1.Meta-analysis and Grade Evidence Evaluation of Qi-reinforcing and Blood-activating/ Stasis-expelling Chinese Patent Medicines in Treatment of Coronary Microvascular Disease
Jiaping CHEN ; Juju SHANG ; Hongxu LIU ; Xiang LI ; Xiaolei LAI ; Huiwen ZHOU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(5):157-166
ObjectiveTo systematically evaluate the efficacy and safety of Qi-reinforcing and blood-activating/stasis-expelling Chinese patent medicines in the treatment of coronary microvascular disease (CMD). MethodsPubMed, Cochrane Library, CNKI, Wanfang Data, and VIP were searched for the randomized controlled trials (RCTs) on the treatment of CMD with Chinese patent medicines for reinforcing Qi and activating blood/expelling stasis with the time interval from inception to December 31, 2023. The primary outcome indicators included the index of microcirculatory resistance (IMR), coronary flow reserve (CFR), and corrected TIMI flow frame count (cTFC). The secondary outcome indicators included symptomatic efficacy, left ventricular ejection fraction (LVEF), hypersensitive C-reactive protein (hs-CRP), nitric oxide (NO), and adverse events. Cochrane risk-of-bias assessment tool 2.0 (RoB 2.0) and Stata 17.0 were used for literature quality evaluation and meta-analysis of the included RCTs. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used to evaluate the quality of evidence. ResultsA total of 36 RCTs were included in this study, involving 3 029 patients. Compared with conventional Western medicine alone, the combined use of Chinese patent medicines for reinforcing Qi and activating blood/expelling stasis and Western medicine reduced the IMR [mean difference (MD)=-5.93, 95% confidence interval (95%CI) [-8.73,-3.14], n=382, P<0.01], cTFC (MD=-9.35, 95%CI [-13.94,-4.76], n=618, P<0.01), and hs-CRP [standard mean difference (SMD)=-1.50, 95%CI [-1.90,-1.11], n=1 483, P<0.01], improved the CFR (SMD=1.14, 95%CI [0.08,2.19], n=304, P=0.03), symptomatic efficacy [relative risk (RR)=1.36, 95%CI [1.21,1.53], n=756, P<0.01], LVEF (MD=4.39, 95%CI [2.31,6.47], n=533, P<0.01), and NO (SMD=3.16, 95%CI [2.07,4.25], n=946, P<0.01) of CMD patients. In terms of safety, the combined therapy reduced the occurrence of adverse events in CMD patients (RR=0.49, 95%CI [0.29,0.82], n=591, P=0.01). GRADE showed moderate quality evidence for adverse events, low quality evidence for cTFC, symptomatic efficacy, LVEF, and NO, and very low quality evidence for IMR, CFR, and hs-CRP. ConclusionBased on microcirculatory function indicators, the combined use of Qi-reinforcing and blood-activating/stasis-expelling Chinese patent medicines and Western medicine may further improve the coronary microvascular function in CMD patients with good safety. The above conclusions remain to be verified with high-quality clinical trials.
