Connotation， Key Scientific Issues， and System Building of Classical Herbal Formulae for Critical Care Medicine / 中国实验方剂学杂志

In contemporary clinical practice of traditional Chinese medicine （TCM）， there is a strong emphasis on treating chronic difficult diseases and preventing diseases before they occur （"pre-disease" treatment）. However， the treatment of critical care medicine has not received as much attention and is even facing a trend of diminishing influence in the field of emergency medicine and critical care. Critical care medicine refers to a class of diseases that are characterized by rapid onset， severity， quick progression， and high mortality rates in clinical practice. The growth and development of renowned TCM experts throughout history have invariably been honed through practical experiences in managing critical care medicine. Treatise on Cold Damage （《伤寒论》） is a dedicated work for treating critical care medicine， and the classic prescriptions in Treatise on Cold Damage are particularly central to the treatment of these diseases. In the current clinical context， it is important to break through the prevailing mindset that the strengths of TCM lie solely in treating chronic diseases and maintenance-type illnesses， identify the entry point of TCM in the clinical advantages in the field of critical care medicine， explore the interdisciplinary relationship between Treatise on Cold Damage and critical care medicine， enhance the ability to treat critical care medicine using classic prescriptions， establish a disciplinary system for prescription-based treatment of critical care medicine， reveal clinical evidence for prescription-based treatment of these diseases， and elevate the contribution of TCM in the domain of critical care medicine. These have become a strong call and demand in contemporary TCM clinical practice. Regarding key scientific issues， the system of using classic prescriptions to treat critical care medicine encompasses traditional core theories such as the nature of cold damage， the essence of the six meridians， the implications of specific clauses， and the dosages of classic prescriptions. In the context of future academic inheritance and system construction， it is recommended to focus on clinical challenges， break away from the current limitations of traditional classical disciplinary systems， such as their singular patterns and weak innovative and translational capabilities， suggest defining diseases in critical care medicine responding specifically to TCM， advocate a research model based on combining disease mechanisms with pathology and combining medicinal properties with pharmacology， establish a comprehensive multidisciplinary thinking mode， and encourage collaborative innovative research among medical， educational， research， and manufacturing institutions. This will help chart the path and address key aspects of constructing a comprehensive system for prescription-based treatment of critical care medicine.

Strengthening the oral health system in Nigeria: A health systems building block approach

Aim: The present study aimed to describe the building blocks of the oral health system, including the role that the community plays in strengthening the oral health system in Nigeria. Methodology: This research was a scoping review of the existing literature retrieved from search engines and databases. Thus, we utilised grey literature, peer-reviewed literature, policy documents and websites. The oral health system was analysed using the World Health Organisation's Health systems framework, and we adapted this framework by introducing a seventh block, community participation. We also inserted the links between the oral health service delivery and oral health workforce blocks of the framework to improve the oral health outcomes. Results: More dental clinics are required to improve the availability and accessibility of oral health services. Dental workforce expansion is imperative. This can be approached by training of junior cadre dental professionals and incorporating community health practitioners to deliver basic oral care. There is an unregulated access to medication to treat dental conditions; hence, oral disease treatments need to be included in the country's treatment guidelines to improve standard of care. The government needs to improve on overall health spending and invariably increase oral health care allocation urgently. Furthermore, the country's stewardship of oral health care is hinged on well disseminated and implemented national policies on oral health. The oral health system can achieve its overall goals with community participation, engagement and ownership. Conclusion: Strengthening the oral health system in Nigeria requires urgent attention on each building block and cross-cutting interventions across the system's building blocks. The role of the community will need to be recognised because it is vital in sustaining any organisational change.

Profiles of sugar fermenting bacteria of the oral cavity among children with dental caries attending stomatology services at Ruhengeri referral hospital in Musanze District, Northern Rwanda

