A Comparative Analysis of the Control Effect of Medical Expenses between General Hospitals and Traditional Chinese Medicine Hospitals from 2012 to 2021

Objective To analyze the changing trend of average medical expenses and structure in general hospitals and traditional Chinese medicine(TCM)hospitals and the effects and differences achieved by the two kinds of hospitals through controlling unreasonable growth of medical expenses,so as to provide reference for controlling the rapid rise of medical cost in public hospitals and optimizing the cost structure.Methods Based on the changes of related indicators of medical expense control from 2012 to 2021,the overall characteristics,changes of cost structure and trends of medical expenses in general hospitals and TCM hospitals were investigated.Results and Conclusion From 2012 to 2021,the increase of medical expenses in general hospitals and traditional Chinese medicine hospitals had slowed down,the proportion of drug revenue to medical income began to decline,and the medical service income increased.However,the proportion of inspection,test and sanitary materials income has increased instead of decreasing,but the management cost has decreased.The two kinds of hospitals have achieved certain cost control results,the structure of medical cost has changed greatly,and the technical service and labor value of medical personnel have been reflected to a certain extent.However,it is still necessary to explore a more scientific and reasonable cost control mechanism to promote the further optimization of medical cost structure.

Study on the Changes of Medical Income Structure in Governmentrun Hospitals of Traditional Chinese Medicine from 2012 to 2021

Objective To study the changing characteristics and trend of medical income structure in the government-run hospitals of traditional Chinese medicine(TCM),evaluate the effects of relevant reform measures,and to put forward corresponding suggestions for further optimizing their income structure.Methods The data related to the average medical income of government-run hospitals of TCM from 2012 to 2021 were sorted out.Then,descriptive analysis method was used to analyze the changes of related indicators.Besides,structural change method was applied to investigate the changes of outpatient income and inpatient income.Results and Conclusion From 2012 to 2021,the growth of medical income in government-run hospitals of TCM tended to be stable,and the proportion of medical service income increased from 22.62%(2012)to 29.38%(2021),but the average annual growth rate was only 0.68%.The main items that caused the change of outpatient income structure were medicine revenue,laboratory tests,diagnosis and treatment,and the cumulative contribution rate was 89.15%.The main items that caused the change of inpatient income structure were medicine revenue,sanitary materials,and auxiliary examinations income,with a cumulative contribution rate of 80.04%.However,the contribution rate of registration,diagnosis,treatment,surgery and nursing income reflecting the value of medical personnel’s technical labor was relatively small.The medical income structure of government-run hospitals of TCM underwent great changes and gradually became reasonable,but the medical service income increased slowly,and not all indicators achieved the expectations.To promote the sustainable development of public hospitals of TCM and enable them to provide high-quality and efficient TCM medical and health services,it is necessary to further improve the relevant policy mechanism.

Automatic Keyphrase Extraction from Scientific Chinese Medical Abstracts Based on Character-Level Sequence Labeling

Purpose:Automatic keyphrase extraction(AKE)is an important task for grasping the main points of the text.In this paper,we aim to combine the benefits of sequence labeling formulation and pretrained language model to propose an automatic keyphrase extraction model for Chinese scientific research.Design/methodology/approach:We regard AKE from Chinese text as a character-level sequence labeling task to avoid segmentation errors of Chinese tokenizer and initialize our model with pretrained language model BERT,which was released by Google in 2018.We collect data from Chinese Science Citation Database and construct a large-scale dataset from medical domain,which contains 100,000 abstracts as training set,6,000 abstracts as development set and 3,094 abstracts as test set.We use unsupervised keyphrase extraction methods including term frequency(TF),TF-IDF,TextRank and supervised machine learning methods including Conditional Random Field(CRF),Bidirectional Long Short Term Memory Network(BiLSTM),and BiLSTM-CRF as baselines.Experiments are designed to compare word-level and character-level sequence labeling approaches on supervised machine learning models and BERT-based models.Findings:Compared with character-level BiLSTM-CRF,the best baseline model with F1 score of 50.16%,our character-level sequence labeling model based on BERT obtains F1 score of 59.80%,getting 9.64%absolute improvement.Research limitations:We just consider automatic keyphrase extraction task rather than keyphrase generation task,so only keyphrases that are occurred in the given text can be extracted.In addition,our proposed dataset is not suitable for dealing with nested keyphrases.Practical implications:We make our character-level IOB format dataset of Chinese Automatic Keyphrase Extraction from scientific Chinese medical abstracts(CAKE)publicly available for the benefits of research community,which is available at:https://github.com/possible1402/Dataset-For-Chinese-Medical-Keyphrase-Extraction.Originality/value:By designing comparative experiments,our study demonstrates that character-level formulation is more suitable for Chinese automatic keyphrase extraction task under the general trend of pretrained language models.And our proposed dataset provides a unified method for model evaluation and can promote the development of Chinese automatic keyphrase extraction to some extent.

