This paper made systematic description of the three objectives of sustainable development designed for the policy based on the sustainability theory for the health sector.The essential drug system for secondary hospitals comprises the list coverage and allocation percentage of essential drugs,requirements for bidding and purchasing as well as pricing practice; management and conditions of these hospitals,including leadership determination and competency,doctors prescription behavior,and supportive reforms at these hospitals; external policies and social environment,including government financial subsidy,medical service prices adjustment,medical insurance,and the awareness and attitude of the people on essential drugs.

In this consideration,the paper described the imperatives of drug safety,constraints of governance by the government,and advantages of social co-governance,proposing the necessity to establish aFive-in-One (referring to the involvement of the government,enterprises,industry associations,media and the public) drug safety social co-governance.In its analysis of the present dilemma o[drug safety governance,the authors proposed such measures as perfecting legal and institutional system,reforming governmental power allocation mechanism,improving the incentive mechanism,innovating governance means and improving social governance ability,for the purpose of enhancing such a co-governance pattern.

Objective summarize the delicacy management practices through the NSFC application procedures in a university affiliated hospital,to provide further reference for improvement of the NSFC project approvai ratio.Methods To summarize the management experiences by analyzing the approval number,project category and funds of NCFS from 2006 to 2015.Results The delicacy man agement practices include cultivate scientific research atmosphere by strengthen motivation,initiate application as early as possible,enlarging application number by extensive mobilization,improve applica tion quality by massive training,multi-round updates,tutorial,prevent avoidable errors by cross-over review.Conclusions Delicacy management by scientific research management department during the application process is critical to improve the project approval ratio of NCFS in a hospital.

Objective To reveal the self-management status of patients with hypertension in community, and to analyze the influencing factors of self-management behavior so as to provide theoretical basis for the formation and maintenance of self-management. Methods With the method of stratified random cluster sampling, 559 patients with hypertension were selected from twelve communities in six urban districts of Wuhan completed the questionnaire survey to analyze the demographic characteristics, executive condition of self-management behavior and related psychological behavior with hypertension patients. Results The average age was (61.2 ± 8.4) years. The rate of measuring blood pressure regularly was 38.39%, rate of regular medication was 63.83%, rate of low salt diet was 37.72%, and the rate of regular exercise was 50.45%. The score of self-management was 0.60 ± 0.21. Self efficacy was the influencing factor of self-management score (β=0.042 1,P<0.01). Conclusion Self assessed efficacy is closely related to self-management. Intervention should be guided by psychological behavior theory, and emphasized on psychological aspect.

Objective To analyze the influencing factors for doctors' prescription of essential medicines at county hospitals of Anhui province.Methods Multi-stage random sampling method was designed to conduct an investigation for doctors at nine county hospitals in Anhui province,and SPSS 1 6.0 was used to conduct descriptive statistical,chi-square test and binary logistic regression.Results 50.8% respondents reported that they had prescribed essential medicines with the rate of less than 60%. The factors of doctors'prescription for essential medicines are work experience,average monthly income, policy awareness, recognition, training willingness, training times, hospital support, medication preferences,and drug marketing.Conclusion The prescription rate of essential medicines in the sampled hospitals is low,and the targeted comprehensive intervention measures should be taken to promote prescription rate of essential medicines in county hospitals.

Postoperative pancreatic leakage remains a persistent problem after pancreaticoduodenectomy.For patients with a soft and nonfibrotic pancreas,double binding continuous hemstitch suture is an optimal method for anastomosis.From January 2011 to June 2012,92 cases of periampullary carcinoma with a soft pancreas underwent pancreaticoduodenectomy,and then a modified technique of pancreaticogastrostomy was performed with 2 continuous hemstitch sutures placed in the mucosal and seromuscular layers of the posterior gastric wall,respectively.The median time for pancreaticogastrostomy was 12 minutes,and only 15 patients had postoperative complications.Two patients developed pancreatic leakage(1 grade A and 1 grade B)postoperatively.Pancreaticogastrostomy with double binding continuous hemstitch sutures is a simple and safe reconstruction procedure for patients with a soft and fragile pancreas who received pancreaticoduodenectomy.

