Microsatellite instability (MSI) which resulted from the deficiency of DNA mismatch repair (MMR), is an important clinical significance in the related solid tumors, such as colorectal cancer and endometrial cancer. There are several methods to detect MSI status, including immunohistochemistry for MMR protein, multiplex fluorescent polymerase chain reaction (PCR) for microsatellite site and MSI algorithm based on next generation sequencing (NGS). The consensus elaborates the definition and clinical significance of MSI as well as the advantages and disadvantages of the three detection methods. Through this expert consensus, we hope to promote the screening which based on MSI status in malignant tumors and improve the acknowledge of clinicians about various testing methods. Thereby, they could interpret the results more accurately and provide better clinical services to patients.
Antineoplastic Agents ; administration & dosage ; adverse effects ; therapeutic use ; China ; Colorectal Neoplasms ; genetics ; pathology ; Consensus ; DNA Mismatch Repair ; DNA Sequence, Unstable ; Delivery of Health Care ; standards ; Endometrial Neoplasms ; Female ; Humans ; Immunohistochemistry ; Microsatellite Instability ; Microsatellite Repeats ; Microscopy, Fluorescence ; Polymerase Chain Reaction ; Practice Guidelines as Topic

The incidence of retroperitoneal tumor is low, and treatment is difficult.According to the recent updates of evidence-based medical evidence at home and abroad, the consensus on the standardized treatment of retroperitoneal tumors were discussed including examination and diagnosis , surgical treatment comprehensive treatment, nutrition, rehabilitation, and review and follow-up, etc.
Antineoplastic Agents ; administration & dosage ; adverse effects ; therapeutic use ; China ; Consensus ; Delivery of Health Care ; standards ; Humans ; Practice Guidelines as Topic ; Retroperitoneal Neoplasms ; diagnosis ; drug therapy ; pathology

Precision medicine became the key strategy in development priority of science and technology in China. The large population-based cohorts become valuable resources in preventing and treating major diseases in the population, which can contribute scientific evidence for personalized treatment and precise prevention. The fundamental question of the achievements above, therefore, is how to construct a large population-based cohort in a standardized way. The Chinese Preventive Medicine Association co-ordinated experienced researchers from Peking University and other well-known institutes to write up two group standards Technical specification of data processing for large population-based cohort study (T/CPMA 001-2018) and Technical specification of data security for large population-based cohort study (T/CPMA 002-2018), on data management. The standards are drafted with principles of emphasizing their scientific, normative, feasible, and generalizable nature. In these two standards, the key principles are proposed, and technical specifications are recommended in data standardization, cleansing, quality control, data integration, data privacy protection, and database security and stability management in large cohort studies. The standards aim to guide the large population-based cohorts that have been or intended to be established in China, including national cohorts, regional population cohorts, and special population cohorts, hence, to improve domestic scientific research level and the international influence, and to support decision-making and practice of disease prevention and control.
China ; Cohort Studies ; Delivery of Health Care ; Humans ; Population Surveillance ; Quality Control ; Reference Standards

Objective: Chronic obstructive pulmonary disease, asthma, interstitial lung disease and pulmonary thromboembolism are the most common and severe respiratory diseases, which seriously jeopardizing the health of the Chinese citizens. Large-scale prospective cohort studies are needed to explore the relationships between potential risk factors and respiratory disease outcomes and to observe disease prognoses through long-term follow-ups. We aimed to develop a common data model (CDM) for cohort studies on respiratory diseases, in order to harmonize and facilitate the exchange, pooling, sharing, and storing of data from multiple sources to serve the purpose of reusing or uniforming those follow-up data appeared in the cohorts. Methods: The process of developing this CDM of respiratory diseases would follow the steps as: ①Reviewing the international standards, including the Clinical Data Interchange Standards Consortium (CDISC), Clinical Data Acquisition Standards Harmonization (CDASH) and the Observational Medical Outcomes Partnership (OMOP) CDM; ②Summarizing four cohort studies of respiratory diseases recruited in this research and assessing the data availability; ③Developing a CDM related to respiratory diseases. Results: Data on recruited cohorts shared a few similar domains but with various schema. The cohorts also shared homogeneous data collection purposes for future follow-up studies, making the harmonization of current and future data feasible. The derived CDM would include two parts: ①thirteen common domains for all the four cohorts and derived variables from disparate questions with a common schema, ②additional domains designed upon disease-specific research needs, as well as additional variables that were disease-specific but not initially included in the common domains. Conclusion: Data harmonization appeared essential for sharing, comparing and pooled analyses, both retrospectively and prospectively. CDM was needed to convert heterogeneous data from multiple studies into one harmonized dataset. The use of a CDM in multicenter respiratory cohort studies would make the constant collection of uniformed data possible, so to guarantee the data exchange and sharing in the future.
Data Collection/standards* ; Databases, Factual/standards* ; Delivery of Health Care/organization & administration* ; Humans ; Information Dissemination ; Pulmonary Disease, Chronic Obstructive

