This article is based on the work practice of Medical-lnsurance-Medicine Linkage carried out by the Nanping First Hospital Affiliated to Fujian Medical University under the reform of payment based on diagnosis related group (DRG). It outlines the connotation and extension of Medical-lnsurance-Medicine Linkage in the hospital, including concept definition, organizational structure, the relationship between DRG payment and Medical-lnsurance-Medicine Linkage, and summarizes the specific measures and positive results of the Medical-lnsurance-Medicine Linkage work mechanism from four aspects: medical quality management, medical insurance management, medical drugs/consumables management, and performance evaluation. These experiences are of great significance for improving the quality and efficiency of medical care, actively responding to the reform of medical insurance payment methods, enhancing the level of medical services in public hospitals, and achieving a win situation among the medical insurance management departments, hospitals, and patients.
ObjectiveTo evaluate the developing methodologies of Essential Medicines Lists for Children (EMLcs) in global, in order to provide reference in developing EMLc of China. MethodsWe searched ProQuest, ScienceDirect, SpringerLink and MEDLINE databases, World Health Organization (WHO) official website, and 67 websites of National Ministry of Health and Drug Administration Section, to collect literature about selection methodology of children and/or adult essential medicines list (EML). A descriptive analysis was conducted. ResultsA total of fourteen literatures were included. Of which, 6 were about the essential medicines selection methodology in children, and the other 8 were about the essential medicines selection methodology in adult. The WHO had established independent EMLc selection committee. Paediatricians were involved in the selection of EMLc in the WHO and India. There was no selection criteria and process for EMLc globally. The WHO, India, and South Africa selected their EMLcs referring to the WHO EML selection criteria. The WHO and South Africa had their own updating time, period and process for EMLc. The WHO EMLc was updated per 2 years, which in high frequency and conducts in rigorous process. However, the EMLc of India had not been updated yet. ConclusionIt is suggested that China could build a national EMLc selection committee involving paediatricians and evidence-based medicine experts etc. in referring to the framework of the WHO Child Health Working Group. The EMLc selection criteria and process of China could be established referring to the one of the WHO, based on the disease burden, drug accessibility and medical insurance of children of China. The EMLc of China should be simultaneously updated with the adult EML of China.
MTT assay was presented in this paper and used in 3 cases of retinoblastoma afert enucleation to evaluate the clinical effect of different chemotherapeutic agents.The results showed that the sensitivity of anticancer agents were various in different cases of retinoblastoma.The combining treatment of tow anticacer agents together was seemingly preferable to a single use.When a single drug was chosen,it was advisable to use carboplatin,cisplatin,mitomycin C or etopside.If a combination of 2 anticancer drugs were applied,vincristin with carboplatin or cisplatin will give a better effect than others,but vincristin is not sensitive when applied alone. （Chin J Ocul Fundus Dis,1993,9:207-209）
Objective To learn the current situation of traditional Chinese medicine (TCM) systematic reviews/meta-analyses published in Chinese journals. Methods All TCM systematic reviews/meta-analyses published from 1978 to July 31, 2009 were searched in the Chinese Biomedical Database (CBM). According to the inclusion and exclusion criteria, relevant information was extracted on the basis of research purpose. Meanwhile, publication year, journal name, author’s district, number of authors and their articles, types of diseases and interventions were took as the indexes, and then descriptive analysis was performed using SPSS 15.0 software. Results A total of 245 articles including 238 in Chinese and 7 in English were included. All of them were published in 117 different journals from 1998 to 2008, showing an accelerating growth trend of article number. In addition to only one article with first author from Germany, the first author of other 244 were from 24 domestic provinces (autonomous regions and municipalities); the number of authors ranged from 1 to 11; a total of 186 people had published articles as first author, and the number of their published articles ranged from 1 to 29. There were 16 types of diseases according to the International Classification of Diseases 10th Edition (ICD-10). Totally, 218 articles took drugs as interventions (including 106 listed drugs, 25 self-made prescriptions, 70 related to both listed drugs and self-made prescriptions, and 17 without reporting detailed interventions), accounting for 89%; and 27 articles were about non-drug interventions (including 26 about acupuncture and 1 about massage), accounting for 11%. Most (95.8%) of the articles about self-made prescriptions and listed drugs/self-made prescriptions adopted inappropriate pooled analyses. Conclusion Evidence-based medicine has been spread into the field of TCM, the number of TCM systematic reviews/meta-analyses shows an accelerated growth trend. The types of diseases discussed in the literature were almost the same as the diseases those could be effectively treated by TCM, but there existed imbalance in districts. In the future, systematic review/meta-analysis on drug intervention should aim at Chinese patent medicines and single medicines rather than self-made prescriptions, and should pay more attention to advantageous drugs and advantageous treatments of diseases. Moreover, importance should be also attached to clinical heterogeneity controlling when using acupuncture as a non-drug intervention.
There are a great number of uncertainties in medical practice, causing considerable difficulties in medical activities such as diagnosis and prognostic prediction. Neural-fuzzy system (NFS) combines the advantages of artificial neural networks and fuzzy logic very well, and has become a new type of artificial intelligence model which is capable of acquiring knowledge from data and expressing it in the form of fuzzy rules. Because of its strong capability of classification and processing fuzzy information, NFS is more and more used in medical practice. Adaptive neural-fuzzy inference system (ANFIS) is one of the most popular forms of NFS. This review focuses on the use of ANFIS in medical practice.
ObjectiveTo understand the current situation and challenges of basic research on respiratory diseases in China.MethodsTo summarize and analyze the application and projects funded in the field of respiratory medicine (Code: H01 and H1615) from National Natural Science Foundation of China (NSFC) during 2010 to 2017.ResultsA total of 2 191 projects of 11 766 applications were funded by NSFC in the field of respiratory medicine and the total subsidy fund reached ￥981 279 000. A total of 1 130 projects of 5 915 applications were funded in the Research Projects, including 1 021 General Program projects, 14 Key Program projects, 16 Major Research Plan projects, 1 Major Research Program project, 2 Program projects of Joint Funds, 30 International (Regional) Cooperation and Exchange Program projects, and 46 Emergency Management Program projects. A total of 1 061 projects of 5 851 applications were funded in the Talent Projects, including 853 Young Scientists Fund projects, 191 projects of Fund for Less Developed Regions, 4 projects of Distinguished Young Scholars, 4 projects of Excellent Young Scientists Fund, and 9 projects of the Research Fund for International Young Scientists. The projects funded were mainly distributed in the field of respiratory inflammation and infection, asthma, chronic obstructive pulmonary disease, pulmonary circulation and pulmonary vascular disease. The top three research directions were asthma (19.0%), acute lung injury and acute respiratory distress syndrome (15.4%), chronic obstructive pulmonary disease (12.7%), pulmonary circulation and pulmonary vascular disease (12.7%) in sequence. Average funding rate of respiratory tumor (application code: H1615) was 17.2%.ConclusionsSince the Department of Health Science of NSFC was established in 2009, with the increasing of NSFC budget, the basic research in the field of Respiratory Medicine has been developed rapidly. With the efforts of scientific researchers and clinical medical workers, research in the field of respiratory medicine will achieve rapid development in China.
