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“The Kampo Future Vision Study Group responsible for health and medical care of people” was established in 2016 with the aim of discussions to resolve various problems related to Kampo, and issued six proposals as important items. Among these proposals, the emphasized themes that are directly linked to clinical practice are “Kampo as a supportive treatment for cancer” and “Kampo as a countermeasure against frailty in the elderly.” The Japan Society of Oriental Medicine decided on a policy to be involved in these themes and established the Proposal-Discussing Committee (later absorbed into the Policy Advisory Committee). At first, the committee asked experts to present the research status of Kampo medicine as supportive care for cancer and as countermeasures against frailty. The committee, then, decided to lead clinical research by itself on frailty treatment with Kampo medicine. In such clinical research, evaluation criteria for judging therapeutic effects are necessary. Therefore, the existing well-defined diagnostic criteria were combined to create a Kampo frailty score. This article explains the Kampo frailty score, citing the supporting literature.
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The goal of achieving elimination of schistosomiasis across all endemic counties in China by 2030 was proposed in the Outline of the Healthy China 2030 Plan. On June 16, 2023, the Action Plan to Accelerate the Elimination of Schistosomiasis in China (2023—2030) was jointly issued by National Disease Control and Prevention Administration and other 10 ministries, which deployed the targets and key tasks of the national schistosomiasis elimination programme in China. This article describes the progress of the national schistosomiasis control programme, analyzes the opportunities to eliminate schistosomiasis, and proposes targeted recommendations to tackle the challenges of schistosomiasis elimination, so as to accelerate the process towards schistosomiasis elimination and facilitate the building of a healthy China.
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Objective:To investigate the status of the knowledge of cardiopulmonary resuscitation (CPR) in community medical staff, and analyze the factors influencing their levels of CPR knowledge and skills, and to provide a basis for improving community CPR training programs.Methods:From January to March 2022, we conducted a survey for the knowledge of CPR among community medical staff in Beijing through WeChat using a self-made questionnaire based on the 2016 National Consensus on Cardiopulmonary Resuscitation in China and the 2020 American Heart Association CPR guidelines. The questionnaire mainly focused on the basic information and CPR knowledge (full score, 17 points) and practice of medical workers. R4.0.3 software was used to perform multiple linear regression analysis.Results:A total of 990 medical personnel from 51 communities effectively responded to the survey. The mean CPR knowledge score was (10.27±2.87) points. The regression analysis showed that the CPR score was significantly lower in groups of male, non-31-40-year-olds, technical degrees, only 0-1 trainings in two years, not ever practicing CPR, and not ever using an automated external defibrillator (AED), suggesting that sex, age, educational attainment, training frequency, whether having the experience of CPR and AED practice or not were independent factors influencing the CPR score of community medical staff.Conclusions:The CPR competency of community medical staff needs to be improved, especially for those with technical degrees and non-31-40-year-olds. The training frequency should be increased based on the Ebbinghaus' forgetting curve, and stratified training is recommended for different populations. Those without practical experience should receive more CPR training with real-time feedback devices and high-fidelity simulation to improve their CPR skills.
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@#Traditional Chinese medicine (TCM) equipment is the industry representative possessing independent intellectual property rights and unique Chinese characteristics. By integrating TCM and information technology, TCM equipment is experiencing an unprecedented period of opportunity. Here, based on the practical significance, we reviewed the recent series of policies to promote the TCM equipment development. In accordance, we analyzed the current main problems and causes, and finally put forward some policy demand and suggestions to boost TCM equipment industry.
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ObjectiveThis paper analyzed the punishment situation of unlicensed medical practice in recent 7 years in Jinshan District of Shanghai， then suggested the countermeasures to prevent and combat unlicensed medical practice in the future. MethodsA total of 190 cases of unlicensed medical practice from 2016 to 2022 were investigated. The basic situation of the punishment，legal basis，subject distribution，clue source and individual characteristics were analyzed. ResultsThe case-filing number of unlicensed medical practice showed a decreasing trend，but the amount of fines increased obviously. The clues of investigation and punishment of unlicensed medicine practice were mainly found by inspection（32.11%） and transferred from other departments（28.42%）， while the number of complaints and clues reported from grassroots increased year by year. Medical and dental were the two major unlicensed practice，accounting for 35.79% and 33.16%， respectively. In addition， unlicensed medical cosmetology practice was increasing year by year. 78.62% of the unlicensed medical practioners are immigrants， 62.76% of them aged between 31 and 50 years old， among them 70.34% are men， and 62.76% of them have a fixed place. ConclusionThough the prevention and crack-down on unlicensed medical practice has achieved significant achievements，it is still necessary to enhance the responsibility of local administration，strengthen the inspection，investigate and deal with cases jointly by multiple departments，and implement the comprehensive supervision mechanism of the health care industry.
