This article examines a comprehensive model for managing refractive errors, with a specific focus on myopia. It investigates the epidemiological context of refractive errors and their socio-economic implications. It underscores the importance of early detection and management, especially for severe ocular conditions like retinal lesions and glaucoma. The article critiques existing refractive error management models' limitations and highlights challenges in managing asymptomatic myopic patients. It proposes a “Myopia Chronic Disease Management(MCDM)” model as an innovative comprehensive management approach. The model establishes a data-driven closed-loop management pathway that encompasses screening, diagnosis, intervention, follow-up, and feedback. Through a comparative analysis with the chronic care model(CCM)and the World Health Organization's(WHO)Integrated Patient-Centered Eye Care(IPCEC), it highlights its innovative strengths in integrating digital technologies with multi-tiered healthcare networks. This model encompasses the entire refractive correction process and incorporates strategies for public education via the internet and new media. In terms of strategy implementation, the article discusses the necessity of establishing eye health records and long-term follow-up plans, as well as the potential applications of medical consortium models and family contract-based services in management. Moreover, the article emphasizes the importance of intelligent software systems in chronic ocular condition health management. It provides an overview of the benefits and challenges associated with this novel management model and proposes directions for future research and potential enhancements. Through this thorough examination and analysis, the article highlights the critical importance and effectiveness of implementing comprehensive, multifaceted, and sustained strategies in the management of refractive errors.

The construction of the close-knit medical consortium is the starting point for realizing hierarchical diag-nosis and treatment,and the construction of the close-knit medical consortium requires the formation of prob-lem-oriented and interest-oriented cooperation between different types of hospitals.It selected typical cases of cooperation between different types of hospitals in the United States,Canada,Germany and Japan,and gave the key points of cooperation between different types of hospitals,such as agreement signing and cooperation frame-work,establishment of resource sharing and cooperation mechanism,expert exchange and training,case discus-sion and remote consultation,referral and continuum of care,and effect evaluation and continuous improvement.The practice of these hospital,cooperation provides a reference for the extension of high-quality urban resources to the county level in China.

The management of chronic diseases at the county-level faces the problems of low degree of standardized manage-ment,weak management capacity of chronic diseases at the grassroots level,and shedding management of chronic disease patients.The"county-level chronic disease management center"proposed in the"Thousand Counties Project"can promote the county-town-ship-village medical institutions to jointly provide integrated and continuous chronic disease management services for county resi-dents.The study conducted in-depth interviews and analyses on the construction of the centers in 10 county(district)hospitals.Con-clusion:Firstly,the construction of the centers is in its infancy,and the support of government investment,performance incen-tives,and informatization construction is insufficient;secondly,the service content of the current centers is not clear enough,and the collaborative management model of chronic diseases in counties and villages is not stable.Enlightenment:The county-level med-ical community has built an effective path for the centers and the construction of chronic disease management centers needs to be fur-ther strengthened in terms of finance,medical insurance,interest mechanism,informatization construction and awareness of chronic diseases.

The construction of the close-knit medical consortium is the starting point for realizing hierarchical diag-nosis and treatment,and the construction of the close-knit medical consortium requires the formation of prob-lem-oriented and interest-oriented cooperation between different types of hospitals.It selected typical cases of cooperation between different types of hospitals in the United States,Canada,Germany and Japan,and gave the key points of cooperation between different types of hospitals,such as agreement signing and cooperation frame-work,establishment of resource sharing and cooperation mechanism,expert exchange and training,case discus-sion and remote consultation,referral and continuum of care,and effect evaluation and continuous improvement.The practice of these hospital,cooperation provides a reference for the extension of high-quality urban resources to the county level in China.

The management of chronic diseases at the county-level faces the problems of low degree of standardized manage-ment,weak management capacity of chronic diseases at the grassroots level,and shedding management of chronic disease patients.The"county-level chronic disease management center"proposed in the"Thousand Counties Project"can promote the county-town-ship-village medical institutions to jointly provide integrated and continuous chronic disease management services for county resi-dents.The study conducted in-depth interviews and analyses on the construction of the centers in 10 county(district)hospitals.Con-clusion:Firstly,the construction of the centers is in its infancy,and the support of government investment,performance incen-tives,and informatization construction is insufficient;secondly,the service content of the current centers is not clear enough,and the collaborative management model of chronic diseases in counties and villages is not stable.Enlightenment:The county-level med-ical community has built an effective path for the centers and the construction of chronic disease management centers needs to be fur-ther strengthened in terms of finance,medical insurance,interest mechanism,informatization construction and awareness of chronic diseases.

