Objective:To systematically evaluate the relationship between thiazide diuretics and the risk of hip fracture in the elderly patients.Methods:The relevant databases at home and abroad were searched up to December 31, 2023 and case-control studies and cohort studies on the relationship between thiazide diuretics and the risk of hip fractures in the elderly patients were collected. Quality of the enrolled studies was evaluated by bias risk assessment tool of Newcastle-Ottawa Scale (NOS). RevMan 5.4 software was used for meta-analysis on related outcome indicators, and the effect sizes were odds ratio ( OR) and the 95% confidence interval ( CI). Funnel plots, Egger′s method and Begg′s method were performed using Stata 15.1 software to analyze the inclusion literature for publication bias. Results:A total of 18 studies were enrolled in the study, including 7 case-control studies and 11 cohort studies and involving 175 200 patients in the trial group (thiazide diuretics) and 1 574 989 in the control group (placebo or other medications). All 18 studies scored ≥5 on the NOS (15 articles of high quality and 3 articles of medium quality). The meta-analysis results indicated that the risk of hip fractures in the trial group was lower than that in the control group ( OR=0.82, 95% CI: 0.75-0.89, P<0.001). Subgroup analyses by study type and gender both revealed that thiazide diuretics were associated with a reduced risk of hip fractures in the elderly (adjusted OR in case-control studies was 0.78, 95% CI: 0.72-0.84, P<0.001; adjusted OR in cohort studies was 0.83, 95% CI: 0.74-0.93, P=0.002; adjusted OR in female was 0.78, 95% CI: 0.72-0.85, P<0.001; adjusted OR in male was 0.73, 95% CI: 0.68-0.80, P<0.001). The subgroup analysis of 11 large-sample studies (≥2 000 cases) indicated that thiazide diuretics were associated with a reduced risk of hip fractures in the elderly (adjusted OR=0.79, 95% CI: 0.72-0.87, P<0.001). However, 6 small-sample studies did not find the similar correlation. A combined analysis of studies that rigorously controlled for confounding factors revealed that thiazide diuretics were associated with a lower risk of hip fractures in the elderly ( OR=0.79, 95% CI: 0.74-0.84, P<0.001), and the combined results showed no heterogeneity ( P=0.72, I2=0%). Conclusions:Thiazide diuretics were associated with a reduced risk of hip fractures in the elderly patients. Based on a comprehensive assessment of the risks and benefits of medication for elderly patients, clinicians may prioritize thiazide diuretics as a component of combination therapy for eligible patients, which may be beneficial in reducing their risk of hip fractures.

Objective:To systematically evaluate the relationship between thiazide diuretics and the risk of hip fracture in the elderly patients.Methods:The relevant databases at home and abroad were searched up to December 31, 2023 and case-control studies and cohort studies on the relationship between thiazide diuretics and the risk of hip fractures in the elderly patients were collected. Quality of the enrolled studies was evaluated by bias risk assessment tool of Newcastle-Ottawa Scale (NOS). RevMan 5.4 software was used for meta-analysis on related outcome indicators, and the effect sizes were odds ratio ( OR) and the 95% confidence interval ( CI). Funnel plots, Egger′s method and Begg′s method were performed using Stata 15.1 software to analyze the inclusion literature for publication bias. Results:A total of 18 studies were enrolled in the study, including 7 case-control studies and 11 cohort studies and involving 175 200 patients in the trial group (thiazide diuretics) and 1 574 989 in the control group (placebo or other medications). All 18 studies scored ≥5 on the NOS (15 articles of high quality and 3 articles of medium quality). The meta-analysis results indicated that the risk of hip fractures in the trial group was lower than that in the control group ( OR=0.82, 95% CI: 0.75-0.89, P<0.001). Subgroup analyses by study type and gender both revealed that thiazide diuretics were associated with a reduced risk of hip fractures in the elderly (adjusted OR in case-control studies was 0.78, 95% CI: 0.72-0.84, P<0.001; adjusted OR in cohort studies was 0.83, 95% CI: 0.74-0.93, P=0.002; adjusted OR in female was 0.78, 95% CI: 0.72-0.85, P<0.001; adjusted OR in male was 0.73, 95% CI: 0.68-0.80, P<0.001). The subgroup analysis of 11 large-sample studies (≥2 000 cases) indicated that thiazide diuretics were associated with a reduced risk of hip fractures in the elderly (adjusted OR=0.79, 95% CI: 0.72-0.87, P<0.001). However, 6 small-sample studies did not find the similar correlation. A combined analysis of studies that rigorously controlled for confounding factors revealed that thiazide diuretics were associated with a lower risk of hip fractures in the elderly ( OR=0.79, 95% CI: 0.74-0.84, P<0.001), and the combined results showed no heterogeneity ( P=0.72, I2=0%). Conclusions:Thiazide diuretics were associated with a reduced risk of hip fractures in the elderly patients. Based on a comprehensive assessment of the risks and benefits of medication for elderly patients, clinicians may prioritize thiazide diuretics as a component of combination therapy for eligible patients, which may be beneficial in reducing their risk of hip fractures.

