Hospitals heed Xi Jinping's call to make use of "social capital", then rip off investors

by MICHAEL WOODHEAD
One of the cornerstones of Xi Jinping's healthcare reforms is the urging of public hospitals to take advantage of "social capital" (ie private investors) for future expansion and development.

Unfortunately, in China's murky and non-transparent climate of investment, things are quickly going wrong in predictable ways. A hospital in Jiangsu now owes its mom and pop investor almost a billion yuan, according to reports in the People's Daily. The Workers Hospital of Suqian asked locals and employees to put their capital into the hospital's investment fund and promised regular interest and dividend payments.

In 2012, a man called Chen heeded the call to invest in the Suqian hospital to help fund the building of a new hospital and to further develop and expand medical services. The hospital guaranteed a fixed income and this was backed by the local government. Mr Chen put in his 2 million yuan retirement savings and was initially  pleased with the interest payments he received on a regular monthly basis. In fact, Mr Chen was so impressed he persuaded his family and friends to invest their money in the hospital as well. In addition, local TV advertising that was aired to promote the fund resulted in more than 2000 small time investors putting close to 900 million yuan into the Worker's Hospital Investment Fund. However, things started to go wrong in April this year when the hospital defaulted on its interest payments. Investors who asked why they hadn't received their usual payments were fobbed off with non-commital replies.

However, as public complaints and protests increased, the local police and authorities have opened a financial investigation into the missing monies. So far they have found that there is not enough money to pay the interest and also not enough to repay the principal sums that were invested and which most investors are now demanding be repaid.

Several of the hospital financial managers have been detained for further investigation and the local authorities say they are now tracking a number of unauthorised financial investments. It looks very much like the Suqian people have had their social capital blown on the roller coaster Chinese stock market that crashed so spectacularly this year.

Putian cartel?

Meanwhile, China's private hospital market has started to take off in a big way with more than 8000 hospitals and clinics in the loose "Putian Network" forming an procurement alliance. The Putian hospitals network is a loose association of healthcare establishments set up from the 1980s onwards by entrepreneurial families from the Fujian town of the same name. Although suffering from a poor reputation for marketing of dodgy services such as fertility clinics and cosmetic centres, many of the Putian hospitals are trying to transition into more respectable establishments. Several of the hospitals have formed groupings and sought investors through IPOs. Now the Putian group hospitals say they are seeking to consolidate and form buyer's groups to give themselves greater purchasing clout. However, Putian hospital are still suffering from a credibility after being banned from Baidu for their dodgy advertising claims.

China's rural timebomb: half a billion elderly people with chronic diseases and no care

by Michael Woodhead
A survey of elderly villagers in rural parts of China has revealed some of the monumental healthcare problems the country faces.

Simply put, China is on track to have almost half a billion elderly people by 2050 and most of them will have chronic diseases but no treatment. The research carried out in 4400 households in rural areas of nine provinces found that a staggering 58% of elderly people are illiterate and many of them have been 'left behind' by children who have moved to towns or cities in search of work.

For almost 70% of elderly people their annual income was below 5000 yuan ($810).  And worryingly, they had high rates of chronic diseases: 18% had diagnosed hypertension, 3% had diabetes and 6% had asthma. However, these figures are likely to be underestimates because very few elderly people are getting health checks - only 3% had any kind of health preventive check in the past few weeks. Only 2% of patients had their blood pressure checked.

Not surprising then that substantial proportions of those people with chronic diseases are not receiving any kind of treatment - 25% of people with hypertension and a third of those with diabetes were untreated, the study found.

Published in the journal International Health, the findings show that China has huge numbers of vulnerable people with high health needs who are missing out on basic preventive care and treatment, says the author of the study, Dr Dai Baozhen of the Department of Health Policy and Management at Jiangsu University.

Dr Dai says one of the main reasons for this sorry state of affairs is the lack of funding for preventive health in rural China. Most rural residents are covered by the New Cooperative Medical Insurance Scheme, which provides modest reimbursement for inpatient treatment for acute illness. However, the New Cooperative Medical Insurance Scheme does not cover much outpatient treatment and does not reimburse village clinics for preventive health checks such as measurement of blood pressure or diabetes checks. Even if it did, the scheme also fails to cover the basic 'disease management' approaches needed to curb chronic diseases.

