Based on the questionnaire survey among 10 Traditional Chinese Medicine medical institutions in Beijing , this paper found that 65 . 2％ of the medical staffs and 82 . 0％ of the patients agreed to include the medical expertise into Traditional Chinese Medicine service system;37 . 3％ of the medical staffs believed that there was a certain risk of relaxing access of Traditional Chinese Medicine clinics, and 38. 4％ of the patients showed that they would choose private clinics to see a doctor. Most medical staffs considered that the current risks of Traditional Chinese Medicine diagnosis and treatment focused on standardized use of toxic decoction pieces and overdose of drugs. Medical staffs were most concerned about the risk of"diagnosis and treatment" on the Internet, were least worried about the risk of "distribution". The clinic registration system of the Law of the People ' s Republic of China on TCM, the registration system of the processed concocted decoction pieces, and the unclear scope of diagnosis and treatment technology posed challenges to future risk management, and it need to adopt the following countermeasures to respond:establishing a new multiple and multi-level risk management mechanism, exploring differentiated supervision, perfecting the technical norms and application scope of Traditional Chinese Medicine diagnosis and treatment, establishing a special system for regulating Traditional Chinese Medicine health care services, and establishing and improving a flexible supervision and law enforcement model to protect the legitimate rights and interests of relatives.

Objective: To investigate and understand the causes of partial disorder in health care market of traditional Chinese medicine in recent years and put forward relevant countermeasures and suggestions. Methods: A multi-stage stratified random sampling method was used to investigate 410 medical staff and 535 patients in 10 traditional Chinese medicine medical institutions in Beijing. Self-filling questionnaires were used to obtain relevant data on their views on partial disorder of health care services in traditional Chinese medicine. Statistical software SPSS22.0 was used to analyze the data. Results: Firstly, both doctors and patients believed that "unclear functions of supervision department" was the main cause of some disorder in health care industry of TCM. Secondly, medical staff were more inclined than patients to think that the main causes were "lack of access threshold for institutions and personnel", "unclear functions of supervision department"and "lack of basis for law enforcement". Thirdly, 63.0％ of medical staff said that the legal system most needed to promote the healthy development of health care industry in traditional Chinese medicine was "industry standard system". Conclusion: According to the results of the survey, this paper holds that the healthy development of health care services in traditional Chinese medicine should be ensured by standardizing the supervision system of health care in traditional Chinese medicine, strengthening the construction of industry standards, establishing the self-regulatory mechanism of the industry, standardizing the media propaganda of health care in traditional Chinese medicine, and strengthening the ethical constraints of practitioners.

Different from Western medicine theory, Traditional Chinese Medicine knowledge is tacit knowledge, and the Traditional Chinese Medicine knowledge system also is a complete system independent from the Western medicine system. But the protection for Traditional Chinese Medicine knowledge nowadays still mainly stems from the Western intellectual property system. The current intellectual property system is in a dilemma in the protection of Traditional Chinese Medicine due to its limitations, and it urgently needs to build a special knowledge protection system that is specially applicable to traditional knowledge;while using genetic resources protection system and benefit sharing system of traditional knowledge from Convention on Biological Diversity to protect Traditional Chinese Medicine has its advanced nature and rationality. In the premise of clarifying the definition of "intellectual property right of Traditional Chinese Medicine", this paper proposed 5 countermeasures and suggestions, including establishing the legal content of Traditional Chinese Medicine intellectual property, promoting the legislative coordination of existing intellectual property law and the Law of the People' s Republic of China on TCM, strengthening the institutional coordination of the Law of the People' s Republic of China on TCM, the Law of Intangible Cultural Heritage and the Law of the People' s Republic of China on Drug Administration, promoting the institutional innovation at the local legislation level, and building a benefit sharing mechanism for the holders of Traditional Chinese Medicine knowledge.

BACKGROUND:The displacement change parameters of the bone structure of the first metatarsal bone at the two-dimensional level of hallux valgus deformity are of great significance for clinical diagnosis and treatment,while the quantitative analysis of the three-dimensional deformity index may have some influences on the postoperative efficacy. OBJECTIVE:To explore the quantitative change of the three-dimensional deformity index of the first metatarsal bone after routine osteotomy and orthosis for hallux valgus deformity and to provide reference for clinical work. METHODS:100 patients with hallux valgus deformity(foot)in Hengshui People's Hospital from October 2020 to April 2023 were selected and all of them underwent conventional osteotomy and orthosis.Foot function was assessed by the American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale 6 months after surgery.Anterolateral X-rays of the foot in weight-bearing position and CT images in simulated weight-bearing position were taken before surgery and 6 months after surgery.The three-dimensional deformity indexes of the first metatarsal bone before and after surgery were quantitatively analyzed in patients with different ages,genders and therapeutic effects,including first-second intermetatarsal angle,hallux valgus angle,distal metatarsal articular angle,tibial sesamaid position,and first metatarsal rotation α angle.The value of the difference of three-dimensional deformity indexes of the first metatarsal bone before and after operation in evaluating the curative effect was analyzed. RESULTS AND CONCLUSION:(1)Six months after operation,the American Orthopedic Foot and Ankle Society score was 75-98(88.25±4.14)points,among which 56 cases were excellent,28 cases were good,14 cases were average,and 2 cases were poor.The excellent and good rate was 84%(84/100).(2)Compared with the preoperative results,first-second intermetatarsal angle,hallux valgus angle,distal metatarsal articular angle,tibial sesamaid position,and first metatarsal rotation α angle were significantly improved in patients of different ages and genders 6 months after surgery(P<0.05).First-second intermetatarsal angle,hallux valgus angle,distal metatarsal articular angle,tibial sesamaid position,and first metatarsal rotation α angle were all lower in patients with good curative effect 6 months after surgery than those with poor curative effect,and the difference before and after surgery was greater than those with poor curative effect(P<0.05).(3)The area under the curve of the difference evaluation of the first metatarsal three-dimensional deformity index before and after surgery was above 0.7,and the area under the curve of the combined evaluation of all indexes was the largest(0.902),which was significantly greater than the first metatarsal rotation α angle and distal metatarsal articular angle(P<0.05).(4)The quantitative analysis of the three-dimensional deformity index of the first metatarsal in patients with hallux valgus deformity is related to the postoperative effect,which has important guiding significance for improving the accuracy and comprehensiveness of preoperative evaluation and improving the treatment plan.