Multidisciplinary integration and fusion based on critical care medicine and immunology:History,current status,and prospects

Critical care medicine focuses on understanding the pathophysiological mechanisms and treatment approaches for life-threatening conditions,including sepsis,severe trauma/burns,hemorrhagic shock,heatstroke,and acute pancreatitis,all of which have high incidence rates.These conditions are primarily characterized by acute multi-organ dysfunction,with sudden onset,severe illness,and high mortality rates.Additionally,critical care treatment demands substantial medical resources,imposing significant economic burdens on patients’families and society.In recent years,critical care medicine has achieved notable progress,especially in multidisciplinary integration with immunology-based fields.Collaboration across disciplines has not only accelerated advancements in critical care but also propelled the rapid development of modern immunology.This paper provides an overview and assessment of the cross-disciplinary fusion between critical care medicine and immunology,exploring how these fields related extensions mutually enhance each other.It further analyzes China’s potential to become a global leader in this area within the next 5 to 10 years.

Expert consensus on diagnosis and treatment of ulcerative colitis with integrated traditional Chinese and Western medicine:A nursing perspective

Ulcerative colitis(UC)is a chronic nonspecific intestinal inflammatory disease of unclear etiology,characterized by continuous and diffuse inflammatory changes of colorectal mucosa.In recent years,the incidence rate of UC in China has increased year by year,but there is no effective cure method in Western medicine.Traditional Chinese medicine treatment based on syndrome differentiation has the unique advantages of simplicity,convenience,effectiveness,and low cost.Therefore,integration of Chinese and Western medicine has become an important strategy for UC diagnosis and treatment,and has made significant progress in UC.On the basis of learning from a number of consensuses at home and abroad,combined with Chinese research results and the actual clinical situation of traditional Chinese and Western medicine,the UC group of the Chinese Association of Integrative Medicine has formulated the expert consensus on the diagnosis and treatment of UC with integrated traditional Chinese and Western medicine.In this consensus,the pathogenesis,etiology and pathogenesis,diagnosis,integrated traditional Chinese and Western medicine treatment,and chronic disease management with integrated traditional Chinese and Western medicine for UC were recommended by experts.This article interprets the consensus from the perspective of nursing in order to provide reference basis for clinical nursing workers.

Outcomes of Integrated Community Care Interventions for Frail Elderly People: A Literature Review

This study aimed to summarize the outcome measures and the significant outcome of effective integrated community care for frail elderly people through a literature review. A literature search was conducted using the Cochrane Library and PubMed for articles published up to November 2016 with the following search terms: Integrated community care, primary care, community, frail elderly, and effectiveness. A total of 106 articles were identified, of which eight with an interventional research design the inclusion criteria. All outcome measures were classified into the three categories: Functional abilities, quality of life, and health. As the significant effect, the physical function was perceived in four references, the quality of life in one reference, and the mental health in one reference. The evidence of the effectiveness of integrated community care seemed to be lacking. More studies will need to be conducted.

Significant Differences in Elderly Health between Urban and Rural Communities: A Literature Review

This study aimed to examine measures pertaining to elderly health in urban versus rural settings, and to identify differences in the health of elderly people living in urban and rural communities through a literature review. An electronic literature search was performed using PubMed for English articles published in peer-reviewed journals up to August 2018, with the following search terms: “urban”, “rural”, “comparison of community”, “elderly health”, and “comparison of community health”. A total of 35 articles were extracted for a critical full-text review, and six articles that met the inclusion criteria were subjected to analysis. Measures related to elderly health in urban and rural communities were classified into the following three categories: functional abilities, health, and health perception. Five of the six articles described functional abilities (e.g., social function) and health (e.g., mental health, depression) as categories with significant differences in elderly health between urban and rural communities. The results suggest that elderly health measures related to social function and mental health or depression are more important outcome measures of effective person-centered integrated community care systems from the perspective of community characteristics. As there were only a few articles reporting on elderly health according to differences in environment between urban and rural communities, further investigation is globally warranted.

