We studied policies of traditional Chinese medicine (TCM) on four levels ( national,Shanghai city, Pudong New District and community health services (CHS)) from 2008 to 2009 with the method of literature review,questionnaire survey and group interview. 18 national, 5 Shanghai's, 4 Pudong New District's and 87 CHS' TCM related policies were identified. By defining the development target,financial capability, human resource and proper technology of TCM care, those policies ensured and prompted the progression of community TCM services. Yet TCM policy fulfill in community remained lagged,and talent cultivating, medical insurance support and TCM participating in public health needed to be improved.

Objective To conduct a health check-up intention analysis to understand residents' altitude to health eheck-up. Methods A total of 3600 residents living in Shanghai completed the selfdesigned questionnaire. Results About 35.2% participants received health check-up onee per year. In 36 to 60 or > 60 age group, the figure was increased up to 62.6% or 50. 4%, respectively. Public institution employees and those with medical insurance were found to have the highest rate of health checkup. Conclusion Our investigation results suggest that government leadership,health management model and contents, and personnel training should be improve.

Background Laser in situ keratomileusis (LASIK) is widely applicated to correct the refractive error in ophthalmology nowadays.However,the morphology and structure changes of anterior eye segment caused by the ablation of corneal stroma and suction of negative pressure during surgery should be concerned.Objective This study was to assess the changes of the anterior eye segment parameters and the factors influencing these parameters after LASIK.Methods The clinical data of 59 eyes of 31 patients who received LASIK in Chongqing Medal Eye Institute during May 2012 to July 2013 were retrospectively analyzed.The mean age of the patients was (24.52±8.41) years and the spherical equivalent was (-5.96±3.75) D.The central anterior chamber angle (ACA),anterior chamber volume (ACV),anterior chamber depth (ACD) were measured with Sirius Scheimpflug tomography,and lens thickness (LT) was measured by A-scan before operation and 1,3,6 months after operation.The anterior chamber was divided into anterior and posterior parts by the plane of cornea 4 mm radius area.The ACD of cornea 4 mm radius area sagittal height section (Sag4mm ACD) (the height from posterior corneal vertex to corneal radius of 4 mm plane) and residual ACD (RACD) (the height from corneal radius of 4 mm plane to the anterior lens surface) were computed.The association between ACD and RACD or LT were assessed by Pearson correlation analysis.Results The ACA,ACV,ACD,RACD and LT were significantly different among various time points before and after LASIK (F =8.319,P＜0.05;F =11.596,P＜0.05;F =24.045,P＜0.01;F =16.087,P＜0.05;F =15.333,P＜0.01),and the ACA,ACV,ACD and RACD were significantly decreased 1-6 months after LASIK than those before LASIK (all at P＜0.05).There were no significant differences in the Sag4 mm ACD between pre-and postLASIK (all at P＞0.05).The LT was significantly increased after surgery in comparison with that before surgery (P＜0.01).The positive correlations were found between RACD and ACD before LASIK and in 1,3,6 months after LASIK (r =0.976,0.824,0.724,0.938,all at P＜0.05) and negative correlation between LT and ACD in 3 and 6 months after LASIK (r=-0.344,P＜0.01;r =-0.363,P＜0.01).Conclusions The ACD decrease following LASIK mainly in the sector from the plane of cornea 4 mm radius area to lens surface.The change of ACD might be associated with forward shifting of anterior lens surface caused by enhanced accommodation.

Objective To investigate the efficacy and adverse events of BACOD regimen for relapsed and refractory non-Hodgkin lymphoma (NHL). Methods Sixty patients with relapsed and refractory NHL received chemotherapy of BACOD regimen: bleomycin 10 mg/m2, intravenous drip on the 2nd and 9th day;cyclophosphamide 750 mg/m2, intravenous drip on 1st day; vindesine 3 mg/m2, intravenous drip on 1st and 8th day; cytarabine 150 mg/m2, intravenous drip on 2nd-5th days; dexamethasone 10 mg/m2, intravenous drip on 2nd-5th days; every 3 weeks was one cycle. Results Eighteen cases (27.7 %) received the complete remission (CR), 30 the partial remission (PR), 13 stable disease (SD) and 4 progressive disease (PD). The overall response (CR+PR) rate was 70.8 %. The median remission time of patients with response was 11 months(2-38 months). The 1-year survival rate was 32.3 % and the 2-year survival rate was 24.6 %. The main adverse events were myelosuppression. Conclusion BACOD regimen can be used as the relief regimen of relapsed and refractory NHL.

OBJECTIVETo explore the relationship between job burnout and cognitive function and the influencing factors of job burnout among medical staff.

