Ecological construction of ESP curriculum system in medical schools under perspective of learning science / 中华医学教育探索杂志

English for specific purpose (ESP) courses for the postgraduates in medical schools have both physical and social attributes, with emphasis to improve practical language learning of medical specialties. It's an effective way to develop the English language application ability of high-level medical college students by constructing an ESP teaching and learning ecological system with professional and social contextual characteristics. In this study, through design-based implementation research, scenario simulation class was designed and implemented to accomplish task-based language teaching and learning. Further discussions on how to integrate blended and interrelated classes, on how to define combined and interactive teachers' role were explored. Based on the teaching and learning practices, organically combining the innovative curriculum concept with the construction of ESP ecological system effectively directs the practical application of the ESP class under the perspective of learning science, and verifies the feasibility of the ecological construction of ESP curriculum system.

Conversion of traditional Chinese medicine (TCM) into nanomedicine:application of theory of unification of medicines and excipients / 中国中药杂志

In recent years, the use of active substances as excipients or as substitutes for other excipients in the design of modern drug delivery systems has received widespread attention, which has promoted the development of the theory of unification of medicines and excipients in the design of traditional Chinese medicine(TCM) preparations. Adopting the theory of unification of medicines and excipients to design drug delivery systems can reduce the use of excipients and thus the cost of preparations, reduce drug toxicity, increase drug solubility and biocompatibility, enhance synergistic effect, and realize targeted delivery and simultaneous delivery of multiple components. However, the research on the application of this theory in the modern drug delivery system of TCM preparations is still insufficient, with few relevant articles. In addition, the TCM active substances that can be used as the excipients remain to be catalogued. In this paper, we review the types and applications of the drug delivery systems with TCM active substances as excipients and describe their common construction methods and mechanisms, aiming to provide references for the in-depth research on the modern drug delivery systems for TCM preparations.

Spray Drying in Research of Traditional Chinese Medicine Powders： A Review / 中国实验方剂学杂志

After more than 100 years of development， spray drying technology has become more mature and widely used， and it is of great importance in the field of traditional Chinese medicine （TCM）. TCM powders prepared by spray drying is the raw material of dispensing granules， and the powder properties have an important influence on subsequent molding process and product quality. As a new form of TCM， dispensing granules have been included in the management category of TCM decoction pieces， indicating a broader application market， and a consensus has also been reached on the importance of TCM powder research. Based on this， the author summarized the application progress of spray drying in the study of TCM powders， including the factors affecting spray drying process， such as liquid properties， process parameters and equipment factors， as well as the application of computational fluid dynamics （CFD） and thermodynamic model in spray drying process simulation. Moreover， some commonly used pharmaceutical excipients for the modification of TCM powders were also introduced such as maltodextrin， microcrystalline cellulose and povidone. In addition， spray drying technology can also be used as a preparation technology for new drug delivery systems such as microcapsules and solid dispersions. Through the summary of this paper， the author suggests that the future research direction of spray drying of TCM can be carried out from the aspects of application rule of the coprocessing auxiliary materials based on the "unification of medicines and excipients"， the "structure-property" relationship of spray-dried powders and the application of computer simulation and design， so as to further enrich the application of spray drying in the field of TCM powders.

Pluralismo evolutivo e o ideal de unificação da biologia / Evolutionary pluralism and the ideal of a unified biology

Resumo A evolução biológica é frequentemente considerada um eixo central e unificador da biologia. O artigo discute aspectos históricos desse ideal de unificação, bem como os seus sinais de desintegração entre os anos 1960 e 1980. Argumentamos que apesar das novas propostas de síntese do conhecimento biológico, a biologia evolutiva contemporânea é caracterizada por um pluralismo. Os principais pontos a favor do pluralismo evolutivo são discutidos, e algumas consequências dessa perspectiva são apresentadas, particularmente em relação ao ideal de unificação da biologia. Por fim, defendemos um pluralismo evolutivo crítico do ideal de unificação como um objetivo da ciência, mas ainda favorável a integrações locais.

