ObjectiveTo investigate the current status of the promotion of appropriate health technologies in Zhejiang province from 2009 to 2013, in order to provide baseline data for appropriate health technologies, application and research. MethodsThe status of promotion of appropriate health technologies in different regions of Zhejiang province were quantitatively described and compared according to the information in the websites of The Application and Promotion of Appropriate Techniques of Health, The Application and Promotion of Appropriate Techniques of Traditional Chinese Medicine as well as the Bank of Appropriate Technologies. Resultsa) A total of 127 Model Bases of Appropriate Health Technologies were set up, which were combined 127 leading institutions and 513 joint units, covering 11 cities, 40 counties, and 206 townships. b) The type of first aid base and chronic diseases base accounted for 33.0% and 25.3% of total types of model bases respectively; however, the number of bases dealing with rehabilitation care, public health and diseases referred to Ophthalmology & Otolaryngology and skin disease were very small. c) There were 486 appropriate health technologies promoted in Zhejiang province; appropriate technology about first aid, chronic diseases, women and children, rehabilitation care, public health, Ophthalmology & Otolaryngology and skin disease, traditional Chinese medicine and family planning accounted for 26.5%, 18.9%, 17.9%, 11.0%, 10.6%, 7.6%, 4.6% and 1.4%, respectively of total types of appropriate health technologies. d) The numbers of appropriate health technologies promoted in different regions were varied. Most of appropriate health technologies were promoted in more developed regions or more regions rich in health resources. Conclusiona) The model of "1+X" is used to promote the application of appropriate health technologies in Zhejiang province, and the prefecture-level regions of Zhejiang province have established the Model Bases of Appropriate Health Technologies in 11 cities. The promotion system of appropriate health technology is constructed and it achieves good results. b) In nine model bases, the most types of promotion bases are chronic diseases and first aid, and the technologies about first aid, chronic diseases, women and children are most promoted. c) The types of appropriate health technologies promoted in different areas are varied. d) It is necessary to evaluate and select appropriate health technology bases according to the burden of local disease and evidence.
ObjectiveTo systematically review the model and mechanism, efficacy and its influencing factors of the promotion and application of appropriate health technology in China. MethodsSuch database as VIP, CNKI, CBM and WanFang Data were electronically searched to collect studies on the promotion and application of appropriate health technology in China published from the establishment dates to January 2013. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted and cross-checked data, and assessed quality. Qualitative synthesis method was used to systematically summarize the included studies. ResultsA total of 73 studies were finally included. Targeted populations included primary medical staff and personnel who provided or developed appropriate health technologies, medical institutions and their managers, as well as patients who received service or treatment of appropriate health technology. The promotion of appropriate health technologies mainly contained five fields: Chinese medicine, biomedicine, family planning services, maternal and child health, and community health services. The government-leading model had been widely applied currently, besides, there were other four models: government-guidance, government-driven, market-leading and a third sector-leading models. Factors related to project funding, organization and management, technology holders, the supply and demand parties in technical services and technology itself might affect the application of appropriate health technology. Among all evaluation studies, the number of needs assessment was less, the contents of process evaluation were one-sided and the effect evaluation was mainly cross-sectional studies. ConclusionThis study shows that sustainable development of appropriate health technology promotion model need to fully consider market demand and people's needs, on the basis of using government-leading or introducing a third sector-leading model. Corresponding measures should be taken according to the influencing factors of promotion and application of appropriate health technology. It is necessary to conduct high quality evaluation studies in future and comprehensively evaluate the efficacy of the promotion and application of appropriate health technology.
ObjectiveTo systematically summarize and analysis the patterns of the screening, organization and promotion of appropriate health technology, to provide references for establishing the localization and long-term mechanism of appropriate health technology promotion for different regions. MethodsDatabases including CBM, CNKI, WanFang Data and VIP databases were searched from their inception to February 2016, to collect studies about the promotion and application of appropriate health technology in China. Two reviewers independently screened literature, and extracted data. Then, a descriptive analysis was conducted. ResultsA total of 26 studies were included, of which, 21 studies were related to specific patterns of the appropriate health technologies promotion and 5 studies were related to indicators screening system. The screening principle of appropriate health technology was a reference to national screening recommendation technology with local optional technology, taking into account locals needs and four aspects of technology:safety, effectiveness, economy and suitability. At the provincial and county levels, a leading group and a technical experts' group were established to take responsibility for project coordination and management, and provide technical guidance. Two patterns were being formed, one is a three or four level vertical promotion network, such as from the county to the townships and villages, the other is a radiation promotion from the point to the surface revolving around county and township. ConclusionThe screening of appropriate health technology is lack of objectivity, unified and strong operability index system. The "top-down" model led by the government could not meet the reality requirement of grassroots. It is necessary to establish a "bottom-up" mechanisms for the screening, organization and promotion of appropriate health technology, which can meet the reality requirement of grassroots.
Evidence-based medicine (EBM) provides a reliable evidence decision-making model for the medical field. The concepts and methods of EBM are gradually extended to other disciplines. At present, the paradigm of evidence-based science (EBS) is formally proposed, which is not only based on a methodological cooperation between different disciplines, but also a deeper potential driving force in optimizing the operation process of knowledge. The advantages of EBS helps promote its extension to other disciplines through standardization concepts and systematic methods, through which the common theories and supporting organization of EBS are formed. Under the guideline of EBS, the evidence-based concepts and methods will play a supportive role in scientific development.
ObjectiveTo identify a more popularized preparation protocol of leukocytes-rich platelet-rich plasma (L-PRP) for higher tolerance rate.MethodsThe peripheral blood samples of 76 volunteers (45.0 mL/case) were mixed with 5 mL sodium citrate injection for blood transfusion, and L-PRP was prepared by twice centrifugations. All blood samples were divided into three groups according to the parameters of twice centrifugation: experimental group A (12 cases, 400×g, 10 minutes for the first time and 1 100×g, 10 minutes for the second time), experimental group B (27 cases, 800×g, 10 minutes for the first time and 1 100×g, 10 minutes for the second time), and control group (37 cases, 1 360×g, 10 minutes for the first time and 1 360×g, 10 minutes for the second time). The platelet recovery rate and platelet and leukocyte enrichment coefficient of L-PRP in each group were calculated and compared.ResultsAfter removal of abnormal blood samples (platelet recovery rate was more than 100% or white thrombus), the remaining 55 cases were included in the statistical analysis, including 10 cases in experimental group A, 21 cases in experimental group B, and 24 cases in control group. The platelet enrichment coefficient and platelet recovery rate of experimental group B were significantly higher than those of experimental group A and control group (P<0.05); there was no significant difference between experimental group A and control group (P>0.05). There was no significant difference in leukocyte enrichment coefficient between experimental groups A, B, and control group (P>0.05).ConclusionThe preparation quality of PRP is affected by various factors, including centrifugal force, centrifugal time, temperature, and operation process, etc. Twice centrifugation (800×g, 10 minutes for the first time and 1 100×g, 10 minutes for the second time) is an ideal and feasible centrifugation scheme, which can obtain satisfactory platelet recovery rate and enrichment coefficient with thicker buffy coat, which can reduce the fine operation requirements for operators, improve the fault tolerance rate and generalization.