：A total of 452 people were interviewed by relevant departments of pharmaceutical industry ，industry associations ，pharmaceutical enterprises and some consumers in Fujian province. After sorting out the interview data ，based on the theory of causal loop diagram and problem basic model methods ，the key variables and problem basic models affecting the technological innovation system of pharmaceutical industry in Fujian province were investigated . The leverage solutions and suggestions were put forward. RESULTS & CONCLUSIONS：The scientific and technological innovation environment ，managers’innovative ideas ，scientific and technological innovation motivation ，enterprise profits，product’s market competitiveness ，social organizations of pharmaceutical industry ，and industrialization of scientific and technological innovation achievements in the technological innovation system of pharmaceutical industry in Fujian province were closely related to the technological improvement of pharmaceutical industry in Fujian province. There were basic modes of “the rich getting richer ”for the technological innovation system of pharmaceutical industry in Fujian province ，i.e. the investment of external resources on scientific and technological innovation of pharmaceutical enterprises was mostly concentrated in the pharmaceutical enterprises above designated size. At the same time ，due to the lack of industry-research-university interaction and the unsmooth achievement transformation channel ，some small and medium-sized pharmaceutical enterprises with the potential of scientific and technological innovation or with traditional advantages may form the problem basic model “to attend to trifles and neglect the essentials”. It is suggested that the subjects related to pharmaceutical industry should give full play to the role of various scientific and technological platforms ，strengthen the attention and support to innovative small and medium-sized pharmaceutical enterprises ， create and optimize the financial service environment for scientific and technological innovation of pharmaceutical enterprises ，and support pharmaceutical enterprises with innovation power and potential to carry out technological innovation projects.

Prevalence of obesity and its relationship with hypertension in the elderly over 65 in Fujian / 公共卫生与预防医学

Objective To investigate current status of obesity and its relationship with hypertension in the elderly over 65 in Fujian. Methods From February 2018 to March 2020, cluster sampling method was used to select 11 203 elderly people over 65 years old from residential areas and villages with concentrated population, representative medical and economic development level in Fujian, such as Fuzhou, Xiamen, Zhangzhou, Quanzhou, Sanming, Putian, Nanping, Longyan and Ningde. All the selected individuals completed the questionnaires, and the basic data including height, weight, waist circumference, hip circumference and blood pressure were measured. Results Among the 11 203 elderly people over the age of 65 in 9 city, there were 5 224 males, 5 979 females, 4 545 patients aged 65-70 years, 3 239 patients aged 70-75 years, 2 200 patients aged 75-80 years, and 1219 patients aged > 80 years. There were 309 cases of low weight (2.76%), 4 971 cases of normal weight (44.37%), 4 362 cases of overweight (38.94%) and 1561 cases of obesity (13.93%). The obesity rate of females was significantly higher than that of males, and the height and overweight rates of males were significantly higher than that of females (P80 age group were lower than those of other age groups, and the detection rate of hypertension was significantly higher than that of other age groups (P<0.05). Conclusion Overweight is more common among the elderly over 65 in Fujian, and the prevalence of hypertension is relatively high among people with low BMI.

COⅠ and 16S rDNA Sequence Identification of Common Necrophagous Flies in Fujian Province / 法医学杂志

Objective To identify the species of common necrophagous flies in Fujian Province by gene fragment sequences of mitochondrial cytochrome c oxidase subunit Ⅰ （COⅠ） and 16S ribosomal deoxyribonucleic acid （16S rDNA）, and to explore the identification efficacy of these two molecular markers. Methods In total 22 common necrophagous flies were collected from the death scenes in 9 different regions in Fujian Province and DNA was extracted from the flies after morphological identification. The gene fragments of COⅠ and 16S rDNA were amplified and sequenced. All the sequences were uploaded to GeneBank and BLAST and MEGA 10.0 software were used to perform sequence alignment, homology analysis and intraspecific and interspecific genetic distance analysis. The phylogenetic trees of DNA fragment sequences of COⅠ and 16S rDNA of common necrophagous flies in Fujian Province were established by unweighted pair-group method with arithmetic means （UPGMA）, respectively. Results The flies were classified into 6 species, 5 genera and 3 families by morphological identification. The results of gene sequence analysis showed that the average number of interspecific and intraspecific genetic distance of 16S rDNA ranged from 1.8% to 8.9% and 0.0% to 2.4%, respectively. The average number of interspecific and intraspecific genetic distance of COⅠ ranged from 7.2% to 13.6% and 0.0% to 6.3%, respectively. Conclusion The gene sequences of COⅠ and 16S rDNA can accurately identify the species of different necrophagous flies, and 16S rDNA showed higher value in species identification of common calliphoridae necrophagous flies in Fujian Province.

