It is one of the priorities of the new round of healthcare reform to develop regional healthcare alliances through vertically integrating resources. This paper reviews the framework and characteristics of Shanghai’s healthcare system, and then analyzes its strengths and weaknesses, underscoring Shanghai’s exploration in the vertical integration of medical resources as a response to the pressing issues in healthcare. The paper outlines the main tasks and groundwork of the Shanghai healthcare alliance initiative and gives an outlook on the expected outcomes. It ends with some thoughts on the problems and challenges confronting regional healthcare alliances in Shanghai.
Objective To review the advance in the experimental studies of microRNA(miRNA) and the relationship between miRNA and stem cells. Methods The related literature was reviewed, and the research findings of miRNA and stem cell were summarized. Results miRNA was noncoding small RNA (20-25 nt) involved in posttranscriptional change, that have been shown to regulate gene expressions. Ithas been reported that some kinds of miRNAs were likely important regulators forstem cells maintaining their state of selfrenewal，and play key roles in theirdifferentiation. Conclusion miRNA as regulation of gene expressions, can be served as a new way for stem cells research.
Objective To know the basic research and the clinical application of cartilage-derived retinoic acid-sensitive protein (CD-RAP) in orthopedic and in other clinical fields. Methods The literature related to CD-RAP in basic research and clinical application were extensively reviewed. Results CD-RAP, as a protein, which is cartilage-specific,could be a marker of the joint diseases. It also can be used to monitor metastsais of melanoma. Conclusion CD-RAP test provides a new way to study repair of cartilage and metastsais of melanoma.
Objective To investigate the initiation of fracture repair and regulation on molecular level.Methods Literature concernedfracture repair and effects of correlative factors in the process in recent years was reviewed. The initiation in the process of fracture repair and the effects of the correlative factor were summarized to probe into effective methods to intervene. Results During fracture repair, the initiation had particular character and the correlative factors were concerned with the process. Conclusion The correlative factors regulate the initiation of fracture repair on molecular level.
Objective Interpretation of the growing body of global literature on health care risk is compromised by a lack of common understanding and language. This series of articles aims to comprehensively compare laws and regulations, institutional management, and administration of incidence reporting systems on medical risk management in the United Kingdom, the United States, Canada, Australia, and Taiwan, so as to provide evidence and recommendations for health care risk management policy in China. Methods?We searched the official websites of the healthcare risk management agencies of the four countries and one district for laws, regulatory documents, research reports, reviews and evaluation forms concerned with healthcare risk management and assessment. Descriptive comparative analysis was performed on relevant documents. Results?A total of 146 documents were included in this study, including 2 laws (1.4%), 17 policy documents (11.6%), 41 guidance documents (28.1%), 37 reviews (25.3%), and 49 documents giving general information (33.6%). The United States government implemented one law and one rule of patient safety management, while the United Kingdom and Australia each issued professional guidances on patient safety improvement. The four countries implemented patient safety management policy on four different levels: national, state/province/district, hospital, and non-governmental organization. Conclusion?The four countries and one district adopted four levels of patient safety management, and the administration modes can be divided into an “NGO-led mode” represented by the United States and Canada and a “government-led mode” represented by the United Kingdom, Australia, and Taiwan.
ObjectiveTo summarize the research progress of the regulation effect of hypoxia inducible factor (HIF) on intervertebral disc. MethodsThe domestic and foreign related literature about the regulation effect of HIF on intervertebral disc was reviewed, summarized, and analyzed. ResultsHIF is a key transcription factor that is in response to hypoxia by cells, which is widely distributed in tissues and organs, including intervertebral disc. