Health poverty alleviation is an important practice in implementing the basic strategy of precision poverty alleviation. It is also an important measure to win the battle against poverty in rural areas. Through the investigation of local medical and health conditions, West China Hospital of Sichuan University built a demand-oriented framework for medical poverty alleviation in Ganzi Prefecture, and gradually carried out precision top-level design, discipline construction, technical training, talent training, endemic disease prevention and control; through establishinga regional medical cooperation network, built featured specialies, built the backbone of medical and health forces, achieved the prevention of endemic diseases throughout life cycle, and improved the overall medical and health service capacity of Ganzi Prefecture. This article introduces the exploration and practice of the demand-oriented model in Ganzi Prefecture by West China Hospital of Sichuan University, aiming at providing a guide for the precision health poverty alleviation in China.
Tuberculosis (TB) is one of the major public health concerns worldwide. Since the development of precision medicine, the filed regarding TB control and prevention has been brought into the era of precision medicine. Although great progress has been achieved in the accurate diagnosis, treatment and management of TB patients, we have to face several challenges. We should seize the opportunity, and develop and improve novel measures in TB prevention on the basis of precision medicine. The accurate diagnosis criteria, treatment regimen and management of TB patients should be carried out according to the standard of precision medicine. We aim to improve the treatment of TB patients and prevent the transmission of TB in the community, thereby contributing to the achievement of the End TB Strategy by 2035.
West China Hospital of Sichuan University as a national-level regional medical center in the western part of the country, focused on the actual situation in Tibet and actively carried out precision health poverty alleviation work. Guided by " precision”, the hospital has built a close-knit medical association – Hospital of Tibet People’s Government in Chengdu Office, and through the comprehensive improvement of medical care, teaching, scientific research, and management, creates a medical and health service system with Tibet characteristics. Combining " blood transfusion” and " hematopoietic” to build a " West China Model” for precision health poverty alleviation, West China Hospital of Sichuan University fully demonstrates the public welfare and responsibility of a national-level regional medical center, and constantly exerts regional radiation and leading role, promotes the medical and health service system continuous improvement in Tibet.
ObjectiveTo evaluate the complete blood count performance quality of Sysmex-XN automatic hematology analyzer. MethodsWe investigated the precision rate, residual contamination rate, analytic linearity range, and background counting of Sysmex-XN-B3 analyzer. ResultsThe inner and inter-group precision test showed that the inaccuracy of the analyzer was lower than the allowable standard of 1/4 (CLIA'88). The highest level of residual contamination rate was 0.12%, lower than the standard of manufacturer (≤1%). Linearity evaluation showed that the white blood cell count analytic linear range was from 0.51×109/L to 393.40×109/L, the red blood cell count analytic linear range was from 0.51×1012/L to 8.15×1012/L, the hemoglobin analytic linear range from 15.0 g/L to 244.5 g/L, and the platelet count analytic linear range was from 3.0×109/L to 2 072.5×109/L. Background counting was also lower than the standard of manufacturer. Comparison between the two different series of analyzers showed that the inaccuracy rate of Sysmex-XN-B3 was not only lower than the standard of National Center for Clinical Laboratories, but also lower than the standard of 1/2 (CLIA'88). ConclusionSysmex-XN automatic hematology analyzer has a high performance in capability evaluation. It is an excellent tool for routine hematologic blood examination.
Basing on development of medical model, new national diagnostic standard is interpreted according to three aspects: classification, diagnostic standard, and diagnostic contents. Tracheobronchial tuberculosis and tuberculous pleurisy are added into the classification. The value of molecular and pathological techniques for diagnosis of the pulmonary tuberculosis is emphasized. The status of drug-resistance is included in the diagnostic content. Two opinions are suggested: some practical methods such as diagnostic chemotherapy are indicated in some grassroots areas, while new molecular techniques for detection of DNA/RNA of mycobacteria and resistant mutation are encouraged in some suitable institutions.
Precision medicine is a novel medical modality based on genome sequencing, bioinformatics and big data science. The studies regarding tuberculosis always concentrated on the bacteria and host in the setting of precision medicine. This review mainly introduces the application of precision medicine in the diagnosis and treatment of tuberculosis. The limits of the Chinese studies with respect to precision medicine in tuberculosis are also discussed. Moreover, the article predicates its future development.
The prevention and control of hospital infection should be precise. Otherwise, a lot of medical resources will be wasted. To achieve accuracy, prevention and control should be considered from the microbial level to enhance its scientific nature. It is specifically reflected in the need of having knowledge of microorganisms, understanding the pathogens of infection and their transmission routes, therefore to carry out prevention and control work contrapuntally. Specific measures include infection surveillance at the microbial level, establishing the idea and habits of infection diagnosis from the microbial level, being familiar with microbial perspective to identify infection risks and vulnerabilities, implementing evidence-based prevention and control measures for different pathogens, encouraging researches on infection control and management at the microbial level, and developing precise prevention and control regulations, standards, or guidelines for specific pathogens.
Retinitis pigmentosa (RP) is an inherited retinal disease characterized by degeneration of retinal pigment epithelial cells. Precision medicine is a new medical model that applies modern genetic technology, combining living environment, clinical data of patients, molecular imaging technology and bio-information technology to achieve accurate diagnosis and treatment, and establish personalized disease prevention and treatment model. At present, precise diagnosis of RP is mainly based on next-generation sequencing technology and preimplantation genetic diagnosis, while precise therapy is mainly reflected in gene therapy, stem cell transplantation and gene-stem cell therapy. Although the current research on precision medicine for RP has achieved remarkable results, there are still many problems in the application process that is needed close attention. For instance, the current gene therapy cannot completely treat dominant or advanced genetic diseases, the safety of gene editing technology has not been solved, the cells after stem cell transplantation cannot be effectively integrated with the host, gene sequencing has not been fully popularized, and the big data information platform is imperfect. It is believed that with the in-depth research of gene sequencing technology, regenerative medicine and the successful development of clinical trials, the precision medicine for RP will be gradually improved and is expected to be applied to improve the vision of patients with RP in the future.
Precision poverty alleviation is the key task of China’s development, and its accuracy needs to be ensured in the implementation process. From the perspective of policy tools, this article defines the types of precision health poverty alleviation policy tools and explains the specific tools included in each type. Precision health poverty alleviation includes precision identification, precision implementation and precision assessment. This article also analyzes the selection of policy tools in different links. On this basis, combined with the choice of policy tools and the actual development of China, the problems in the application of different types of policy tools are summarized, and corresponding suggestions are put forward based on the existing problems. The purpose of this article is to providea reference for promoting the implementation of precision health poverty alleviation policies.
The umbrella trial has received increasing attention in the design of clinical trials for oncology drugs in recent years. This trial design categorizes a single disease into multiple sub-types based on predictive biomarkers or other predictive factors, and simultaneously evaluates the efficacy of multiple targeted therapies. When compared with the traditional drug development model of phase Ⅰ, phaseⅡ, and phase Ⅲ randomized controlled trials, umbrella trials are a more scientifically rigorous trial design that can speed up drug evaluation to address the conflict between numerous untested drugs and diseases with a lack of effective treatment options. This article will focus on the concept, main characteristics, eligibility criteria, design and statistical considerations, ethical considerations, and future directions of umbrella trials, with the aim of providing methodological guidance for the design of clinical trials for oncology drugs.