Seven imported films’ pre-war summer files [Fast and Furious 10 staged the final journey; Transformers Part VI, the unprecedented gathering of two camps]

　　According to previous years’ practice, the market was generally cold before entering the summer movie file. Due to the release of seven Hollywood blockbusters, such as Transformers: The Rise of the Super Warrior, The Dreamweaver and Spider-Man: The Universe, May and June this year may be different.

　　The last time an imported film was released, it was at the end of December last year — — Led by Avatar: The Way of Water, nine imported films were released, including Voyager with Red Hair, Cat in Boots and Detective Conan: The Bride of Halloween. In the end, Avatar: The Way of Water earned 1.697 billion yuan at the box office.

　　Speed and Passion 10

　　On May 12th, Speed and Passion 10 premiered in Rome. On the 17th, the film will be released in the mainland. As the final chapter of the series, the expected value of the film is full. In 2001, when Speed and Passion 1 was released in North America, although it was produced at a low cost, it made a box office of 200 million dollars worldwide. "Speed and furious 7" and "Speed and Passion 8" both exceeded 2 billion yuan at the box office in the mainland market. The box office performance of Fast and Furious 10 in the Mainland is worth looking forward to.

　　Dream maker

　　On May 25th, The Dreamweaver directed by Spielberg was released, which won the Best Drama and the Best Director at last year’s Golden Globe Awards. Based on Spielberg’s personal experience, the film tells the story of a teenager named Sam Faberman, who gradually grows into a famous filmmaker under the influence of his family.

　　Spider-Man: The Universe.

　　On June 2nd, the film Spider-Man: The Vertical and Horizontal Universe was released. In 2018, Spider-Man: Into the Spider-Verse told a story about Spider-Man by combining two-dimensional hand-drawn cartoons with three-dimensional CG modeling animation, and won the best animated feature film at the 91st Academy Awards. The film tells the story of "Little Black Spider" Miles Morales, vowing to break the fate curse of "saving one person or the whole universe" experienced by three generations of Spider-Man, and stand alone against the "Spider Alliance" led by Spider-Man 2099.

　　The flash

　　On June 16th, the superhero blockbuster "The Flash" was released simultaneously in mainland China and North America. The film tells the story of Flash barry allen who once had a happy family and lost his parents overnight. In order to save his parents, Flash tried to change history by going back to the past quickly, but unexpectedly disrupted the universe and met the story of Batman, Super Girl and the villain General zod in another time and space.

　　The little mermaid

　　On May 26th, The Little Mermaid was released. The film is a live-action movie, adapted from the animated film version in 1989. It tells the story of the little mermaid who lives in the sea, after falling in love with the prince, resolutely gives up her country and race, becomes human and pursues love.

　　Transformers: The Rise of Super Warriors

　　On June 9, "Transformers: The Rise of Super Warriors" was released. As the sixth film in this series, the film is also the first film made by the Big Mac camp. The two camps, Autobots and Big Mac, have gathered unprecedentedly, and the villains are as sinister as ever.

　　Crazy element city

　　Pixar’s new animation "Crazy Element City" was released on June 16th. The film constructs the characters in the animation with the four elements of wind, fire, water and earth in nature, and deduces a brand-new story for the audience.

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　　Rome premiere of the final chapter of "speed shock"

　　The fast-paced journey across the film history for more than 20 years set off again, and the new chapter "Speed and Passion 10" premiered in Rome on May 12. On the red carpet of the premiere ceremony, Vin Diesel made a dazzling appearance with the style of "Boss Tang". As a leading actor and producer, he is the soul of The Fast and the Furious series. In this final journey, everything that Tang loves and his loved ones will face unprecedented crisis.

　　Charlize Theron, the Oscar-winning actress, plays the villain Seve in the previous play, which is one of the most ruthless, cunning and greedy opponents that Tang’s team has ever met. With the return, her relationship with Boss Tang and the Feiche family became more complicated, and Charlize Theron’s wonderful performance also showed her powerful female strength.

　　Recently, several movie clips and behind-the-scenes tidbits have revealed the highlights of Speed and Passion 10, a highly anticipated masterpiece. Especially in the location of this premiere — — The street racing chase in Rome was described by director Letril as "an unprecedented high-level scene".

　　Over the years, The Fast and the Furious has always been deeply concerned and loved by the global audience, from the initial street racing story to a well-known series of movies, and Speed and Passion 10 will also lead fans to embark on this grand final. "It will pay tribute to those who have grown up, married and supported us for a quarter of a century." Dissel promised that "die-hard fans of the The Fast and the Furious series will feel full at the end of Fast and Furious 10."

　　This group/reporter Xiao Yang

　　Coordinator/Liu Jianghua

Dragon TV’s first documentary variety "Dear, Come to Eat" of urban observation food in China came to Hangzhou, a pilot city of national informatization and e-commerce. Under the epidemic situation, the program will be parachuted into Binjiang with concern about the living conditions of employees in the new economic industry. In this programme, guests Jerry, Li Sheng and Wong Cho Lam Li Yanan went into the families of video bloggers and e-commerce anchors respectively to record the warmth of their busy lives.

Video blogger "Meet Parents" and Jerry Li Shengcheng "Mentor"

In the program, guests Jerry and Li Sheng walked into the homes of video bloggers Yang Yadong and Chen Huimin. Although the small rental house was a little messy, they also decorated it with warmth and love, and the sweetness of their lives could be seen everywhere. Two people from Harbin and Qingdao stayed in Hangzhou to start a business after graduating from college. The post-95 couple edited their daily lives into short videos and posted them on a social platform, which attracted the attention and love of a large number of fans with a relaxed and humorous style. The good viewing volume and click volume of the video have brought economic benefits that can balance daily expenses.

But in my mother’s eyes, making videos can’t be a career that can support my family. After seeing her son’s life suddenly, she was worried that she would work too hard outside, hoping that he could return to his hometown Harbin to find a stable job and buy a house to settle down. The couple were obviously unprepared for their mother’s expectations, and Jerry and Li Sheng became their "mentors" and acted as "lubricants" between generations. How will they resolve the conflict of ideas between the two generations in one meal?

Entering the "anchor house", Wong Cho Lam Li Yanan helped "reunion"

On the other hand, Wong Cho Lam and Li Yanan met the "anchor family", and all four members of the family were engaged in the live broadcast of e-commerce. Because of the long time span of the live broadcast, it was difficult for the mother and twin daughters who broadcast live in different time periods to get together. In order to know more about the anchor’s daily life, Wong Cho Lam and Li Yanan decided to have this special dinner in the studio where they work.

During the live broadcast, Wong Cho Lam and Li Yanan met their twin sister Chufei Churan who was preparing for the live broadcast. They feel that the fast pace of work makes it rare for the family to sit together and have a meal. Even their birthdays can’t be celebrated with their parents. The unexpected arrival of Wong Cho Lam and Li Yanan has given the family a long-lost meal.

At the dinner table, my father frankly revealed the hardships of the sisters’ work: many times, they had no time to eat, so they could only eat two bites between live broadcasts; Always in a tense working environment, even dreaming will worry about insufficient inventory … … Words are full of concern and love for her daughter’s life. As a practitioner in the same industry, my mother pays more attention to the status of the two sisters at work, and often gives some professional suggestions and opinions.

In the program, the anchor dad also disclosed the criteria for choosing a husband. What is the perfect son-in-law in his heart? What interesting story happened at the dinner table? For more touching stories and warm-hearted moments, please look forward to the Dragon TV "Dear, Come to dinner" which will be launched at 22 o’clock this Saturday night.

　　Handling conditions:

　　Any Beijing citizen who holds a normal entity social security card can apply for an electronic social security card.

　　Handling materials:

　　You don’t need to provide materials, you can pass face recognition authentication and set a password.

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　　You can apply through "Beijing People’s Society" APP, "Electronic Social Security Card" WeChat applet, "Pocket 12333”APP," the State Council Client "WeChat applet," National Government Service Platform "APP and WeChat applet, bank channels or third-party channels.

　　(Note: Banking channels: China Industrial and Commercial Bank, China Agricultural Bank, China Bank, China Construction Bank, Bank of Communications, UnionPay China Unionpay Quick Pass, etc. Third-party channels: WeChat and Alipay. )

　　Tip: After a successful application in one channel, you only need to enter the password for verification when you collect it in other channels.

　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　 　

Scan the QR code to download the "Beijing People’s Society" APP.　 　 　 　 　 　 　 　 　 　 　Scan the QR code to open the "Electronic Social Security Card" WeChat applet.

　　Handling process:

　　Go to the homepage of the platform and follow the prompts.

　　Take the "Electronic Social Security Card" WeChat applet as an example:

　　Open the homepage of the applet-> click "electronic social security card"-> click "collect"-> enter personal identification information-> face recognition verification-> set password-> collect successfully.

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The exhibition "Elegance and Artistic Interest-Life, Wisdom and Art of Chinese" is being exhibited in the Art Museum of Beijing Academy of Painting. More than 110 classic paintings and calligraphy works are selected from the fine works collected by the Academy. From the perspectives of elegance and folklore, the painting art is used to tell the quiet and transcendent life that the literati yearn for and the flavor and interest in the lives of the folk people. The Spring Festival in Jihai is approaching, and there is also a popular "Year Culture" in the exhibition hall, such as a picture of "Year of the Year" painted by Qi Baishi, a great master, on the occasion of the Spring Festival, to celebrate the farewell of the old year and the welcome of the new year.

Qi Baishi

Year of the DPRK In 1950, it was collected by Beijing Painting Academy.

Chinese aesthetic presentation of "taste both refined and popular"

Qi Baishi, Wu Jingting, Hu Peiheng, Xu Yansun and Wu Guangyu cooperated."Chang Chun Xiu Mao" (Partial) Collected by Beijing Painting Academy

In Chinese’s aesthetic standards, there is a word called "taste both refined and popular". "Elegance" is the ultimate pursuit of ancient China literati. It is not only reflected in the daily speech and behavior of ancient literati, but also runs through their daily life. It can be said that "elegance" is the core of the aesthetic taste of elite cultural classes. High mountains and flowing water, playing the piano, is a kind of elegance; It is a kind of elegance to gather all the sages, fight for wine and recite poems; It is also a kind of elegance to look at the clouds and play with ink. For thousands of years, China literati have been enriching the connotation of elegance.

"Vulgarity" is the flavor and interest of China folk culture. Hard-working and simple Chinese summed up a lot of wisdom and philosophy about life in his work and life. China’s folk culture is more lively and interesting than the elegant things that literati care about. Auspicious patterns with the expectation of a better life, the strong New Year flavor embellished with lanterns and firecrackers, and the Chinese zodiac animals composed of real animals or unreal animals … all these are full of China flavor.

The exhibition not only introduces the elegant things that China literati are keen on, such as reading, playing the piano, watching paintings and collecting elegance; Four gentlemen in the flowers who express their aspirations through things-plum, orchid, bamboo and chrysanthemum; Natural philosophy with emotion and landscape. At the same time, it also introduces the traditional customs of ordinary people, such as attaching importance to loyalty, filial piety, propriety and righteousness, believing in religious beliefs, praying for good luck and longevity, and expecting a full house for future generations, as well as opera songs and dances with China cultural characteristics and the chronology of the zodiac. You can come here, watch "Chang Chun Xiu", and appreciate the grand occasion of Beijing painting circles in the late Qing Dynasty and the early Republic of China. Or taste the Mei Lanzhuju of Wu Changshuo, Chen Shiceng and Qi Baishi, and watch the literati play with ink and express their aspirations through things. You can also read and explain the characters and think about China’s unique religious culture; Or enjoy "Shoutao" and "Hundred philosophers", and consider that the painter’s painting implies auspiciousness and ingenuity.

Auspicious and festive, sharing a happy year together

Pray for the Spring Festival

Every time I bid farewell to the old and welcome the new, Chinese always uses the customs handed down from the older generation to ward off disasters and evil spirits and welcome the new. Every household writes blessings, cuts out window grilles, puts up New Year pictures, hangs lanterns, firecrackers and red lanterns, and the streets and alleys are filled with joy and joy of the Spring Festival. However, with the increasing proportion of science and information technology in our lives, people have begun to forget some customs in traditional culture. To this end, the exhibition leads the audience to recall the taste of the "Year" especially when the Spring Festival comes. Tell the origin of the word "Fu", the style of paper-cutting, the rubbing of New Year pictures and the message of stationery. The audience can come here to cut a window flower and stick it on the window to watch the spring flowers bloom; Write a blessing and stick it in front of the door, asking Fulu to get home safely; Send a letter, a short message, and send a New Year greeting; Print a New Year picture, which is more than enough every year, and pray for a bumper harvest. During the exhibition, the Beijing Academy of Painting held a "blessing" activity for the appreciation of the support of the audience from all walks of life over the years. From New Year’s Eve to the fifth day of junior high school, visitors to the Art Museum of Beijing Academy of Painting have the opportunity to get a famous "Fu" to celebrate the New Year.

The exhibition will last until February 28, 2019.

Appreciation of exhibition works

Chou Ying (model)The Picture of Peach and Plum Garden in Spring Banquet was collected by Beijing Painting Academy in Ming Dynasty.

Ancient literati in China liked to invite friends to gather in their own gardens, enjoy painting and calligraphy, drink wine and enjoy the scenery, and burn incense and tea together. The old man in red in the work is the master of the courtyard. He holds a candlelight dinner with his family and friends. The white porcelain wine glasses and red lacquer holders placed on the table are typical drinking utensils for literati in the Ming Dynasty, while the scroll paintings put away show that the owner has just enjoyed painting and calligraphy with the guests. After the tea banquet, there are some ancient books, scrolls, stone appreciation, bronze ribbons and wine sets on the mahogany table, all of which show the elegance of the party.

Qi Baishi Reading Map Collected by Beijing Painting Academy

After the May 4th Movement in 1919, influenced by western culture, horizontally typeset books appeared in China. Before that, ancient books were arranged vertically from the right, so Chinese developed a top-down reading habit, pitching heaven and earth between raising his head and lowering his head.

Li ShanThree Friends in the Collection of Beijing Painting Academy in Qing Dynasty

Pine trees, full of vitality and evergreen, are born in adversity and grow together with bamboo and plum blossoms in the cold winter. Therefore, in the eyes of the ancient people in China, these three plants are symbols of high morals and integrity, and they are called "three friends who are old and cold". Scholars like to keep company with three friends who are old and cold, and put them into paintings, which reflects their pursuit of loneliness, luxury and out of touch.

Yu Feian"Up to the Blue Sky" was collected by Beijing Painting Academy in 1958.

