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

"Yunnan Medical and Health Service System Planning (2016-2020)" has been agreed by the provincial people’s government and is hereby issued to you, please implement it carefully.

General Office of Yunnan Provincial People’s Government

October 22, 2016

(This piece is publicly released)

Planning of Medical and Health Service System in Yunnan Province

(2016-2020)

In order to further optimize and rationally allocate medical and health resources, improve the quality and efficiency of medical and health services in our province, and provide better health protection for the demonstration area of national unity and progress, the vanguard of ecological civilization construction, and the construction of radiation centers facing South Asia and Southeast Asia, this plan is formulated according to the spirit of the Notice of the General Office of the State Council on Printing and Distributing the Outline of the National Medical and Health Service System Planning (2015-2020) (No.14 of the State Council [2015]) and the actual situation of our province.

Chapter 1 Planning Background

Section 1 Basic Status Quo

First, the current situation of medical and health resources

With the great attention of governments at all levels, after years of development, our province has basically established a medical and health service system covering urban and rural areas, which consists of hospitals, primary medical and health institutions and professional public health institutions. Medical and health resources are increasing year by year. Compared with 2010, the number of medical and health institutions at all levels increased from 22,888 to 24,186 in 2015, the number of beds in medical and health institutions per thousand permanent residents increased from 3.41 to 5.01, the number of practicing (assistant) doctors increased from 1.38 to 1.68, the number of registered nurses increased from 1.07 to 1.97, and the number of professional public health personnel increased from 0.44.

Second, the utilization of medical and health resources

In 2015, compared with 2010, the total number of patients in medical institutions in the province increased from 176.1324 million to 228.3867 million, with an average annual growth rate of 5.93%. The number of inpatients increased from 4.836 million to 7.4485 million, with an average annual growth rate of 10.80%. In 2015, the number of patients in hospitals and primary health care institutions accounted for 38.60% and 57.63% respectively, of which public hospitals were the main ones, accounting for 83.06% of the total number of patients in hospitals. The utilization rate of hospital beds in medical institutions in the province was 76.23%, and the average hospitalization day was 8.18 days.

Third, the level of health

The average life expectancy of the province’s population is expected to increase from 69.5 years in 2010 to 73.6 years in 2015, and the maternal mortality rate will drop from 37.27/100,000 in 2010 to 23.63/100,000 in 2015. The infant mortality rate and the mortality rate of children under five will drop from 12.24‰ and 15.31‰ in 2010 to 8.7‰ and 15.31 ‰ respectively.

Main problems in the second quarter

First, the total amount of medical and health resources is insufficient and the quality is not high.

There is still a big gap between the quantity and quality of medical and health resources in our province and the health needs of people of all ethnic groups. At the end of 2015, the number of beds in medical and health institutions, the number of licensed (assistant) doctors, the number of registered nurses and the number of professional public health personnel per thousand permanent residents in the province were lower than the national average. Health human resources are particularly scarce. From 2010 to 2015, the average annual growth rate of practicing (assistant) doctors per thousand permanent residents was only 3.84%, which was much lower than the growth rate of the number of patients. The academic qualifications and professional titles of health technicians are generally low. In 2015, only 28.84% of health technicians had a bachelor’s degree or above, and the sub-high and above titles only accounted for 6.41% of health technicians. 27.4% of maternal and child health care institutions in the province are still unable to carry out hospital delivery.

Two, the uneven distribution of medical and health resources, unreasonable structure

The distribution of medical and health resources is uneven, and under-utilization and over-utilization of resources coexist. 93% provincial hospitals, 46% third-class first-class hospitals and 30% licensed (assistant) doctors and registered nurses are concentrated in Kunming. The development of different types of medical and health institutions is uneven. The characteristic advantages of traditional Chinese medicine (ethnic medicine) have not been fully exerted. In 2015, the number of specialized hospitals in the province only accounted for 19% of the total number of hospitals, and beds only accounted for 13% of the total number of hospital beds. The medical service capacity and medical service radiation capacity were not strong, and specialties such as pediatrics, mental health, rehabilitation, geriatrics, hospice care, maternal and child health care, and family planning were relatively lacking. There are still some problems in social hospitals, such as low level, obscure specialty features, weak talent base and low social recognition, which have not yet formed a pattern of mutual promotion and common development with public hospitals.

Three, the basic medical and health institutions have low management level and weak service ability.

The management level of township hospitals and village clinics is relatively low. The management of community health service institutions is backward and the service function is not perfect. There are some problems in primary medical and health institutions, such as "unable to go down, unable to stay, unable to use well" and low professional quality. It is difficult to improve the service level, and it is difficult for the service ability to undertake the basic functions of primary diagnosis and graded diagnosis and treatment. At the same time, the medical business of primary medical and health institutions has shrunk, and the proportion of beds in township hospitals and the number of people admitted to hospitals have declined.

Four, the development of health information construction lags behind, and the regional development is quite different.

The information infrastructure is poor, the investment in health informatization construction is insufficient, the standards are not uniform, the information utilization and personnel training are not in place. Medical and health institutions at all levels have different degrees of informatization construction, and information interconnection mechanism has not been established between institutions, and medical and health information services for the public are insufficient.

Five, the function orientation of public hospitals is unclear, and the division of labor and cooperation mechanism has not yet been established.

The functional orientation of public hospitals at all levels in the medical and health service system is unclear. The division of labor and cooperation mechanism between medical and health institutions has not yet been established, and the fragmentation of medical and health service system is more serious. The scale of some hospitals is too large, which reduces the management efficiency, increases the burden on patients, siphons off grassroots medical and health talents and patients, occupies the development space of grassroots medical and health institutions and social hospitals, and affects the improvement of the overall efficiency of the medical and health service system.

Section 3 Opportunities and Challenges

In the next five years, the construction of medical and health service system in our province will usher in many rare opportunities. The CPC Central Committee and the State Council attach great importance to the development of medical and health undertakings, give priority to people’s health, focus on popularizing healthy life, optimizing health services, improving health protection, building a healthy environment and developing health industries, accelerate the construction of a healthy China, and strive to ensure people’s health in an all-round and full-cycle manner. The provincial party committee and government regard the protection of people’s health as a major livelihood project, and vigorously promote the construction of healthy Yunnan, which provides a historic opportunity for our province to further improve the medical and health service system. Our province actively serves and integrates into the national "Belt and Road" construction, strives to become a radiation center for South Asia and Southeast Asia, and brings opportunities for medical and health undertakings to open up and develop for South Asia and Southeast Asia. The state has stepped up efforts to get rid of poverty and created policy opportunities for our province to speed up the development of medical and health undertakings. The rapid development and popularization of information technology has provided technical support for the innovation of medical and health service and management mode and the improvement of accessibility and convenience of medical and health services.

At the same time, after years of rapid development, the downward pressure on the economy of our province continues to increase, and the growth of public finance budget revenue is weak, so the development of medical and health undertakings must adapt to the new normal; The new urbanization construction and the optimization and adjustment of the spatial layout of the whole province put forward new requirements for the medical and health service system architecture and resource allocation; With the aging of the population, it is estimated that by 2020, the population of our province will reach 49.1 million, of which the elderly population will reach 6.5 million, accounting for 13%. Geriatrics, rehabilitation and other fields are under great pressure; The major adjustment of birth policy will aggravate the contradiction between supply and demand in pediatrics, maternal and child health care, reproductive health and other fields; The incidence of chronic non-communicable diseases is rising, major infectious diseases have not been completely controlled, and sudden new infectious diseases and imported infectious diseases pose potential threats to the province, especially the border areas; The improvement of the medical security system will further release the medical service needs of people of all ethnic groups; Deepening the reform of medical and health system in an all-round way, and establishing and implementing graded diagnosis and treatment system have set new goals for optimizing the layout and allocation of medical and health resources.

Chapter II General Requirements

The first section guiding ideology

Comprehensively implement the spirit of the 18th National Congress of the Communist Party of China, the 3rd, 4th and 5th Plenary Sessions of the 18th Central Committee and the National Conference on Health and Wellness, thoroughly implement the series of important speeches by the Supreme Leader General Secretary and inspect the spirit of important speeches in Yunnan, closely focus on the "four comprehensive" strategic layout and the decision-making arrangements of the CPC Central Committee, the State Council and the provincial party committee and government, adhere to the concept of innovation, coordination, green, openness and shared development, and implement the new policy of health and wellness work in the new period, with the aim of improving the health level of people of all ethnic groups in the province.

Section 2 Basic Principles

First, demand-oriented, rational layout

Guided by health needs and solving people’s major health problems, with adjusting the layout, upgrading the energy level, and strengthening the shortcomings as the main line, we will develop moderately and orderly and strengthen the weak links. Strengthen the management of the whole industry and localization, make unified planning and layout of medical and health resources with different subordinate relations and ownership forms within the administrative area, and scientifically and reasonably determine the number, scale and layout of various medical and health institutions at all levels.

Second, government-led, multi-input

Strengthen the government’s responsibility for the planning, financing and supervision of basic, grass-roots and basic medical and health resources, and safeguard the public welfare of public medical and health care. Give play to the role of market mechanism, strengthen policy guidance, mobilize the enthusiasm and creativity of social forces, encourage and support the society to run medical services, so as to meet the people’s multi-level and diversified medical and health service needs.

Third, fairness and accessibility, improve efficiency

Focusing on the goal of ensuring the fairness and accessibility of basic medical and health services and benefiting the masses, we will promote the equalization of basic medical and health services in ethnic minority areas and concentrated contiguous poverty-stricken areas. Pay attention to the scientific and coordinated allocation and use of medical and health resources, give full play to the advantages of information technology, build a scientific, reasonable and convenient medical and health service system, improve efficiency, reduce costs, and achieve the unity of fairness and efficiency.

Fourth, people-oriented, innovative mechanism

Reform the development mode of public hospitals, rationally regulate the scale of public hospital resources, and build a people-oriented integrated service model. Strengthen the construction of talent team, improve the service level of primary medical and health institutions, and enhance the service capacity of public health institutions.

Five, according to local conditions, overall coordination

Fully consider the level of economic and social development, the number of people served, the service radius, the traffic situation and the current situation of medical and health resources, and formulate allocation standards by classification. Coordinate the allocation of urban and rural and regional resources, coordinate the current and long-term, coordinate prevention, medical care and rehabilitation, focus on the grassroots, take reform and innovation as the driving force, give priority to prevention, and pay equal attention to Chinese medicine (ethnic medicine) and western medicine, give play to the overall function of the medical and health service system, and promote balanced development.

Section III Overall Objectives

Optimize the allocation of medical and health resources, build an integrated medical and health service system that is compatible with the national economic and social development level of our province, matches the health needs of people of all ethnic groups, has a complete system, a clear division of labor, complementary functions, close cooperation and convenient access, and realizes that everyone enjoys basic medical and health services. By 2020, the number of beds in medical and health institutions per thousand permanent residents in the province will be controlled at 6.0, the number of licensed (assistant) doctors will reach 2.5, the number of registered nurses will reach 3.14, the number of professional public health personnel will reach 0.83, and the number of general practitioners per 10,000 permanent residents will reach 2 (see Table 1 for details). According to the strategy of "controlling development, moderately developing and accelerating development", the allocation standards of medical and health resources in different States and cities will be formulated, and the gap in the allocation of medical and health resources among States and cities will be gradually narrowed, and a "15-minute health service circle in dam area" and a "30-minute health service circle in mountain area" will be built, with the rate of medical treatment in the county reaching 90%, which will comprehensively improve the fairness and accessibility of basic medical and health services in the province.

Chapter III Layout of Medical and Health Service System

Section 1 Framework of Medical and Health Service System

The medical and health service system mainly includes hospitals, grass-roots medical and health institutions and professional public health institutions.

Hospitals are divided into public hospitals and social hospitals. Among them, public hospitals are divided into government-run hospitals (mainly divided into county-run hospitals, state-run hospitals, provincial-run hospitals and departmental hospitals according to their functional orientation) and other public hospitals (mainly including military hospitals, state-owned and collective enterprises and institutions, etc.). Below the county level are primary medical and health institutions, which are divided into two categories: public and social. Professional public health institutions are divided into government-run professional public health institutions and other professional public health institutions (mainly including professional public health institutions organized by state-owned and collective enterprises and institutions).

Section 2 Hospital Planning and Setting-up

First, public hospitals

(A) functional positioning

As the main body of the medical service system, public hospitals must adhere to the maintenance of public welfare, give full play to the backbone role in the provision of basic medical services, the diagnosis and treatment of critical and difficult diseases, undertake the tasks of personnel training, medical research and medical teaching in medical and health institutions, and undertake the tasks of public health services, emergency medical rescue, foreign aid, national defense and health mobilization, supporting agriculture, supporting the border and supporting the community specified by the law and the government. County-run hospitals are mainly responsible for the diagnosis and treatment of common and frequently-occurring diseases, emergency rescue and referral of difficult diseases, training and guiding staff of primary medical and health institutions, undertaking corresponding public health services and emergency medical rescue, etc. They are an important carrier for the government to provide basic medical and health services to residents in county-level areas.

State-run hospitals mainly provide comprehensive or specialized medical services representing the high level of the region to residents in state-level administrative areas, accept referrals from lower-level hospitals, and undertake personnel training and certain scientific research tasks as well as corresponding public health and emergency medical rescue tasks.

Provincial hospitals mainly provide diagnosis and treatment of critical and difficult diseases and specialized medical services to the states and cities within the provincial administrative region, accept referrals from lower-level hospitals, and undertake personnel training, medical research and corresponding public health and emergency medical rescue tasks.

(2) Institutional setup

Various types of public hospitals are set up scientifically in various regions according to local urbanization, population distribution, geographical transportation, disease spectrum and other factors, and the number and scale of public general hospitals are reasonably controlled. For specialized medical services with large demand, corresponding specialized hospitals are set up according to specific conditions.

According to the number of permanent residents in county-level administrative regions, in principle, each county-level administrative region is set up with one county-run general hospital and one county-run traditional Chinese medicine hospital (including traditional Chinese medicine, integrated traditional Chinese and western medicine and ethnic medicine, the same below). The county that lacks TCM resources and unconditionally sets up TCM hospitals should set up TCM or ethnic medicine rooms in county-run general hospitals, with the number of beds not less than 10%. National autonomous county-level administrative regions give priority to the establishment of national medical hospitals. County-run general hospitals must set up psychiatric departments and infectious diseases departments. Counties with a population of more than 500,000 can appropriately increase the number of public hospitals.

In the prefecture-level administrative regions, according to the number of permanent residents, the service radius is generally about 50 kilometers per 1 million-2 million population, and 1-2 prefecture-level general hospitals (including traditional Chinese medicine hospitals) are set up, which can be appropriately relaxed in sparsely populated areas. In accordance with the principle of "reasonable layout, clear positioning and prominent focus", all prefectures and cities should set up at least one general hospital run by prefectures and cities and one hospital of traditional Chinese medicine, and encourage other existing general hospitals to develop into specialized hospitals for children, obstetrics and gynecology, oncology, stomatology, rehabilitation, psychosis, infectious diseases, senile diseases and hospice care as needed. Cities that have not set up specialized psychiatric hospitals and infectious diseases hospitals must set up psychiatric departments and infectious diseases departments in general hospitals in cities.

