Expert consensus on COVID-19 vaccination for children with special medical conditions / 上海预防医学

Children with certain comorbidities and immunocompromising conditions are highly vulnerable to SARS-CoV-2 infection. Vaccination against SARS-CoV-2 is an important strategy to reduce death， critical illness and overall disease burden. With the evolving and increasing transmission of SARS-CoV-2， universal vaccination is essential to achieve this goal. Children with special medical conditions are considered as the priorities for SARS-CoV-2 vaccination. However， vaccine hesitancy towards the implementation of SARS-CoV-2 vaccination currently remains an urgent challenge. In order to promote the sustainable vaccination for those children in Shanghai as well as China， Shanghai municipal center for disease control and prevention， together with the national children’s medical center， children’s hospital of Fudan university and the expert group on immunization planning of the Shanghai preventive medicine association， organized a consensus expert working group to formulate the evidence-based recommendations and implementation suggestions for children with common chronic diseases， allergy history， diseases involving adverse events related to vaccination， and immunocompromising conditions， based on the published evidence of SARS-CoV-2 vaccination for populations and children with special medical conditions.

Investigation on clinical application and management of food for special medical purpose in China's 592 medical institutions in 2020 / 中华临床营养杂志

Objective:To understand the current situation of clinical application and management of food for special medical purpose (FSMP) in China's medical institutions.Methods:A questionnaire was developed based on literature review, consultation with experts and multiple discussions to investigate the application and management of FSMP in hospitals. The survey was conducted in secondary and tertiary general or specialized hospitals in China. The accountable person of Clinical Nutrition Department in each hospital filled in the questionnaire with the guidance from provincial quality control center.Results:A total of 592 hospitals across 30 provinces/municipalities participated in the survey. The majority (40.5%) of prescription for FSMP with approved batch number was given by clinical nutrition departments, nutritional risk screening was conducted before using FSMP as enteral nutrition in 64.0% of the hospitals, consent from patients or their families prior to initial FSMP use was required in 94.8% of the hospitals, follow-up after FSMP use was carried out in 86.5% of the hospitals, 79.2% of the hospitals maintained electronic or paper documentation of the clinical application of enteral nutrition preparations, 41.6% of the hospitals had no organization or institution to supervise the standardized application of FSMP.Conclusion:In the future, we should strengthen the construction of FSMP professional team, establish convenient and efficient nutrition diagnosis and treatment information module, and set up special institutions to implement FSMP standardized management.

Application of enhanced recovery after surgery concept in laparoscopic radical cystectomy and ileal conduit diversion under modular operation / 国际外科学杂志

Objective:To explore the application value of enhanced recovery after surgery (ERAS) in laparoscopic radical resection of bladder cancer and ileal bladder surgery under modular operation procedures.Methods:A retrospective selection of 42 cases of laparoscopic radical radical resection of bladder cancer and ileal bladder surgery performed by the Department of Urology, General Hospital of Southern Theater Command from January 2017 to December 2019 were divided into two groups according to the different management methods adopted during the perioperative period: ERAS management group and conventional management group, each with 21 cases. Among them, patients in the ERAS management group were managed by ERAS during the perioperative period, and patients in the conventional management group were managed by conventional management during the perioperative period. The postoperative hospital stay, first exhaust time, first defecation time, first time to get out of bed, first liquid food time, postoperative visual analogue scale (VAS) score, as well as transferrin, upper arm circumference, body mass index, plasma albumin, total protein, and total protein were compared between the two groups of patients after surgery. The measurement data conforming to the normal distribution were expressed as mean±standard deviation ( Mean± SD), and the in dependent t-test was used for comparison between groups; the measurement data of non-normal distribution were expressed as the median (interquartile range) [ M( P25, P75)], the independent sample Mann-Whitney U test was used for comparison between groups; the Chi-square test was used for comparison of enumeration data between groups. Results:The postoperative hospital stay in the ERAS group was (8.9±1.8) d, the first exhaust time was (33.4±3.2) h, the first defecation time was (60.3±7.8) h, the first time to get out of bed was (23.1±6.7) h, the first liquid food time was (82.7±18.5) h and postoperative VAS was (1.3±0.6), that were significantly reduced compared with the conventional treatment group [(12.3±2.3) d, (51.4±5.2) h, (73.0±8.1) h, (34.7±8.2) h, (109.7±21.6) h, (3.6±0.8)], the difference were statistically significant ( P<0.05). In the ERAS group, the decreased value of transferrin was [0.8 (-0.4, 2.2) g/L], the decreased value of body mass index was[1.61±0.73], the decreased value of plasma albumin was [3.5±1.5 g/L], the decrease value of total protein was[10.1±5.6 g/L] and the decrease value of prealbumin was [90.5±11.3 mg/L] were significantly lower than those of the conventional management group[(1.9(0.9, 3.6) g/L, (2.32±1.05) kg/m 2, (9.6±2.0) g/L, (16.3±4.9) g/L, (131.3±7.4) g/L], and the difference were statistically significant ( P<0.05). Conclusion:Modular laparoscopic precision resection of bladder cancer and ERAS concept after ileal bladder surgery is beneficial to shorten the hospital stay, reduce postoperative pain, have less impact on the patient′s body loss and immune function, and can speed up the patient′s postoperative recovery.

Management and Clinical Application of Food for Special Medical Purposes as Enteral Nutrition Prepara-tion / 中国药师

Enteral nutrition preparation is one of most important tools to perform clinical nutrition support. Food for special medi-cal purposes ( FMSP) as a special category of enteral nutrition preparation was developed from foods gradually. At present, the man-agement of FMSP bases on the evidence at home and its development has been accelerated. A complete understanding and appropriate use of FMSP will become one essential clinical skill for doctors, pharmacists and dietitians in a multidisciplinary medical team. The re-view revealed the current situation of FMSP and addressed the authors' understanding on the differences between FMSP, medications and foods in order to provide reference for the clinical application of FMSP.