Studies on a Traditional Chinese Medical Prescription Ma Xing Shi Gan Tang by Bio-coordination Chemistry

本文报道 pH 电位滴定法测出麻黄碱与生石膏中的 Cu^(2+)、Fe^(2+)、Zn^(2+)、Mn^(2+)离子形成的 ML 及 ML_2型络合物的稳定常数。滴定曲线显示甘草酸与上述四种金属离子也能分别形成不同稳定程度的络合物。用麻黄碱加甘草酸和上述四种金属离子配制成的模拟麻杏石甘汤和单纯生石膏煎剂与麻性石甘汤一样均有使家兔退热的效果,与对照组比较均有显著性差异(P<0.05);而用麻黄碱加甘草酸配制成的溶液无退热效果。作者认为应从生物—配位无机化学的多金属—多配体体系的观点去研究某些传统中医药方剂。

International Transmission of Chinese Medical Culture: Problems and Solutions

International transmission of Chinese medical culture is of great importance for the worldwide spread of traditional Chinese culture, which faces many problems, like the serious impact from western medicine and other traditional medicines, low professional quality of its practitioners, language barriers, etc. It's urgent to propose some practical solutions.

Curved Spine:The Shape of Spine in Taoist Body Diagrams and Its Influence on Medical Body Diagrams

From the early Taoist diagrams of the human body to the end of the Qing dynasty and the beginning of the Republic of China,Taoists exaggerated and deformed the human spine in a shape-shifting manner.It is likely that medical practitioners were influenced by this style of representation,and there are also numerous diagrams of the human body with the curved spine in the lateral-view diagrams of viscera and Ming Tang Tu(明堂图Acupuncture and Moxibustion Chart),which constantly show the human torso in an elliptical“egg shape”.No later than the Ming dynasty,medical practitioners began to depict the actual physiological spinal curve of the human body.By the Qing dynasty,the depiction of the spinal curve in medical diagrams of the human figure showed a tendency to part ways with the Taoist freehand style of the previous generation.Although the representation of the curve of the spine was very crude,later medical images of the human body at least gradually straightened the spine and no longer depicted it in a shape-shifting manner.However,the curved spine in Taoist diagrams of the human body continued to exist,and the presentation of the curved spine never changed.This way of depicting its appearance,which is very different from reality,is shaped by Taoism's special way of perceiving and viewing the body,and may also contain another form of truth.

Idiopathic mesenteric phlebosclerosis associated with long-term use of medical liquor:Two case reports and literature review

A 62-year-old woman was admitted to our hospital in2011 because of recurrent abdominal pain,nausea and constipation for six months.Computed tomography enterography(CTE)showed tortuous thread-like calcifications in the ileocolic vein and right colic vein,while colonoscopy revealed purple-blue mucosa extending from the cecum to the splenic flexure.Based on the results of these tests,the patient was diagnosed with idiopathic mesenteric phlebosclerosis(IMP).She had a history of Chinese medical liquor intake for one and a half years and her symptoms subsided after conservative treatment.In 2013,a 63-year-old male patient who presented with recurrent lower right abdominal pain,bloating,melena and diarrhea for fifteen months was admitted to our institution.Colonoscopy and CTE led to the diagnosis of IMP.He also used Chinese medical liquor for approximately 12 years.The patient underwent total colectomy and the postoperative course was uneventful.We searched for previously published reports on similar cases and analyzed the clinical data of 50 cases identified in PubMed.As some of these patients admitted use of Chinese medicines,we hypothesize that Chinese medicines may play a role in the pathogenesis of IMP.

