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As a new form of medical industry， internet medicine has not only the endogenous risk of internet industry， but also the blind area and exogenous risk because of lagging regulation. With the continuous progress of internet information technology， online diagnosis and treatment will gradually integrate and reconstruct the traditional medical service. In the history of medical development， the emergence of new technologies generally has the characteristics of risk. Therefore， the supervision of internet medicine should adhere to the rule of inclusiveness and prudence， and take into account the cultivation of the market and standardized development. It should also build a regulatory community， coordinate governance from the four dimensions of legitimacy， compliance， rationality and superiority. Taking the law as the bottom line， we should make full use of early online warning monitoring， off-site supervision， online supervision， reputation mechanism and other measures to promote the innovative development of internet medicine under the framework of legal compliance.
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The penetration and integration of internet with medical industry is apparently falling behind its interaction with other industries in terms of speed and scale. The main reason is due to the high risk and difficult supervision of internet medicine. Based on the regulatory context， this paper analyzes the endogenous and exogenous risk of internet medicine. The inherent characteristics of the internet （such as openness， diversity， multi subjectivity， virtuality， transparency， and high aggregation） lead to endogenous risks， including jurisdiction disputes， uncertainty of rights and obligations， security of personal information and medical information， monopoly. The lag of specific law in internet medicine， the lack of extensibility and synergy of traditional hierarchical regulatory system， the uncertainty of internet hospital regulatory policy details， the lack of technical specifications/operating procedures and other external system coverage in internet diagnosis and treatment lead to regulatory blind areas and exogenous risks. Based on the risk analysis， this paper discusses further construction of the mechanisms of risk assessment and regulation for internet medicine.
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Internet medicine is not a concept of jurisprudence. China's current medical law system mainly focuses on main qualifications of the participants who conduct diagnosis and treatment. This paper focuses on several business models of the core element （diagnosis and treatment） in internet medicine， namely： online health consultation provided by internet medical platform， online diagnosis and treatment by internet hospital， and certain artificial intelligence（AI） medicine products that are specialized for diagnosis and treatment. This paper summarizes the development of these three business models， and analyzes the main problems in their development， including the legitimacy identification of online consultation， the dilemma of the development of internet hospitals， the impact of insufficient sample data on the development of medical AI， and the reverse restriction of regulatory difficulties to the development of internet medicine. The next step of developing internet medicine is to broaden the scope of internet diagnosis and treatment on the premise of medical safety， which will be based on the improvement of current regulatory system. It is urgent to build early risk warning system and supervision/ management mechanism for internet medicine.
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In the fifth scientific and technological revolution， information technology is the first productivity， which has a great impact on the supply and demand of medical services. Generally， internet medicine is equivalent to the combination between health industry and information technology. "Healthy China" strategy is China's "priority development strategy"， which adheres to the principle of health equity， emphasizes the integration of health into all policies， and takes co-construction and sharing as the basic path. With implementing internet medicine， "Healthy China" strategy promotes the mobility of medical service with three tools： interconnection， data and artificial intelligence. This enhances the operation efficiency of overall medical and health system， and optimizes the allocation of medical resources. The future development of internet medicine follows the double helix mode driven by technology and policy， and the policy determines the development boundary of the industry. On the basis to ensure medical safety， we should explore the possibility of internet diagnosis and treatment further， and pay attention to the fairness of resource allocation while improving efficiency， so as to realize the co-construction and sharing of health services.
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It is a major public health task to promote the construction of modern disease prevention and control system in the prevention and control of the novel coronavirus pneumonia epidemic. In this study, we identified the current situation and challenges in the construction of disease prevention and control system in Shanghai, including the infrastructures, disciplines, human resources, information system, operational mechanism, and legalization. It is proposed that we should promote the construction of modern disease prevention and control system in Shanghai, which is aimed to improve the capacity in the disease prevention and control services, response to the major epidemics and public health emergencies, and scientific research in public health, in accordance with municipal functional orientation large-scale metropolitan public health security requirements in Shanghai. Moreover, we should promote policy-making, including upgrading infrastructures, facilitating discipline construction and scientific research innovation, optimizing development environment for human resources, accelerating comprehensive information construction, improving systems and mechanisms, and strengthening legal governance.
