The scientific program will consist of symposia and poster sessions. Topics related to theoretical and applied research in the domain of toxicology and toxicological studies on chemicals of public concern will be welc...The scientific program will consist of symposia and poster sessions. Topics related to theoretical and applied research in the domain of toxicology and toxicological studies on chemicals of public concern will be welcome. The presenter’s name, address, and telephone and FAX numbers should be submitted along with the title of the presentation and whether it is oral or poster. Deadline: April 15, 1990. Papers should be submitted to:展开更多
Objective To explore the different modes and approaches of medical and preventive integration in current primary health care institutions in China.Methods Through literature analysis,field research,telephone interview...Objective To explore the different modes and approaches of medical and preventive integration in current primary health care institutions in China.Methods Through literature analysis,field research,telephone interviews,and other methods the implementation status was evaluated to systematically study the main experience and effect of implementing medical and preventive integration services in pilot areas.Results and Conclusion At present,there are three implementation modes of medical-prevention integration,namely,vertical mode based on the medical community,internal mode with optimized service process,and internal mode with great service capabilities.The three medical-prevention integration modes have their respective focuses,but they need to be further improved in terms of policy support,technical staffing,information system construction,and drug use.展开更多
Objective To evaluate the preventive drug use of magnesium isoglycyrrhizinate injection beyond the instructions by rapid health technology,and to provide reference for its rational clinical application.Methods The dat...Objective To evaluate the preventive drug use of magnesium isoglycyrrhizinate injection beyond the instructions by rapid health technology,and to provide reference for its rational clinical application.Methods The databases such as PubMed,Embase,the Cochrane Library,HowNet,Wanfang,VIP and HTA websites were searched.Two researchers screened the literature to extract data according to the inclusion and exclusion criteria.If necessary,a third researcher was consulted.The included literature was analyzed and concluded through corresponding quality evaluation.Results and Conclusion Four meta-analysis articles and five pharmacoeconomics articles were included.In terms of effectiveness,compared with the blank group and the control group(diammonium glycyrrhizinate,glutathione,and polyene phosphatidylcholine),the preventive use of magnesium isoglycyrrhizinate injection had a lower incidence of drug-induced liver injury with a more significant reduction in the levels of alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,and total bilirubin.In terms of safety,except for an economic study in which some patients had a transient increase in blood pressure during the use of magnesium isoglycyrrhizinate injection,other studies did not show the increasing risk of adverse reactions due to preventive medication.In terms of economy,the use of magnesium isoglycyrrhizinate injection for prevention of different diseases did not necessarily have economic advantages over the control group(blank group and reduced glutathione,polyene phosphatidylcholine injection,traditional Chinese medicine combined with magnesium isoglycyrrhizinate injection).In the prevention of drug induced liver injury,magnesium isoglycyrrhizinate injection used beyond the instructions has certain efficacy and safety,but it may not be the economic optimal for other different diseases.展开更多
<strong>Introduction:</strong><span style="white-space:normal;font-family:;" "=""> Atherosclerotic cardiovascular disease is a dysmetabolic medical condition resulting i...<strong>Introduction:</strong><span style="white-space:normal;font-family:;" "=""> Atherosclerotic cardiovascular disease is a dysmetabolic medical condition resulting in the #1 cause of morbidity and mortality in the United States. Coronary Artery Calcium (CAC)</span><span style="white-space:normal;font-family:;" "=""> </span><span style="white-space:normal;font-family:;" "="">CT non-invasively identifies athe</span><span style="white-space:normal;font-family:;" "="">rosclerosis in asymptomatic individuals. This translational study tested the hypothesis that clinically overt</span><span style="white-space:normal;font-family:;" "=""></span><span style="white-space:normal;font-family:;" "="">cardiovascular disease can be prevented in asymptomatic individuals in a medical clinic. <b>Methods:</b> Two hundred </span><span style="white-space:normal;font-family:;" "="">and </span><span style="white-space:normal;font-family:;" "="">six</span><span style="white-space:normal;font-family:;" "=""> asymptomatic adults requested a CAC scan to identify subclinical heart disease. Individuals with a positive CAC score ></span><span