ABSTRACT
Based on the theory of traditional Chinese medicine(TCM)and clinical manifestations of seborrheic alopecia,Professor YANG Yu-Feng believes that the fundamental pathogenesis of seborrheic alopecia is due to spleen deficiency with dampness accumulation,and dampness and fat sharing the same origin.The internal accumulation of dampness and turbidity results from the deficiency of spleen,and then the dampness and turbidity blended with heat attack the head and face.For dampness and fat share the same origin,the turbid fat forms,and then overflows and blocks the hair roots,which causes the qi and blood being difficult to go upward and nourish the hair roots,and then induces hair loss.Among them,spleen deficiency with dampness accumulation is the core pathogenesis of the disease,heat activating the movement of dampness is the key pathogenesis to the disease,and the disharmony of qi and blood is the pivot of the pathogenesis.For the treatment of seborrheic alopecia,Professor YANG Yu-Feng suggested that the hair root should be unblocked and the hair quality should be nourished by blood essence,and emphasized the importance of the method of invigorating the spleen and removing dampness,controlling oil and removing fat in dredging the hair root and relieving seborrheic alopecia.It is proposed that invigorating the spleen and removing dampness is the key,expelling wind and clearing heat is for assistance,and harmonizing qi and blood serves as the pivot.
ABSTRACT
From the perspective of the physiological basis of liver and kidney sharing the common source in traditional Chinese medicine(TCM),and by integrating the theory of kidney dominating bone,liver dominating tendon,and meridian sinew of TCM as well as the bone resorption and collapse theory,and non-uniform settlement theory and lower-limb musculoskeletal bowstring structure theory of modern orthopedics,the pathogenesis of osteonecrosis of the femoral head(ONFH)under the system of non-uniform settlement during bone resorption and multidimensional composite bowstring working in coordination with the theory of liver-kidney and muscle-bone was explored.The key to the TCM pathogenesis of ONFH lies in the deficiency of the liver and kidney,and then the imbalance of kidney yin-yang leads to the disruption of the dynamic balance of bone formation and bone resorption mediated by osteoblasts-osteoclasts,which manifests as the elevated level of bone metabolism and the enhancement of focal bone resorption in the femoral head,and then leads to the necrosis and collapse of the femoral head.It is considered that the kidney dominates bone,liver dominates tendon,and the tendon and bone together constitute the muscle-bone-joint dynamic and static system of the hip joint.The appearance of collapse destroys the originally balanced muscle-bone-joint system.Moreover,the failure of liver blood in the nourishment of muscles and tendons further exacerbates the imbalance of the soft tissues around the hip joint,accelerates the collapse of the muscle-bone-joint dynamic and static system,speeds up the process of femoral head collapse,and ultimately results in irreversible outcomes.Based on the above pathogenesis,the systematic integrative treatment of ONFH should be based on the TCM holistic concept,focuses on the focal improvement of internal and external blood circulation of the femoral head by various approaches,so as to rebuild the coordination of joint function.Moreover,attention should be paid to the physical constitution of the patients,and therapy of tonifying the kidney and regulating the liver can be used to restore the balance between osteogenesis and osteoblastogenesis,and to reconstruct the muscle-bone-joint system,so as to effectively delay or even prevent the occurrence of ONFH.
ABSTRACT
The influence of bed sharing on children′s physical and psychological health has been concerned as one of the main types of sleep arrangements.At present, there are significant differences in bed sharing among children of different ages, groups, regions and races.There are also studies on the impact of bed sharing sleep on children′s health, on the one hand, it is conducive to breastfeeding, where infants get enough security; on the other hand, it leads to an increase in the incidence of sudden infant death syndrome, and an increase in the number of night awakenings.Therefore, it is important to understand the current research situation of bed sharing and its influences on children, thus to better promote children healthy growth.