Abstract Biological evolution is often regarded as a central and unifying axis of biology. This article discusses historical aspects of this ideal of unification, as well as signs of its disintegration from the 1960s to 1980s. We argue that despite new proposals for the synthesis of biological knowledge, contemporary evolutionary biology is characterized by pluralism. The main points in favor of evolutionary pluralism are discussed and some consequences of this perspective are presented, particularly in terms of the ideal of a unified biology. Finally, we defend an evolutionary pluralism that critiques the ideal of unification as a scientific objective, but still favors local integrations.

Exploratory study on preparation of high drug loading granules with traditional Chinese medicine raw powder as carriers / 中国中药杂志

With Sangtang Yin granule as model drug,and based on the strategy of " unification of medicines and excipients",the feasibility of preparing high drug loading granules with traditional Chinese medicine( TCM) raw powder as carrier was explored. The powder yield,particle size and particle size distribution,fillibility,flowability,hygroscopicity,reconstituability and other key physical properties relating to preparations of 8 herbs( Dioscoreae Rhizoma,Euryales Semen,Atractylodis Macrocephalae Rhizoma,Coicis semen,Poria,Puerariae Lobatae Radix,Puerariae Thomsonii Radix and Coicis Semen by stir-frying with bran) were studied after being smashed,and the feasibility of taking them as excipients of TCM granules was evaluated by co-spray drying,dry granulation and other preparation techniques. According to the results of the physical properties of raw powders,raw powders of Dioscoreae Rhizoma,Euryales Semen and Puerariae Thomsonii Radix had a high powder yield,uniform particle size distribution,good fillibility,poor hygroscopicity and good reconstitutability,with the feature of assisting granule forming. Compared with the prescription of spray dry powder Sangtang Yin without any excipient,the co-sprayed powder had a high yield,good fillibility and compressibility. The yield of dry granules prepared by co-spraying dry powder was increased by more than 10%,and the particles had a uniform color,good fluidity and dissolubility with the drug-loading rate up to 100%. Based on the physical characteristics of TCM raw powder combined with the analysis of the preparation process,Dioscoreae Rhizoma and Puerariae Thomsonii Radix raw powder were selected as the carriers of granule preparations,and Sangtang Yin granule without any excipient was successfully prepared. The findings provide a feasible idea for the preparation of TCM granules with a high drug loading capacity.

Practice and exploration on the construction of hospital outsourcing project supervision system / 中华医院管理杂志

As more and more non-core services are outsourced to other companies, it is necessary for hospitals to build an effective outsourcing project supervision system to improve service quality and reduce potential risks. The authors introduced the construction practice of outsourcing project supervision system in the Second Affiliated Hospital of Zhejiang University School of Medicine of emphasizing four core elements: system guarantee, organization establishment, standard unification and quality monitoring. The authors also summarized five important aspects of building a thorough, consolidated, less risky and user-friendly outsourcing project supervision system: selecting suppliers carefully under unified standards; orienting dynamic supervision with details, problems and outcome; strengthening quality improvement and dual supervision equally; upgrading the concept of supervision and build a good cooperative relationship with suppliers; paying attention to the whole process management with learned lessons.

Progress in application of Bletilla striata polysaccharide in novel drug delivery systems and biomaterials / 中国中药杂志

As the main active ingredient of the orchidaceous herb Bletilla striata, B. striata polysaccharide(BSP) has pharmacological activities such as promoting coagulation, anti-inflammation, anti-oxidation, promoting wound healing, anti-tumor, and immunomodulation, and is biodegradable and non-toxic. Additionally, it has the material properties of suspension thickening, film-forming adhesion, coating and solubilizing, targeting and slow releasing, effect-enhancing and toxicity-reducing, etc., playing the role of unification of medicines and excipients. Therefore, BSP has a wide application prospect in the fields of drug delivery system and trauma repair. This paper reviews the research progress of BSP application in new drug delivery systems and biomaterials based on the related li-terature in recent years, with the aim of providing reference for the further research and application of BSP.