2.Discount rate setting and adjustment in international pharmacoeconomic evaluation guidelines
Yiwei LI ; Jingbo ZHANG ; Huiwen YANG ; Hanfei WANG ; Yusi SUO ; Han WANG ; Zhien GU ; Xuejing JIN
China Pharmacy 2025;36(20):2542-2547
OBJECTIVE To provide direction and reference for the adjustment of the discount rate (DR) in China’s pharmacoeconomic guidelines. METHODS Search was conducted on the official websites of the International Society for Pharmacoeconomics and Outcomes Research, health technology assessment agencies in various countries/regions, as well as relevant websites of other upper-middle-income or high-income countries/regions. The recommended DR, adjustment trends, and setting rationales in pharmacoeconomic evaluation guidelines across different countries/regions were then summarized and compared. Based on theoretical derivation and literature analysis, the effects of different DR on the incremental cost-effectiveness ratio (ICER) were examined. RESULTS & CONCLUSIONS Among the 40 included guidelines, the base-case DR ranged from 1.5% to 5%, with 5% being the most common value; the range for sensitivity analysis was 0 to 12%. Thirty-six countries/regions applied the same DR to both costs and health outcomes, while in the Netherlands, Belgium, Poland and Czech Republic, DR for costs was higher than for health outcomes. In recent years, Korea, France and Ireland had lowered their DR in response to economic changes, whereas the Netherlands and Czech Republic had raised their DR for cost. The setting of the DR was primarily based on the public project investment interest rate or referred to recommendations from internationally authoritative institutions and other relevant guidelines. The direction and magnitude of the impact of different DR on the ICER largely depended on the distribution of costs and health outcomes between the intervention and reference measure. The setting and adjustment of DR were closely associated with the economic environment. Based on international experience, the DR in China can be lowered by 0.5% to 1.5%, and localized empirical research can be conducted using internationally common estimation methods.
3.Review and Prospect of China’s Medical and Health Policy Since the Founding of the People’s Republic of China: Analysis based on Policy Tools
Chinese Medical Ethics 2024;35(3):290-296
Policy tools are ways to quantitative analysis of policy text content and the construction of a "Policy Tools-Policy Objectives (X-Y Dimension)" framework to explore long-term stability and late-stage innovation of policy development. This paper reviewed the development process of medical and health policies since the founding of the People’s Republic of China, and divided 1949-2021 into four stages of reform breeding, institutional transformation, reform improvement and continuous deepening. Screening 121 medical and health policy texts issued at the national level since the founding of the People’s Republic of China, quantitatively analyzing 5 957 policy text cells from the perspective of policy tools, counting the use of policy tools in various periods, and excavating the inherent logic of policy texts, policy tools and policy objectives to derive development characteristics of internal logic deduction. The development of China’s medical and health policy in the new period will serve the people’s health in the first place, adhere to the development direction of equalization of basic public service, strengthen the coordinated development of scientific and technological innovation and talent training, build a health and healthy development system with Chinese characteristics.
4.Analysis of correlation between job embedding and turnover intention of hospital nurses
Huiwen WU ; Yuru QIU ; Xiaojing HE ; Jiarong LI
Modern Hospital 2024;24(1):68-70,87
Objective To understand the status quo of job embeddedness and turnover intention of hospital nurses,and to explore their correlation.Methods Using convenient sampling method,we selected 538 nursing workers from 8 tertiary hospi-tals in Guangzhou,and conducted an electronic questionnaire survey with job embeddedness Scale and Turnover Intention Scale.Results The total average score of job embeddedness was(3.41±1.26),and the total average score of turnover intention was(2.66±0.94).There was a negative correlation between job embeddedness and turnover intention(r =-0.060,P>0.05).Conclusion The scores of job embeddedness and turnover intention of hospital nurses are at the middle level,and job embed-dedness is negatively correlated with the total average score of turnover intention.It is suggested that the management mode of hospital nurses should be standardized,the legitimate rights and interests of nurses should be guaranteed,the construction of pro-fessional certification system should be promoted,the nurses'positive job embeddedness should be promoted,the hospital nurs-ing staff should be stabilized,and the satisfaction of nursing service should be improved.
