The development of health-promoting hospitals is an important part of the Healthy China Initiative， facilitating the transformation of medical institutions from a primary focus on medical and surgical treatments to a patient-centered approach prioritizing public health. To promote the scientific， standardized， and sustainable development of health-promoting hospitals， the Shanghai Municipal Center for Health Promotion， together with Shanghai General Hospital and other institutions， has jointly developed the Standards for the Development of Health⁃promoting Hospitals （Standards） in accordance with the principles of scientific rigor， feasibility， and advancing with the times. The Standards outlines the requirements for the development of health-promoting hospitals across four aspects： organizational and institutional guarantees， creation of a healthy environment， implementation of health education and promotion， and evaluation. It is applicable to all levels and types of public medical institutions in Shanghai， and can also be referred to and implemented by other medical institutions. The introduction of the Standards is of great significance for promoting the formation of a long-term mechanism in health-promoting hospitals. This paper introduces the basis， principles， main content， precautions， and implementation suggestions of the Standards. Taking into account relevant policies and standards， it interprets the technical aspects in the process of developing health-promoting hospitals， which is helpful for medical institutions and their management to better understand and apply the standards in their work.

With the continuous development of China's economy,the people expect for higher quality medical services,and medical humanistic care is increasingly emphasized.Under this background,the"Duplex Linkage Mode",which integrates medical social workers and volunteers,has emerged.This paper reviews the current state of applying the mode in China,ex-pounds its benefits,and details its application within hospital services.This application covers guidance for outpatient and emer-gency department,inpatient ward services,hospice care,and community residents volunteer services.In addition,this paper proposes suggestions on furth for optimizing recruitment and training programs,improving management systems,establishing intel-ligent management systems,and improving volunteer support mechanisms.These measures aim to promote the sustainable and healthy development of medical humanistic services and to support the implementation of the Healthy China Initiative.

Objective:To analyze the hot spots and frontiers of medical quality and safety management since the new medical reform, and to provide reference for the continuous improvement of medical quality and safety management.Methods:Chinese literatures related to medical quality and medical safety management in CNKI database from April 2009 to December 2022 were retrieved, and the included literatures were processed and analyzed by CiteSpace software and Excel software.Results:1 921 literatures related to medical quality management and 2 497 literatures related to medical safety management were included. The publication trend showed a " double peak", showing a downward trend. The research hotspots in literature related to medical quality and safety management in China since the new medical reform have focused on practice exploration and influencing factors. The trend of future research is to closely follow the background of the times in medical quality and safety management research and intelligent medical quality and safety management evaluation system research.Conclusions:In the future, research on medical quality and safety management should be more in line with the changes of medical reform policies, focus on high-quality development to deepen the research on micro issues, promote information construction to continuously improve the indicator evaluation system, so as to promote the sustainable and high-quality development of medical quality and safety management in China.

Objective:To construct a theoretical model of medical quality and safety management based on the current situation of medical quality and safety management mode in China, providing reference for continuous improvement of medical quality and safety management.Methods:The CNKI database was used as the data source to search literature, with a high citation index H=38 as the judgment standard, the core literature related to the quality and safety management in China was selected. Based on the structure-process-outcome (SPO) model, Nvivo qualitative analysis software was used to code and analyze the included literature, sort out the relevant elements of China′s medical quality and safety management, and clarify the logical relationship between the elements, forming a generalized SPO model of China′s medical quality and safety management.Results:Through a systematic summary and review of relevant literature, a generalized SPO model for medical quality and safety management was proposed, including 5 structural elements (organizational structure, personnel management, resource management, informatization, management standards), 2 process elements (management methods, service processes), and 3 outcome elements (patient outcomes, employee outcomes, organizational results). The logical relationships between and within the three major elements were constructed.Conclusions:To improve the level of medical quality and safety management in China, the structural dimension should be focused on clarifying the responsibilities of the main body of quality management, establishing an independent and perfect quality control department, strengthening the investment and construction of information technology, and promoting the implementation of the medical quality management standard; the process dimension should be focused on promoting the rational application of quality management tools; and the outcome dimension should be focused on strengthening the management of patient safety and improving the individual satisfaction.

Objective:To systematically construct the foreign medical quality and safety management model by searching the English literature related to medical quality and safety management, so as to provide reference for improving the level of medical quality and safety management in China.Methods:The Web of Science database was used as the data source, the English literature related to medical quality and safety management in foreign countries was screened following the PRISMA guidelines, and the content of the screened literature was analyzed using qualitative text analysis based on the Structure Process System Outcome (SPSO) theoretical model.Results:In this study, a total of 37 articles were screened, 5 first-level themes of structure, process, system, outcome and continuous quality improvement were identified, 16 second-level themes were found, and their functional relationships were established. A theoretical model of the SPSO-Extension (SPSO-E) for medical quality and safety management was constructed, added new elements of the external environment, organizational outcome and employee outcome, and refined the continuous quality improvement into three segments of quality checking, problem handling and quality consolidation.Conclusions:In order to improve medical quality and safety management in China, the internal management model of the hospital should be dynamically adjusted according to the changes of external environment, and the result dimension should pay attention to the improvement of organization′s operational effectiveness and the physiological and psychological aspects of the staff. The final management results have a feedback effect on the hospital′s resource allocation, service delivery, organizational arrangements and cultural construction, promoting continuous improvement and enhancement of the hospital′s quality.

