Pre-admission is a critical initiative to optimize medical service processes and alleviate the challenge of "difficult access to healthcare. "However, there is currently a lack of standardized protocols for pre-admission procedures. This study aims to systematically analyze key nodes and risk factors in pre-admission process design and propose optimization strategies, providing a foundation for policy formulation and hospital practices. By constructing a "forward-reverse" dual-process model of pre-admission and identifying risk points based on stakeholder theory (patients, hospitals, healthcare administration, and insurance), the study reveals that while pre-admission can reduce the average length of stay, improve bed turnover rates, and enhance patient satisfaction, it also presents risks such as cross-period financial settlement, challenges in insurance policy adaptability, demands for information system integration, and the need for defining medical safety boundaries. To optimize the pre-admission process and mitigate these risks, this study explores framework improvements in areas including eligibility criteria, mode selection, cost settlement, transition between pre-admission and inpatient status, and cancellation of pre-admission, offering practical guidance for public hospitals. The authors argue that pre-admission requires tripartite collaboration among hospitals, insurers, and healthcare administrations: hospitals should establish top-level design, continuously refine processes, and implement dynamic risk assessment mechanisms; insurance providers should support cross-period settlement policies; and healthcare administrations should issue guiding policies or standardized protocols. Through multi-department coordination and collaborative efforts, the optimization and innovation of pre-admission processes can be advanced, ultimately delivering more efficient and convenient healthcare experiences for patients.

This paper Summarizes the experience of national renowned Chinese medical practitioner professor YANG Jun in treating lumbar pain with acupuncture and moxibustion.In the view of professor YANG Jun,the etiology of lumbar pain is various and the pathogensis is complex,of which mainly related to be invaded by external pathogen,meridians obstructing blockage,kidney deficiency due to elderly,less of moistening due to kidney essence deficiency,sprain caused by fall and strike,and blood stasis obstructing meridians,and the syndrome differentiation of lumbar pain usually involves cold-damp obstructing blockage,kidney essence deficiency,and blood stasis blocking collaterals.The waist is the residence of kidney,kidney meridian runs through the spine and connecting it to the kidney,the bladder meridian locates on both sides of the spine and connecting it to the kidney,the circulation of governor vessel(GV)to the kidney,so the pathogensis of lumbar pain is closely related to kidney,bladder meridian,governor vessel.The basic pathogensis of lumbar pain is meridian qiand blood stasis stagnation,or the meridian less of moistening due to kidney essence deficiency,both of which cause pain.The main therapeutic principle for lumbar pain should be focusing on mind-regulating and meridians-dredging,cold-dispersing and damp-removing,kidney-boosting and blood-activating,as well as collateral-unblocking and pain-relieving,combining the lumbosacral spinal tri-needling,regulating the bladder meridian with moxibustion and electro-acupuncture,thus to achieve the optimal quantitative and effective state.

Objective To investigate the status quo of nurses' comfort about physical touch and to analyze the influencing factors.Methods Totally 398 nurses were selected during March to May 2017 from three tertiary hospitals in Tianjin with convenience sampling.General information questionnaire,Maslach Burnout Inventory General Survey (MBI-GS),and Nurses' Comfort with Touch Scale (NCTS) were used to collect data and analyze influencing factors.Results The score of nurses' comfort with touch was (44.18±6.27).The average score of nurses' comfort was (5.84±1.43) in task-oriented contact dimension,higher than scores of the other three dimensions.Multiple linear regression analysis indicated that age and emotional exhaustion were main influencing factors.Conclusion The nurses' comfort with touch was at a moderate level.Nurses aged between 25 and 46 years,with emotional exhaustion scored less than 27,had higher comfort with touch.

Objective To observe the effect of shRNA interference lentivirus vector targeting rat Sirt1 gene on the expression of Sirt1 in retinal ganglion cell (RGC). Methods Four short hairpin (sh) RNA interference sequences targeting rat Sirt1 gene were designed. The target sequences of Oligo DNA were synthesized and annealed to double strand DNA, which was subsequently connected with pGLV3 lentivirus vector to build the lentiviral vector. The positive clones were identified by polymerase chain reaction (PCR) and DNA sequencing. The lentiviral vector construct and lentiviral packaging plasmids were co-transfected into 293T cells, then the titer of lentivirus were determined. The RGC were divided into 6 groups including blank group, negative control group and si-Sirt1-1, si-Sirt1-2, si-Sirt1-3, si-Sirt1-4 groups. Real-time PCR and Western blotting were used to detect the expression of Sirt1 mRNA and protein in the RGC cells. Results PCR and DNA sequencing analysis confirmed that the shRNA sequence was successfully inserted into the lentivirus vector. The concentrated titer of virus suspension was 8×108 TU/ml after the recombinant lentiviral vector successfully transfected and harvested in 293T cells. Comparing with NC group, the expression of Sirt1 mRNA and protein were significantly decreased in the si-Sirt1-1, si-Sirt1-2, si-Sirt1-3 and si-Sirt1-4 groups (F=27.682, 1185.206; P=0.000, 0.000). The si-Sirt1-2 group had the strongest effect in reducing the expression of Sirt1 mRNA and protein. Conclusion The 4 lentiviral vectors harboring RNAi targeting rat Sirt1 gene can effectively down regulate the expression of Sirt1 mRNA and protein in RGC cells.

Objective To identify the role of RNA-editing enzyme ADAR1 (adenosine deaminase acting on RNA) in EV71 infection and virus mutation.Methods RNAi technology was applied to establish ADAR1 knock-down stable cell lines.Then the cells were served to evaluate the role of ADAR1 in EV71 infection by MTT assay for detecting virus-induced cell viability,virus plaque assay for quantification of the virus titer and the cellular susceptibility to the virus,and Western blot for virus protein expressions.ADAR1-mediated RNA editing can result in the genetic A-G and T-C mutations.To further determine whether the effects of ADAR1 on EV71 infection were correlated with ADAR1-mediated EV71 RNA editing and therefore increased the viral mutations during the infection,the characteristics of EV71 mutation were analyzed based on the different full-length viral genomes from epidemic regions.The viral genome was also sequenced from the infected ADAR1 knock-down cells.Results After ADAR1 knock-down,the cell viability decreased quickly after the virus infection,and formed much more and larger sizes of plaques than the control cells.The virus capsid protein VP1 expressions and virus titer in the cells culture media were both increased in ADAR1 knockdown cells.Statistic analysis showed that A-G and T-C mutations were the major mutations of EV71,which were believed to be the hot sites for RNA-editing.However,the results of viral RNA genomic sequencing data indicated that ADAR1 did not edit EV71 genome directly.Conclusions ADAR1 was a restriction factor for controlling EV71.However,ADAR1 does not directly edit EV71 genome.