Objective:To develop an improved wireless intelligent capsule cystoscope (WCE)for dynamic detection of bladder mucosa in a pig model.Methods:The WCE was introduced into a healthy experimental pig that under general anesthesia via urethra by applying an improved device. Multi-angle images of the bladder mucosa were then obtained by controlling the position of capsule cystoscope with an external magnetic field system. The shutter speed of the WCE was 2.5 fps and was automatically converted to 1.5 fps 30 minutes after initiation. The Vue software was utilized to download the shoot pictures which were former received by a computer via wireless transmission. The pig was roused and sent to the pigpen, without limitations in moving. The improved WCE was connected with a 2 cm thread. 12 hours later, the dilated sheath was inserted again, and the capsule was removed by a foreign body forceps under observation of a ureteroscopy.Results:The WCE was successfully placed and removed from the pig's bladder with the application of the improved devices. Over 20 thousand images that with 60K pixels of bladder mucosa were captured by the WCE at various angles within 12 hours, which revealed the process of urine filling and excreting in a time-dependent way. No notable adverse effects (bleeding, urinary tract injury, etc) were noted during the process of cystoscope placement, image acquisition, transmission, and removal.Conclusion:This study developed a novel WCE that could dynamically, intelligently and accurately monitor all aspects of the pig bladder mucosa, and has preferable application prospect.

Patient safety is the cornerstone of medical quality and an important foundation for a healthy China.In May 2023,the National Health Commission and the National Administration of Traditional Chinese Medicine jointly is-suedthe Action Plan for Comprehensively Improving Medical Quality(2023-2025),which identified patient safety as an important task and special action.It introduces the concept of patient safety,the status quo of patient safety ac-tions at home and abroad,and the research trend of patient safety,and compares the work requirements of patient safety management and special actions in the Action Plan for Comprehensively Improving Medical Quality(2023-2025),and finally puts forward a series of suggestions for formulating the Implementation Plan of Special Ac-tions for Patient Safetywith Chinese characteristics.

This article reviews the overview of digital integration of geriatric patients and related influencing factors, the current situation of smart outpatient service, and the aging measures of smart outpatient service, with a view to providing reference for Chinese scholars to further study digital integration of geriatric patients.

"Westward Migration Spirit" is the precious spiritual wealth of Chinese Communist Party and the Chinese nation. The course teaching team takes the undergraduate students of clinical medicine as the teaching object, tries to integrate the "Westward Migration Spirit" into the cultivation of medical students’ medical professionalism, so as to endow new connotation of medical professionalism and promote the improvement of medical students’ professionalism. Through literature review, expert consultation and questionnaire survey, the paper sorted out the context of "Westward Migration Spirit" of Chongqing Medical University, and typical examples with the spirit of medical science and humanity were selected and integrated into the teaching. A questionnaire was designed to investigate the evaluation of 425 clinical medicine undergraduates and 5 teachers on the medical professionalism course integrated with "Westward Migration Spirit" . The results show that the students and teachers have good feedback to the medical professionalism courses integrated with the "Westward Migration Spirit" , and the course has a significant positive effect on the cultivation of medical students’ medical professionalism.

