1.A three-party evolutionary game analysis of patient privacy protection in live surgery
Han TIAN ; Jinping WU ; Yan ZHANG ; Jianyu ZHOU
Chinese Medical Ethics 2025;38(1):123-130
With the rapid development of network technology, live surgery has become the new way of surgery teaching. However, the issue of patient privacy protection caused by live surgery has received widespread attention. Based on the evolutionary game theory, this paper constructed an evolutionary game model from the three-party perspectives of doctors, patients, and government and analyzed the game behaviors of the three parties in the process of live surgery. Matlab software was utilized to conduct dynamic simulation and numerical simulation analysis. It was found that the factors affecting the choice of doctors’ strategies included protection costs, the cost of privacy leakage, the benefits of protection, high-traffic benefits, and other aspects; the factors affecting the choice of patient strategies encompassed surgical costs, the risk of privacy leakage, additional benefits, and other aspects; the factors affecting the choice of government strategies embodied regulatory costs and the improvement of credibility. To realize a win-win situation among doctors, patients, and the government, the three parties need to work together to ensure that patient privacy is not violated and find a balance between expanding the influence of medical education and protecting patient privacy.
2.Study on medical damage liability dispute cases involving breach of the duty to inform
Yan ZHANG ; Jinping WU ; Han TIAN ; Jianyu ZHOU
Chinese Medical Ethics 2025;38(5):582-587
ObjectiveTo understand the current situation of medical damage liability disputes involving breach of the duty to inform in China, analyze the factors influencing the types of medical staff’s breach of the duty to inform, and explore the notification problems of medical staff in clinical practice. On these foundations, suggestions were proposed to improve the performance of the duty to inform and reduce medical disputes. MethodsUsing public cases from the China Judgements Online as the data source, the relationship between risk points and types of breach of duty to inform was analyzed using the Chi-square test. Logistic regression analysis was performed to explore the influencing factors of the types of breach of the duty to inform, and qualitative research summarized the specific contents of breach of the duty to inform. ResultsThere were differences in the effects of factors, including whether the patient was hospitalized, whether surgery was performed, whether Intensive Care Unit (ICU) treatment was required, the level of the medical institution, and whether a consultation occurred, on the types of breach of the duty to inform (P<0.05). Whether surgery was performed was an influencing factor for the types of breach of the duty to inform. Qualitative research showed that the contents of breach of duty to inform primarily involve risk, treatment plan, and deficiencies in disease notification. ConclusionStrengthening the performance of the medical staff’s duty to inform should mainly focus on the medical side, coordinating with multiple parties and taking measures to improve the performance of the duty to inform, to reduce unnecessary medical disputes.
3.Clinical Dominant Disease of Traditional Chinese Medicine: Rheumatoid Arthritis
Jinping WANG ; Qingwen TAO ; Mei MO ; Zihan WANG ; Nan ZHANG ; Yuan XU ; Xiaoxiao ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):202-210
Rheumatoid arthritis (RA) is an autoimmune disease characterized primarily by erosive arthritis, with a high prevalence and disability rate. Although significant progress has been made in the treatment of RA in recent years, challenges such as suboptimal efficacy, drug resistance, severe side effects, and high costs of long-term treatment remain, especially for patients in the early stages of RA, as well as those with RA complications, comorbidities, and severe conditions. Hosted by the China-Japan Friendship Hospital and organized by the Youth Committee of the China Association of Chinese Medicine, the 27th session of the Clinical Dominant Disease Series (Rheumatoid Arthritis) Youth Salon invited nearly 20 experts and scholars from traditional Chinese medicine (TCM), western medicine, and interdisciplinary fields to actively discuss the clinical needs of modern medicine and the advantageous stages and aspects of TCM in RA. Experts at the salon agreed that TCM has unique advantages in the treatment of RA, especially during the early stage, periods of low to moderate disease activity, remission phase, and in addressing complications and comorbidities. TCM can achieve both prevention and treatment by regulating the immune system and restoring immune homeostasis. The integrated approach of traditional Chinese and western medicine demonstrates significant advantages in active RA, refractory cases, and stages with severe complications, by rapidly controlling disease progression, alleviating symptoms, enhancing the quality of life, and facilitating recovery. Given the frequent occurrence of multiple comorbidities in RA, TCM shows potential in regulating immunity, alleviating symptoms, and improving physical constitution, which provides new insights into the comprehensive treatment of RA with comorbidities. However, high-quality clinical studies on integrated traditional Chinese and western medicine in RA are still lacking. It is necessary to establish large-scale clinical cohorts and biological databases to provide a scientific basis for the development of precision-targeted therapies and clinical treatment protocols. In the future, individualized treatment strategies integrating traditional Chinese and western medicine are expected to become an important direction for improving the quality of life in RA patients.