ABSTRACT
Purpose: To clarify the significance of attempts to improve palliative care unit (PCU) quality using self-assessment sharing programs formulated by the Hospice Palliative Care Japan. Method: We conducted self-assessments of 7 sections (detection and assessment of patient’s needs, care planning, care implementation, preparation, and support for patients’ discharge, management at the dying stage, care of bereaved family, hospice bed management and meeting community needs) including 47 items on a five-point scale, and determined targets for care improvement in 2018, 2021, and 2022. The change of mean scales of 7 sections and 47 items in each fiscal year and the relationship to the targets for care improvement were investigated. Results: From 2018 to 2022, mean scores increased for detection and assessment of patient’s needs, near-death care, and care for bereaved family members. Conclusion: The self-assessment sharing programs have potential to analyze the status of PCU, clarify improvement targets, and improve the care quality in PCU.
ABSTRACT
Purpose/Significance To put forward strategies for the open sharing of biomedical scientific data and provide theoretical support for the sustainable development of scientific data in China.Method/Process The paper adopts the multiple-case study method to analyze open sharing practices of four international typical biomedical scientific data platforms,including UK Biobank,National Center for Biotechnology Information(NCBI),Global Initiative on Sharing All Influenza Data(GISAID)and Cortellis Drug Discovery Intelli-gence(CDDI).Result/Conclusion Suggestions are proposed based on three processes of before,during and after data sharing.In the construction of data resources,the division of data rights and rights subjects should be determined.The open use of data should be differ-entiated according to data attributes.In terms of data ecology construction,mechanisms and measures to promote data value-added should be formulated.
ABSTRACT
In recent years， countries around the world have invested a lot of resources in neuroimaging research on brain function and diseases. The abundant and more easily accessible neuroimaging data will have a profound impact on the research of cognitive neuroscience and psychiatry， thereby assisting the development of the diagnosis and treatment of brain diseases. At present， neuroimaging data sharing is gradually becoming a trend， but it is also worth considering of some unique ethical issues that come with it. Therefore， from the four shared entities of the public， researchers， users， and data centers， this paper sorted out the ethical issues in neuroimaging data sharing， and deeply analyzed the reasons for these issues. Based on the responsibility ethics and combined with the guidance of the Belmont principles， governance responses were proposed， including strengthening the construction of neuroethics committees， improving informed consent models， building data sharing infrastructure， establishing data privacy protection mechanisms， and introducing regulatory protections， to provide a certain reference for promoting the neuroimaging data sharing and maximizing the contribution of participants.
ABSTRACT
Data sharing is the fundamental work for building a " Healthy China" and a technical support for improving China′s healthcare service system. It is of great significance to the government, society, and individuals. In the digital era, public health data could be referred to various data collected, connected, read, and stored on digital platforms for research, monitoring, prevention, and control of diseases, health events, and the operation of health systems. China′s public health data sharing has initially formed a development pattern of " four modernizations", providing basic conditions and practical preparations for vigorously promoting data sharing. In the process of data sharing, the risk prevention principle should be fully considered and established, including establishing a series of measures to balance legal protection and interest protection for different entities and situations, that is, data information typing to limit data access rights, building a unified public health data sharing platform, and continuously improving public health data sharing mechanisms. At the same time, appropriate data use policies and security measures should be formulated to ensure data privacy and security.
ABSTRACT
Purpose/Significance To clarify the construction mode and key factors of data sharing in Chinese medical alliances,and to provide references for promoting data sharing in medical alliances.Method/Process Taking children's medical alliance of Yangtze River Delta as an example,Delphi method and qualitative interview method are used to explore the key contents and effect evaluation of specialty alliance construction,and the key factors of specialty alliance data sharing are defined based on the technology-organization-environment framework;SWOT analysis model is used to propose development strategies.Result/Conclusion Member hospitals are less satisfied with the construction effect of information interconnection.Key factors for realizing data sharing in specialty alliances include:support from government administrative departments,uniform and systematic compatibility of information standards,information security emergency response,patient privacy protection and informed consent,willingness of department directors to share,and internal communi-cation and compensation mechanism of alliances.