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Bone cement, consisting of polymethyl methacrylate, is a bioinert material used for prothesis fixation in joint arthroplasty. To treat orthopedic infections, such as periprosthetic joint infection, antibiotic-loaded bone cement (ALBC) was introduced into clinical practice. Recent studies have revealed the limitations of the antibacterial effect of ALBC. Moreover, with the increase in high infection risk patients and highly resistant microbes, more researches and modification of ALBC are required. This paper reviewed latest findings about ALBC for most popular and destructive pathogens, summarized the influence of antibiotic kind, drug dosage, application method, and environment towards characteristic of ALBC. Subsequently, new cement additives and clinical applications of ALBC in joint arthroplasty were also discussed.
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Humans , Anti-Bacterial Agents/therapeutic use , Arthroplasty, Replacement, Knee , Bone Cements , Polymethyl Methacrylate , Prosthesis-Related Infections/drug therapyABSTRACT
@#【Objective】To investigate the value of medical exome sequencing in copy number variation detection in genetic diseases. 【Methods】 Here we tested two separated cases. There are no similar symptoms except intelligent disability between the cases. Fragile X syndrome，G-banding，chromosome microarray and medical exome sequencing were sequenced tested for the two cases and their parents. 【Results】We found the copy number variants in both of the patients from the two families，which distributed from 11.4 kb to 13.03 Mb in size. The copy number variants were all verified by other technologies. 【Conclusion】 medical exome sequencing is useful for the detection of copy number variation in genetic diseases，although the value still need more verification.
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BACKGROUND: Microwave treatment is a common physical therapy method that can increase the temperature and blood circulation of deep tissues, and is used for improving fracture repair. However, microwave treatment cannot be used if there is surgically implanted metal plate or screw. OBJECTIVE: To observe the dame of microwave treatment to the tissues surrounding the titanium alloy implants. METHODS: Forty-four New Zealand white rabbits were randomized into experimental and control groups. The model of the fracture at the middle of the femur was established in all rabbits, and the rabbits in the experimental group were implanted with titanium alloy internal fixation systems. A 30-day microwave treatment (2 450 MHz, 20 W or 40 W, 20 minutes daily) was applied to the fracture site in all rabbits at 3 days after operation. RESULTS AND CONCLUSION: After 20 W of wave microwave treatment, the temperature of tissues around the implants showed no significant increase or severe heat injury. While, 40 W of wave microwave treatment significantly increased the temperature of tissues around the implants and the tissue was damaged severely. Our results indicate that, the low-dosage microwave treatment may be a promising method in the rehabilitation therapy of fractures with titanium alloy internal fixation.
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BACKGROUND: Non-surgical spinal decompression system can be used for the treatment of diseased intervertebral discs and avoid contraction and resistance of paravertebral muscle during traction. At present, there is lack of analysis of the efficacy of non-surgical spinal decompression in the treatment of lumbar disc herniation through surface electromyography. OBJECTIVE: To compare the effect of non-surgical spinal decompression system DRX9000 with conventional traction device in the treatment of lumbar disc herniation through surface electromyography. METHODS: Totally 60 patients with lumbar disc herniation were randomly divided into DRX9000 group and general traction group, with 30 cases in each group. The patients in DRX9000 group were treated with non-surgical spinal decompression system DRX9000 and the patients in general traction group were treated with conventional tractor. All patients underwent surface electromyography examination of erector spinal muscle and multifidus muscle before and after all treatment to evaluate the strength and fatigue of paravertebral muscle. The Visual Analogue Scale and Japanese Orthopaedic Association scores were used to assess the degree of pain and impairment due to lumbar disc herniation. RESULTS AND CONCLUSION: (1) After all of the treatment, the average electromyogram and mean power frequency slope of affected erector spinal muscle and multifidus muscle in both groups were increased than those before treatment (P < 0.05). The data of DRX9000 group were significantly higher than that of the general traction group (P < 0.05). (2) After all the treatment, the Visual Analogue Scale score decreased and the Japanese Orthopaedic Association score increased in both groups at the end of treatment compared with before treatment (P < 0.05). The Visual Analogue Scale score of DRX9000 group was significantly lower than that of the general traction group (P < 0.05) and the Japanese Orthopaedic Association score of DRX9000 group was significantly higher than that of the general traction group (P < 0.05). (3) These results showed that non-surgical spinal decompression system could effectively improve paravertebral muscle activity and muscle strength, lessen muscle fatigue, relieve pain, and improve function in patients with lumbar disc herniation, and its effect is obviously better than that of general traction.