Background: Dental caries remains a public health threat of concern among children. About 2.3 billion people are affected by dental caries, of which 530 million are children globally. Objective: This study was carried out to identify sugar fermenting bacteria in the oral cavity and their antibiotic susceptibility pattern, assess the association with sugar fermenter bacteria and dental caries and evaluate dental caries outcomes among children. Materials and Methods: This was a cross-sectional study conducted between October 2021 and February 2022 at Ruhengeri Referral Hospital. About 136 oral swab samples were collected from children with and without dental caries at 1:1 ratio. The samples were put in Stuart sterile container and transported to INES-clinical microbiology laboratory for microbial identification. Logistic regression analysis of demographic characteristics was performed to study the relationship between demographic variables and dental caries. Chi-square test was performed for the association between variables. Results: About 67.6% were male, while children of age 7­9 years (64.7%) dominated the age groups. Lactobacilli spp (15.29%) and Streptococcus mutans (12.94%) were the most predominant microorganisms observed in the oral cavity among children with dental caries. The S. mutans (x2 = 27.03, P < 0.00001, 95% confidence interval [CI]=0.2901­0.5785), S. aureus (x2 = 34.59, P < 0.00001, 95% CI = 0.3541­0.6292), Enterobacter aerogenes (x2 = 13.5, P = 0.000239, 95% CI = 0.151­0.4622), Serratia marcescens (x2 = 11.64, P = 0.00645, 95% CI = 0.1275­0.4418) and Klebsiella pneumonia (x2 = 13.51, P = 0.000237, 95% CI = 0.1511­0.4623) were significantly associated with dental caries. Teeth loss (x2 = 51.04, P < 0.00001, 95% CI = 0.4757­0.7205), teeth pain (x2 = 5.05, P = 0.0246, 95% CI = 0.0249­0.33499), and infection (x2 = 4.73, P = 0.02964, 95% CI = 0.0186­0.3441) were dental outcomes associated with tooth decay. Ciprofloxacin, clindamycin, and amoxicillin were the most sensitive antibiotics, while vancomycin and chloramphenicol were the most resistant. Conclusion: Sugar consumption favours the growth of sugar fermenter bacteria that cause dental caries among children. Dental caries is associated with adverse oral health outcomes among children. Oral health education is recommended for children. Parents are advised to reduce the consumption of sugary food for their children for oral health safety.

Analysis of comprehensive budget management system of public hospitals / 中华医院管理杂志

Objective:To understand the construction and problems of budget management system in public hospitals, and to provide countermeasures and suggestions for its continuous improvement and construction.Methods:Literature review was used to summarize the national policy requirements for comprehensive budget management system of these hospitals in China. Random sampling was used to select 109 public hospitals as pilots, and a questionnaire was customized from March to April in 2019, to investigate the current budget management and problems, with the data studied by descriptive statistical analysis.Results:Seventy-seven hospitals (70.64%) reported in self-appraisal their budget management as satisfactory and above, 78 hospitals (71.56%) had in place a comprehensive budget management system, 90 hospitals(82.57%) had in place a budget management committee, and 91 hospitals (83.49%) had in place refined budget preparation. The main problems were unclear budgeting requirements and nonstandard process, poor information integration and informationization, inadequate inter-department synergy, and poor alignment between business and finance.Conclusions:The public hospitals are recommended to enhance their comprehensive budget management system and their informationization, for full-process informationized management.

The development status and countermeasures of the foreign postgraduate students education / 中华医学教育探索杂志

This article conducted a study on the foreign postgraduate students in Chongqing Medical University from the development scope,resources of students,major distribution,finical supporting from the year of 2006 to 2012.Based on the former analysis,it is found that students are of poor quality.There are very less Chinese learning channels.It is very urgent to optimize enrollment and improve the quality of students.There should be multi-channel expansion of Chinese learning and training refined Chinese expert.

Patient safety monitoring indicators based on medical complaints / 中华医院管理杂志

Objective To build the indicators system to collect patient safety monitoring information, focusing on medical complaints. Methods With such methods as literature review and expert advice, building the system for medical complaints collection and monitoring. Such indicators are modified and improved in pilot operations. Results The framework of the medical complaint monitoring indicators system is built in five dimensions, comprising 8 grade-1 indicators including patient complaint causes and hospital cause analysis, and 20 grade-2 indicators. Conclusion These indicators are scientific and operable to detect adverse patient safety events.

Discussion of several legal issues concerning compensation for mental damage / 中华医院管理杂志

Based on a study of 33 cases of medical tangle wherein demand for compensation for mental damage was met, the paper analyzes the current status of demand for compensation for mental damage, including the cause, extent and smount of money. It also discusses the double effect of mental compensation and points out that perfecting the establishment of medical laws and regulations is the only way which must be passed in solving issues of medica1 tangle concerning mental compensation.

The Significance of System Building in Solving Physician-Patient Information Dissymmetry / 中国医学伦理学

Dissemination in physician-patient relationship seriously destroys the credit system in medical field,in which information dissymmetry contributed a lot.However,information dissymmetry only serves as the necessary condition for the current physician-patient conflict,not the sufficient condition.The fundamental causation lies in the pursuit for economic benefit in medical service.Therefore,it is necessary to establish a value concept oriented by patient's benefit.Physician-patient communication is useful to improve current information dissymmetry,but can't guarantee the trusting medical behaviors of medical staff.Characteristics of systems satisfy the need of transformation from specialized trust which may lead to cheating behaviors in the state of information dissymmetry to universal trust which brings trust into a regulatory system.In order to improve the effect of system in improving the current state of information dissymmetry,the compliance rate and feasibility of the system should be improved,and the system of reward and penalty be perfected.