刍议新医疗机构财务会计五项制度执行的难点及存在问题

新《医院财务制度》和《医院会计制度》等五项制度自2011年7月1日起在公立医院改革国家联系试点城市施行,自2012年1月1日起在全国施行。由于在全国公立医院发展步伐快慢不一、内部管理办法各异,特别是信息化建设程度不同,造成了执行和落实新《医院财务制度》等五项制度过程中出现疑问和困难,在执行和落实新《医院会计制度》等五项制度过程中,应该深化财政财务管理体制改革,实现科学化精细化管理,维护公共医疗卫生公益性,科学、合理确定公立医院补偿机制,进一步完善相关规定。

A Study on Construction of Quality Security System in the Cultivation of Top-notch Innovative Medical Talents

In order to cultivate the top-notch innovative talents with the intemational perspectives, on the basis of the principles of objective, utility, humanities and practice, medical institutions should update the concept of talent cultivation led by employment, innovate teaching mode by deepening teaching reform, optimize the teaching staff by strengthening cooperation between college and enterprise, widen the practical teaching by participating interaction with pharmaceutical industries, and improve the teaching supervision system by implementing quality requirements to construct quality security system in the cultivation of top-notch innovative medical talents.

Research Progress of Transdermal Patches in Veterinary Drug Preparations

With the development of pharmaceutics and other disciplines theories and advanced technologies, the application of many new drug delivery systems has gradually increased in clinical veterinary. Among the many drug delivery systems, transdermal patch can maintain stable and effective plasma concentration and therapeutic effect in vivo for a long time after skin dressing delivery, which provides a safe and effective drug-delivery way for the therapy and prevention of some chronic diseases and partial analgesia in a simple and convenient way. Veterinary drug transdermal preparations have been developed both at home and abroad, and satisfactory results have been achieved in the experimental application. Based on the study of veterinary transdermal patches at home and abroad, this paper systematically describes the development and characteristics of transdermal patches, the factors affecting skin permeation and the evaluation this type of preparations in veterinary drugs.

腹膜后恶性纤维组织细胞瘤的螺旋CT诊断价值

目的探讨腹膜后恶性纤维组织细胞瘤(MFH)的螺旋CT表现及诊断价值。材料和方法回顾性分析20例经手术或活检病理证实的后腹膜恶性纤维组织细胞瘤的临床和CT检查资料。结果 20例中,肿瘤最大平均直径为10.5cm。肿瘤形态不规则伴明显分叶,坏死部分占肿瘤体积的大部分,病灶呈浸润性生长。5例肿瘤内可见钙化,3例肿瘤见出血灶,3例肿瘤有脂肪成分。增强扫描肿瘤强化较明显,所谓轨道样强化4例。重建后肿瘤定位准确18例。结论螺旋CT对腹膜后恶性纤维组织细胞瘤(MFH)有一定的诊断价值。

Clinical Efficacy and Therapeutic Mechanisms of Traditional Chinese Medicine for Neuroprotection and Neurogenesis in Stroke Treatment

Stroke is the leading cause of human disability with limited effective drugs availability. The disruption of multiple signaling pathways in stroke makes developing new drugs be difficult. Traditional Chinese medicine(TCM) has its unique advantage in targeting multiple signaling pathways with multiple components. Many TCM formulas have the potential for neuroprotection and neurogenesis, but well-designed clinical trials are insufficient and underlying mechanisms unclear. Herein, we introduce the commonly used TCM formulas for stroke treatment and selectively introduce two classic formulas, An Gong Niu Huang(AGNH) pill and Bu Yang Huan Wu Decoction(BYHWD) for neuroprotection and neurogenesis, respectively. Current scientific evidence and clinical trials indicate AGNH pill could be an effective neuroprotective formula as adjunct therapy with relative safety. On the other hand, as a representative TCM formula for post stroke disability, BYHWD could improve the neurological outcome with its neuroprotective and neurogenic effects. The underlying mechanisms could be attributed to the modulation of multiple molecular targets with its multiple components. In conclusion, TCM formulas could be potential adjunct therapies for stroke treatment. The clinical efficacies and molecular mechanisms of promoting neuroprotection and neurogenesis remain to be further studies.