Epidemiological characteristics of imported malaria cases in Fujian Province from 2014 to 2018 / 中国血吸虫病防治杂志

Objective To analyze the epidemiological characteristics of imported malaria cases in Fujian Province from 2014 to 2018, so as to provide scientific basis for the development of the control strategy for imported malaria. Methods The epidemiological data of malaria cases in Fujian Province from 2014 to 2018 were retrieved from the Notifiable Disease Reporting System and Parasitic Disease Information Reporting System of Chinese Center for Disease Control and Prevention, and the classification, origin of infections, temporal distribution, spatial distribution, population distribution, reporting institutions and diagnosis were analyzed. Results A total of 540 overseas imported malaria cases were reported in Fujian Province from 2014 to 2018, and all cases were laboratory-confirmed, including 398 cases with falciparum malaria, 88 cases with vivax malaria, 38 cases with ovale malaria, 14 cases with malariae malaria and 2 cases with mixed infections. There were 90.56% (489/540) of the imported malaria cases with infections in 27 African countries, 5.92% (32/540) with infections in 5 Asian countries and 3.52% (19/540) with infections in one Oceania country. There was no significant seasonal distribution of the cases, and the imported malaria cases were predominantly detected in Fuzhou City (80.00%, 432/540) and at ages of 20 to 49 years (81.48%, 440/540). Initial diagnosis was predominantly at the city-level medical institutions, and 77.96% (421/540) were diagnosed as malaria at the initial diagnosis institutions. The median duration from onset to initial diagnosis was 2 days and 70.19% (379/540) were diagnosed within 3 days of onset. The interval between initial diagnosis and definitive diagnosis was 0 day, with 85.37% (461/540) definitively diagnosed within 3 days of initial diagnosis. Conclusions Overseas imported malaria is a continuous problem challenging the malaria elimination programme of Fujian Province. Improving the healthcare-seeking awareness and the diagnostic capability of healthcare workers, and intensifying the monitoring and management of malaria among overseas labors are strongly recommended.

Investigation on seroprevalence of Toxoplasma gondii infections among neonates in Fujian Province / 中国血吸虫病防治杂志

Objective To investigate the seroprevalence of Toxoplasma gondii infections among neonates in Fujian Province, so as to provide insights into the development of interventions for the prevention and control of congenital toxoplasmosis. Methods A total of 1 045 neonates delivered in Fujian Province from 2017 to 2018 were recruited, including 387 preterm infants and 658 full-term infants. Umbilical cord blood was sampled from all neonates, and the seroprevalence of anti-T. gondii IgG antibody was detected and compared between preterm and full-term infants. In addition, elbow venous blood samples were collected from neonates’mothers, and the seroprevalence of anti-T. gondii IgG antibody was detected and compared between preterm and full-term infants’mothers. Results The overall seroprevalence of anti-T. gondii IgG antibody was 9.38% among the 1 045 neonates in Fujian Province. The seroprevalence of anti-T. gondii IgG antibody was 18.35% in the 387 preterm infants, and there was no significant difference in the seroprevalence of anti-T. gondii IgG antibody between male and female infants (17.69% vs. 18.75%, χ2 = 0.07, P > 0.05). The seroprevalence of anti-T. gondii IgG antibody was 4.10% in the 658 full-term infants, and there was no significant difference in the seroprevalence of anti-T. gondii IgG antibody between male and female infants (4.14% vs. 4.08%, χ2 = 0, P > 0.05). In addition, the overall seroprevalence of anti-T. gondii IgG antibody was 15.02% in all neonates’ mothers, and the seroprevalence was significantly greater in preterm infants’mothers than in full-term infant’s mothers (20.93% vs. 11.55%, χ2 = 16.79, P < 0.01). Conclusions The seroprevalence of T. gondii infections is significantly higher in preterm infants and their mothers than in full-term infants and their mothers. Prenatal detection of T. gondii infections and health education pertaining to toxoplasmosis prevention and control knowledge are required to be strengthened to effectively reduce the incidence of congenital toxoplasmosis.

Policy Effect of the Medicines Procurement Based on Health Insurance Reimbursement Standards in Fujian Province / 中国药学杂志

