ABSTRACT
As a new form of medical industry， internet medicine has not only the endogenous risk of internet industry， but also the blind area and exogenous risk because of lagging regulation. With the continuous progress of internet information technology， online diagnosis and treatment will gradually integrate and reconstruct the traditional medical service. In the history of medical development， the emergence of new technologies generally has the characteristics of risk. Therefore， the supervision of internet medicine should adhere to the rule of inclusiveness and prudence， and take into account the cultivation of the market and standardized development. It should also build a regulatory community， coordinate governance from the four dimensions of legitimacy， compliance， rationality and superiority. Taking the law as the bottom line， we should make full use of early online warning monitoring， off-site supervision， online supervision， reputation mechanism and other measures to promote the innovative development of internet medicine under the framework of legal compliance.
ABSTRACT
The penetration and integration of internet with medical industry is apparently falling behind its interaction with other industries in terms of speed and scale. The main reason is due to the high risk and difficult supervision of internet medicine. Based on the regulatory context， this paper analyzes the endogenous and exogenous risk of internet medicine. The inherent characteristics of the internet （such as openness， diversity， multi subjectivity， virtuality， transparency， and high aggregation） lead to endogenous risks， including jurisdiction disputes， uncertainty of rights and obligations， security of personal information and medical information， monopoly. The lag of specific law in internet medicine， the lack of extensibility and synergy of traditional hierarchical regulatory system， the uncertainty of internet hospital regulatory policy details， the lack of technical specifications/operating procedures and other external system coverage in internet diagnosis and treatment lead to regulatory blind areas and exogenous risks. Based on the risk analysis， this paper discusses further construction of the mechanisms of risk assessment and regulation for internet medicine.
ABSTRACT
Internet medicine is not a concept of jurisprudence. China's current medical law system mainly focuses on main qualifications of the participants who conduct diagnosis and treatment. This paper focuses on several business models of the core element （diagnosis and treatment） in internet medicine， namely： online health consultation provided by internet medical platform， online diagnosis and treatment by internet hospital， and certain artificial intelligence（AI） medicine products that are specialized for diagnosis and treatment. This paper summarizes the development of these three business models， and analyzes the main problems in their development， including the legitimacy identification of online consultation， the dilemma of the development of internet hospitals， the impact of insufficient sample data on the development of medical AI， and the reverse restriction of regulatory difficulties to the development of internet medicine. The next step of developing internet medicine is to broaden the scope of internet diagnosis and treatment on the premise of medical safety， which will be based on the improvement of current regulatory system. It is urgent to build early risk warning system and supervision/ management mechanism for internet medicine.
ABSTRACT
In the fifth scientific and technological revolution， information technology is the first productivity， which has a great impact on the supply and demand of medical services. Generally， internet medicine is equivalent to the combination between health industry and information technology. "Healthy China" strategy is China's "priority development strategy"， which adheres to the principle of health equity， emphasizes the integration of health into all policies， and takes co-construction and sharing as the basic path. With implementing internet medicine， "Healthy China" strategy promotes the mobility of medical service with three tools： interconnection， data and artificial intelligence. This enhances the operation efficiency of overall medical and health system， and optimizes the allocation of medical resources. The future development of internet medicine follows the double helix mode driven by technology and policy， and the policy determines the development boundary of the industry. On the basis to ensure medical safety， we should explore the possibility of internet diagnosis and treatment further， and pay attention to the fairness of resource allocation while improving efficiency， so as to realize the co-construction and sharing of health services.
ABSTRACT
Objective The incidence of prostate cancer (PCa) is increasing year by year in China. G protein coupled receptor family C,group 6,member A (GPRC6A ) is a susceptible gene of PCa found in recent years. To investigate therole of GPRC6A and extracellular signal-regulated kinase (ERK) mediated by GPRC6A in the proliferation and apoptosis of PCaLncapC4-2 cells, and provide new ideas for targeted therapy of PCa. Methods The experiment was divided into the LncapC4-2 PCDH group (only the empty vector pCDH was transfected), the LncapC4-2 GPRC6A group (only the pCDH-GPRC6A was transfected) and the LncapC4-2 GPRC6A + U0126 group (pCDH-GPRC6A was transfected and treated with U0126). The proliferation of LncapC4-2 cells was detected by using CCK8 kit. The changes of cell cycle and apoptosis were detected using flow cytometry. Cell cycle and apoptosis-related proteins were evaluated by Western blot. Results The result ofWestern blots showed the expression ofGPRC6A and P-ERK in LncapC4-2 GPRC6A group washigher than that in LncapC4-2 PCDH group(P<0.05), and the expression of P-ERKin LncapC4-2 GPRC6A + U0126 group was evidently lower than that in LncapC4-2 GPRC6A group(P<0.05). The result of CCK8 tests showed the cell proliferation ability in LncapC4-2 GPRC6A group was higher than that in LncapC4-2 PCDH group, and the proliferation ability in LncapC4-2 GPRC6A + U0126 group was lower than that in LncapC4-2 GPRC6A group, and there was statistical difference between two groups(P<0.05).Flow cytometry results showed the ratio of G1/（G2+S）in LncapC4-2 GPRC6A groupwas evidently lower than that in LncapC4-2 PCDH group(P<0.05), and the ratio of G1/(G2+S)in LncapC4-2 GPRC6A + U0126 group was evidently higher than that in LncapC4-2 GPRC6A group(P<0.05). Western blot results showed that the expression of CyclinD1 were evidently increased in LncapC4-2 GPRC6A group(0.88±0.04) compared to LncapC4-2 PCDH group(0.66±0.02, P<0.05), the expression CyclinD1 wasevidently reduced in LncapC4-2 GPRC6A +U0126 group(0.71±0.02) compared with LncapC4-2 GPRC6A group (P<0.05). The ratio of apoptosis in LncapC4-2 GPRC6Agroup(3.64%) was evidently reduced than that in LncapC4-2 PCDH group(9.00%) and in LncapC4-2 GPRC6A +U0126 group(19.57%, P<0.05). Meanwhile, western blot results showed that the expression of BCL2 was increased and the expression of Cleaved-caspase3 was lower in LncapC4-2 GPRC6A group compared to LncapC4-2 PCDH group (P<0.05). The expression of BCL2 was reduced and the expression of Cleaved-caspase3 was increased in LncapC4-2 GPRC6A +U0126 group compared with LncapC4-2 GPRC6A group (P<0.05). Conclusion GPRC6A may be promote the proliferation and inhibit apoptosis of PCa cells through ERK signaling pathway, thus to be involved in the development of PCa .