4.Clinical Dominant Disease of Traditional Chinese Medicine: Rheumatoid Arthritis
Jinping WANG ; Qingwen TAO ; Mei MO ; Zihan WANG ; Nan ZHANG ; Yuan XU ; Xiaoxiao ZHANG
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(17):202-210
Rheumatoid arthritis (RA) is an autoimmune disease characterized primarily by erosive arthritis, with a high prevalence and disability rate. Although significant progress has been made in the treatment of RA in recent years, challenges such as suboptimal efficacy, drug resistance, severe side effects, and high costs of long-term treatment remain, especially for patients in the early stages of RA, as well as those with RA complications, comorbidities, and severe conditions. Hosted by the China-Japan Friendship Hospital and organized by the Youth Committee of the China Association of Chinese Medicine, the 27th session of the Clinical Dominant Disease Series (Rheumatoid Arthritis) Youth Salon invited nearly 20 experts and scholars from traditional Chinese medicine (TCM), western medicine, and interdisciplinary fields to actively discuss the clinical needs of modern medicine and the advantageous stages and aspects of TCM in RA. Experts at the salon agreed that TCM has unique advantages in the treatment of RA, especially during the early stage, periods of low to moderate disease activity, remission phase, and in addressing complications and comorbidities. TCM can achieve both prevention and treatment by regulating the immune system and restoring immune homeostasis. The integrated approach of traditional Chinese and western medicine demonstrates significant advantages in active RA, refractory cases, and stages with severe complications, by rapidly controlling disease progression, alleviating symptoms, enhancing the quality of life, and facilitating recovery. Given the frequent occurrence of multiple comorbidities in RA, TCM shows potential in regulating immunity, alleviating symptoms, and improving physical constitution, which provides new insights into the comprehensive treatment of RA with comorbidities. However, high-quality clinical studies on integrated traditional Chinese and western medicine in RA are still lacking. It is necessary to establish large-scale clinical cohorts and biological databases to provide a scientific basis for the development of precision-targeted therapies and clinical treatment protocols. In the future, individualized treatment strategies integrating traditional Chinese and western medicine are expected to become an important direction for improving the quality of life in RA patients.
5.Analysis of 100 Cases of Nurse-patient Communication from the Perspective of Ethic, Psychology and Law
Jinping ZHAO ; Xinqing ZHANG ; Jie HU
Chinese Medical Ethics 2024;35(6):643-648
With the implementation of the Healthy China Strategy, the value of care has become increasingly prominent. It has become an important nursing topic to strengthen the theoretical and practical research of nurse-patient communication, especially to understand the current state, and explore the essential characteristics, the influencing factors and the differences in interdisciplinary perspectives of nurse-patient communication. Through systematic analysis of 100 real clinical nurse-patient communication cases, this paper found that the problem of poor nurse-patient communication still existed widely, which is prominently manifested as the inhibition of communication willingness, the dislocation of communication topics and the lack of communication consensus. The causes of poor nurse-patient communication were nurses’ poor communication skills, negative emotional distress, the lack of humanistic literacy and insufficient energy investment in communication, as well as the patient’s fragile state, the limitation of knowledge and cultural level, and insufficient trust in nurses. The interdisciplinary perspective analysis of ethics, psychology and law is conducive to enriching and developing the theoretical basis and research methods of nurse-patient communication, and can also provide useful suggestions for improving nurse-patient communication in clinical.
