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With the core of "molecules and cells", the integrated curriculum group of School of Basic Medical Sciences, Lanzhou University, focuses on the transfer of life molecules, reorganizes teaching content, and integrates Medical Cell Biology, Biochemistry and Molecular Biology, and Medical Genetics to construct a new integrated course of Molecular Medicine. The curriculum group actively explores and practices the mode of medical integration through reconstruction of the curriculum system and optimization of the course content. On the basis of establishing the online course system, the group explores the diversified teaching methods and evaluation systems suitable for Molecular Medicine and discusses the problems in curriculum construction.
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Objective:To explore the effect of intervention model based on comprehensive nutrition management on glucose and lipid metabolism and pregnancy outcome in patients with gestational diabetes mellitus (GDM).Methods:104 GDM patients admitted to Shanxi Bethune Hospital from February 2022 to March 2023 were randomly divided into control group and experimental group, with 52 cases in each group. The control group implemented routine management measures and nutrition guidance, while the experimental group implemented an intervention model based on comprehensive nutrition management on the basis of routine management. The indexes of glucose and lipid metabolism (glycosylated hemoglobin, fasting blood glucose, 2 h postprandial blood glucose, total cholesterol, triglyceride and low density lipoprotein cholesterol), pregnancy outcome, self-management ability and self-efficacy were compared between the two groups before and after intervention.Results:Before the intervention, there was no significant difference in general situation, glucose and lipid metabolism index, self-management ability and self-efficacy between the two groups ( P>0.05). After the intervention, the level of glucose and lipid metabolism index in the experimental group was significantly lower than that in the control group, with statistical significance ( P<0.05). The incidence of adverse pregnancy outcome in the experimental group was significantly lower than that in the control group, with statistical significance ( P<0.05). The scores of self-management ability and self-efficacy in the experimental group were significantly higher than those in the control group, with statistical significance ( P<0.05). Conclusion:The intervention model based on comprehensive nutrition management can effectively improve the glucose and lipid metabolism index and pregnancy outcome of GDM patients, and significantly improve their self-management ability and self-efficacy related to nutrition management, which has high clinical application and promotion value.
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To promote the construction of a wound repair and regeneration system with Chinese characteristics, it is necessary to follow the principle of combining traditional Chinese and Western medicine, and integrate theory, clinical practice, and teaching. Traditional Chinese medicine emphasizes a holistic concept and the principle of dialectical treatment, while Western medicine focuses on etiological analysis and local treatment. The combination of Chinese and Western medicine can complement each other's advantages and improve treatment effectiveness. The key technological innovations in repairing and regenerating systems cover areas such as drug therapy, physical therapy, and the application of biomaterials. This article discusses the development potential and challenges of combining traditional Chinese and Western medicine in the field of wound repair and regeneration, providing new ideas and methods for the development of wound repair and regeneration. It is expected to bring better medical services and treatment effects to patients undergoing repair and regeneration.
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The Rainbow Model of Integrated Care(RMIC)is a new conceptual framework that integrates primary care principles,integrated care characteristics,and a triple aim framework based on the Rainbow Model,which helps researchers better understand the concept of integrated care from a primary care perspective and thus scientifically conduct integrated care practice programs.This paper reviews the emergence and development of RMIC,its conceptual framework,and its application in integrated care,with the aim of providing a guiding basis for improving the quality of integrated care and positively transforming the health care delivery model in China.
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Continuing medical education for general practitioners is an important measure to upgrade the quality of primary health care services in China, which is still facing various challenges and need to be further developed and improved. This article analyzes the status quo and existing problems of continuing medical education for general practitioners in China, and proposes suggestions based on the concept of people centered and integrated health care (PCIC), including faculty development, training contents, assessment methods, and experience learning, to provide references for the improvement of continuing medical education for general practitioners.