style="white-space:normal;font-family:;" "=""> </span><span style="white-space:normal;font-family:;" "="">1 (n = 125) were prescribed targeted</span><span style="white-space:normal;font-family:;" "=""> medical therapy to reverse their atherosclerosis. The goal was to achieve an LDL Cholesterol (LDL-C) ≤</span><span style="white-space:normal;font-family:;" "=""> </span><span style="white-space:normal;font-family:;" "="">60 mg/dl. One hundred </span><span style="white-space:normal;font-family:;" "="">and </span><span style="white-space:normal;font-family:;" "="">ten individuals</span><span style="white-space:normal;font-family:;" "=""> reached this goal (67 male, 43 female) receiving 10 mg/d of rosuvastatin and 10 mg/d of ezetimibe plus a low cholesterol diet. Other fifteen individuals with positive CAC scores did not achieve this LDL-C goal. <b>Results:</b> In the group following medical therapy and achieving an LDL-C ≤</span><span style="white-space:normal;font-family:;" "=""> </span><span style="white-space:normal;font-family:;" "="">60 mg/dl, no cardiovascular events</span><span style="white-space:normal;font-family:;" "=""> were observed during a maximum observation period of 5 years (mean observation time = 3.6 years). Based on previously published CVD outcome data in individuals with similar CAC scores, 12.6 cardiovascular events were expected. Two of fifteen individuals with positive CAC scores not following medical therapy had a cardiovascular event. None of the 81 individuals </span><span style="white-space:normal;font-family:;" "="">with a </span><span style="white-space:normal;font-family:;" "="">zero score had a cardiovascular event during follow-up. No adverse effects of therapy occurred. <b>Conclusion:</b> In a medical</span><span style="white-space:normal;font-family:;" "=""> </span><span style="white-space:normal;font-family:;" "="">clinic</span><span style="white-space:normal;font-family:;" "="">,</span><span style="white-space:normal;font-family:;" "=""> adult population with positive CAC scores</span><span style="white-space:normal;font-family:;" "=""> and an LDL-C ≤</span><span style="white-space:normal;font-family:;" "=""> </span><span style="white-space:normal;font-family:;" "="">60</span><span style="white-space:normal;font-family:;" "=""> </span><span style="white-space:normal;font-family:;" "="">mg/dl, targeted medical therapy prevented overt</span><span style="white-space:normal;font-family:;" "=""> cardiovascular disease. These result</span><span style="white-space:normal;font-family:;" "="">s</span><span style="white-space:normal;font-family:;" "=""> should encourage other physicians to aggressively treat </span><span style="white-space:normal;font-family:;" "="">atherosclerotic cardiovascular disease in their clinic popula</span><span style="white-space:normal;font-family:;" "="">tions.</span>展开更多
Purpose: Cardiovascular disease is the number one cause of death in the Western world. The purpose of this manuscript is to compare the benefits and deficiencies of coronary artery calcium scanning versus compute...Purpose: Cardiovascular disease is the number one cause of death in the Western world. The purpose of this manuscript is to compare the benefits and deficiencies of coronary artery calcium scanning versus computer generated risk equations in identifying atherosclerotic cardiovascular disease. These two approaches provide significantly different cardiovascular risk assessments and often lead to therapeutic differences in recommendations from the physician to the patient. Methods: Pertinent medical literature is reviewed concerning both risk assessment approaches (i.e., coronary artery scanning and computer generated risk equations). The strengths and weaknesses of both approaches are discussed, and recommendations are provided based upon available data. Results: Cardiovascular risk equations are simple and readily obtained at no charge by physicians. However, their drawbacks are several, including non-applicability to specific populations, disagreements among different cardiovascular society risk equations, wide ranges of risk outputs (e.g., intermediate 10-year risk is between 5% and 20%), inability to definitively identify coronary artery plaques, and lack of definitive anatomical coronary disease. Alternatively, coronary artery calcium scanning costs approximately $100/scan (if not covered by insurance), requires time and effort by the patient, and exposes the patient to a minimal amount of radiation. However, coronary calcium scanning identifies specific atherosclerotic coronary disease and provides additional information about the anatomical location (i.e., coronary artery) of the atherosclerotic plaque. Conclusion: Based on the published literature, coronary artery calcium scanning is the preferred approach for identifying atherosclerotic cardiovascular disease. Although there are minor drawbacks, overall it provides superior clinical information compared with computer generated risk equations.展开更多