5.Expert consensus on the diagnosis and treatment of osteoporotic proximal humeral fracture with integrated traditional Chinese and Western medicine (version 2024)
Xiao CHEN ; Hao ZHANG ; Man WANG ; Guangchao WANG ; Jin CUI ; Wencai ZHANG ; Fengjin ZHOU ; Qiang YANG ; Guohui LIU ; Zhongmin SHI ; Lili YANG ; Zhiwei WANG ; Guixin SUN ; Biao CHENG ; Ming CAI ; Haodong LIN ; Hongxing SHEN ; Hao SHEN ; Yunfei ZHANG ; Fuxin WEI ; Feng NIU ; Chao FANG ; Huiwen CHEN ; Shaojun SONG ; Yong WANG ; Jun LIN ; Yuhai MA ; Wei CHEN ; Nan CHEN ; Zhiyong HOU ; Xin WANG ; Aiyuan WANG ; Zhen GENG ; Kainan LI ; Dongliang WANG ; Fanfu FANG ; Jiacan SU
Chinese Journal of Trauma 2024;40(3):193-205
Osteoporotic proximal humeral fracture (OPHF) is one of the common osteoporotic fractures in the aged, with an incidence only lower than vertebral compression fracture, hip fracture, and distal radius fracture. OPHF, secondary to osteoporosis and characterized by poor bone quality, comminuted fracture pattern, slow healing, and severely impaired shoulder joint function, poses a big challenge to the current clinical diagnosis and treatment. In the field of diagnosis, treatment, and rehabilitation of OPHF, traditional Chinese and Western medicine have accumulated rich experience and evidence from evidence-based medicine and achieved favorable outcomes. However, there is still a lack of guidance from a relevant consensus as to how to integrate the advantages of the two medical systems and achieve the integrated diagnosis and treatment. To promote the diagnosis and treatment of OPHF with integrated traditional Chinese and Western medicine, relevant experts from Orthopedic Expert Committee of Geriatric Branch of Chinese Association of Gerontology and Geriatrics, Youth Osteoporosis Group of Orthopedic Branch of Chinese Medical Association, Osteoporosis Group of Orthopedic Surgeon Branch of Chinese Medical Doctor Association, and Osteoporosis Committee of Shanghai Association of Integrated Traditional Chinese and Western Medicine have been organized to formulate Expert consensus on the diagnosis and treatment of osteoporotic proximal humeral fracture with integrated traditional Chinese and Western medicine ( version 2024) by searching related literatures and based on the evidences from evidence-based medicine. This consensus consists of 13 recommendations about the diagnosis, treatment and rehabilitation of OPHF with integrated traditional Chinese medicine and Western medicine, aimed at standardizing, systematizing, and personalizing the diagnosis and treatment of OPHF with integrated traditional Chinse and Western medicine to improve the patients ′ function.
6.Health Resources Supporting High-quality Development of Urban Industrial Economy:Situation Analysis and Countermeasure Suggestions
Qi LI ; Lu LI ; Huiwen LI ; Chaofan LI ; Shuping WANG
Chinese Health Economics 2024;43(7):47-51
Industry serves as the main body and driving force of national economy.The high quality of the urban industrial economy depends on the role of health resources in maintaining the health of the workforce population.It analyzes the allocation of health resources in typical cities ranked within the top 10 in terms of industrial added value,identifies prevailing the new situation facing the allocation of health resources,and puts forward suggestions.It is found that health resources supporting high-quality development of urban industrial economy is currently facing the main situations of population increase and decrease differentiation within the city,more frequent cross-regional medical treatment,and accelerated aging trend of labor force.
7.Research on the Construction of a New Cultural Indicator System for High-quality Development of Public Hospitals
Chaohong LI ; Xiaoyu ZHANG ; Jingrong WANG ; Jun YAO ; Xueying LI ; Yifan XU ; Huiwen ZHANG ; Jun YU ; Xiaojin AI ; Limei JING
Chinese Hospital Management 2024;44(6):1-4
Objective It constructs a new culture index system for high-quality development of public hospitals to provide scientific tool for evaluating the level of new culture construction of public hospitals and promoting high-quali-ty development.Methods A pool of indicators was established based on policy combing and literature research.Then,an indicator system was formed through Delphi expert consultation and demonstration,and weighting coefficients were assigned using the hierarchical analysis method.Results The indicator system of the new culture in public hospi-tals contains four primary indicators,eight secondary indicators and 23 specific entries.The four primary indicators are hospital culture system construction,strengthening the orientation of patients'needs,caring for medical staff and distinctive hospital culture.The effectiveness of implementation as an additional dimension contains two secondary indicators and eight specific entries.The weights of the primary indicators are balanced.Among the sec-ondary indicators,institutional planning(0.250),staff care(0.170),medical services(0.130),discipline branding(0.125)and professionalism(0.125)have higher weights.Conclusion The new culture index system for high-quality development of public hospitals is in line with Xi Jinping's cultural thought and the requirements of the new culture for high-quality development of public hospitals.It needs to pay attention to the planning of the cultural system,em-phasises the care of employees and the cultivation of professionalism,and focuses on the construction of medical services and disciplinary brands,so as to promote the construction of the new culture in public hospitals in line with the requirements of the national strategies.