Different from western still life, Chinese’s paintings like to show the vitality of nature. Birds, or fly high, or chirp; Butterflies, or dancing, or nostalgia for flowers. Yu Feian, a painter, is good at drawing flowers and birds. In order to observe birds’ demeanor and movements, he also keeps pigeons at home. The two pigeons in the painting, one with its head held high and the other looking back, are lifelike, like a couple. This is the painter’s observation of life, which can be regarded as a sketch, and the auspicious cloud pattern in the painting is a classic pattern in China’s traditional painting.

Qi Baishi"Double Mantis" Collected by Beijing Painting Academy

In ancient Chinese, the seasons were known by observing nature, thus guiding farming. After the cold winter, the insects burst out of the ground, indicating the coming of farming season. Therefore, Chinese is very fond of insects. If landscape is Chinese’s thinking about the macro world, then grass bugs are their exploration of the micro world. Qi Baishi, a painter, loves life, and even a tiny creature has become something he is willing to show. Moreover, the grass insects he described are so real that even entomologists are full of praise, and the handling of details is even more exquisite.

Qi BaishiThe picture of making a fortune was collected by Beijing Painting Academy in 1927.

The object in the painting is an abacus, an ancient computing tool in China, which started in the Song Dynasty and is still in use today. Before the calculator appeared, Chinese always used abacus for calculation and statistics. Whether it is an inn, restaurant, teahouse or drugstore, every family has an abacus to calculate the operating income of the day, month and year. As a result, the abacus gradually has another meaning-making a fortune. Qi Baishi, a painter, did not draw coins, but used an abacus to make a fortune. This is Chinese’s wisdom and implication.

Qi BaishiAlbum of the 12 Zodiac Animals was collected by Beijing Painting Academy in 1940.

Zodiac is a unique commemorative method in China. Guan Weishan commissioned Qi Baishi to create the Twelve Zodiacs, and asked for two or three pictures every year. It took four years to collect one set. Then they took over the ink margin and became friends. This set of Zodiac is not created in the order of the zodiac, among which So Thousand Miles was first created in 1940, while The Picture of the Peach Monkey was painted in 1944. The old man Baishi vividly shows the characteristics of various animals in his paintings, and also conveys his own life feelings and emotions.

Guan LiangDramatic Characters was collected by Beijing Painting Academy in 1953.

Guan Liang’s four works of dramatic figures are all the national quintessence of China’s art-Peking Opera. Peking Opera was born in the Qianlong period of Qing Dynasty, and evolved from Huizhou Opera. It entered the court at the beginning of its formation, so the aesthetic requirements for the stage image are higher. There is a complete program for repertoire creation, gongs and drums singing, costumes and masks. Different from western drama, the performing arts of Beijing opera pay attention to the combination of reality and reality. Without landscaping, a gesture can show pushing the door and entering; Without props, one action can show galloping. And this kind of expressive stage essentials is related to Chinese philosophy.

Qi Baishi"Kingfisher Prawn" Collected by Beijing Painting Academy

Elegant and Artistic —— Chinese’s Life, Wisdom and Art

Exhibition period: January 29-February 28, 2019

Venue: Exhibition Hall, Floor 1-4, Art Museum, Beijing Academy of Painting

The government work report proposes to expand high-level opening to the outside world and promote mutual benefit and win-win results. Actively connect with high-standard international economic and trade rules, steadily expand institutional opening, enhance the linkage effect of two resources in the domestic and international markets, consolidate the basic disk of foreign trade and foreign investment, and cultivate new advantages in international economic cooperation and competition.

In the past year, the CPC Central Committee with the Supreme Leader as the core unswervingly promoted high-level opening up, persisted in promoting reform, development and innovation through opening up, promoted the construction of an open world economy, and opened up a broad space for development. China’s export share in the international market has remained stable, the actual use of foreign capital has been optimized, and the international influence and appeal of building the "Belt and Road" have become more prominent.

The deputies said that in the new era and new journey, we must unswervingly expand high-level opening up, continuously optimize the business environment, consolidate the basic disk of foreign trade and foreign investment, cultivate new advantages in international economic cooperation and competition, and constantly bring new impetus and opportunities to the world with our new development.

Promote a steady increase in the quality and quantity of foreign trade and accelerate the construction of a trade power.

The government work report proposes to promote a steady increase in the quality of foreign trade. The deputies said that at present, the momentum of world economic growth is insufficient and the demand is weak, but the industrial base, factor endowment and innovation ability on which China’s foreign trade development depends are constantly enhanced. We should continue to play the supporting role of exports in the economy, strengthen our confidence, go all out to stabilize foreign trade and accelerate the cultivation of new kinetic energy of foreign trade.

Expand new growth points such as intermediate trade and green trade. Representative Du Weidong, Chairman of Chongqing Xiyong Microelectronics Industrial Park Development Co., Ltd. believes that it is necessary to base on the local industrial base, cultivate new quality productivity, promote the upgrading of processing trade, increase the added value of products, and enhance the international competitiveness of Chinese enterprises and products. At present, Xiyong Microelectronics Industrial Park mainly exports smart terminals such as notebook computers, and is deeply empowered by new technologies such as naked-eye 3D and artificial intelligence (AI), which promotes the processing trade to extend to the high end of the industrial chain value chain.

Promote the healthy development of new formats such as cross-border e-commerce. "Cross-border e-commerce, as a new foreign trade format with fast development speed, great potential and strong driving effect, is becoming the development trend of international trade." Deputy Li Kuiwen, member of the Party Committee of the General Administration of Customs and director of Guangdong Branch, said. In recent years, China has continuously improved policies on customs clearance, taxation and foreign exchange, supported the reform and innovation of cross-border e-commerce comprehensive test area, cultivated and expanded cross-border e-commerce entities, optimized the layout of infrastructure such as overseas warehouses, and promoted the healthy and vigorous development of cross-border e-commerce.

Optimize the trade environment. Deputy Li Kuiwen said that as a major foreign trade province, Guangdong is actively building a high-level gateway hub for opening to the outside world, solidly promoting the construction of smart customs, implementing the action of "strengthening the country through smart customs", continuously improving the port business environment, optimizing the customs clearance operation process, and creating a market-oriented, rule-of-law and international first-class port business environment.

Increase investment and steadily expand institutional opening up.

The government work report puts forward that "more efforts should be made to attract foreign investment" and "restrictions on foreign investment access in the manufacturing sector should be completely abolished, and market access for services such as telecommunications and medical care should be relaxed".

The deputies said that to accelerate the construction of a new development pattern, it is necessary to promote the efficient connection between the domestic and international markets and resources, steadily expand the institutional opening of rules, regulations, management and standards, and build a new open economic system at a higher level.

Actively attract and utilize foreign investment. "Last year, the State Council issued opinions and put forward 24 policies and measures to stabilize foreign investment, which released China’s firm determination to promote opening up and greatly encouraged the confidence of foreign investment in China." Member Jiang Ying, the relevant person in charge of Deloitte Limited, said that China’s pragmatic measures of continuous opening-up are of great benefit to foreign investors, and Deloitte will continue to give full play to its professional advantages to help foreign-funded enterprises deepen their cultivation in China.

In-depth implementation of the promotion strategy of the Pilot Free Trade Zone to create a new highland for opening up. "Implement investment facilitation measures focusing on process supervision; The implementation of the’ non-stop flight permit’ in the transportation field has shortened the processing time by an average of 70% … Since its establishment, the Lingang New Area of Shanghai Pilot Free Trade Zone has maintained its openness, reform intensity and development momentum, and gradually formed a’ five freedoms and one convenience’ system. " Deputy Gu Jun, deputy secretary-general of Shanghai Municipal Government and director of the Municipal Development and Reform Commission, said that Shanghai will continue to benchmark the highest standards and the best level, focus on cross-border service trade and the development of leading industries, and explore the construction of an institutional system and supervision model that is linked to high-standard economic and trade rules, so as to explore new paths and accumulate new experiences for comprehensively deepening reform and opening up.

On March 1st, Hengqin Guangdong-Macao Deep Cooperation Zone officially implemented the branch line management and customs clearance operation. "Zhuhai actively meets high-standard international economic and trade rules, relies on the policy advantages of Hengqin Guangdong-Macao Deep Cooperation Zone, and allows more innovative elements to converge and overlap in Hengqin through infrastructure’ hard connectivity’ and institutional rules’ soft connectivity’ to promote the optimal combination of global industrial chain supply chains." Deputy Huang Zhihao, Deputy Secretary of Zhuhai Municipal Committee and Mayor of Guangdong Province, introduced that in the next step, Zhuhai will accelerate the construction of a new economic and trade channel for the Hong Kong-Zhuhai-Macao Bridge, expand the platform function of global cooperation for the China Air Show, and promote high-quality development through high-level opening.

Deeply participate in global industrial division of labor and cooperation, and promote the construction of an open world economy.

The deputies said that efforts should be made to promote the high-quality development of foreign trade, deeply participate in the global industrial division of labor and cooperation, maintain a pluralistic and stable international economic structure and economic and trade relations, and let more win-win results of cooperation benefit people of all countries.

Promote high-quality joint construction of the "Belt and Road" and go deep and practical. "For more than 10 years, the joint construction of the Belt and Road has achieved fruitful results and has become the most popular international public product and the largest international cooperation platform in the world today." Member Gong Fuwen, vice president of the Higher People’s Court of Shaanxi Province, said that it is necessary to do a good job in the implementation of the eight actions of building the "Belt and Road" with high quality, steadily promote cooperation in major projects, implement a number of "small but beautiful" livelihood projects, and actively promote cooperation in the fields of digital, green, innovation, health, cultural tourism and poverty alleviation.

Deepen bilateral and regional economic cooperation. Negotiate and sign high-standard free trade agreements and investment agreements with more countries and regions, promote the negotiation of the China-ASEAN Free Trade Area version 3.0, and fully and deeply participate in the WTO reform … China’s efforts to build an open world economy are progressing steadily.

"ASEAN has been China’s largest trading partner for four consecutive years, and bilateral trade and investment have continued to grow. With the in-depth implementation of the Regional Comprehensive Economic Partnership Agreement (RCEP) and the negotiation of the China-ASEAN Free Trade Area version 3.0, the potential of economic and trade cooperation is expected to be further explored. " Wei Zhaohui, Party Secretary and Director of International Expo Bureau of Guangxi Zhuang Autonomous Region, said that Guangxi will continue to hold China-ASEAN Expo with high quality, deepen and expand cooperation with ASEAN countries in the fields of commerce, trade, industry, labor, science and technology, education, etc., and show new achievements in China-ASEAN destiny community with closer service construction. (Reporter Luo Shanshan Tian Wei Huang Ford Wang Liang; Reporters Chang Qin, Li Gang, Jiang Xiaodan, Yuan Taoxiong, Zhu Jiaqi and Xie Weiqun participated in the writing)

Order of Beijing Municipal People’s Government

No.300

　　The Decision of the Beijing Municipal People’s Government on Amending the Measures of Beijing Municipality on Construction Permit has been adopted at the 127th executive meeting of the Municipal People’s Government on September 14, 2021, and is hereby promulgated and shall come into force as of the date of promulgation.

Mayor Chen Jining　　　　

October 1, 2021　　

Decision of the Beijing Municipal People’s Government on Amending the Measures of Beijing Municipality on Construction Permit

　　The Beijing Municipal People’s Government has decided to make the following amendments to the Measures of Beijing Municipality on Construction Permit:

　　1. Article 2 is amended as: "Where the following construction projects are carried out within the administrative area of this Municipality, the construction unit shall obtain a construction permit. However, the construction project with an investment of less than 300,000 yuan or a construction area of less than 300 square meters may not apply for a construction permit:

　　"(a) the new construction, renovation and expansion project of housing construction and its ancillary facilities and its supporting lines, pipelines and equipment installation;

　　"(two) the construction, renovation and expansion of municipal infrastructure;

　　"(three) housing decoration project.

　　"The municipal administrative department of housing and urban-rural construction may, according to the actual situation of this Municipality, adjust the scope of construction projects that may not apply for construction permits as stipulated in the preceding paragraph of this article, and report to the competent department of housing and urban-rural construction of the State Council for the record.

　　"Construction projects that have approved the commencement report in accordance with the authority and procedures stipulated by the State Council will no longer receive construction permits."

　　2. One paragraph is added to Article 3 as the third paragraph: "For housing construction projects and municipal engineering projects with a large amount of earthwork, the construction unit has obtained planning approval documents such as project design review opinions, and if the construction site meets the requirements stipulated by the municipal housing and urban construction administrative department, earthwork, slope protection, precipitation and other operations can be carried out in advance, but the building construction permits should be obtained before the main project construction at the latest."

　　III. Article 6 is amended as: "To apply for a construction permit, a construction unit shall meet the following conditions:

　　"(a) has been approved for the construction project, housing decoration project shall obtain the consent of the owner of the house.

　　"(two) the construction project planning permit shall be handled according to law, and the construction project planning permit has been obtained.

　　"(three) the construction site has basically met the construction conditions, and it is necessary to levy houses, and its progress meets the construction requirements.

　　"(four) the construction enterprise has been identified. If there is no tender for the project that should be invited in accordance with the regulations, there is no public tender for the project that should be invited in public, or the contracted project is dismembered, and the project is contracted to an enterprise that does not have the corresponding qualifications, the determined construction enterprise is invalid.

　　"(five) to meet the needs of construction funds, construction drawings and technical information, the construction unit shall provide the construction funds have been implemented in the letter of commitment, construction drawing design documents have been reviewed in accordance with the provisions.

　　"(six) there are specific measures to ensure the quality and safety of the project. In the construction organization design compiled by construction enterprises, there are corresponding quality and safety technical measures formulated according to the characteristics of construction projects. Establish project quality and safety responsibility system and implement it to people. The project with strong professionalism has compiled a special quality and safety construction organization design, and handled the project quality and safety supervision procedures in accordance with regulations. "

　　4. Article 10 is amended as: "The issuing authority shall timely examine the application for construction permit of the construction unit, and if the documents submitted by the applicant are incomplete, it shall inform all the documents that need to be supplemented at one time.

　　"If the documents submitted by the applicant are complete and conform to the provisions of Article 6 of these Measures, the issuing authority shall issue the construction permit within 5 working days from the date of receiving the application; Does not meet the provisions of article sixth of these measures, it shall make a written decision not to issue certificates and explain the reasons.

　　"The issuing authority may conduct on-site reconnaissance of the land for construction projects as required."

　　5. One paragraph is added to Article 23 as the first paragraph: "For construction projects that do not need to apply for construction permits, the relevant departments shall strengthen management, service and guidance according to law."