High-quality public health service of medical and prevention integration is the premise of people's healthy life, and general hospital is an important link. This paper expounds the current situation of public heal...High-quality public health service of medical and prevention integration is the premise of people's healthy life, and general hospital is an important link. This paper expounds the current situation of public health service of general hospital, analyzes the difficulties and solutions, and provides reference for promoting the reform of public health service system of medical and prevention integration.展开更多
Drawing on the Mazmanian Sabatier comprehensive model of policy implementation,this study conducted a systematic analysis of the pilot implementation of the disease control supervisor system in medical institutions in...Drawing on the Mazmanian Sabatier comprehensive model of policy implementation,this study conducted a systematic analysis of the pilot implementation of the disease control supervisor system in medical institutions in Shenzhen.By assessing three key dimensions—namely,the manageability of policy issues,regulatory capacity,and the external environment—the study found that the system has significantly improved the capacity of medical institutions in public health prevention and control,and enhanced their responsiveness to public health emergencies.However,several challenges continue to impede policy effectiveness,including unclear job responsibilities,insufficient professional staffing,and limited cross-sectoral collaboration efficiency.In response,the study proposes a set of measures to further promote the integration of medical and preventive services and offer a practical model for modernizing national public health governance.These measures include clarifying roles and responsibilities,establishing a tiered training system,strengthening multisectoral collaborative governance,and enhancing the support of information platforms.展开更多
Low adherence to secondary prevention medications(ATM)of patients after acute coronary syndrome(ACS)is associated with poor clinical outcomes.However,literature provides limited data on assessment of ATM and risks ass...Low adherence to secondary prevention medications(ATM)of patients after acute coronary syndrome(ACS)is associated with poor clinical outcomes.However,literature provides limited data on assessment of ATM and risks associated with poor in Chinese patients with ACS.In the current work,ATM was assessed in consecutively recruited patients with ACS in Tongji Hospital from November 5,2013 to December 31,2014.A total of 2126 patients were classified under low adherence(proportion of days covered(PDC)〈50%)and high adherence(PDC〉50%)groups based on their performance after discharge.All patients were followed up at the 1st,6th,and 12th month of discharge while recording ATM and major adverse cardiac events(MACE).Bivariate logistic regression was used to identify the factors associated with ATM.Cox regression was used to analyze the association between ATM and MACE within one year after discharge.Results showed that coronary artery bypass grafting(CABG)alone had significantly lower proportion of high adherence to P2Y12 antagonists(83.0%vs.90.7%,P〈0.01)than patients treated with percutaneous coronary intervention(PCI)only.Moreover,in patients undergoing PCI,high adherence to P2Y12 antagonists decreased the risk of MACE(hazard ratio=0.172,95%confidence interval:0.039-0.763;P=0.021).In conclusion,PCI-treated patients are more prone to remaining adherent to medications than CABG-treated patients.High adherence to P2Y12 antagonists was associated with lower risk of MACE.展开更多
文摘The scientific program will consist of symposia and poster sessions. Topics related to theoretical and applied research in the domain of toxicology and toxicological studies on chemicals of public concern will be welcome. The presenter’s name, address, and telephone and FAX numbers should be submitted along with the title of the presentation and whether it is oral or poster. Deadline: April 15, 1990. Papers should be submitted to:
基金Source of the project:the Social Science Planning Fund Project of Liaoning Province(L19BG034)the Philosophy and Social Science Planning Key Project of Shenyang City(SZ202001L)the Key Project of Shenyang Social Science Funding(SYSK2020-04-01).
文摘Objective To explore the different modes and approaches of medical and preventive integration in current primary health care institutions in China.Methods Through literature analysis,field research,telephone interviews,and other methods the implementation status was evaluated to systematically study the main experience and effect of implementing medical and preventive integration services in pilot areas.Results and Conclusion At present,there are three implementation modes of medical-prevention integration,namely,vertical mode based on the medical community,internal mode with optimized service process,and internal mode with great service capabilities.The three medical-prevention integration modes have their respective focuses,but they need to be further improved in terms of policy support,technical staffing,information system construction,and drug use.