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With the wide application of artemisinin and its derivatives,its safety has become particularly important.Previous studies have shown that artemisinin and its derivatives have adverse reactions such as nausea,vomiting and diarrhea in clinical use,but they are all within the controllable range.In animal experiments,it has toxic effects on kidney,liver,heart,nerve,blood,embryo and DNA at a high dose.Toxicity and adverse reactions can be alleviated or eliminated by combining medication or changing the drug administration mode,solvent and preparation type.This article mainly discusses the drug safety,toxicity mechanism and attenuation countermeasures of artemisinin and its derivatives,in order to improve the understanding of the potential toxicity of artemisinin and its derivatives and provide reference for the safe use of the drug in clinic.
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Objective:This study is to understand the hot spots and trends in the recruitment of clinical trial subjects in China over the past 20 years, explore the existing problems and countermeasures, and provide scientific ideas for domestic clinical trial institutions to effectively solve the problem of subject recruitment.Methods:Bibliometric analysis was used to study the relevant literature from three major domestic databases from 2001 to 2021, analyzing key indicators such as annual publication volume, journal distribution, institutional distribution, regional distribution, and high-frequency keyword co-occurrence.Results:A total of 162 articles were selected. The results showed that the overall publication volume in this field showed an upward trend, and the research institutions were diversified, with a concentration of medical and pharmaceutical institutions and universities. The current research hotspots in this field focused on quality and efficiency improvement of subject recruitment, with themes of subject protection, ethical review, regulation development, standardized management, etc.Conclusions:The research in this field has made significant progress, but the overall research level is still relatively weak. Therefore, it is suggested that the country should play a role in macro-regulation, on the one hand, starting with top-level design, promoting the construction of a standardized management system for subject recruitment, continuously strengthening subject protection, and enhancing the effectiveness of scientific recruitment. On the other hand, releasing the potential of grassroots institutions and giving full play to the volume advantage by promoting the sinking of advantageous resources. Meanwhile, great importance should be attached to the development of Phase I clinical trials, giving full play to the strong internal energy of traditional medicine and promoting the development of Chinese traditional medicine. These multi-measures should provide a theoretical basis for exploring the transformation of ′clinical research hospitals′, and promote the high-quality development of new drug research and development in China.
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Objective:This study aims to identify and enhance management strategies for fostering the conversion of scientific and technological advancements in tertiary general hospitals in Beijing.Methods:A questionnaire survey was conducted to pinpoint and organize the areas needing improvement in the transformation process of scientific and technological achievements at Beijing Tiantan Hospital. This involved aspects such as organization, leadership, investment, incentives, and service guarantees. The data were then analyzed and summarized, taking into account the hospital′s management, research activities, and the specific circumstances of the institution.Results:The primary drivers for successful achievement transformation in Beijing′s tertiary general hospitals were identified across six key indicators: proficiency of professional and technical managers, allocation of special funds, access to market and industry resources, criteria for job title evaluation and promotion, a culture promoting diligence and fault tolerance, and comprehensive transformation training programs.Conclusions:The study concludes that implementing effective incentives and refining the institutional environment for innovation and transformation are crucial. Additionally, it′s vital to adjust work focus and enhance management in weaker areas, in line with the hospital′s actual situation. Moreover, boosting service efficiency and providing full life cycle services have emerged as pivotal measures to augment the efficacy of hospital innovation and transformation efforts.
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Critical care medicine is the last line of defense for people′s lives and health, and it is necessary to attach great importance to the development of critical care medicine and the construction of treatment capabilities. This study analyzed the development effect of critical care medicine and critical care capacity in China, analyzed the shortcomings of the current shortage of talent and treatment capacity reserves in the field of critical care medicine, combed the experience of foreign countries in attaching importance to the reserve of critical care resources, the mechanism of combining peacetime and wartime, and the construction of critical care database. Targeted suggestions were proposed to strengthen development planning, optimize investment mechanism, improve talent cultivation and growth, and build critical care database, so as to provide reference for promoting the development of critical care medicine and improving the ability of critical care in China.
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With the increasing development of technology and decreasing costs over the years, genetic diagnosis is gradually becoming the ultimate means of diagnosing neurogenetic diseases. Clinicians often face various predicaments in the process of genetic diagnosis due to the high clinical variability and genetic heterogeneity of neurogenetic diseases. This editorial proposes countermeasures to address these predicaments and suggests that specialists in the field of neurogenetic diseases should not only be familiar with the clinical, genetic and causative genes of neurogenetic diseases, and the characteristics of genetic testing techniques, so as to develop the most reasonable genetic testing protocol, but also learn to correctly analyze and interpret genetic test results to avoid missed diagnoses and misdiagnoses.