　　This decision shall come into force as of the date of promulgation. The "Measures" of Beijing Municipality on the Construction Permit of Construction Projects were revised and re-promulgated according to this decision.

attach

Measures of Beijing Municipality on Construction Permit of Construction Projects

　　(Promulgated by Decree No.139 of Beijing Municipal People’s Government on November 25, 2003, first revised according to Decree No.277 of Beijing Municipal People’s Government on February 12, 2018, and second revised according to Decree No.300 of Beijing Municipal People’s Government on October 1, 2021)

　　Article 1 In order to strengthen the supervision and management of construction activities, maintain the order of the construction market, and ensure the quality and construction safety of construction projects, these Measures are formulated in accordance with the Construction Law of People’s Republic of China (PRC) and the Regulations on the Quality Management of Construction Projects, combined with the actual situation of this Municipality.

　　Article 2 Where the following construction projects are carried out within the administrative area of this Municipality, the construction unit shall obtain a construction permit. However, for a construction project with an investment of less than 300,000 yuan or a construction area of less than 300 square meters, it is not necessary to apply for a construction permit:

　　(a) new construction, renovation and expansion projects of housing buildings and their ancillary facilities and their supporting lines, pipelines and equipment installation;

　　(two) the construction, renovation and expansion of municipal infrastructure;

　　(3) House decoration and fitment works.

　　The municipal administrative department of housing and urban-rural construction may, according to the actual situation of this Municipality, adjust the scope of construction projects that may not apply for construction permits as stipulated in the preceding paragraph of this article, and report to the competent department of housing and urban-rural construction of the State Council for the record.

　　In accordance with the authority and procedures prescribed by the State Council, the construction project that has approved the commencement report will no longer receive a construction permit.

　　Article 3 If a construction permit should be obtained according to law, but it has not been obtained, the construction project may not be started.

　　The term "commencement" as mentioned in these Measures refers to the commencement of construction work of construction projects, in which the commencement of new projects refers to the commencement of foundation pile construction or earthwork excavation; The commencement of renovation, expansion and renovation of old houses refers to the commencement of demolition and renovation work.

　　Housing construction projects and municipal engineering projects with a large amount of earthwork, the construction unit has obtained planning approval documents such as project design review opinions, and if the construction site meets the conditions stipulated by the municipal housing and urban construction administrative department, earthwork, slope protection, precipitation and other operations can be carried out in advance, but at the latest, building construction permits should be obtained before the main project construction.

　　Article 4 No unit or individual may break down the project that should apply for a construction permit into projects below a certain limit to avoid applying for a construction permit.

　　Fifth city housing and urban construction administrative department is the competent authority of the city’s construction permit. The district housing and urban construction administrative department shall be responsible for the construction permit of construction projects within its administrative area in accordance with the prescribed responsibilities.

　　Article 6 To apply for a construction permit, a construction unit shall meet the following conditions:

　　(a) has gone through the approval procedures for the construction land, and the house decoration project shall obtain the consent of the owner of the house.

　　(two) the construction project planning permit shall be handled according to law, and the construction project planning permit has been obtained.

　　(three) the construction site has basically met the construction conditions, and it is necessary to requisition houses, and its progress meets the construction requirements.

　　(4) The construction enterprise has been identified. If there is no tender for the project that should be invited in accordance with the regulations, there is no public tender for the project that should be invited in public, or the contracted project is dismembered, and the project is contracted to an enterprise that does not have the corresponding qualifications, the determined construction enterprise is invalid.

　　(five) there are capital arrangements, construction drawings and technical data to meet the needs of construction, and the construction unit shall provide a letter of commitment that the construction funds have been implemented, and the construction drawing design documents have passed the examination as required.

　　(six) there are specific measures to ensure the quality and safety of the project. In the construction organization design compiled by construction enterprises, there are corresponding quality and safety technical measures formulated according to the characteristics of construction projects. Establish project quality and safety responsibility system and implement it to people. Professional engineering projects have compiled special quality and safety construction organization design, and gone through the supervision procedures of engineering quality and safety in accordance with regulations.

　　Article 7 Construction permits shall be obtained on the basis of construction projects. However, housing construction projects can be collected separately for one or several individual projects; Linear municipal infrastructure projects can be collected in sections.

　　In accordance with the provisions of the preceding paragraph, the construction projects shall receive construction permits respectively, and the project investment or construction area of each single project and sub-project shall not be less than the limit as stipulated in Article 2 of these Measures; The sum of the construction scale and project investment of each single project and subsection project shall be consistent with the total construction scale and total project investment of the construction project respectively.

　　Article 8 The underground pipeline project of newly-built roads shall receive the construction permit along with the newly-built road project; Housing ancillary facilities, lines, pipelines and equipment installation projects supporting the housing should be accompanied by housing construction projects to obtain construction permits; The newly-built housing decoration project can receive the construction permit along with the housing construction project.

　　Article 9 The construction unit shall, before the construction project starts, apply to the municipal administrative department of housing and urban-rural construction or the district administrative department of housing and urban-rural construction where the construction project is located (hereinafter referred to as the issuing authority) for obtaining the construction permit, and submit the following documents:

　　(a) to fill in a complete application form for a construction permit with the seal of the construction unit, which can be downloaded from the website of the municipal administrative department of housing and urban-rural construction or obtained free of charge from the issuing authority;

　　(two) documents that meet the conditions stipulated in Article 6 of these Measures.

　　Article 10 The issuing authority shall examine the application for construction permit of the construction unit in a timely manner. If the documents submitted by the applicant are incomplete, it shall inform all the documents that need to be corrected at one time.

　　If the documents submitted by the applicant are complete and conform to the provisions of Article 6 of these Measures, the issuing authority shall issue the construction permit within 5 working days from the date of receiving the application; Does not meet the provisions of article sixth of these measures, it shall make a written decision not to issue certificates and explain the reasons.

　　The issuing authority may, if necessary, conduct on-site reconnaissance of the land for construction projects.

　　Article 11 A construction permit is divided into one original and two copies, both of which have the same legal effect.

　　It is forbidden to forge, alter or alter the construction permit.

　　Twelfth after the issuance of the construction permit, the construction unit or the construction unit changes, it should re apply for a construction permit.

　　If other conditions specified in Article 6 of these Measures are changed, it shall be reported to the relevant administrative departments for changing procedures according to law, and the construction unit shall inform the issuing authority within 10 days after going through the changing procedures; If it is not necessary to report to the relevant administrative department for change procedures according to law, the construction unit shall inform the issuing authority within 10 days after the conditions change.

　　Thirteenth construction units shall publicize a copy of the construction permit in a prominent position on the construction site of the construction project.

　　Fourteenth construction units shall start construction within 3 months from the date of receiving the construction permit. If it is unable to start work for some reason, it shall apply to the issuing authority for an extension before the expiration; The extension is limited to two times, each time not exceeding 3 months. If the project is neither started nor extended, or the number and time limit of extension are exceeded, the construction permit shall be automatically abolished.

　　Article 15 If the construction of a building project under construction is suspended for any reason, the construction unit shall report to the issuing authority in writing within one month from the date of suspension, including the time, reason, construction progress, maintenance management measures, etc. of the suspension, and do a good job in the maintenance management of the building project in accordance with the regulations.

　　When a building project resumes construction, it shall report to the issuing authority; Before the project that has been suspended for one year resumes construction, the construction unit shall report to the issuing authority for verification of the construction permit.

　　Sixteenth city housing and urban construction administrative departments shall regularly summarize the construction permits issued by the city, to the public and accept public inquiries.

　　Seventeenth any unit or individual shall have the right to report and report the acts of construction without obtaining the construction permit or not in accordance with the provisions of the construction permit.

　　Eighteenth city housing and urban construction administrative departments shall, in accordance with the provisions of the construction unit, the construction unit and the construction permit related credit information recorded in the Beijing enterprise credit information system.

　　Article 19 If the construction unit does not obtain the construction permit, or if the construction unit or the construction unit changes and fails to obtain the construction permit again, the municipal or district housing and urban-rural construction administrative department shall order it to stop the construction, make corrections within a time limit, and impose a fine of more than 1% but less than 2% of the project contract price.

　　Twentieth in violation of the provisions of the second paragraph of Article 12 of these measures, the construction unit fails to inform the issuing authority about the changes on time, the municipal or district housing and urban construction administrative department shall give it a warning and impose a fine of 5000 yuan to 30000 yuan.

　　Article 21 If the issuing authority and its staff fail to issue construction permits in accordance with regulations, or fail to perform their duties of supervision and management after issuing construction permits, or fail to investigate and deal with illegal acts that should be investigated according to law, the higher authorities shall order them to make corrections, and the responsible personnel shall be given administrative sanctions according to law; If a crime is constituted, criminal responsibility shall be investigated according to law.

　　Twenty-second construction units believe that the specific administrative act of the issuing authority in handling the construction permit infringes upon their legitimate rights and interests, and may apply for administrative reconsideration or bring an administrative lawsuit according to law.

　　Twenty-third for construction projects that do not need to apply for construction permits, the relevant departments shall strengthen management, service and guidance according to law.

　　The repair of memorial buildings and ancient buildings approved as cultural relics protection according to law shall be implemented in accordance with the provisions of relevant laws and regulations on cultural relics protection.

　　Measures for the administration of construction permits for military housing construction projects shall be implemented in accordance with the relevant provisions of the State Council and the Central Military Commission (CMC).

　　These Measures are not applicable to emergency rescue and disaster relief and other temporary housing construction and the construction of farmers’ self-built houses with two floors or less.

　　Twenty-fourth the implementation since January 1, 2004. On November 25, 1989, the Beijing Municipal People’s Government issued Order No.36, and the Interim Measures for the Administration of Construction Projects in Beijing, which was revised according to Order No.12 of the Beijing Municipal People’s Government on December 31, 1997, was abolished at the same time.

The United States has again "black hand"

According to the reference news quoted by the US media, on September 13th, the US government decided to substantially increase the import tariffs on China products, including 100% tariffs on electric vehicles, 50% tariffs on solar cells and 50% tariffs on China semiconductors.

The latest action of the United States has aroused complaints from many industries in the United States, saying that the price increase will disrupt the supply chain, including the supply chain of semiconductor-intensive products. One study after another shows that Americans bear almost all the costs of imposing tariffs on China products. Once importers pay the tariffs, they usually pass some or all of the costs on to consumers. Jason oxman, president of the Information Technology Industry Association of the United States, said, "Since its implementation, tariffs have caused cumulative losses to American enterprises and consumers of $221 billion. With today’s announcement, the Office of the US Trade Representative once again relies on blunt and ineffective tariff tools, and its effectiveness has no support. "

Recently, He Yongqian, spokesman of China’s Ministry of Commerce, said that the US 301 tariff on China was unpopular and urged the US to immediately cancel all tariffs on China.

The United States substantially raised tariffs on China products.

According to the reference news quoted on the website of VOA Radio on September 13th, the US government decided on the 13th to substantially raise the import tariffs on China products, including the tariff on electric vehicles by 100%, in order to strengthen the protection of strategic industries in the United States.

A press release from the Office of the United States Trade Representative says that some tariffs will take effect on September 27th. In addition to imposing 100% tariffs on electric vehicles in China, the United States will also impose 50% tariffs on solar cells in China and 25% tariffs on steel, aluminum, electric vehicle batteries and key minerals in China.

At the same time, the United States will increase the import tariff of China semiconductor by 50%, and this new tax rate will take effect in January 2025. In the category of semiconductor, two categories of polysilicon and silicon wafer used in solar panels have been added.

He Yong, spokesman of China’s Ministry of Commerce, said on September 5th that the office of the US Trade Representative had solicited public comments on the results of the tariff review, and most of them opposed to increasing tariffs or applying for expanding the scope of tariff exemption, which showed that the US tariff 301 on China was unpopular and urged the US to immediately cancel all tariff increases on China.

He Yongqian said, "China has repeatedly made solemn representations to the US on the issue of tariff 301. The WTO has already ruled that tariff 301 violates WTO rules, and it is a mistake for the US to increase tariffs on China. We urge the US to correct its wrong practices, actively respond to voices from all walks of life and immediately cancel all tariffs on China. "

Earlier in May, a spokesman for the Ministry of Commerce made a statement on the results of the four-year review of the tariff 301 imposed on China by the United States. On May 14th, the United States released the results of the four-year review of the tariff 301 imposed on China, announcing that on the basis of the original tariff 301 imposed on China, it would further increase tariffs on products imported from China, such as electric vehicles, lithium batteries, photovoltaic cells, key minerals, semiconductors, steel and aluminum, port cranes and personal protective equipment. China resolutely opposes and makes solemn representations.

Due to domestic political considerations, the United States abused the 301 tariff review procedure, further increased the 301 tariff imposed on some Chinese products, and politicized and instrumentalized economic and trade issues, which is a typical political manipulation. China expresses strong dissatisfaction with this. The WTO has already ruled that tariff 301 violates WTO rules. Instead of correcting it, the United States has gone its own way and made mistakes again and again.

The Ministry of Commerce said that the United States should immediately correct its wrong practices and cancel the tariff increase measures against China. China will take resolute measures to defend its own rights and interests.

The EU has also made small moves.

On September 12th, a spokesman for the European Commission said that the price commitment solutions submitted by the China Chamber of Commerce for Electromechanical Industry and all electric vehicle manufacturers in the EU’s anti-subsidy case failed to meet the requirements, and the European side intended to reject the relevant price commitment applications.

In this regard, on the evening of September 13th, the spokesman of the Ministry of Commerce answered a reporter’s question about the European Commission’s plan to reject the price commitment solution of the EU anti-subsidy case for electric vehicles submitted by the China industry, saying that China has taken note of the relevant statement of the European side. Ignoring the sincerity and efforts of the China industry, the European Commission proposed to reject the flexible solutions proposed by the China industry without in-depth communication. China is deeply disappointed.

On August 20th and September 9th, the European Commission twice released the final disclosure of the EU anti-subsidy case on electric vehicles, and still continued the wrong practice and awarded a high tax rate. China can’t agree and accept this, but it always upholds the greatest sincerity and strives to properly resolve the friction through dialogue and consultation.

On August 24th, the China industry put forward a price commitment solution within the time limit of the investigation procedure of this case, which fully considered the demands of the European side and showed maximum flexibility. China industry indicated that its price commitment proposal is completely compliant and enforceable, and all technical problems can be solved through consultation. It is understood that several EU member states have also shown great interest in price commitment solutions.

The European Commission’s rejection of the relevant plan without detailed evaluation has not only undermined the confidence of China’s industry in continuing cooperation, but also failed to meet the expectations of EU member States, and even failed to meet its public statement that it hopes to solve the case through dialogue.

On June 22nd, since China and the EU agreed to start the consultation on the countervailing case of electric vehicles in the EU, the working teams of the two sides have conducted more than ten rounds of intensive consultations. China has submitted tens of thousands of pages of facts and evidence to the European side, and also put forward flexible solutions, making great efforts.