Complex adaptive system theory provides an interdisciplinary perspective for people to understand modern complex medical systems.This study introduces the background of complex adaptive system theory, basic viewpoints, demonstration of complex attributes of nursing, its application in the nursing field and analysis and evaluation of the theory, in order to provide new theoretical methods and ideas for the clinical practice and research of nursing scholars in China.

Objective:To compare the research status of smart aged care platforms at home and abroad by bibliometrics, so as to provide a reference for the smart transformation of Chinese industry of health care for the aged from a macro level.Methods:Web of Science core collection and China National Knowledge Infrastructure (CNKI) were taken as sources to analyze the research progress at home and abroad from 2010 to 2020. The analysis function of the database, VOSviewer and CiteSpace were used to quantitatively analyze and visualize the research situation and hotspots of the smart aged care platform, and perform a qualitative analysis of the included literature.Results:Totally, 166 articles in English and 78 articles in Chinese were included. The annual number of papers published at home and abroad showed an overall growth trend, and the research field involved multiple disciplines. The keywords that appeared frequently in the research on foreign smart medical care platforms were "assistive technology""elderly""smart home""e-health""telecare", and "rehabilitation". The top five keywords in the ranking of the number of occurrences in China were "smart elderly care""Internet of things""smart home""Internet +" and "combined medical care". Foreign research had become in-depth and diverse in the four aspects of platform technology preparation, functions, privacy and data protection, and effect evaluation.Conclusions:The development of academic research on the smart aged care platform and its related technologies is steady and diverse. However, compared with foreign countries, there is still a certain gap in content and technology in China. It is necessary to learn from foreign excellent technologies and concepts on the basis of conforming to national conditions to promote the further development of smart medical care platforms.

Patient safety is a serious global public health problem. In March 2017, World Health Organization (WHO) released the 3rd global patient safety challenge: Medication Without Harm, called for reducing serious and avoidable drug-related injuries in all countries by 50% in the next 5 years, and formulated a strategic action framework for medication safety at the same time. In June 2019, WHO released 3 technical reports, including medication safety in high-risk situations, medication safety in polypharmacy, and medication safety in transitions of care, so as to promote countries to take effective planning and actions as soon as possible to solve problems in the field of medication safety. In April 2021, WHO held a " Medication Without Harm" network conference, emphasizing that it′s an arduous and long-term work to achieve the goal. In May 2021, WHO issued the global patient safety action plan 2021—2030, which took medication safety as the most important task in the 3rd strategic goal, and put forward 4 actions for this task: actions for governments, actions for health care facilities and services, actions for stakeholder, and actions for the WHO. China′s National Health Commission issued the notice on further strengthening patient safety management in April 2018, focusing on promoting patient medication safety. The realization of the 3rd global patient safety challenge requires the joint efforts of all countries in the world.

Patient safety is a serious global public health problem. In March 2017, World Health Organization (WHO) released the 3rd global patient safety challenge: Medication Without Harm, called for reducing serious and avoidable drug-related injuries in all countries by 50% in the next 5 years, and formulated a strategic action framework for medication safety at the same time. In June 2019, WHO released 3 technical reports, including medication safety in high-risk situations, medication safety in polypharmacy, and medication safety in transitions of care, so as to promote countries to take effective planning and actions as soon as possible to solve problems in the field of medication safety. In April 2021, WHO held a " Medication Without Harm" network conference, emphasizing that it′s an arduous and long-term work to achieve the goal. In May 2021, WHO issued the global patient safety action plan 2021—2030, which took medication safety as the most important task in the 3rd strategic goal, and put forward 4 actions for this task: actions for governments, actions for health care facilities and services, actions for stakeholder, and actions for the WHO. China′s National Health Commission issued the notice on further strengthening patient safety management in April 2018, focusing on promoting patient medication safety. The realization of the 3rd global patient safety challenge requires the joint efforts of all countries in the world.