Preparation of personalized traditional Chinese medicine condensed water pill without excipients based on correlation between concentrate viscosity and molding quality / 中国中药杂志

To explore the correlation between concentrate viscosity and molding quality of personalized traditional Chinese medicine(TCM) condensed water pill, this study established a concentrate viscosity characterization method with rotational rheometry. Seven model prescriptions were respectively concentrated to different degrees and the viscosity of each concentrate was determined. The pre-sence of 'viscosity jump' in the middle stage of 'flag hanging' of all the model prescriptions implied that there might be an ideal viscosity range in the preparation of condensed water pill. The further study of 22 model prescriptions demonstrated that the optimum viscosity range of concentrate was 5-15 Pa·s(25 ℃) for approximately 82% of the prescriptions. About 18% of the prescriptions had a wide range, which might be caused by the high proportions of mineral and crustacean drugs in the crushing part and sugar and fibrous drugs in the decocting part. This study clarified the optimum viscosity range for concentrates of personalized TCM condensed water pills and achieved a preparation technology without any excipient, laying a foundation for the on-line control of the preparation.

Box-Behnken response surface method optimized BSP/PVA wet spinning process and fiber performance evaluation / 中草药

Objective: To optimize Bletilla striata polysaccharide (BSP)/polyvinylalcohol (PVA) wet spinning process by Box- Behnken response surface method and prepare the composite fiber and performe their structural characterization and performance evaluation. Methods: Taking the OD value of three types of mechanical property data (breaking force, breaking strength and elongation at break) of the fiber as the evaluation index, five factors (BSP mass fraction, PVA mass fraction, volumetric mix ratio of BSP/PVA, coagulation time and spinning speed) were investigated by single factor experiments. On the basis of the results of single factor experiments, three factors (BSP mass fraction, volumetric mix ratio of BSP/PVA, coagulation time) were investigated by response surface method to optimize BSP/PVA composite fiber wet spinning process. The morphology, structure, thermal property, and absorption property of the fibers were characterized and analyzed by SEM, IR, DSC, and water absorption test. Berberine hydrochloride (BH) was used as model drug to evaluate the drug loading property of the composite fiber and antibacterial activity of the drug loading fiber. Results: The optimal spinning process of composite fiber were as follows: BSP mass fraction was 7.5%, volume mixing ratio of BSP/PVA was 1:1 and coagulation time was 3 min. The composite fiber had a dense surface and formed a three-dimensional network structure inside, generated intermolecular forces, which enhanced the thermal and mechanical properties, and exhibited excellent water absorption capacity. The encapsulation efficiency of the composite fiber reached 70.2%. And the drug loading fiber formed obvious inhibition zone in the bacteriostatic zone test, which presented excellent antibacterial effect against E. coli and S. aureus. Conclusion: The optimized spinning process is feasible and low cost. The prepared composite fiber has better physical property and certain coating ability, and its application in the field of biomedical textiles is worth further study.

Mechanism of "unification of drugs and excipients" for Chinese medicine semi-extract based on powder compression behavior analysis / 中国中药杂志

In this paper, five representative Chinese herbal decoction pieces of Scutellariae Radix, Paeoniae Radix Alba, vinegar-processed Corydalis Rhizoma, Polygoni Multiflori Radix Praeparata and Lonicerae Japonicae Flos were selected to prepare the corresponding fine powder of pieces, extract powder, semi-extract powder and physical mixed powder. The physical properties of 20 kinds of powders, such as related parameters of particle size, density, stability and flowability, were evaluated comprehensively. The compression curves of powder porosity and tensile strength changing with pressure were plotted, and the Heckel equation and the Kawakita equation were used to describe the powder compression behavior. The results showed that compared with the fine powder of pieces, the compressibility of the semi-extract powder and the extract powder was significantly improved. Compared with the extract powder, the particle size and relative uniformity of the semi-extract powder were increased, indicating that the uniformity of the powder was improved. Besides, the semi-extract powder could reduce the hygroscopicity of the powder. Particularly, the semi-extract powder of Scutellariae Radix, Paeoniae Radix Alba and vinegar-processed Corydalis Rhizoma could maintain the porous structure of the tablet even under a high tableting pressure, which was beneficial to tablet disintegration. For some traditional Chinese medicines(such as Lonicerae Japonicae Flos), the semi-extract powder could reduce the viscosity, which avoided the sticking in the die compression. The semi-extract powder and the physical mixture powder prepared by the same Chinese herbal decoction pieces had similar physical properties and compression behaviors. Principal component analysis(PCA) was carried out on the 17 physical attributes and 5 compression parameters of the powder. It was found that the first principal component mainly reflected the differences among the material sources, while the second principal component could reflect the differences among fine powder of pieces, extract powder, semi-extract powder and physical mixed powder originating from the same Chinese herbal decoction pieces. In this paper, the mechanism of "unification of drugs and excipients" of Chinese medicine semi-extract powder was explained in terms of physical properties and compression behavior of powders, which provided reference for the formulation design and process development of Chinese medicine tablets.