However, on the one hand, the European side claimed to be willing to solve the problem through dialogue, on the other hand, it quickly and rashly rejected the Chinese proposal, and never gave any specific case, which did not show the sincerity of moving in the opposite direction at all. If the consultation fails to reach a consensus, the responsibility lies entirely with the European side.

The key to the current consultations lies in whether the European side really has the political will to solve the problem. China urges the European side to earnestly implement the important consensus reached at the tripartite meeting of leaders of China, France and Europe on properly handling economic and trade frictions through dialogue and consultation, show sincerity and actions, and seriously consider the legitimate concerns of the French industry.

China has both the greatest sincerity to properly resolve differences through dialogue and consultation and the greatest determination to safeguard the legitimate rights and interests of China enterprises. China will pay close attention to the follow-up progress of the European side and will take all necessary measures to firmly defend the legitimate rights and interests of China enterprises.

Original title: "Sudden! The United States, a substantial increase in tariffs! 》

Read the original text

introduction

Sudden cardiac death is one of the most important problems faced by cardiologists. In many cases, the success rate of rescue is not high, so the mortality rate is still high. At present, most of the solutions are passive, and ICD (Implantable Defibrillator) is installed after patients survive, but the status quo of diagnosis and treatment of sudden cardiac death (SCD) is not optimistic. In this regard, Fuwai Hospital of China Academy of Medical SciencesProfessor Hua Wei.Report on "Current situation and challenges of prevention and treatment of sudden cardiac death in China".He mentioned that early defibrillation is the key to improve the survival rate of cardiac arrest, and early preventive implantation of ICD is the most effective means to prevent sudden cardiac death.

Sudden cardiac death is the first killer of cardiovascular disease.

The leading cause of death among adults in the United States is SCA (cardiac arrest), with an annual incidence of 450,000, which exceeds the sum of all these diseases, such as stroke (167,366), lung cancer (157,400), breast cancer (40,600) and AIDS(42156).

As a populous country, how many people have sudden cardiac death every year in China? Fuwai Hospital conducted an epidemiological survey more than ten years ago, and included the population of Beijing, Guangzhou, Shanxi and Xinjiang for sampling survey. It was the first time that the incidence of SCD in China was 418.4/100,000. If calculated by the population of 1.3 billion, the total number of sudden deaths in China was about 544,000/year, ranking first in the world.

The concept of sudden cardiac death

Definition: Sudden death due to heart causes is characterized by quickness, natural and unexpected within 1 hour after symptoms occur. About the etiology of SCA, 80% are coronary heart disease, chronic myocardial scar after myocardial infarction, acute plaque instability, rupture, bleeding and thrombosis. 10-15% are cardiomyopathy, including hypertrophic cardiomyopathy and dilated cardiomyopathy. Less than 5% of uncommon causes, such as primary electrical activity and hereditary ion channel abnormality, valvular disease or congenital heart disease, and other reasons. The triggering mechanism of SCA: transient ischemia, hemodynamic fluctuation, neurocardiovascular influence and environmental factors.

Prevention and treatment of sudden cardiac death-first aid outside the hospital

First aid outside the hospital:

Timely cardiopulmonary resuscitation and electrical defibrillation;

Most patients can not get timely and effective cardiopulmonary resuscitation;

The data shows that the popularity and effect of SCD out-of-hospital first aid are not good; According to the data of the United States in 2004, there were 166,000 cases of sudden cardiac death outside the hospital. Among them, only about 60% received emergency medical services, and the average survival rate after rescue was only 6.4%.

The above data may be lower in China.

Electrical defibrillation should be performed as soon as possible for patients with sudden cardiac death. Early defibrillation is the key to improve the survival rate of cardiac arrest.

Promote the use of AED (automated external defibrillator) in public areas with relatively high probability of witness cardiac arrest. Try to shorten the interval between stopping pressing and giving electric defibrillation, and CPR must be resumed immediately after giving electric defibrillation.

In 2010, JACC magazine reported the comparison of survival rate between CPR alone and CPR+AED for SCD patients outside the hospital. 13769 cases of SCD were selected, and only CPR was given before EMS arrived, with a survival rate of 9% (382/4 403). The survival rate was 24%(69/289) after CPR+AED treatment before EMS arrived, which was more than 2 times higher. Logistic regression results show that:AED therapy was significantly related to the survival rate of SCD patients, and the OR value was 1.75(p<0.002).

Current situation of AED configuration in China

At present, the number of defibrillators installed in public places in China is very limited, and fewer people know how to use them, which makes many patients lose the opportunity of first aid. It is difficult to carry around and play a role in time. It is impossible to issue treatment before the patient has syncope, which reduces the damage of important organs.

Prevention and Treatment of Sudden Cardiac Death —— Application of Wearable Defibrillator (WCD)

WCD can monitor the heart rhythm in real time. Once a patient has ventricular fibrillation, it can identify ventricular fibrillation in the shortest time, deliver electrode defibrillation, and effectively save the patient’s life. Automatic glue spraying during defibrillation; No conductive paste, no sticky electrode sheet; Light weight (the wearing part is only 0.815 kg); Make patient’s conscious judgment before defibrillation; Bidirectional wave 150 joules; Record and save the data 30 seconds before the heart event; Store ECG data for up to 75 minutes at a time.

AHA medical advice:

WCD technology has also been preliminarily studied in China. From June 2018 to October 2019, Fuwai Hospital and several hospitals jointly led a multi-center clinical observation study on wearable defibrillators in China. 54 patients with WCD were enrolled,Baseline information is as follows:

Indications of WCD under study:

1. Early acute myocardial infarction (within 40 days) with LVEF≤35%, 19 cases (35.2%).

2. 9 cases (16.7%) were waiting for heart transplantation and had high risk of SCD.

3. ICD could not be implanted temporarily for various reasons (such as infection), 7 cases (13.0%).

4. Newly diagnosed non-ischemic cardiomyopathy with LVEF<35%, 5 cases (9.3%).

5. Five cases (9.3%) met the secondary prevention of SCD, but the estimated survival time was less than one year.

6. ICD implantation was refused for various reasons (such as economy), 5 cases (9.3%).

7. After emergency revascularization (within 3 months), LVEF≤35%, 4 cases (7.4%).

Follow-up

1. Average wearing days: 51 34 days (longest 145 days, shortest 1 day);

2. Only 18 patients (33.3%) insisted on wearing it for one month during the three-month follow-up;

3.59.3% patients feel good about wearing; 33.3% feel ordinary when wearing;

4. The two main problems of wearing are the influence, and the size does not meet the requirements of its own body shape;

5. Only one patient was monitored for ventricular fibrillation (successful defibrillation);

6. Error-free discharge occurs.

The most effective means to prevent sudden cardiac death-implantable defibrillator (ICD)

In the United States, the annual incidence of sudden cardiac death is 250,000 to 350,000, and the average survival rate is only 5%. It is necessary to identify this high-risk patient to prevent cardiac arrest. Data show that ICD is as effective as 99% in the treatment of cardiac arrest. At the earliest, ICD needed open chest implantation, and now there are many jugular vein implants.

The progress of ICD treatment: the first ICD was implanted in the United States in 1980, approved by FDA in 1985, simple program control in 1987, hierarchical treatment in 1988, non-thoracotomy electrode lead system in 1989, biphasic ICD system in 1989, chest ICD system in 1993, unipolar defibrillation in 1993, miniaturization in 1993-1997, prolonged life and improved diagnostic ability. Now it has become a widely used method to prevent sudden cardiac death.

2017 ACC/AHA/HRS Guidelines for Patients with Ventricular Arrhythmia Management and SCD Prevention

Class I indications:

1. Survivors of SCD caused by ischemic heart disease, ventricular tachycardia or ventricular fibrillation, or stable ventricular tachycardia caused by hemodynamic instability or irreversible factors, with an estimated survival time of > 1 year, ICD implantation is recommended.

2. In patients with ischemic heart disease and syncope, if electrophysiological examination induces monomorphic sustained ventricular tachycardia and the expected survival time is more than 1 year, ICD implantation is recommended.

3. If the LVEF of ischemic heart disease is less than 35%, at least 40 days after myocardial infarction, or 90 days after revascularization, if the cardiac function is still Grade II or III on the basis of drug treatment guided by the guidelines, ICD is recommended for primary prevention.

Although ICD is a type I indication, it also has defects. After ICD is implanted in human body, its utilization rate is not very high. A prospective, non-randomized international multi-center clinical study of so-called level 1.5 prevention enrolled 3889 patients in 17 countries.

Level 1.5 prevention = level 1 prevention plus one or more items:

Non-persistent ventricular tachycardia; Frequent ventricular premature beats (> 10 beats/hour); LVEF<25%； History of syncope.

The results showed that the average follow-up was 21 10 months. Compared with the patients who did not receive ICD implantation, the all-cause mortality of the patients who received ICD implantation decreased by 49%.

The application of ICD in China, the first epicardial ICD system was implanted in 1992, and the first intravenous ICD system was implanted in China in 1996. With the formulation of ICD implantation indication guidelines and publicity and education, the number of implants has increased greatly every year since 2002. At present, about 5000-6000 patients are implanted with ICD every year in China. The proportion of primary prevention and secondary prevention in patients with ICD implantation in China is equal.

Difficulties that traditional intravenous ICD system may encounter;

Subclavian vein occlusion;

Vascular malformation;

Wear of venous lead (broken lead/broken insulation);

Difficult to pull out the lead (infection and other reasons);

The whole system needs to be removed due to infection.

In order to reduce and avoid complications caused by defibrillation leads via intravenous ICD electrodes, a brand-new technology "total subcutaneous ICD" has been developed. Vein-free lead defibrillation system, subcutaneous implantable ICD system, total subcutaneous implantation. There is no need to implant electrode leads into the heart through blood vessels to ensure the structural integrity of blood vessels. Implantation is strictly in accordance with anatomical structure, and radioscopy is not needed during implantation. The disadvantage is that pacing is not possible.

On December 23, 2014, Fuwai Hospital implanted the first SICD in China.

In 2015, ESC Guidelines recommended its Class Ⅱa:

For patients with ICD indications who do not need pacing, CRT or ATP treatment, S-ICDs should be considered as an alternative treatment for intravenous ICD.

2017 AHA/ACC/HRS VA/SCD guidelines will transfer it to Class I indications, but there are conditions: 　

"Implanting a subcutaneous cardioverter defibrillator (S-ICD) has a lower risk of infection than TV-ICD. Therefore, S-ICD is more suitable for patients with high risk of infection, such as patients with device infection, patients with end-stage renal disease, or patients with long-term immunosuppression. "

Multi-center SICD research in China and follow-up analysis of clinical application in multi-centers in implantable cardioverter defibrillator under the skin included 111 patients who successfully implanted S-ICD in 42 centers in China and had stable follow-up. The follow-up period was (272 283) d, with 39 cases of primary prevention (35.1%) and 72 cases of secondary prevention (64.9%). The results showed that 22 patients (20.8%) received 51 appropriate defibrillation treatments, and 9 patients (8.5%) had 24 inappropriate defibrillation treatments. The main cause of inappropriate defibrillation is t-wave oversensing. It is suggested that S-ICD implantation is effective and safe in China.

NEJM magazine published a prospective randomized controlled study of PRAETORIAN. This is the first prospective randomized controlled head-to-head study of S-ICD vs TV-ICD. There are 849 patients enrolled in 39 centers (Europe and the United States) in 6 countries, including 426 cases of S-ICD and 423 cases of TV-ICD. All products of TV-ICD can be enrolled (single cavity ICD), with ICD indications and meeting the requirements of S-ICD implantation.

Main end point:Compared with TV-ICD, S-ICD has non-inferiority, inappropriate electric shock, complications related to ICD system and needing intervention, and lead-related complications.

Main results:The incidence of inappropriate treatment and complications of S-ICD is similar to that of TV- ICD. The mortality of S-ICD & TV-ICD is low; The lead-related complications were significantly reduced, with 6.6% (n=24) in the control group (TV-ICD) and 6.6%(n=24) in the control group (TV-ICD).

The future and development prospect of SICD. The disadvantage of full subcutaneous ICD is that it can not effectively pace the heart. If the patient has bradycardia, he can pace bradycardia with the help of a leadless pacemaker.

Another feasible scheme, EV-ICD,Defibrillation coil is under the sternum, closer to the heart, and can conduct effective cardiac pacing. The purpose of research and development is to realize low defibrillation threshold (DFTs), small size, long service life and pacing function including ATP (anti-tachycardia pacing) through EV-ICD. This technology has been clinically studied.

EV-ICD research is a prospective, non-randomized, first long-term clinical study in human body. Patients who meet the indications of class ⅰ or ⅱ A ICD were included; Under fluoroscopy, the defibrillation lead was buried in the posterior sternum area by subcutaneous tunnel tool, and the pulse generator was placed on the left side of the chest. The defibrillation efficiency was tested by inducing fibrillation during implantation, detecting and converting ventricular fibrillation. The energy to terminate ventricular fibrillation was usually 20J once or 30J； twice in succession. Follow-up was performed at 2 weeks, 4-6 weeks and 3 months after operation. The main safety end point was no instrument or operation-related complications within 3 months after operation.

The results showed that 21 patients tried to implant, and finally 20 patients successfully implanted EV-ICD；. One patient with mediastinal fibrosis failed to be implanted successfully.

Defibrillation therapy:One patient failed to induce ventricular fibrillation/tachycardia; 89.5% patients (17/19 cases) successfully terminated ventricular fibrillation, and the defibrillation threshold was ≤30J, and the median defibrillation threshold was 15J；. The defibrillation threshold of 10.5% patients was > 30J.

Bradycardia treatment:95% patients (19/20 cases) successfully completed the pacing test, and the pacing threshold in acute phase was ≤10V, with an average of 5.1±1.9V；; R wave perception test: the average amplitude of R wave is 3.2±1.7mV；; The amplitude of R wave during ventricular fibrillation is 2.8±1.7mV, and ventricular fibrillation during operation can be correctly identified.

EV-ICD studies the clinical application experience of long-term implantation of infrasternal extravascular ICD, which proves that EV-ICD overcomes the shortcoming that SICD can’t pace, and will have a wider application prospect.

summary

Sudden cardiac death should attract our attention. The prevention and treatment of sudden cardiac death in China has a long way to go, and we need all of you to work together to reduce the occurrence of SCD in China and save more patients.

-End-　

State and municipal people’s governments, provincial committees, offices, departments and bureaus:

　　"Yunnan Fuwai Cardiovascular Hospital Comprehensive Reform Pilot Overall Plan" has been approved by the provincial people’s government and is hereby issued to you, please implement it carefully.