ABSTRACT
Purpose/Significance Aiming at the difficulty of medical data sharing in traditional medical information systems,an elec-tronic medical record(EMR)security sharing scheme based on blockchain is proposed.Method/Process The blockchain features of de-centralization,tamper-proof and traceability are utilized to build a data security sharing platform and establish security mechanisms such as user authentication,medical record encryption,privacy protection and full traceability to realize the safe sharing of EMR.Result/Conclusion The proposed scheme can resist the potential network attack and meet the needs of patients'privacy protection and confiden-tiality.The feasibility and operation efficiency of the scheme are verified by experiments.
ABSTRACT
Objectives:To investigate the clinical efficacy and safety of posterior reduction and fixations in patients with thoracolumbar burst fractures with Load-sharing classification(LSC)score of 7 and 8 points.Methods:The data of 36 patients with LSC score of 7 and 8 who underwent posterior reduction and internal fixation between October 2009 and December 2014 were retrospectively analyzed.There were 21 males and 15 females,with an average age of 42.67±14.67 years(range 21 to 67 years).The fractured vertebrae were T12-Ll.LSC score was graded according to the imaging data including X-ray radiographs,CT and MRI.The index vertebral Cobb angle and anterior vertebral height were collected at preoperative,postoperative 1 week and final follow-up,respectively.Visual analogue scale(VAS)was used to evaluate residual back pain at final follow-up.The complications were recorded for safety evaluation.Results:All the patients were followed up for 49.83±18.20 months on average(23-86 months),of which 19 cases had internal fixations removed,and the follow-up period for patients after internal fixation removal was 28.00±20.12 months on average(3-69 months).Fracture healing was achieved in all the patients without significant residual pain,or broken screw or rod,or significant kyphosis,or pedicle screw cutting vertebral body or loosening of the internal fixation.For imaging evaluation,the postoperative sagittal Cobb angle was significantly improved to 6.67°±5.06° from the preoperative 15.87°±8.35°,and the postoperative height of anterior margin of the fractured vertebral body recovered to 2.88±0.32cm from 1.81±0.49cm before operation,all with statistically significant differences(P＜0.05).The vertebral body height at the final follow-up was 2.81±0.41cm,and there was no statistically significant difference between postoperative and the final follow-up vertebral body heights(P＞0.05).At the final follow-up,the neurological functions of all the patients recovered compared with the conditions at the time of injury,with no loss of intervertebral space height.The anterior edge height of the vertebral body recovered to(94.92±18.41)％,the middle edge height recovered to(81.16±11.82)％,and the posterior edge height recovered to(97.48±7.63)％,all with significant differences compared to those before surgery(P＜0.05).Conclusions:The posterior reduction and internal fixation for patients with thoracolumbar burst fracture with LSC scores of 7 and 8 can achieve good preservation of vertebral stability at later stage,high safety,and satisfactory clinical efficacy and imaging results.
ABSTRACT
Objective:To explore the development, application and practical experience of investigator-initiated integrated clinical research information platform.Methods:The process of developing and constructing an integrated clinical research platform in a tertiary hospital in Beijing was introduced, the functions and advantages of the platform were described and displayed, and the main problems and risk points in the development and construction process were analyzed.Results:The integrated clinical research platform meets the management requirements of clinical research initiated by investigators, and the standardized management of the whole life cycle of the project can be realized through the platform, and the key issues of data security, information capture, sharing and interoperability need to be further explored in terms of platform docking.Conclusions:The integrated clinical research platform effectively improves the standardization, management quality and efficiency of investigator-initiated clinical research.
ABSTRACT
Blockchain technology has the advantages of decentralization, secure sharing and tamper resistance, and high privacy, which can solve the current problem of sharing electronic medical records in medical institutions in China. A tertiary hospital established an electronic medical record sharing services convenience service platform based on blockchain in collaboration with China mobile gansu company in September 2021. The hardware architecture of the platform consisted of a hospital data warehouse, a local front-end computer and a blockchain platform. The functional architecture included platform front-end services, the blockchain electronic medical record archiving and service platform. The technical architecture included the underlying blockchain, service layer, interface layer and application layer, which was embedded with asymmetric encryption technology, hash algorithm, smart contract and other technical means, ensuring data ownership and on-demand, controllable, real-time and secure sharing of data. Since the operation of the platform in September 2021, as of October 2022, a tertiary hospital had accumulated 21 545 patient medical records on the chain. The overall operation of the platform was smooth, achieving reliable storage and secure sharing of patient electronic medical records, providing reference for further promoting the interconnection trusted sharing of electronic medical records in medical institutions in China.