Disruptive Innovation in the Nordic Countries＇ Healthcare Systems

The Nordic healtheare model is recognized to be one of the most innovative in the world. Here billions of USD are annually invested in developing new treatments, drugs, robots etc. to diagnose and cure diseases. Nevertheless, this study establishes that there is a fundamental shortcoming in the system that supports healthcare innovation： It is strongly biased towards micro-level innovation projects focusing on new products, alternative processes, and new financial solutions. The problem with this approach to support new projects is that the results are created as inventions within the system thus lacking holistic perspectives. This has consequently contributed with increasing costs that are out of proportion with existing budgets. Therefore this study seeks to analyze the current understanding of the Nordic healthcare system from a business model perspective. Here other aspects of the healthcare system are explored to determine if they could be redesigned to promote new types of innovation projects. The purpose of undertaking this task is to challenge the established patterns of the current healthcare innovation support practices. Here the vertical innovation process （VIP） framework, which is a systematic radical innovation model that seeks macro-level outcomes based on standalone inventions （see more below）, is applied to analyze the current state-of-the-art in Nordic healthcare innovation projects. The results determine that very little attention is given to rethink and redesign the healthcare system at a macro-level, and it is discussed that stand-alone inventions ought to be rethought into the entire healthcare system to create a larger impact. Finally, it is argued that existing performance measures are inappropriate to foster projects that innovate the existing system： New measuring points should be developed to promote macro-level projects and to avoid the current rapid increase of costs in the Nordic healthcare system.

The study of the situation of critical thinking emotional tendency of nursing teachers

Critical thinking （CT） is an important content of nursing education. It is also the important symbol of the improvementof overall quality of nursing teachers. In recent years, educational circles pay more and more attention to the cultivationof students’ CT ability, take CT and solve the problem as two basic skills of thinking. In the early 1980s, critical societytheory was led into the nursing field. After years of development, CT has become one of research hotspots in today’sinternational nursing. Numerous studies had confirmed that the CT played a significant role in nursing education, clinicalpractice and nursing scientific research. The paper studied the whole status and characteristics of CT emotional tendencyof college nursing teachers, and analyzed potential cause and discussed deeply on the corresponding factors of how toimprove college nursing teachers’ teaching ability and scientific ability. This research adopted random sampling method,in which questionnaires were distributed among some nursing teachers in six universities and 97 nursing teachers. Thestatistical results indicated that nursing teachers had a positive performance towards CT emotional tendency, but notstrong positive, and there were statistical significance among nursing teachers with different age, different length ofservice and reading habit （all P〈0.05）. In a conclusion, the managers of universities should lay stress on the importanceof critical thinking, and provide the development space to enhance the nursing teachers’ CT ability and offer betterservices for nursing student.

Opportunities and challenges for the development of traditional Chinese medicinenursing under the new healthcare reform

Based on the “Opinions on Deepening the Reform of Medicine and Health”, “Strategic planning outline of thedevelopment of Traditional Chinese Medicine （2016-2030）” and the other relevant polices announced by StateAdministration of Traditional Chinese Medicine of the People’s Republic of China, this paper analyzes and summarizesthe opportunities and challenges for the development of Traditional Chinese Medicine nursing （TCM nursing） under thenew healthcare reform, in order to provide reference and thinking for the professional development of TCM nursing.

Health Is the Key to Happiness——Profile of Dr.Lixin Shen,President & CEO of Wuxi Howfond Biopharma Co.,Ltd.

No matter where he is and what he does,Dr. Shen always considers himself as a devoted researcher,and holds tough mind that he will go further along the medicine innovation, heading for the health and happiness of human being.

Hospital readmissions in decompensated cirrhotics: Factors pointing toward a prevention strategy

AIM To reduce readmissions and improve patient outcomes in cirrhotic patients through better understanding of readmission predictors.METHODS We performed a single-center retrospective study of patients admitted with decompensated cirrhosis from January 1, 2011 to December 31, 2013(n = 222). Primary outcomes were time to first readmission and 30-d readmission rate due to complications of cirrhosis. Clinical and demographic data were collected to help describe predictors of readmission, along with care coordination measures such as post-discharge status and outpatient follow-up. Univariate and multivariateanalyses were performed to describe variables associated with readmission.RESULTS One hundred thirty-two patients(59.4%) were readmitted at least once during the study period. Median time to first and second readmissions were 54 and 93 d, respectively. Thirty and 90-d readmission rates were 20.7 and 30.1 percent, respectively. Predictors of 30-d readmission included education level, hepatic encephalopathy at index, ALT more than upper normal limit and Medicare coverage. There were no statistically significant differences in readmission rates when stratified by discharge disposition, outpatient follow-up provider or time to first outpatient visit.CONCLUSION Readmissions are challenging aspect of care for cirrhotic patients and risk continues beyond 30 d. More initiatives are needed to develop enhanced, longitudinal post-discharge systems.