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The medical-research-industry integrated development is an effective way to promote the development of the research and development chain, industrial chain and market chain in the medical and health field, and helps to solve the technical problems of medical field. Based on the development of the eye health industry, the Optometry Hospital Affiliated to Wenzhou Medical University, combined with the scientific and technological innovation research of the hospital, jointly built the China Eye Valley with the government and universities, and built a platform for achievement transformation. The authors summarized the joint construction path of the Affiliated Optometry Hospital of Wenzhou Medical University, Wenzhou Medical University and China Eye Valley from the aspects of organizational structure, management functions, platform construction, policy formulation and resource gathering, as well as the achievements made. In view of the existing problems such as insufficient policy support, insufficient talent reserve and limited sharing of platform resources in the current development, the following suggestions were proposed: continue to increase government support and give more policy " concessions" ; Optimize the management organization of the hospital in the development of medical-research-industry integration, and set up a specialized cooperative management department; Continuously strengthen the reserve of disciplinary talents and cultivate and introduce interdisciplinary and composite talents; Establish a unified information resource sharing management platform; Clarify the benefits distribution of medical personnel, medical institutions, research and development institutions, and enterprises in the achievement transformation.
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[Objective]To explore the clinical efficacy of modified Yupingfeng Powder combined with western medicine in the treatment of pregnant women with mild corona virus disease 2019(COVID-19).[Methods]The pregnant women with mild COVID-19 admitted to Shanghai Public Health Clinical Center from April 2022 to June 2022 were divided into treatment group and control group randomly.The control group(52 cases)was treated with western medicine such as Vitamin C,and the treatment group(48 cases)was treated with modified Yupingfeng Powder on the basis of control group.A comparison was made between the two groups in terms of each symptoms scores,incidence of adverse pregnancy outcomes and total effective rate.Besides,the levels of laboratory indicators involving lymphocyte,C reactive protein(CRP),interleukin-2 receptor(IL-2R)and interleukin-6(IL-6)were also be compared.The negative changes of virus nucleic acid and disease outcome were observed in the two groups.[Results]Compared with control group,after treatment cessation,the total symptom score in treatment group significantly decreased(P<0.001),and the total effective rate significantly increased(P<0.01).The levels of inflammatory markers including CRP and IL-6 decreased significantly in treatment group(P<0.001,P<0.01),while the count of lymphocyte increased significantly(P<0.001).Besides,there was no difference in the incidence of adverse pregnancy outcomes between the two groups(P>0.05).[Conclusion]Modified Yupingfeng Powder combined with western medicine can significantly relieve the clinical symptoms of pregnant women with mild COVID-19,while shortening nucleic acid negative conversion time and does not affect the pregnancy outcome,which has certain clinical value and is worthy of clinical application.
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Chronic hepatitis B (CHB) is still a major public health issue in China, and without effective control, it can further progress to liver cirrhosis and liver cancer, bringing huge social and economic burdens. At present, antiviral therapy is the main treatment method for CHB, and integrated traditional Chinese and Western medicine therapy is the characteristic treatment method for CHB in China and can improve clinical efficacy by complementing each other’s advantages. In order to promote the concept integrated traditional Chinese and Western medicine collaborative diagnosis and treatment, facilitate the development of integrated traditional Chinese and Western medicine diagnosis and treatment techniques for CHB, and establish standardized disease diagnosis and treatment regimens, Expert Committee on Hepatology in Doctor Society of Integrative Medicine, Chinese Medical Doctor Association, established a consensus expert group to discuss and formulate Expert consensus on integrated traditional Chinese and Western medicine diagnosis and treatment of chronic hepatitis B, which elaborated on the concept of integrated traditional Chinese and Western medicine collaborative diagnosis and treatment from the four aspects of CHB epidemiology, pathogenesis and etiology, integrated traditional Chinese and Western medicine diagnosis and syndrome differentiation, and integrated traditional Chinese and Western medicine therapy and proposed related recommendations, in order to improve the prognosis and quality of life of CHB patients.