　

　

General Office of Yunnan Provincial People’s Government

August 29, 2018

　

　　(This piece is publicly released)

　

Overall scheme of comprehensive reform pilot of Fuwai Cardiovascular Hospital in Yunnan Province

　　In order to promote the reform and development of Fuwai Cardiovascular Hospital in Yunnan Province (hereinafter referred to as Yunnan Fuwai Hospital), we strive to explore a new way of comprehensive reform of public hospitals that is in line with the actual situation in our province, build Yunnan Fuwai Hospital into a world-class high-end medical service center, and make every effort to help our province build a world-class "healthy living destination card".

　　I. Scope of reform

　　This reform pilot was implemented in Fuwai Hospital in Yunnan, which is managed as a public welfare second-class institution.

　　Second, the overall requirements

　　Guided by the Supreme Leader’s Socialism with Chinese characteristics Thought in the New Era, conscientiously implement the spirit of the 19th National Congress of the Communist Party of China, conscientiously deepen the reform and deployment of the medical and health system, follow the basic path of the "three-medical linkage" reform of medical care, medical insurance and medicine, earnestly implement the government’s responsibility for running medical services, give full play to the main role of Yunnan Fuwai Hospital, and try first in exploring and innovating the management system and operation mechanism of public hospitals. Efforts will be made to promote reforms focusing on medical consumables and drug procurement methods, total personnel management, medical insurance payment methods, personnel compensation systems, medical service prices, financial subsidies, etc., and strive to achieve the organic unity of social benefits and operational efficiency, forming a good situation in which the government is at ease, patients are satisfied, and hospitals are healthy and sustainable.

　　III. Objectives and tasks

　　By the end of 2020, we will explore the formation of a relatively perfect modern hospital management system and a new mechanism for maintaining public welfare, mobilizing enthusiasm and ensuring sustainable operation of public hospitals, so as to realize the homogenization of management between Yunnan Fuwai Hospital and China Academy of Medical Sciences, and significantly improve the medical level and service quality. Yunnan Fuwai Hospital has fully opened 12 clinical centers and 27 medical departments for coronary heart disease, hypertension, congenital heart disease and arrhythmia, with 10,000 cases of interventional surgery and 2,500 cases of heart, great vessels and peripheral vascular surgery each year, of which the proportion of third-and fourth-grade operations exceeds 50%, the total service volume and the number of difficult and severe cases in diagnosis and treatment have reached the leading position in China, and the number of new technologies and projects for diagnosis and treatment of cardiovascular diseases has been at the forefront in China, initially covering all. Yunnan Fuwai Hospital will be built into "Yunnan Congenital Heart Disease Screening Management Center" and "Yunnan Cardiovascular Disease Quality Control Center", and gradually become a national regional medical center and clinical medical research center based in Yunnan, facing southwest and radiating South Asia and Southeast Asia.

　　On the basis of accelerating the improvement of clinical discipline construction level and disease prevention ability of Fuwai Hospital in Yunnan, a high-quality cardiovascular disease specialist training base will be basically built, which will be used as a technical support platform to radiate the whole province and promote the continuous improvement of cardiovascular disease treatment ability of hospitals at all levels in the province. By 2020, more than 500 cardiovascular medical professionals will be trained in the province, and the cardiovascular department of 50 county-level hospitals in the province will meet the basic standards of medical service capacity of county hospitals required by the state, and 10 county-level hospitals will meet the recommended standards; Support five state-level hospitals to carry out more than 10 kinds of cardiovascular surgery, and provide technical support for the construction of the province’s cardiovascular chronic disease prevention and control system.

　　Fourth, reform measures

　　(a) to carry out the reform of modern hospital management system. Formulate the Articles of Association of Fuwai Cardiovascular Hospital in Yunnan Province. On the premise of strengthening government supervision and assessment, the relevant departments directly under the provincial government delegated the authority of internal personnel management, department setting, middle-level cadre appointment, internal performance assessment and salary distribution to Fuwai Hospital in Yunnan, giving the hospital full autonomy in operation and management. Strengthen the Party building in Fuwai Hospital of Yunnan in an all-round way, give full play to the leading role of the Party Committee of the hospital, and build the Party organization into a strong fighting fortress. Improve the internal management organization, management system, rules of procedure and procedures of Yunnan Fuwai Hospital, and standardize the internal governance structure and power operation rules.(Responsible unit: Provincial Health and Family Planning Commission, Editorial Office, Human Resources and Social Security Department, Finance Department, Yunnan Fuwai Hospital; The first one is the lead department, the same below)

　　(two) to carry out the reform of medical consumables and drug procurement methods. Yunnan Fuwai Hospital is allowed to be the main body of procurement, directly negotiate prices with high-value medical consumables manufacturers and purchase independently. Take the procurement with quantity and budget, explore the way of cross-regional and specialized hospital joint procurement, and reduce the inflated price of high-value medical consumables. High-value medical consumables are purchased in the high-value medical consumables procurement system of the provincial centralized drug procurement platform, and independent bargaining is carried out offline. The negotiated unit price and total amount are subject to the supervision of relevant departments. According to the reform requirements of Fuwai Hospital in Yunnan, the high-value medical consumables procurement system of the provincial centralized drug procurement platform was developed and reformed individually. In the medical insurance information system, the actual purchase price of Yunnan Fuwai Hospital is protected accordingly. Explore the implementation of the "one-vote system" for the procurement of high-value medical consumables, and Yunnan Fuwai Hospital will directly settle the payment with the production enterprises. According to the procurement method of high-value medical consumables, the procurement reform of suitable drugs and low-value medical consumables will be carried out. For the cases paid according to the project, Yunnan Fuwai Hospital reduces the burden of patients by reducing the high-value medical consumables and the inflated price of drugs.(Responsible units: Provincial Health and Family Planning Commission, Department of Finance, Department of Human Resources and Social Security, Public Resources Trading Administration, Yunnan Fuwai Hospital)

　　(three) to carry out the total personnel management pilot. According to the type characteristics and related factors of Fuwai Hospital in Yunnan, the total number of personnel needed for Fuwai Hospital in Yunnan is determined scientifically and reasonably, and the dynamic adjustment is implemented. Strictly regulate the scope of the total number of personnel, and the personnel within the total number shall be managed according to the staffing of the institution and enjoy the treatment of the personnel of the institution. Simultaneously carry out the pilot reform of government procurement services.(Responsible unit: Provincial Organizing Office, Human Resources and Social Security Department, Finance Department, Health and Family Planning Commission, Yunnan Fuwai Hospital)

　　(four) to carry out the reform of medical insurance payment methods. The reform of medical insurance payment mode will be carried out mainly by grouping payment methods according to disease types and disease diagnosis. Medical insurance agencies at all levels in the province shall pay for the diseases with clear diagnosis and treatment plan and admission criteria and mature diagnosis and treatment technology in Fuwai Hospital, and reasonably determine the payment standard of diseases (disease groups), the proportion of medical insurance payment and the proportion of individual patients’ payment, and implement packaged payment, with the balance retained and the cost overruns not covered. Strive to make the proportion of cases paid by groups according to diseases and disease diagnosis in Yunnan Fuwai Hospital exceed 80% by 2020, and the medical insurance agency will adjust and maintain the settlement method and information system according to the reform needs of Yunnan Fuwai Hospital. The hospital information system of Yunnan Fuwai Hospital is open to medical insurance agencies and audit departments, and is subject to supervision and audit. According to the principle of "scientific, safe, standardized, effective, economical and ethical", the clinical pathway management and quality control work adapted to the functions and tasks of Yunnan Fuwai Hospital should be implemented, and the diagnosis and treatment behavior should be standardized in strict accordance with the diagnosis and treatment routine and technical regulations to ensure medical quality and safety.(Responsible unit: Provincial Department of Human Resources and Social Security, Department of Finance, Health and Family Planning Commission, Yunnan Fuwai Hospital)

　　(five) to carry out the reform of personnel compensation system. Establish a personnel management system that is compatible with the total personnel management. Implement the autonomy of employing people in Yunnan Fuwai Hospital, and allow Yunnan Fuwai Hospital to independently recruit and introduce personnel by means of examination or inspection under the premise of strictly implementing information disclosure, process disclosure and results disclosure. Encourage Fuwai Hospital in Yunnan to introduce outstanding professionals from abroad, and play a good role as a platform to cultivate and improve the level of relevant medical disciplines in the province. Talents who are urgently needed and in short supply from outside the province and have the qualifications of deputy senior and above professional and technical positions or have obtained doctoral degrees can re-establish personnel files after leaving their original units to work in Fuwai Hospital in Yunnan. Fuwai Hospital in Yunnan should change the fixed employees into contract employees, change the identity management into post management, and set up posts according to needs, compete for posts, hire by posts, and set salaries by posts. Formulate specific personnel management systems such as personnel entry and exit, assessment, rewards and punishments within the total amount, and establish an employment mechanism that can enter and exit, and can be promoted and demoted. Boldly innovate the talent incentive mechanism, and high-level talents introduced by Yunnan Fuwai Hospital can enjoy relevant subsidy policies and project support in accordance with regulations.(Responsible unit: Provincial Health and Family Planning Commission, Editorial Office, Human Resources and Social Security Department, Finance Department, Yunnan Fuwai Hospital)

　　In accordance with the requirements of "allowing hospitals to break through the current wage control level of public institutions, allowing medical service income to deduct costs and withdraw funds according to regulations to be mainly used for personnel rewards", we will actively explore the establishment of a salary system that conforms to the characteristics of the medical industry and fully mobilize the enthusiasm, initiative and creativity of medical personnel. Yunnan Fuwai Hospital will be included in the pilot unit of salary system reform of public hospitals in our province, and the corresponding policy inclination will be given when the total performance salary is approved. Support Yunnan Fuwai Hospital to actively explore various distribution methods such as target annual salary system, agreed salary system and project salary system. Explore the implementation of the target annual salary system management for the main person in charge of Yunnan Fuwai Hospital, and the required funds will be uniformly charged from the operating subsidy funds and service purchase funds arranged by the provincial finance, and will not be arranged separately. Encourage medical staff in Fuwai Hospital in Yunnan to strengthen scientific research innovation. If important scientific research achievements and achievements are transformed into clinical diagnosis and treatment standards and technical specifications, holders of scientific research achievements can enjoy 80% of the benefits from the transformation of achievements and promote the transformation of achievements. It is strictly forbidden to link the salary of medical staff with business income and income from medicines, consumables, inspections and tests.(Responsible units: Provincial Department of Human Resources and Social Security, Department of Finance, Health and Family Planning Commission, Science and Technology Department)

　　(six) to carry out the price reform of hospital medical services. Yunnan Fuwai Hospital is allowed to set its own price within the range of no more than 10% on the basis of the current first-class medical service price in our province. For the medical service items with no approved price in our province, if there are existing ones in Fuwai Hospital of China Academy of Medical Sciences, according to the principle of homogeneity and same price, Fuwai Hospital of Yunnan can refer to the medical service price of Fuwai Hospital of China Academy of Medical Sciences. Yunnan Fuwai Hospital’s new medical service project authorizes Yunnan Fuwai Hospital to independently check the trial price. On the basis of establishing and perfecting the clinical pathway management system, we will support Fuwai Hospital in Yunnan to carry out the reform of pricing mode of charging according to diseases and independently formulate charging standards. Yunnan Fuwai Hospital is allowed to carry out special outpatient service within the scope of not exceeding 10% of the total medical service, and the special outpatient service fee is subject to market adjustment. The actual implementation price of Yunnan Fuwai Hospital should be reported to the Provincial Price Bureau, the Health and Family Planning Commission and the Human Resources and Social Security Department for the record within 10 working days before implementation.(Responsible units: Provincial Price Bureau, Health and Family Planning Commission, Human Resources and Social Security Department)

　　(seven) to carry out the reform of financial subsidies. Reform and improve the financial guarantee mode for Fuwai Hospital in Yunnan, explore the establishment of financial support mode suitable for the reform of Fuwai Hospital in Yunnan, and gradually arrange hospital operation subsidy funds by purchasing services to realize the decoupling of financial subsidy funds from staffing. From 2018 to 2021, according to the principle of "full support, fixed subsidy, gradual adjustment and stimulating vitality", the operating subsidy funds of Yunnan Fuwai Hospital will be reasonably arranged; After 2022, according to the quantity and quality of services provided by Fuwai Hospital in Yunnan, the government will approve the funds for purchasing services. The financial subsidy funds are invested in the planned equipment purchase, key discipline development, personnel training, retirees’ expenses in line with national regulations, policy loss subsidies, and government-designated emergency treatment, disaster relief, foreign aid, agriculture support, border support and counterpart support for urban and rural hospitals.(Responsible units: Provincial Department of Finance, Development and Reform Commission, Human Resources and Social Security Department, Health and Family Planning Commission)

　　(eight) to carry out the reform of hospital service model. The Provincial Health and Family Planning Commission delegated the establishment of departments and the management authority of doctors’ practice in Fuwai Hospital of Yunnan. Yunnan Fuwai Hospital can set up its own departments according to the needs of reform and development, and report them to the Provincial Health and Family Planning Commission for the record; Doctors and nurses from Fuwai Hospital of China Academy of Medical Sciences are allowed to practice at Fuwai Hospital in Yunnan and report to the Provincial Health and Family Planning Commission for the record. Fuwai Hospital in Yunnan should strengthen the construction of hospital culture and build a harmonious doctor-patient relationship. Carry out appointment diagnosis and treatment, increase the proportion of appointment diagnosis and treatment services, and vigorously promote appointment diagnosis and treatment by time and centralized appointment inspection. Steadily carry out daytime surgery to shorten the time for patients to wait for hospitalization and surgery. Take patients as the center, promote multidisciplinary diagnosis and treatment mode, and provide "one-stop" diagnosis and treatment service for patients. Innovate emergency services to provide patients with a green channel for medical treatment and integrated comprehensive treatment services. Using Internet technology to continuously optimize the medical service process, and provide patients with convenient services such as appointment, mobile payment, inter-clinic settlement, bedside settlement, medical reminder, result inquiry and information push.(Responsible unit: Provincial Health and Family Planning Commission, Yunnan Fuwai Hospital)

　　V. Safeguards

　　(1) Strengthen organizational leadership. The leading group for the construction, reform and development of Fuwai Cardiovascular Hospital in Yunnan Province and Yunfu International Cardiovascular Hospital should strengthen the overall coordination of the pilot reform of Fuwai Hospital in Yunnan Province.

　　(2) create a good atmosphere. Relevant departments at the provincial level should strengthen the overall situation awareness and sense of responsibility, cooperate with each other and make concerted efforts to form a joint effort and a good atmosphere for fully caring for and supporting the reform and development of Yunnan Fuwai Hospital, and give active support to Yunnan Fuwai Hospital in participating in scientific research projects and achievements declaration in the province, employing graduate students with teachers’ qualifications, and evaluating the first and the best. Other medical and health institutions in the province should strengthen cooperation and exchanges with Fuwai Hospital in Yunnan with a more open and inclusive attitude, and jointly promote the continuous improvement of the diagnosis and treatment capacity of cardiovascular diseases in the province.