ABSTRACT
Objective:To explore the effect of whole-process management mode based on "Internet + nursing service" in the management of children with concealed penis.Methods:This study adopted a quasi-experimental research method. A total of 383 children with concealed penis who were hospitalized in the Third Department of Urology of Hunan Provincial People′s Hospital from January 2018 to August 2021 were convenient selected. According to the sequence of admission, 195 children admitted from January 2018 to May 2020 were set as the control group, and 188 children admitted from June 2020 to August 2021 were set as the observation group. The control group was received conventional treatment and nursing, but the observation group was received whole-process management mode based on "Internet + nursing service". The length of hospitalization, incidence of complications after discharge, anxiety of the children′s parents and satisfaction of the doctors, the specialist & nurse sharing and the children′s parents were compared between the two groups.Results:Finally, 186 and 193 children were included in the observation group and the control group, respectively After the intervention, in the observation group, the length of hospitalization, anxiety score of the children′s parents, difference of anxiety score of the children′s parents, satisfaction content of the doctors, satisfaction effect of the doctors, satisfaction content of the specialist & nurse sharing, satisfaction effect of the specialist & nurse sharing, satisfaction content of the children′s parents and satisfaction effect of the children′s parents were (4.30 ± 1.35) d, (35.08 ± 3.17) points, (19.14 ± 4.35) points,(4.57 ± 0.54) points, (4.71 ± 0.49) points, (4.75 ± 0.50) points, (5.00 ± 0.00) points, (4.60 ± 0.49) points, (4.65 ± 0.49) points; in the control group, the scores were (5.50 ± 1.41) d, (44.79 ± 3.30) points, (9.22 ± 3.67) points, (3.71 ± 0.49) points, (4.00 ± 0.58) points, (3.50 ± 0.58) points, (3.25 ± 0.50) points, (3.54 ± 0.59) points, (3.64 ± 0.67) points. The differences between the two groups were statistically significant ( t values were -23.94-29.19, all P<0.05). The complication rates of the observation group and the control group were not statistically significant ( χ2=0.64, P>0.05). Conclusions:The whole-process management mode based on "Internet + nursing service" is beneficial to shorten the length of hospitalization, relieve the degree to anxiety of the children′s parents, improve the satisfaction of the doctors, the specialist & nurse sharing and the children′s parents, and accelerate the rehabilitation of children, which is worthy of clinical promotion.
ABSTRACT
Pancreatic diseases is a kind of complex, high-risk gastrointestinal diseases. Pancreatic cancer is highly malignant and seriously endangers people′s health. Developing multi-center, large-scale real world research can better understand the incidence patterns and treatment outcomes of pancreatic diseases. Based on the multi-center and heterogeneous data, the authors for-mulate data standards for real world studies of pancreatic diseases, and build a database of pancreatic cancer, integrating and sharing data from multi-center sources, in order to fully explore the scientific research value of pancreatic cancer clinical information, and provide experience and reference for the construction of other real world research specific disease databases in the future.
ABSTRACT
Islet transplantation has developed rapidly over the last 20 years and is becoming one of the ideal clinical treatment options for type 1 diabetes mellitus (T1DM). There is growing clinical evidence that islet transplantation has significant efficacy in insulin independence or reduction, preventing hypoglycemic episodes and preventing diabetic complications.However, clinical islet transplantation still faces challenges, such as a shortage of donor resources, difficulties in early implantation and survival of islet grafts, and immune rejection.In the future, donor pancreatic donation and its effective utilization should be promoted, and clinical exploration of xenogeneic islet transplantation and stem cell-derived islet transplantation should be encouraged to effectively solve the problem of insufficient islet source.At the same time, through continuous research and development of new materials and technologies, optimize the location of islet transplantation to improve the implantation and survival of islet grafts, and gradually eliminate the need for immunosuppression.In addition, we should actively promote the development and application of post-islet transplantation graft monitoring tools to further ensure the long-term survival of post-islet transplantation grafts, so that more diabetic patients can benefit from it.