METHODSQuestionnaire survey was conducted for 197 medical workers in a grade-three general hospital in Beijing. Maslach Burnout Inventory-General Survey (MBI-GS) was carried out to assess the degree of job burnout among medical staff; Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used to evaluate the overall cognitive function and cognitive situations of different dimensions.

RESULTS(1) There was a certain level of job burnout among medical staff, especially for the emotional exhaustion dimension (13.29 ± 7.67). (2) High level job burnout group (81.08 ± 12.34) scored lower on visual span than low level job burnout group (92.48 ± 19.62), P<0.05. Overall, job burnout had a negative influence on the general cognitive function (P<0.05). (3) The results of regression analysis indicated that, inefficacy was negatively correlated with age (r=-0.162, P<0.05). Job burnout was positively correlated with level of education (r=0.234, P<0.05) as well as exercise frequency (r=0.320, P< 0.001), and emotional exhaustion was correlated with overtime work (r=0.135, P<0.05); Level of job burnout stayed higher among doctors and nurses, compared with administration staff in hospitals (t=2.966, P<0.05).

CONCLUSIONJob burnout of medical staff was relatively in high level; influenced by age, education level, overtime work, exercise frequency and occupational type, job burnout affected the visual span and general cognitive function.

Burnout, Professional ; Cognition ; Hospitals ; Humans ; Medical Staff ; psychology ; Nurses ; supply & distribution ; Physicians ; psychology ; Regression Analysis ; Surveys and Questionnaires

Dorzagliatin is a new dual action allosteric systemic glucokinase agonist (GKA), which can simultaneously activate the glucokinase (GK) in the pancreas and liver, promote insulin secretion and liver glycogen conversion in patients with type 2 diabetes, and improve pancreatic islets β - Cell function and insulin resistance simultaneously stimulate intestinal GK to regulate the secretion of Glucagon-like peptide-1 to play multiple hypoglycemic effects. As the first marketed GKA drug, it provides a new therapeutic approach for patients with type 2 diabetes. This article reviews the mechanism of action, pharmacokinetics, Drug interaction, clinical research and safety of Dorzagliatin.

Objective:To quantify any correlation between the severity of spinal curvature of an adolescent with idiopathic scoliosis and their cardiopulmonary exercise endurance.Methods:The cardiopulmonary exercise test (CPET) results and the full-length spinal X-rays in a standing position of 64 adolescents with idiopathic scoliosis were reviewed retrospectively. Independent t-tests were used to compare the two datasets obtained from those with left or right thoracic scoliosis. The correlation between the Cobb angle and cardiopulmonary exercise endurance was analyzed using Pearson correlation coefficients, multiple factor linear regression and two-stage linear regression.Results:After adjusting for gender, age, height and weight, the multiple linear regression analysis showed that the Cobb angle was significantly negatively correlated with maximum tidal volume (β=-0.013) and significantly positively correlated with the rate of respiration (β=0.421). The relationship between the Cobb angle and cardiopulmonary exercise endurance was non-linear. With a Cobb angle > 34°, a 1° increase reduces cardiopulmonary exercise endurance by a factor of 1.4 on average. At smaller Cobb angles the corresponding increase is about 0.87 times.Conclusions:The Cobb angle is a negative predictor of ventilation during exercise among adolescents with idiopathic scoliosis. The more severe a patient′s spinal curvature, the lower the cardiopulmonary exercise endurance is likely to be.

The laboratory medicine is aimed to support clinical decisions and patient health by providing accurate results. The internal statistical quality control (SQC) can help laboratories detecting the instability of the analytical system and preventing laboratories from reporting the patient results with medically important errors, so it is essential to ensure the quality of testing results and patient safety. The traditional methods of designing SQC strategy are based on the probability of error detection (P_ed) and the probability of false rejection (P_fr). With the introduction of risk management concepts, the design of SQC strategy began to be based on the patient risk parameter [MaxE(N_uf)] proposed by Parvin, which means the maximum increase in the number of unacceptable patient results reported compared to the in-control condition during the existence of an undetected out-of control error condition. MaxE(N_uf) is related to the SQC frequency and patient risk, which is very essential for optimizing the SQC frequency and designing a risk-based SQC strategy.