　　(3) Strengthen performance appraisal. The Provincial Health and Family Planning Commission should guide Yunnan Fuwai Hospital to formulate performance evaluation methods, establish a public welfare-oriented evaluation system, and effectively strengthen the internal management of the hospital. According to the specialty characteristics of Fuwai Hospital in Yunnan and the requirements of the reform pilot task, the assessment and evaluation indicators are determined scientifically and reasonably, with emphasis on indicators such as the degree of public welfare goal realization, medical quality, cost control, sustainable development, operational performance, social satisfaction and employee recognition. The performance appraisal of Yunnan Fuwai Hospital should be carried out simultaneously with the annual and term target responsibility appraisal of the dean, and the party building work should be carried out simultaneously with the professional work. The assessment results should be linked with financial subsidies, medical insurance payment, total performance salary, salary, appointment and dismissal, rewards and punishments of the dean (secretary), so as to promote the improvement of medical service quality in Yunnan Fuwai Hospital.

　　(4) Strengthen supervision and evaluation. Give full play to the role of monitoring, evaluation and special supervision, timely supervise the implementation of key tasks of Fuwai Hospital in Yunnan, establish and improve the supervision and inspection mechanism and evaluation accountability mechanism, increase supervision and guidance, and focus on matters that are ineffective or slow in progress. The Provincial Health and Family Planning Commission takes the lead in establishing a monitoring and evaluation system, formulating methods for evaluating the effect of hospital reform, regularly monitoring and evaluating the implementation of the pilot reform of Fuwai Hospital in Yunnan and the reform effect, analyzing and studying the difficulties and problems arising in the reform process in a timely manner, and monitoring the reform progress once every six months to form a monitoring report. By the end of 2020, the third party will be organized to evaluate and summarize the reform effect of Fuwai Hospital in Yunnan, and mature and effective experiences will be promoted in due course. Relevant provincial departments should sum up and improve relevant reform policies in time to ensure the continuity of policies and the stable and sustainable development of Fuwai Hospital in Yunnan.

　　Attachment: 1. Pilot Program for the Reform of Medical Consumables and Drug Purchase Mode in Fuwai Cardiovascular Hospital of Yunnan Province

　　　　　2. Yunnan Fuwai Cardiovascular Hospital Staff Total Management Pilot Program

　　　　　3. Yunnan Fuwai Cardiovascular Hospital Medical Insurance Payment Mode and Personnel Compensation System Reform Pilot Program

　　　　　4. Yunnan Fuwai Cardiovascular Hospital Medical Service Price Reform Pilot Program

　　　　　5. Yunnan Fuwai Cardiovascular Hospital Financial Subsidy Reform Pilot Program

　　　　　6. Implementation plan for improving the diagnosis and treatment capacity of Fuwai Cardiovascular Hospital in Yunnan Province

　

Annex 1

Pilot program for the reform of medical consumables and drug procurement mode in Fuwai Cardiovascular Hospital of Yunnan Province

　　In order to promote Yunnan Fuwai Cardiovascular Hospital (hereinafter referred to as Yunnan Fuwai Hospital) to carry out the pilot reform of medical consumables and drug procurement methods, this plan is formulated according to the Overall Plan for Comprehensive Reform Pilot of Yunnan Fuwai Cardiovascular Hospital.

　　I. General requirements

　　In accordance with the general direction and requirements of the reform of public hospitals, adhere to the principles of openness, fairness and justice, strengthen the "three-medicine linkage" of medical care, medical insurance and medicine, encourage Fuwai Hospital in Yunnan to try first, and further reduce the inflated prices of medical consumables and medicines through various procurement methods such as independent procurement, quantity procurement and joint procurement.

　　Yunnan Fuwai Hospital uses business income and its own funds to carry out medical consumables and drugs procurement projects, allowing hospitals to purchase independently, openly selecting distribution enterprises to be responsible for distribution, and linking with medical insurance payment and disease charging policies. Encourage Yunnan Fuwai Hospital to jointly purchase with relevant specialized hospitals across regions, and further improve the participation of hospitals in centralized drug procurement. The procurement projects of medical consumables and drugs carried out by Yunnan Fuwai Hospital with special financial funds are carried out in strict accordance with the provisions and procedures of People’s Republic of China (PRC) Government Procurement Law, People’s Republic of China (PRC) Bidding Law and other laws and regulations.

　　Second, the reform measures

　　(A) the scientific preparation of procurement plans

　　According to the catalogue of medical consumables and drugs used in Fuwai Hospital of China Academy of Medical Sciences, the procurement plan and budget are put forward with reference to not less than 80% of the medical consumables and drugs used in the previous year.

　　(B) to carry out high-value medical consumables procurement reform.

　　1. Purchasing method. On the premise of carrying out the compound payment mode of grouping payment according to disease type and disease diagnosis, and combining various payment methods, Yunnan Fuwai Hospital is allowed to be the main purchasing body, adopt online procurement and offline negotiation on the provincial centralized drug procurement platform, and directly negotiate the purchase price of high-value medical consumables with high-value medical consumables manufacturers, and the negotiated unit price and purchase amount are subject to the supervision of relevant departments. According to the reform requirements of Fuwai Hospital in Yunnan, the high-value medical consumables procurement system of the provincial centralized drug procurement platform was developed and reformed individually. In the medical insurance information system, the actual purchase price of Yunnan Fuwai Hospital is protected accordingly. Yunnan Fuwai Hospital is allowed to explore cross-regional joint procurement with relevant domestic specialized hospitals to ensure that the procurement price is lower than the reference price of the provincial centralized drug procurement platform.

　　2. Distribution management. Yunnan Fuwai Hospital openly selects high-value medical consumables comprehensive service enterprises according to relevant laws and regulations. Comprehensive service enterprises can set up a first-class management warehouse of high-value medical consumables in Fuwai Hospital of Yunnan, and implement zero inventory management to ensure the timely supply and quality safety of high-value medical consumables.

　　(three) to carry out the reform of purchasing methods of drugs and low-value medical consumables.

　　1. Purchasing method. In accordance with the principle of "platform procurement, bargaining with quantity, two-vote system and centralized distribution" and the relevant provisions of the provincial health and family planning commission on classified procurement, Yunnan Fuwai Hospital is allowed to carry out bargaining procurement of drugs and low-value medical consumables with quantity through the provincial centralized drug procurement platform, which will be distributed centrally by distribution enterprises. Belonging to the pricing procurement, the winning bid price announced by the provincial centralized drug procurement platform is the highest price limit, and the method of exchanging price for quantity is adopted, and the quantity procurement is linked with the quantity price; Belonging to bargaining procurement, independent bargaining procurement on the provincial centralized drug procurement platform; For special drugs, such as poisonous drugs, blood products and some new drugs, which are not hung on the procurement platform, they are indeed purchased for the record according to the relevant requirements because of clinical needs.

　　2. Distribution management. According to relevant laws and regulations, Fuwai Hospital of Yunnan Province selected distribution enterprises for drugs and low-value medical consumables to ensure the supply, quality and safety of drugs and low-value medical consumables.

　　(4) Charge management

　　1. Charge for high-value medical consumables. For cases paid by the project, the high-value medical consumables used are charged according to the actual purchase price and the markup rate stipulated in the Interim Measures for the Price Management of Non-profit Medical Services in Yunnan Province. According to the disease, according to the disease diagnosis related group payment cases, the balance retained, cost overruns do not make up.

　　2. Fees for drugs and low-value medical consumables. Drugs are charged according to the winning bid price announced by the provincial centralized drug procurement platform, and the bonus is cancelled. Low-value medical consumables shall be implemented in accordance with the relevant provisions of the price management of medical services in our province. With the further improvement of the national drug price negotiation mechanism, the scope of negotiation varieties is gradually expanded, and the policy convergence with medical insurance management and handling departments is well done.

　　3. Price protection. The list of expenses issued by Yunnan Fuwai Hospital to patients can only list the quantity of drugs and medical consumables used, subtotal and total expenses, and protect the prices of individual categories.

　　(5) Contract management

　　Yunnan Fuwai Hospital signed a distribution service contract with the distribution enterprise. The procurement of high-value medical consumables is subject to the "one-vote system".

　　Third, the job requirements

　　(1) Strengthen supervision. Provincial Health and Family Planning Commission, Public Resources Trading Administration, Food and Drug Administration, Finance Department, Audit Office and other departments should strengthen the supervision and inspection of the procurement, distribution and use of medical consumables and drugs in Yunnan Fuwai Hospital. Information on the purchase and use of medical consumables and drugs in Fuwai Hospital of Yunnan Province should be disclosed to the public in a timely manner and consciously accept social supervision; It is necessary to establish a publicity and interview system, implement prescription comments, give full play to the role of pharmacists in rational drug use, and improve the level of rational use of medical consumables and drugs; It is necessary to strengthen prescription management and ensure that doctors prescribe drugs according to their generic names. Outpatients can choose to buy drugs at Fuwai Hospital or retail pharmacies in Yunnan by prescription. Strictly control the unreasonable increase of medical expenses.

　　(2) Strengthen the prevention and control of integrity risks. Fuwai Hospital in Yunnan should make collective decisions by including medical consumables and drug procurement in the "three majors and one big project"; It is necessary to focus on strengthening the system construction, with the support of modern information technology, to build a clean and honest risk prevention and control system with clear powers and responsibilities, standardized processes, clear risks, effective measures, timely early warning and in line with the characteristics of the health industry, and to establish a long-term working mechanism to control commercial bribery in the field of medical purchase and sale.

　

Annex 2

Pilot Program of Total Staff Management in Fuwai Cardiovascular Hospital of Yunnan Province

　　In order to promote Yunnan Fuwai Cardiovascular Hospital (hereinafter referred to as Yunnan Fuwai Hospital) to carry out the pilot project of total personnel management, this plan is formulated according to the Overall Plan of Comprehensive Reform Pilot of Yunnan Fuwai Cardiovascular Hospital.

　　I. General requirements

　　In accordance with the relevant requirements of deepening the classification reform of public institutions, deepening the reform of "streamline administration, delegate power, strengthen regulation and improve services" and deepening the reform of medical and health system, we should persist in the innovation of system and mechanism, innovate the staffing management of Fuwai Hospital in Yunnan, implement the management of total personnel, and establish an employment mechanism that can enter and exit, and can be promoted and demoted. Adhere to decentralization, fully give Yunnan Fuwai Hospital the autonomy of employing people, and stimulate the endogenous motivation of hospital reform and development. Adhere to the principle of "active, cautious and controllable", steadily push forward the reform pilot work, study and solve the difficulties and problems in the pilot work in time, and accumulate experience and practices.

　　Second, the reform task

　　(1) Scientifically and reasonably verify the total number of personnel. The provincial editorial office, together with the Provincial Health and Family Planning Commission, the Department of Finance and the Department of Human Resources and Social Security, comprehensively considers the characteristics of Yunnan Fuwai Hospital, the actual number of open beds, the service population, the service volume, the personnel structure and the development trend, and scientifically and reasonably determines the total number of personnel needed for Yunnan Fuwai Hospital. The total number of staff in Yunnan Fuwai Hospital is 550 for the first time. The total number of personnel shall be dynamically managed, and in principle, it shall be dynamically adjusted once every two years.

　　(two) the scope and proportion of total personnel management. The personnel included in the total personnel management include: members of the hospital leadership, administrative personnel, professional and technical personnel (doctors, pharmacy, medical technology, nursing and other professional and technical personnel) and the backbone of the workers. Within the approved total number of personnel, the proportion of professional and technical personnel is not less than 90%, and the administrative personnel and workers are not higher than 10%.

　　(3) Establish a personnel management system that is compatible with the total personnel management. In accordance with the relevant requirements of the "streamline administration, delegate power, strengthen regulation and improve services" reform, simplify administration and decentralize power, and fully give Yunnan Fuwai Hospital the autonomy of employing people. According to the staffing management of public institutions, the personnel within the total amount enjoy the corresponding treatment of the staff of public institutions in terms of post employment, professional title evaluation, assessment, rewards and punishments, social insurance, personnel flow, income distribution and retirement benefits. The recruitment staff of Fuwai Hospital in Yunnan should make the recruitment plan and scheme according to the requirements of information disclosure, process disclosure and results disclosure, and after being approved by the Provincial Health and Family Planning Commission and the Provincial Department of Human Resources and Social Security, take the form of examination or investigation to recruit independently; After joining the company, it is qualified by the evaluation of Fuwai Hospital in Yunnan and approved by the Provincial Health and Family Planning Commission and the Provincial Department of Human Resources and Social Security, and can be included in the total personnel management.

　　Fuwai Hospital in Yunnan should establish and improve the employment mechanism of being able to enter and exit, be able to go up and down, formulate the evaluation method, index system and specific personnel management system for the entry and exit of personnel within the total number of personnel, and organize the implementation after being reported to the provincial office, the Department of Finance, the Department of Human Resources and Social Security and the Health and Family Planning Commission for the record.

　　Third, the job requirements

　　(1) Strengthen organizational leadership. The provincial editorial office is responsible for verifying the total number of staff in Yunnan Fuwai Hospital and taking the lead in coordinating and promoting the pilot work; The Provincial Health and Family Planning Commission is responsible for the guidance and supervision of Fuwai Hospital in Yunnan; The Provincial Department of Finance and the Department of Human Resources and Social Security cooperate to do the relevant work. Fuwai Hospital in Yunnan is the main body responsible for the pilot work, so we should earnestly organize and implement it.

　　(2) Steady and orderly progress. Fuwai Hospital in Yunnan should formulate a specific implementation plan and refine the work tasks item by item; It is necessary to strictly implement various policies and regulations, strictly perform work procedures, establish a correct orientation for employing people, and fully mobilize and stimulate the enthusiasm of cadres and workers.

　　(3) Strengthen supervision and guidance. The provincial editorial office shall, jointly with the Provincial Health and Family Planning Commission, the Department of Finance and the Department of Human Resources and Social Security, strengthen supervision and guidance on the pilot work, closely follow the progress of the pilot work, study and solve problems in the work in a timely manner, and sum up experiences and practices.

　

Annex 3

Pilot scheme of medical insurance payment method and personnel salary system reform in Fuwai Cardiovascular Hospital of Yunnan Province

　　In order to promote Fuwai Cardiovascular Hospital of Yunnan Province (hereinafter referred to as Yunnan Fuwai Hospital) to carry out the pilot reform of medical insurance payment method and personnel compensation system, this scheme is formulated according to the Overall Plan for Comprehensive Reform Pilot of Fuwai Cardiovascular Hospital of Yunnan Province.

