Path analysis of internet medicine supervision and management / 上海预防医学

As a new form of medical industry， internet medicine has not only the endogenous risk of internet industry， but also the blind area and exogenous risk because of lagging regulation. With the continuous progress of internet information technology， online diagnosis and treatment will gradually integrate and reconstruct the traditional medical service. In the history of medical development， the emergence of new technologies generally has the characteristics of risk. Therefore， the supervision of internet medicine should adhere to the rule of inclusiveness and prudence， and take into account the cultivation of the market and standardized development. It should also build a regulatory community， coordinate governance from the four dimensions of legitimacy， compliance， rationality and superiority. Taking the law as the bottom line， we should make full use of early online warning monitoring， off-site supervision， online supervision， reputation mechanism and other measures to promote the innovative development of internet medicine under the framework of legal compliance.

Risk analysis of internet medicine regulation / 上海预防医学

The penetration and integration of internet with medical industry is apparently falling behind its interaction with other industries in terms of speed and scale. The main reason is due to the high risk and difficult supervision of internet medicine. Based on the regulatory context， this paper analyzes the endogenous and exogenous risk of internet medicine. The inherent characteristics of the internet （such as openness， diversity， multi subjectivity， virtuality， transparency， and high aggregation） lead to endogenous risks， including jurisdiction disputes， uncertainty of rights and obligations， security of personal information and medical information， monopoly. The lag of specific law in internet medicine， the lack of extensibility and synergy of traditional hierarchical regulatory system， the uncertainty of internet hospital regulatory policy details， the lack of technical specifications/operating procedures and other external system coverage in internet diagnosis and treatment lead to regulatory blind areas and exogenous risks. Based on the risk analysis， this paper discusses further construction of the mechanisms of risk assessment and regulation for internet medicine.

Current situation and prospect of internet medicine development / 上海预防医学

Internet medicine is not a concept of jurisprudence. China's current medical law system mainly focuses on main qualifications of the participants who conduct diagnosis and treatment. This paper focuses on several business models of the core element （diagnosis and treatment） in internet medicine， namely： online health consultation provided by internet medical platform， online diagnosis and treatment by internet hospital， and certain artificial intelligence（AI） medicine products that are specialized for diagnosis and treatment. This paper summarizes the development of these three business models， and analyzes the main problems in their development， including the legitimacy identification of online consultation， the dilemma of the development of internet hospitals， the impact of insufficient sample data on the development of medical AI， and the reverse restriction of regulatory difficulties to the development of internet medicine. The next step of developing internet medicine is to broaden the scope of internet diagnosis and treatment on the premise of medical safety， which will be based on the improvement of current regulatory system. It is urgent to build early risk warning system and supervision/ management mechanism for internet medicine.

Integration of internet health and "Healthy China" strategy / 上海预防医学

In the fifth scientific and technological revolution， information technology is the first productivity， which has a great impact on the supply and demand of medical services. Generally， internet medicine is equivalent to the combination between health industry and information technology. "Healthy China" strategy is China's "priority development strategy"， which adheres to the principle of health equity， emphasizes the integration of health into all policies， and takes co-construction and sharing as the basic path. With implementing internet medicine， "Healthy China" strategy promotes the mobility of medical service with three tools： interconnection， data and artificial intelligence. This enhances the operation efficiency of overall medical and health system， and optimizes the allocation of medical resources. The future development of internet medicine follows the double helix mode driven by technology and policy， and the policy determines the development boundary of the industry. On the basis to ensure medical safety， we should explore the possibility of internet diagnosis and treatment further， and pay attention to the fairness of resource allocation while improving efficiency， so as to realize the co-construction and sharing of health services.

