Objective To analyze the problems frequently found in medical equipment bidding at public hospitals and come up with countermeasures for building a scientific and standardized bidding procedure.Methods 168 cases of medical equipment bidding of the hospital in the recent five years served as objects of study,for a full-process longitudinal study.It covered the preparation of technical parameters,compilation of bidding documentation,bid opening/evaluation process,all the way to final acceptance and after-sales service,and complaints responses.Results In the 168 cases,imported equipments accounted for 86.90%;only 16.07% of the purchases involved consumables,yet their importance deserved high attention;59.52% of the equipments involved after-sales maintenance costs,calling for regular maintenance to ensure smooth operation of the equipments.Conclusions Quality of domestic equipments should be enhanced,for optimization of the ratio between domestic and imported equipments;equipment purchase,after-sales service and consumables purchase should be taken into account in general;scientific evaluation levels and standards should be established to enhance supervision,for the purpose of scientific and rational purchase of medical equipments.

An introduction to the classified management of such trials and clinical application,documents submission for ethical review,operating procedures and review key points,as well as the problems found in the review.These efforts aim to provide guidance to the review of medical technique clinical trials,and to promote ethical supervision for new medical techniques.

Objective To study the impacts and the difference made by the pilot reform and comprehensive reform of clinic-pharmacy-separation on the medical visit behaviors of outpatients in Beijing.Methods Invoice information of outpatients′ fee payment during the December 2012 reform and April 2017 reform at the hospital was collected.Information of these patients at the same time as controls was collected to analyze patients′ fee categories, so as to study the effect on the behavior of these patients.Results The outpatient visits decreased by 5.29% as a result of the pilot reform.The ratio of medical insurance patients rose by 6.86%, and that of such patients seeking only prescriptions rose by 4.30%;number of outpatient visits decreased by 2.03% after the comprehensive reform, while the ratio of medical insurance outpatients dropped by 2.61%, and those seeking prescription only dropped by 2.54%.Conclusions The comprehensive reform of clinic-pharmacy-separation has influenced the outpatient′s medical visit behavior, evidencing a positive outcome of the healthcare reform.

Objective To investigate the differential expression of P57kip2 and CDK5 in neural tube defects t(NTD) from the normal ,and provide the clue for the research of the molecular mechanism of the normal neurula formation .Methods A cDNA mi-croarray containing 1 100 known genes was used to compare differences in P57kip2 and CDK5 gene expression between the normal control group and the retinoic acid(RA)-induced NTD group on embryonic(E) day 9 .5 and 10 .5 .Two differentially expressed genes were randomly selected from the two groups for Northern blotting to verify the results of the cDNA microarray .Results Compared the differences of between P57kip2 and CDK5 in normal and E9 .5 d ,E10 .5 d ,E9 .5 d-NTD ,E10 .5 d-NTD ,P57kip2 and CDK5 expression was significantly up-regulated in the before and after the formation of the normal neurulation ,but them showed a downward trend in retinoic acid (RA)-induced NTD(including two phase E9 .5 d and E10 .5 d) .Conclusion P57kip2 and CDK5 in-volved in the physiological process of NTD ,and provide the useful clue for the research of the molecular mechanism of the normal neurula formation .

Objective:To understand main problems existing in the construction of advanced stroke centers in China and put forward solutions, for reference in promoting the standardization construction of advanced stroke centers and improving the efficiency of acute stroke treatment.Methods:The data were derived from relevant data of on-site export guidance in the construction of advanced stroke centers at 175 tertiary hospitals from 2020 to 2021, and the scores of on-site evaluation indicators for the establishment of stroke centers and their formal approval were compared and analyzed. Based on on-site investigation and expert consultation, the common problems existing in the construction of advanced stroke centers were summarized. All data were analyzed by descriptive analysis, the scores of on-site evaluation indicators were expressed by ± s, and paired t test was used for comparison between groups. Results:Compared with the total score(693.04±72.06) of on-site evaluation at the stage of project launch, the total score(747.94±78.10) of on-site evaluation for formal approval of stroke centers of 70 hospitals was higher, and the difference was significant( P<0.01). There were seven common problems in the construction of stroke centers in 175 hospitals, including insufficient attention paid by hospitals, lack of effective performance incentive policies, imperfect treatment procedures and medical norms, and so on. Conclusions:Experts on-site guidance plays an important role in the construction of stroke centers in China. At present, there were still problems to tackle in the construction of stroke centers in hospitals. In order to promote the standardized construction of stroke centers in China and improve the efficiency of stroke treatment, the authors suggest fuorther strengthening the importance attached by hospital leadership and the coordination and organization of functional departments, establishing stroke center models conforming to the actual situation of the hospital, seting up the post of brain and heart health manager, and improving the regional prevention and treatment level of acute stroke.

The authors compared and analyzed the guidelines and the index system of public hospitals as stated in such papers as " State Council′s Opinions on Performance Evaluation of Tertiary Hospitals" (No.4 Document of State Council, 2019)and " Guidance on Strengthening the Performance Evaluation of Public Hospitals" (No.94 Document of Guo Wei Ren, 2015). Based on their studies, this paper summarized the commonness and law of development of the two editions of the indexes. They proceeded on such basis to collect data from over 3 600 medical institutions of tertiary hospitals in Beijing and the rest of China before and after the drug-clinic-separation reform in Beijing, National tertiary public hospitals and analyzed key indexes to learn the guidelines and impacts of the 2019 edition on hospital management. The performance indexes of the 2019 edition highlight the public welfare of public hospitals, strengthen the functional orientation of tertiary public hospitals, and point out the direction for further healthcare reform. These papers have a far-reaching impact on hospital strategy and management mode, guiding public hospitals to change their concepts and take on dual responsibilities of public welfare and self-development.