What this means in practice is that many people in rural China have chronic diseases such as hypertension and diabetes that are easily detected and which can be prevented and treated by simple and widely-available therapies. However, most elderly people miss out on the basic preventive and disease management approaches and so their chronic diseases are allowed to progress unchecked until patients develop later stages of disease that are more debilitating and more difficult (and expensive) to treat.

But as Dr Dai points out, there is no point in offering health checks if there is no capacity to provide follow up with early treatment and preventive programs.

"Until now, the New Cooperative Medical Insurance Scheme has not been structured to provide payment for prevention, promotion services and disease management for chronic conditions, and no health intervention (e.g. health education and promotion) is provided for groups at high risk of developing chronic conditions," he writes.

Dr Dai concludes that with adequate funding, the New Cooperative Medical Insurance Scheme could provide early identification and management of chronic conditions and thus help prevent a huge burden of disease in some of China's most vulnerable and deprived people.

Web rumour of the day: doctor sued after helping woman give birth on train

by Michael Woodhead
One of Xinhua's top stories today is about a female doctor who helped a woman give birth on a train from Beijing to Nanjing and was then sued by the mother because the baby was injured. 
Amazing story, but it isn't true, according to Xinhua. The news agency says the whole story was concocted by a disaffected young man from Henan who spread the 'baseless rumour'  on Weixin and caused the legal authorities in Nanjing a lot of grief.
The story started on June 29 when a story went viral on Weixin, Weibo and QQ. It described the case of a female doctor called Li Qian of the Beijing Third People's Hospital, who was travelling to Nanjing by train. A woman on the train went into labour and Dr Li helped to deliver her baby and saved its life. However, during the birth the baby aspirated some amniotic fluid and had breathing difficulties which required treatment at a hospital in Nanjing. The mother sued the doctor for the treatment costs and was awarded 15,000 Yuan compensation by the Nanjing Peoples Intermediate Court.
When the story was posted online it was circulated by hundreds of thousands of' 'netizens'  and elicited thousands of negative comments directed at the stupidity of the Nanjing legal authorities. The following day the Nanjing city legal office became aware of the negative and untrue rumour and reported the matter to the police. They acted swiftly and the original post was traced to a young man in Henan called Shang Mo. The Xinhua article doesn't say who Shang Mo is or what he does for a living, but he was presumably a doctor as he was said to be unhappy about the lack of legal protection for doctors against frivolous and false litigation.
 The legal authorities apprehended the man and Xinhua said he would face 'appropriate punishment from the relevant authorities'. They also reminded netizens that they must act within the law when posting things online and must not 'cross the line' and post material that is illegal and untruthful such as baseless rumours.
Update: The SCMP has now covered this story but with a major difference - it says the perpetrator was motivated by frustration over the law that restricts doctors working at only one location. That is quite different from the report by Xinhua which states that he was angry that "the law did not give doctors sufficient protection" . Not sure why the SCMP has reported this way.

Freaky Friday: nurses now dress as air hostesses at Jiangsu Hospital

by Michael Woodhead
Just when you thought you'd seen it all, here's a Chinese hospital that has come up with a gimmick to promote its service-oriented approach.
The Lianshui Huaian Hospital of Chinese Medicine has sent 12  nurses on an Eastern Airlines-style airline cabin crew training course and now requires them to wear air hostess uniforms on the wards. The aim is to emphasise the personal service aspect of the hospital's care, says hospital manager Bo Haijuan.  He came up with the idea a year ago and has been doing market research about the plan, which was implemented this month. The nurses were recruited from other departments and hospitals based on age, height and appearance, and their etiquette skills were nurtured in a one-month training course.
Bo Haijun says he wanted the 'hostess nurses' to stand out from ordinary nurses, who he said gave patients a 'cold face', lacked manners and had little personal caring spirit. The hostess nurses always have a warm smile and patience, he said. However, they still carry out all the normal patient care and technical functions of regular nurses. A reporter from Yangzi Evening News noted that in the hospital the nurses administered treatment such as moxibustion, but they also dealt with small service matters such as offering coffee and comfortable chairs for waiting patients. Their uniforms resemble those of airline cabin crew although the skirts are slightly longer for modesty reasons.
The new nurses who spoke to the reporter said they felt more pride in their job but now had to be more careful about their lifestyle and appearance. One said she no longer dare stay up past midnight on social media because she feared having dark rings under her eyes and looking tired - now she went to bed at 10pm. Another said she had to avoid fatty food because she must keep her figure. The hospital said the hostess nurses got higher pay, but that was because they did harder work in providing service to patients.