文摘Objective To evaluate the preventive drug use of magnesium isoglycyrrhizinate injection beyond the instructions by rapid health technology,and to provide reference for its rational clinical application.Methods The databases such as PubMed,Embase,the Cochrane Library,HowNet,Wanfang,VIP and HTA websites were searched.Two researchers screened the literature to extract data according to the inclusion and exclusion criteria.If necessary,a third researcher was consulted.The included literature was analyzed and concluded through corresponding quality evaluation.Results and Conclusion Four meta-analysis articles and five pharmacoeconomics articles were included.In terms of effectiveness,compared with the blank group and the control group(diammonium glycyrrhizinate,glutathione,and polyene phosphatidylcholine),the preventive use of magnesium isoglycyrrhizinate injection had a lower incidence of drug-induced liver injury with a more significant reduction in the levels of alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,and total bilirubin.In terms of safety,except for an economic study in which some patients had a transient increase in blood pressure during the use of magnesium isoglycyrrhizinate injection,other studies did not show the increasing risk of adverse reactions due to preventive medication.In terms of economy,the use of magnesium isoglycyrrhizinate injection for prevention of different diseases did not necessarily have economic advantages over the control group(blank group and reduced glutathione,polyene phosphatidylcholine injection,traditional Chinese medicine combined with magnesium isoglycyrrhizinate injection).In the prevention of drug induced liver injury,magnesium isoglycyrrhizinate injection used beyond the instructions has certain efficacy and safety,but it may not be the economic optimal for other different diseases.
文摘<strong>Introduction:</strong><span style="white-space:normal;font-family:;" "=""> Atherosclerotic cardiovascular disease is a dysmetabolic medical condition resulting in the #1 cause of morbidity and mortality in the United States. Coronary Artery Calcium (CAC)</span><span style="white-space:normal;font-family:;" "=""> </span><span style="white-space:normal;font-family:;" "="">CT non-invasively identifies athe</span><span style="white-space:normal;font-family:;" "="">rosclerosis in asymptomatic individuals. This translational study tested the hypothesis that clinically overt</span><span style="white-space:normal;font-family:;" "=""></span><span style="white-space:normal;font-family:;" "="">cardiovascular disease can be prevented in asymptomatic individuals in a medical clinic. <b>Methods:</b> Two hundred </span><span style="white-space:normal;font-family:;" "="">and </span><span style="white-space:normal;font-family:;" "="">six</span><span style="white-space:normal;font-family:;" "=""> asymptomatic adults requested a CAC scan to identify subclinical heart disease. Individuals with a positive CAC score ></span><span style="white-space:normal;font-family:;" "=""> </span><span style="white-space:normal;font-family:;" "="">1 (n = 125) were prescribed targeted</span><span style="white-space:normal;font-family:;" "=""> medical therapy to reverse their atherosclerosis. The goal was to achieve an LDL Cholesterol (LDL-C) ≤</span><span style="white-space:normal;font-family:;" "=""> </span><span style="white-space:normal;font-family:;" "="">60 mg/dl. One hundred </span><span style="white-space:normal;font-family:;" "="">and </span><span style="white-space:normal;font-family:;" "="">ten individuals</span><span style="white-space:normal;font-family:;" "=""> reached this goal (67 male, 43 female) receiving 10 mg/d of rosuvastatin and 10 mg/d of ezetimibe plus a low cholesterol diet. Other fifteen individuals with positive CAC scores did not achieve this LDL-C goal. <b>Results:</b> In the group following medical therapy and achieving an LDL-C ≤</span><span style="white-space:normal;font-family:;" "=""> </span><span style="white-space:normal;font-family:;" "="">60 mg/dl, no cardiovascular events</span><span style="white-space:normal;font-family:;" "=""> were observed during a maximum observation period of 5 years (mean observation time = 3.6 years). Based on previously published CVD outcome data in individuals with similar CAC scores, 12.6 cardiovascular events were expected. Two of fifteen individuals with positive CAC scores not following medical therapy had a cardiovascular event. None of the 81 individuals </span><span style="white-space:normal;font-family:;" "="">with a </span><span style="white-space:normal;font-family:;" "="">zero score had a cardiovascular event during follow-up. No adverse effects of therapy occurred. <b>Conclusion:</b> In a medical</span><span style="white-space:normal;font-family:;" "=""> </span><span style="white-space:normal;font-family:;" "="">clinic</span><span style="white-space:normal;font-family:;" "="">,</span><span style="white-space:normal;font-family:;" "=""> adult population with positive CAC scores</span><span style="white-space:normal;font-family:;" "=""> and an LDL-C ≤</span><span style="white-space:normal;font-family:;" "=""> </span><span style="white-space:normal;font-family:;" "="">60</span><span style="white-space:normal;font-family:;" "=""> </span><span style="white-space:normal;font-family:;" "="">mg/dl, targeted medical therapy prevented overt</span><span style="white-space:normal;font-family:;" "=""> cardiovascular disease. These result</span><span style="white-space:normal;font-family:;" "="">s</span><span style="white-space:normal;font-family:;" "=""> should encourage other physicians to aggressively treat </span><span style="white-space:normal;font-family:;" "="">atherosclerotic cardiovascular disease in their clinic popula</span><span style="white-space:normal;font-family:;" "="">tions.</span>