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Objective:To explore the ethical issues arising from stem cell research in China and propose countermeasures to regulate stem cell research.Methods:This article analyzed the ethical issues arising from stem cells in terms of regulatory systems, source channels, production processes, storage industries, and translational applications.Results:Combining the current ethical situation of stem cell research and the practical exploration of the authors' unit, we proposed countermeasures to address the ethical issues of stem cell research in five aspects, including forming a scientific and effective stem cell ethical regulatory system, building an open and transparent stem cell traceability mechanism, creating a GMP-compliant stem cell production platform, selecting a legal and compliant stem cell storage institution, and conducting ethical stem cell clinical research.Conclusions:It is of great practical significance to strengthen the ethical construction of stem cell research and regulate stem cell transformation research to promote the healthy development of the stem cell industry.
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Objective: To analyze the current status and problems in the process of transfer and transformation of health science and technology achievements, and propose countermeasures. Methods: A total of four universities, two research institutes, two medical institutions, two biomedical innovation enterprises and two biomedical industrial clusters were selected as the research subjects using the purposive sampling method. Field investigations and qualitative interviews were conducted. Additionally, relevant literature was reviewed to analyze the progress, achievements, main experiences, and problems in the process of health science and technology achievement transfer and transformation in China. Results: The policy for transformation of health science and technology achievements in China is gradually improving. There is a steady growth in investment in scientific and technological innovation, leading to continuous emergence of transformative achievements. The innovative entities are growing, and the service system for achievement transformation is being established with expanding capital support. However, challenges persist, including the lack of an effective evaluation system to promote achievement transformation, shortages of specialized service organizations and talents for transformation, unclear guideline for the transformation and industrialization of scientific and technological outcome, insufficient innovation research and development institutes in biomedical, and imperfection in the mechanism for transforming scientific and technological program achievements. Conclusion: Although great progress has been made in the transformation of health science and technology achievements in China, the quality and quantity of achievement still need to be improved. It is urgent to establish and implement an evaluation system for achievements transformation, accomplish the construction of specialized service institutions and the training of versatile talents for transformation, highlight the market-oriented mechanism for scientific and technological achievements transformation, explore system and mechanism reform, establish the mechanism for transforming scientific and technological program achievements in a faster pace, and optimize the policy, so as to promote the high-quality transfer and transformation of health science and technology achievements.
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Introduction: The aim of this study was to consider the definition of solitary death by examining characteristics of cases, and to explore the impact of the coronavirus pandemic.Methods: Subjects were individuals with post-mortem examination and autopsy imaging data recorded between 2017 and 2022. Subjects were classified by whether they passed away at home (solitary). We investigated differences between groups in their causes of death, time elapsed between death and discovery, presence or absence of housemates, and prior symptoms.Results: There were 129 cases (79.9%) of solitary death and 41 cases (24.1%) of death outside the home. Solitary death cases were significantly younger. Among these, less than half were discovered more than a day after death, lived alone, or were older adults. Older adults and those discovered more than a day after death were more likely to have trauma as their official cause of death. The frequency and characteristics of solitary death did not change before or after the coronavirus pandemic.Conclusion: Preventive measures for solitary death should not be limited to older adults or those living alone. In particular, deaths from diseases other than sudden death, trauma in older adults, and cases where symptoms were present or medical attention was sought before death are potentially preventable. Countermeasures for solitary death are important in the post-coronavirus pandemic period.