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Background@#The enactment of the Philippine Universal Health Care (UHC) Act mandates the formation of Integrated Health Care Provider Networks (IHCPN), linking hospitals and health facilities, which includes government and privately-owned primary care providers. While hospitals and some health facilities are already under government regulation, primary care providers have not been subjected to formal licensing requirements. In this changing service delivery model, the possible impact of three regulatory policy options being considered need to be assessed according to the goal of ensuring that health services remain affordable and are of high quality.@*Methodology@#A multi-method approach to regulatory impact analysis (RIA) systematically assessed three regulatory options: 1) one Department of Health (DOH) license per hospital and health facility (status quo); 2) one DOH license for all public hospitals and health facilities within an IHCPN and another for individual private hospitals and health facilities; and 3) one DOH license per individual hospital and health facility, and one DOH certification issued to individual hospitals and health facilities as part of an IHCPN. Information from literature, documents, focus group discussions, and cost analyses were triangulated.@*Results@#Regulators are faced with two main risks: there is no standard for networked health care delivery that could provide a foundation for regulation, and provider participation is voluntary, which could lower the interest of private providers to integrate. The three regulatory options considered these risks. Option 1 requires the least change in regulatory policy, but is expected to increase costs to regulators due to the expansion of licensing and enforcement work covering primary care providers. Option 2 requires the most change in regulatory policy, but may be the least expensive to enforce, especially if all facilities join a network. This can also be preferred in a setting with existing interlocal health zones, and participation in the network by private providers poses the most challenge. Option 3 is a tiered regulatory set up that projects the highest cost to regulators as a result of both establishing new certification standards and guidelines on top of a wider scope for enforcement.@*Conclusion@#This is the first RIA conducted for the Philippine health system, with challenges similar to those experienced in developing countries. Across the three pre-determined regulatory models, the least costly option may not be the easiest to mount and enforce. Implementability appears to be a stronger consideration which seems to be hinged to the option requiring incremental rather than large form of changes.
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Developmental coordination disorder (DCD) is a neurodevelopmental disorder with high incidence, low diagnosis rate and early onset of symptoms, which hinders the development of physical and mental health in children.Early identification and intervention of DCD can help reduce the lifelong adverse effects of the disease.However, general public in China still lacks awareness of this condition,and healthcare workers do not pay enough attention to the early screening and intervention of DCD.This paper summarizes the clinical characteristics, early screening and diagnosis of DCD, and expounds the clinical treatment of DCD from the two aspects of western and Chinese medicine intervention, and proposes the intervention treatment of integrated Chinese and western medicine for the first time, hoping to promote the development of early screening work, provide a new method for the research and development of DCD intervention in China, and improve the effectiveness of treatment.
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Chinese medicinal formulae (CMF), as the main form and means of clinical treatment, are a key link in traditional Chinese medicine (TCM) theory and clinical practice. Exploring the relationship between the chemical substances of CMF and the life activities of the body, as well as their complex interaction patterns, is one of the key issues in modern research of TCM. However, due to the complexity of chemical composition and the diversity of biological effects, evidence remains to be mined for the chain involving chemical composition, in vivo process, and pharmacological activity of CMF, which results in serious fragmentation of related studies. Integrated pharmacology is proposed as an effective strategy for analyzing the molecular interactions of complex systems in TCM. Particularly, it reflects the new trend of using new technologies such as the Internet, big data, and artificial intelligence to drive the development of complex systems in TCM in the context of the fourth wave represented by the biotechnology revolution. This provides a practical and feasible approach for systematically revealing the interaction, integration patterns, and principles of action between multi-component drugs and the body. This article reviews the emergence and development, research ideas, key technologies, and applications of integrated pharmacology of TCM, providing support for explaining the scientific connotation of TCM theory and the scientific value of original thinking of TCM, inheriting the experience of famous doctors, and facilitating the quality control, mechanism explanation, and new medicine development of TCM.
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@#Abstract: Integrated stress response is an adaptive response produced by eukaryotic cells after intracellular and extracellular stimulation. The activation of integrated stress response inhibits the translation of most proteins, yet it can promote the translation of certain proteins to cope with complex cellular microenvironment changes. A large number of studies have found that in a variety of nervous system diseases, the integrated stress response can be activated by stress signals of disease-related cells and participates in the occurrence and progression of diseases through processes such as learning and memory consolidation, myelin regeneration and synaptic plasticity. This article summarizes the role, mechanism and possible drug targets of integrated stress response in central nervous system diseases and discusses the potential of pharmacological methods to regulate integrated stress response in the treatment of central nervous system diseases, in order to provide reference for pathological research on and drug development for central nervous system diseases.
