1.Establishment of evaluation index system for management capability of general practitioner team leaders in Shanghai community health centers
Huining ZHOU ; Jianwei SHI ; Huimin DAI ; Lan TANG ; Ning CHEN ; Hong CHEN ; Ya GAO ; Zhaoxin WANG ; Zhengyi WU
Chinese Journal of General Practitioners 2022;21(6):519-525
Objective:To develop an evaluation index system for the management ability of general practice team leaders in community health service centers.Methods:Based on literature review, key insider interviews and other methods, the framework and indicator pool for management capability of general practice team leaders were formed. Two rounds of Delphi consultations with 15 experts were conducted from July to October 2021, and the evaluation index system of general practice team leaders' management ability established.Results:All 15 experts had at least 5 years of work experience, including 10 engaging in clinical general practice, 3 in public health and 2 in community management. The response rates for the two rounds of expert consultation was 15/15, and the expert authority coefficient was 0.84, with Kendall's W coefficient of 0.35 ( P<0.001) and 0.46 ( P<0.001), respectively. Finally, the evaluation index system of the management ability of general practice team leaders was established, which consisted of 5 primary indicators (personal quality, special business management, organizational management, teaching and research management, strategy and culture building), 11 secondary indicators and 37 tertiary indicators. Conclusions:The management capability evaluation index system general practitioner team leaders of the community health centers has been established in this stu, which may be used for the training and selection of general practice team leaders in the community health centers.
2.Treatment of Chronic Cough of Phlegm-Dampness Syndrome Based on the Theory of “Removing the Earth Stagnation”
Qingxiang MU ; Zhaoxin DAI ; Yi HE ; Maorong FAN
Journal of Traditional Chinese Medicine 2023;64(23):2407-2411
This paper discussed the treatment of chronic cough of phlegm-dampness type based on the theory of “removing the earth stagnation”. It is believed that stagnation of qi in the middle energizer caused malfunction of water metabolism in the human body, which is the key pathogenetic mechanism leading to phlegm-dampness cough. Pathogenesis like cold and dampness attacking the spleen, dampness-heat obstruction, weakness of the middle energizer, failure to ascend clear yang, and internal blazing of yin fire may lead to “earth stagnation”, which triggered phlegm-dampness cough. The treatment advocated “removing the stagnation” to improve qi transformation in the middle energizer, eliminate stagnation, and use different treatment methods such as warming the middle, circulating qi, transforming phlegm and dampness based on different disease cause and mechanism to calm cough. As for prescriptions, Jiangling Banxia Decoction (姜苓半夏汤) could be used for cold-dampness syndrome, Banxia Xiexin Decoction (半夏泻心汤) plus Xiangsu Powder (香苏散) used for damp-heat syndrome, and Buzhong Yiqi Decoction (补中益气汤), Tiaozhong Yiqi Decoction (调中益气汤), Shengyang Yiwei Decoction (升阳益胃汤) and Bupiwei Xieyinhuo Shengyang Decoction (补脾胃泻阴火升阳汤) could be selected for spleen-stomach weakness syndrome according to different characteristics and pathogenesis.
3.Biomechanical difference between resin ceramic crown and zirconia all-ceramic crown implant restorations in three occlusal relationships
Huijuan DAI ; Zhaoxin WANG ; Yelisi BAIBUJIAFU ; Jiangwei SUN ; Yibulayin GULIZAINU ; Tuerxun NIJIATI
Chinese Journal of Tissue Engineering Research 2024;28(5):657-663
BACKGROUND:In implant restoration in the aesthetic area,zirconium dioxide is gradually becoming the most commonly used upper restorative material and has achieved better clinical results.Resin-ceramic composite,a new type of dental restorative material,begins to try to be used as an upper restorative material in implant restoration,but there is less research on the application of this material in implant restoration. OBJECTIVE:To compare the biomechanical differences between resin ceramic crowns and zirconia all-ceramic crown implant restorations in three occlusal relationships for restoring maxillary central incisors. METHODS:The cone-beam CT image data of a patient with single-crown implant restoration of maxillary central incisor were selected,and the maxillary bone model was extracted by using Mimics 21.0 software,and the model was imported into Solidworks 2020 software.The crown,adhesive,abutment,central screw,and implant were modeled,and the model of single-crown implant restoration of maxillary central incisor was assembled.After giving the model material property parameters(resin-ceramic composite and zirconia for the upper restoration materials)in ANSYS Workbench 2021 R1 software,three occlusal relationships(edge-to-edge occlusion,normal overjet and deep overbite)were simulated and loaded to analyze the stress distribution of the resin-ceramic crown and zirconia all-ceramic crown implant restoration models. RESULTS AND CONCLUSION:(1)The stress concentration areas in the implant restoration models of the resin-ceramic crown group and the zirconia all-ceramic crown group in different occlusal relationships were distributed in the upper restoration loading point,the abutment-implant connection,the implant neck and the surrounding bone tissue.As the occlusal relationship changed from the edge-to-edge to normal and deep overbite,the peak equivalent forces of the restorative abutment,central screw,implant,and bone tissue in both the resin-ceramic and zirconia all-ceramic crown groups gradually decreased.The highest peak equivalent forces were observed for the upper restorations in deep overbite.The zirconia all-ceramic crown group had the highest peak equivalent force in the adhesive layer in the edge-to-edge relationship,and the resin-ceramic crown group had the highest peak equivalent force in the adhesive layer in the deep overbite.(2)In the edge-to-edge occlusion,the peak equivalent force of the adhesive layer and central screw in the resin-ceramic crown group was slightly smaller than that in the zirconia all-ceramic crown group,and there was no significant difference between the two groups in the peak equivalent force at the upper restoration,restoration abutment,implant,and bone tissue.The peak stresses in the upper restoration,adhesive layer,and central screw of the resin-ceramic crown group were slightly less than those of the zirconia all-ceramic crown group at normal fit,and there were no significant differences between the two groups in the peak equivalent forces at the restoration abutment,implant,and bone tissue.In deep overbite,the peak adhesive,abutment,and central screw stresses were greater in the resin-ceramic crown group than in the zirconia all-ceramic crown group,with no significant differences in the upper restorations,implants,or bone tissue.(3)The results showed that the upper restorative material had no significant effect on the stress distribution of the implant and bone tissue,and had some effects on the stress distribution of the upper restoration,adhesive,restoration abutment,and central screw,but the difference was not significant.The occlusal relationship has a significant influence on the stress distribution in all structures and bone tissue of the implant restoration.The resin-ceramic crowns have a buffering effect on the stresses in the case of edge-to-edge and normal occlusion.