In provincial administrative regions, according to the number of permanent residents, 1-2 provincial-run general hospitals are planned for every 10 million people, and provincial-run specialized hospitals for children, obstetrics and gynecology, oncology, cardiovascular disease, mental illness, infectious diseases, occupational diseases, stomatology, rehabilitation, etc. (including traditional Chinese medicine specialized hospitals) are planned according to needs. Through exchanges and cooperation, innovation and development, we will continuously improve the level of medical services and the strength of medical scientific research, and build provincial hospitals into medical highlands based in Yunnan and facing South Asia and Southeast Asia.

Second, the society runs hospitals

Running a hospital by the society is an indispensable part of the medical and health service system and an effective way to meet the people’s multi-level and diversified medical service needs. Social-run hospitals can provide basic medical services, high-end services or services in short supply such as rehabilitation and elderly care, and form an orderly competition and supplement with public hospitals.

By 2020, planning space will be reserved for social hospitals according to no less than 1.5 beds per 1,000 permanent residents, and the setting of diagnosis and treatment subjects and the configuration space of large medical equipment will be reserved simultaneously. Guide the development of social hospitals to a high level and scale, encourage social hospitals to upgrade infrastructure construction, and develop professional hospital management groups. Support the society to run hospitals with large medical equipment.

Improve supporting policies, and encourage and guide social capital to set up medical institutions on the premise of meeting the planned total amount and structure. Speed up the examination and approval procedures, and approve hospitals run by the society with corresponding qualifications in accordance with the regulations, simplify the examination and approval process and improve the examination and approval efficiency. Relax the requirements for service areas, and all areas that are not explicitly prohibited by laws and regulations can be opened to social capital. Give priority to supporting the establishment of non-profit medical institutions. Promote doctors to practice more, strengthen business cooperation between public hospitals and community-run hospitals, improve clinical level and academic status, support community-run hospitals to be included in the designated scope of medical insurance, improve planning layout and land security, optimize investment and financing guidance policies, improve fiscal and taxation price policies, and implement market-adjusted prices for medical services in community-run hospitals. Strengthen industry supervision to ensure medical quality and safety.

Section III Planning and Setting of Grassroots Medical and Health Institutions

First, the functional orientation

The main duties of primary medical and health institutions are to provide basic public health services such as prevention, health care, health education, family planning, diagnosis and treatment services for common diseases and frequently-occurring diseases, and rehabilitation and nursing services for some diseases, and to refer common diseases, frequently-occurring diseases and critical and difficult patients beyond their own service capacity to hospitals. Grass-roots medical and health institutions mainly include township hospitals, community health service centers (stations), village clinics, outpatient departments, infirmary (offices) and so on. Township hospitals and community health service centers are responsible for providing basic public health services, comprehensive services such as diagnosis, treatment, nursing and rehabilitation of common and frequently-occurring diseases, and entrusted by county-level health and family planning administrative departments to undertake public health management within their administrative areas, and are responsible for comprehensive management, technical guidance and training of rural doctors in village clinics and community health service stations. Township hospitals are divided into central township hospitals and general township hospitals. In addition to the service functions of general township hospitals, central township hospitals should also carry out common operations, focus on strengthening medical service capabilities and undertake technical guidance for general township hospitals in surrounding areas. Village clinics and community health service stations, under the unified management and guidance of township hospitals and community health service centers, undertake basic public health services for people in administrative villages and neighborhood committees, and carry out primary diagnosis, treatment and rehabilitation of common and frequently-occurring diseases. The basic medical and health institutions such as the infirmary and outpatient department (institute) within the unit are responsible for the basic public health and basic medical services of the unit or the functional community.Other out-patient departments, clinics and other grassroots medical and health institutions provide relevant medical and health services according to the health needs of residents. The government can subsidize the services it provides by purchasing services.

Second, the institutional setup

Township hospitals and community health service centers shall be set up according to the administrative divisions of townships and sub-district offices or a certain service population. By 2020, a township health center run by the government will be well established in each township, and a community health service center run by the government will be set up within the scope of each street office or according to the plan for every 30,000-100,000 residents. Comprehensively improve the service capacity and level of community health service centers and township hospitals. Considering urbanization, geographical location, population concentration and other factors, about one-third of township hospitals are selected to improve their service capacity and level, and central township hospitals are built. Reasonably determine the number and layout of village clinics and community health service stations, and reasonably set them according to the coverage of township hospitals and community health service centers, service radius, service population and other factors. In principle, each administrative village should set up a village clinic and each community should set up a community health service station. The establishment of individual clinics and other primary medical and health institutions is not limited by the planning and layout, and the management mode of market regulation is implemented.

Section 4 Planning and Setting of Professional Public Health Institutions

First, the functional orientation

Professional public health institutions are institutions that provide professional public health services (mainly including disease prevention and control, comprehensive supervision and law enforcement of health and family planning, health education, maternal and child health care, mental health, first aid, blood collection and supply, food safety risk monitoring and evaluation and standard management, family planning, birth defect prevention, etc.) within their administrative areas, and undertake corresponding management work. Professional public health institutions mainly include disease prevention and control institutions, health education institutions, health and family planning comprehensive supervision and law enforcement institutions, maternal and child health care family planning service institutions, mental health professional institutions, emergency centers (stations), blood stations, etc., which are organized by the government in principle.

The main duties of county-run professional public health institutions are: to undertake professional public health tasks, corresponding business management, information submission and other work within the administrative area, and to provide technical guidance, personnel training, supervision and assessment on public health work of medical and health institutions within the administrative area, and to complete the mandatory tasks assigned by superiors.

The main responsibilities of state-run professional public health institutions are: to undertake professional public health tasks and corresponding information management within the administrative area, and to carry out business guidance, personnel training, supervision and assessment for subordinate professional public health institutions, and to complete the mandatory tasks assigned by superiors.

The main responsibilities of provincial professional public health institutions are: undertaking professional public health tasks within the administrative area, carrying out regional business planning, scientific research and training, information management, technical support, business guidance, personnel training, supervision and assessment of subordinate professional public health institutions, and completing mandatory tasks assigned by superiors.

Second, the institutional setup

Professional public health institutions are set up reasonably according to the number of permanent residents, service scope, workload and other factors in the administrative area. Strengthen the integration of public health service resources in administrative areas and encourage the formation of comprehensive public health service centers; Strengthen the capacity building of disease prevention and control in border areas; Strengthen the capacity building of health education. According to administrative divisions and levels, there is only one similar professional public health institution in each administrative region at or above the county level in principle, and the government at or above the county level regulates the establishment of comprehensive supervision and law enforcement institutions for health and family planning according to their work responsibilities, which will undertake the task of comprehensive supervision and law enforcement for health and family planning.

Below the county level, community health service centers (stations), township hospitals (maternal and child health care and family planning service stations), village clinics and family planning service rooms undertake professional public health-related work. Integrate the maternal and child health care functions of township family planning technical service institutions and township hospitals. Village clinics and village family planning service rooms are reserved at the village level and shared.

In principle, there are one disease prevention and control, one comprehensive health and family planning supervision, and one maternal and child health care and family planning service institution within the county-level administrative region. At present, the specialized prevention and control institutions for leprosy and schistosomiasis are gradually integrated into the disease prevention and control center; There is an emergency center (station) and a blood bank attached to the county-run general hospital, and the location of the state government is not repeated.

One public health institution, including disease prevention and control, comprehensive supervision of health and family planning, maternal and child health care and family planning services, blood collection and supply, and one emergency center (station) are set up independently or relying on the state-run general hospital. Kunming will no longer set up emergency centers and blood centers repeatedly. All localities can integrate resources according to the actual situation. Within the provincial administrative region, one professional public health institution is set up, including disease prevention and control, health education, comprehensive supervision of health and family planning, maternal and child health care, scientific research of population and family planning, mental health, first aid, blood center and so on.

Within the scope of the province, the mental health service system and network will be established and improved on the basis of professional mental health institutions as the main body, psychiatric departments of general hospitals as the auxiliary, primary medical and health institutions and community rehabilitation institutions for mental illness.

Within the province, the prevention and control of infectious diseases in the province will be strengthened based on disease prevention and control institutions as the main body, infectious diseases specialist hospitals and general hospitals as the auxiliary, and primary medical and health institutions.

Within the scope of the province, with the provincial and municipal emergency centers as the leader, the county-run emergency center and the pre-hospital emergency network hospital jointly built a relatively complete emergency network. Strengthen the construction of emergency medical rescue bases in areas with frequent geological disasters, locations of large-scale petroleum refining and chemical projects, and areas along oil pipelines.

Section 5 Building a Regional Medical and Health Center

According to the development idea of "strengthening central Yunnan, invigorating the border areas, linking corridors, multi-point support and two-way opening", combined with the new urbanization construction plan, we will build six medical and health service areas in central Yunnan, western Yunnan, southeastern Yunnan, northwestern Yunnan, southwestern Yunnan and northeastern Yunnan. The medical and health service areas in central Yunnan include Kunming, Yuxi, Chuxiong and Qujing; The medical and health service areas in western Yunnan include Dali, Baoshan and Dehong; The medical and health service areas in southeastern Yunnan include Honghe and Wenshan; The medical and health service areas in northwest Yunnan include Lijiang, Diqing and Nujiang. The medical and health service areas in southwest Yunnan include Xishuangbanna, Pu ‘er and Lincang. The medical and health service area in northeast Yunnan includes Zhaotong. Coordinate high-quality medical and health resources in various regions, develop interactively, build regional medical and health centers, and improve the overall level of medical and health services in the province.

In the medical and health service area in central Yunnan, based on the construction of national and provincial clinical key specialties and clinical disciplines, relying on the provincial-run tertiary hospitals, we will introduce domestic high-quality medical and health resources to cooperate and build a provincial-level high-level medical and health center; Relying on Fuwai Cardiovascular Hospital, we will build a national cardiovascular disease diagnosis and treatment center and a provincial cardiovascular disease diagnosis and treatment training base for South Asia and Southeast Asia. Strive to build the provincial high-level medical and health center into a medical and health institution with beautiful environment, talented people, outstanding characteristics, excellent equipment, leading technology, rigorous academic research, innovation and advanced management, and provide efficient and high-quality diagnosis and treatment of critical and difficult diseases and specialized medical services for the whole province and neighboring countries, leading the improvement of the medical and health level of the whole province.

In the medical and health service areas of western Yunnan, southeastern Yunnan, northwestern Yunnan, southwestern Yunnan and northeastern Yunnan, regional medical and health centers in western Yunnan, southeastern Yunnan, northwestern Yunnan, southwestern Yunnan and northeastern Yunnan will be built through the construction of key clinical specialties and clinical disciplines jointly established by provincial and provincial cities, and relying on tertiary hospitals with strong technical capabilities and good service capabilities in the region to provide high-level medical and health services to the people in the region, and train and guide primary medical and health personnel in the region.

In the medical and health service areas of western Yunnan, northwest Yunnan, southwest Yunnan and central Yunnan, we will give full play to the traditional advantages of ethnic medicine, actively carry out ethnic medicine services and build ethnic medicine service centers such as Tibetan medicine, Dai medicine and Yi medicine, relying on existing ethnic hospitals such as Tibetan medicine hospitals, Dai medicine hospitals and Yi medicine hospitals.

Section 6 Division of Labor and Cooperation of Medical and Health Institutions

Establish and improve the division of labor and cooperation among public hospitals, professional public health institutions, grass-roots medical and health institutions and social hospitals, integrate the service functions of various medical and health institutions at all levels, and provide systematic, continuous and all-round medical and health services for the masses.

I. Combination of prevention and control

Professional public health institutions should strengthen guidance, training and assessment for public hospitals, primary medical and health institutions and social hospitals to carry out public health services, and establish cooperation mechanisms such as information sharing and interconnection. Clarify the responsibilities of professional public health institutions and medical institutions, and do a good job in the comprehensive prevention and treatment of chronic diseases such as hypertension, diabetes and cancer. General hospitals or specialized hospitals carry out diagnosis and treatment of key infectious diseases such as tuberculosis and AIDS, as well as patients with occupational diseases and mental diseases, and professional public health institutions are responsible for tracking and management. Provide women and children with life-cycle health care and clinical health services, and carry out comprehensive prevention and treatment of birth defects. Strengthen the coordination between maternal and child health care institutions and general hospitals, and focus on strengthening the referral and treatment of high-risk pregnant women and high-risk children. General hospitals and related specialized hospitals should rely on relevant departments and cooperate closely with professional public health institutions to undertake certain public health tasks within their administrative areas and provide operational guidance to primary medical and health institutions. Establish a compensation mechanism and a service purchase mechanism for medical institutions to undertake public health tasks. Strengthen the construction of public health service capacity of grassroots medical and health institutions to ensure that all public health tasks are in place.

Second, pay equal attention to Chinese and western medicine

Efforts will be made to promote the revitalization and development of Chinese medicine, adhere to the principle of paying equal attention to both Chinese and Western medicine, give full play to the unique advantages of Chinese medicine (ethnic medicine) in medical prevention and health care in our province, establish and improve the development mechanism of Chinese medicine (ethnic medicine), strengthen the team building of Chinese medicine (ethnic medicine), and improve the management system, inheritance and innovation system and service system of Chinese medicine (ethnic medicine). Use modern science and technology to strengthen the cooperation between Chinese and western medicine in disease prevention, clinical treatment and medical research, and promote the complementary and coordinated development of Chinese medicine (ethnic medicine) and western medicine. Increase the information support of traditional Chinese medicine (ethnic medicine) hospitals. In general hospitals, maternal and child health institutions and other non-Chinese medical and health institutions, Chinese medicine (ethnic medicine) departments are set up. Strengthen the construction of comprehensive service areas of traditional Chinese medicine (ethnic medicine) in township hospitals and community health service centers. Strengthen the development of ethnic medicine such as Tibetan medicine, Yi medicine and Dai medicine. Strive to realize the creative transformation and development of traditional Chinese medicine health preservation culture.

Third, up and down linkage

Establish and improve the graded diagnosis and treatment mode in line with the actual situation in our province, build a division of labor and cooperation mechanism between hospitals at different levels, hospitals and primary medical and health institutions, and continue medical institutions, improve the operation mechanism of networked urban and rural primary medical and health services, and gradually realize the diagnosis and treatment pattern of primary diagnosis, two-way referral, up-and-down linkage, and rapid and slow division. With the goal of forming a graded diagnosis and treatment order, we will actively explore scientific and effective medical associations and telemedicine and other graded diagnosis and treatment methods, and strive to improve the incentive mechanism of the reimbursement ratio of basic medical insurance for two-way graded diagnosis and treatment. Make full use of information technology to promote the disclosure of medical service information and the vertical flow of high-quality medical resources, and realize the information channel of sharing diagnosis and treatment information, developing telemedicine service and teaching and training between hospitals and primary medical and health institutions. Improve the service chain of treatment-rehabilitation-long-term care, develop and strengthen continuous medical institutions such as rehabilitation, elderly care, long-term care, chronic disease management, hospice care, establish a system of acute and slow treatment, and improve the utilization efficiency of medical resources in public hospitals.

