In recent years medical rebates suspected of illegal and criminal cases frequently appeared in the media and newspaper, triggering the public continuous attention to the problems of commercial bribery in the field of medicine. Starting from the definition of medical rebates concept, this paper deeply analyzed the deep cause of medical rebates, jumped out of the existing countermeasures and suggestions framework, and starting from the inter-nal supervision and restriction approach of discipline inspection and supervision, discussed the solution from four aspects of cultural atmosphere, interests chain, management process, self-supervision, in order to provide refer-ence for the comprehensive treatment of medical rebates.

In recent years,the occurrence of medical unsafe incidents in hospital has seriously affected the construction of a harmonious relationship between doctors and patients.In view of this,specialized research on the patient safety culture has become one of the focuses of attention.The United States is the country that carried out research on patient safety culture earlier.Through the retrieval of relevant website,case and literature about patient safety culture,this paper scientifically defined the connotation of patient safety culture,introduced the research progress of patient safety culture in United States,and had the localization research and reference to it,in order to help the research on patient safety culture in our country.

At present,the network media reports of Chinese medical disputes appeared blowout growth,and also brought the loss of propriety,the loss of balance,the loss of justice and other ethical issues while it played the role of public opinion supervision in the medical disputes.In view of these,from the concept definition of ethics anomie in network media report of medical disputes,this paper analyzed and interpreted the ethics anomie in network media report of medical disputes,pointed out existing problems and further put forward creating the network media professional ethics norms,establishing a social supervisory system which integrates self-discipline and heteronomy,building a doctor-patient docking platform and other perfecting countermeasures.

Objective:To evaluate the safety and feasibility of the laparoscopic indocyanine green (ICG) fluorescence imaging during the sentinel node navigational surgery for the early gastric cancer.Methods:Patients with <4 cm early gastric cancer were chosen. 0.5 ml ICG (2.5 mg/ml) was preoperatively injected into submucosa around the lesion in four points by the endoscopy. The sentinel lymph node basin including the stained tissue and lymph node (LN) were completely resected guided by the fluorescence mapping under ICG laparoscopy. The specimen was inspected by frozen pathology section. The radical gastrectomy was dependent on the pathology result.Result:Between 2019 and 2021, a total of 18 patients were included in the final analysis. Most tumors (16/18) located in the middle or distal stomach. Median tumor size was 2.0 cm. Lymph vessel invasion was revealed in five cases and perineural invasion in three cases. According to AJCC tumor grading system, tumor depth was classified as Tis in 2 cases, T1a in 5 cases and T1b in 11 cases. Lymph node metastasis (LNM) was revealed in four patients (4/18, 22%). Median sentinel lymph node basins per patient were 2 (range, 1-5). An average 6 (range, 2-13) LNs were harvested in each case, including 6 (1-13) ICG stained LNs and 1 (0-5) non stained LNs. All of four LNM patients were detected by sentinel node navigational surgery. The rate of the sensitivity and accuracy were 100% and 100%, respectively. The median follow-up for the entire group was 58.3 months (0.3-59.9 months), with no recurrence or metastasis observed in any patient.Conclusion:The sensitivity and accuracy of the laparoscopic indocyanine green fluorescence imaging during the sentinel node navigational surgery were satisfactory.

The analysis of big data in medical field cannot be isolated from the high quality clinical database, and the construction of first aid database in our country is still in the early stage of exploration. This paper introduces the idea and key technology of the construction of multi-parameter first aid database. By combining emergency business flow with information flow, an emergency data integration model was designed with reference to the architecture of the Medical Information Mart for Intensive Care III (MIMIC-III), created by Computational Physiology Laboratory of Massachusetts Institute of Technology (MIT), and a high-quality first-aid database was built. The database currently covers 22 941 medical records for 19 814 different patients from May 2015 to October 2017, including relatively complete information on physiology, biochemistry, treatment, examination, nursing, etc. And based on the database, the first First-Aid Big Data Datathon event, which 13 teams from all over the country participated in, was launched. The First-Aid database provides a reference for the construction and application of clinical database in China. And it could provide powerful data support for scientific research, clinical decision making and the improvement of medical quality, which will further promote secondary analysis of clinical data in our country.
Big Data ; Critical Care ; Databases, Factual ; Humans ; Medical Informatics