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A gas chromatography-mass spectrometry(GC-MS)method was established for the analysis of volatile components in Mentha haplocalyx, and seven principal components were quantified by gas chromatography(GC). Based on these analyses, the differences of volatile components in M. haplocalyx from Jiangsu, Anhui and other regions were compared. The results showed that the volatile oil of M. haplocalyx was divided into four chemical types：menthol-menthone type, pulegone-menthone type, piperitone-menthol type, piperitone epoxide type, and menthol-menthone type was the principal type. Menthol was the highest and pulegone was the lowest. The differences of M. haplocalyx from Anhui and other regions were obvious. The major volatile components and the differences of M. haplocalyx from different regions were confirmed and a quantitative method was established for the determination of volatile components, which provided the basis for improving the quality standard of M. haplocalyx.
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@# Objective To explore an economic and effective management strategy for lumbar disc herniation (LDH) in community health center. Methods 62 LDH patients treated in Xujiahui community health center (observation group), 48 LDH patients treated in Huajing community health center (control group A) and 55 LDH patients treated in Shanghai 6th People's Hospital (control group B) were included.The observation group was managed by associate professor from Shanghai 6th People's Hospital and accepted different treatment strategy in mild, medium and heavy grades. The control groups A and B were managed routinely. 3 month later, costs of illness were computed and curative effects were accessed in 3 groups. Results There was no difference in curative effects between observation group and control group B (P>0.05), but better than control group A (P<0.05). The observation group cost the least among the groups (P<0.05). Conclusion Graded treatment strategy united with tertiary hospital is an economic and effective mode for LDH management in community health center.
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The expression of the hemagglutinins of Avian influenza virus H5 H7and H9 subtypes was studied in this article by Pichia pastoris, one of the eukaryotis expression systems. Three reconstructed expression plasmids and engineering strains, named pPIC9K-H5HA, pPIC9K-H7HA, pPIC9K-H9HA and GS115/pPIC9K-H5HA, GS115/pPIC9K-H7HA, GS115/pPIC9K-H9HA repectively, were obtained. The reconstructed yeast engineering strains were identified by MD and MM plate selecting and PCR. The induced interests proteins were examined by SDS-PAGE and Western-bloting,the results showed that the interest genes were expressed exactly. And this will be helpful in the future study of antigen detection and antibody detection kit, as well in the subunit vaccines developing.
Subject(s)
Animals , Hemagglutinin Glycoproteins, Influenza Virus , Genetics , Influenza A Virus, H5N1 Subtype , Genetics , Influenza A Virus, H7N7 Subtype , Genetics , Influenza A Virus, H9N2 Subtype , Genetics , Pichia , Genetics , MetabolismABSTRACT
Anti-HIV-1 gp120 single chain antibody(scFv) gene and staphylococcus extoxin A(SEA) gene were inserted into vector pPIC9K. The recombinant plasmid was integrated into Pichia pastoris by electroporation. High level expression was performed by determining the Muts phenotype and screening muti-copy integrants. The recombinant protein was about 57kD and the production was 50.1 mg/L. It was shown that the two kinds of protein affected the conformation of each other by antibody affinity assay, but the recombinant targeting toxins could highly mediate CTLs to kill HIV-1 target cells.