8.Health Resources Supporting High-quality Development of Urban Industrial Economy:Situation Analysis and Countermeasure Suggestions
Qi LI ; Lu LI ; Huiwen LI ; Chaofan LI ; Shuping WANG
Chinese Health Economics 2024;43(7):47-51
Industry serves as the main body and driving force of national economy.The high quality of the urban industrial economy depends on the role of health resources in maintaining the health of the workforce population.It analyzes the allocation of health resources in typical cities ranked within the top 10 in terms of industrial added value,identifies prevailing the new situation facing the allocation of health resources,and puts forward suggestions.It is found that health resources supporting high-quality development of urban industrial economy is currently facing the main situations of population increase and decrease differentiation within the city,more frequent cross-regional medical treatment,and accelerated aging trend of labor force.
9.Research on the Construction of a New Cultural Indicator System for High-quality Development of Public Hospitals
Chaohong LI ; Xiaoyu ZHANG ; Jingrong WANG ; Jun YAO ; Xueying LI ; Yifan XU ; Huiwen ZHANG ; Jun YU ; Xiaojin AI ; Limei JING
Chinese Hospital Management 2024;44(6):1-4
Objective It constructs a new culture index system for high-quality development of public hospitals to provide scientific tool for evaluating the level of new culture construction of public hospitals and promoting high-quali-ty development.Methods A pool of indicators was established based on policy combing and literature research.Then,an indicator system was formed through Delphi expert consultation and demonstration,and weighting coefficients were assigned using the hierarchical analysis method.Results The indicator system of the new culture in public hospi-tals contains four primary indicators,eight secondary indicators and 23 specific entries.The four primary indicators are hospital culture system construction,strengthening the orientation of patients'needs,caring for medical staff and distinctive hospital culture.The effectiveness of implementation as an additional dimension contains two secondary indicators and eight specific entries.The weights of the primary indicators are balanced.Among the sec-ondary indicators,institutional planning(0.250),staff care(0.170),medical services(0.130),discipline branding(0.125)and professionalism(0.125)have higher weights.Conclusion The new culture index system for high-quality development of public hospitals is in line with Xi Jinping's cultural thought and the requirements of the new culture for high-quality development of public hospitals.It needs to pay attention to the planning of the cultural system,em-phasises the care of employees and the cultivation of professionalism,and focuses on the construction of medical services and disciplinary brands,so as to promote the construction of the new culture in public hospitals in line with the requirements of the national strategies.
10.Health Resources Supporting High-quality Development of Urban Industrial Economy:Situation Analysis and Countermeasure Suggestions
Qi LI ; Lu LI ; Huiwen LI ; Chaofan LI ; Shuping WANG
Chinese Health Economics 2024;43(7):47-51
Industry serves as the main body and driving force of national economy.The high quality of the urban industrial economy depends on the role of health resources in maintaining the health of the workforce population.It analyzes the allocation of health resources in typical cities ranked within the top 10 in terms of industrial added value,identifies prevailing the new situation facing the allocation of health resources,and puts forward suggestions.It is found that health resources supporting high-quality development of urban industrial economy is currently facing the main situations of population increase and decrease differentiation within the city,more frequent cross-regional medical treatment,and accelerated aging trend of labor force.

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