Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:Analyzing the core position of hospital in value-based healthcare practice and designing IT platform to support value medicine practice.Methods:Based on the orchestral model and the enterprise architecture theoiy,making the hospital as the leading part of the practice of value-based healthcare,taking value-based healthcare as the business strategy,standing on the advance of value-based healthcare in China,considering fully of the existing organizational inertia on business,IT foundation and IT implementation mode based on the software prototype development method in hospital,it manages to establish an IT architecture dominated by the business operations and supplemented by business strategies.Results:The hospital IT application architecture was built around the five themes of"one-stop integrating all service,four-stream integrating to promoting business operation,reducing the cost of major supplies,scientific management and cost controlling,and evaluating the healthcare value by the total data".Conclusion:A feasible and practical hospital IT application architecture oriented to value-based healthcare is designed,which provides an reliable guidance for the hospital to push forward the value-based healthcare.

Objective:To evaluate the efficacy and safety of endoscopic submucosal dissection (ESD) for circular superficial esophageal cancer.Methods:A retrospective analysis was conducted on 74 consecutive cases of circular superficial esophageal squamous cell carcinoma treated with ESD at Nanjing Drum Tower Hospital from January 2015 to December 2019. The success rate of ESD, curative resection rate, incidence of complications, and additional treatment were mainly observed.Results:One case was transferred to surgery, and the remaining 73 cases successfully completed ESD treatment. The success rate of ESD was 98.6%. Postoperative pathology of ESD revealed that 39 cases achieved curative resection, with a curative resection rate of 53.4% (39/73). Intraoperative muscle layer injury occurred in 15 cases (20.5%), and intraoperative perforation occurred in 1 case (1.4%). Two cases (2.7%) experienced delayed bleeding, and one case (1.4%) experienced delayed perforation. Eleven cases were lost to follow-up, and the remaining 62 cases received follow-up for 36.4±19.0 months. Among the follow-up cases, 12 underwent additional surgery and 5 cases additional chemotherapy and radiotherapy. Among the 57 patients with follow-up data who did not underwent surgery, 49 developed esophageal stenosis after ESD, with an incidence rate of 86.0%.Conclusion:ESD for circular superficial esophageal cancer is generally safe, but it is prone to muscle layer injury during the operation, with a low curative resection rate, a high incidence of postoperative esophageal stenosis, and a high proportion of additional surgical procedures.

Objective: To systematically evaluate the efficacy and safety of Bifidobacteria in preventing caries. Methods : Databases including PubMed, Embase, The Cochrane Library, Web of Science, Scopus, Clinicaltrials. gov, CNKI, WanFang Data and VIP were electronically searched from inception to April 2020 to collect randomized controlled trials of Bifidobacterium for caries. Meta-analysis was performed using Revman 5.4 software. Results: In total, 10 randomized controlled trials (RCT) of 518 patients, including 262 in the test group and 256 in the control group, were included. Meta-analysis results reveal no statistically significant differences in salivary Streptococcus mutans counts (SMD=-0.31, 95%CI -0.66 to 0.04, P=0.08) (RR=0.53, 95%CI 0.17 to 1.66, P=0.28) and salivary Lactobacilli counts (SMD=-0.07, 95%CI -0.39 to 0.26, P=0.69) (RR=0.87, 95%CI 0.59 to 1.29, P=0.50). No statistical differences in the counts of Streptococcus mutans and Lactobacillus counts were noted in dental plaque, and no statistical difference in the occurrence of caries in deciduous teeth. Three of the 10 RCTS included in this study did not report adverse events, 5 had no adverse reactions, and 2 reported gastrointestinal discomfort. Conclusion Current evidence suggests that Bifidobacteria do not effectively reduce Streptococcus mutans counts and Lactobacillus counts in saliva and dental plaque, or reduce the occurrence of caries in deciduous teeth. The safety of this treatment also requires further investigation.