Biofeedback therapy improves motor function following stroke Meta-analysis of 14 articles from Chinese Medical Institutions

OBJECTIVE： To evaluate feasibility of biofeedback therapy in China Medical Institutions to improve dysfunction following stroke. DATA SOURCE： A computer-based online search of publications was conducted using the Vip and PubMed Databases to identify publications that addressed biofeedback. The search key words included ＂electromyogram＂, ＂biofeedback＂, and ＂stroke＂. In total, 81 articles were retrieved. DATA SELECTION： Studies closely related to biofeedback, or studies with contents recently published in the same study field or in authorized journals, were included. Duplicated articles were excluded. Following full-text retrieval of selected articles, a total of 14 articles were collected, which addressed randomized, controlled trials of biofeedback therapy for dysfunction after stroke. Methodological quality was assessed for randomized, controlled trials using criteria from Cochrane reviewers＇ handbook. Results were analyzed using Revman 4.2 software. MAIN OUTCOME MEASURES： Outcomes and evaluation indices were expressed by odds ratio （OR）, weighted mean difference （WMD）, and 95% confidence interval （95% CO. Potential publication bias was presented using the funnel plot. RESULTS： The study included 14 randomized, controlled trials of 1 147 patients. Following biofeedback therapy, meta-analysis results demonstrated that： （1） The total effective rate was significantly greater in the biofeedback therapy group compared with the control group [OR = 3.46, 95% Cl （2.09, 5.73）, P = 0.62]. （2） Electromyogram changes were better in biofeedback therapy patients compared to the control group [WMD= 22.31, 95% C/（17.19, 27.43）, P〈 0.001]. （3） Motor function was better in biofeedback therapy patients compared with the control group [WMD = 12.43, 95% CI （6.71, 18.16）, P 〈 0.001]. （4） Daily living activities were better in biofeedback therapy patients compared with the control group [WMD= 18.11, 95% C/（15.77, 20.44）, P= 0.36]. （5） Joint range of motion was better in biofeedback therapy patients compared with the control group [WMD = 6.43, 95% Cl （4.44, 8.41）, P = 0.77]. Sensitivity analysis also demonstrated similar results after eliminating articles that described unknown diagnostic criteria and statistical methods. CONCLUSION： Following stroke, biofeedback therapy for dysfunction was shown to result in significant and valid outcomes, increased motor function and electromyogram values, improved joint range of motion, and improved daily living activities.

Comments on Nigel Wiseman's A Practical Dictionary of Chinese Medicine (Ⅱ) ——On the Use of Western Medical Terms to Express the Concepts of Traditional Chinese Medicine

Mr. Wiseman believes that Western medical terms chosen as equivalents of Chinese medical terms should be the words known to all speakers and not requiring any specialist knowledge or instrumentation to understand or identify, and strictly technical Western medical terms should be avoided regardless of their conceptual conformity to the Chinese terms. Accordingly, many inappropriate Western medical terms are selected as English equivalents by the authors of the Dictionary, and on the other hand, many ready-made appropriate Western medical terms are replaced by loan English terms with the Chinese style of word formation. The experience gained in solving the problems of translating Western medical terms into Chinese when West- ern medicine was first introduced to China is helpful for translating Chinese medical terms into English. However, the authors of the Dictionary adhere to their own opinions, ignoring others＂ experience. The English terms thus created do not reflect the genuine meaning of the Chinese terms, but make the English glossary in chaos. The so-called true face of traditional Chinese revealed by such terms is merely the Chinese custom of word formation and metaphoric rhetoric. In other words, traditional Chinese medicine is not regarded as a system of medicine but merely some Oriental folklore.

Development and Validation of a Simplified Chinese Version of the Assessment Tool for Students' Perceptions of Medical Professionalism

Professionalism is crucial in all professions and is particularly important in the medical field.Measuring students' perceptions of professionalism can help to form education targeting the enhancement of professionalism.This study aimed to validate an effective assessment tool for the measurement of medical students5 perceptions of medical professionalism in China's Mainland.The cross-sectional survey was conducted in three medical colleges in Guangdong,China.Of the 2103 eligible medical students,1976 responded,and 1856 questionnaires were deemed valid.Students from clinical medicine in these three medical colleges were randomly selected by cluster sampling.First,a Simplified Chinese Version questionnaire to measure Student's Perception of Medical Professionalism (SCV-SPMP) was constructed.Second,questionnaires from 1856 students majoring in clinical medicine at three medical colleges were included in the analysis.Third,exploratory factor analysis,Cronbach's alpha,item-subscale correlation,and confirmatory factor analysis were conducted to test the validity and reliability of the SCV-SPMP.Nine items were eliminated following exploratory factor analysis,and four subscales were extracted from the analysis.All internal consistency reliability exceeded the minimum standard.The overall Cronbach's alpha was 0.94,and four subscales' alphas were 0.82 (Accountability and excellence),0.81 (Duty),0.89 (Honor and integrity),and 0.85 (Practice habits and respect for others),respectively.The model fit was good.The convergent validity and discriminant validity were acceptable.The modified SCVSPMP was found to be a valid and reliable tool to capture the main features of Chinese students' perceptions of medical professionalism in four dimensions,and it provides a quantitative method for the measurement of the students' perceptions in China's Mainland..