Fourth, the combination of medical care and nursing

Combined with the unique advantages of natural conditions in our province, we will establish various types of combination models of medical care and nursing. Encourage all kinds of medical institutions to carry out pension services, support all kinds of pension institutions to load medical service functions, increase the number of resources to provide medical services for the elderly, and enhance the ability of general hospitals, traditional Chinese medicine hospitals, geriatric hospitals, rehabilitation hospitals, nursing homes, hospice care institutions and primary medical and health institutions to serve the elderly. From the aspects of common diseases, chronic diseases, rehabilitation nursing and health promotion, we will focus on strengthening the ability of primary medical and health institutions to provide diagnosis and treatment services for the elderly. Medical and health institutions have opened a green channel for the old-age care institutions to provide services such as medical rounds, health management, health consultation, appointment, emergency treatment, and Chinese medicine health care for the elderly, so as to ensure that the elderly can get timely and effective medical treatment. Conditional medical institutions set up in old-age care institutions can be used as post-rehabilitation nursing places for the elderly in hospitals (including traditional Chinese medicine hospitals). Encourage two or more general hospitals (including Chinese medicine hospitals) to carry out counterpart support and cooperation with old-age care institutions. We will integrate medical, rehabilitation, old-age care and nursing resources by building a medical and old-age care consortium, and provide the elderly with health and old-age care services that integrate hospitalization during treatment, rehabilitation care, stable life care and hospice care. Promote the extension of medical and health services to communities and families. Encourage social forces to set up institutions that combine medical care with nursing care.

V. Diversified development

Strengthen the coordinated development of social medical institutions and public medical and health institutions, and improve the overall efficiency of medical and health resources. Encourage social capital to invest in service areas that meet diverse needs. Encourage social capital to invest in establishing community health service institutions through various forms and channels. Encourage social forces to set up Chinese medicine specialized hospitals, rehabilitation hospitals, nursing homes (stations) and clinics for oral diseases, geriatric diseases and chronic diseases. Encourage social forces to give priority to the establishment of non-profit specialized hospitals of traditional Chinese medicine such as gynecology, pediatrics, orthopedics and anorectal diseases, and develop rehabilitation hospitals and nursing homes with Chinese medicine characteristics. There are no layout restrictions on the establishment planning of medical institutions and regional health development planning for Chinese medicine clinics and clinics that only provide traditional Chinese medicine services with social capital. Support qualified Chinese medicine professionals and technicians, especially famous old Chinese medicine practitioners to set up Chinese medicine clinics and clinics. Encourage pharmaceutical trading enterprises to hold traditional Chinese medicine clinic. Actively carry out more practice of doctors. Support social medical institutions to strengthen the construction of key disciplines, introduce and train talents, and enhance their academic status. Encourage and support social forces to participate in public health work, and strengthen technical guidance and supervision and management. Social forces should strengthen their own management, constantly strengthen their own capabilities, and work closely with professional public health institutions to ensure the smooth development of public health work.

Chapter IV Allocation of Medical and Health Resources

The first section configuration ideas

In view of the overall shortage of medical and health resources and the extreme shortage of health human resources in our province, we should control the growth rate of beds, improve service efficiency, speed up the construction of practicing (assistant) doctors, professional public health personnel and general practitioners, and rationally allocate registered nurses in accordance with the development idea of overall coordination.

In view of the uneven distribution of medical and health resources, according to the social and economic development, geographical traffic conditions, current situation of medical and health resources and the needs of regional medical and health center construction, 16 provinces and cities in the province are divided into: Kunming, the control development area; Moderately developed areas: Yuxi, Chuxiong, Honghe, Xishuangbanna and Dehong; Areas for accelerated development: Qujing, Baoshan, Zhaotong, Lijiang, Pu ‘er, lincang, Wenshan, Dali, Nujiang and Diqing.

According to the strategy of "controlling development, moderately developing and accelerating development", the allocation standard of medical and health resources in different regions is formulated, which requires controlling the development regions to promote structural adjustment, strengthen connotation construction, control the growth rate of all kinds of resources, guide the society to do fine medical work, encourage state-run hospitals and county-run hospitals to explore new service models, and gradually compress beds; Encourage moderately developed areas to improve efficiency, revitalize stocks, and rationally allocate and utilize various medical and health resources; Support to accelerate the development of areas to increase the construction of service supply capacity, and gradually narrow the gap in medical and health service capacity between various regions. Appropriate tilt will be given to the allocation of various resources in eight border States and cities, including Honghe Prefecture, Xishuangbanna Prefecture, Baoshan City, Pu ‘er City, lincang, Wenshan Prefecture, Dehong Prefecture and Nujiang Prefecture, so as to strengthen the medical and health services and disease prevention and control capabilities in border areas and provide health protection for the construction of a radiation center for South Asia and Southeast Asia.

Section 2 Allocation of Bed Resources

I. Structural configuration

By 2020, the total number of beds in medical and health institutions in the province will be controlled at about 295,000, the number of beds in medical and health institutions per 1,000 permanent residents will be controlled at 6.0, and the number of beds in public hospitals will be controlled at 3.25, including 1.94 hospitals run by counties, 0.88 hospitals run by cities and 0.33 hospitals run by provinces. There are 0.10 other public hospitals, 1.5 social hospitals and 1.25 primary medical and health institutions organized by state-owned and collective enterprises and institutions. The number of beds in Chinese medicine hospitals can be configured according to 0.55 beds per thousand permanent residents. Public specialized hospitals can be set up according to the proportion of 15% beds in public hospitals. If the number of beds in public hospitals per thousand permanent residents exceeds 3.25, in principle, the scale of public hospitals will no longer be expanded, and areas with conditions will be encouraged to optimize and adjust the excessive stock resources of public hospitals. The government has increased investment in areas and fields where medical and health service resources are short and social capital investment is insufficient to meet the basic medical and health service needs of the people. According to the basic tasks and functions undertaken, reasonably determine the size of beds in primary medical and health institutions, focusing on improving the quality of beds, improving the efficiency of use, and focusing on strengthening the combination of medical care, nursing and rehabilitation beds.

Second, the regional configuration

Considering the social economy, geographical location, service population, existing bed resources, bed utilization and other factors of each state and city, the bed allocation standards of each state and city are formulated according to the strategy of "controlling development, moderately developing and accelerating development" (see Table 3 for details).

Third, the monomer scale

Strictly control the bed size of public hospitals (single practice point). The number of beds in county-run comprehensive hospitals is generally about 500, and the number of beds in counties with a population of more than 500,000 can be appropriately increased. In principle, the number of beds in counties with a population of more than 1 million does not exceed 1,000; The number of beds in state-run general hospitals is generally about 800, and cities with a population of more than 3 million can be appropriately increased, in principle, not more than 1200; The number of beds in provincial and above general hospitals is generally about 1000, and in principle it is not more than 1500. General hospitals with more than 1,500 beds before 2015 shall not add any more beds. The size of beds in specialized hospitals is reasonably set according to actual needs.

Section III Allocation of Health Human Resources

The allocation of health human resources is adapted to the people’s health service demand, institutional function orientation and bed allocation. The distribution of medical and health talents in urban and rural areas and regions tends to be reasonable, and all kinds of talent teams develop in a coordinated manner. Strengthen the standardized training of general practitioners and residents, improve the coordination mechanism of medical education, and gradually establish and improve the general practitioner system. Promote the rational flow of medical personnel, optimize their allocation in the flow and give full play to their functions. Strengthen the construction of special capacity of public health personnel.

First, the configuration of licensed (assistant) doctors and registered nurses

Considering the social economy, geographical location, service population, existing human resources, medical and health service demand and other factors of each state and city, according to the strategy of "controlling development, moderately developing and accelerating development", the allocation standards of licensed (assistant) doctors and registered nurses in each state and city are formulated.

By 2020, the number of licensed (assistant) doctors and registered nurses per thousand permanent residents in the province will reach 2.5 and 3.14 respectively, with a total of about 123,000 and 154,000 respectively (see Table 4 for the allocation guidelines). States and cities can make appropriate adjustments according to the changes of population, economic development level and medical service needs and demands in the region.

Second, the hospital staffing

Hospital staff should focus on the allocation of licensed (assistant) doctors and registered nurses, and allocate the number of licensed (assistant) doctors and registered nurses on the basis of residents’ health service demand and doctors’ standard workload, combined with factors such as serving population, economic situation and natural conditions. The doctor-nurse ratio is 1: 1.25, and the bed-nurse ratio of state-run and above hospitals is not less than 1: 0.6. Medical and health institutions undertaking clinical teaching, teaching practice, supporting grassroots units, foreign aid medical care, emergency rescue, medical research and other tasks may appropriately increase staffing. Hospitals that do not meet the standard of bed-to-nurse ratio are not allowed to expand the size of beds in principle.

Three, the basic medical and health institutions staffing

By 2020, the number of primary health workers per thousand permanent residents will reach more than 3.5; The number of rural doctors per thousand service population is not less than 1, and the number of administrative villages with scattered residence can be appropriately increased; Every village clinic has at least one village doctor practicing. Village clinics equipped with more than two village doctors should have one female village doctor, and at least one village doctor who can attend the Western Conference. There are 2 general practitioners per 10,000 permanent residents, and each township health center has 2 general practitioners. The general practitioner system has been initially established, and a unified and standardized general practitioner training model and a service model of "first diagnosis at the grassroots level" have basically been formed. General practitioners and urban and rural residents have basically established a relatively stable contract service relationship, which basically meets the basic medical and health service needs of the people.

Fourth, the staffing of professional public health institutions

By 2020, the number of public health personnel per thousand permanent residents will reach 0.83, and all kinds of public health personnel at all levels will meet the needs of work. In principle, the staff of the Center for Disease Control and Prevention shall be approved according to the proportion of resident population of 1.75/ 10,000, and the number of infectious diseases in high-incidence areas and remote areas may be appropriately increased. Among them, the proportion of professional and technical personnel in the total establishment shall not be less than 85%, and the proportion of health technical personnel shall not be less than 70%. Maternal and child health care and family planning institutions should be reasonably staffed according to the local service population, social needs, traffic conditions, regional health and family planning development plans and the functions and tasks undertaken. The proportion of health technicians in maternal and child health care and family planning service institutions shall not be less than 80% of the total number. Professional mental health institutions shall allocate public health personnel according to the population in the region and the mental health prevention and control tasks undertaken. Blood collection and supply institutions shall allocate health technical personnel according to the annual business volume of blood collection and supply. Emergency centers, health and family planning comprehensive supervision and law enforcement agencies should be staffed according to the service population and annual business volume.

Section IV Information Resource Allocation

To guide the construction of population health informatization in the whole province with the national health insurance informatization project, and effectively improve the application level of population health informatization business; With information benefiting the people as the goal and business and management requirements as the guidance, a practical, shared and safe population health information service network will be built in an all-round way. Accelerate the construction of population health information platforms at the provincial, city and county levels, integrate and improve six business application systems, including public health, family planning, medical services, medical security, drug management and comprehensive management, and connect three databases, namely, population information, electronic medical records and electronic health records of residents, build a big data center for population health in the whole province, and popularize the application of residents’ health cards. Study and formulate the standard system of population health information in our province and implement the safety guarantee system.

By 2020, an interconnected population health information service system in the whole province will be initially established, so as to realize the integration of all-in-one coverage of health and family planning, all-in-one health card for residents and government social resources, and establish a national health security information service mechanism with full population coverage, whole life process, equal emphasis on Chinese and Western medicine, and all-weather work; Strengthen the application of medical and health big data analysis based on residents’ electronic health records throughout their life cycle; Promote health and family planning business collaboration, information sharing and scientific decision-making.

Section 5 Allocation of Other Resources

I. Configuration of large-scale equipment

According to the functional orientation, medical technology level, subject development and people’s health needs, strengthen the allocation planning of large medical equipment. Adhere to resource sharing and ladder configuration, guide medical institutions to rationally allocate appropriate equipment, gradually improve the allocation level of domestic medical equipment, and reduce medical costs. Strictly control the unconventional and debt-borrowing equipment of public hospitals. Moderately relax the allocation conditions of social medical institutions, do not take the level of social medical institutions and the size of beds as the necessary preconditions for determining the allocation of large-scale equipment, focus on assessing the qualifications and technical service capabilities of institutional personnel, and reserve a certain allocation quota for large-scale equipment of social medical institutions. In order to control the unreasonable increase of medical expenses caused by large-scale medical equipment and ensure the safety of large-scale medical equipment, medical insurance reimbursement support and price charging license support are not allowed for large-scale medical equipment that has not been allowed. Support the development of professional medical inspection institutions and imaging institutions, and gradually establish a mechanism for sharing, sharing and co-management of large medical equipment. Encourage the establishment of regional medical imaging centers in central Yunnan, southeastern Yunnan, southwestern Yunnan and other areas with conditions, promote the establishment of a service model of "inspection by primary medical and health institutions and hospital diagnosis", and improve the service capacity of primary medical imaging inspection and inspection. According to the unified and standardized standard system, the inspection of medical institutions above the second level is open to all medical institutions, and the promotion is conditional.In the area to carry out centralized inspection and mutual recognition of inspection results. Large-scale medical equipment shall be classified and managed according to the items, and the specific configuration plan shall be formulated separately. Strictly implement the relevant provisions on the purchase and use of second-hand large-scale medical equipment by medical institutions. It is strictly forbidden to use the models that have been eliminated by the state.

Second, the technical configuration

According to the demand of medical and health services, the functional orientation of medical and health institutions, disease spectrum, difficult and critical diseases, etc., the medical and health technology is rationally allocated. The establishment of medical technology clinical application evaluation management system, the clinical application of medical technology for the record management. Focusing on common diseases and health problems, we will strengthen the research and development, popularization and application of appropriate medical technologies, and strengthen the popularization and application of traditional Chinese medicine (ethnic medicine) technology. Build 50 provincial clinical key disciplines and 20 Chinese medicine key disciplines, form superior disciplines with Yunnan characteristics, and promote the overall level of disease diagnosis and treatment and the comprehensive competitiveness of hospitals. We will implement 300 provincial-level key clinical specialty construction projects and 200 provincial-level key clinical specialty cultivation projects, and build a number of key clinical specialty groups with radiation and demonstration functions to solve the problems of diagnosis and treatment of difficult, critical and specialized diseases for the masses. Strive to build 1-3 national regional medical diagnosis and treatment centers by 2020, and 40 specialties will meet the national standards of key clinical specialties, and the ability to treat difficult and critical diseases will be significantly improved. Strengthen the system construction of county-level medical institutions and the capacity building with talents and technology as the core, realize the rule of law, standardization, refinement and informatization of hospital management, and achieve the basic requirements of the state for comprehensive medical services. Each township health center and community health service center should build at least one clinical key department to achieve the goal of "common diseases do not leave the countryside and serious diseases basically do not leave the county". Strengthen the allocation of pre-hospital emergency transport equipment and the construction of pre-hospital emergency capacity in ethnic minority areas and remote areas.

Third, the allocation of funds

Strengthen the government’s investment responsibility for basic, grass-roots and basic medical and health resources, safeguard the public welfare of public medical and health services, and effectively ensure the funds for public health services and primary health services. The newly increased medical and health investment should focus on public health, primary health care, traditional Chinese medicine (ethnic medicine) and other key areas. Reform the way of financial subsidies and establish a mechanism linking financial subsidies with performance appraisal results. Provincial, state and municipal finance will give preferential support to areas and regional medical and health centers where medical and health services are lagging behind, and increase support for health services in poverty-stricken areas.