ABSTRACT
Asymptomatic spleen-stomach diseases refer to diseases without related symptoms and signs of abdo-minal pain， bloating， diarrhea an others in patients， but showing lesions or pathological changes discovered by modern medical techniques such as endoscopy， CT， MRI. The four examination techniques of traditional Chinese medicine （TCM） are based on symptoms and signs of patients， which are the advantage of TCM but also have certain limitations. In the context of the increasingly modernized diagnosis and treatment in TCM， it is proposed to expand the application of the four examination techniques from three aspects including microcosmic syndrome differentiation， data sharing， and artificial intelligence in asymptomatic spleen-stomach diseases， in order to achieve the goals of dynamically observing the disease process， collecting disease data in multiple dimensions， and intelligently processing disease data. This will strengthen the modern requirements of early diagnosis and treatment in TCM， and highlight the advantages of TCM in “treating disease before it arises and treating the symptoms beforehand”.
ABSTRACT
The “conception vessel， governor vessel and thorough vessel sharing the same origin” theory refers to the concept that the conception vessel， governor vessel and thorough vessel all originate from the same source within the uterus and emerge from the perineum. Based on the modern research of McNeal's prostate zonal anatomy theory， it is believed that the conception vessel， governor vessel and thorough vessel have the closest relationship with the prostate in terms of their origin and running course. It is proposed that the essential meaning of the ‘conception vessel， governor vessel and thorough vessel sharing the same origin’ theory in relation to the prostate is that the conception vessel， governor vessel and thorough vessel respectively connect to the transition zone， peripheral zone， and central zone of the prostate. Moreover， the differences in the yin-yang attributes of the conception vessel， governor vessel and thorough vessel exhibit distinct functional characteristics in different zones of the prostate， which serve as an important basis for the physiological and pathological differences in various prostate zones. Based on this premise， a prostate meridian， qi and blood syndrome differentiation method is further proposed， wherein the differences in the meridian characteristics of the conception vessel， governor vessel and thorough vessel determine the differences in the yin-yang aspects of qi and blood in different prostate zones. When clinical diagnosis is conducted， the inherent physiological differences of the different prostate zones should be fully taken into account， as well as the pathological characteristics of the disease， in order to guide the diagnosis and treatment of related clinical conditions.
ABSTRACT
The concept of "virus sovereignty" proposed by Indonesia in 2007 challenges the international tradition of virus sharing. In the context of the global outbreak of coronavirus disease 2019, the issue of virus sharing has become an important topic in the reform of the global health governance mechanisms. Virus sharing is an important guarantee of dealing with major global infectious diseases. However, the emergence of the concept of "virus sovereignty" shows that there are defects in the operation of virus sharing mechanism in the international community. The "virus sovereignty" problem is an ethical issue essentially, involving asymmetric interests hindering unity and cooperation, intellectual property rights expansion challenging the principle of solidarity, and excessive self-defense amplifying utility risks. "Community of common health for mankind" provides a constructive and feasible option to solve the dilemma of "virus sovereignty".
