As a chronic disease that seriously endangers public health, the number of coronary heart disease (CHD) patients in China has increased in recent years. There is great potentiality to integrate traditional Chinese a...As a chronic disease that seriously endangers public health, the number of coronary heart disease (CHD) patients in China has increased in recent years. There is great potentiality to integrate traditional Chinese and Western medicine therapies to prevent and treat CHD in clinical practice. However, most of the current integrated therapies still lack sufficient high-quality evidence, and the key links in how to apply are unclear. It is urgent to optimize them through evidence-based research to further improve the effectiveness. Therefore, we propose strategies to conduct evidence-based optimization of integrated traditional Chinese and Western medicine therapies in prevention and treatment of progressive cardiovascular diseases. These are integrated clinical trial design, attention to the key links of taking effect, combination of clinical and basic research. Based on the strategies, we started the national key research and development project "Evidence-based optimization research of TCM therapies in prevention and treatment of CHD (angina pectoris - myocardial infarction - heart failure)", which is expected to be a new paradigm in the field.展开更多
Objective To analyze the development of“internet plus medical treatment”and to explore advantages.Methods The literature of“internet plus medical treatment”was systematically combed and analyzed.Results and Conclu...Objective To analyze the development of“internet plus medical treatment”and to explore advantages.Methods The literature of“internet plus medical treatment”was systematically combed and analyzed.Results and Conclusion After exploring the status quo of“internet plus hospitals”,smart pharmacy and web-assisted health management in China,we find that there are some problems in the medical service at present,such as the imperfect laws and regulations,the hidden dangers of information security and the obstacles of medical insurance payment.Therefore,we propose that the development of web-assisted medical service should be led by the government and relevant policies must be improved.Then,self-regulation should be strengthened,and industry standards should be enhanced.Three suggestions are made to improve medical insurance payment and benefit both hospitals and patients,which can provide reference for promoting the development of“internet plus medical treatment”in China.展开更多
Objective To explore the different modes and approaches of medical and preventive integration in current primary health care institutions in China.Methods Through literature analysis,field research,telephone interview...Objective To explore the different modes and approaches of medical and preventive integration in current primary health care institutions in China.Methods Through literature analysis,field research,telephone interviews,and other methods the implementation status was evaluated to systematically study the main experience and effect of implementing medical and preventive integration services in pilot areas.Results and Conclusion At present,there are three implementation modes of medical-prevention integration,namely,vertical mode based on the medical community,internal mode with optimized service process,and internal mode with great service capabilities.The three medical-prevention integration modes have their respective focuses,but they need to be further improved in terms of policy support,technical staffing,information system construction,and drug use.展开更多
Objective:To understand the clinical manifestation of severe acute respiratory syndrome (SARS) and explore its effective treatment with integrative Chinese and western medicine (ICWM). Methods:The data of patients, wh...Objective:To understand the clinical manifestation of severe acute respiratory syndrome (SARS) and explore its effective treatment with integrative Chinese and western medicine (ICWM). Methods:The data of patients, whose diagnosis of SARS had been confirmed were summarized and analyzed, and clinical observation was conducted when the patients were treated with ICWM. Results:In the early stage of the 42 patients, the symptoms revealed were fever in 100% of SARS patients, headache in 92. 9%, aversion to cold in 76. 2%, chest stuffiness in 76. 2% , cough in 73. 8% and myalgia in 88.1%; pulmonary lesion involves >3 lobes in 42. 9%, 2 lobes in 47. 6% and 1 lobe in 9. 5%; 61. 9% of them showed liver function abnormality (increase of ALT or AST), 47. 6% showed elevated myocardial enzyme (CK or CK-MB) , 0. 48% showed an inclination of renal function (higher of BUN or Cr); in their T lymphocyte subsets, 91. 2% (31/34 patients) had lowered CD3 and 76. 5% (26/34 patients) lowered CD4/CD8 ratio. In the mid-late stage, the symptoms were lassitude and weakness in 85. 7%, scare in 81. 0%, short of breath or chest stuffiness in 71. 4%, loss of appetite in 64. 3%;light dark tongue proper in 52. 4%, yellow and white tongue coating in 45. 2%, and yellow thick coating on the middle-root part of the tongue in 21. 4%. Most of them were asymptomatic when discharged from hospital, with 92. 8% of their pulmonary lesion, according to chest film, completely absorbed and liver function, myocardial enzyme and renal function all normalized. However, of the 30 patients who had CD3 reexamination, 70% of the CD3 showed lower than normal range and 36. 