Pharmacodynamics and mechanism of Shaoyao Gancao Intragastric Floating Tablets based on unification of medicines and excipients / 中草药

Objective: To study the pharmacodynamic effect of “unification of medicines and excipients” and the mechanism of action about Shaoyao Gancao Intragastric Floating Tablets (SGIFT). Methods: Rabbits were randomly divided into control group and model group, Shenmei Yangwei Granule group (1.0 g/kg), Shaoyao Gancao Decoction extract group (1.0 g/kg), low-dose SGIFT group (1.0 g/kg), high-dose SGIFT group (1.5 g/kg), chitosan blank excipients group (1.0 g/kg). The acute gastric ulcer model was established in the blank excipient group without chitosan (1.0 g/kg). Six rats in each group, fasting for 24 h after 13 d of continuous administration, and gastric administration of anhydrous ethanol (2.5 mL/single). The blood and gastric tissue were taken out after 1.5 h to observe the pathological damage in each group. The expression of GAS, MDA, PG, epidermal growth factor (EGF) in serum and EGF, PGE2, TFF1 in gastric tissue of each group were detected. Results: Compared with the model group, the other groups can improve the gastric histopathology of rabbits with acute gastric ulcer effectively. The content of EGF in serum and EGF, PGE2, and TFF1 in gastric tissue of rabbits was increased in varying degrees, and the content of GAS, MDA, and PG in serum was all decreased in different degrees. Conclusion: SGIFT had certain therapeutic effects on rabbits with anhydrous ethanol gastric ulcer. The mechanism might be related to protecting gastric mucosa, increasing the content of protective factors, and reducing the content of attack factors.

Challenges and Strategies for Unified Health System of South and North Korea / 보건행정학회지

This paper aims to make a step-by-step strategy to formulate an unified health system by clarifying and overcoming challenges facing South and North Korea and to estimate costs needed for South Korea to assist North Korea to recover to normal health delivery system. We explored implications through literature review and estimated costs under the assumption that supportive activities be provided for 5 years in three ways: support for the development of health and medical care manpower; support for health and medical facilities; and support for the provision of both preventive and primary health care. Step-by-step strategy is formulated for a unified health system with the cost estimation resulting as follows: in case of basic scenario, a total of 3 trillion and 341 billion won (at present value of the year 2017) is in need for the 5-year period at the initial ‘recovery support stage’ with 135.9 billion won for the development of health and medical care manpower, approximately 2 trillion won for health and medical facilities, and 1.2 trillion won for the provision of both preventive and primary health care. Step-by-step approach is more realistic and applicable in formulating unified health system. Suggested stages are ‘recovery support stage,’ ‘system homogenization stage,’ and ‘unified system stage.’ Strategies at ‘recovery support stage’ suggested in this paper need to be pursued and followed by those at ‘system homogenization stage’ and ‘unified system stage.’

