This article described the basics of the University of Hong Kong-Shenzhen Hospital and the practices of Shenzhen government to promote the comprehensive reform of public hospitals.The article also introduced the reform,on such aspects as hospital management structure,corporate governance,hospital operating mechanism,compensation mechanisms,service mode,staff training mechanism,and supervision mechanisms.In addition,it analyzed the benefits of these reforms and proposed policy changes.

Shenzhen public hospitals management system reform implemented the strategies that separated the functions of government agencies from public institutions and separated the hospital management from hospital regulation.The reform also established the medical management center and promoted the autonomous operation management of public hospitals.This articles described the disadvantage of current public hospitals management system,introduced the basic framework and major implementations of Shenzhen public hospitals management system reform program,and analyzed the characteristics and effect of this program.

Objective To study the effects of ligustrazine(LTZ) on the preeclampyic umbilical serum induced-expression of precollagen I,III in cultured human umbilical artery smooth muscle cell(HUSMC). Methods The cultured HUSMC was treated with LTZ for 30 min, and then incubated with medium containing 20% serum either from women with preeclampsia or normal pregnant women for 48h. The cell activity was determined by MTT, the cell cycle was analyzed by flow cytomerty, and RT-PCR analysis was used to dectect the expression of precollagen I,III. Results The cell proliferation, percentage of S and G2/M phases, and expression of precollagen I obviously increased in HUSMC incubated with preeclampsia umbilical serum compared with normal pregnant women one(P

Objective To study the effect of protein kinase C-nuclear factor-kappa B (PKC-NF-?B) signal transduction pathway on the umbilical sera-induced human umbilical artery smooth muscle cell (HUASMC) proliferation and the expression of precollagen Ⅰ, and Ⅲ mRNA in preeclamptic women. Methods HUASMC from normal pregnancy were cultured and generated. After 30 minutes of incubation with or without Polymyxin B (PMB), the umbilical serum from the preeclamptic women was added. Two hours later, the expression of Ⅰ-?B and NF-?B were detected by Western blot. After 48 h, the activity of HUASMC was evaluated by MTT, the cell cycle by flow cytomerty and the expression of precollagenⅠ,ⅢⅢ and bcl-3 mRNA by reverse transcription-polymerase chain reaction(RT-PCR). Results Ⅰ-?B level (0.3765?0.0321) and the percentage of G_0+G_1 phase cells (62.53?2.85)% in preeclamptic group were significantly lower than those in control group [(0.7857? 0.0296),(78.66?3.25)%, P

Analysis of setbacks found in the existing system and mechanism of public hospitals. Based on the health reform principles of Separation of administration and management, Separation of administration and operation, Separation of prescribing and dispensing, and Separation of for-profit hospitals and nonprofit hospitals, the authors named the following roadmap for public hospital governance reform. First, set up a management committee for each public hospital to coordinate the government function for medical service; set up a public hospital authority to upgrade the management level of these hospitals; transform functionality of health authorities to encourage diversity in medical service providers. Second, establish the tiered decision making mechanism, autonomous operation system and diversified supervision system, to separate administration and management. Third, formulate articles of association for hospitals to encourage their evolution to legal entities, consolidating the government reforms by legal means.

In order to set up a medical security system suitable for laborers and solve for them the problem of inadequate and expensive medical services,the city of Shenzhen started on March 1,2005(apilot) cooperative medical care for laborers in the four neighborhoods of Buji,Longgang,Longhua and Shajing on the basis of an earlier model.The new model,which stipulated that each person paying 12 yuan each month,with the employer paying 8 yuan and the individual laborer paying 4 yuan,was entitled to both outpatient and inpatient medical services,was popular with both businesses and laborers.At present the number of people participating in the new model of cooperative medical care for laborers exceeded 1 million,the number of designated medical institutions was gradually increasing,and medical expenses were put under control.

Objective To identify problems and reduce death and disability rates in emergency care so as to provide basis for upgrading the emergency care network. Methods Questionnaires were filled out with information from the medical records of 1446 cases that had been admitted for emergency care to 60 hospitals of the city's emergency care network and that had died in 2002, a database was set up with Profox 6 0, and a statistical analysis was made with SPSS 11 0. Results The median time for various emergency care procedures was: 5 minutes for the issuing and execution of the first medical order respectively and also for the arrival of a senior doctor; 10 minutes for the arrival of the doctor on call; 120 and 180 minutes after admission respectively for case discussion and intra-hospital consultation; 60 minutes after admission for the start of blood transfusion. It was found that some doctors had a poor grasp of emergency care techniques and procedures, the entry of time was not detailed enough in some medical documents, and some rules and regulations failed to be carried out. In addition, differences existed in the spectrum of causes of post-emergency hospitalization death and pre-hospitalization death. Conelusion Improvements need to be made in such aspects of emergency hospitalization care as the detailing of time, the grasp of techniques and the guarantee of quality. And more attention needs to be attached to emergency care.

Description of the practice, significance and principles of networking operation for primary medical institutions in Shenzhen, and an introduction to the strategy and implementation assurance. The paper covered the following features of such operation: establishment and upgrading of the primary patients movement system; establishment of the tiered health service system; establishment of the consultation and referral system based on networking operation; establishment of multi-institution practice system for physicians within the network; establishment of medical resources sharing system within the network; support for joint research programs; experiment in effective medical insurance payment and health service price support system; diversity and loose structure of institutions within the network

In the development of primary care system,Shenzhen has called into play the model of hospital-centering,and made it a link to build a new urban medical service system of clear-cut levels,rational division of responsibilities and mutual benefit.This design provides the primary care with a good credit,a reasonable medical insurance system,and appropriate technical support.Furthermore,it improved the efficiency of unban health resource allocation and utilization and alleviated residents' burden of medical costs.This study aims to introduce the measures and advantages in the implementation of the primary care system in Shenzhen,analyze the problems found in Shenzhen' s community health service system and make recommendations for the improvement.

Shenzhen implemented the health reform on the separation of drug prescribing and dispensing.This policy abolished the drug price addition system,which interrupted the interest chain between hospitals and pharmaceutical enterprises,and curbed the over-medication and use of expensive drugs.Such a reform has lowered the average cost of diagnose and treatment,the out-of-pocket payment by those covered by social insurance,outpatient infusion and the utilization of antibiotics.To further strengthen these outcomes and maintain the momentum of this policy,Shenzhen will further improve the compensation system for public hospitals,encourage the medical staffs' work enthusiasm and implement the reform measures actively.