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ObjectiveTo observe the effect of Shengxiantang (SXT) on cell senescence mediated by wingless/integrated (Wnt)3a/β-catenin pathway in rats with idiopathic pulmonary fibrosis (IPF) and reveal the possible mechanism in improving lung function of IPF rats. MethodA total of 32 SPF level SD rats were randomly divided into sham group, model group, pirfenidone group, and SXT group. The IPF rat model was established by intratracheal instillation of bleomycin (0.005 g·kg-1). The following day after surgery, rats in the SXT group were given the aqueous solution of SXT granules (0.78 g·kg-1), and the pirfenidone group was given pirfenidone suspension (0.05 g·kg-1). The other groups were given deionized water (10 mL·kg-1) for 28 consecutive days. Lung tissue was collected after the lung function was measured. The pathological changes of the lung tissue were observed by hematoxylin-eosin (HE) and Masson staining, and then the Szapiel score and Ashcroft score were performed. Real-time fluorescence quantitative polymerase chain reaction (Real-time PCR) was used to detect telomere length. Western blot was applied to detect the expressions of epithelial-mesenchymal transformation (EMT) markers [α-smooth muscle actin (α-SMA) and E-cadherin], telomere reverse transcriptase (TRET), aging-related proteins (p53 and p21), senescence-associated secretory phenotype [interleukin-6 (IL-6) and matrix metalloproteinase-1 (MMP-1)], and key proteins of Wnt signaling pathway [Wnt3a, glycogen synthase kinase-3β (GSK-3β), β-catenin, Cyclin D1, and c-Myc]. ResultCompared with those in the Sham group, peak expiratory flow (PEF) and minute ventilation volume (MV) in the model group were significantly decreased (P<0.01), and the frequency of respiratory (f) was significantly increased (P<0.01). The Szapiel score, Ashcroft score, and protein expression of α-SMA, p53, p21, IL-6, MMP-1, Wnt3a, GSK3β, β-catenin, Cyclin D1, and c-Myc were increased (P<0.01). The expressions of E-cadherin and TERT, as well as telomere length were significantly decreased (P<0.01). Compared with those in the model group, PEF and MV in the SXT group were significantly increased (P<0.01), while f was significantly decreased (P<0.01). The Szapiel score, Ashcroft score, and protein expression of α-SMA, p53, p21, IL-6, MMP-1, Wnt3a, GSK3β, β-catenin, Cyclin D1, and c-Myc were significantly decreased (P<0.05, P<0.01). Nevertheless, the expression of E-cadherin and TERT, as well as telomere length were significantly increased (P<0.01). ConclusionSXT presents a significant protective effect on lung function in IPF rats, and the prescription may act on the Wnt3a/β-catenin signaling pathway to regulate cell senescence induced by TERT to inhibit EMT.
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Analgesia is an important link in the treatment of severe patients after neurosurgery and plays a vital role in improving the prognosis of the patients.Understanding the status quo and influencing fac-tors of pain in severe patients after neurosurgery helps to predict the occurrence of pain,which is crucial for determining the new pain assessment methods and auxiliary analgesic methods and developing novel analgesic drugs.This paper reviews the pain status,pain evaluation and analgesic methods of severe patients after neuro-surgery in recent years so as to understand the pain management current status of the patients with severe neurological conditions and provide reference for the medical staff to implement the analgesic programs.