中西医结合阶梯疗法治疗肥胖症临床报道1例

肥胖是一种慢性代谢性疾病,与2型糖尿病、心血管疾病、高血压病、癌症、代谢综合征和慢性肾脏疾病的患病风险呈线性相关,未来由此引起的肥胖健康负担将急剧增加。因此如何治疗肥胖及其继发性疾病,已成为患者、医生和社会迫切需要解决的问题。目前防治肥胖的中西医方法较多,但如何将中西医方法进行整合,实现临床效果最大化,仍然是值得探索的问题。近几年,作者在代谢与肥胖专病门诊的临床实践中,尝试使用中西医结合阶梯疗法治疗肥胖症,希冀探索出整合中西医方法的治疗模式。此文呈现1例疗程近2年的中西医结合阶梯疗法治疗肥胖症的典型案例。

The Application of Sentiment Treatment and Narrative Medicine in Infertility

This study delves into the integration of traditional Chinese medicine(TCM)sentiment therapy with modern medical interventions in treating infertility,aiming to enhance the therapeutic outcomes for patients.It posits that infertility encompasses not only physical factors but also significant psychological and emotional dimensions.The synthesis of TCM sentiment therapy and contemporary reproductive medicine signifies a paradigm shift in comprehending the interactions among health,emotions,psychology,and physiology.By analyzing the diagnostic and treatment methods of TCM,this study elucidates how sentiment can enhance modern treatments,thereby promoting a more holistic,patient-centered approach to infertility care.Furthermore,it underscores the necessity of fostering a comprehensive understanding of health and disease within medical education.

Integration of traditional Chinese medicine and Western medicine in a Chinese community health center

Objective:Although the literature is abundant on traditional Chinese medicine(TCM)in the West,there is limited information on how TCM is integrated with Western medicine(WM).We describe how one Chinese Community Health Service(CHS)system located in Beijing integrates WM and TCM.Methods:Our information is based on the authors’observations,interviews with center TCM practitioners,and discussions with center administrators.Results:We summarize our observations according to the following themes:selection of type of practitioner;frequent diagnoses of patients seen by TCM clinicians;types of TCM ser-vices provided;economic factors;challenges;and future directions.Patient age,nature of the problem,and cost may determine whether or not Chinese patients initially consult TCM or WM practitioners.Because of referral pathways between the WM and TCM practitioners,up to one-third of the patients receive integrated care.TCM physicians see more patients per day than do their WM counterparts;TCM physicians also earn higher salaries.Although there are clearly close collaborative relationships between the TCM and WM practitioners,a few TCM providers report that lack of respect between the two fields may be a barrier towards further integration.Conclusion:Given governmental policies and the cost differentials between WM and TCM,the future for the integration of the two medical traditions within the CHS system appears to be favorable;however,issues of mutual respect and workforce issues may challenge success-ful integration.Our impressions are limited by the fact that we observed practices in only one community in one district of Beijing.

溃疡性结肠炎中西医治疗及护理研究进展

溃疡性结肠炎是由免疫介导的炎症性肠病,临床症状为反复发作的腹泻、腹痛及黏液脓血便。中西医诊疗各有所长,探索行之有效的中西医结合治疗和护理方法对提高溃疡性结肠炎疗效有着积极意义。本研究总结中西医诊疗溃疡性结肠炎的研究现况及临床护理进展,以期为临床进一步提升溃疡性结肠炎的诊疗质量提供一定的理论依据。

Lessons learned from the hospital to home community care program in Singapore and the supporting AI multiple readmissions prediction model

In a prior practice and policy article published in Healthcare Science,we introduced the deployed application of an artificial intelligence(AI)model to predict longer‐term inpatient readmissions to guide community care interventions for patients with complex conditions in the context of Singapore's Hospital to Home(H2H)program that has been operating since 2017.In this follow on practice and policy article,we further elaborate on Singapore's H2H program and care model,and its supporting AI model for multiple readmission prediction,in the following ways:(1)by providing updates on the AI and supporting information systems,(2)by reporting on customer engagement and related service delivery outcomes including staff‐related time savings and patient benefits in terms of bed days saved,(3)by sharing lessons learned with respect to(i)analytics challenges encountered due to the high degree of heterogeneity and resulting variability of the data set associated with the population of program participants,(ii)balancing competing needs for simpler and stable predictive models versus continuing to further enhance models and add yet more predictive variables,and(iii)the complications of continuing to make model changes when the AI part of the system is highly interlinked with supporting clinical information systems,(4)by highlighting how this H2H effort supported broader Covid‐19 response efforts across Singapore's public healthcare system,and finally(5)by commenting on how the experiences and related capabilities acquired from running this H2H program and related community care model and supporting AI prediction model are expected to contribute to the next wave of Singapore's public healthcare efforts from 2023 onwards.For the convenience of the reader,some content that introduces the H2H program and the multiple readmissions AI prediction model that previously appeared in the prior Healthcare Science publication is repeated at the beginning of this article.