Intravitreal injection of Ranibizumab treating noninfectious uveitic macular edema / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM:To evaluate the effects and safety of intravitreal injection of Ranibizumab on noninfectious uveitic macular edema(UME). <p>METHODS: This was an open and prospective study without control trial. Seventeen eyes from 17 patients with UME diagnosed by fundus fluorescein angiography(FFA)and optical coherence tomography(OCT)were enrolled in this study. Before the injection, best-corrected visual acuity(BCVA)of early treatment of diabetic retinopathy study(ETDRS)and central macular thickness(CMT)measured by OCT were examined. All affected eyes were treated with intravitreal ranibizumab 0.05mL(0.5mg). The BCVA, CMT and intraocular pressure(IOP)were compared with baseline at 2, 4, 8 and 12wk after treatment. Related complications were recorded. <p>RESULTS: The median BCVA before treatment was 57(P₂₅ and P₇₅ were 52.5 and 64.5, respectively). The median CMT was 524μm(P₂₅ and P₇₅ were 365.5 and 571, respectively). At 2, 4, 8, and 12wk after injection, the median BCVA of the affected eyes was 76(P₂₅ and P₇₅ were 71 and 80, respectively), 81(P₂₅ and P₇₅ were 78.5 and 83, respectively), 82(P₂₅ and P₇₅ were 68.5 and 84, respectively), and 82(P₂₅ and P₇₅ are 78.5 and 83, respectively). The Friedman <i>M</i> test showed that there were differences in the BCVA in the four groups at different follow-up times, that was, BCVA after injection was higher than before injection(<i>χ</i>²=47.58, <i>P</i><0.01). At 2, 4, 8, and 12wk after injection, the median CMT was 307μm(P₂₅ and P₇₅ were 249.5 and 374.5, respectively),231μm(P₂₅ and P₇₅ were 212.5 and 267), 219μm(P₂₅ and P₇₅ were 210.5 and 365.5,respectively), and 217μm(P₂₅ and P₇₅ were 201.5 and 366.5,respectively). The Friedman <i>M</i> test showed that there was difference in the CMT in the four groups at different follow-up times(<i>χ</i>²=40.33, <i>P</i><0.01), that was, CMT after injection was lower than before injection. At the 12wk after injection, increased CMT and decreased BCVA were found in 35% of study eyes(6/17)that had uncontrolled intraocular inflammation, and all these patients needed to increase prednisone again. No adverse events were found during the follow-up duration.<p>CONCLUSION: Intravitreal ranibizumab is a safe and effective approach for noninfectious uveitic macular edema in the short term, which can significantly improve visual acuity and reduce CMT in patients refractory to or intolerant of standard corticosteroid/ immunomodulatory therapy.

Effects of the site and method of liposuction on differentiation of human preadipocytes / 中华整形外科杂志

<p><b>OBJECTIVE</b>To illustrate the effects of the site and method of liposuction on differentiation of human preadipocytes.</p><p><b>METHODS</b>Forty-two fatty samples were obtained with liposuction, which were then divided into four groups according to operation sites (abdomen, hip or extremity) and the methods (conventional negative-pressure or syringe method). Each sample was treated with collagenase I to release preadipocytes for in vitro culture. Affected by the differentiation-induced agents for 9 days or 28 days, the cultured adipocytes were stained with Nile red and observed under a fluorescent microscope. The differentiation rates were examined with flow cytometric analysis and the quantity of intracytoplasmic lipids was determined with oil red O staining. The results were analyzed with independent samples t-test (Mann-Whitney) using SPSS 10.0.</p><p><b>RESULTS</b>There was no statistical difference in differentiation at the 9th day or 28th day among the preadipocytes obtained from the abdomen, hip or extremity with the negative-pressure method. The preadipocytes from the abdomen differentiated more at the 28th day than the 9th day (P < 0.05), which was not observed in the hip or the extremity. The preadipocytes obtained from the abdomen with the negative-pressure method differentiated more than those with the syringe method (P < 0.05).</p><p><b>CONCLUSION</b>No essential difference was found in preadipocyte differentiation among the liposuction sites, while the abdomen might have some superiority. The negative-pressure method of liposuction is the first option in future research of tissue engineering. The flow cytometric analysis is a convenient way to study preadipocyte differentiation.</p>

Leg re-contouring by using a new technique of partially removing gastrocnemius / 中华整形外科杂志

<p><b>OBJECTIVE</b>To evaluate a method to partially remove gastrocnemius for improvement of the contour of the leg.</p><p><b>METHODS</b>Thirteen patients with bulked calf were undergoing the treatment. With a self-designed apparatus, the gastrocnemius was partially removed by placing the device in the muscle through an incision in the popliteal fossa. The follow-ups were carried out for 1-6 months.</p><p><b>RESULTS</b>Thirteen patients were successfully treated by above mentioned technique. The removed amount of muscle was weighted between 11 g and 201 g, averaged 77 g. All of the patients could be able to walk three days after the operation. But, the normal walk had to take 1 month after of the surgery for recovering. The function of the ankle joint was not obviously influenced.</p><p><b>CONCLUSION</b>The above mentioned technique is a safe and effective method for re-contouring the leg.</p>