　　I. General requirements

　　Focusing on the goal of deepening the reform of medical and health system, we will explore the establishment of medical insurance payment methods that conform to the actual situation and medical service characteristics of Fuwai Hospital in Yunnan, and stimulate the endogenous motivation of hospitals to standardize diagnosis and treatment behavior, control costs, and reasonably treat and refer patients; Explore the establishment of a flexible and efficient personnel management system that is compatible with the total personnel management; According to the requirements of "allowing hospitals to break through the current wage control level of public institutions, allowing medical service income to deduct costs, and then withdrawing various funds according to regulations, we will explore the establishment of a salary distribution system that conforms to the actual situation of Fuwai Hospital in Yunnan, and strive to reflect the value of medical staff’s knowledge, technology and labor, mobilize the enthusiasm of medical staff, enhance the public welfare of the hospital, and promote the healthy development of Fuwai Hospital in Yunnan.

　　Second, the reform task

　　(A) to carry out medical insurance payment reform pilot.

　　1. The implementation of multiple compound medical insurance payment methods based on disease types and disease diagnosis related groups. According to the characteristics of medical services in Fuwai Hospital in Yunnan, for diseases with clear diagnosis, clear diagnosis and treatment path and mature diagnosis and treatment technology, payment is implemented according to the disease type and related groups of disease diagnosis. For complex cases that cannot be settled by disease type and disease diagnosis, they shall be paid according to the project. All kinds of payment methods implemented by Fuwai Hospital of China Academy of Medical Sciences and outside the province can be supported in time in combination with the actual situation in our province. By 2020, Yunnan Fuwai Hospital will make the proportion of cases that are paid according to diseases and diseases diagnosis more than 80%, and medical insurance agencies will adjust and maintain the settlement methods and information systems according to the needs of hospital reform. Establish and improve the equal consultation mechanism between medical insurance agencies and Yunnan Fuwai Hospital, and the incentive and risk sharing mechanism of "balance retention and reasonable cost overruns sharing".

　　2. Support Yunnan Fuwai Hospital to develop new technologies and projects. The provincial human resources and social security department timely studied and formulated the medical insurance payment policy to support the new technologies and new projects carried out by Fuwai Hospital in Yunnan.

　　(B) to carry out the personnel management system reform pilot.

　　1. Decentralize the right to evaluate professional titles. The right to evaluate the deputy senior title of health technology was delegated to Yunnan Fuwai Hospital, which independently evaluated the qualification of the deputy senior title of health technicians in our hospital in accordance with the national and provincial professional and technical title evaluation procedures and relevant management regulations.

　　2. For foreign high-level experts and young doctors under 40 years old who are mainly introduced from Fuwai Hospital in Yunnan Province, if they are selected as "high-end foreign experts" and "special young talents" in Yunnan Province’s Thousand Talents Program after evaluation, they will be given a one-time working and living allowance of 500,000 yuan and a maximum project funding of 1 million yuan.

　　3. The high-level talents introduced by Fuwai Hospital in Yunnan Province are in urgent need of shortage in our province. Upon the assessment of the Provincial Department of Human Resources and Social Security, they are given 500,000 yuan, 300,000 yuan and 200,000 yuan housing subsidies and 100,000 yuan, 70,000 yuan and 50,000 yuan working funds respectively, and actively do a good job in introducing talents.

　　4. Timely apply for the "Green Channel Service Certificate for Introducing High-level Talents in Yunnan Province" for talents who meet the prescribed conditions introduced by Yunnan Fuwai Hospital, and enjoy corresponding services in accordance with the regulations.

　　(C) to carry out the pilot reform of the salary system

　　1. Yunnan Fuwai Hospital will be included in the pilot reform of salary system of public hospitals in our province. Yunnan Fuwai Hospital is allowed to break through the current wage control level of public institutions, allowing medical service income to deduct costs and withdraw various funds according to regulations, which are mainly used for personnel rewards.

　　2. Tilt the relevant salary policy. Yunnan Fuwai Hospital is allowed to establish a salary system that adapts to the characteristics of the hospital in accordance with the Implementation Opinions of the Provincial Department of Human Resources and Social Security, the Department of Finance, and the Health and Family Planning Commission (Yun Ren She Fa [2017] No.96). The Provincial Department of Human Resources and Social Security gives corresponding policy inclination when approving the total amount of performance pay.

　　3. Give internal distribution autonomy. Give Yunnan Fuwai Hospital autonomy in performance appraisal and internal distribution, focusing on key positions and high-level talents, focusing on reflecting the value of medical staff’s technical services and mobilizing the enthusiasm of medical staff.

　　Third, the job requirements

　　(1) Strengthen organizational leadership. Relevant departments directly under the provincial government should closely cooperate and coordinate to promote reform, properly link up policies and give full play to policy synergy; It is necessary to carry out the evaluation of the reform effect in time to provide support for the reform and improvement of the province’s medical insurance payment method and personnel compensation system.

　　(2) Strengthen internal management. Fuwai Hospital in Yunnan should establish and improve the internal management system matching with the reform pilot, make full use of the role of medical insurance in regulating, guiding, supervising and restricting medical service behavior and expenses, strengthen the management of medical personnel, actively control costs and expenses, and improve the efficiency of the use of medical insurance funds. On the basis of the approved total number of personnel, exercise the autonomy of hospital personnel management and salary distribution according to the law and regulations.

　　(3) Strengthen supervision and management. Provincial departments should strengthen the supervision and management of medical service behavior, personnel management and salary distribution of Fuwai Hospital in Yunnan. The medical insurance management department should strengthen the management of medical insurance service agreement, improve the medical insurance information system, improve the scientific and reasonable assessment system, strengthen the dual control of medical expenses and medical quality, and link the assessment results with the medical insurance fund payment.

　

Annex 4

Pilot scheme of medical service price reform in Fuwai Cardiovascular Hospital of Yunnan Province

　　In order to promote Fuwai Cardiovascular Hospital of Yunnan Province (hereinafter referred to as Yunnan Fuwai Hospital) to carry out the pilot reform of medical service price, this scheme is formulated according to the Overall Plan for Comprehensive Reform Pilot of Fuwai Cardiovascular Hospital of Yunnan Province.

　　I. General requirements

　　Actively and steadily push forward the reform of the pricing mode of medical services in Fuwai Hospital in Yunnan, do a good job in linking the price of medical services with policies such as medical care, medical insurance and medicine, and gradually establish a scientific, reasonable, dynamic adjustment and multi-participation medical service price formation mechanism to ensure the sustainable operation of Fuwai Hospital in Yunnan, the affordability of medical insurance funds and the overall burden of the masses.

　　Second, the reform task

　　(1) Yunnan Fuwai Hospital is allowed to set its own price within the range of no more than 10% on the basis of the current price of first-class medical services in our province.

　　(II) For the medical service items with no approved price in our province, if the Fuwai Hospital of China Academy of Medical Sciences already exists, according to the principle of homogeneity and the same price, Fuwai Hospital of Yunnan can refer to the medical service price of Fuwai Hospital of China Academy of Medical Sciences.

　　(three) the new medical service projects carried out by Fuwai Hospital in Yunnan Province shall be independently approved by the hospital for trial price.

　　(4) For the diseases that have not been charged by diseases in our province at present, on the basis of establishing and perfecting the clinical pathway management system, support Yunnan Fuwai Hospital to carry out the reform of charging by diseases and independently formulate charging standards.

　　(5) In order to meet patients’ medical service needs at different levels, Yunnan Fuwai Hospital is allowed to carry out special outpatient service within the scope of not exceeding 10% of the total medical service, and the special outpatient service fee is subject to market adjustment.

　　Third, the job requirements

　　(1) Strengthen guidance and supervision. The Provincial Price Bureau, the Health and Family Planning Commission, and the Human Resources and Social Security Department should closely cooperate and cooperate with each other, strengthen the guidance and supervision of the reform of medical service price in Fuwai Hospital in Yunnan, make overall consideration of the interests of all parties, and do a good job in the convergence of policies such as medical service price, medical insurance and fee control; It is necessary to guide Yunnan Fuwai Hospital to establish and improve the internal price management system, implement the system of clearly marked price and detailed list of medical expenses, and create an honest medical unit.

　　(2) Do a good job in monitoring and evaluation. The Provincial Price Bureau, the Health and Family Planning Commission, and the Human Resources and Social Security Department should pay close attention to the situation after the reform of medical service prices to prevent the relevant supporting policies from being in place, resulting in an increase in the burden on hospitals or patients; It is necessary to strengthen the evaluation of the reform situation and effect, and timely adjust and improve the reform policy.

　　(3) Strengthen support for reform. Fuwai Hospital in Yunnan should scientifically calculate the cost of medical services and diseases, and provide scientific data support and reference for setting prices; It is necessary to bring cost accounting, price management and patient burden into the hospital performance appraisal system, and mobilize the enthusiasm of medical staff and management personnel to control fees; It is necessary to publicize the service items, prices and charging basis, supervision and reporting telephone numbers and other contents to the society in a prominent position.

　　(4) Standardize the price adjustment behavior. For medical services that are subject to market adjustment and independently set prices, Yunnan Fuwai Hospital reasonably sets prices according to service costs and market conditions and keeps them relatively stable, and the price adjustment period shall not be less than one year. The actual implementation price of Yunnan Fuwai Hospital should be reported to the Provincial Price Bureau, the Health and Family Planning Commission and the Human Resources and Social Security Department for the record within 10 working days before implementation.

　

Annex 5

Pilot program of financial subsidy reform in Fuwai Cardiovascular Hospital of Yunnan Province

　　In order to promote Fuwai Cardiovascular Hospital of Yunnan Province (hereinafter referred to as Fuwai Hospital of Yunnan Province) to carry out the pilot reform of financial subsidies, this plan is formulated according to the Overall Plan for Comprehensive Reform of Fuwai Cardiovascular Hospital of Yunnan Province.

　　I. General requirements

　　Adhere to the public welfare nature of public hospitals, reform and improve the way public finance supports public hospitals, establish a scientific and reasonable financial guarantee and compensation mechanism, and promote the formation of a new mechanism for hospital operation that is conducive to maintaining public welfare, mobilizing enthusiasm and ensuring sustainability.

　　Second, the reform task

　　(1) Arrangement of subsidy funds

　　From 2018 to 2021, Yunnan Fuwai Hospital will be subsidized by means of fixed subsidy and gradual adjustment. Among them, 70 million yuan will be allocated for operation subsidy in 2018, 70 million yuan in 2019, 60 million yuan in 2020 and 50 million yuan in 2021.

　　After 2021, in accordance with the requirements of government procurement service reform of public institutions and referring to the security policies of other provincial public hospitals, Yunnan Fuwai Hospital will be subsidized.

　　(2) Ways of financial subsidies

　　In 2018, the transitional financial subsidy policy was implemented, and the financial funds were directly allocated to Yunnan Fuwai Hospital. Starting from 2019, we will implement the reform of financial support mode based on government purchasing services, and arrange the financial subsidy funds of Yunnan Fuwai Hospital to be included in the departmental budget of the Provincial Health and Family Planning Commission for protection. As the main body of government purchasing services, the Provincial Health and Family Planning Commission will include the subsidy funds in the departmental budget of the Provincial Health and Family Planning Commission in the form of government purchasing services, and report them to the Provincial Department of Finance for review, and sign a government purchasing service contract with Yunnan Fuwai Hospital in accordance with the relevant provisions on government purchasing services, and pay them according to the contract.

　　Third, the job requirements

　　(1) Strengthen policy implementation. The Provincial Department of Finance earnestly implemented the financial subsidy policy for Fuwai Hospital in Yunnan. The Provincial Health and Family Planning Commission studied and formulated a specific implementation plan for the reform of government procurement services in Fuwai Hospital in Yunnan.

　　(2) Improve financial management. All revenues and expenditures of Yunnan Fuwai Hospital are included in the budget management, and the relevant provisions of the financial system and accounting system are strictly implemented. The Provincial Department of Finance strengthens the overall budget and financial management of Fuwai Hospital in Yunnan, and organizes the annual financial report audit of the hospital in conjunction with the Provincial Health and Family Planning Commission to promote the steady and healthy development of the hospital.

　　(3) Strengthen performance appraisal. The Provincial Department of Finance, together with the Provincial Health and Family Planning Commission and other departments, explored the third-party performance evaluation of government-purchased services in Fuwai Hospital of Yunnan Province, and established an incentive and restraint mechanism linking the assessment results with the subsidy funds. The evaluation results served as an important reference for the payment of service purchase funds and the selection of service purchase projects, and effectively improved the efficiency in the use of financial funds.

　

Annex 6

Implementation plan of improving diagnosis and treatment ability of Fuwai Cardiovascular Hospital in Yunnan Province

　　In order to further improve the diagnosis and treatment ability and level of Fuwai Cardiovascular Hospital in Yunnan Province (hereinafter referred to as Yunnan Fuwai Hospital), this plan is formulated according to the Overall Plan for Comprehensive Reform of Fuwai Cardiovascular Hospital in Yunnan Province.

　　I. General requirements

　　Relying on the support of the medical management level and technical force of Fuwai Hospital of China Academy of Medical Sciences (hereinafter referred to as Fuwai Hospital of the Academy of Medical Sciences), we will gradually improve the diagnosis and treatment ability and level of Fuwai Hospital. Yunnan Fuwai Hospital has fully opened its clinical center and medical technology department, and its discipline construction has reached the requirements of the national evaluation standard for key clinical specialties. It has basically built a high-quality cardiovascular disease specialist training system, which is used as a technical support platform to radiate the whole province, promote the continuous improvement of cardiovascular disease treatment ability of hospitals at all levels in the province, provide technical support for the construction of the prevention and control system for cardiovascular chronic diseases in the province, and realize the objectives and tasks set in the Overall Plan for Comprehensive Reform of Cardiovascular Hospital in Fuwai, Yunnan Province.

　　Second, the main measures

　　(1) Homogenized introduction of advanced medical technology from Fuwai Hospital of Chinese Academy of Medical Sciences

　　1. Homogenization and introduction of hospital information system. Fuwai Hospital of Yunnan adopts the core information system independently developed by Fuwai Hospital of Chinese Academy of Medical Sciences to ensure the seamless connection of information between Fuwai Hospital of Yunnan and Fuwai Hospital of Chinese Academy of Medical Sciences, and the core information system is homologous and homogeneous. Establish a closed-loop information solution with hospital information system and electronic medical record system as the core, highly integrated image archiving and transmission system, laboratory information system and other whole processes, covering different fields such as medical treatment, teaching, scientific research and disease prevention and control.