A Decade of Scien tific and Tech no logical Inno vati on at Chin ese Academy of Medical Sciences&Peking Union Medical College:Retrospect and Prospect

Focusing on the reform initiatives of Chinese Academy of Medical Sciences(CAMS) & Peking Union Medical College(PUMC) in medical scientific and technological innovation from perspectives of deepening the reform and optimizing the ecosystem of science and technology innovation,this article summarizes the highlights of CAMS & PUMC’s efforts in safeguarding people’ s health and promoting the Healthy China 2030 strategy through scientific and technological innovation in the fields including basic research,disease prevention and treatment,and medical technology in the past ten years.These achievements embody the endeavors and responsibility of CAMS& PUMC in realizing self-reliance and self-improvement of Chinese medical science and technology and highlight its contributions to the development of medical science and technology of China.

The rationale behind the four major anti-COVID-19 principles of Chinese herbal medicine based on systems medicine

As the novel coronavirus disease 2019(COVID-19)and its variants continue to rage into the second year of a global pandemic,many success stories of applying Chinese herbal medicine(CHM)to treat COVID-19 patients continue to emerge from China and other part of the world.Herewith,from a systems medicine perspective,the authors analyze those experiences and categorize them into four major treatment principles:(1)focusing on eliminating toxins in the early stage of the disease,(2)tonifying deficiency of the body throughout the entire disease course,(3)treating the affected lung and intestine simultaneously based on visceral interactions,(4)cooling blood and removing blood stasis at the later stage,as well as interpret the rationale of these principles.This is helpful not only in reducing the complexity of promoting the CHM applications to enhance anti-COVID-19 efficacy,but also in ramping out the process of integrating traditional Chinese medicine with modern medical practices.

A Brief Review of Animal Models for COVID-19

Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)causes an outbreak of corona virus disease 2019(COVID-19)globally.It is to date one of the biggest public health threat in the world.Although studies on this emerging coronavirus have developed rapidly since the COVID-19 case was confirmed,there is much remains unknown about SARS-CoV-2.To better understand the mechanism of cross-species transmission and search for efficient vaccines and therapeutics for COVID-19,animal models are highly required to evaluate countermeasures against emerging COVID-19.An ideal animal model should respond as similar as human be-ings to SARS-CoV-2 infection and show analogical symptoms,reflecting the human beings clinical sign,viral replication,and pathology that can be applied to identify in human beings.Fortunately,several animal models have been developed to study SARS-CoV-2 and aim to find new vaccines,antiviral agents,and Chinese materia medica very shortly.We aim to review the climical presentations of COVID-19 concerning pathologic features in humans and summarize the current animal models'strengths and limitations of use for SARS-CoV-2.

Discussion on the thinking innovation of the “Treatment based on syndromedifferentiation” according to “Precision medical”

Based on the concept of ＂precision medicine＂, this paper is to probe into the thinking innovation thought anddevelopment direction of ＂dialectical theory＂ of TCM, and to compare the development prospects of ＂syndromedifferentiation＂ and ＂genetic constitution＂. It points out that the dialectical concept of ＂syndrome differentiation andtreatment＂ is combined with the concept of high and new technology of ＂precision medicine＂ to further clarify thescientific connotation of traditional Chinese medicine.

Quality 4.0 technologies to enhance traditional Chinese medicine for overcoming healthcare challenges during COVID-19

The Quality 4.0 concept is derived from the industrial fourth revolution,i.e.,Industry 4.0.Quality 4.0 is the future of quality,where new digital and disruptive technologies are used to maintain quality in organizations.It is also suitable for traditional Chinese medicine(TCM)to maintain quality.This quality revolution aims to improve industrial and service sectors’quality by incorporating emerging technologies to connect physical systems with the natural world.The proposed digital philosophy can update and enhance the entire TCM treatment methodology to become more effective and attractive in the current competitive structure of the pharmaceutical and clinical industries.Thus,in healthcare,this revolution empowers quality treatment during the COVID-19 pandemic.There is a major requirement in healthcare to maintain the quality of medical tools,equipment,and treatment processes during a pandemic.Digital technologies can widely be used to provide innovative products and services with excellent quality for TCM.In this paper,we discuss the significant role of Quality 4.0 and how it can be used to maintain healthcare quality and fulfill challenges during the pandemic.Additionally,we discuss 10 significant applications of Quality 4.0 in healthcare during the COVID-19 pandemic.These technologies will provide unique benefits to maintain the quality of TCM throughout the treatment process.With Quality 4.0,quality can be maintained using innovative and advanced digital technologies.