舒缓医学教学培训对神经重症医师共情能力培养的探索与实践

目的探索舒缓医学教学培训对神经重症专科住院医师共情能力的影响。方法选取2021年9月―2022年12月在中日友好医院神经外科神经重症亚专科参加培训的30名医师作为研究对象,按照随机数字表法分为试验组和对照组,各15名。试验组进行基于舒缓医学课程整合的神经重症医学培训,对照组按照常规神经重症医学内容进行培训。在培训前后采用杰弗逊共情量表(Jefferson scale of physician empathy,JSPE)对2组进行评分,评估舒缓医学教学培训对共情能力的影响。同时对试验组在培训结束后的3、6和12个月进行JSPE评分,观察共情能力的变化。结果试验组在观点采择,怜悯关怀,换位思考维度的JSPE量表评分分别为(50.00±3.21)分、(38.53±3.02)分和(9.60±1.63)分,均高于培训前的评分[(37.87±3.02)分、(27.60±1.64)分和(7.53±1.68)分],差异有统计学意义(P<0.05)。试验组在培训后的随访时间内,JSPE的3个维度的评分仍有所提升,但差异无统计学意义(P>0.05)。结论舒缓医学教学培训有助于提高神经重症专科住院医师的共情能力,其影响具有持续稳定性。

1例腰椎间盘突出症患者的医护一体化中医护理查房

总结1例腰椎间盘突出患者的医护一体化中医护理查房实践经验。分析患者临床资料,由责任护士汇报病例,医生分析病情,医护联合对重点护理内容进行讨论,协同制定护理措施。通过医护一体化查房,医护之间专业互补,重建医、护、患三位一体的治疗和护理模式,达到实施整体护理的效果。

基于米特-霍恩模型的中医药政策在医养结合执行中的分析研究

目的分析我国中医药政策在医养结合执行过程中存在的问题,为完善中医药政策提供借鉴,以此更好地推动医养结合服务的发展和进步。方法采用米特-霍恩模型:政策标准与目标、政策资源、执行方式、执行机构特性、执行人员价值取向、系统环境六大因素为框架,分析中医药政策在医养结合服务执行中存在的问题。结果中医药政策越来越受重视,但在执行中仍受到政策目标不清晰、资源不足、执行方式单一、执行机构特性缺乏规划、执行人员价值取向低和复杂的系统环境等因素的影响。结论为解决中医药政策在医养结合执行中存在的问题,提出建议:完善顶层设计,细化政策实施目标;强化资源保障,提升政策执行效率;丰富执行方式,确保执行效果;多部门联动,加强沟通交流;优化政策执行环境。

干燥综合征的中西医结合护理进展

干燥综合征(SS)是一种以泪腺和唾液腺的淋巴细胞浸润,伴有干燥性角膜结膜炎及口腔干燥为主要临床表现的免疫反应介导疾病,临床上分为原发性和继发性。本文主要对SS相关中西医结合护理进行总结,主要包括各器官、皮肤、呼吸道护理、饮食干预等,对SS患者给予心理指导,保证护理措施的正确性、系统性,提高SS患者及家属对疾病的认知,建立患者治疗信心,临床中医护人员需积极主动配合,保证治疗、护理工作顺利开展,最终改善患者生命质量。

新质生产力赋能社区老年“体医养融合”健康服务困境与纾解

由新技术、新产业、新要素、新组织构成的新质生产力,为老年健康服务发展注入了新的活力。研究运用文献资料法和逻辑分析法,探究新质生产力赋能社区老年“体医养融合”健康服务的价值、内涵、逻辑、困境和策略。研究认为,新质生产力赋予“体医养融合”健康服务新的内涵,包括但不限于健康服务技术突破与创新、生产要素配置创新性、服务模式“高智高效高质”。新质生产力赋能社区老年“体医养融合”健康服务要突出引领与指导的理论先导逻辑、创新与突破的技术驱动逻辑、互动与合作的资源开发逻辑、优化与互补的结构支撑逻辑。“体医养融合”健康服务能满足老年多元化、个性化健康需求,但面临新型劳动者匮乏、劳动资料升级滞后、老年群体认知落后、生产要素不协同等困境。提出以下纾解策略:引导劳动者技能升级与角色重塑,激发新质生产力赋能活力;促进劳动资料创新与升级,启动新质生产力赋能引擎;聚焦老年群体特点与需求,助力老年群体融入新生产力时代;探索生产要素重组与优化,推动新质生产力赋能升级。