7% showed their CD4/CD8 inclined to lower margin, follow-up should be done for these patients. Of the 42 patients, who received western medicine (WM) alone in the early stage and ICWM in the mid-late stage, 10 were severe cases and 3 critical cases, but none of them died. The mean defervescent time was 3. 52±0. 85 days, the time for complete absorption of pulmonary lesion judged by chest X-ray film was 26. 82±5. 98 days, and the mean hospitalization time was 33. 60±4. 37 days. Conclusion:The manifestation of SARS is multifarious, showing that there were damage in multiple organs. The T lymphocyte count percentage and its subsets, CD3 and CD4 /CD8 ratio, are valuable for early diagnosis and follow-up in the rehabilitation stage. Majority of the patients could be clinically cured. Combined treatment of WM and TCM according to syndrome differentiation and psychiatric intervention are beneficial to remit partial symptoms and promote rehabilitation.展开更多
In spite of a documented reduction in incidence in highincome countries over the last decades, stroke is still a leading cause of death and disability worldwide. With the ageing of the population stroke-related econom...In spite of a documented reduction in incidence in highincome countries over the last decades, stroke is still a leading cause of death and disability worldwide. With the ageing of the population stroke-related economic burden is expected to increase, because of residual disability and its complications, such as cognitive impairment, high risk of falls and fractures, depression and epilepsy. Furthermore, because of the substantial rate of early and long-term vascular recurrences after the first event, secondary prevention after cerebral ischaemia is a crucial issue. This is even more important after minor stroke and transient ischaemic attack(TIA), in order to reduce the risk of potentially more severe and disabling events. To accomplish this aim, acute long-term medical and surgical treatments as well aslifestyle modifications are strongly recommended. However, apart from the well-established indications to thrombolysis, studies in acute phase after a first stroke or TIA are scarce and evidence is lacking. More trials are available for long-term secondary prevention with different classes of drugs, including antithrombotic medications for ischaemic events of arterial and cardiac origin, especially related to atrial fibrillation(antiplatelets and anticoagulants, respectively), lipid lowering agents(mainly statins), blood pressure lowering drugs, surgical and endovascular revascularization procedures.展开更多
药物相关性颌骨坏死(medication-related osteonecrosis of the jaw,MRONJ)是指因恶性肿瘤骨转移、骨质疏松等疾病使用抗骨吸收类药物(anti-resorptive,AR)和抗血管生成类药物(anti-angiogenic,AA)等所致的颌骨代谢紊乱及骨坏死类疾病...药物相关性颌骨坏死(medication-related osteonecrosis of the jaw,MRONJ)是指因恶性肿瘤骨转移、骨质疏松等疾病使用抗骨吸收类药物(anti-resorptive,AR)和抗血管生成类药物(anti-angiogenic,AA)等所致的颌骨代谢紊乱及骨坏死类疾病。美国口腔颌面外科医师协会(American Association of Oral and Maxillofacial Surgeons,AAOMS)根据临床表现将MRONJ分成5期,其中,风险期指口服或静脉注射相关药物的患者,颌面部无任何异常症状;0期指没有发现临床可见的颌骨坏死,但是有非特异性的临床表现、影像学变化和症状。目前,0期MRONJ的诊断和治疗方法尚存在不确定性,如何有效预防风险期和0期患者向确立期的MRONJ转化存在争议。本文通过回顾0期MRONJ的诊断方法与治疗现状,分析针对风险期患者实施口腔有创操作的临床实践与研究成果,指出当前研究领域中存在的争议点与不确定性,旨在为未来的科学研究与临床实践提供参考与启示。展开更多
文摘As a chronic disease that seriously endangers public health, the number of coronary heart disease (CHD) patients in China has increased in recent years. There is great potentiality to integrate traditional Chinese and Western medicine therapies to prevent and treat CHD in clinical practice. However, most of the current integrated therapies still lack sufficient high-quality evidence, and the key links in how to apply are unclear. It is urgent to optimize them through evidence-based research to further improve the effectiveness. Therefore, we propose strategies to conduct evidence-based optimization of integrated traditional Chinese and Western medicine therapies in prevention and treatment of progressive cardiovascular diseases. These are integrated clinical trial design, attention to the key links of taking effect, combination of clinical and basic research. Based on the strategies, we started the national key research and development project "Evidence-based optimization research of TCM therapies in prevention and treatment of CHD (angina pectoris - myocardial infarction - heart failure)", which is expected to be a new paradigm in the field.
基金Source of the project:2021 Scientific Research Project of Liaoning Provincial Department of Education(No.LJKR0298).
文摘Objective To analyze the development of“internet plus medical treatment”and to explore advantages.Methods The literature of“internet plus medical treatment”was systematically combed and analyzed.Results and Conclusion After exploring the status quo of“internet plus hospitals”,smart pharmacy and web-assisted health management in China,we find that there are some problems in the medical service at present,such as the imperfect laws and regulations,the hidden dangers of information security and the obstacles of medical insurance payment.Therefore,we propose that the development of web-assisted medical service should be led by the government and relevant policies must be improved.Then,self-regulation should be strengthened,and industry standards should be enhanced.Three suggestions are made to improve medical insurance payment and benefit both hospitals and patients,which can provide reference for promoting the development of“internet plus medical treatment”in China.
基金Source of the project:the Social Science Planning Fund Project of Liaoning Province(L19BG034)the Philosophy and Social Science Planning Key Project of Shenyang City(SZ202001L)the Key Project of Shenyang Social Science Funding(SYSK2020-04-01).