Chapter V Safeguard Measures

Section 1 Strengthening organizational leadership

First, strengthen leadership

The planning of medical and health service system is an important means for the government to carry out macro-control on health undertakings. It is necessary to strengthen the leadership of regional health planning, put regional health planning on the important agenda, include it in the government’s work objectives and assessment objectives, and establish an accountability system. Governments at all levels should make overall consideration of the development needs of medical and health institutions in the overall land use planning and urban and rural planning, rationally arrange land supply, and give priority to ensuring the land for non-profit medical institutions.

Second, rationally divide the responsibilities of governments at all levels

The people’s governments of prefectures and cities are responsible for studying and compiling the regional health planning and the establishment planning of medical institutions, and organizing their implementation. It is necessary to focus on the planning of hospitals and professional public health institutions at the prefecture level and below, refine the bed allocation standards to counties, and make overall plans for the establishment of various medical and health institutions at all levels in the city according to the principle of territoriality. The county-level government shall be responsible for the establishment of county-run hospitals, professional public health institutions and primary medical and health institutions in the region in accordance with the requirements of the regional health planning and medical institution establishment planning of the city where it is located.

Third, clarify the responsibilities of relevant departments

Departments of health and family planning, development and reform, finance, urban and rural planning, human resources and social security, institutional establishment and Chinese medicine management should conscientiously perform their duties and promote regional health planning in a coordinated manner. In terms of health and family planning, formulate regional health planning and medical institution setting planning and make dynamic adjustments in a timely manner; In terms of development and reform, we will carry out capital construction management for new reconstruction and expansion projects according to the plan, and actively strive for central construction funds in accordance with capital construction procedures; In terms of price, promote the reform of medical service price; In terms of finance, it is necessary to implement relevant funds in accordance with the government’s health investment policy, and pay attention to the principle of paying equal attention to both Chinese and western medicine; In terms of urban and rural planning and management, construction land should be approved in accordance with the urban and rural planning approved according to law; In terms of institutional establishment, it is necessary to coordinate the establishment of public medical and health institutions according to relevant regulations and standards; In terms of social security, we should speed up the reform of medical insurance payment system; Other relevant departments should carry out their duties and do a good job in relevant work.

Section 2 Innovating System and Mechanism

Deepen the reform of medical and health system and create favorable conditions for the implementation of medical and health service system planning. The main content of this plan is the allocation of medical and health resources. The overall deployment of deepening medical reform during the "Thirteenth Five-Year Plan" period will be arranged by the medical and health system reform plan. In the process of implementation, it is necessary to make a good connection with relevant plans. It is necessary to establish and improve the government’s health input mechanism and clarify the leading position of the government in providing public health and basic medical services. Effectively implement the investment policy for public and social non-profit medical and health institutions. Reasonably divide the responsibility of governments at all levels for medical and health investment. Deepen the comprehensive reform of primary medical and health institutions, improve the operational mechanism of networked urban and rural primary medical and health services, and improve service quality and efficiency; Accelerate the reform of public hospitals, establish a reasonable compensation mechanism, a scientific performance evaluation mechanism and a personnel compensation system that adapts to the characteristics of the industry, and promote the separation of management and administration, politics and medicine. Scientifically establish a dynamic adjustment system for performance pay in professional public health institutions, and allow grassroots public health institutions to extract a certain proportion from the balance of income and expenditure as an incentive performance pay increment, which will be included in the overall management of performance pay. Accelerate the development of serious illness insurance and commercial health insurance for urban and rural residents, and establish and improve a multi-level medical security system with basic medical insurance as the main body. Reform the medical insurance payment method and establish a more reasonable medical insurance payment mechanism. Strengthen the supervision of the whole medical and health industry. We will implement various forms of medical practice insurance such as medical liability insurance and medical accident insurance, and accelerate the development of third-party mediation mechanisms such as people’s mediation of medical disputes.Improve the medical dispute handling mechanism.

Section III Intensifying the Adjustment of Resources

According to the principle of "strictly planning increment and scientifically adjusting stock", the number and layout of public hospitals in the region are reasonably determined, and various measures are taken to promote the layout and structural optimization of public hospitals. Reasonably control the bed size, construction standards and large-scale equipment configuration of public hospitals, and prohibit borrowing for construction and equipment. For weak areas such as new urban areas, suburbs and satellite urban areas, the government should build public medical and health institutions in a planned and step-by-step manner to meet the basic medical and health needs of the people. Focus on strengthening the construction of service capacity in weak areas such as traditional Chinese medicine, pediatrics, obstetrics and gynecology, maternal and child health care, family planning, mental health, infectious diseases, elderly care, oral cavity and rehabilitation. Give priority to supporting the development of concentrated contiguous destitute areas, populous counties and areas lacking medical resources, and guide the flow of urban high-quality medical and health resources to grassroots and rural areas. Priority should be given to strengthening the service capacity of county-run hospitals and improving the medical capacity and level in the county. By 2020, 90% of county-run hospitals and county-run Chinese medicine hospitals will meet the basic standards for comprehensive capacity building of county hospitals and county Chinese medicine hospitals respectively, and the rate of medical treatment in the county will increase to 90%. Support the standardization of village clinics, township hospitals and community health service institutions, and build a "15-minute health service circle in dam area" and a "30-minute health service circle in mountain area". We will increase support for the development of medical and health service system and the targeted training of talents in ethnic minority areas, border areas and concentrated contiguous destitute areas. Newly built residential areas and communities shall ensure basic medical and health facilities in accordance with relevant regulations. In areas with surplus resources of public hospitals, it is necessary to optimize the structure and layout and proceed from reality.According to the needs, some public hospitals will be actively and steadily transformed into rehabilitation, elderly care and other continuing medical institutions or community health service institutions. For public hospitals that exceed the scale standard, comprehensive measures should be taken to gradually compress beds.

Section IV Strengthening the Training and Use of Talents

Carry out the basic talent training plan, strengthen the coordinated development of medical education, establish a supply-demand balance mechanism between medical talent training and talent demand in health and family planning industry, accelerate the construction of a clinical medical talent training system with "5+3" as the main body and "3+2" as the supplement, continue to carry out the free training of rural order-oriented medical students, and explore the "5+3+X" specialist training model. We will fully implement standardized training for residents and assistant general practitioners, and carry out pilot projects for standardized training system for specialists. Further promote continuing medical education. By 2020, a standardized and standardized clinical medical personnel training system with Yunnan characteristics will be basically established, which is organically connected with college education, post-graduation education and continuing education.

Carry out the training plan for 10,000 doctors and speed up the construction of practicing (assistant) doctors. Strengthen the construction of grassroots medical and health teams focusing on general practitioners, improve the on-the-job training system, and encourage rural doctors to participate in academic education. Strengthen the training of nursing, pediatrics, psychiatry and other urgently needed professionals. Taking the training project of "Yunling famous doctor", high-level talents and "provincial famous Chinese medicine practitioners" as the starting point, the selection and training of "Yunling famous doctor" and high-level talents will be carried out in a planned way in the whole province every year, and the introduction plan of high-level talents will be carried out to promote and lead the development of high-level talents in various fields of health and family planning, such as public health, medical care and health management, and to expand the ranks of high-level talents and improve their level. Improve the policy environment for the development of medical and health talents, and improve the systems and mechanisms for the evaluation, selection, mobility, incentive and guarantee of medical and health talents. Strengthen the government’s policy guidance on the flow of medical and health talents, formulate and implement the policy of "keeping people at the grassroots level", promote the flow of medical and health talents to the grassroots level, study and implement the special post plan for general practitioners and county-run hospitals in grassroots medical and health institutions, create good career development conditions, and encourage and attract medical personnel to work at the grassroots level. Improve the employment mechanism of public institutions with the employment system and post management system as the main content, improve the post setting management, ensure that the professional and technical posts are not less than 80% in principle, and implement open recruitment and competitive recruitment for posts. Improve the scientific and socialized evaluation mechanism based on job responsibilities, oriented by morality, ability and performance, and in line with the characteristics of health talents.Improve the evaluation system of professional and technical titles of health and family planning personnel, and promote the growth and development of talents and rational flow. We will deepen the reform of the income distribution system, establish an assessment and incentive mechanism centered on service quality, service quantity and satisfaction of clients, based on job responsibilities and performance, adhere to the principle of getting more for more work and excellent performance, and give priority to key positions, business backbones and medical and health personnel with outstanding achievements. Establish an investment mechanism for the construction of health talent team with government investment as the main input, supplemented by employers and social assistance, give priority to ensuring investment in talent development, and provide necessary financial guarantee for the development of medical and health talents. Innovating the organization of public hospitalsSystem management, reasonably check the total establishment of public hospitals, and make dynamic adjustments, gradually implement the establishment and filing system, and explore various forms of employment mechanisms and government procurement services.

Section 5 Strengthening Supervision and Evaluation

First, standardize the planning process

States and cities in the preparation of medical and health resources allocation standards and regional health planning, according to the health needs of the masses, to set a reasonable allocation of various medical and health resources. Do a good job in connecting with this plan, local economic and social development planning, urban and rural planning, overall land use planning, etc., reasonably control the standard of total resources and the single scale of public hospitals, and make appropriate adjustments to the proportion of beds in different levels and types of institutions according to actual needs on the basis of strengthening the grassroots. The drafting of regional health planning in each state and city shall be approved by the provincial health and family planning administrative department and then submitted to the people’s government of Honshu for approval to ensure the suitability, feasibility and authority of the planning. The cycle of regional health planning is generally 5 years.

Second, strict planning and implementation

Timely release information such as institutional setup and planning layout adjustment, and encourage qualified areas to determine the host or operation subject by means of bidding. Incorporating planning as a prerequisite for the establishment of construction projects. All new medical and health resources, especially the establishment, reconstruction and expansion of public hospitals, the expansion of hospital beds and the purchase of large-scale medical equipment, must be strictly managed in accordance with the requirements and procedures of regional health planning, regardless of the funding channels. Establish a grading filing and publicity system for the size of beds in public hospitals. In public hospitals with more than 1,500 beds, the increase in beds must be reported to the National Health and Family Planning Commission for the record (Chinese medicine hospitals should also be reported to state administration of traditional chinese medicine for the record); In public hospitals with more than 1,000 beds, the increase of beds shall be reported to the Provincial Health and Family Planning Commission for the record. For public hospitals that seriously exceed the prescribed number of beds, carry out project construction without approval, expand the construction scale and improve the construction standards without authorization, informed criticism should be carried out, and the allocation of large medical equipment, grade evaluation and financial arrangements should be suspended.

Third, establish a supervision and evaluation mechanism for the implementation of the plan

The people’s governments of prefectures and cities should strengthen the supervision and evaluation of planning implementation, establish a supervision and evaluation mechanism of regional health planning and resource allocation, set up a special evaluation working group, organize the evaluation of the implementation progress and effect of regional health planning, find out the problems existing in the implementation in time, and study and solve countermeasures. In the process of evaluation, public appraisal and fair competition should be carried out, and legal, economic and administrative means should be used to standardize, manage and ensure the effective implementation of regional health planning.

Attachment: Division of Key Tasks of Provincial Departments

　　In July, Gamma Data released the "2019 China Game Industry Semi-annual Report" — — In the first half of the year, the growth rate of China Mobile’s e-sports revenue was far ahead of that of client-side e-sports games, accounting for more than 60%.

　　Earlier, the Leisure Game Market Opportunity Research Report of 2018-2019, also from gamma data, pointed out that mobile leisure game users accounted for 66.4% of the total mobile game users in the past year, but leisure games only accounted for 6.6% of the mobile game market & hellip; …

　　Thanks to the demographic dividend of China and the rapid development of mobile Internet, mobile e-sports has gradually become the main force in the field of e-sports, but mobile leisure games are still a low-lying area with huge room for growth, which seems to mean that "mobile e-sports+leisure" will become an opportunity in the development tide of e-sports and games in China.

　　In the e-sports market, female users surged.

　　In the 2019 Tatan Elite Challenge, which just ended in Qingdao, 12 teams fought for two days, attracting thousands of live audiences and over one million online audiences. It seems that the e-sports event created by a light casual game also has strong box office and market appeal.

　　In fact, the Tatan Cup has been born for four years, and the popularity of "Ball-Ball Battle" is behind it.

　　As a casual game produced by Giant Network, official data show that there are more than 500 million users, 10 million daily activities and 150 million monthly activities, and the gender ratio of players is close to 4 to 6 (35% women and 65% men); In terms of age, 40.08% of the players aged 18 to 24, and 33.07% of the users aged 13 to 17 & hellip; …

　　The rise of "Ball Fight" has indeed caught up with the fast lane of China mobile e-sports development — — It was launched in mid-2015, which is earlier than many popular mobile games, but the precise positioning is probably more worthy of attention.

　　In the e-sports game market, especially on the mobile side, the scale of female users has surged.

　　Public data shows that from 2013 to 2018, the number of female players has increased from less than 80 million to 290 million.In the past, there were high barriers to heavy games, which made light games that focused on "leisure" just needed by the market. Its "popularization", such as relatively simple rules and operation, was not only more suitable for covering young people of all ages, but also met the needs of the rapidly growing group of female players.

　　In fact, not only female players, but also professional players in Tatan Classic, which is a difficult scene to see in other e-sports events.

　　Leisure+animation, the future industrial direction

　　Of course, there is still a long way to go from a popular game to a traditional e-sports event.

　　On the one hand, it benefits from the high stickiness of mobile e-sports users. According to the survey, the proportion of mobile e-sports users playing games every day is as high as 43.1%, and the proportion of playing games every week is also 25.3%, among which the proportion who are willing to watch events online is as high as 67.2%.

　　In addition, industry insiders also analyzed that while the competition of heavy game e-sports is intensifying, leisure e-sports built around light games is expected to become a "single product" in the market. Since 2016, Giant Network has successively launched a series of subdivided events such as BPL Professional League, Tatan Cup Elite Challenge, CEST Campus Challenge and BUC City Challenge, and deeply cultivated leisure e-sports.

　　It is worth mentioning that while maintaining the attributes of the game, leisure e-sports emphasizes the social functions in e-sports games.

　　According to statistics, "Ball Battle" creates a community online through team battles, seasons, leaderboards and other settings. On average, each player has 15+ friends, and the platform generates more than 12 million private messages every day, with a cumulative upload of more than 100 million selfies.

　　In terms of offline events, the Tatan Cup is closer to the carnival, with diverse scenes such as band performances, players meeting, audience interaction with the event presented together.

　　With the increasing social needs of young people, mobile e-sports has become a social product to some extent. According to the 2018 China Leisure Mobile Game Industry Report released by iResearch, 82% of leisure mobile game users said that they need to meet social needs in the game.

　　Producer Wu Meng has also said that social attributes will help game products to extend their life cycle. In fact, for leisure e-sports with weak antagonism, socialization is not only empowerment, but also its lifeline.

　　At present, giant network’s e-sports are actively seeking cross-border and circle-breaking. The previously launched "Journey" series has joined hands with the classic animation "Huluwa" to implant Huluwa elements in e-sports games. At present, the serial comics "Xingyun Brigade" and the virtual idol "Tatan" related to "Ball Fight" are also officially launched … …

　　Judging from the industry and market forecast, leisure, animation and massively multiplayer online e-sports and games still have considerable potential in the future.