Ancient Respected and Modern Absorbed,Chinese Essence and Western Utility-Thoughts of the Integrated Chinese Medicine and Western Medicine

Traditional Chinese medicine(TCM)and Western medicine are two medical systems formed in different cultural backgrounds.The differences between them are that TCM focuses on the study of the invisible state while Western medicine focuses more on the study of the visible state of the human body;TCM pays attention to systematicity and integrity,while Western medicine pays attention to local evidence;TCM attaches importance to dialectical thinking,while Western medicine attaches importance to materialistic thinking.For the development of TCM.it is necessary to take the initiative to learm from and absorb all the advanced scientific and technological achievements in the world today.To innovate TCM,it is necessary to need to adhere to(1)the integration of"research on TCM with the thought of TCM"and"research on TCM based on the thought of Western medicine";(2)the integration of scientization of TCM and scientization for TCM;(3)the integration of mobilization therapy and allopathic therapy;(4)the integration of treating patients and treating diseases;(5)the integration of preventive treatment and existent disease treatment;(6)the integration of individuality and commonality;and(7)the integration of the macro and the micro.

The status and progress ofrevascularization on clinical applications

The development of biomedicine has offered new prospects for clinical tissue transplantation. In researching tissue engineering products, the key issue is the construction of micro-circulation network and effective induction of angiogenesis is the current continuous explore direction. Revascularization strategy currently focuses on angiogenesis and angiogenesis, but with the advent of microscopic engineering technology, direct construction of artificial micro-circulation pipe has been a new way of thinking.

Design and Implementation of a Digital PID Temperature Controller for Neonatal Incubator ESVIN

The project has as its aim the design and implementation of the control of temperature in the cockpit of the prototype of neonatal life support equipment ESVIN based on the international standard IEC 60601-2-19 concerning the basic security and operation of the neonatal incubators. The prototype has been developed and is important because the cockpit is a new concept of medical equipment of neonatal life support. There was a modeling of the system of heating of the incubator using the concepts of system identification with the purpose of finding a mathematical model that describes the dynamic behavior of the system. Then, design and implement the strategy of feedback control with digital PID （proportional-integral-derivative） algorithm. The model allowed the design and implementation of a digital PID controller that meets in a satisfactory manner with the requirements, in accordance with the international standard. The control system implemented in the neonatal incubator ESVIN improved the effectiveness of the neonatal life support equipment in regard to temperature controller of the cockpit.

Liu Shih-Hao:Pioneer of translational medicine in China

Editorial comment Translational medicine is a new discipline which aims to eliminate the barrier between preclinical and clinical medicine. Here, Dr. Li discusses the application of translational medicine in the research, teaching and clinical work of Prof. Liu Shih-Hao, the founder of endocrinology in China, who was particularly renowned for his early work in calcium and phosphorus metabolism. This well-known success story can be traced back to an early appreciation of translational medicine by Prof. Liu Shih-Hao, and serves as an important and revelatory lesson for us all.

Potential advantages of a combination of Chinese Medicine and bone marrow mesenchymal stem cell transplantation for removing blood stasis and stimulating neogenesis during ischemic stroke treatment

Combined treatment of ischemic stroke with Chinese medicine and exogenous bone marrow mesenchymal stem cell(BMSC) transplantation may improve the removal of blood stasis and stimulation of neogenesis.Chinese medicines that remove blood stasis not only promote blood circulation but also calm the endopathic wind,remove heat,resolve phlegm,remove toxic substances and strengthen body resistance.The medicinal targeting effect of Chinese medicine can promote the homing of BMSCs,and the synergistic therapeutic effects of drugs can contribute to BMSC differentiation.As such,exogenous BMSC transplantation has potential advantages for neogenesis.Chinese medicines and exogenous BMSCs provide complementary functions for the removal of blood stasis and stimulation of neogenesis.Therefore,a combination of Chinese medicine and transplantation of exogenous BMSCs may be particularly suited to ischemic stroke treatment.