文摘Objective To explore the different modes and approaches of medical and preventive integration in current primary health care institutions in China.Methods Through literature analysis,field research,telephone interviews,and other methods the implementation status was evaluated to systematically study the main experience and effect of implementing medical and preventive integration services in pilot areas.Results and Conclusion At present,there are three implementation modes of medical-prevention integration,namely,vertical mode based on the medical community,internal mode with optimized service process,and internal mode with great service capabilities.The three medical-prevention integration modes have their respective focuses,but they need to be further improved in terms of policy support,technical staffing,information system construction,and drug use.
文摘Objective:To understand the clinical manifestation of severe acute respiratory syndrome (SARS) and explore its effective treatment with integrative Chinese and western medicine (ICWM). Methods:The data of patients, whose diagnosis of SARS had been confirmed were summarized and analyzed, and clinical observation was conducted when the patients were treated with ICWM. Results:In the early stage of the 42 patients, the symptoms revealed were fever in 100% of SARS patients, headache in 92. 9%, aversion to cold in 76. 2%, chest stuffiness in 76. 2% , cough in 73. 8% and myalgia in 88.1%; pulmonary lesion involves >3 lobes in 42. 9%, 2 lobes in 47. 6% and 1 lobe in 9. 5%; 61. 9% of them showed liver function abnormality (increase of ALT or AST), 47. 6% showed elevated myocardial enzyme (CK or CK-MB) , 0. 48% showed an inclination of renal function (higher of BUN or Cr); in their T lymphocyte subsets, 91. 2% (31/34 patients) had lowered CD3 and 76. 5% (26/34 patients) lowered CD4/CD8 ratio. In the mid-late stage, the symptoms were lassitude and weakness in 85. 7%, scare in 81. 0%, short of breath or chest stuffiness in 71. 4%, loss of appetite in 64. 3%;light dark tongue proper in 52. 4%, yellow and white tongue coating in 45. 2%, and yellow thick coating on the middle-root part of the tongue in 21. 4%. Most of them were asymptomatic when discharged from hospital, with 92. 8% of their pulmonary lesion, according to chest film, completely absorbed and liver function, myocardial enzyme and renal function all normalized. However, of the 30 patients who had CD3 reexamination, 70% of the CD3 showed lower than normal range and 36. 7% showed their CD4/CD8 inclined to lower margin, follow-up should be done for these patients. Of the 42 patients, who received western medicine (WM) alone in the early stage and ICWM in the mid-late stage, 10 were severe cases and 3 critical cases, but none of them died. The mean defervescent time was 3. 52±0. 85 days, the time for complete absorption of pulmonary lesion judged by chest X-ray film was 26. 82±5. 98 days, and the mean hospitalization time was 33. 60±4. 37 days. Conclusion:The manifestation of SARS is multifarious, showing that there were damage in multiple organs. The T lymphocyte count percentage and its subsets, CD3 and CD4 /CD8 ratio, are valuable for early diagnosis and follow-up in the rehabilitation stage. Majority of the patients could be clinically cured. Combined treatment of WM and TCM according to syndrome differentiation and psychiatric intervention are beneficial to remit partial symptoms and promote rehabilitation.
文摘In spite of a documented reduction in incidence in highincome countries over the last decades, stroke is still a leading cause of death and disability worldwide. With the ageing of the population stroke-related economic burden is expected to increase, because of residual disability and its complications, such as cognitive impairment, high risk of falls and fractures, depression and epilepsy. Furthermore, because of the substantial rate of early and long-term vascular recurrences after the first event, secondary prevention after cerebral ischaemia is a crucial issue. This is even more important after minor stroke and transient ischaemic attack(TIA), in order to reduce the risk of potentially more severe and disabling events. To accomplish this aim, acute long-term medical and surgical treatments as well aslifestyle modifications are strongly recommended. However, apart from the well-established indications to thrombolysis, studies in acute phase after a first stroke or TIA are scarce and evidence is lacking. More trials are available for long-term secondary prevention with different classes of drugs, including antithrombotic medications for ischaemic events of arterial and cardiac origin, especially related to atrial fibrillation(antiplatelets and anticoagulants, respectively), lipid lowering agents(mainly statins), blood pressure lowering drugs, surgical and endovascular revascularization procedures.
文摘药物相关性颌骨坏死(medication-related osteonecrosis of the jaw,MRONJ)是指因恶性肿瘤骨转移、骨质疏松等疾病使用抗骨吸收类药物(anti-resorptive,AR)和抗血管生成类药物(anti-angiogenic,AA)等所致的颌骨代谢紊乱及骨坏死类疾病。美国口腔颌面外科医师协会(American Association of Oral and Maxillofacial Surgeons,AAOMS)根据临床表现将MRONJ分成5期,其中,风险期指口服或静脉注射相关药物的患者,颌面部无任何异常症状;0期指没有发现临床可见的颌骨坏死,但是有非特异性的临床表现、影像学变化和症状。目前,0期MRONJ的诊断和治疗方法尚存在不确定性,如何有效预防风险期和0期患者向确立期的MRONJ转化存在争议。本文通过回顾0期MRONJ的诊断方法与治疗现状,分析针对风险期患者实施口腔有创操作的临床实践与研究成果,指出当前研究领域中存在的争议点与不确定性,旨在为未来的科学研究与临床实践提供参考与启示。