OBJECTIVE: To analyze the effects of "adjusting structure and vacating space" of the transparent medicines procurement basing health insurance reimbursement standards, through comparing medicines consumption structure of health insurance designated health facilities of Fujian province. And to generate evidence as well as to propose recommendations for policy improvement and experience promotion. METHODS: Based on the 2016 and 2017 provincial medicines pooled procurement database, adopting the pivot table statistical functions of EXCEL software, the consumption value and value in proportion of Class and Ⅱ chemical products (Fujian provincial medicines procurement list therapeutic classification for chemical products), as well as active pharmaceutical ingredients, consumption value and volume (standardized units in tablet/bottle/vial) of originator and generics were analyzed and compared. The consumption value of Class formulations of traditional Chinese medicines (Fujian provincial medicines procurement list therapeutic classification for formulations of traditional Chinese medicines) was also analyzed and compared. RESULTS: Nearly 2.38 billion yuan procurement budget was saved in 2017 through adjustment of the medicines procurement list in Fujian province. There were a certain changes of the consumption structure of medicines. The procurement value of adjuvant and nutraceutical medicines dramatically reduced. The procurement value of medicines for treatment of chronic diseases like hypertension and cancers significantly increased. The procurement volume of generics started to surpass that of the originator, and showed potential competitiveness of generic substitution. However, the originator still dominated the market of quite a number of medicines. Prices of both generics and originators decreased. CONCLUSION: The effect of “adjusting structure and vacating space” has been demonstrated. Fully implementation of the health insurance reimbursement standards will make the above effect more apparent. To promote effective generic competition, Fujian should set the same health insurance reimbursement standard for originator and its generics (quality and efficacy validated) to promote generics substitution.

Experience and reflection on the construction of medical alliances in a government and hospital partnership model / 中华医院管理杂志

Active exploration for building a model of medical alliances fitting local needs, proves imperative for the functional positioning of medical institutions, promoting inter-institutional cooperation and enhancing the capacity of primary medical services. The authors described experiences and insights of the No.1 Affiliated Hospital and the People′s government of Quangang District in their partnership, and building a brand new model of medical alliance between a hospital and a local government. Also presented are characteristics of such a model, and analysis of operational data in benefiting the people. They held that such a partnership is a worthy attempt in the healthcare reform, by means of building medical alliances between local government and provincial hospitals. Such a practice can provide valuable references for promoting government-hospital synergy, elevating primary healthcare capacity and advancing the hierarchical medical system.

Research on the relationship between supply structure of health resources and growth of medical expenses in medical institutions from supply perspective: based on data from Fujian province / 中华医院管理杂志

Objective@#To compare such supply structure differences of health resources as number of beds and manpower at medical institutions of different types, and to analyze the extent and direction of the health resources supply in affecting the growth of medical expenses.@*Methods@#Clustering analysis was used to cluster health resources indicators in Fujian province. The hierarchical regression model was used to estimate the impact of such factors as population, social economy and health resource supply structure on medical cost growth. All the sample data were logarithmically processed to eliminate the influence of different index measurement units on the analysis results.@*Results@#The clustering indicators of health resources were classified into two categories: basic and quality health resources indicators. The per capita GDP had a positive impact on the per capita total hospital expenses(β=0.228, P<0.05), and the number of basic beds had a negative impact on the per capita total hospital expenses(β=-0.719, P<0.001). The increase in basic bed allocation had a significant effect on reducing the total cost of hospitalization per capita, but the regression results of quality health resources were generally not significant.@*Conclusions@#From the perspective of supply-side reform policy, the supply structure of health resources should be in line with the growth level of medical expenses, and the control of medical expenses should be strengthened. The government should strengthen the pertinence in the selection and target of health resource investment to ensure the sustainable and healthy development of health care.

Research on the relationship between supply structure of health resources and growth of medical expenses in medical institutions from supply perspective: based on data from Fujian province / 中华医院管理杂志

Objective To compare such supply structure differences of health resources as number of beds and manpower at medical institutions of different types,and to analyze the extent and direction of the health resources supply in affecting the growth of medical expenses.Methods Clustering analysis was used to cluster health resources indicators in Fujian province.The hierarchical regression model was used to estimate the impact of such factors as population,social economy and health resource supply structure on medical cost growth.All the sample data were logarithmically processed to eliminate the influence of different index measurement units on the analysis results.Results The clustering indicators of health resources were classified into two categories:basic and quality health resources indicators.The per capita GDP had a positive impact on the per capita total hospital expenses (β =0.228,P ＜ 0.05),and the number of basic beds had a negative impact on the per capita total hospital expenses (β =-0.719,P ＜ 0.001).The increase in basic bed allocation had a significant effect on reducing the total cost of hospitalization per capita,but the regression results of quality health resources were generally not significant.Conclusions From the perspective of supply-side reform policy,the supply structure of health resources should be in line with the growth level of medical expenses,and the control of medical expenses should be strengthened.The government should strengthen the pertinence in the selection and target of health resource investment to ensure the sustainable and healthy development of health care.

Practical exploration of developing medical alliances in various models in Fujian Provincial Hospital / 中华医院管理杂志

Development of medical alliances is an important step and institutional innovation to deepen the healthcare reform.The authors analyzed the practice and experience in Fujian Provincial Hospital in this regard, and discussed the confusion and difficulties faced in the process.On such basis, they raised such proposals as transforming conception of the people, forming a multi-departmental coordination mechanism and policy superposition effect, building a sound medical alliance assessment system, and clarifying information construction standards, hence developing a new era of hierarchical medical system by means of developing medical alliances.