　　The Paper reporter Chen Jun

In October, 2021, the sculpture of "Big Guitar" beside Binjiang Leisure Square in Ji ‘an, Jilin. The pictures in this article are all Matt diagrams.

I will leave Dandong for Ji ‘an along the Puyi Palace in Dandong.

On August 9, 1945, the Soviet army entered the northeast, and Puyi went to Ji ‘an from Xinjing (now Changchun), the capital of the puppet Manchukuo, to prepare to flee to Japan through Korea, and he would spend 10 days in his life. There have been many such days before, and there will be more later.

On August 13th, Puyi stopped at Dalizigou Mining Institute of Dongbiandao Development Co., Ltd. near Linjiang in the north of Ji ‘an. On the 15th, Japan surrendered, and on the evening of 17th, in the miners’ canteen, Puyi announced his abdication for the third and last time in his life, and the Kantian dynasty of Manchukuo ended. On the 19th, Puyi arrived in Fengtian (present-day Shenyang) through Tonghua, was arrested by the Soviet troops who occupied the airport by air at Dongta Airport, and then was escorted to Chita (present-day capital of post-Baikal Territory of Russian Federation).

Five years later, when the Korean War broke out, the advance team of volunteers first entered North Korea from Ji ‘an for reconnaissance. Ji ‘an county was established in 1902, taking the meaning of "Your Majesty acceded to the throne, saved the world and set up an China" in Biography of Historical Records and Sima Xiangru. In 1965, in order to take care of North China’s national sentiment, the South Korean government renamed Ji ‘an Ji ‘an. In 1985, Ji ‘an was under the jurisdiction of Tonghua City, and in 1988, Ji ‘an established a city (county-level city).

coach

There is no direct train from Dandong to Ji ‘an, only a 4320 train from Dandong to Tonghua, which leaves the next day. Although the scenery along the train is wonderful, it doesn’t match my travel time, so I choose to take a long-distance bus instead.

In the era when high-speed rail is becoming more and more convenient, long-distance buses are becoming rare in first-and second-tier cities, but in small cities and rural areas, they are more convenient and flexible modes of transportation. Now high-speed railway station is far away from the urban area, and most of the long-distance bus stops are still in the city center. When passing through the mountainous areas of villages, long-distance buses will stop at any time according to the needs of passengers, which is an irreplaceable function of trains.

I like listening to drivers and bus captains chatting on long-distance buses. They will pay attention to the recent increase in vegetable prices, the situation in the Taiwan Strait, the poor economic development and employment situation in Northeast China, and finally the topic will always fall on their bus operation.

During my trip, there were only single-digit passengers at the starting station, and villagers occasionally hitchhiked during the four or five-hour journey, and the fare was only a few dollars. I understand that drivers have to carry a lot of goods to earn a little hard work. Apart from a small amount of personal express delivery, many of those goods are ingredients and engineering items in village shops along the way. As these buses are fixed trains, pulling goods is the main income of those drivers.

Our bus passed Hunjiangkou Bridge halfway, which is the confluence of China-Korea border and Liaoning-Jilin border. Hunjiang is the ancestral home of the Jurchen people in Jianzhou, once called Tongjiajiang. Tong Jia is a Manchu surname. The Tong family was originally a prominent family of Han people in Liaodong, and they had a good relationship with Jurchen. Emperor Kangxi’s mother and imperial concubine were both from Tong Jiashi. He ordered Tong Jiashi to be changed from the Eight Banners of Han Dynasty to the highest yellow flag.

"Big Guitar" Sculpture

In this city, which is famous for its world cultural heritage on the border between China and North Korea, I have to look for a very new landmark first: the "big guitar" sculpture.

In the movie Sewing Machine Band, the cement guitar sculpture in a fictional rock park exists as a symbol of idealism. This movie, with the theme of rock band, takes place in Ji ‘an, and the local people also know the shooting scene. But maybe it’s just because the director himself is from Ji ‘an. The rock capital in the movie has nothing to do with Ji ‘an in reality. The driver was also confused when I asked if there was a local band performance venue and asked if I was a KTV or a bar resident.

I walked to the riverside leisure square by the river, and a huge guitar sculpture was set up next to the square, but not the one in the movie. The guitar sculpture in the film was demolished in the plot. Later, the Ji ‘an municipal government suddenly realized the influence of this film and felt that it might attract young artists to travel here, so it really built a "big guitar" sculpture.

In October, 2021, next to Binjiang Leisure Plaza in Ji ‘an, Jilin, the landmark building "Big Guitar" sculpture in the night.

The "big guitar" in the movie is made of concrete, and its appearance and tone are relatively calm. Now, in order to cooperate with the light show, it has been changed into a pure white and more modern shape, and its position has also changed. At night, there is no rock music performance in Binjiang Leisure Square, only a square dance that is uniform and not lost to Arirang on the other side.

In October, 2021, Ji ‘an, Jilin, was the riverside leisure square at night, and in the darkness in the distance was North Korea on the other side of the Yalu River.

In 2004, 43 sites (42 in Ji ‘an) of Koguryo’s royal city, tombs and noble tombs were listed in the World Cultural Heritage List. The city of Ji ‘an is completely attached to the Koguryo site. The former Koguryo Capital Domestic City happened to be in the core block of Ji ‘an City.

With Goguryeo Ruins Park as the center, the ruins of domestic cities are all over the city, surrounded by the ruins of gates, city walls, turrets and drainage culverts. The city wall made of rectangular stones is surrounded by wooden fences, and there are many old people exercising beside the drainage culverts of the west city wall. Next to the Wenmen of Dongcheng wall is Ji ‘an Morning Market, but the Goguryeo Ruins Park in the center of the city itself has no ruins, and it is purely a fitness and leisure park.

Walking along the city wall is like walking in a big park, because many sites are in residential areas. It is also a rare experience to touch the world cultural heritage as soon as you get downstairs.

In October, 2021, Ji ‘an, Jilin, was the site of Koguryo National City in the urban area.

Wandu Mountain City Fortress

The next morning, I arrived in Marudo Mountain City. At that time, it was cloudy and slightly cold, which was very suitable for climbing mountains. The taxi driver told me that I didn’t have to go into the mountains, so I just had a look outside by car. That was probably the aesthetic fatigue of their locals.

In the eyes of people who don’t understand, there are no large-scale architectural remains in this mountain. It seems that there is nothing to see, just a pile of stones and graves. But people who know it will know that Marudo Mountain City is a fortress of repeated tug-of-war between Koguryo and the Central Plains regime in Liaodong and the northern part of the Korean Peninsula, from the Han Dynasty to the Tang Dynasty.

October, 2021, Ji ‘an, Jilin, Koguryo Marubu Mountain City Site.　

After the Han Empire conquered Weiman Korea, it set up four counties in Liaodong, and named the place where the native nationalities in Northeast China lived as Koguryo County, which was under the jurisdiction of Xuantu County. In 37 BC, Go Jumong, the prince of Fuyu (an ancient nation who lived in the northeast of China from the Han Dynasty to the Tang Dynasty), was pushed away and established an independent country, Koguryo, in Zubenchuan, which is now Wunv Mountain in Huanren, Liaoning Province, which is referred to as Juli in Chinese classics. In AD 3, Koguryo moved the capital to the domestic city, which is now Ji ‘an, and built Wei Na Yan City as the acropolis on the mountain, echoing the domestic city. This echo of two cities on the mountain and below is the characteristic of Koguryo city, and the ancient cities on the Korean peninsula also have this design, which is a defense habit in war-prone areas.

In 197 AD, Gongsun Du, the Eastern Han Dynasty Liaodong satrap, attacked Goguryeo, and the present Marubu Mountain City was expanded and renamed by the 10th King "Mountain King" to resist Gongsun Du’s invasion. Goguryeo joined forces with the Cao Wei regime to fight against the Gongsun family, but soon after, the two sides turned against each other. From 244 to 245 AD, Wu Qiujian, an assassin from Youzhou of the Cao Wei regime, went on an expedition to Goguryeo and destroyed Marubu Mountain City, but Goguryeo soon rebuilt the city.

In 311 AD, during the reign of Meichuan King, Goguryeo was in a strong position in the northern part of the Korean Peninsula and began to counterattack. By the time of Guangkai King, it occupied all the land east of Liaohe River. However, at this time, China entered the great division period from Wuhu Sixteen Countries to the Southern and Northern Dynasties, and new opponents appeared one after another. The first confrontation with Goguryeo was the Qianyan regime. In 342 AD, Murong Mu, the founding monarch of Qianyan, attacked Goguryeo and destroyed the Marubu Mountain City again. Fortunately, at this time, there are only 30 years left before the most ambitious monarch in Koguryo’s history succeeded to the throne, and Koguryo is about to enter its heyday.

I got off and walked to the foot of Marudo Mountain. For a long time, it was forgotten in the wilderness because of the blockade outside the customs. Until 1906, when the road was built, the "Buqiujian Ji Gong Monument" was discovered. The inscription recorded the historical facts of the expedition to Koguryo mentioned above.

The mountains in the east, west and north of Marudo Mountain City are steep, with broad and gentle flat land in the middle and low terrain in the south. The city wall is built on the cliff in the south and surrounded by a moat. I am the only one in the whole Marudo Mountain. The layout in the mountain city is very simple, and the number of buildings is not much. The palace is the center, but only the cornerstone remains, as well as the watchtower and the garrison station.

October, 2021, Ji ‘an, Jilin, Koguryo Marubu Mountain City Site.　

There is a small lotus pond in the mountain city. There is a story about this lotus pond. In 28 AD, the Han Empire attacked Goguryeo, and the third monarch of Goguryeo, King Dawu, stuck to Marubu Mountain City. The Han army hoped to make Goguryeo surrender by siege. King Dawu caught a carp from the lotus pond and wrapped it with aquatic plants and sent it to the military camp of the Han army. When the Han army saw the carp and aquatic plants, they thought that there was enough water and food in the city to be besieged, so they withdrew.

Walking out of the mountain city, I came to the Koguryo cemetery at the foot of the mountain. I was too relaxed and happy along the way. The mountains in the distance fluctuated and birds echoed, and there were tombs nearby.

In October, 2021, the Koguryo aristocratic tombs at the foot of Marudo Mountain in Ji ‘an, Jilin Province.　

Koguryo advocates thick burial, and the exterior of the mausoleum is piled into a cone with multiple layers of stones. In this cemetery, we can see the characteristics of Koguryo’s tombs in different historical periods: some of them are lined with strips of stones at the bottom and covered with gravel; Some of them are built directly with large stone strips; There is another kind, which is closer to Han tombs, that is, mounds.

Koguryo people believe in natural polytheism, so the murals in the tombs here mostly depict the gods of the sun and the moon. Later, Buddhism was introduced to Koguryo from the Central Plains, and Koguryo began to believe in Buddhism. Koguryo civilization influenced the whole Northeast Asia in later generations. It can be said that this mountain is the land of Longxing in Northeast Asia.

Haotai tomb and Changshou tomb

After leaving Marudo Mountain City, I went to two tombs in the urban area: Haotai Mausoleum and Changshou Mausoleum, which were developed as the core scenic spots of Koguryo Ruins in Ji ‘an. King Haotai and King Changshou were father and son. During their reign (AD 391-491), Koguryo’s national strength reached its peak.

Haotai Mausoleum is a small scenic spot, mainly visiting tombs and tombstones. When I entered the cemetery, the first thing I saw was the famous monument of King Hao Tai. The huge monument was covered by a glass wall room, but I could walk in and visit it. The full name of this monument is "The Monument to King Haotaiwang, whose land is wide open in Guogang", which records Koguryo’s founding history, King Haotaiwang’s life achievements and information about the laws and regulations of grave keepers, the most important part of which is the story of King Haotaiwang’s conquering everywhere during his reign.

In October, 2021, Ji ‘an, Jilin, the monument of King Haotai in Koguryo remains scenic spot.

Haotai Aric Tan De was born in an era of crisis in Koguryo. Shortly after his birth, his father, Koyilian, was killed in a battle with Baekje. Baekje was ambitious for the control of the Korean Peninsula. At this time, the Houyan Murong family who occupied Liaodong often threatened Koguryo. King Haotai, who succeeded at the age of 17, faced the risk of being attacked by both the north and the south.

King Haotai showed his superb strategic mind at this time. He pretended to surrender to Hou Yan to the north to avoid confrontation, and first solved the threat of Baekje in the south. King Haotai led the army to defeat Baekje many times and established his absolute superiority on the Korean Peninsula. At this time, Houyan was facing the attack of the newly rising Northern Wei Dynasty, and Goguryeo no longer obeyed Houyan. After defeating Houyan’s attack in a row, Wang Faqi fought back and occupied Liaodong. During this period, Japan began to intervene in the situation on the Korean Peninsula, and Baekje tried to form an alliance with Japan. King Haotai attacked Baekje again and drove Japanese forces out of the Korean Peninsula.

Go along the path after the monument to the Great King, and you will come to the foot of the tomb. Haotai Mausoleum looks not high from the flat ground, but it has a large area, surrounded by gentle slopes, and the terrain is open, and there is a step that can walk to the door of the tomb. Different from the tomb in Han Dynasty, the tomb is set underground, with a sealed mound above it, and the tomb of Haotai Mausoleum is at the top of the tomb.

In October, 2021, Ji ‘an, Jilin, the Haotai Mausoleum in Koguryo Ruins Scenic Area.　　

I walked up the steps to the tomb and came to the door of the tomb. The opened tomb was built with large strips of stone, but the top and the outside of the tomb were surrounded by broken stones, and some stones were scattered at random, which was different from the tomb of his son Changshou Wang that I saw behind me. Perhaps it took too much energy to dig stone tablets, so the tomb itself was a bit ordinary.

Walking down from Haotai Tomb, I went to Changshou Tomb. Perhaps in order to build a tourist city, although Ji ‘an has a small urban area, it has introduced a developed shared electric car. Except Marudo Mountain, other scenic spots can be visited by electric car, which is very convenient.

Changshou Mausoleum is located 1.5 kilometers east of Haotai Mausoleum, which is called "Oriental Pyramid" in tourism propaganda. Tourism propaganda is always misleading. When a mausoleum is called the Oriental Pyramid, people will inevitably compare it with the pyramids in Egypt. In fact, the mausoleum is not very tall, but it looks like a pyramid.

In October, 2021, Ji ‘an, Jilin, was the tomb of Changshou in Koguryo Ruins Scenic Area.　

Walking in front of the tomb of Changshou, it is not difficult to find that the construction technology of this tomb is obviously more advanced and advanced than that of Haotai Tomb. The tomb of Changshou Mausoleum is built into a square cone by huge stone strips layer by layer, and there are seven steps step by step. A huge tombstone is placed around the tomb and pressed on the outer wall to offset the outward force caused by the weight of the stone above and protect the tomb from collapse. As far as the building itself is concerned, there is obviously no connection between this mausoleum and the Egyptian pyramids. The volume difference between the two is too great, and the mausoleum is completely piled up by large stones and needs lateral protection, which is different from the Egyptian pyramids.

In AD 413, the 19-year-old son of King Haotai, Changshou Aric Lian, ascended the throne. He reigned for 78 years and died at the age of 97. In ancient times, a long-lived old man was regarded as a human being, and a long-lived monarch was a symbol of the prosperity of the country.