6.Effects of ivabradine on vascular endothelial function in patients with coronary artery disease:a meta-analysis
Congling CHEN ; Xian YANG ; Han WU ; Jiachen YING ; Ruobin ZHANG ; Xi LAN ; Jinping ZHANG
China Pharmacy 2024;35(6):744-749
OBJECTIVE To evaluate the effects of ivabradine on vascular endothelial function in patients with coronary artery disease. METHODS PubMed, Embase, the Cochrane Library, Web of Science, CNKI, Wanfang Data, VIP and CBM databases were retrieved to collect randomized controlled trials (RCTs) about ivabradine (intervention group) versus placebo or β-blocker (control group) from the inception to Mar. 20th 2023. The meta-analysis was performed by using RevMan 5.4 software after literature screening, data extraction and quality evaluation. RESULTS A total of 12 RCTs were included, involving 1 206 patients. The results of meta-analysis showed that the levels of flow-mediated dilation (FMD) [MD=1.71, 95%CI (0.96, 2.46), P<0.000 01] and nitric oxide (NO) [MD=5.80, 95%CI (5.02, 6.59), P<0.000 01] in the intervention group were significantly higher than control group, while endothelin-1(ET-1) level was significantly lower than control group [MD=-7.45, 95%CI (-8.42, -6.47), P<0.000 01]. There was no statistical significance in nitroglycerin-mediated dilation (NMD) level between 2 groups [MD=0.13, 95%CI(-0.74, 1.00), P=0.77]. Subgroup analyses based on the different medications and intervention time in the control group showed better improvement in FMD level of patients receiving ivabradine, compared with placebo (P<0.05); compared with placebo and β-blocker, the level of NO in patients receiving ivabradine was improved significantly (P<0.05), while ET-1 level was decreased significantly (P<0.05). Regardless of the duration of the intervention, the levels of FMD, NO, and ET-1 in the intervention group were significantly improved compared to the control group (P<0.01), while the difference in NMD was not statistically significant (P>0.05). CONCLUSIONS Ivabradine can improve vascular endothelial function in patients with coronary artery disease.
7.Establishment of hierarchical management standard in patients with chronic obstructive pulmonary disease from the perspective of pharmacists based on Delphi method
Ruobin ZHANG ; Qiuhui WU ; Xinrui CAO ; Congling CHEN ; Jinping ZHANG
China Pharmacy 2024;35(7):860-865
OBJECTIVE To develop a standard of hierarchical management for patients with chronic obstructive pulmonary disease (COPD) from the perspective of pharmacists. METHODS The triangle hierarchical management model was used as the framework. Through literature research, the indicators of the hierarchical management standard for COPD patients were preliminarily compiled. A questionnaire was designed and administered to 18 experts, and Delphi method was conducted in two rounds to determine the contents of the standard. RESULTS The response rates for both rounds of expert consultation were 100%, with both authority coefficients of experts of 0.903 and Kendall coordination coefficiens of 0.279 and 0.189 for each indicator. The final established standard of hierarchical management for COPD patients included 25 stratified indicators and 17 pharmaceutical hierarchical management indicators. There were 9, 8 and 8 indicators in the high-risk, medium-risk, and stable layers, respectively, considering three aspects: disease, medication, and self-management level. The corresponding first-level, second- level, and third-level pharmaceutical management included 6, 6 and 5 indicators, respectively, including inhalation technical guidance, medication adherence guidance, treatment monitoring, and follow-up, etc. CONCLUSIONS The standard of hierarchical management for COPD patients established by Delphi method is scientific and reliable, which can provide a reference for pharmacists to carry out hierarchical management of COPD patients in China.