The effect evaluation on catastrophic disease medical assistance policy in China: A case study of Qindao City / 中国卫生政策研究

Objective: In order to evaluate the effect of catastrophic disease medical assistance policy in Qingdao and provide suggestions for Qingdao policy reform.Methods: This paper selects NSCLC and liver cancer as the typical deceases to analyze the effects of the policy on patients and medical insurance institutions and finally evaluate the effect of the policy.Results: results shows that after the implementation of special medicines and special medical equipment assistance, the rate of co-paying patients decreased 40.57%, and the pressure on medical insurance institutions' expenditure was significantly reduced;while after the implementation of large cost assistance, but rate of co-paying patients only decreased 7.13%, and the pressure on medical insurance institutions' expenditure was not effectively alleviated.Conclusions: Therefore, the policy not only protects patients with catastrophic disease by greatly reducing their medical burdens, but it also achieves the fine management of medical insurance fund and increases the efficiency of the fund.

Management and Clinical Application of Food for Special Medical Purposes as Enteral Nutrition Prepara-tion / 中国药师

Enteral nutrition preparation is one of most important tools to perform clinical nutrition support. Food for special medi-cal purposes ( FMSP) as a special category of enteral nutrition preparation was developed from foods gradually. At present, the man-agement of FMSP bases on the evidence at home and its development has been accelerated. A complete understanding and appropriate use of FMSP will become one essential clinical skill for doctors, pharmacists and dietitians in a multidisciplinary medical team. The re-view revealed the current situation of FMSP and addressed the authors' understanding on the differences between FMSP, medications and foods in order to provide reference for the clinical application of FMSP.

An Assessment Framework to Delineate Between Dietary Foods for Special Medical Purposes and Normal Foods.

This paper describes an assessment framework (‘decision tree’) to delineate between ‘dietary foods for special medical purposes’ and normal ‘foods’. The Netherlands Food and Consumer Product Safety Authority commissioned this work in 2010. The background for the 2010 request was that some normal foods to which the EU Nutrition and Health Claims Regulation 1924/2006 applies [1], were presented on the market in the Netherlands as ‘dietary foods for special medical purposes’ falling under Directive 1999/21/EC [2]. In order to assist in the enforcement of the EU Nutrition and Health Claims Regulation 1924/2006 it was necessary to have an assessment framework. In 2010, the National Institute for Public Health and the Environment (RIVM) produced its final report. This report was since then used by the Netherlands Food and Consumer Product Safety Authority to enforce appropriate law in Europe/the Netherlands. Although since 2010 this decision tree has worked satisfactory, it was available only in the Dutch language on the website of the Netherlands Food and Consumer Product Safety Authority [3]. Hence, it could not be communicated internationally. However, once international experts became aware of this document existing in Dutch and indicated their active interest, it was decided to have a full translation of the original document in the public domain. This paper shortly describes the relevant definitions of “foods” in the applicable EU legislations and then the full translation (in English) of the original document (in Dutch). In an annex, the definition of ‘food’ in the applicable EU legislation is given.

Investigational analysis on the responsiveness of 139 inpatlents in a special medicine center / 中华医院管理杂志

d infrastructure quality.Conclusions Raising responsiveness for special medical services will be conducive for improving the quality of non-medical services for these inpatients when they are in the hospital.

Discussion on the adaptation of special medical service to medical market competition / 中华医院管理杂志

The author attempts to discuss the laws of special medical service market from the perspective of the combination of theory and practice, makes an in-depth analysis of the seven features of special medical service, and puts forward four strategies for responding to competition on special medical service market. Using the success of the hospital he works with as an example, the author proves the feasibility of implementing the competitive strategies and hopes to share their experience with people working in the same field.

Survey and analysis of special medical services marketing / 中华医院管理杂志

Objective To understand and master the system for assessing the strategies, management and effect of special medical services marketing. Methods Survey sheets on customer satisfaction towards special medical services and survey sheets on the effect of special medical services on the caliber of medical personnel were fandomly distributed to the patients and medical staff in a particular hospital and special topic interviews and statistical analyses of special topic survey data were conducted. Results The satisfaction rate of customers receiving special medical services was 98.9%, and special medical services had a positive effect on the improvement of the quality of medical services, economic benefits and the caliber of the medical personnel. Conclusion Correct orientation is the marketing strategy guiding special medical services. Market-based orientation, marketing-based medical services and resources-based guidance are of important practical values to special medical services while high quality, high caliber and high benefits are the major indexes for assessing special medical services.

Ethical Reflection on of Patients′ Rights of Informed Consent in Special Medical Examination / 中国医学伦理学

The right to informed consent in special medical examinations contains a lot of ethical values and principles.The authors describe ethical principles of medical examinations,put forward some ethical requirements for implementing the patient′s rights of informed consent in medical examinations,and analyze some ethical conflicts in the implementation of informed consent in special medical examinations.

Design and Realization of Hospital Special Medical Information System / 医疗卫生装备

Objective To design and realize hospital special information system and solve the information management questions of special diagnosis, such as emergency observation, radiation therapy, hemodialysis, assisted reproductive of bear and rear better children. Methods The main problems of hospital special medical in China were analyzed and defined the basic concept of hospital special medical. The main flow and system of hospital special medical from 13 aspects were introduced. Results The work mode and management methods about special medical were changed and solved the limitations of traditional management. Conclusion The design and realization of hospital special medical information systems can be improved work efficiency, medical quality effectively and the informationization level of the hospital.