Comparative study on the service capacity changes of county-level general hospitals in Fujian province / 中华医院管理杂志

Objective To learn the present development and comprehensive reform of county-level general hospitals in Fujian province.Methods Questionnaires were used to survey the development of 59 county-level general hospitals in 2013 and 2016 in the province. The study covered such aspects as basic profile, number of beds, human resources, service capacity, department setup and medical technology development among others. These data were replenished by information from the service capacity survey data collection system for county-level hospitals of the National Health and Family Planning Commission. The data so acquired were subject to descriptive statistics. Results 59 such hospitals had made developments and progress to various extents in terms of the number of beds, human resources, medical service capacity, department setup and medical technology development. Compared with those in 2013, their beds, employees, and number of inpatients and outpatients had grown by 3. 78% , 12. 24% and 7. 95% respectively. Conclusions These hospitals should, based on scientific planning, appropriately scale up, strengthen their high-caliber talent teams, focus on the development of key technologies and key weak disciplines. These efforts will help develop core competitiveness, and deepen their comprehensive reform.

The investigation and analysis of core competency among midwives from 13 hospitals in Fujian Province / 中华护理杂志

Objective To understand the status quo of midwives' core competency in Fujian Province and analyze its influencing factors.Methods A total of 374 midwives from 13 hospitals in Fujian Province were surveyed by the midwife core competency scale.Results The average score of midwives' core competency were(3.96±0.54).The scores of vocational literacy,postnatal care skills and health care skills during pregnancy were relatively high.The scores of public health care knowledge,public health care skills and women's health knowledge were relatively low.The scores of core competence for junior,senior and expert abilities for midwives were (4.03±0.55),(3.78±0.59)and (3.54±0.75),respectively.In seven dimensions,the scores for skills were all higher than those for knowledge.Multivariate stepwise regression analysis showed that years of working,hospital grade,marital status and form of employment were influencing factors of midwives' core competency (P＜0.05).Conclusion The core competence of midwives in 13 hospitals in Fujian Province was generally at the middle level.The junior ability was satisfactory,and the senior and expert abilities should be improved.Midwives who were newly employed,working in primary institutes,non-institution personnels should be paid more attention in order to promote midwives' core competency holistically.

Investigation and Analysis of Parents’Cognition,Attitude and Behavior on Pediatric Medication Safety in Part of Urban Area of Fujian Province / 中国药房

OBJECTIVE:To provide reference for guaranteeing safety and rationality of pediatric medication. METHODS:Questionnaire survey was designed to investigate and analyze the cognition,attitude and behavior of parents on pediatric medication safety in urban area of Fujian province. RESULTS:Totally 1 405 questionnaires were sent out,and 1 326 were effectively received with effective rate of 94.38%. The education level of the respondents was high,and the respondents with college degree or above accounted for 57.92%. The total monthly income was also high,the respondents with monthly income of 4 000 yuan or above accounted for 61.61%. The correct answer rates of the respondents about pediatric medication safety was above 55%,but the lowest correct rate of 3 questions was only 13.73%,14.25% and 23.83%,respectively. The average score of cognition was (13.92 ± 2.80). The scores of low educational background,low monthly income and farmers were relatively low (P＜0.01). 97.06% of the respondents had trouble or difficulty in giving children drugs;the frequency of choice for children who didn’t cooperate with medication due to the taste or dosage was 29.83%;14.58% of the respondents didn’t know the accurate dosage;12.13% lacked of pediatric medication guide. 11.37%of the respondents thought that there was no drug for child specific use or not enough child-specific varieties;when children suffered from common diseases,the majority of respondents would choose municipal level or above hospitals and community health service,accounting for 49.55% and 15.46%. 85.22% of respondents had the experience of giving drug to their children by themselves. As to medication information,10.94% of respondents hold that"wanted to know but did not have the channel"and 47.66%"would read when had opportunity". 40.05% of the respondents sometimes took the initiative to consult doctor or pharmacist about pediatric medication attention,but 19.60% of respondents took little or no initiative to that. For main sources of the respondents accessing to pediatric medication guidance,the frequency of choosing doctors was 65.53%,and that of choosing pharmacists was 20.31%. 61.09% of respondents wanted to get the medication education from doctors,while 19.76% from pharmacist. Information on pediatric medication information when the respondents visited doctors and purchased drugs were also relatively simple,and were mainly about the usage and dosage. CONCLUSIONS:At present,it is common for parents to give drug to children by themselves in Fujian province. But the cognition,attitude and behavior on medication safety of children still remain to be improved. There are shortcomings in the publicity and education of knowledge and information,and the pediatric pharmaceutical care functions of pharmacists have not been fully embodied. At the same time,the development and production of children specific drugs need to be strengthened,and the information about pediatric medication in drug instructions should be standardized and improved.