Eight medical stories from China you should read

by Michael Woodhead

1. Beijing will start to enforce new anti-smoking laws with 200 yuan on-the-spot fines (up from 10 yuan) for people who smoke in public indoor shared areas, and institutional fines of 30,000 yuan (up from 5000 yuan). Cameras will be used to compensate for the lack of enforcement officers, especially after hours, the city government says.

2. The Chinese government has been accused of withholding medical care from dissidents. An article by Sophie Richardson in the WSJ says civil rights campaigner Cao Shunli is now in intensive care because she was denied access to medical care while detained for her efforts to promote a civil society.

3. A link has been found between damp housing in Shanghai and rates of asthma in children. Researchers from the University of Shanghai for Science and Technology say asthma symptoms could be reduced by 25% by simply keeping a child's window open at night.

4. A vaccine against enterovirus 71 developed by Sinovac Biotech has proved effective against EV71-associated hand, foot, and mouth disease or herpangina in infants and young children, according to a study in 5000 children done by the Jiangsu Provincial Center for Disease Control and Prevention, published in the New England Journal of Medicine.

5. Eating shark fin is not only cruel and bad for the environment, it is also a health hazard because of high mercury levels in the product, researchers from Zhejiang have shown. After testing samples of shark fin they found that up to 33% contained toxic levels of mercury.

6. Antibiotics are widely overused by parents in rural China, with more than 60% dosing their children with antibiotics bought over the counter, Shanghai researchers have found. Most parents were ignorant about how antibiotics worked and had little idea hat they do not help viral infections.

7. Migrant workers have little access to healthcare and many of them put off seeing a doctor for illness, a survey in Shanghai has found. Two thirds of migrant workers said they had never had a medical check up and nearly 40% said they had ignored symptoms because they couldn't get to see a doctor.

8. Health workers in Guangdong have completed a successful pilot trial of a cervical cancer screening program using the ThinPrep cytological system. The program offered Pap test cancer screening to more than 40,000 women, and found that improvements are needed in basic education regarding cervical cancer screening for young and poorly educated women.

Chinese people with diabetes have poor insulin injection techniques

by Michael Woodhead
People with type 2 diabetes have poor insulin injection techniques that cause bruising, bleeding and lumps in the skin, a Nanjing study has found.
A survey of the injection techniques of 380 patients with diabetes from 20 centres across China found that their injection techniques with insulin pens were poor and they often re-used single use needles.
The survey found that 36% of patients had lipohypertrophy (fatty lumps under the skin) and 57% of patients had bleeding and bruising, and abdominal lipohypertrophy at injection sites. The re-use of single use needles was a major factor in lipohypertrophy, and there was also a link with rolling the insulin pen while pulling out the needle after injection.

"The bleeding and bruising at the injection sites may be associated with suboptimal absorption of injected insulin. Improved education in optimal insulin injection technique, including reducing needle reuse and correct rotation of injection sites should be emphasized, the researchers concluded..

The study was conducted by Lou Qingqing  and Ji Jiajia at the Jiangsu Province Hospital, Nanjing. The findings are published in Current Medical Research and Opinion.

Seven important items of medical research from China

N95 masks don't work for Chinese faces
The specialised N95 face masks used to protect against infections such as influenza are not shaped to fit Chinese faces and most would fail to prevent transmission because of poor fit and leakage, tests by Wuhan researchers have shown. Evaluation tests on ten different types of N95 mask found that only two performed within acceptable limits to prevent transmission of infections. Performance of some masks was better when users were trained and they were specially fitted, the study in PLOS One showed.
"This study indicated that widely used N95 filtering facepiece respirators in China didn't fit well and can't provide desired protection for respirator users," the researchers concluded.