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Objective To explore the nutritional risk influencing factors in stroke patients， and to discuss the formulation of rehabilitation nursing countermeasures. Methods We randomly selected 152 patients with acute hemorrhagic stroke admitted to our hospital from July 2018 to July 2020. Based on the results of the mini nutritional assessment （MNA） score， the patients were divided into normal group （49 cases）， risk group （53 cases）， and bad group （50 cases）. Single factor analysis and correlation analysis were used to analyze the nutritional risk factors， and the countermeasures for the influencing factors were discussed. Results Univariate analysis showed that stroke time， mechanical ventilation， swallowing dysfunction， ADL score， upper arm muscle circumference， serum albumin， and total lymphocyte count in risk and bad groups were different from the normal group. In comparison， the proportion of patients with mechanical ventilation and swallowing dysfunction was higher， and ADL score， upper arm muscle circumference， serum albumin level and total lymphocyte count were lower （P<0.05）. The Spearman rank correlation analysis showed that the factors with differences in the univariate analysis also showed correlation （P<0.05）. Among them， the positive correlation factors included the duration of stroke， receiving mechanical ventilation， swallowing dysfunction， NIHSS score， negatively related factors included ADL score， serum levels of albumin， transferrin， and hemoglobin. Multivariate Logistic regression analysis showed that stroke time （OR=1.739， P<0.001） and swallowing dysfunction （OR=3.966， P=0.008） were independent risk factors for malnutrition. ADL score （OR=0.687， P<0.001）， upper arm muscle circumference （OR=0.770， P=0.012）， serum albumin level （OR=0.870， P=0.003） were independent protective factors for malnutrition. Conclusion The nutritional status in stroke patients is not optimistic. Most patients have swallowing disorders， motor dysfunction， and poor self-care ability. At the same time， the body protein content in patients has decreased significantly. The clinical work is needed to deal with the patients' swallowing function recovery together with the treatment of nerve damage.
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Objective:To understand main problems existing in the construction of advanced stroke centers in China and put forward solutions, for reference in promoting the standardization construction of advanced stroke centers and improving the efficiency of acute stroke treatment.Methods:The data were derived from relevant data of on-site export guidance in the construction of advanced stroke centers at 175 tertiary hospitals from 2020 to 2021, and the scores of on-site evaluation indicators for the establishment of stroke centers and their formal approval were compared and analyzed. Based on on-site investigation and expert consultation, the common problems existing in the construction of advanced stroke centers were summarized. All data were analyzed by descriptive analysis, the scores of on-site evaluation indicators were expressed by ± s, and paired t test was used for comparison between groups. Results:Compared with the total score(693.04±72.06) of on-site evaluation at the stage of project launch, the total score(747.94±78.10) of on-site evaluation for formal approval of stroke centers of 70 hospitals was higher, and the difference was significant( P<0.01). There were seven common problems in the construction of stroke centers in 175 hospitals, including insufficient attention paid by hospitals, lack of effective performance incentive policies, imperfect treatment procedures and medical norms, and so on. Conclusions:Experts on-site guidance plays an important role in the construction of stroke centers in China. At present, there were still problems to tackle in the construction of stroke centers in hospitals. In order to promote the standardized construction of stroke centers in China and improve the efficiency of stroke treatment, the authors suggest fuorther strengthening the importance attached by hospital leadership and the coordination and organization of functional departments, establishing stroke center models conforming to the actual situation of the hospital, seting up the post of brain and heart health manager, and improving the regional prevention and treatment level of acute stroke.
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Background China is facing enormous challenges of occupational disease prevention and control and high incidences of occupational diseases. Occupational disease diagnosis is an important part of occupational disease prevention and control. However, the current situation of occupational disease diagnosis service system in China is not optimistic. Relevant national laws, regulations, policies, and plans require to improve the current technical support system of occupational disease diagnosis and treatment, and to establish a sound occupational disease diagnosis, treatment, and rehabilitation network on the foundation of existing medical and health institutions. Objective To analyze the development status and existing problems of occupational disease diagnosis institutions in China, and propose countermeasures and suggestions. Methods All occupational disease diagnosis institutions in China were surveyed by questionnaire using comprehensive census. The Occupational Health Center of the National Health Commission organized the preparation of the questionnaire and the participation of all relevant institutions in the survey. All data collected in the survey were for the year 2020 and available as of December 31, 2020. The questionnaire covered the overall situation, service provided, staffing of certified physicians for providing occupational disease diagnosis, and instruments in selected categories of occupational disease diagnosis institutions. Results As of December 2020, there were 587 occupational disease diagnosis institutions in China; the highest average number of enterprises served by an occupational disease diagnosis institution was 39000, and that of employees served by an occupational disease diagnosis institution was 2.15 million in Chongqing. There were a total of 5809 physicians certified to diagnose occupational diseases in China, with 20.4 doctors per specified occupational disease prevention and treatment hospital, 9.5 doctors per general hospital, and 8.3 doctors per disease control and prevention center. Only 87.7% of the institutions were equipped with digital radiography (DR), 58.1% with computed tomography (CT), and 96.4% with pulmonary function meters; the equipment rate of computed radiography (CR) was only 6.5%, and that of CT was only 14.6% in all-level disease control and prevention centers; 45 disease control and prevention centers were not equipped with any common x-ray machine, CR, DR, or CT. Conclusion In the face of the still serious situation of prevention and treatment of occupational diseases, the overall distribution of institutions is uneven around China, the number of institutions in some regions is relatively insufficient, and the comprehensive capacity of centers for disease control and prevention at all levels needs to be improved. Strengthening comprehensive capacity building of occupational disease diagnosis institutions and training of relevant physicians would be helpful to ensure the accuracy and scientificity of diagnosis. At the national level, further increasing policy guidance and financial input would help occupational disease diagnosis institutions upgrade their techniques and service capacity, and protect workers' occupational health rights.