The Longevity King continued the expansion policy of his father, King Haotai. In order to contain the gradually powerful Northern Wei Dynasty, Goguryeo supported the Beiyan regime. When Beiyan perished, Goguryeo’s army covered the evacuation of clans and people in the Longcheng of Beiyan National Capital. In the year before the Northern Wei Dynasty launched a war of subjugation against Beiyan, Changshou Wang sent envoys to visit the Northern Wei Dynasty to request the imperial edict. Later, although Goguryeo supported Beiyan, it caused dissatisfaction in the Northern Wei Dynasty. However, with the death of the last monarch of Beiyan, the two sides reconciled, and Goguryeo not only accepted the conferment of the Northern Wei Dynasty regime, but also accepted the conferment of the Southern Liu and Song Dynasties, maintaining a stable and balanced relationship between the North and the South.

During the Southern and Northern Dynasties, the Central Plains regime began to take "Korea" as the abbreviation of Koguryo, and Koguryo gradually took "Korea" as the official title. In order to prevent the invasion of the Northern Wei Dynasty and suppress Baekje and Silla better, in 427 AD, Changshou Wang moved the capital from Ji ‘an to Pyongyang. When he captured Baekje and occupied the Hanjiang River Basin on the Korean Peninsula, Goguryeo’s territory reached its peak.

Ride an electric car from Changshou Mausoleum and return to the city center, passing through some small aristocratic tombs along the way. There used to be a mural exhibition hall here, but it is no longer open. Tomb murals can be seen in Koguryo Museum. In 1997, the Koguryo Mausoleum in Ji ‘an was stolen, and the director of Ji ‘an Korean Cultural Center was also involved. Many murals were smuggled to South Korea, and some were destroyed in the excavation. Later, some China scholars discovered Koguryo cultural relics when they visited the museum in South Korea, and asked for them in vain.

Special tenderness

The Yalu River in Ji ‘an is very narrow, and people who are good at swimming come from the other side for dozens of times. At six o’clock in the evening, there was no one on the street in Ji ‘an. Looking across the bank, the North Korean side was more pure black.

During the day, the taxi driver took me to the port, opposite the city of Manpu, North Korea. The cement factory aided by the Soviet era was still working in the thick smoke, and the mountain was bare. The driver said that North Korea was worried that someone would escape, so it cut down all the mountains to facilitate surveillance.

In October, 2021, Ji ‘an, Jilin, Manpu City, North Korea, on the other side of Yalu River, the border river between China and North Korea, was a cement factory aided by the Soviet era.

Ji ‘an always gives me a different flavor from other cities in Northeast China, especially neat and orderly. Cars always give way to pedestrians, and even the morning market is very regular. Breakfast stalls and other stalls selling vegetables, meat and aquatic products, and mountain products specialties have their own positions and are clearly separated. At a certain moment, such a civilized scene gave me the illusion of acting. Looking at the neatness and order of Ji ‘an, I wonder if this norm is also the ideal state that the other side of the river yearns for.

In October 2021, Ji ‘an, Jilin, was a morning market in the urban area.

But not everyone appreciates this specification. A taxi driver told me that the city’s economic situation is not good, and the real estate development that has been heated up around North Korea’s reform and opening up has always been a dream. After the epidemic, basically only tourists from the province came. What doesn’t match the high-level world cultural heritage is the lack of entertainment services that can retain tourists’ consumption. Moreover, the history of Koguryo is relatively unpopular, and many tourists just stop by to see the ruins and go to other places to stay. When the government was unable to develop the economy, it began to attach importance to the construction of civilization. Although the local people enjoyed cleanliness and order, they also had a tired response.

In this way, what I see is more like "we are very happy here, and only happiness is allowed."

In October 2021, Ji ‘an, Jilin, when night fell, there were no people on the street.

But in my feelings as a foreigner, Ji ‘an has a special gentleness. Perhaps because of the vigorous development of tourism construction, its public service facilities are completely high-level even compared with first-tier cities, with clean streets, clean and adequate public toilets, clear and perfect tourist guide signs, and Koguryo Museum with unique appearance. This public museum is charged, which is rare. The advantage is that there is no reason not to open on Mondays, which is more convenient for tourists to arrange their time.

In addition, the natural environment here is very pleasant, with mountains and rivers, warm in winter and cool in summer, and long T-shirts in late autumn during the day. No wonder Koguryo built the capital here. This place is very suitable for literary and artistic creators to move in for a short time, concentrate on their work, climb mountains when they are tired, and walk by the river.

Ceng Zhaolun is one of the pioneers of China’s introduction of modern western chemistry, the founder of organic chemistry in China, one of the main founders of chinese chemical society, a famous national defense chemistry expert and military critic of the Anti-Japanese War. During the Anti-Japanese War, Ceng Zhaolun published a large number of military discourses, so as to sum up the past, evaluate the present situation and look forward to the future, inspire Chinese people’s fighting spirit in the war of resistance against Japan, and thus establish his position and influence as a critic of military issues in the intellectual circles.

曾昭抡（1937年1月27日摄）

曾昭抡1899年5月25日生于湖南湘乡，为曾国藩胞弟曾国潢的曾孙，1915年考入清华留美预备学校（清华大学前身），1920年毕业赴美留学，进入美国麻省理工学院学习化学化工，1926年获该院科学博士学位。同年夏天回国，先后任广州兵工试验厂技师、南京中央大学化学系副教授兼化工科主任，1931年任北京大学化学系教授、系主任。1937年”七七”事变爆发，北大、清华、南开三校南迁，至长沙组成临时大学，后再迁昆明改称”国立西南联合大学”。曾昭抡任西南联大化学系教授，直至抗战胜利。1945年11月，曾昭抡返北平接收北大化学系，1946年赴美国考察原子弹，1949年回到北平。新中国建立后，曾昭抡的主要任职有北京大学教务长兼化学系主任，教育部副部长兼高教司司长，高教部副部长，全国高等学校招生委员会副主任，全国科联副主席，中国科学院学部委员兼化学研究所所长，全国人大代表，全国政协委员，民盟中央常委等。1958年任武汉大学化学系教授，”文革”中不幸逝世。

1. Training anti-chemical cadres for the PLA.

At the end of 1950, the People’s Liberation Army began to establish anti-chemical arms. In 1951, the Chemical Corps School was established in Beijing (the predecessor of the Anti-chemical Command Engineering College of the People’s Liberation Army). It is urgent to train a group of technical cadres to enrich teaching and command positions. At that time, the Training Director Department of the Military Commission sent Zhao Guohui and other cadres to contact the Ministry of Education, and the Ministry of Education put Ceng Zhaolun in charge of reception, which was very supportive of Ceng Zhaolun. After active contact, Ceng Zhaolun entrusted four universities, including Peking University and Tsinghua University, to set up special training courses to train the first batch of cadres for anti-chemical warfare schools. Not only that, Ceng Zhaolun also took time out of his busy Ministry to personally teach the main courses of national defense chemistry for these cadres and guide them to do relevant experiments. From 1951 to 1953, Peking University held three training courses for chemical defense soldiers, and Ceng Zhaolun continued to teach them three courses. Since then, these students have become the backbone of teaching and scientific research in the Institute of Chemical Defense of the People’s Liberation Army and the technical cadres of the chemical defense forces. This is Ceng Zhaolun’s important contribution to the construction of the people’s army. Zhao Guohui said: "All this should be thanks to Professor Ceng Zhaolun’s great help and support for our study and further study."

Peking University Department of Chemistry, 1954 Class Anti-chemical Soldiers (originally published in "Hundred Years of Peking University Chemistry")

Finding Nemo 2 and Grand Theft Auto 1

1905 movie network news In 2016, the North American film market experienced a wonderful year, with the total box office revenue reaching $11.4 billion, a record high. The box office record of $11.1 billion in 2015 is dead.

　

It is reported that the data comes from ComScore, a well-known American internet statistics company. The attendance data has not been calculated, but the company’s analysts believe that the attendance rate in 2016 will be the same as that in 2015. Without counting inflation, the realization of the box office record in 2016 benefited from high ticket prices. At the beginning of 2016, the ticket price of North American movies once reached a new high point, but the average ticket price for the whole year has yet to be calculated.

　

This record exceeded the expectations of the industry, especially the lack of "007" and two blockbuster series last year.

　

2016 was Disney’s strongest year, with its North American box office exceeding $3 billion, accounting for more than a quarter of the annual market share, and it was also the one with the least film distribution among the six major Hollywood companies.

　

Produced by Disney and Pixar, and released by Disney, the North American box office reached 486.3 million US dollars, ranking first in the North American annual box office. If you count the box office receipts in 2016 (released in North America on December 18, 2015), six of the top ten box office charts in 2016 are Disney movies.

　

The other four Disney movies are: (408.2 million dollars, up to 2016.12.31), (408.1 million dollars), (364 million dollars) and (341 million dollars).

　Author: Hu Jianli

The film "Hot Search" tells the story behind a "girl’s bullying on campus" incident. By launching an online public opinion war, the heroine finally reveals the criminal truth of the real abuser, which not only has ups and downs and many reversals, but also reveals how online public opinion is incited and used.

In the current complex network public opinion environment in China, the release of this film is just the right time, which well reflects the presence and timeliness of film and television works, has a strong social practical significance, and has a warning effect on the majority of netizens. It is a realistic genre film with novel ideas and thought-provoking.

In 2013, Xin Yukun, a 29-year-old young director, won the Best Director Award at the 8th FIRST Youth Film Festival and the Best New Director nomination at the 51st Taiwan Film Golden Horse Award for his blockbuster suspense film Heart Maze. In 2017, the crime suspense film "Breaking Silent" directed by him also enjoyed a good reputation, with 8.2 points for Douban and 54.25 million yuan at the box office.

In the above two films, Xin Yukun showed his exquisite multi-line circuitous narrative ability and unique cold realistic image style. Hot Search is the third cinema film directed by him independently, which also has suspense and criminal elements. The difference is that the story takes place in contemporary China metropolis, focusing on hot social topics such as online public opinion, online violence and sexual assault, which is more likely to resonate with young audiences.

This time, Xin Yukun took the initiative to change the theme and background of the story, and adopted a typological narrative technique that was more in line with the aesthetics of ordinary audiences. He told a story that was not very complicated, which was exciting and full of twists and turns, and was quite ornamental and topical, showing his strong narrative ability as always.Compared with the previous two works, Hot Search is a mature commercial film, but the background color of sharp observation of social reality and concern for vulnerable groups has not changed.

At the beginning of the film, Chen Miao, the editor-in-chief of the media played by Zhou Dongyu, published an explosive article on "Girls’ Campus Bullying" on the large-scale operated by his team, and also talked proudly about the skills of inciting online public opinion at the pre-editing meeting: "If netizens want to scold Zhang Xiaosui, we will provide scolding points". Unexpectedly, the girl Zhang Xiaosui committed suicide by jumping off a building after encountering cyber violence. Before jumping off the building, she sent a letter to Chen Miao to explain the hidden feelings. Chen Miaocai knew that she had been accidentally used as a gun. Although she had a desire for traffic and an ambition to become bigger and stronger from the media, she was a media person with conscience at heart. In order to make amends and get justice for Zhang Xiaosui, with the help of her colleagues, she burned her bridges and launched a just online public opinion war with Justin.

The framework of the whole story is not complicated, but the advantages are full and vivid details, exquisite narrative techniques, foreshadowing from time to time, and even sharp contrast between the hero and heroine, leaving some suspense until the last moment. Although it is not difficult to guess, because the focus of this film is not to create a suspense atmosphere, it enhances the drama and appreciation of the film.

Through the superb typological narrative skills presented in Hot Search, Xin Yukun once again proved himself to be a master narrator among the new generation directors in China, who can not only tell complex stories clearly, but also tell simple stories twists and turns.

Although Hot Search is a commercial film, it has a sharp observation and vivid description of the current chaos of online public opinion in China, showing reflection on online violence, criticism of those who are rich and heartless, and sympathy for the vulnerable groups.

In recent years, some plots in TV series, such as The Beginning and Imperfect Victims, have expressed and reflected on the phenomenon of cyber violence. However, on the big screen, except for a film "Search" directed by Chen Kaige in 2012, few works with this theme have met the audience. "Hot Search" can be called the most complete, complete and profound domestic film that shows the chaos of network public opinion and the phenomenon of network violence so far, and it has great social practical significance.

The film describes in detail the whole process of Chen Miao’s self-media and the investors behind it inciting and using online public opinion, and shows the audience the complete processing process of "hot search" one after another, which has a certain behind-the-scenes nature.

In the film, as an influential editor-in-chief from the media, Chen Miao’s mantra when she first appeared was "There are hot spots that cannot be ignored". In order to attract fans’ attention and reading, and win investors to increase investment, she broke the news about the video with ulterior motives, deliberately incited speculation without investigation and verification, and concocted the topic of "girl bullying on campus" into a hot search, which triggered cyber violence against Zhang Xiaosui, a girl who was pushed by netizens. Unexpectedly, as Zhang Xiaosui committed suicide by jumping off a building, online public opinion reversed, and netizens began to accuse Chen Miao of eating "human blood steamed bread" from the media. Chen Miao had a brainwave and quickly came up with a new trick: throwing a pot at a swearing netizen, interviewing Zhang Xiaosui’s mother, and using the video of the other side’s tears, not only earned another wave of traffic, but also successfully washed himself.

The wolf has a winning game when the shepherds quarrel. Chen Miao’s self-media farewell concoction of hot search and harvest traffic is just a pawn of the boss of the investor behind it, and Chen Miao is still complacent when he is shot by others. Subsequently, Chen Miao launched an online public opinion war with the other party to uncover the truth. The two sides constantly broke the news, and the public opinion reversed several times. Justice was once forced to the rescue …

The online public opinion war described in Hot Search not only makes the audience who are not familiar with online hype look thrilling, but also makes everyone alert: sometimes the so-called facts you see online are not necessarily the facts, and the so-called truth you see is not necessarily the truth. Each of us should maintain the ability of independent thinking, be objective and rational when speaking online, and don’t become an accomplice of cyber violence.

One of the most heartbreaking news in the first half of this year was that a primary school student in Hubei was knocked down by a car and killed. In the process of seeking advice from the school, his mother was attacked and insulted by some netizens because of her good image and elegant dress. In the end, the distraught and unbearable mother committed suicide by jumping off a building at the first seven hours of her child.

How to make the cyber violence that Hubei’s mother encountered before her death not happen again? How to make the cyber violence that Zhang Xiaosui encountered in the film not repeat itself? The film "Hot Search" has played a very good role in alerting the majority of netizens. I hope everyone can learn from it, consciously oppose cyber violence and jointly create a clean and tidy network public opinion environment.

(The writer is Secretary-General of China Film Critics Association and Secretary-General of New Media Committee of China Literary Critics Association.)

　　CCTV News:The data shows that the proportion of users who use mobile phones to watch videos exceeds 70%, and watching videos and live broadcasts on the move has become the urgent need of the majority of users. In order to meet the audience’s strong demand for watching live broadcasts on mobile phones, Glory has joined hands with China Telecom and CCTV Easy Orange to give away 90GB of telecom traffic free of charge to users who buy Glory’s 5C full netcom version since August.

　　Traffic is free to send live broadcasts.