Objective:To construct future-oriented theoretical management model for medical quality and patient safety.Methods:Procedure grounded theory was applied to code data including 30 expert interview records from July 2021 to June 2022 and the qualitative analysis results of 71 core literatures in Chinese and English, and then the theoretical model was constructed.Results:After three-level coding, 555 reference points, 249 initial concepts, 41 categories, 27 main categories and 7 core categories related to medical quality and safety management were sorted out, and the theoretical model of SQ (I-SPORT) matrix for medical quality and safety management was constructed. This model extended the traditional dimension in quality and safety management.Conclusions:Regarding medical quality and safety management, on one hand, should focus on the systematic improvement of structure, process, results, reengineering, education and training in terms of management functions; on the other hand, it is necessary to improve the organization, employees, resources, technology and tools, and patient experience in terms of management elements.

Objective To explore methods to measure the management level of Chinese hospitals in natural conditions of Chinese hospitals, for improvement of their operation efficiency. Methods The methodology of World Management Survey( WMS) was introduced, and the questionnaire was localized using expert consultation method. Double-blind telephone interviews were conducted to investigate the management level of Chinese hospitals in the four dimensions of standardized operation, performance monitoring, target setting and talent management. Results The management level of hospitals in China varied greatly from places. Among them, the hospital management scoring was found to range from 2. 50 to 2. 75 in most cases, averaging 2. 55. These hospitals scored relatively poor at the four specific management practices of hospital layout(2.48), performance communication(2.27), talents retention, and clarity and comparability of objectives(2. 45). Management level of a hospital was correlated to such factors as its history, ownership form, human capital and hospital size. Conclusions This study uses WMS methodology to quantify Chinese hospital management. The overall management level of Chinese hospitals is expected to improve with much gaps to cover. At this stage, it is imperative to solve the unbalanced and inadequate development of hospital management levels, among regions, hospital grades and forms of ownership.

China still has more than 30,000 patients of advanced schistosomiasis while new cases being reported consistently. D-dimer is a fibrin degradation product. As ascites being the dominating symptom in advanced schistosomiasis, the present study aimed to explore a prediction model of ascites with D-dimer and other clinical easy-achievable indicators. A case-control study nested in a prospective cohort was conducted in schistosomiasis-endemic area of southern China. A total of 291 patients of advanced schistosomiasis were first investigated in 2013 and further followed in 2014. Information on clinical history, physical examination, and abdominal ultrasonography, including the symptom of ascites was repeatedly collected. Result showed 44 patients having ascites. Most of the patients' ascites were confined in the kidney area with median area of 20 mm². The level of plasma D-dimer and pertinent liver function indicators were measured at the initial investigation in 2013. Compared with those without ascites, cases with ascites had significantly higher levels of D-dimer (0.71±2.44 μg/L vs 0.48±2.12 μg/L, P=0.005), as well ALB (44.5 vs 46.2, g/L) and Type IV collagen (50.04 vs 44.50 μg/L). Receiver operating characteristic curve analyses indicated a moderate predictive value of D-dimer by its own area under curve (AUC) of 0.64 (95% CI: 0.54–0.73) and the cutoff value as 0.81 μg/L. Dichotomized by the cutoff level, D-dimer along with other categorical variables generated a prediction model with AUC of 0.76 (95% CI: 0.68–0.89). Risks of patients with specific characteristics in the prediction model were summarized. Our study suggests that the plasma D-dimer level is a reliable predictor for incident ascites in advanced schistosomiasis japonica patients.
Area Under Curve ; Ascites* ; Case-Control Studies ; China ; Cohort Studies ; Collagen Type IV ; Fibrin ; Humans ; Kidney ; Liver ; Physical Examination ; Plasma* ; Prospective Studies* ; ROC Curve ; Schistosoma japonicum ; Schistosomiasis japonica* ; Schistosomiasis* ; Ultrasonography

A series of 4-phenyl-pyrrolo[2,3-d] pyrimidine derivatives were synthesized through modifying the structure of the lead compound ruxolitinib by molecular hybridization strategy.It was synthesized from pyrimidine-4,6-diol by Vilsmeier-Haack reaction,SNAr reaction,cyclized,dehydration,Suzuki coupling and finally acylated to give 12 new compounds(12a-121).All structures of the synthesized compounds were confirmed by 1H NMR,13C NMR,and HRMS analysis.The biological activities were evaluated in vitro.Their JAK2 inhibitory activities were studied using JAK2 enzymatic and TF1-GMCSF cellular assays.The results indicated that compounds 12b,12e and 12h showed moderate activity.The anti-tumor activities were studied against JAK2-independent A549 cell line by the MTT assay.Results showed that the tide compounds exhibited potent antiproliferative effect on A549,especially compound 12c(IC50 =0.12 μmol/L),suggesting that this series compounds might be promising anti-tumor agents for futher investigation.

OBJECTIVE:To explore the application and feasibility of tracer methodology in the continuous improvement of high-alert medications management in the hospital,and to improve the quality of high-alert medications management and ensure the safety of clinical medication. METHODS:According to the theory and requirements of tracer methodology,a series of interven-tions were applied to the management of high-alert medications in our hospital. The comparisons on the mastery of high-alert medi-cations knowledge,review and evaluation results and the incidence of adverse events were conducted before and after applying trac-er methodology,so as to evaluate the improvement effect of tracer methodology on high-alert medications management. RESULTS:After implementing intervention measures such as the reduction of high-alert medications list and medical staff training about high-alert medications,compared to before management,medical staffs had improved the knowledge level of high-alert medica-tions (the average awareness rate increased from 69.6% to 88.5%);the review and evaluation results had been improved signifi-cantly (the proportion of the terms with qualified level evaluation results or above increased from 66.67% to 88.89%);the inci-dence of adverse events was reduced(from 0.321% to 0.139%). CONCLUSIONS:The tracer methodology has a significant effect on the management of high-alert medications in our hospital. It is feasible and can be widely used in the management of high-alert medications in the hospitals.