Chinese medical service and medical education in urgent need of reform in the context of public welfare-based medical reform

After six years＇medical reform,about 7.8 billion person-times of medical service has been achieved by2014,and the number of persons covered by basic medical insurance for urban employees,basic medical insurance for urban residents,and new rural cooperative medical insurance exceeded 1.3 billion,of which the coverage ratio reached as high as over 95%,establishing the largest basic medical security network in the world.

Evaluation of Medical Cost Lost Due to Smoking in Chinese Cities

Smoking induces substantial diseases burden on both individual and the whole society.To identify the true smoking-attributable economic loss, we introduce medical cost accounting as a means to calculate disease-speciflc medical cost, including inpatient and outpatient cost of those diseases caused by smoking. Medical cost is defined as health fesource consumption in terms of money. Cost is allocated to departrpent and services according to coeffcient of benefit and operation time. The study in 1988 indicates that total smoking-attributable medical cost is 2.32 billion RMB Yuan in China, 1.70 billion RMB Yuan for outpatient, 0.62 billion RMB Yuan for inpatient. If indirect cost is included, the cost will be greater. Chronic obstructive emphysema has the highest proportion (55.41%) in smoking attributable medical cost

Liver Transplantation (in Chinese), revised edition, Edited by Shu-Sen Zheng. Pp843. Beijing: People's Medical Publishing House, 2012. ISBN: 978-7-117-15494-9/R.15495. ￥RMB 158

Liver Transplantation (in Chinese), revised edition, edited by Professor Shu-Sen Zheng and prefaced by Professor Guo-Wei Sang, has just been published. The revised edition is mainly based on the clinical practice of the Liver Transplant Center, the First Affiliated Hospital, Zhejiang University and the experience

NUMERICAL INVESTIGATION OF EFFECT OF ROLLING MANIPULATION OF TRADITIONAL CHINESE MEDICAL MASSAGE ON BLOOD FLOW

The hemodynamic mechanism of rolling manipulation (RM) of traditional Chinese medical massage (TCMM) is investigated. An axisymmetrical nonlinear model and an arbitrary Lagrangian-Eulerian finite element method (ALE-FEM) with rezoning algorithm were introduced to study the viscous flow through an axisymmetrical rigid tube with axially moving stenosis to simulate the rolling manipulation. Flow rate and wall shear stress were obtained by solving complete Navier-Stokes equations numerically. The numerical results show that the stenosis moving frequency, namely the frequency of rolling manipulation, has great effect on the disturbance of flow and the wall shear stress. The stenosis coefficient, which characterizes the severity of the stenosis, another adjustable parameter in rolling manipulation, also shows the significant effect on flow rate and wall shear stress. These numerical results may provide some data that can be taken into consideration when massage is used in clinic.

On Standard Nomenclature of Basic Chinese Medical Terms(IV)

ETIOLOGICAL TERMSIn traditional Chinese medicine, etiology is commonly called "cause of disease". The various factors that may cause disease are called "pathogenic factors". In the past they were classified into three categories: "exogenous factors", "endogenous factors", and "non-exo-endogenous factors". In the modern textbooks this tri-causal hypothesis is not so widely used, while a new classification has been developed.

Progresses in Integrated Traditional Chinese and Western Medical Research on Reproductive Immunology

Reproductive immunology is a crossed subject of reproductive biology and immunobiology. Great progresses have been achieved in the subject along with the deep development in life science. Modern reproductive immunology includes immunological regulation of fertility, materno-fetal immuno-regu-lation, and neuro-reproductive endocrino-immune network. With the integrated traditional Chinese and western medicine (ICWM) applied to reproductive immunology it has been greatly enriched in research contents and depth. The present review is to introduce the recent progresses in research of integrated medicine on reproductive immunology.