For the formation of a health community on the Korean Peninsula, inter-Korean cooperation should begin in the field of healthcare

On April 27, 2018, a historic inter-Korean summit took place. Accordingly, the hostile confrontation that lasted for the past 70 years is over, and many exchanges of human resources and material between the two Koreas are expected. In this situation, I propose that the reasons for and methods of cooperation in healthcare between North and South Korea should be among the first issues to be considered. The reasons are as follows. First, as exchanges increase, the South and the North will rapidly develop into a single health community on the Korean peninsula. Second, cooperation in the field of healthcare can play a leading role in fostering a positive attitude among South and North Koreans toward the improvement of inter-Korean relations and the possibility of future unification. Third, the two Koreas have conditions that make them ideal partners for improving healthcare quality and systems in each country. Some suggestions for specific ways to do this are presented. First, an inter-Korean healthcare agreement should be concluded. Second, specific organizations for inter-Korean cooperation should be established and operated. Third, it is necessary to form and operate a ‘control tower’ for this process in South Korea. It is expected that cooperation between the two Koreas in the field of healthcare will eventually extend to cooperation in all areas.

The Study of Medical Perspectives of Korean Traditional Medicine for Treating Pigmented Skin Benign Tumor / 대한피부과학회지

Although the management of benign pigmented skin tumors are mainly conducted by dermatologists, some Korean traditional doctors provide care. We aimed to evaluate the appropriateness of the medicinal knowledge of pigmented benign skin tumors that is recorded in the Korean traditional medicinal literature, in the context of modern medicine. We defined benign pigmented skin tumors as macules, papules, or nodules with homogeneous surfaces and coloration patterns, that are round or oval in shape, exhibit regular outlines, and have relatively sharp borders. We investigated textbooks and articles in the Korean traditional medicinal field to analyze descriptions of clinical classification, pathophysiology, histologic knowledge, and treatment method. We compared them with modern medicinal facts. In Korean traditional medicine, clinical classification of pigmented skin tumors is simple and did not include histologic natures. Unique theories, such as Yin-Yang and Qi, were applied to pathophysiologic understanding of these diseases. Interestingly, oral medications were used beside surgical methods. We could not find any comment about skin tumors with worrisome clinical features that warrant excision in Korean traditional medicinal literature. There is still a gap between traditional medicine and modern medicine regarding pigmented skin tumors. Traditional Korean medicinal knowledge about benign pigmented skin tumors seemed to be insufficient in the context of modern medicinal standards.

Study on theory and application value of "unification of medicines and excipients" in Chinese materia medica preparations / 中草药

"Unification of medicines and excipients" was the particular concept of medication use, pharmaceutical experience and philosophical wisdom in Chinese materia medica (CMM) preparations. However, the traditional experience has not been fully summed up, and the modern research and application have not attracted enough attentions. In this paper, the theoretical connotation and basic characteristics of "unification of medicines and excipients" were concluded, and the common phenomena and their physical chemical basis were summarized. Then, the design and application law of "medicines as excipients" and "excipients as medicines" were discussed. What's more, we have enumerated several modern research examples and analyzed its application value in the development of new excipients, new pharmaceutical preparation technology, and new CMM preparations. We hope to explore wisdom from the traditional experience, promote the integration of traditional knowledge and modern study, and finally accelerate the inheritance and innovation of pharmaceutics of CMM.

Changes in Providers' Behavior after the Reviewer Unification of Auto Insurance Medical Benefit Claims / 보건행정학회지

BACKGROUND: This study aims to analyze the behavioral changes of healthcare providers and influencing factors after the reviewer unification of auto insurance medical benefit claims by an independent review agency. METHODS: The comparison data were collected from the second half of 2013 and the same period of 2014. The key indicators are the number of admission days, the number of outpatient visits, inpatient ratio, inpatient medical expenses, and outpatient medical expenses. RESULTS: Four indicators (number of admission days, number of outpatient visits, inpatient ratio, and outpatient medical expenses) showed statistically significant drops, while one indicator (inpatient medical expenses) showed no significant change. CONCLUSION: The reviewer unification of auto insurance medical benefit claims by an independent review agency showed significant reduction in cost and patient days.