Malaria from Africa now a problem in China
Malaria has been virtually eliminated in China but doctors now face the problem of treating malaria in Chinese workers who have returned from Africa. In Jiangsu there have been 918 malaria cases and six deaths in the last decade due to malaria imported from other countries. The imported cases make up 12% of all malaria cases and account for all malaria deaths, according to researchers from the Jiangsu Institute of Parasitic Diseases, Wuxi, writing in the Malaria Journal.

No cardiovascular treatment for many Chinese patients
Two out of three Chinese people with cardiovascular disease are still going untreated, a major study has found. Data from of 512,891 Chinese adults showed that 5% had a history of cardiovascular disease. However, of these only 35% had been treated with any cardiovascular medicine for secondary prevention such as statins, antiplatelet drugs or antihypertensives. The findings from a team from Oxford and Beijing universities, are published in the International Journal of Cardiology.

Shenzhen women have high rates of HPV
More than one in ten women in Shenzhen are have HPV serotypes that put them at risk of cervical cancer, researchers say. A study of 4, 413 women measured HPV infection rates and the prevalance was 14%. The high risk HPV types 16 and 18 that are likely to cause cervical cancer were found in 3.5% of women and 1.27% of women, according to the study published in the Asia Pacific Journal of Cancer Prevention.

Avian H7N9 flu virus on way to mutation
The H7N9 influenza virus is genetically much more diverse than previously thought, suggesting that it is reassorting and closer to mutating into a pandemic virus, researchers from the Jiangsu Provincial Center for Disease Control and Prevention, have shown. They report their findings in Nature.

Medical teacher burnout
Staff at medical colleges in China have high rates of burnout, a study from Shanxi shows. Staff who had a love of teaching and those who received praise and recognition were less likey to suffere burnout, according to the study in Archives of Environmental & Occupational Health.

Pancreatic cancer in Shanghai
The diagnosis and treatment of pancreatic cancer in Shanghai has room for improvement, according to researchers from Fudan University. In a review of management of pancreatic cancer published in Cancer Letters, they report that most patients miss out on the recommended histologically verified diagnosis and the 1-year and 2-year survival rates were 35% and 14.4%, respectively.

China medical news headlines for Saturday 25th January

Bribery and medical profiteering targeted in new campaign
Chinese authorities have launched a major national campaign targeting bad practices in medical services, including excessively high prices for drugs. According to the Global Times the reform campaign will stress better monitoring of drug production and marketing and address inappropriate practices within medical institutions and among medical practitioners. Medical ethics will be further promoted, and bribery in marketing of drugs will be addressed. Deaprtments taking part include the National Health and Familiy Planning Commission. The campaign calls for violators to be identified and cases of bad medical practice to be punished  in a serious way.

STDs a major problem in sex workers
Urgent efforts are needed to tackle the high rates of sexually transmitted diseases among prostitutes in Jiangsu, researchers say. A study of sex workers in Yangzhou and Changzhou found that 15% were infected with chlamydia, 5% had gonnorhoea, 5% had syphilis and 0.2% had HIV infection. The findings are published in PLOS One.

Dietary advice for obese students
Shanghai students should be given dietary advice and better access to health food at school to combat the rising trend in obesity, a political adviser has suggested. According to Shanghai Daily, Chen Lei said 17% of Shanghai school students were obese, three times the national average. Over half of the parents he surveyed expressed dissatisfaction with lunch provided by schools, which often included fried food such as pork and chicken.

Fujian hospital chief arrested for bribery
The president of a hospital in Fujian province has been removed from his post for accepting bribes. ECNS reports that Lu Kaiming, who also served as the vice chairman of the Municipal Committee of the Chinese People's Political Consultative Conference in the city of Sanming, has been detained and investigated for law infringement and serious disciplinary violations. Authorities have confiscated his illegal gains and he will be transferred to a local judicial organ for his alleged crime.