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【Objective】 To study the current situation of apheresis platelets collection in various regions of Gansu province by comparing and analyzing relevant data from blood stations in 14 prefecture-level cities of Gansu province. 【Methods】 The units of collected platelets and rate of double-dose collection in 13 regional blood stations and 1 provincial blood center from 2016 to 2020, as well as the clinical supply and demand was statistically analyzed. 【Results】 From 2016 to 2020, the total units of platelets collected by 13 blood stations and 1 blood center in Gansu increased from 11 255 U to 15 270 U, with the increase rate at 35.7% in 5 years, and mainly were collected by the provincial blood center (74.57%, 50 253/ 67 392). Although the rate of double-dose collection in the province showed a steady upward trend, only 3 blood stations realized annual double-dose collection more than 20%. There was still a gap of about 10% between supply and clinical needs. 【Conclusion】 Although the number of platelet collections and units in each blood station in Gansu is on the rise in general, the units collected varies in each blood station. Therefore, further measures need to be taken from the aspects of publicity, recruitment, optimizing the collection process, improving the rate of double-dose collection, retention of regular blood donors and regional coordination to increase the collection units, narrow down the regional gap and ensure the balance between supply and demand.
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After the completion of the pilot work of traditional Chinese medicine formula granules （TCMFGs）， the national and provincial medical products administrations have published and implemented about 440 varieties of TCMFGs standards. Based on the previous work， this paper analyzed technical problems encountered in the review and evaluation of Shandong TCMFGs standards， mainly involving the executive standards and distinguishing technologies of raw materials， the adding process of excipients in the procedure item， the rationality of quality control methods， the information content and reproducibility of characteristic chromatograms， the nomenclature and accessibility of reference materials， etc. The common problems such as the coverage of standards， specification differences， and the integrity of quality control items of current TCMFGs standards were discussed deeply. It is proposed to promote the upgrading of provincial standards to national standards， accelerate the research and development of reference materials， advocate the use of high-quality raw materials， explore the evaluation methods of high-quality products， and strengthen the quality supervision of the whole process. Suggestions of this paper is hoped to provide references for the formulation of national and provincial TCMFGs standards， promote the continuous improvement of TCMFGs standard system， and ensure the healthy and orderly development of the TCMFGs industry.
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Online and offline blended learning is the key link to change the teaching mode of higher education. As a new teaching mode, it faces problems such as too much emphasis on students' autonomous learning ability, inadequate supervision of students, and difficulty in building a holistic view of the medical system when applied to medical education. To better promote the reform of blended learning in medical colleges and universities, it is necessary to take the following actions: designing the course content carefully and scientifically arranging the length of online lectures; adopting various ways to follow up in all aspects and building a "whole course" supervision system; always maintaining a holistic view of medicine throughout the blended learning to cultivate comprehensive talents.
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ObjectiveThe clinical research team is the key to improving clinical research ability. The purpose of this study is to identify the main problems with the development of clinical research teams in specialized hospitals， and to explore countermeasures. MethodsOn the basis of literature review and consultation with experts， a self-made questionnaire was distributed online to survey 300 relevant staff engaged in clinical research in 10 tertiary specialized hospitals in Shanghai. The severity of existing problems was analyzed from four aspects： clinical research personnel planning， recruitment and allocation； training and development； evaluation and performance management； career management. Then in-depth personal interviews were conducted with the main heads of clinical research departments in some hospitals. ResultsFour problems have relatively high severity scores， with 3.65±1.0， 3.43±1.0， 3.53±1.0， and 3.44±1.0 points， respectively. They are： “The development of the clinical research team is incomplete， and there is a lack of stable multidisciplinary and multi-level talent teams”， “A systematic and continuous clinical research training system has not been established”， “An objective and fair evaluation index system has not yet been established”， and “There are obstacles in the career development and promotion path of clinical research professionals”. ConclusionTo further enhance the clinical research capabilities of hospitals， we urgently need to establish multidisciplinary and multi-level clinical research teams， strengthen the training of clinical researchers on their clinical research capabilities， establish a scientific evaluation index system and incentive methods， and explore career development that meets the characteristics of clinical researchers.