Objective To evaluate the efficacy and safety of Chinese herb compared with an analgesic drug in the treatment of cancer pain. Methods We electronically searched CBM (1990 to 2008), CNKI (1990 to 2008), VIP (1990 to 2008), The Cochrane Library (Issue 3, 2008), and MEDLINE (1990 to 2008). Relevant journals and conference proceedings were also handsearched. The quality of the included trials was assessed according to the criteria recommended by the Cochrane Handbook for systematic reviews of interventions and meta-analyses were performed for homogeneous studies using the Cochrane collaboration’s review manager 4.2.2 software. Results Five randomized controlled trails (RCTs), all published in Chinese, involving 590 participants, were included. The quality of all RCTs was graded C (low). Meta-analyses were not performed due to heterogeneity. Instead, descriptive analyses were conducted. The results showed that as for the total effective rate in pain-relieving, Zhentongsan (RR=1.11, 95%CI 1.00 to 1.24, P=0.05) and Xiaozhengzhitong paste (RR=1.35, 95%CI 1.02 to 1.78, P=0.04) were more effective than Indometacin, with significant differences. There were no significant differences between Duyiwei capsule and Indometacin, and so were between Huajianbadumo as well as Shebingzhitong paste and Tramado. In terms of early potency, there were significant differences between Zhentongsan (SMD= –?9.87, 95%CI –10.84 to –8.89, Plt;0.000 01) as well as Xiaozhengzhitong paste (SMD= –8.74, 95%CI –10.164 to –7.32, Plt;0.000?01) and Indometacin, and so were between Shebingzhitong paste and Tramadol (SMD= –2.24, 95%CI –3.00 to –1.49, Plt;0.000?01). There were no significant differences between Huajianbadumo and Tramodo. With regard to the durative effect on pain-relieving, there were significant differences between Xiaozhengzhitong paste and Indometacin (WMD=4.78, 95%CI 2.99 to 6.57, Plt;0.00001), but not between Shebingzhitong paste and Tramadol. Conclusion Because of low quality of the existing studies, the current evidence is insufficient to define the efficacy and safety of compound Chinese herb, and further large-scale and high-quality RCTs are needed.
ObjectiveTo investigate the drug use,symptoms and lung function of asthma patients in communities. MethodsA cooperation project of "Cohort Study in Putuo District Health Survey" was conducted by Shanghai Putuo People's Hospital and the Harvard School of Public Health from August 2007 to January 2010 .Home questionnaires were collected in the communities in 13 residential quarters in Changzheng town,Ganquan town in Putuo District,Shanghai. ResultsA total of 27 042 respondents was inquired,in which there were a total of 488 asthma patients with the total prevalence rate of 1.80 percent. 189 cases (47.49%) frequently used anti-asthma drugs in nearly a year,and 209 cases (52.51%) less frequently used anti-asthma drugs. In the patients frequently using anti-asthma drugs,FEV1%pred was (65.30±25.78)% with FEV1%pred ≥80% in 50 cases (32.68%).St. George score was 36.80±28.02 in this subgroup.More symptoms presented in 129 cases(69.73%)in the past year. In the patients less frequently using anti-asthma drugs,FEV1%pred was (81.55±19.01)% with FEV1%pred ≥80% in 99 cases (56.57%). St. George score was 7.61±15.56.There were symptoms presented in 42 cases (20.59%) in the past year. ConclusionMore than half asthmatic patients do not receive regular medicine treatment in communities in Shanghai. Some patients still suffer from asthma symptoms long with poor St. George score and lung function although frequently using anti-asthma medication,suggesting asthma treatment is not standard.
Objective To analyze the hot topics and trends of medical research integrity in China and to provide references for future studies. Methods The CNKI, WanFang Data and VIP databases were searched from inception to December 2021. Data on the number of publications, journals, institutions, authors, keywords, and emergent themes were analyzed using bibliometric methods and CiteSpace software. Results A total of 324 studies were included. The results showed that the number of publications increased annually, and "Chinese Journal of Medical Science Research Management" and Peking University were the journal and institution with the most publications, respectively. The three most prolific authors published five studies each, and the publications were mainly concerned with identifying and preventing issues, in addition to education regarding medical research integrity. Conclusion Medical research integrity in China has attracted significant attention. Several leading journals in this research field have emerged; however, there is no clearly dominant research team. The depth and breadth of the research remain to be improved. It is suggested that researchers focus on the effectiveness of strategies for preventing issues, promoting the establishment of the lifelong education system and improving related rules and regulations to advance the development of medical research integrity in China.