Data Masking for Chinese Electronic Medical Records with Named Entity Recognition

With the rapid development of information technology,the electronifi-cation of medical records has gradually become a trend.In China,the population base is huge and the supporting medical institutions are numerous,so this reality drives the conversion of paper medical records to electronic medical records.Electronic medical records are the basis for establishing a smart hospital and an important guarantee for achieving medical intelligence,and the massive amount of electronic medical record data is also an important data set for conducting research in the medical field.However,electronic medical records contain a large amount of private patient information,which must be desensitized before they are used as open resources.Therefore,to solve the above problems,data masking for Chinese electronic medical records with named entity recognition is proposed in this paper.Firstly,the text is vectorized to satisfy the required format of the model input.Secondly,since the input sentences may have a long or short length and the relationship between sentences in context is not negligible.To this end,a neural network model for named entity recognition based on bidirectional long short-term memory(BiLSTM)with conditional random fields(CRF)is constructed.Finally,the data masking operation is performed based on the named entity recog-nition results,mainly using regular expression filtering encryption and principal component analysis(PCA)word vector compression and replacement.In addi-tion,comparison experiments with the hidden markov model(HMM)model,LSTM-CRF model,and BiLSTM model are conducted in this paper.The experi-mental results show that the method used in this paper achieves 92.72%Accuracy,92.30%Recall,and 92.51%F1_score,which has higher accuracy compared with other models.

基于DEA-Malmquist指数的长江经济带中医类医疗机构卫生资源配置效率评价

目的评估2017—2021年长江经济带中医类医疗机构的卫生资源配置效率,为科学配置中医类卫生资源提供参考依据。方法选取2018—2022年《中国卫生健康统计年鉴》中的数据作为样本,分析中医类医疗机构卫生资源的投入和产出指标。采用数据包络分析(DEA)法的BCC模型,对2021年中医类医疗机构的卫生资源配置效率进行静态分析。采用Malmquist指数模型,对2017—2021中医类医疗机构的卫生资源配置效率进行动态分析。结果2017—2021年长江经济带中医类医疗机构的投入指标(机构数、床位数及卫生技术人员数)和出院人次呈逐年下降趋势,诊疗人次呈逐年增加趋势。2021年长江经济带中医类医疗机构卫生资源综合效率总均值为0.856,有3个省市的卫生资源配置达到DEA强有效,8个省市的卫生资源配置为非DEA有效,存在投入冗余和产出不足的情况。2017—2021年长江经济带11个省市中医类医疗机构的全要素生产率指数总均值为0.863,其中10个省市的全要素生产率指数均<1。2017—2021年长江经济带中医类医疗机构全要素生产率指数呈先上升后下降再回升的总体趋势,技术效率、纯技术效率和规模效率的指数变化模式均为先增后减。结论2021年长江经济带中医类医疗机构的卫生资源配置效率亟须提升,其中规模效率是其主要制约因素,且各区域间的配置效率存在差异。因此,建议合理控制中医类医疗机构的规模,创新其管理模式,科学地制定区域规划,从而实现卫生资源配置的优化。

Chinese medical students’interest in COVID-19 pandemic

BACKGROUND The outbreak of coronavirus disease 2019(COVID-19)happened in early December and it has affected China in more ways than one.The societal response to the pandemic restricted medical students to their homes.Although students cannot learn about COVID-19 through clinical practice,they can still pay attention to news of COVID-19 through various channels.Although,as suggested by previous studies,some medical students have already volunteered to serve during the COVID-19 pandemic,the overall willingness of Chinese medical students to volunteer for such has not been systematically examined.AIM To study Chinese medical students’interest in the relevant knowledge on COVID-19 and what roles they want to play in the pandemic.METHODS Medical students at Peking Union Medical College were surveyed via a webbased questionnaire to obtain data on the extent of interest in the relevant knowledge on COVID-19,attitude towards volunteerism in the pandemic,and career preference.Logistic regression modeling was used to investigate possible factors that could encourage volunteerism among this group in a pandemic.RESULTS A total of 552 medical students responded.Most medical students showed a huge interest in COVID-19.The extent of students’interest in COVID-19 varied among different student-classes(P<0.05).Senior students had higher scores than the other two classes.The number of people who were‘glad to volunteer’in COVID-19 represented 85.6%of the respondents.What these students expressed willingness to undertake involved direct,indirect,and administrative job activities.Logistic regression analysis identified two factors that negatively influenced volunteering in the pandemic:Student-class and hazards of the voluntary job.Factors that positively influenced volunteering were time to watch COVID-19 news,predictable impact on China,and moral responsibility.CONCLUSION More innovative methods can be explored to increase Chinese medical students’interest in reading about the relevant knowledge on COVID-19 and doing voluntary jobs during the pandemic.