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Objective:To explore the early predictive value of umbilical cord blood S100β protein and lactate combined with amplitude integrated electroencephalogram(aEEG)in small for gestational age(SGA)preterm infants with brain injury.Methods:One hundred and six cases of SGA preterm infants were enrolled in this study in Neonatology Department of Inner Mongolia People's Hospital from January 2019 to December 2021. Umbilical cord blood serum S100β protein and lactate at birth of All SGA preterm infants were tested,and aEEG was monitored at 6h and 72 h after birth,corrected gestational age of 32 weeks and 37 weeks. According to the diagnostic criteria of brain injury in preterm infants,SGA preterm infants were divided into brain injury group(45 cases)and non-brain injury group(61 cases),and compared the differences of S100β protein,lactate and the designated time aEEG between the two groups.SGA preterm infants with brain injury were further divided into symmetrical group(28 cases)and non-symmetrical group(15 cases). The differences of umbilical cord blood S100β protein and lactate level between the two groups were compared,and the diagnostic value in different types of SGA preterm infants with brain injury was also compared.Results:SGA preterm infants in the brain injury group had significantly higher levels of umbilical cord blood S100β protein[(0.826±0.218)μg/L vs(0.397±0.196)μg/L, t=8.316, P<0.05]and lactate[(8.5±1.3)mmol/L vs(3.8±0.9)mmol/L, t=3.281, P<0.05]than those in non-brain injury group.Symmetric SGA group had higher level of S100β protein than the asymmetric SGA group[(0.924±0.205)μg/L vs(0.438±0.196)μg/L, t=5.734, P<0.05].But there was no statistically significant difference in lactate levels[(5.6±1.4)mmol/L vs(3.9±1.2)mmol/L, t=0.932, P>0.05]between symmetric SGA group and asymmetric SGA group. The abnormal rates of aEEG in brain injury group and non-brain injury group were respectively 100%(45/45)vs 22.95%(14/61)at 6 h after birth,95.56%(43/45)vs 16.39%(10/61)at 72 h after birth,62.22%(28/45)vs 6.56%(4/61)at 32 weeks of corrected gestational age,22.22%(10/45)vs 3.28%(2/61)at 37 weeks of corrected gestational age. The abnormal rate of brain injury group was higher than the non-brain injury group in the same nodal time,and the differences were statistically significant( χ 2 value respectively 62.292,64.913,38.074,9.257,all P<0.05). Conclusion:There were significant value in umbilical cord blood S100β protein,lactate level and aEEG monitoring in the early diagnosis in preterm infants SGA with brain injury. The combination of the three might be more helpful for the early diagnosis and timely treatment of brain injury in SGA preterm infants.
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ObjectiveTo analyze the trends, cooperation, topics and hotspots of researches about multi-level rehabilitation service system in China. MethodsThe literature on multi-level rehabilitation service system in China was searched and screened in databases of CNKI from 1983 to 2023. The number of the articles was described, and the cooperation, research hotspots and changing trend were analyzed using VOSviewer. ResultsA total of 4 643 articles were included. The number of the articles tended to increase and developed in stages. Nine groups with five or more researchers were found, and seven of them cooperated with each other. The most frequent keywords were community-based rehabilitation (occurrence 1 251 with connection strength 1 780), stroke (occurrence 674 with connection strength 1 126), family rehabilitation (occurrence 412 with connection strength 514), rehabilitation nursing (occurrence 178 with connection strength 240) and quality of life (occurrence 156 with connection strength 311). The researchers initially focused on disability rehabilitation, then focused on community-based rehabilitation and family rehabilitation, and gradually focused on the quality of life, activities of daily living, satisfaction, mental health, negative emotion and healthcare consortium in recent years. ConclusionThe researches about multi-level rehabilitation service system are developing in China, focusing on community-based rehabilitation, stroke, family rehabilitation, rehabilitation nursing and quality of life. The cooperation among scholar groups need to be strengthened. Quality of life, activities of daily living, satisfaction, mental health, negative emotion and healthcare consortium may be the hotspots in the future.