　　According to the statistics released by CNNIC, 71.9% of users use mobile phones to watch videos, and the current hot live broadcast has intensified this trend. However, in most cases, WiFi signals are only available indoors. Although the speed of 4G network is fast, the huge traffic consumption has become the most troublesome problem for users.

　　In order to enable users to watch mobile video and live broadcast anytime and anywhere, Glory teamed up with China Telecom and CCTV Easy Orange to launch a special event: giving away 90GB of free traffic from China Telecom (*90GB of telecom traffic, which is directed traffic for CCTV Integrated application, only applicable to Glory Play 5C Full Netcom Edition). Users of China Telecom who purchase Glory 5C full netcom version can upgrade their mobile phone system to the latest version (B121 version or above), and open the built-in "CCTV Comprehensive" APP in their mobile phones to receive the traffic for free. The traffic will take effect on the same day, and they will be given for 6 months in a row, and 15G of local directional traffic will be given every month (subject to the operator’s notice).

　　In the "CCTV Comprehensive" APP built in Glory Play 5C Netcom Edition, the traffic consumed by users to watch programs will be deducted from the 90GB free traffic.

　　Glory and play 5C, enjoy it for a long time.

　　Glory Play 5C Full Netcom Edition is equipped with Kirin 650 chip with 16 nm 8-core, which is the first time to introduce the 16 nm process technology of the same generation as flagship models such as iPhone6s and Huawei Mate8 into the thousand yuan machine market. Compared with the 28 nm chip mobile phone on the market, Glory Play 5C performance is improved by 65%, and the power consumption of the whole machine is reduced by 40%. At the same time, it supports 4G+ technologies such as carrier aggregation and Cat.6, and the downlink speed can reach up to 300Mbps.

　　In this way, under the extremely fast 4G network, using the Glory 5C equipped with 16 nm 8-core to watch live video, the buffer is fast, the load is fast, the video is more refreshing, the heat is less, the power consumption is less, and the video can be played for a longer time, thus getting rid of the double pain that the progress bar can’t be dragged and the traffic can’t be hurt.

　　Watch the wonderful things anytime, anywhere.

　　CCTV mobile TV service was officially launched in December, 2006. It is committed to building the first cross-media interactive mobile TV station in China and providing the most authoritative, convenient and beautiful mobile video viewing service for mobile phone users in China. Information broadcast at home and abroad, the first time to take you to the news site; The hot events in the European Cup and the Olympic Games continue; CCTV famous columns, Spring Festival Gala, two sessions, military parade and other exclusive hot columns, witness the passionate moment of major events! Now all you need is a glory to play 5C full netcom version, which is exciting anytime and anywhere, and 90GB free traffic is waiting for you!

　　Beijing Yi Orange Tianxia Technology Co., Ltd. is a wholly-owned subsidiary of CCTV, and the only authorized operator of CCTV’s mobile TV integrated broadcast control license and content service license; It is the only channel for CCTV’s massive and high-quality copyright content to be exported to mobile terminals. Approved by the State Administration of Radio, Film and Television, the call sign of CCTV mobile TV content service license is "CCTV mobile TV" and the call sign of integrated broadcast control license is "China mobile video".

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Unconsciously, the Spring Festival holiday has ended, and many people have returned or are on their way back. Are you ready to start the work mode? What should I pay attention to before and after returning? What adjustments are needed to start work, diet, work and rest after the holiday?

After the Spring Festival holiday, many people set foot on the return journey. What should they pay attention to before, during and after the trip? After the long vacation, some people may have symptoms such as sleep disorder, anxiety and depression. How to alleviate and deal with "holiday syndrome"? A picture to understand.

Is it difficult for you to eat on time? Rushing to work and class in the morning, giving up breakfast after breakfast; Working overtime until late at night, you can only fill your stomach with snacks and supper. Even in order to lose weight, eating one less meal every day is designated as a personalized "rule" for eating.

　　Residents take photos and smell the fragrance among the rose flowers. Reporter Wang Liting photo

　　Longsha Gem, Juliet, Royal Rouge, Eve Wine Cellar … … In front of an open courtyard in Huilong Garden Community, Houhu Street, Jiang ‘an District, 320 kinds of Chinese roses compete for beauty. On the morning of the 13th, residents shuttled among the rose flowers to take photos and smell the fragrance, as if they were in a small rose garden. In the richness and profusion of flowers, the neighborhood relationship in the community is also more harmonious.

　　She is like collecting stamps.

　　Collect 320 kinds of Chinese roses

　　The reporter walked into the rose garden along the stone road, and the mixed flowers came to my face. Vines, shrubs and miniature roses came into view, with flowers and fragrance.

　　"I am 47 years old. After my daughter went to college in 2020, I began to grow Chinese roses." Chen Ting introduced, "There are not only many varieties of roses, but also a long flowering period, which is very suitable for flower arrangement, so I began to plant roses."

　　"I tried to plant 20 pots at first, and the results were very good, which gave me confidence." Chen Ting told reporters that she often watches flowers growing videos online, learns how to grow Chinese roses, and becomes more and more skilled in flower growing technology. Every time the nursery grows new roses, she always buys a few. "This feeling is like collecting stamps, more and more. Later, I couldn’t stop, and before I know it, there were 320 varieties."

　　Only one plant is left for each variety, and the rest are given to friends. This is Chen Ting’s principle of raising Chinese rose flowers. "I like to try new varieties and want to see the difference between new varieties and classic varieties." Chen Ting said that due to the limited space, the remaining roses were carefully screened.

　　"It is hot in Leng Xia in winter and short in spring. European and European varieties such as juice balcony, parade and Miranda are very suitable for planting here." Chen Ting introduced that different varieties of Chinese rose have different requirements for light and temperature, and they have to buy them for trial planting to know whether they are suitable for Wuhan’s climate. In daily observation, she has summed up the rose varieties that perform better and have good skin and good nutrition under the climatic conditions in Wuhan. "I often share my planting experience and experience with flower friends, hoping to make them take fewer detours in the process of planting roses."

　　Watering, fertilizing, spraying, pruning, cleaning yellow leaves and pulling branches, Chen Ting works in the garden for at least 6 hours every day. After a long period of work, Chen Ting’s arms were covered with scratches of different lengths. "There are many thorns in the rose, and it is common for the arm to be scratched." With a photosensitive skin disease, she often relapses dermatitis, but she is still enthusiastic about raising flowers.

　　Residents and properties

　　Help manage the "Rose Garden"

　　"When the flowers are in full bloom, she will invite us to enjoy the flowers and often cut them for us." Resident Zhang Ping said that with this garden, neighbors often walk around, enjoy flowers, walk and take photos, and the neighborhood relationship is more harmonious. "We will also bring friends to enjoy the flowers, and residents in the nearby community will come to punch in."

　　During the flower viewing, Chen Ting will explain the varieties and characteristics of flowers. "She is a flower grower in our community, and we often turn to her when we are confused in the process of growing flowers ‘ Learn from the scriptures ’ 。” Resident Zhou Cuiping told reporters that flower friends usually go to the flower and bird market to choose flowers and see flowers.

　　"I have only moved to the community for two years. I have met many neighbors through raising flowers and made many flower friends." Chen Ting recalled that at the end of 2021, Tan Heqing, the master gardener of the property, and the community flower friends spontaneously came to help prune the Chinese rose in winter. "The task of pruning and clearing the garden originally took two weeks, but it was all completed in two days."

　　Chen Ting named the garden "Ian’s Rose Garden", symbolizing beauty and happiness. "I feel very comfortable enjoying flowers, drinking tea and chatting with flower friends in the garden on weekdays."

　　Flowers bloom in the garden all the year round. Chen Ting’s enthusiasm also gained a lot of warmth by sending cut flowers every day and cutting branches in winter. The warm greeting when we meet, the flower friends who accompany us to chat when we take care of the garden, and the homemade sauerkraut presented by the neighborhood & HELIP; … Every little bit of daily life promotes the feelings between neighbors a little bit.

　　"The beauty of the garden needs to be discovered and appreciated by everyone." Chen Ting said that in the future, she intends to continue to introduce new varieties and improve the scenery of the garden, so that neighbors who also love life can have a more comfortable and beautiful viewing experience.

　　Reporter Wang Liting Correspondent Yu Wei Gu Wenjia

Tiger Sniff Note: Matt Ward is an angel investor, start-up consultant, entrepreneur, writer and cryptographer. He published an article on thinkgrowth, detailing the development strategies of the four major science and technology giants in the world today. This article is the first in this series, and the original text isAmazon: The Company Consuming ConsumersInterested friends can click to read.

Compile | Crow Mounted Police

Today’s Amazon looks unstoppable.

The online book buying company founded by Bezos can now be said to be the most dominant and diversified enterprise in the world. At present, their goal is to become the first enterprise in the world with a market value of $1 trillion.

People in the scientific and technological circles have already reached a consensus on the greatness of Amazon, but this is not the case in the eyes of the public. There are still many misunderstandings about this company, so it is necessary for us to study it deeply.

Amazon’s empire today

Unlike most of the Fortune 500 companies, Amazon is characterized by diversification. Most companies only rely on one or two explosive products, butAmazon owns an entire army.. Supporting this "military empire" are "five pillars": Amazon website, Amazon AWS cloud service, Alexa smart speaker, Whole Foods Supermarket and Amazon Prime service.

　

One of these five businesses is enough to amaze the world; So once they are combined, the final "completed body" must be the largest commercial ship in the world.

In order to better understand this behemoth, you need to know about this "five pillars" first.

1. Amazon Mall: the world’s number one e-commerce supermarket

In the eyes of westerners, Amazon is the most monopolistic enterprise in the world, and its position can almost be said to be unshakable. Take a simple data: last year, their revenue was $136 billion, with a double-digit growth rate.

What is even more frightening is that this company is expanding their market territory almost every year. At present, Amazon has won the top 10 major markets in the world. In addition to the earliest North America and Europe, Japanese, China and Indian in Asia also have their footprints. At present, they are establishing a new "base area" in Australia.

More importantly, the train of e-commerce is still roaring forward. Thanks to the strong logistics system construction and the blessing of third-party sellers on the platform, Amazon has actually become a full-category online mall. According to 2017 data, Amazon accounts for 44% of the US e-commerce; And they have increased by at least 13% every year for the past five years.

This growth is not limited to the United States. In Amazon’s total revenue in 2016, 35.5% was contributed by overseas markets; In 2015, this figure was 34%. In the end, the double harvest in domestic and international markets contributed to the soaring of Amazon’s stock.

But there is one project that needs to be pointed out in particular, and that is Amazon Besi.（Amazon Basics）. For sellers who have done business on this platform, Amazon Basics is definitely an ugly word. The platform was originally a gathering place for Amazon’s third-party sellers, but Amazon officials secretly collected the sales data of these sellers, found the most popular products, and then launched "counterfeit products" on their own main platform.

I have seen dozens of products "fortunately" copied by Amazon; I have also witnessed many friends being suppressed by Amazon in this way. exactly,Besides consumers, the only thing Amazon cares about is its main platform.This dirty trick against third-party sellers also indicates Amazon’s future business thinking: now, all third-party sellers on Amazon Besi have been replaced by Amazon’s own business-yes, Amazon only wants to monopolize consumers, and they don’t even want to leave any profits to others.

This kind of thinking is not only aimed at sellers, but also at buyers. For sellers, of course, entering Amazon will get considerable benefits, but Amazon is like junk food. Occasionally, it may taste great, but long-term consumption will bury health risks for itself. Brands are scrambling to squeeze into Amazon, which is nothing more than taking a fancy to hundreds of millions of consumers on the platform; But what they don’t know is that this kind of attempt is actually to quench thirst by drinking poison. Although entering Amazon can bring short-term benefits, in the long run, it is more likely to lose money.

The market is dead. Because the platform builder has become a market competitor.

Excessive support for self-operated products objectively reduces consumers’ choice space, and also makes Amazon’s bargaining power continue to rise. So for consumers, this is not a good thing.

2. AWS: the world’s first network service company

Although Amazon’s e-commerce business is already extremely powerful, in contrast, AWS’s performance is even more eye-catching.(Note: I personally think that Amazon should divest AWS business as soon as possible before the regulatory authorities start to implement anti-monopoly measures)

The purpose of Amazon to build AWS is to better serve its own market. They need AWS to empower Amazon.com with excellent image and information processing capabilities. Only in this way can Bezos be Bezos, and Amazon’s products can maintain their consistent modular style.

AWS is growing, and Amazon Mall is constantly cutting prices. Obviously, this is to crack down on competitors in the same industry, and one of the final results is to make AWS more competitive in the market.

　"Your profit is my opportunity"-Jeff Bezos

Today, 42% of websites are supported by AWS. This figure is even more than the combined market share of cloud services of Microsoft, Google and IBM.

However, considering that AWS is easy to use and reasonably priced, this result is not surprising.

Similar to the e-commerce business, the growth trend of AWS shows no signs of slowing down at all. At present, this business has accounted for 10% of Amazon’s total revenue, and the revenue in the third quarter of 2017 was 4.6 billion US dollars, a year-on-year increase of 42%; Net profit reached $1.2 billion, an increase of 12% over the same period in 2016.

The foundation of most websites is based on Amazon’s infrastructure.

3. Alexa: the world’s number one voice assistant

In 2014, Amazon’s "Monster Family" was added.

For those who have no need to buy books, Amazon is not in a hurry.,Because they will always find a way to include you in their network, so in the end you will realize that,The goal of this company is to win all customers.

And Alexa is the concrete embodiment of this ambition. With the sudden explosion of Alexa products, Amazon spies can finally sneak into your home.

Want to know why I say this?

Just ask a simple question: "How do you buy things?"

Alexa exists to replace all products, and its goal is to make you buy everything smoothly and seamlessly. Compared with voice communication, the mode of clicking and ordering is too primitive.

　"Hey, Alexa, we’re out of toothbrushes and toilet paper … by the way, buy another cotton ball!"

For Amazon, the subtlety of Alexa lies in choice.　　

In the past, most users would choose their favorite brands when shopping in Amazon official website; But now, the appearance of Alexa will change this habit. As the above example shows, when a user wants to order Alexa to buy some daily necessities, he will generally only declare to the latter that he wants to buy a certain type of product, without emphasizing the specific brand of the product. So over time, users will find that almost everything they buy comes from the same platform-Amazon Besi.(Because Alexa’s default shopping platform is this). Since Amazon Besi has become the sales platform of Amazon’s self-operated products, this consumption habit cultivated by Alexa will eventually enable Amazon to successfully defeat other well-known brands on its own platform.

I know that many users love Echo mainly because of Alexa’s wonderful voice. But I have to tell you that this is just a means for Amazon to achieve its goal, and their real goal, as I said above, is to be the only provider of your daily necessities. At present, Alexa’s work is progressing smoothly. According to the data provided by Amazon, in the third quarter of last year alone, they sold more than 20 million Echo sets. I can’t imagine how much this number will increase on holidays …

Further, what if Amazon decides to provide you with food?

4. Whole Foods Supermarket: the 10th grocery store in the world.

Oh, wait, Amazon bought Whole Foods Supermarket for about $13 billion in 2017. So now, things become more interesting …

In a word, Amazon has bought a complete sales network with complete functions and balanced supply and demand.