8.Explorationand practice of hospital air medical rescue capability construction
Taihui ZHANG ; Geng WU ; Jinping MA ; Jintao FENG ; Yangping LIU
Modern Hospital 2024;24(1):107-110,113
Taking into consideration the characteristics and current development status of air medical rescue,an analysis is conducted from the perspective of hospitals to examine the focal points and challenges in establishing the capability of hospital air medical rescue.A capability framework comprising five modules,namely planning system,service model,professional teams,hardware platform,and operational procedures,is proposed.The key tasks for each module are sorted out.Furthermore,the ex-ploration and practical experience of The First Affiliated Hospital of Sun Yat-sen University are shared,with the aim of providing a reference for the construction of hospital air medical rescue capabilities in the modern era.
9.Hotspots and frontiers of human resource allocation research in public hospitals:a CiteSpace-based analysis of domestic and international studies
Ling YIN ; Tong ZHAO ; Jinping DI ; Fangjie WANG ; Haixiang SUN ; Qing ZHANG ; Xue ZHENG ; Wei CAO
Modern Hospital 2024;24(3):340-347,350
Objective To investigate the current status,evolving hotspots,and emerging trends in the field of human re-source allocation research in public hospitals,both domestically and internationally,to provide a reference for future research di-rections in China.Methods CiteSpace was used to conduct a visual analysis of the research literature on human resource alloca-tion in public hospitals based on China National Knowledge Infrastructure(CNKI)and the Web of Science(WOS).The analysis encompassed co-authorship,institutional collaboration,keyword co-occurrence and clustering,and burst detection.Results A total of 1 417 Chinese articles and 981 international articles were included.Domestic research in this field focused more on healthcare reform and management,resource allocation,hierarchical diagnosis,and treatment,and informatization and efficiency improvement.On the contrary,international research primarily centered on the employee satisfaction,healthcare system quality,work environment and medical staff.Future trends in domestic research included cost reduction,efficiency enhancement,and a greater emphasis on public welfare in public hospitals,while international research was beginning to explore the influence of polit-ical concepts in this field.Conclusion Compared to international research,domestic research needs to further improve its theo-retical and localized understanding,broaden its research scope,explore the interdisciplinary collaboration opportunities,and delve into research directions such as the application of artificial intelligence and automation technology in healthcare services,management of a diverse workforce,and innovative management techniques and applications.
10.Pharmacoeconomics of ivabradine in the treatment of CHF in the context of “Quadruple Therapy”
Congling CHEN ; Han WU ; Jie ZHOU ; Ruobin ZHANG ; Jinping ZHANG ; Xue BAO ; Xian YANG
China Pharmacy 2024;35(1):63-68
OBJECTIVE To evaluate the cost-effectiveness of ivabradine in the treatment of chronic heart failure (CHF) in the context of “Quadruple Therapy” from the perspective of the health system. METHODS Based on real-world cohort data, the Markov model was constructed according to the natural progression of CHF, with a cycle time of 3 months, a study timeframe of 20 years, and a discount rate of 5%. Using quality-adjusted life year (QALY) and incremental cost-effectiveness ratios (ICER) as the output indexes, the cost-utility analysis was used to evaluate the cost-effectiveness of ivabradine in combination with the “Quadruple Therapy” regimen, compared with the “Quadruple Therapy” regimen for the treatment of CHF, and the robustness of the results of the base analysis was verified by univariate sensitivity analysis and probabilistic sensitivity analysis. RESULTS The results of the base analysis showed that the ICER of ivabradine combined with the “Quadruple Therapy” regimen was 165 065.54 yuan/QALY, compared with the “Quadruple Therapy” regimen, which was lower than the willingness-to-pay (WTP) threshold (257 094 yuan/QALY) based on 3 times of China’s gross domestic product (GDP) per capita in 2022. The results of the univariate sensitivity analysis showed that the discount rate had the greatest impact on the robustness of the model. The probabilistic sensitivity analysis showed that the probability that the ivabradine combined with the “Quadruple Therapy” regimen was cost-effective under the WTP threshold in this study was 59.50%. CONCLUSIONS When using 3 times China’s 2022 GDP per capita (257 094 yuan/ QALY) as the WTP threshold, the combination of ivabradine and the “Quadruple Therapy” regimen for treating CHF is cost- effective.

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