This paper firstly analyses the sales and purchase contracts in the procurement of drugs in public hospitals, and then points out the market failure in the two contracts. After the implementation of administrative measures such as government pricing, administrative price reduction, price increase, centralized bidding and purcha-sing, various drug procurement stakeholders have adopted various game behaviors, and government procurement and price formation have appeared in government hospitals, not-neglecting the formation of the price ofGovernment fail-ure. The future price formation in public hospitals should be the market pricing under the limited government regu-lation, and increase the medical insurance institutions' price negotiation and the public hospitals' participation degree in the bidding process based on maintaining the centralized bidding and purchasing and zero administrative rate.

The main progress in international critical care medicine in 2020 are: the reflections on the mandatory of implementation of the 1-hour cluster treatment strategy for sepsis are still continuing; the "metabolic resuscitation" therapy, represented by large dose of vitamin C, failed to yield positive results; the global epidemic of coronavirus disease 2019 (COVID-19) continues to spread, with evidences indicating Dexamethasone, Remdesivir or interferon β-1b (IFNβ-1b), Lopinavir/Ritonavir and ribavirin as promising therapy; conservative oxygen therapy did not exert positive effects neither for mechanical ventilated patients nor for acute respiratory distress syndrome (ARDS) patient; the concept of lung- and diaphragm-protective mechanical ventilation illuminates a new opportunity to potentially improve clinical outcomes for critically ill patients; there was no positive evidence for stress ulcer prophylaxis and timing of endoscopy for severe acute upper gastrointestinal bleeding; early initiation of renal-replacement therapy (RRT) for critically ill patients with acute kidney injury (AKI) has not shown positive effect. At last, artificial intelligence (AI) has shown good potential in identifying ARDS phenotypes and early predicting sepsis.

The application of TCM“Preventive Treatment for Disease”in community health care is a major approach to implementing the prevention-first health policy and realizing access to basic health services for all.Covered first in the paper is the significance of TCM“Preventive Treatment for Disease”in community health care.It is followed by a systematic description of the innovative community health care model in Hangzhou in 2008.This innovation started in 2009 to apply the TCM“Preventive Treatment for Disease”in community health care.The authors described the preliminary practice,specific measures and the main results of TCM“Preventive Treatment for Disease”in community health care.They went on to recommend the service model of TCM“Preventive Treatment for Disease”in community health care and provide references for application of TCm in community health care.

Objective To explore the relationship between socioeconomic status and the risk factors of cardiovascular diseases in retirees from a community in Shanghai. Methods Observational study involved 9 943 retirees aged 50 and over in Shanghai. Both single factor and multi-factor analyses methods were used to describe the correlation between factors as:educational level,marital status,annual household income and risk of hypertension,coronary heart disease,stroke etc. A new defined compound index was used to assess the relevance of socioeconomic status on the risk of cardiovascular diseases,based on logistic regression model. Results After adjusted for age,the risk of cardiovascular diseases in these retirees was influenced by socioeconomic status. In general, opponent correlations in education levels and prevalence of hypertension were found between female and male. Compared with those having received college or higher education,the risk of hypertension increased in females when the education level declined,with OR as 1.08(95%CI:0.89-1.30). For those having had senior high school junior high school or elementary education,the risks of hypertension were 1.26(95%CI:1.05-1.51),1.34(95%CI:1.08-1.65),0.72(95%CI:0.59-0.87),0.78 (95%CI:0.64-0.94),and 0.70(95%CI:0.52-0.92)for males,respectively. The risk of cardiovascular diseases increased with annual household income. Compared with high level of socioeconomic status, lower socioeconomic status might decline the risk of cardiovascular diseases in males by approximately 30%,with OR for medium being 0.72(95%CI:0.61-0.84)and for lower ones it was 0.70(95%CI:0.57-0.87). However,similar correlations were not found in females. No significant relationship was found between marital status and the prevalence of cardiovascular diseases in this study. Conclusion The risks of cardiovascular diseases varied with different socioeconomic status, indicating that tailored interventions should be conducted in different socioeconomic groups.

OBJECTIVETo explore the relationship between socioeconomic status and the risk factors of cardiovascular diseases in retirees from a community in Shanghai.

METHODSObservational study involved 9 943 retirees aged 50 and over in Shanghai. Both single factor and multi-factor analyses methods were used to describe the correlation between factors as:educational level, marital status, annual household income and risk of hypertension, coronary heart disease, stroke etc. A new defined compound index was used to assess the relevance of socioeconomic status on the risk of cardiovascular diseases, based on logistic regression model.

RESULTSAfter adjusted for age, the risk of cardiovascular diseases in these retirees was influenced by socioeconomic status. In general, opponent correlations in education levels and prevalence of hypertension were found between female and male. Compared with those having received college or higher education, the risk of hypertension increased in females when the education level declined, with OR as 1.08 (95% CI:0.89-1.30). For those having had senior high school junior high school or elementary education, the risks of hypertension were 1.26 (95%CI:1.05-1.51), 1.34 (95%CI:1.08-1.65), 0.72 (95%CI:0.59-0.87),0.78 (95%CI:0.64-0.94), and 0.70 (95%CI:0.52-0.92) for males, respectively. The risk of cardiovascular diseases increased with annual household income. Compared with high level of socioeconomic status, lower socioeconomic status might decline the risk of cardiovascular diseases in males by approximately 30%, with OR for medium being 0.72 (95%CI:0.61-0.84) and for lower ones it was 0.70 (95% CI:0.57-0.87). However, similar correlations were not found in females. No significant relationship was found between marital status and the prevalence of cardiovascular diseases in this study.

CONCLUSIONThe risks of cardiovascular diseases varied with different socioeconomic status, indicating that tailored interventions should be conducted in different socioeconomic groups.

Adult ; Aged ; Cardiovascular Diseases ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Risk Factors ; Social Class ; Socioeconomic Factors

Hypoxia is a common feature of solid tumors. As transcription factors, hypoxia-inducible factors (HIFs) are the master regulators of the hypoxic microenvironment; their target genes function in tumorigenesis and tumor development. Intriguingly, both yes-associated protein (YAP) and its paralog transcriptional coactivator with a PDZ-binding motif (TAZ) play fundamental roles in the malignant progression of hypoxic tumors. As downstream effectors of the mammalian Hippo pathway, YAP and/or TAZ (YAP/TAZ) are phosphorylated and sequestered in the cytoplasm by the large tumor suppressor kinase 1/2 (LATS1/2)-MOB kinase activator 1 (MOB1) complex, which restricts the transcriptional activity of YAP/TAZ. However, dephosphorylated YAP/TAZ have the ability to translocate to the nucleus where they induce transcription of target genes, most of which are closely related to cancer. Herein we review the tumor-related signaling crosstalk between YAP/TAZ and hypoxia, describe current agents and therapeutic strategies targeting the hypoxia-YAP/TAZ axis, and highlight questions that might have a potential impact in the future.

Cholangiocarcinoma (CCA) has emerged as an intractable cancer with scanty therapeutic regimens. The aberrant activation of Yes-associated protein (YAP) and transcriptional co-activator with PDZ-binding motif (TAZ) are reported to be common in CCA patients. However, the underpinning mechanism remains poorly understood. Deubiquitinase (DUB) is regarded as a main orchestrator in maintaining protein homeostasis. Here, we identified Josephin domain-containing protein 2 (JOSD2) as an essential DUB of YAP/TAZ that sustained the protein level through cleavage of polyubiquitin chains in a deubiquitinase activity-dependent manner. The depletion of JOSD2 promoted YAP/TAZ proteasomal degradation and significantly impeded CCA proliferation