Arrhythmia is one of the most common diseases in clinical practice that can threaten the health and safety of patients and is referred to as "palpitations" in traditional Chinese medicine. Traditional Chinese medicine often uses the method of tonifying qi and nourishing yin to treat palpitations in clinical practice. However, there is currently a lack of relevant research on its treatment mechanism. From the perspective of pharmacology and through a literature search, this paper summarized the progress in the mechanism of traditional Chinese medicine for supplementing qi and nourishing yin commonly used in the treatment of palpitations, as well as traditional Chinese patent medicines and simple preparations for the treatment of arrhythmia, to explore their mechanism of action on palpitations. This paper also summarized that traditional Chinese medicine drugs for tonifying qi and nourishing yin mainly regulate various signal pathways and ion channels through multiple target genes, thereby regulating heart rhythm and improving clinical symptoms in patients with palpitations. The results can provide new ideas for colleagues on palpitations treatment.

Objective To investigate the serum levels of homocysteine(HCY)and cystatin C(Cys-C)in patients with antineutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV)associated renal injury,and to explore the diagnostic value of combined detection of HCY and Cys-C in ANCA-associated renal injury.Methods We selected 70 ANCA-positive patients with renal injury admitted to the Department of Nephrology in our hospital from January 2016 to January 2019.Another 48 patients with ANCA-positive but not complicated with renal injury were in simple ANCA positive group while 50 patients with physical examination who came to the hospital during the same period were in control group.Healthy patients served as the control group.By comparing the differences in the test results of different groups,the area under the curve(AUC)of each test index for ANCA-positive renal injury was determined,and the correlation and diagnostic value of combined detection of HCY and Cys-C for ANCA-related renal injury were calculated.Results The levels of HCY and Cys-C in the ANCA positive combined with renal injury group,the pure ANCA positive group,and the control group differed significantly(P＜0.05).The positive rates of HCY and Cys-C in the two groups were significantly different(P＜0.05).The sensitivity and specificity of HCY and Cys-C in combination for the diagnosis of ANCA-positive related renal injury were significantly higher than those of the above indicators alone(P＜0.05).ROC curve results showed that HCY combined with Cys-C had a better diagnosis for patients with positive ANCA and associated renal injury and a higher correlation.Conclusion HCY combined with Cys-C is closely correlated to ANCA-related renal injury,and the combined detection has a positive effect on the diagnosis of patients with ANCA-positive related renal injury,and has guiding value for the treatment of patients.

As a high-level, applied, and specialized nursing professional, master of nursing specialist (MNS) postgraduates place great emphasis on the importance of clinical practice. Clinical practice helps to improve their clinical skills, identify clinical problems, and cultivate clinical research thinking. However, due to the late start of MNS education in China, there are still many problems in its clinical practice training, such as incomplete training programs, weak academic resources, and unclear self positioning. Based on this, this article reviews the current situation and influencing factors of clinical practice training for MNS postgraduates, and puts forward corresponding suggestions, in order to provide reference and guidance for optimizing the MNS postgraduate training program in China.

Cancer cell membrane (CCM) derived nanotechnology functionalizes nanoparticles (NPs) to recognize homologous cells, exhibiting translational potential in accurate tumor therapy. However, these nanoplatforms are majorly generated from fixed cell lines and are typically evaluated in cell line-derived subcutaneous-xenografts (CDX), ignoring the tumor heterogeneity and differentiation from inter- and intra- individuals and microenvironments between heterotopic- and orthotopic-tumors, limiting the therapeutic efficiency of such nanoplatforms. Herein, various biomimetic nanoplatforms (CCM-modified gold@Carbon, i.e., Au@C-CCM) were fabricated by coating CCMs of head and neck squamous cell carcinoma (HNSCC) cell lines and patient-derived cells on the surface of Au@C NP. The generated Au@C-CCMs were evaluated on corresponding CDX, tongue orthotopic xenograft (TOX), immune-competent primary and distant tumor models, and patient-derived xenograft (PDX) models. The Au@C-CCM generates a photothermal conversion efficiency up to 44.2% for primary HNSCC therapy and induced immunotherapy to inhibit metastasis via photothermal therapy-induced immunogenic cell death. The homologous CCM endowed the nanoplatforms with optimal targeting properties for the highest therapeutic efficiency, far above those with mismatched CCMs, resulting in distinct tumor ablation and tumor growth inhibition in all four models. This work reinforces the feasibility of biomimetic NPs combining modular designed CMs and functional cores for customized treatment of HNSCC, can be further extended to other malignant tumors therapy.
Animals ; Humans ; Squamous Cell Carcinoma of Head and Neck/therapy* ; Heterografts ; Photothermal Therapy ; Biomimetics ; Disease Models, Animal ; Head and Neck Neoplasms/therapy* ; Cell Line, Tumor ; Tumor Microenvironment