　　2. Give full play to the leading role of experts stationed in Fuwai Hospital of Chinese Academy of Medical Sciences. Relying on the long-term team of doctors, technicians, nursing and management experts stationed in Fuwai Hospital of the Academy of Medical Sciences, we will accelerate the formation of an expert group integrating medical treatment, teaching, scientific research, personnel training and international cooperation, and lead the development of cardiovascular disease diagnosis and treatment in the province.

　　3. Actively carry out academic exchange activities at home and abroad. Fuwai Hospital of Chinese Academy of Medical Sciences sent first-class experts to Yunnan to carry out academic exchange activities. Fuwai Hospital of Yunnan actively undertakes academic exchange activities at home and abroad, such as the International Complex Congenital Heart Disease Summit Forum, Kunming International Cardiovascular Disease Forum, Fuwai Aortic Disease Treatment Seminar, the latest progress seminar of interventional therapy for cardiovascular diseases, and the "Heart Pacing in 100 Counties", so as to enhance the diagnosis and treatment ability of cardiovascular diseases in Yunnan and effectively play the role of radiation to drive and lead the demonstration.

　　(B) to strengthen the construction of talent team

　　Arrange all young and middle-aged doctors, technicians and nursing staff in Fuwai Hospital of Yunnan to go to Fuwai Hospital of Chinese Academy of Medical Sciences for standardized training in cardiovascular diseases. Fuwai Hospital in Yunnan adopts various forms, such as young doctors’ growth tutorial system, applying for a master’s degree with the same academic level, and circulating training for further professional study, to give full play to the role of experts in the hospital, to improve the overall quality of medical staff, to build a team of professional and technical personnel with both morality and skills, and to gradually make the academic qualifications, professional titles and age structure of the professional personnel more reasonable and perfect. Relying on the brand advantage of Fuwai Hospital of Chinese Academy of Medical Sciences, talents with associate senior and above professional and technical post qualifications or doctor’s degrees that are urgently needed in hospitals are introduced from outside the province, and personnel files can be re-established after leaving their original units to work in Fuwai Hospital of Yunnan. Fuwai Hospital of Yunnan creates favorable conditions for introducing talents.

　　(C) to strengthen medical quality control

　　Fuwai Hospital in Yunnan should standardize the diagnosis and treatment process according to the requirements of the national cardiovascular disease quality control index system, ensure that the diagnosis and treatment process meets the quality control requirements, effectively reduce the surgical mortality and infection rate, and ensure the homogeneity of hospital medical quality with Fuwai Hospital of Chinese Academy of Medical Sciences. Yunnan Fuwai Hospital should take the lead in establishing quality control indicators of cardiovascular diseases in Yunnan Province in accordance with the requirements of the Provincial Health and Family Planning Commission, and guide relevant medical institutions in the province to standardize the diagnosis and treatment of cardiovascular diseases.

　　(D) to strengthen the guidance and assistance to the grassroots.

　　1. Regularly send experts to primary hospitals to guide the work. Establish a cardiovascular disease specialist alliance with the participation of provincial, prefecture and county hospitals. Through the establishment of "Yunfu Clinic", ward rounds, surgical teaching, etc., directly participate in the clinical work of primary hospitals, and rapidly improve the diagnosis and treatment ability of cardiovascular diseases in primary hospitals. Fuwai Hospital in Yunnan should regularly organize experts to help primary hospitals, and send at least 5 experts with deputy senior titles or above to guide medical activities in cities, counties and hospitals every month for no less than 2 days.

　　2. Regular teaching and on-site training for primary hospitals. Set up a "Yunfu Lecture Hall", formulate personalized training programs according to the needs of primary hospitals and doctors, and strive to improve the standardization of diagnosis and treatment in primary hospitals. Establish a long-term cooperation mechanism with grassroots hospitals to open a "green channel" for people in remote areas to see a doctor. Give priority to the procedures of hospitalization, discharge, and application for special hardship fund for referral patients in primary hospitals, and apply for charitable fund for poor children with congenital heart disease.

　　3. Implement the "Yunyan Plan". Support cardiovascular internal medicine and surgeons from hospitals at or above the county level to go to Fuwai Hospital in Yunnan for standardized training in cardiovascular diseases. According to the needs of the grassroots, short-term (1-3 months), medium-term (3-6 months) and long-term (12 months) training programs are offered for key physicians of different levels, different seniority and different sub-professional directions.

　　4. Improve the scientific research level of primary hospitals. Relying on the scientific research platform of Fuwai Hospital of Chinese Academy of Medical Sciences and Fuwai Hospital of Yunnan Province, we will set up horizontal scientific research projects, absorb the staff of grass-roots hospitals to participate in the research of scientific research projects, and improve the scientific research ability.

　　5. Establish a telemedicine service network. Relying on Fuwai Hospital of Chinese Academy of Medical Sciences and Yunnan Fuwai Hospital as the fulcrum, we will integrate the telemedicine network resources of tertiary hospitals, county hospitals and township hospitals in the province, and further develop the information platform and remote grading diagnosis and treatment network of Yunnan Cardiovascular Disease Diagnosis and Treatment Center. Establish a large database of cardiovascular disease prevention and control in Yunnan Province to improve the ability of cardiovascular disease prevention and control at the grassroots level.

　　Third, the job requirements

　　(1) Strengthen organization and implementation. Fuwai Hospital in Yunnan should refine the work tasks item by item, define the time schedule, and earnestly organize the implementation.

　　(2) Strengthen supervision and inspection. The Provincial Health and Family Planning Commission should strengthen the guidance, inspection and supervision of Fuwai Hospital in Yunnan, and regularly carry out monitoring and evaluation to ensure the effectiveness of the work.

　　What is the effect of the new military revolution in the world after nearly 20 years? What are the prospects after the change?

　　For readers who are slightly familiar with the military, "new military revolution" is a familiar phrase, and new military revolution is in full swing in many countries. It has been almost 20 years since the concept of "new military revolution" was put forward and put into practice. What is its effect? What is the future development prospect? China Youth Daily reporter interviewed Lin Dong, an associate professor of National Defense University.

　　Reporter: When and who initiated the new military revolution, and in what context did it begin?

　　Lin Dong: The 20th century is a century in which military revolution continues to take place. Today, the global new military revolution we are carrying out is relative to the military engineering revolution characterized by mechanization basically completed during the Second World War, and it is marked by informationization.

　　This change was first initiated by the US military, which originated from the contest with the China army and rose from the confrontation with the Soviet army. The early motivation was the Korean War, and then the Vietnam War. The US military deeply reflected on these two unsuccessful wars. Finally, tactically, it concluded that the US mechanized troops were strong in firepower, assault and maneuver, but weak in "melee", "night fighting" and sudden attacks during the March, and it was also unsuccessful to engage in "logistics strangulation war".

　　Reporter: the us military began to change for this?

　　Lin Dong: Yes, the US military began to implement the military sensing revolution in the 1950s, and later it developed into satellite reconnaissance and high-altitude UAV reconnaissance. Until the drastic changes in Eastern Europe occurred in the late 1980s, the US military quickly turned to general local conventional warfare, and prepared to turn the three major achievements in dealing with the Soviet nuclear war into the application of conventional warfare. First, the GPS system used to correct the time difference for intercontinental nuclear missiles flying across time zones was turned to provide navigation and positioning for various conventional mobile weapons and equipment; Second, the internet, a computer communication network established to resist the nuclear destruction of the Soviet Union, has been transferred to joint operations, which has become the basis of digital troops and network-centric warfare; Third, the Star Wars plan, which was prepared to break through with the Soviet Union, laid the foundation for the construction of the missile defense system.

　　It was also during this period that Marshall, director of the Net Assessment Office of the US Department of Defense, put forward the concept of "new military revolution".

　　Reporter: That is to say, the US military has explored the new military revolution before, and then it has an official name?

　　Lin Dong: It’s like this. In 1994, the then Secretary of Defense of the United States, Perry, formally put forward a comprehensive view of military reform based on the achievements of the military technology revolution, and named it the military affairs revolution. By the end of 1990s, after the Bush administration came to power, Rumsfeld, in combination with the needs of the "9.11" anti-terrorism war, re-positioned military reform as military transformation, trying to fully meet the needs of information development in the military establishment system, operational system and operational methods, and surpassing information in the development of weapons and technology, and opening up a broader world of military reform.

　　Reporter: Has the concept of new military revolution been recognized by other countries as soon as it was put forward?

　　Lin Dong: No, this concept was accepted late by other countries. Since 1980s, when people talk about the new military revolution, they mostly use the word high-tech war. It was not until the Gulf War in 1991 that the US military defeated hundreds of thousands of mechanized troops in Iraq with hundreds of casualties. Everyone was shocked and realized that a revolutionary military revolution had arrived.

　　Reporter: What was the goal of the early new military revolution?

　　Lin Dong: In the early days, the US military did not expect a historic leap forward, so the initial goal was not high. First, it was to save money. It was required that the new military revolution would enable the US military to rely on high technology to have a superior combat capability with about 300,000 troops. Second, fewer people are killed. Another important indicator of the new military reform proposed by the US military is that it can make the US military lose less than 10,000 people in conventional wars.

　　Although these two goals were achieved in the Gulf War, the US military at that time did not dare to take them lightly. However, the subsequent wars in Kosovo, Afghanistan and Iraq, without exception, the battlefield situation was one-sided with the US military. The number of combat troops sent by the US military has been reduced to tens of thousands, and even there has been a record of zero casualties in a war, and the US military has become ambitious.

　　Reporter: So far, has the new military revolution of the US military gone smoothly? Have all the goals been achieved?

　　Lin Dong: After Rumsfeld took charge of the US military command, he made every effort to promote military transformation, so in the middle of the new military transformation, he launched a brand-new strategic goal: First, to achieve a global strike, and the US military can strike any corner of the earth with one hour of emergency preparation; The second is to realize the integration of the army, integrated operations and integrated formation.

　　As a result, the integration construction encountered setbacks. First of all, Rumsfeld’s conflict with various services broke out. Rumsfeld made great efforts to promote joint operations and drastically weakened the position of the service headquarters. As a result, Rumsfeld was boycotted. However, Rumsfeld had no intention of quitting, and several generals of the army and navy were dismissed. As a result, he ended up being cornered by various services.

　　Secondly, there are serious differences of opinion among the services on the development direction of the new military revolution, and the Air Force put forward the idea of denying joint operations. The US Air Force believes that the assault stage of modern warfare is mainly air strikes, and the air combat forces of the navy and the army should all be under the command of the air force, and the implementation of coordinated assault with the air force as the main content of winning the war. The navy should become the transportation captain, and the army and the marine corps mainly occupy the city after the completion of the main air assault, and then go into the city to catch prisoners, and then fight terrorism and maintain stability.

　　This argument caused a great division and controversy among the US military services, which is still going on today. At present, the US military’s huge information system, national and theater missile defense systems are all disturbed by differences among various services, and their goals are vague and hesitant.

　　Reporter: Mr. Lin, the world’s new military revolution has been going on for nearly 20 years. Some people think that it is the sprint stage of the new military revolution, but in your new book "Beyond the military service era-systematic scientific thinking about the new military revolution", you suggest that the new military revolution is undergoing a spiral development process. What does this mean?

　　Lin Dong: At present, some people think that the new military revolution has formed a framework and entered a substantial leap stage. However, this is not the case. For example, the US military, as the leader of the new military revolution in the world, has carried out several core projects with budgets of trillions of dollars, such as GIG system of global information grid, NMD system of national missile defense, TMD system of theater missile defense, etc., thinking that they can win the all-round victory of the new military revolution with one effort, but all of them are frustrated and faced with huge strategic risks. At the same time, Rumsfeld, the leader of the new military revolution in the United States and former defense secretary, also resigned because of the quagmire of the Iraq war, and his radical military transformation policy was boycotted by all services of the US military.

　　The great exposure of the new military revolution in the west, led by the US military, shows a huge deviation in the theoretical guidance of military revolution, which comes from people’s stagnation in mechanized thinking to solve the information problem. Therefore, I think that the new military revolution in the west led by the United States is entering an adjustment period, and everyone’s understanding of the new military revolution in the world is also entering a gray area, which requires a breakthrough in thought and theory.

　　Reporter: In your book, you propose to "transcend the military service era". Does it mean that the future army will no longer be divided into land, sea and air forces, so how to organize the future army?

　　Lin Dong: The establishment system of the army is determined by the way of fighting.

　　In the mechanized era, the army fights according to the division of natural geographical space, so it is necessary to divide the army, navy and air force. The army controls the land, the navy controls the sea and the air force controls the air, each of which has its own symmetrical combat targets and fights independently of each other.

　　However, since the late World War II, there has been a phenomenon of cross-growth of services, and the cross-development of services has moved towards a super-service structure, and each service has tried to develop into a big army that includes the forces of other services.

　　Up to now, all services have broken the boundaries of services and extended to other battlefields. The air force can fight naval battles and land battles, the army has planes and surface ships, and the navy is decathlon, thus breaking the pattern of monopolizing land battles, naval battles and air battles respectively, and also bringing about the problems of repeated development of service combat capabilities and serious waste of military resources.

　　In order to solve the problem of the expansion of various services, the military all over the world invariably put forward the strategic problems of developing joint operations, sharing operational resources and dividing the military organizational system for the second time.

　　At present, there are two opinions on reforming the military service system. One is that the German army proposed to abolish the organizational system of the three armed forces and set up three major services, namely, the long-range strike force, the stable operation force and the information support force. Another view is to keep the current service establishment, but make the service units modular and can be reorganized with other service units, and at the same time add a horizontal organization to form three networks of reconnaissance, strike and maneuver, and all service units participate in the actions of these three networks.

　　Now it seems that the US military was adapted according to the second plan.

　　Reporter: When do you think the U.S. military will realize informationization, and where is the direction of change after informationization?

　　Lin Dong: According to the three indicators of global strike, global arrival and global surveillance proposed by the US military, its information transformation will be basically completed around 2025.

　　At that time, the focus of the US military’s reform will also shift. At present, these shifting directions have been used as new concept weapons in experimental research. First, the material revolution, mainly relying on nanotechnology to build micro-weapons. The second is the power revolution to solve the problem of high energy consumption. The third is the firepower revolution. Nowadays, the US military is designing a network fire system, a 64-tube vertical firing artillery array, which does not need a steel shell, and the ammunition fired in one minute can catch up with half of the current battalion. Fourth, laser weapons enter the battlefield and use high-energy lasers to destroy incoming enemy missiles, thus fundamentally solving the missile defense problem. The fifth is the flexible technology revolution, which has created humanoid flying robots that can fly and walk. With the help of intelligent technology, soldiers can fly spaceships that can reach the moon and catch turtles in the sea, spraying inexhaustible lasers and galloping between heaven and earth. (China Youth Daily Xuehong Li)

Editor: Cao Jin