Glycyrrizae Radix et Rhizoma has high medicinal value and is widely used in compatibility. It is used most frequently in the compatibility of Chinese medicine prescriptions，and is known as ''Guolao''（national medicine） and "master of all medicines". The characteristic active ingredients are mainly liquitin，glycyrrizic acid，glycyrrizin，and licochalcone. In different compatibilities，based on traditional and modern pharmacological theories，the corresponding effect of Glycyrrizae Radix et Rhizoma are brought into play through different mechanisms. Based on the traditional pharmacology of Glycyrrizae Radix et Rhizoma for tonifying spleen，replenishing Qi，clearing heat，removing toxin，dispelling phlegm，relieving cough and pain，and harmonizing various medicines，this paper used herbal authentication to analyze its compatibility application and mechanism. It was found that Glycyrrizae Radix et Rhizoma played corresponding effect in compatibilities through "tonification"，"harmonization"，and "regulation". For example，Glycyrrizae Radix et Rhizoma was combined with tonics including Ginseng Radix et Rhizoma and Atractylodis Macrocephalae Rhizoma to tonify the five Zang-organs through its strong tonifying effect，combined with Paeoniae Radix Alba and Aconiti Lateralis Radix Praeparata to relieve emergencies and pains through harmonizing medicine power and properties，and combined with Rhei Radix et Rhizoma and Natrii Sulfas to reduce medicine intensity through regulating medicine properties and body characteristics. The application law and mechanism of the modern pharmacological compatibility of Glycyrrizae Radix et Rhizoma were analyzed by data mining and network pharmacology. It was found that the modern clinical formula was often compatible with Glycyrrizae Radix et Rhizoma for anti-inflammation，cardiovascular and cerebrovascular protection，anti-virus，and anti-tumor，Ephedrae Herba and Scutellariae Radix for anti-inflammation，Bambusae Caulis in Taenias，Salviae Miltiorrhizae Radix et Rhizoma，and Aurantii Fructus Immaturus for cardiovascular and cerebrovascular protection，and Ophiopogonis Radix and Chuanxiong Rhizoma for nerves protection. Meanwhile，the important targets of the characteristic ingredients were protein kinase B1 （Akt1），interleukin-6 （IL-6），tumor necrosis factor （TNF），and epidermal growth factor receptor （EGFR）. The important characteristic pathways such as tyrosine kinase inhibitor resistance pathway and cyclic guanosine monophosphate （cGMP）/protein kinase G （PKG） signal pathway played the role of cardiovascular and cerebrovascular protection，and proteoglycan pathway in cancer played a neuroprotective role. This study is expected to provide references for the rational compatibility and application of Glycyrrizae Radix et Rhizoma，as well as the compatibility application of Chinese medicine prescriptions.

This study aimed to explore key quality control factors that affected the prognosis of intensive care unit (ICU) patients in Chinese mainland over six years (2015-2020). The data for this study were from 31 provincial and municipal hospitals (3425 hospital ICUs) and included 2 110 685 ICU patients, for a total of 27 607 376 ICU hospitalization days. We found that 15 initially established quality control indicators were good predictors of patient prognosis, including percentage of ICU patients out of all inpatients (%), percentage of ICU bed occupancy of total inpatient bed occupancy (%), percentage of all ICU inpatients with an APACHE II score ⩾15 (%), three-hour (surviving sepsis campaign) SSC bundle compliance (%), six-hour SSC bundle compliance (%), rate of microbe detection before antibiotics (%), percentage of drug deep venous thrombosis (DVT) prophylaxis (%), percentage of unplanned endotracheal extubations (%), percentage of patients reintubated within 48 hours (%), unplanned transfers to the ICU (%), 48-h ICU readmission rate (%), ventilator associated pneumonia (VAP) (per 1000 ventilator days), catheter related blood stream infection (CRBSI) (per 1000 catheter days), catheter-associated urinary tract infections (CAUTI) (per 1000 catheter days), in-hospital mortality (%). When exploratory factor analysis was applied, the 15 indicators were divided into 6 core elements that varied in weight regarding quality evaluation: nosocomial infection management (21.35%), compliance with the Surviving Sepsis Campaign guidelines (17.97%), ICU resources (17.46%), airway management (15.53%), prevention of deep-vein thrombosis (14.07%), and severity of patient condition (13.61%). Based on the different weights of the core elements associated with the 15 indicators, we developed an integrated quality scoring system defined as F score=21.35%xnosocomial infection management + 17.97%xcompliance with SSC guidelines + 17.46%×ICU resources + 15.53%×airway management + 14.07%×DVT prevention + 13.61%×severity of patient condition. This evidence-based quality scoring system will help in assessing the key elements of quality management and establish a foundation for further optimization of the quality control indicator system.
Humans ; China/epidemiology* ; Cross Infection/epidemiology* ; Intensive Care Units/statistics & numerical data* ; Quality Control ; Quality Indicators, Health Care/statistics & numerical data* ; Sepsis/therapy* ; East Asian People/statistics & numerical data*