ABSTRACT
In recent years, photon-counting computed tomography (PCD-CT) based on photon-counting detectors (PCDs) has become increasingly utilized in clinical practice. Compared with conventional CT, PCD-CT has the potential to achieve micron-level spatial resolution, lower radiation dose, negligible electronic noise, multi-energy imaging, and material identification, etc. This advancement facilitates the promotion of ultra-low dose scans in clinical scenarios, potentially detecting minimal and hidden lesions, thus significantly improving image quality. However, the current state of the art is limited and issues such as charge sharing, pulse pileup, K-escape and count rate drift remain unresolved. These issues could lead to a decrease in image resolution and energy resolution, while an increasing in image noise and ring artifact and so on. This article systematically reviewed the physical principles of PCD-CT, and outlined the structural differences between PCDs and energy integration detectors (EIDs), and the current challenges in the development of PCD-CT. In addition, the advantages and disadvantages of three detector materials were analysed. Then, the clinical benefits of PCD-CT were presented through the clinical application of PCD-CT in the three diseases with the highest mortality rate in China (cardiovascular disease, tumour and respiratory disease). The overall aim of the article is to comprehensively assist medical professionals in understanding the technological innovations and current technical limitations of PCD-CT, while highlighting the urgent problems that PCD-CT needs to address in the coming years.
Subject(s)
Tomography, X-Ray Computed/methods , Photons , Noise , China , Phantoms, ImagingABSTRACT
Abstract Introduction Increasingly, occupational therapists and scientists across the globe are calling for a shift away from individualised western medical approaches, to working with communities and collectives, and in the social field. This signals the growing motivation to engage in socially responsive and transformative practices that address political structures and oppressive colonial systems. Objective The purpose of our Community of Practice (CoP) was to explore and describe the epistemologies, vocabularies, and understandings that underpin community development and social occupational therapy within diverse global contexts to advance theoretical perspectives and practices. Method As a CoP of occupational therapy and science scholars situated in four countries (Australia, Brazil, Canada, and South Africa), we met virtually bi-monthly from March 2020 to January 2023. Scholarly work involved critical narrative literature reviews, reflexive presentations, group dialogues, and individual and collective reflections and analyses. Results Individual narratives, four thematic threads, and a selection of vocabularies and epistemologies are presented. The thematic threads were: Connecting and making space for decolonial praxis, Questioning the disconnect between occupational therapy practice and contexts, Examining vocabularies that shape contextually relevant practice, and Engaging a reflexive stance to work towards equity, justice and social rights. Conclusions Generating knowledge that supports ways of knowing, being and doing reflective of multiple languages, sciences, and contexts will strengthen occupational therapy. Maintaining the pluriversal and resisting 'one size fits all' approaches to human occupation/everyday life is essential. This paper offers practitioners a catalyst for initiating decolonising praxis for learning across global contexts.
Resumo Introdução De modo crescente, terapeutas ocupacionais mundialmente estão discutindo mudanças das abordagens médicas ocidentais individualizadas para o trabalho com comunidades, coletivos e no campo social. Isto sinaliza uma motivação crescente para se engajar em práticas socialmente responsivas e transformadoras que abordem estruturas políticas e sistemas coloniais opressores. Objetivo Explorar e descrever epistemologias, vocabulários e entendimentos que sustentam a teoria de desenvolvimento de comunidades e da terapia ocupacional social, em diversos contextos globais para avançar em perspectivas teóricas e práticas. Método A partir de uma Comunidade de Prática de terapeutas ocupacionais e acadêmicos situados em quatro países (Austrália, Brasil, Canadá e África do Sul), nos reunimos virtualmente bimestralmente de março de 2020 até janeiro de 2023. Nosso trabalho envolveu revisões narrativas críticas da literatura, apresentações reflexivas, diálogos em grupo e reflexões e análises individuais e coletivas. Resultados Foram escolhidos quatro fios temáticos e uma seleção de vocabulários e epistemologias: Conectando e abrindo espaço para a práxis decolonial, Questionando a desconexão entre a prática da terapia ocupacional e os contextos, Examinando vocabulários que moldam a prática contextualmente relevante e Engajando uma postura reflexiva para trabalhar em direção à equidade, justiça e direitos sociais. Conclusões A geração de conhecimento reflexivo que sustente formas de saber, ser e fazer requer múltiplas linguagens, ciências e contextos que fortalecem a terapia ocupacional. É essencial manter a pluriversalidade e resistir a abordagens únicas para trabalhar com a ocupação humana/vida cotidiana. Este artigo oferece um catalisador para iniciar uma práxis descolonizadora de aprendizado em contextos globais.