Imported schistosomiasis a risk as China develops closer links with Africa

Experts in parasitic disease say imported schistosomiasis is an increasing problem for China as more Chinese travel to Africa
Dr Lu Ping and colleagues from the Key Laboratory of Technology on Parasitic Disease in
Wuxi say that the chronic, debilitating parasitic disease caused by trematode blood flukes is a major public health threat for China. Writing in the Journal of Travel Medicine, they say that at present, only S. japonicum is endemic in China. However, more and more imported cases infected with African schistosomes (including S. mansoni and S. hematobium) are reported owing to the sharp growth in China-aided projects in Africa and labor services exported to Africa. Since 1979, a total of 147 cases infected with S. mansoni and 283 cases infected with S. hematobium have been reported until now, including the two S. hematobium-infected workers returning from Tanzania and Angola They note that there are now over a million Chinese workers now residing in Africa, who have a high risk of exposure to African schistosomiasis, and many infected individuals are asymptomatic and seldom seek care and have a high rate of missed diagnosis and misdiagnosis due to the lack of knowledge on African schistosomiasis;
"Therefore, it is considered that the actual number of the Chinese infected with African schistosomes may be greatly underestimated.
And once the infected cases, as sources of infection of schistosomiasis, are imported to regions where the snail intermediate hosts of African schistosome are present, there is a high likelihood of transmission of African schistosomiasis in China, they say.
A systematic surveillance and evaluation program for schistosome infections in returners from African countries is urgently required under the organization of health sections, entry-exit inspection and quarantine sections, and commerce sections, they suggest.

Woman advised to have abortion after being given wrong pill

A woman has been told she should have an abortion after a doctor mistakenly prescribed a contraceptive pill instead of the progesterone she needed.
There is a high possibility the fetus will be deformed, according to a report on jschina.com.cn yesterday.
Suzhou Municipal Hospital has admitted the error and offered to pay 26,600 yuan (US$ 4,290) compensation and to terminate the pregnancy.
But it has refused to accept responsibility if the 32-year-old, surnamed Chen, can't have another baby or if she suffers complications.
"There are many causes for infertility, which may not be related with taking the wrong medicine or receiving the abortion," said Chen Jian, a hospital vice president. "We can't give promises on uncertain things."
The couple criticized the hospital for its failure to accept responsibility.
Hospital officials said the couple can lodge a lawsuit if the two parties fail to reach an agreement.
The woman was one month pregnant when she was given the wrong medicine on November 20. She went back to the hospital five days later after feeling sick.
The doctor admitted his mistake right away, she said.
Experts asked by the hospital to do a group diagnosis suggested that she have an abortion because there was a high risk of deformity.
Source: Women of China

China medical research in the journals

No increase in obesity among rural children

There are no signs of an obesity epidemic among rural Chinese children, a study from has shown

Researchers from the Capital Institute of Paediatrics, Beijing, monitored overweight and obesity rates in more than 280,000 children from eight counties in Jiangsu and Zhejiang between 1998 and 2005. They found that the prevalence of overweight was barely changed from 3.7% in 1998 to 3.9% in 2005 and there was no increase in the 0.5% prevalence of obesity.  An increase in overweight/obesity was more likely in boys than girls, especially among those aged over three years. The study also found that the prevalence of stunting decreased dramatically.

Full study: Public Health

IVF conception for 1% of Chinese babies

About one in a hundred Chinese babies is born to women undergoing IVF or other assisted reproductive technology, Beijing researchers have shown. Dr Yang Xiaokui and co-researchers from the Department of Human Reproductive Medicine, Beijing Obstetrics and Gynecology Hospital analysed rates of ART among 112,403 deliveries from 14 provinces and 39 hospitals. They found the proportion of infants born as a result of ART in China was about 1.013% in 2011, compared to 4% in developed countries. Their study also found an increased maternal complications such as multiple gestation, higher cesarean section rate, low birth weight infants, higher infant mortality in women who conceived with the help of ART, compared with spontaneously pregnant women.
Full study: Fertility and Sterility

Urgent action needed on liver fluke infections in Heilongjiang

Liver fluke infestations are a common and increasing problem in China’s north east province of Heilonjiang, a study from Harbin Medical University has shown.