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Objective@#To analyze the characteristics of fine particulate matter (PM2.5) pollution in Urumqi City, Xinjiang Uygur Autonomous Region from 2016 to 2023 and establish a prediction model, so as to provide the reference for air pollution prevention and control.@*Methods@#PM2.5 monitoring data of Urumqi City from 2016 to 2023 were collected through the website of Ministry of Ecology and Environment of China. The changing trend of PM2.5 concentration was analyzed using temporal chart and seasonal index. PM2.5 monthly average concentrations from 2016 to 2023 were used to establish an autoregressive integrated moving average (ARIMA) model, and the data in 2023 was fitted and compared with the actual values, using mean absolute percentage error (MAPE) to evaluate the effectiveness of the model, and PM2.5 monthly average concentration from 2024 to 2025 was predicted.@*Results@#PM2.5 daily average concentration in Urumqi City showed a decreasing trend from 2016 to 2023 (rs=-0.239, P<0.001), with high seasonal indexes in January, February and December, indicating certain seasonal characteristics. The optional model was ARIMA (1, 0, 0) (1, 1, 0)12, with the value of Akaike information criterion, corrected Akaike information criterion, and Bayesian information criterion being 727.38, 727.88 and 737.10, respectively. PM2.5 monthly average concentration in 2023 was fitted and compared with the actual values, with an absolute error range of 0.31-7.45 μg/m3, a relative error range of 0.01-0.53, and MAPE of 14.42%. PM2.5 monthly average concentration in Urumqi City from 2024 to 2025 was predicted to be consistent with the trend from 2016 to 2023.@*Conclusions@#PM2.5 concentration in Urumqi City showed a tendency towards a decline from 2016 to 2023, and was relatively high in winter. ARIMA (1, 0, 0) (1, 1, 0)12 can be used for short-term prediction of PM2.5 pollution in Urumqi City.
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In order to cope with the challenges of an aging society,the construction and implementation of a policy system about integrated elderly care and medical services is an important measure to protect the health rights and interests of the elderly.By integrating medical care with elderly care services,the policy aims to provide comprehensive and continuous support for elderly care and health,and meet the diversified needs of the elderly in terms of medical treatment,rehabilitation,nursing,and life care.The construction and implementation of this policy system will not only help to improve the quality of life of the elderly,but also help to improve the service efficiency of the medical and health system and promote sustainable social and economic development.This paper reviews the policy of integrated elderly care and medical services from multiple perspectives such as its development history,policy level,classification and characteristics.
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Objective The rapid growth of data exchange and information volume in hospital information systems has brought significant challenges to the operation,maintenance,and service performance of the system.In order to overcome the performance bottleneck of the software and improve the response performance of the hospital information system,our hospital has tentatively introduced the Exadata database machine.Methods The machine was launched through hardware parameter selec-tion,high availability testing,and data migration.The benefits were evaluated by comparing the I/O operation time,SQL state-ment execution time,and business system module loading time before and after the launch.Results After using this machine,the overall waiting time of I/O operations decreased by 83.47% ,the execution time of the same statement decreased by over 22% ,and the average loadingtime of the business system decreased by43.74% .Conclusion The database machine can effec-tively reduce query time,accelerate the running speed of business modules,and help improve the performance of hospital infor-mation systems.
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Objective:To study the application effect of family integrated ward in maintaining the optimal target pulse oxygen saturation (SpO 2) in premature infants with bronchopulmonary dysplasia (BPD). Methods:This was a retrospective cohort study. Premature infants with BPD admitted to the neonatal intensive care unit of Children's Hospital of Nanjing Medical University from June 2019 to January 2022 were enrolled. Based on whether to stay in family integrated ward and implement family integrated care (FICare), these premature infants were divided into the family ward group and the control group. The ratio of optimal target SpO 2 within 24 h before discharge, the duration of home oxygen therapy, and ratio of readmission due to respiratory disease within 6 months after discharge were analyzed between the two groups. Results:During the study period, a total of 167 premature infants with BPD were admitted, including 101 in the family ward group and 66 in the control group. Compared with the control group, the family ward group showed a higher proportion of achieving the optimal target SpO 2 within 24 h before discharge (58.0% vs. 24.0%), shorter duration for home oxygen therapy (7.0 d vs. 12.0 d), and a lower readmission rate within 6 months after discharge (16.5% vs. 30.2%), which had statistically significant difference (all P<0.05). Further regression analysis showed that participating in the family integrated ward significantly reduced the demand for home oxygen therapy and the duration of home oxygen therapy, but had no significant impact on the readmission rate within 6 months after discharge. Conclusions:Family integrated ward can effectively increase the proportion of achieving the optimal target SpO 2 for premature infants with BPD within 24 h before discharge, reduce the demand for home oxygen therapy, and shorten the time of home oxygen therapy after discharge, which is beneficial for improving the living quality of premature infants with BPD.