Unification Is Healing : Psychiatric Contemplation of Korean Peninsula Division and Unification / 신경정신의학

Koreans have repeatedly experienced societal traumas, of which Korean Peninsula division and 6.25 are the greatest sources of trauma. Such division and the Korean War have destroyed the concept of "nation community," "town community," and "rational community" in the Korean people. Thus, Korean people have come to 1) live in a society with no recognition of community, 2) obsession with extreme ideologism, 3) lower ability to resolve conflict making societal dissension more serious. For the healing of this trauma, the following projects are needed : 1) foreign case analysis of societal trauma healing, 2) analysis of each subject and healing, 3) rebuilding of nation, town, and ration community in Korean society, 4) creation of artwork that gives introspection to division and its sublimation, 5) take the challenge to sublimate suffering in order to create a higher mental state of individual and society. Thus, the professional role of a psychiatrist is important. First, administer professional treatment to those in need of medical psychiatric help who are suffering from societal trauma resulting from division. Second, grasp the mental and societal difficulties and special help needed for the various traumas. Third, help in creation of artwork dealing with the pain of division. Fourth, create a more culturally sensitive and appropriate psychiatric support method for North Korean Refugees in South Korea. Fifth, help in sublimating pain and finding meaning and maturation through it. It is important to acknowledge that "Unification is Healing."

Task and Preparation of Psychiatric Field for Korean Reunification / 신경정신의학

For improving mental health of the future unified Korea, proper preparation would be necessary in the fields of clinical, social, and cultural psychiatry. Clinically, a diagnostic and treatment system for mental illness should be re-established after Korean unification. There should also be specific preparation for suicides, trauma- or stress-related disorders, somatizations, substance abuse, and childhood psychiatric problems which are expected to rapidly increase in North Korean areas after the unification. In the field of social psychiatry, de-stigmatization and de-institutionalization of those with mental illness would be important after the unification. Education of mental health professionals in North Korean areas would also be crucial. Culturally, it would be necessary to expect the psychological change of both South and North Koreans.

Lessons From Unified Germany and Their Implications for Healthcare in the Unification of the Korean Peninsula / 예방의학회지

This study investigated the German experience in the transition to a unified health care system and suggests the following implications for Korea. First, Germany could have made use of the unification process better if there had been a good road map. Therefore Korea must develop a well prepared road map that considers all possible situations. Second, Germany saw an opportunity for the improvement of the health care system in the early stage of unification but could not take advantage of it because the situation changed dramatically and they had not sufficiently prepared for it. Korea should take into account the opportunity for improvement of the present health care system, such as the roles of public health and traditional medicine. Thirdly, the conditions f North Korea seem to be far worse than those of former East Germany and also worse than even those of other transition countries. Therefore Korea should design a long-term road map taking as many variables into account as possible, including the different rigid way of thinking and the interrelationship among the social sectors. Fourthly, during the German reunification unexpected factors changed the direction of the events. Korea should have a separate plan for the unexpected factors.

A Seven-Year Panel Study on North Korean Defectors Perception and Satisfaction on Life in South Korea / 신경정신의학

OBJECTIVES: North Korean defectors' comprehension of South Korean society and satisfaction with their lives in South Korea both symbolize their adaptation to their new society. The current report is an analysis of three serial panel studies of 200 North Korean defectors who entered South Korea in 2000. METHODS: From February 2009 to March 2009, we interviewed 121 defectors face-to-face. RESULTS: The results showed that the participant's satisfaction level had been relatively well-maintained, and their understanding of the South Korean culture and language had increased. However, their attitudes toward fellow North Korean defectors had worsened. Their satisfaction level with government support for medical care was very low. Gender, age, level of education in North Korea, Communist Party membership, completion of military service, and current employment status had significant influences on their interpretation and understanding of South Korea. CONCLUSION: The results suggest creating North Korean defector self-help groups, strengthening the medical support system, developing programs tailored according to defectors' different backgrounds, gender, age, and educational levels, as well as increasing South Koreans' awareness of these North Koreans through a appropriate campaign, will be necessary for the peaceful unification of the Korean Peninsula.