文摘Purpose: Cardiovascular disease is the number one cause of death in the Western world. The purpose of this manuscript is to compare the benefits and deficiencies of coronary artery calcium scanning versus computer generated risk equations in identifying atherosclerotic cardiovascular disease. These two approaches provide significantly different cardiovascular risk assessments and often lead to therapeutic differences in recommendations from the physician to the patient. Methods: Pertinent medical literature is reviewed concerning both risk assessment approaches (i.e., coronary artery scanning and computer generated risk equations). The strengths and weaknesses of both approaches are discussed, and recommendations are provided based upon available data. Results: Cardiovascular risk equations are simple and readily obtained at no charge by physicians. However, their drawbacks are several, including non-applicability to specific populations, disagreements among different cardiovascular society risk equations, wide ranges of risk outputs (e.g., intermediate 10-year risk is between 5% and 20%), inability to definitively identify coronary artery plaques, and lack of definitive anatomical coronary disease. Alternatively, coronary artery calcium scanning costs approximately $100/scan (if not covered by insurance), requires time and effort by the patient, and exposes the patient to a minimal amount of radiation. However, coronary calcium scanning identifies specific atherosclerotic coronary disease and provides additional information about the anatomical location (i.e., coronary artery) of the atherosclerotic plaque. Conclusion: Based on the published literature, coronary artery calcium scanning is the preferred approach for identifying atherosclerotic cardiovascular disease. Although there are minor drawbacks, overall it provides superior clinical information compared with computer generated risk equations.
文摘High-quality public health service of medical and prevention integration is the premise of people's healthy life, and general hospital is an important link. This paper expounds the current situation of public health service of general hospital, analyzes the difficulties and solutions, and provides reference for promoting the reform of public health service system of medical and prevention integration.
文摘Drawing on the Mazmanian Sabatier comprehensive model of policy implementation,this study conducted a systematic analysis of the pilot implementation of the disease control supervisor system in medical institutions in Shenzhen.By assessing three key dimensions—namely,the manageability of policy issues,regulatory capacity,and the external environment—the study found that the system has significantly improved the capacity of medical institutions in public health prevention and control,and enhanced their responsiveness to public health emergencies.However,several challenges continue to impede policy effectiveness,including unclear job responsibilities,insufficient professional staffing,and limited cross-sectoral collaboration efficiency.In response,the study proposes a set of measures to further promote the integration of medical and preventive services and offer a practical model for modernizing national public health governance.These measures include clarifying roles and responsibilities,establishing a tiered training system,strengthening multisectoral collaborative governance,and enhancing the support of information platforms.
基金supported by grants from the National"973"program(No.2012CB518004)the Key Project of National Natural Science Foundation of China(No.91439203)
文摘Low adherence to secondary prevention medications(ATM)of patients after acute coronary syndrome(ACS)is associated with poor clinical outcomes.However,literature provides limited data on assessment of ATM and risks associated with poor in Chinese patients with ACS.In the current work,ATM was assessed in consecutively recruited patients with ACS in Tongji Hospital from November 5,2013 to December 31,2014.A total of 2126 patients were classified under low adherence(proportion of days covered(PDC)〈50%)and high adherence(PDC〉50%)groups based on their performance after discharge.All patients were followed up at the 1st,6th,and 12th month of discharge while recording ATM and major adverse cardiac events(MACE).Bivariate logistic regression was used to identify the factors associated with ATM.Cox regression was used to analyze the association between ATM and MACE within one year after discharge.Results showed that coronary artery bypass grafting(CABG)alone had significantly lower proportion of high adherence to P2Y12 antagonists(83.0%vs.90.7%,P〈0.01)than patients treated with percutaneous coronary intervention(PCI)only.Moreover,in patients undergoing PCI,high adherence to P2Y12 antagonists decreased the risk of MACE(hazard ratio=0.172,95%confidence interval:0.039-0.763;P=0.021).In conclusion,PCI-treated patients are more prone to remaining adherent to medications than CABG-treated patients.High adherence to P2Y12 antagonists was associated with lower risk of MACE.