Henan Province in China has a major epidemic of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS). Chinese medicine (CM) has been used throughout the last decade, and a management modality was developed, which can be described by unified-planning, graded-administration, and centralized-controlling (UGC). The UGC modality has one primary concept (patient-centered medicine from CM theory), four basic foundations (classifying administrative region, characteristics of CM on disease treatment, health resource conditions, and distribution of patients living with HIV), six important relationships (the "three uniformities and three combinations," and the six relationships therein guide the treatment of AIDS with CM), and four key sections (management, operation, records, and evaluation). In this article, the authors introduce the UGC modality, which could be beneficial to developing countries or resource-limited areas for the management of chronic infectious disease.
Acquired Immunodeficiency Syndrome ; therapy ; China ; Delivery of Health Care ; organization & administration ; HIV Infections ; therapy ; HIV-1 ; Health Plan Implementation ; organization & administration ; Health Planning ; organization & administration ; Health Planning Organizations ; organization & administration ; standards ; Humans ; Medicine, Chinese Traditional ; standards

OBJECTIVE: To evaluate outstanding and ordinary persons from personal characteristics using competency as the important criteria, which is the future direction of medical education reform. METHODS: We carried on a behavior event interview about famous doctors of old traditional Chinese medicine, compiled competency dictionary, proceed control prediction test. SPSS and AMOS were used to be data analysis tools on statistics. We adopted the model of peer assessment and contrast to carry out empirical research. RESULTS: This project has carried on exploratory factor analysis and confirmatory factor analysis, established a "5A" competency model which include moral ability, thinking ability, communication ability, learning and practical ability. CONCLUSION Competency model of "excellent doctor" in Chinese medicine has been validated, with good reliability and validity, and embodies the characteristics of traditional Chinese medicine personnel training, with theoretical and practical significance for excellence in medicine physician training.
Delivery of Health Care ; standards ; Education, Medical ; Medicine, Chinese Traditional ; Professional Competence ; Reproducibility of Results

This road map aims to establish a stable and integrated healthcare system for the Korean Peninsula by improving health conditions and building a foundation for healthcare in North Korea through a series of effective healthcare programs. With a basic time frame extending from the present in stages towards unification, the roadmap is composed of four successive phases. The first and second phases, each expected to last five years, respectively, focus on disease treatment and nutritional treatment. These phases would thereby safeguard the health of the most vulnerable populations in North Korea, while fulfilling the basic health needs of other groups by modernizing existing medical facilities. Based on the gains of the first two phases, the third phase, for ten years, would prepare for unification of the Koreas by promoting the health of all the North Korean people and improving basic infrastructural elements such as health workforce capacity and medical institutions. The fourth phase, assuming that unification will take place, provides fundamental principles and directions for establishing an integrated healthcare system across the Korean Peninsula. We are hoping to increase the consistency of the program and overcome several existing concerns of the current program with this roadmap.
Delivery of Health Care/methods/*organization & administration/standards ; Health Care Sector ; Health Manpower ; Humans ; Nutrition Assessment ; Republic of Korea

This study investigated the German experience in the transition to a unified health care system and suggests the following implications for Korea. First, Germany could have made use of the unification process better if there had been a good road map. Therefore Korea must develop a well prepared road map that considers all possible situations. Second, Germany saw an opportunity for the improvement of the health care system in the early stage of unification but could not take advantage of it because the situation changed dramatically and they had not sufficiently prepared for it. Korea should take into account the opportunity for improvement of the present health care system, such as the roles of public health and traditional medicine. Thirdly, the conditions f North Korea seem to be far worse than those of former East Germany and also worse than even those of other transition countries. Therefore Korea should design a long-term road map taking as many variables into account as possible, including the different rigid way of thinking and the interrelationship among the social sectors. Fourthly, during the German reunification unexpected factors changed the direction of the events. Korea should have a separate plan for the unexpected factors.
Ambulatory Care ; Delivery of Health Care/methods/*organization & administration/standards ; Germany ; Germany, East ; Humans ; Medicine, Traditional ; Public Health ; Republic of Korea

Delivery of Health Care ; Education, Medical ; standards ; Humans ; Schools, Medical ; standards ; Singapore

PURPOSE: Doctors are asked to play the roles of both a healer and a professional. In dealing with this inherent demand, we should first ask ourselves if we are selecting students who show traits that would enable them to become a good doctor. The primary concern of this study was to identify the core elements of medical professionalism that will develop into professional competence that we should be sought in medical school applicants. MATERIALS AND METHODS: One hundred-six responses from the Delphi survey done by medical school professors and 230 completed questionnaires from medical students were used for analysis. We also set out to analyze the level of medical professionalism in newly entering medical students using a 5-point Likert scale. RESULTS: Of the 27 elements of medical professionalism examined, the most important core element was thought to be 'life-long learning skills'. The level of professionalism in Korean medical students was mostly assessed to be less than the 3.0 mean score given by the professors. Medical students tended to rate themselves higher than did the professors for their level of medical professionalism. CONCLUSION: Medical professionalism can be categorized into three domains; professional knowledge, professional skills, and professional attitude. For the prominent differences in the recognition of the levels of professionalism elements in medical students by students and professors, further studies investigating the reasons for discrepancy are needed.
Data Collection ; Delivery of Health Care/standards ; Education, Medical/standards ; Physician's Role ; Professional Competence/standards ; Schools, Medical/*standards ; Students, Medical/*statistics & numerical data