The infections, which are caused by eating undercooked fish,  were  seen commonly throughout Heilongjiang Province and mainly along the Songhua River, according to Dr Han Su and colleagues from the university. In a review of 4951 outpatients with suspected liver fluke infections the overall prevalence of clonorchiasis was 26%.  Rates of infection increased from 22.5% in 2009 to 34% in 2012. Farm labourers accounted for two thirds of cases and consumption of freshwater fish was the strongest risk factor. Cases of re-infection were common.

“The present study revealed that clonorchiasis remains widespread and prevalent in Heilongjiang Province. An integrated control programme is urgently needed to reduce the public health impact of clonorchiasis in this endemic area.”

Full study: PLOS One

Benzodiazepine use linked to benign brain tumours

Benzodiazepines may increase the risk of benign brain tumours, according to Taiwanese researchers. In a review of  62,186 patients who had been prescribed benzodiazepines, they found that rates of benign brain tumours were more than three times higher in patients using benzodiazepines. The risk of benign brain tumours was dose dependent and increased over time with increasing exposure to benzodiazepines. There was no increase seen in risk of malignant brain tumours, but this may have been due to the low number of such tumours in the study group.

Full study: Journal ofthe Neurological Sciences

SMS reminders improve allergy medication compliance

For patients with allergic rhinitis, a daily SMS reminder is an effective way to improve adherence with intranasal corticosteroid treatment medication and treatment outcomes, according to researchers from the Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital.

In a study of 50 patients with allergic rhinitis they showed that adherence to medication was 60% in the SMS group and 28% in the control group. Clinic attendance and allergy symptoms scores were also better for patients who received SMS reminders.

Full study: International Archives of Allergy and Immunology

Parents angry as children used in secret trial of vaccine for hand foot and mouth disease

Angry parents have accused a township health service center in Taixing, Jiangsu Province, of using their children as guinea pigs after it was found to have injected more than 100 of them with vaccines still under clinical trial.
Both the health center in Fenjie Town and the Taixing City Disease Control Center admitted that the vaccine was not yet on the market but insisted that the trial had been approved by parents, the Modern Express reported yesterday.
However, parents said they had no idea it was a trial when their children took part in January last year.
Li Wei said the center had asked him to bring his two-year-old daughter to have a free hand-foot-and-mouth disease vaccine a year ago. He understood that 200 children would be taking part in the inoculation program.
"I felt confused as I was told my daughter needed to have blood tests regularly after the inoculation," Li said.
Li told the newspaper that his daughter had tested positive in two blood tests, but the newspaper did not specify what the tests were for.
He told reporters he searched online and found that the vaccine had not been approved for use but was still under clinical trial.
Another parent, Fang Yun, told the newspaper that her daughter had contracted hand-foot-and-mouth disease two months ago and said a worker at the center had told her secretly that the vaccine had some problems.
"No one ever told me it was a trial," Fang said.
An official surnamed Gu at the center told the newspaper the program was nationwide and the center was just one of many places where it was carried out. The trial was conducted with the approval of parents, Gu added.
Yao Genhong, an official with the disease control center, said parents had all signed on agreements for the project, but he failed to provide any documentation when asked.
Source: china.org

China medical news in brief

Headache and migraine a problem for one in ten Chinese children

A study of 4812 children and adolescents in Shanghai, China has found that 10% experienced a headache in the past three months. Of those who had headache, 45% were classified as having migraine. with the highest rates of migraine found at ages 14 years and 15 years. Tension-type headache accounted for 29% of headaches, while  cluster and other headache were responsible for 6.2% and 20%, respectively.
Source: Clinical Journal of Neuroscience 

Zhejiang prostitutes have high HPV rates and cervical cancer risk

Two out of three sex workers are infected with high risk subtypes of HPV putting them at increased risk of cervical cancer, a Zhejiang study has found.
Cervical samples from almost 300 female sex workers  in Huzhou, Zhejiang, showed that the prevalence of HPV was 67%, compared to 19% in the general population. Among the different types of HPV found,  HPV-16 (29%) was the most prevalent, followed by HPV-58 (24%) and HPV-52 (21%), and these were significantly associated with abnormal cervical cytology. The rate of cervical abnormalities was also higher among female sex workers (21%) than among the general population (5%). Researchers from the Huzhou Central Hospital conclude that female sex workers in the city have a greater probability of being infected with high-risk HPV, and novel vaccines against HPV-58 and HPV-52 should be developed. Using condoms could reduce the risk of infection.
Source: International Journal of Gynecology & Obstetrics 