Amazon’s ambition to covet the food retail industry has long existed, but because of transportation problems and food preservation problems, Amazon’s previous efforts ended in failure. The acquisition of Total Foods is a new opportunity for Amazon. Thanks to the complete supply chain of Whole Foods, Amazon can greatly reduce the supply risk and provide various food products for online customers. Of course, there will be some bad situations, for example, some ham and cheese can not be sold online; But this is just as well. Amazon will choose to significantly reduce the prices of these products in physical stores to clean up the inventory.

The addition of the whole food will also make more new scenes in the interaction between users and Alexa, such as:

　"Hey, Alexa, I want a gallon of milk, a loaf of bread, two barrels of yogurt and a jar of peanut butter. In addition, my recipe also includes pizza crust, ketchup and pepperoni. Please add these to my shopping cart! "

Similar scenes can lead to more possibilities. A realistic and reasonable imagination is that Amazon uses AI to recommend many dishes for you according to your favorites, and you are responsible for checking the dishes tonight, while Amazon will automatically place an order for you. Buy ingredients. What do you think? Is it interesting?

Now you can see why the market value of major supermarket chains evaporated by $13 billion after the acquisition was completed …

5. Amazon Prime: the second video service platform in the world; The sixth music streaming media service platform in the world

　The last of Amazon’s five pillars business is a bit complicated. On the one hand, Amazon Prime provides free 2-day delivery service in the United States, on the other hand, it is a streaming media entertainment content platform.

This is an excellent "flywheel connector". Research shows that the average spending of Prime customers is twice that of non-members.($1,300 vs $700)But if Amazon decides to reduce the membership fee to $7.99/month, they may earn more.

The reason lies in Prime Music and Prime Video. Both of these services provide unlimited free streaming services, which enable all authorized and original content of Amazon to compete directly with services such as Spotify and Netflix.

Although there is less original content on the Prime platform at present, and the quantity is less than those of Amazon’s competitors, the key point is-free. As we all know, free services can firmly bind users to Amazon’s product ecosystem.

If you can get 2-day free mail service without using Netflix and Spotify, I guess you will definitely check more products.

It is estimated that there are currently 63 million families in the United States who are Prime members, accounting for about 35% of the total population. Prime service increased Amazon’s recurring revenue by $1.9 billion in the first quarter of 2017, and doubled the purchase volume of almost every household-but this is not enough. For the number of members, Amazon’s principle is only four words: the more the better.

Amazon has "five pillars of business", any of which is enough to stand tall.

But the story is not over yet, and Amazon still has broad future development opportunities.

Amazon’s growth opportunities

Looking ahead, Amazon’s strong leadership and foresight are enough to make them invincible in the competition. The five main businesses all have great development potential and will usher in strong growth in the future.

However, Amazon is not satisfied with this. They are investing heavily in the next potential opportunity. Let’s take a look at them one by one:

1. Expand the market territory of Amazon Besi.

As mentioned above, Amazon Besi is the ultimate answer of Amazon Empire. Control the end-to-end service and you win everything. At present, although Amazon has invested a lot of resources in this business, they still have a long way to go.

As of December 14, 2017, Amazon Besi had 1,500 products.(300 models in 2013)However, with reference to the 480 million products of Amazon official website, the improvement space of Amazon Basics is full of imagination.

2. divest AWS business

I have always believed that Amazon is on the cusp of regulation. Although unlike Facebook, Google and Twitter, it is often at the forefront of public opinion, Amazon has approached the red line of supervision in many fields, naturally because of alleged monopoly.

As people and legislators gradually deepen their understanding of the Internet industry, it is only a matter of time before relevant departments get involved in Amazon. Prior to this, Amazon should pre-empt the AWS cloud service and stay away from the attention of antitrust agencies. After all, AWS is the only one of Amazon’s five branches that does not focus on business and logistics; This business is also the most suitable for independent development among the "five pillars".

Once the business divestiture is completed, the possibility of government intervention will be greatly reduced. What’s more, we all know that no matter what Amazon does, its share price will rise. Therefore, it can be predicted that the total market value of the new company and Amazon parent company after AWS independence is likely to exceed the current figure of 604 billion US dollars.

3. Expand the offline retail industry

Amazon seems to have made up its mind to build an offline physical retail store. Although the one-click online shopping model has made them earn a lot of money, they are also very aware of the importance of offline shopping experience. Some people think that once the physical retail store is completed, Amazon.com will become an important hub for users’ offline conversion rate and sales promotion; And Amazon’s offline stores will in turn boost the turnover of Amazon official website.

I basically agree with this statement. After all, Americans really like to try on clothes in offline stores. In my previous article, I also mentioned that if you really want to build a physical store, then the goods in the store must have at least one of the following two characteristics:

4. Increase the proportion of video content

Have you seen The Big Sick? This is a movie made by Amazon Studio, and the producer is Kumail Nanjiani. For a long time, I thought it was one of the most wonderful movies I have ever seen.

In 2017, Amazon spent $4.5 billion on original content. They saw the defeat of Netflix(market value of 90.57 billion US dollars)Hope, and the weapon is the original video program on Prime Video. Yes, Amazon has realized that streaming media is the future of video entertainment content.

As Amazon constantly updates its own video library, their evergreen content will not only please old customers, but also continuously contribute new members to Amazon Prime.

In a content(attention)For the king’s world, Amazon has successfully owned users’ hearts, brains and wallets.

5. Pay attention to the food industry

After winning Whole Foods Supermarket for $13 billion, the market value of American grocery industry reached $800 billion, which is six times that of Amazon’s global sales.

This contrast is obviously meaningful. However, if Amazon wants to succeed in this vast market, it must concentrate on properly allocating resources. I believe that if the decision is correct, Amazon has the opportunity to quadruple its sales in the next few years.

6. March into the pharmaceutical industry

The pharmaceutical industry is a big business in the United States, and Amazon certainly knows it. It is reported that Amazon’s actions in the pharmaceutical industry have aroused the concerns of major pharmaceutical companies such as CVS and Walgreens.

It is estimated that by 2021, the US prescription drug market will reach $610 billion. This market is close to the food retail industry. Considering that Amazon has the best logistics system in the world, if they choose to enter the pharmaceutical industry, it will be as easy as taking a walk in a nearby park.

Once there are generic drugs of Amazon brand, how many consumers will go to those inconvenient and expensive pharmacies?

It’s time to push some pills.

Other elements to consider.

I wrote in my previous article about how technology giants beat start-ups in the way they are best at; As I mentioned before, Amazon is definitely an expert in this respect: few companies are as ready to deal with all kinds of subversive changes as they are.

leadership

Amazon is one of the best managed companies in the world.

There are many reasons for this conclusion. Amazon follows a result-oriented corporate culture and encourages employees to take risks. The company pays attention to consumers, welcomes constructive criticism, and its employees have a sense of ownership.

Of course, you may think that the above words are exaggerated, but if you have a chance to observe them carefully, you will find that Amazon is really practicing the rules they have made.

Besides, Jeff Bezos did some other things. One of the most important things is the emphasis on commitment. Bezos requires employees to be firm and have strong mobility.

As you can see, whether it is the acquisition of Whole Foods or the announcement of its entry into the pharmaceutical industry, Amazon can gain immediate market recognition in almost every action. In the eyes of the public, Bezos has never missed it.

The ruthless, safe and reliable image carefully created by Bezos allows Amazon to transcend the temptation of short-term profits and always leave enough room for future development.

Of course, this also allows Bezos himself to hold a 17% stake in the company and become a veritable helm of this huge ship.

automation

Have you seen Amazon’s warehouse? If not, I suggest you watch the relevant videos.

The operational efficiency and automation level of Amazon warehouse are unmatched by others. Here, everything will be accurately measured, which enables them to try their best to reduce costs while still ensuring the high quality of products. In the case of large-scale production, this means higher unit economic benefits.

artificial intelligence

I just want to say: Amazon has the best AI experts in the world.

Whether it’s those guys who study Alexa, engineers who do millions of A/B experiments every day, or experts who focus on product recommendation system … Let’s just say that in terms of data processing ability and machine learning, the only one that can compete with Amazon is Google.

strategic acquisitions

Although Amazon has become the world’s top technology company.(if not the best in the world)However, their bank accounts are slightly smaller than those of other competitors in the industry: $22 billion in deposits prevents Amazon from making aggressive acquisitions.

However, after the acquisition of Total Foods last year, Amazon’s stock soared by 32%. This fully demonstrates the market’s trust in Bezos. Based on this reality, if Amazon decides to invest this $22 billion for a strategic acquisitions in the future, the market is likely to give positive feedback again.

Here are six areas where Amazon may make strategic investments:

1. Video industry

As a result, Amazon has invested more and more in Prime Video, and the competition with Netflix has become more and more fierce. The acquisition of a video production company is in line with business logic for Amazon, and there are many potential candidates who meet the standards.

At present, Amazon seems to be unable to afford Netflix. However, if this acquisition really happens, the consequence will be to completely kill cable TV and make Amazon an entertainment content industry.(and other related industries)The czar.

With Disney taking Hulu and time warner Inc. taking HBO, these two acquisitions are hopeless. If Amazon can win one of them before them, it will definitely be a huge victory.

Amazon’s most realistic goals at present should be the smaller film studios and the original video producers on YouTube. As we all know, YouTube is full of various and different styles of video content. If Amazon can attract all those video producers with different styles, then Prime Video can meet the needs of most users in terms of content.(You may even drag users on YouTube.)At the same time, the organic combination of long and short content will also hit Netflix and YouTube indiscriminately.

2. Music industry

Like video, Prime Music is also an important driving force for the expansion of Prime subscription service. Therefore, there is no doubt that investing in music is in line with the development plan of Amazon executives.

But unlike video, the price of buying a music company is lower, but the profit may be more considerable.

As the most commonly used music streaming service platform in the United States(I mean the free version)Pandora’s market value is only $1.33 billion. If it is acquired, Amazon will usher in a big change. The giant can make a big fuss between distribution and licensing agreement, and either one will give them more subscribers.

Another potential acquisition target is SoundCloud, a streaming music platform that is rumored to be bankrupt almost every few months. However, although they haven’t found a clear business realization idea, joining Amazon will be a win-win result for both parties.

Because SoundCloud is an interesting plug-and-play component, it fits well with Amazon’s existing platform foundation and user habits.

Up to now, SoundCloud has received $467 million in financing. However, it is not worth the price now. This affordable acquisition can reward investors and boost Amazon’s greater success.

Not only that, SoundCloud can also provide Amazon with the opportunity to enter the podcasting industry.(Another field with great potential).

3. Giant entity Shangchao

In stark contrast to the booming e-commerce industry, the traditional retail industry is increasingly depressed. However, if Amazon decides to enter the physical retail industry, then direct acquisition is obviously more cost-effective than self-built stores. The cooperation with Target will be a mutually beneficial cooperation, which is equivalent to a fatal blow to the common rival of the two companies-Wal-Mart.

Target has 1,828 branches in North America, although in Amazon’s view, these stores may be too big.(resulting in high maintenance cost)But this is not a big problem. Target’s distribution ability, storage space and sales ability are the key to attracting Amazon. Especially, considering the market value of Target is only $37.58 billion.(Only about 1/9 of Wal-Mart’s)Amazon can afford such an acquisition.

Add another fact: Target’s old customers are also Amazon’s ideal customers..

4. Fashion industry enterprises

Amazon is expanding into the fashion industry. Different from many other products, clothes in the fashion industry are not only fit, but also glamorous.

It is precisely because of this that the significance of clothing stores lies not in function, but in feeling; The driving force of sales is not the clothes themselves, but the try-on experience. Putting on beautiful tops and tight jeans is the fundamental reason why people are willing to pay.

So, if Amazon decides not to buy a full-category retailer,(such as Target)Instead of focusing on the fashion industry itself, Nordstrom is a good choice. This luxury clothing store has 349 branches in North America, and its market value is only $8 billion, which is similar to that of Whole Foods.

In addition to Nordstrom, Kohl, Macy, J.C., and Penney can also be included in the shortlist.

Don’t forget Amazon Besi, their goal has always been to turn all good products into their own. Through such an acquisition, Amazon designers can get closer to customers and quickly iterate on fashion trends across the country.

Realistically speaking, Amazon’s fashion ambition is still difficult to see, but we might as well give them two years to see if this online shopping giant can also win a place in the fashion world..

5. "Wild Ace" shared travel

This seemingly wild idea is not wild at all. Considering the huge potential of the taxi industry and Uber, it is definitely an ideal choice to win Lyft now. Let me explain to you why:

At present, the unit economic benefit of carpooling business is not good. Because of the dual characteristics of localization and globalization at the same time, the war between taxi companies can occur in every city in the world, and in the end, it is difficult for both sides to make a profit.

But what about brand advertising? How much value will it bring to your brand if the advertisement in the taxi can attract passengers’ attention?

From this perspective, Lyft is likely to become Amazon’s "sales engine".

In South Africa, Uber drivers often put a screen in the car that can play advertisements, so as to bring higher customers to Uber. Amazon can also learn from this promotion form, whether by signing a cooperation agreement or direct acquisition, Amazon can make a fortune. By understanding the positioning information of passengers, Amazon can promote their Prime Music and Video services in the local area, and also promote the sales of the online shopping platform itself. In other words, Lyft can become Amazon’s "high value-added old driver".

In addition, Amazon can also increase the bet on the Prime service, so that members can get more discounts when using Lyft to take a taxi. This will not only further tap the potential of Lyft, but also increase the number of Prime users.

Even if you think that "car ownership is dead" and "driverless is the future", it will not affect Amazon’s income in this field. To be exact, the popularity of self-driving cars will give Amazon more space to plan and arrange passengers’ "car life".

6. The telecommunications giant of Wild Ace

Imagine what would happen if Amazon won the Sprint? I know it is the smallest compared with other telecom giants, but Rao, Sprint also has 50.4 million customers.

Another important message is that Amazon itself is a platform for many users to buy mobile phones. Think about it, if Amazon says that you can get a month’s free phone service on Sprint by buying a mobile phone on the platform.(or other attractive conditions)Guess how many people will be willing to "take the bait"?

Because you have free advertisements on your own platform.(I mean Whole Foods). Amazon can easily carry out mobile sales services.(After all, most retail stores have started to handle prepaid package business now.).

Sprint is currently valued at 22.76 billion, which Amazon can still afford. This acquisition will have a significant impact on the existing competitive landscape of the telecommunications industry. Considering Amazon’s consistent style-lowering prices and reducing profits-users are likely to flock to Sprint, which will certainly increase the added value of this acquisition and effectively attack competitors.

grade

In fact, it is difficult for me to give Amazon any score except A+, but considering some unstable factors of the company itself and the potential impact of decentralized blockchain start-ups,I think the grade A is more reasonable.

In fact, Amazon has only two weaknesses: one is the potential regulatory risk, and the other is the high operating cost. Although I haven’t mentioned the latter in this article, it is still a topic worth discussing.

As of now, Amazon still does not have it.(although it is close)Profit. And that’s why Bezos can’t get an A+ from me. Although the market is still saying that "it doesn’t matter whether it is profitable or not", we all know that the climate may change at any time. Once the capital market changes dramatically and Amazon is affected, their stocks are likely to be turbulent.

But even so, I am still optimistic about Amazon. Welcome the future monopolist, he is Mr. Jeff Bezos.

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Amazon is really a great enterprise.

This "five-headed dragon" occupies a dominant position in almost all his fields. Never go against Bezos, you won’t get good results.