重症专科信息化架构的设计与实践

为了加速发展重症专科信息化建设,提升重症科室的临床诊疗能力和科研水平,实现科室质量管理数字化、医院同质管理一体化,根据东南大学附属中大医院的重症专科信息化建设规划,通过标准化临床业务流程和整合全院数据,设计了包括重症监护临床信息系统、院内重症患者早期预警及快速反应平台、远程重症同质化诊疗平台和重症大数据科研管理系统。这一举措提高了医护的工作效率和服务质量,强化了医护人员的数据提取、整合能力,质控能力,优化了对院内、区域患者的救治能力,助力学科科研成果转化,实现了医院同质管理一体化,形成区域示范带动效应。

基于紧缺人才培训的老年医学科和医养结合机构护士培训体验质性研究

了解老年医学科和医养结合机构护士在紧缺人才培训期间的真实感受,为完善和制订老年医学科和医养结合机构护士培训方案提供参考依据,以提升培训的效果与质量。结果表明,老年医学紧缺人才培训有助于提升护士的业务水平,提升其自身价值感,但需进一步完善培训方案,以提升培训效果与质量。

中医延续护理联合“一体化”中医医联体模式延续护理对肿瘤患者的影响

目的中医延续护理联合“一体化”中医医联体模式延续护理对肿瘤患者的影响。方法采用便利抽样法选取2019年5月—2021年5月广西医科大学第二附属医院肿瘤内科经化疗出院的120例患者,根据随机数字表法将其分为对照组和观察组,各60例。对照组采取常规延续护理干预模式,观察组采取中医延续护理联合“一体化”中医医联体模式的干预方法。对比2组生命质量测定量表、焦虑自评量表(self-rating anxiety scale,SAS)和抑郁自评量表(self-rating depression scale,SDS)评分。结果对照组生命质量测定量表的躯体功能评分为(84.86±11.37)分,角色功能评分为(56.75±6.44)分,认知功能评分为(67.54±5.72)分,情绪功能评分为(61.58±19.40)分,低于观察组的(90.13±12.47)分、(71.54±6.47)分、(72.46±5.87)分、(70.54±18.56)分,差异有统计学意义(P<0.05)。干预后,对照组SAS评分为(56.77±2.22)分,SDS评分为(55.42±2.47)分,高于观察组的(47.58±0.54)分、(48.72±0.69)分,差异有统计学意义(P<0.05)。结论将中医延续护理联合“一体化”中医医联体模式延续护理运用于肿瘤患者中,可以有效改善患者的生活质量,减少心理问题,加速患者康复进程,对患者预后改善有积极影响。

中西医结合护理干预应用于初产妇剖宫产术后护理的效果研究

分析中西医结合护理干预应用于初产妇剖宫产术后护理的效果。选取2022年6月—2023年6月青岛大学附属威海市立第二医院收治的90例行剖宫产的初产妇为研究对象,随机将其分为常规组和试验组两组,每组各45例。常规组采用常规护理,试验组采用中西医结合护理,比较两组的护理效果。结果显示,试验组整体护理效果优于常规组(P<0.05)。研究发现,在初产妇剖宫产术后护理中应用中西医结合护理干预,可缩短产妇泌乳始动时间,增加产妇泌乳量,加速产妇产后恢复,提高产妇满意度,值得推广。

瑞典体医融合服务模式经验及启示

运用文献资料,逻辑分析等方法,阐述瑞典体医融合服务模式概况、经验,并提出对我国的启示。从形成动因、指导思想、流程内容三方面阐述了瑞典体医融合服务模式概况。经验:国家战略推动,提供方向指导;多方共同参与,倡导资源整合;基于循证实践,提供循证建议;以个人为中心,重视社区基础。启示:强化支撑体系,健全制度保障;强调循证依据,落实运动处方;夯实社区基础,提升健康服务;强调随访追踪,完善持续监督。

中医急危重症诊疗知识融合路径探析

知识融合技术能将诊疗决策医师群体的知识融合成集群体智慧的综合诊疗知识,实现更加科学准确的诊疗决策,从而提高中医急危重症临床诊疗效率。本研究结合中医急危重症诊疗知识的复杂性和模糊不确定性提出构建中医急危重症诊疗知识表示模型、建立中医急危重症诊疗知识模糊不确定性测度模型、构建中医急危重症诊疗知识融合框架的知识融合的实现路径,为实现中医急危重症诊疗知识融合提供参考,为提高中医急危重症诊疗效率提供思路。