Jiangsu simplifies medical insurance claims

Medical insurance claims can now be settled on the spot for outpatients in  Jiangsu. Outpatients from 13 cities including Changzhou, Nantong, and Wuxi can immediately settle their medical insurance if they go to see a doctor with their medical insurance cards, according to Jiangsu provincial Human Resources and Social Security Bureau.
Source: Jiangsu China.


Gay men in Yunnan have high HIV risk

More intensive HIV and STD screening and prevention campaigns are needed for gay men in Yunnan, say researchers who found a high incidence of new infections. In an 18 month study of 378 seronegative gay men in Yunnan they found that 11 became infected with HIV and 15 were infected with syphilis. Subgroups at high risk included students, retirees and minority ethnic groups, say the researchers from the No.1 Hospital of China Medical University, Nanjing.
Source: BMC Infectious Diseases.

COPD patients at high risk due to poor treatment: study

About one in three men with COPD continue to smoke

by Michael Woodhead 
Patients with chronic obstructive pulmonary disease in China are highly vulnerable to exacerbations because many continue to smoke and few take medications appropriately, a Jiangsu study shows.
Dr Lou Peian and other researchers from the Xuzhou Center for Disease Control and Prevention in Jiangsu Province, Xuzhou, China interviewed 2825 male and 2825 female patients with COPD living in rural areas.
They found that 30% of  men were still smoking and 11% of women were current smokers, despite smoking being a major risk factor for poor disease control. In addition, 32% of men and 75% of women were using fuel such as coal in the house, despite this being know to exacerbate their COPD.
In terms of COPD medication, 26% of male patients and 16% of the female patients did not take theophylline regularly when their disease was stable. During acute exacerbations, 66% of the male patients and 40% of the female patients took theophylline or similar drugs.
The researchers estimated that COPD would reduce life expectancy by 1.76 years for men and 1.18 years for women. The disease also imposed an indirect economic burden was 11,158 yuan for men and 7481 yuan for women. The quality of life was worse in female patients than in male patients.
"We found that patients with COPD were vulnerable and that factors determining vulnerability were different for men than for women. Therefore, we recommend adopting different measures for men and women when attempting to prevent, control, and treat COPD, rehabilitate these patients, and improve their quality of life," they conclude.
Source: International Journal of Chronic Obstructive Pulmonary Disease.

Nanjing offers free health checks to migrant workers

Nanjing city launched on Tuesday a free physical examination program for migrant workers at construction sites in the city and the first batch of 170,000 workers have already started to enjoy free physical examination.
The city released in September a new regulation on enhancing basic medical care and treatments for construction workers, which stipulates that all construction operators in Nanjing whose major disease medical insurances are valid can enjoy a free check-up after they receive the Nanjing Resident Card.
Before that, construction workers in Nanjing already enjoyed the favorable policy of “refund for 50 to 80 percent of medical care bills below 800 yuan” and refund for over 80 percent of hospitalization expenses if their medical insurance covers related treatments.
Statistics show there are some 500,000 migrant workers at construction sites in Nanjing.
Source: Jiangsu China

Medtronic acquires China Kanghui for $775 million

Medical equipment company Medtronic Inc has completed its $755 million acquisition of Jiangsu-based China Kanghui Holdings, a Chinese provider of orthopedic devices.
Chris O'Connell, executive vice-president and president of Medtronic's Restorative Therapies Group, said that China is one of the fastest-growing medical device markets with significant scale opportunities.
"Medtronic will establish a bigger and more direct local presence. Kanghui brings Medtronic a broad product portfolio, a strong local research and development and manufacturing operation, a vast China distribution network and an exceptional management team," he said.
Kanghui brings a strong product portfolio and new products pipeline in trauma, spine and joint reconstruction.

Read more: China Daily