Objective To investigate the changes of cardiac function at pre -and post -treatment in preterm infants with patent ductus arteriosus (PDA)in order to guide drug treatment.Methods Totally 84 preterm infants with PDA admitted to Neonatal Intensive Care Unit of Xuzhou Hospital Affiliated to Medical College of Southeast University from July 201 2 to June 201 4 were divided into 4 groups according to treatment drug:Ibuprofen group (27 cases),Indo-methacin group (24 cases),control group (1 1 cases),and Paracetamol group (22 cases).Patients were also divided into symptomatic PDA group (38 cases)and asymptomatic PDA group (46 cases)according to severity;PDA closed group (69 cases)and PDA unclosed group (1 5 cases)according to sequel.The level of plasma brain natriuretic pep-tide (BNP),cardiac troponin I (cTnI),correct QT intervals dispersion (QTcd)were monitored pre -and post -treat-ment.Data were analyzed by using SPSS 1 9.0 software.Results Three cardiac markers at post -treatment were of no significant difference among 4 treatment drugs.The changes of the cTnI and QTcd at pre -and post -treatment were of no significance.The level of BNP in symptomatic PDA group was significantly higher than that in asymptomatic PDA group at pre -treatment [(378 ±94)ng/L vs (1 47 ±75)ng/L,t =2.584,P =0.01 4].In the symptomatic PDA group,the level of BNP at post -treatment [(1 82 ±81 )ng/L]was significantly decreased than that at per -treatment (t =2.741 ,P =0.009).In the asymptomatic PDA group,there was no significant difference between the pre - and post -treatment [(1 21 ±61 )ng/L]in the level of BNP (t =1 .254,P =0.207).There was no significant difference in the level of BNP at per -treatment between PDA closed group and PDA unclosed group [(274 ±91 )ng/L vs (289 ± 87)ng/L,t =-0.874,P =0.391 ].In PDA closed group,the level of BNP at post -treatment [(1 21 ±74)ng/L] was significantly decreased compared with that at per -treatment (t =3.580,P =0.000).In PDA unclosed group, there was no significant difference between the pre - and post -treatment [(245 ±74)ng/L]in the level of BNP (t =0.854,P =0.392).Conclusion Early medication intervention for symptomatic PDA of preterm infants is benefi-cial for the closure of PDA and for attenuating negative effects on cardiac function of PDA.

Objective:Using the method-point-factor to construct a system of evaluation indexes for clinician positions in county-level public hospitals to assess the relative value of clinician positions in county-level public hospitals in Anhui province.Methods:Questionnaire survey was used for a questionnaire survey of 12 county-level public hospitals in northern Anhui, central Anhui and southern Anhui in the province from July to August 2019. The content of the questionnaire survey mainly includes such doctor′s basic information as gender, age, and department, as well as the doctor′s score on the four dimensions of " post qualification, skills, risks and responsibilities, work intensity and environment" . In this study, Excel 2010 and SPSS 16.0 were used to perform descriptive statistical analysis on the collected data.Results:In this study, a job evaluation system for doctors in county-level public hospitals was established, covering 4 level-1 indicators, 10 level-2 indicators, and 37 level-3 indicators. Among the 1 895 clinical doctors participating in the survey in 12 county-level public hospitals, the average score of doctor′s job evaluation was 768.4 points, of which the neurosurgeons had the highest average score of 800.90 points and endocrinologists had the lowest average score of 735.40 points. There were differences in the overall score rate in the four dimensions of job evaluation, in the order of " risk and responsibility, work intensity and environment, skills, job qualification" (80.09%>79.49%>79.24%>66.72%).Conclusions:The results and grades of clinical doctors′ job evaluation were reasonable. The overall trend of the scores was in line with the job characteristics of doctors, and provided a theoretical basis for improving the internal performance salary distribution system of county-level public hospitals.

Objective:To form the workload relative value of 10 general surgery projects in Anhui province based on the theoretical framework of resource-based relative value scale(RBRVS).Methods:Cluster sampling was used to identify the 12 county-level public hospitals surveyed from July to August 2019; Expert consultation method was used to select the benchmark project of general surgery and the measured projects; Magnitude estimation was used by doctors surveyed to find the relative evaluation of the surgeries selected, and RBRVS principle was used to find surgeon workload relative value of the 10 surgeries; Pearson correlation analysis was used to analyze the relationship between the charging price of surgeries and the relative value of surgeons′ workload in Anhui province.Results:The study found the time consumption, work intensity relative value and surgeon work load relative value of 10 general surgeries; The relative value of the current surgical item price was positively correlated with the relative value of the doctor′s workload, and the correlation coefficient was r=0.928, P<0.01(bilateral). But in some surgeries, the pricing fails to represent the relative value of the workload. Conclusions:Based on RBRVS theory, 10 localized relative value scales of general surgeons′ workload were developed via empirical studies from such dimensions as time consumption, mental labor, physical labor and risk stress; Pearson′s correlation analysis found part of the pricing in general surgeries as groundless.

ObjectiveTo encourage development of county-level hospitals by building a performance appraisal indicator system for such institutions. Methods Using the PATH model ( a performance appraisal tool for hospital ) quality improvement, an appraisal system was built for such institutions. Centering on patients, this system encompassed such dimensions as public benefits, quality of care and safety, staff and hospital development. Results This system consisted of six level-1 indicators, 21 level-2 indicators and 70 level-3 indicators, each given due weight. Conclusions This indicator system centers on patients, follows guidance of public benefits, and aims at continuous quality improvement, making it an effective in evaluating hospital performance and providing reference for the decision-makers to promote and adjust medical reform policies.