Objective To evaluate the short-term prediction of high-sensitivity cardiac troponin T (hs-cTnT) and other cardiovascular risk biomarkers in patients undergoing maintenance hemodialysis (MHD).Methods We conducted a cohort survey in 296 consecutive MHD patients whose clinical data were retrospectively analyzed.Before MHD,hs-cTnT and other relative cardiovascular biomarkers were detected.The end point (all-cause death) and time of occurring were recorded in the next 13 months.The differences between survival and all-cause death were analyzed by t-test,Mann-Whitney test and x2 test.The best two percentile cutoff point was calculated by X-tile and the survival rate was calculated by Kaplan-Meier Logistic regression analysis was applied to analyze the odd ratio between high risk and non-high risk hs-cTnT group.Non-high risk group was divided into intermediate risk and low risk group based on the 99th percentile of hs-cTnT in healthy population,to further evaluate its short-term prediction value for MHD patients.The short-term significance of hs-cTnT was proved to be independently associated with all-cause death by Logistic regression analysis.Results The mean value of serum hs-cTnT in survival group was 0.05 (0.03～0.07) ng/mL,while in the death group it was 0.07 (0.04～0.14) ng/mL,which had statistical significance (P =0.027).The best two percentile cutoff of hs-cTnT in MHD patients was 0.1 ng/mL.The survival rate in high risk group (hs-cTnT＞0.1 ng/mL) is lower than it in non-high risk group (hs-cTnT≤0.1 ng/mL) (76.67％ vs.96.62％,P ＜0.05).The odd ratios for high risk group and non-high risk group was 7.288 (P＜ 0.001).Moreover,further grouping the non-high risk group by hs-cTnT =0.014 ng/mL,intermediate risk group (hs-cTnT＞0.014 ng/mL) group has lower survival rate than low risk group (hs-cTnT≤0.014ng/mL),while there wasn't any death case occurred in the low risk group.Conclusions Hs-cTnT is an independent risk factor to all-cause death.Thus hs-cTnT can be a strong indicator of short-term prediction and prognostic evaluation.

The international NGOs have been playing an important role in global health governance, and also represent a channel for countries to exert international influence. However, the Chinese NGOs are not actively in-volved in global health so far. This purpose of this paper is to analyze and show the picture of the social and political context of NGOs in China, to learn from the experience of emerging global health-related NGOs through describing their development, provides a strategy for China to support NGO participation in the global health governance, and to put forward recommendation on how to develop China’s global health NGOs based on experiences from international counterparts. The results of this paper found that China has a better international environment, which is a beneficial opportunity for the country to engage in global health governance. Domestic social NGOs are developing progressive-ly, while they are still being harnessed by political safety considerations, for example being affiliated to public admin-istrative system and policy orientation development. However, this would possibly not obstruct health-related NGOs for its minimal political relevance as it is oriented at professionalism, i. e. specialization, public service attributes and relevance to public governance. Therefore, health-related NGOs can have more support from governments since their number is relatively small, with less foundation ( they are undeveloped) and less participation in international cooper-ation ( they lack international involvement) . International experience indicates that supports from governmental enti-ties represent a backbone of the emerging institutions in the participation into the global health programs. The author suggests that the Chinese government should establish a specific global health development strategy of “prioritizing and improving the whole” and setting up the global development strategy in the county. The government should attach more importance to the government-owned and affiliated and private-capital-supported (social elites) NGOs, guide and subsidize them to the international stage, to engage intensely in global health.

The global health system is undergoing dramatic reforms, which would further bring about signifi-cant changes in key global health stakeholders. As a key actor and decision maker in global health system, NGO owns extensive experiences in global health governance and can provide a systematic experience for China’s participa-tion in global health decision-making as a reference model. This paper aimed at studying the roles of NGOs in the field of global health, the roles which can be summarized in four aspects of advocacy, implementation, support, and community mobilization. In addition, NGOs also developed some potential risks and unexpected impacts on global health governance. As represented by some typical examples, there occurred conflicts of interests between some NGOs and the local governments. A number of local health systems suffered from a considerable brain drain of health personnel to NGOs, especially the health officials and technical staff, which weakened the country’s health workforce and system. The financing model driven by external donors could weaken the influences and capacity of local govern-ments on health planning. As a key member involved in global health, we that suggested China and Chinese NGOs should strategically and rationally borrow their experiences and try to avoid these risks.

The International Foundations have invested large sums of funds to participate in global health gov-ernance and greatly contributed to the promotion of global health. The foundations have extensive experience in the management of global health projects. Based on the nature of the foundation and its structure in the government, this paper compares the management methods of project management, project selection, project planning, project imple-mentation, project follow-up, project evaluation and project completion in two stages of the Gates Foundation and Global Fund. It summarizes the project management features, provided references for China participating in global health governance.

NGOs play an important role in global health governance, and have become the key partners of World Health Organization ( WHO) , European and American governments. The goal of the sustainable development of the United Nations also proposes to strengthen NGOs as global health governance partners. Taking WHO, the Unit-ed States and Britain as case examples, this study reviewed the NGOs positioning and cooperation in their global health strategies. The results found that these entities explicitly define the roles of NGOs and strengthen cooperation in their global health strategies to expand their influence in the field of global health. Results also found that WHO, US and UK have given NGOs a clear positioning, that is, they have strengthened the mutual cooperation ( partner-ships) in the same way of expanding their influence in the field of global health for China’s global health strategy de-velopment referred to those NGOs. Therefore, China should incorporate NGOs into the global health strategy, estab-lish NGOs management and cooperation mechanism and define their roles and make it an important complement to global health. China should also strictly select international NGOs to cooperate with and strive to nurture and support Chinese NGOs to participate in global health programs set by the Government, formulate the cooperation list and neg-ative list for NGOs, and at the same time strengthen the supervision and audit to avoid possible risks of NGOs.

Non-governmental organizations ( NGOs) are playing an increasingly significant role in global health governance. This study selected ten key NGOs that play an important role in global health affairs and summarized the tools employed by NGOs participating in global health governance, including nine dimensions:“Generating informa-tion and evidence/intelligence”, “Cooperation ( Partnerships )”, “Participation”, “Consultation”, “Transparen-cy”,“Organizational adequacy/system design”, “Formulating policy / strategic direction”, “Responsibility” and“Regulation”. Four types of NGOs including Operational, Supportive, Advocacy and Integrated ones presented com-monness and their priorities in the selection of tools to participate in global health governance. Meanwhile, China should strive to nurture local NGOs, which should pay attention to“Transparency”,“Participation” and“Cooperation ( Partnerships)”.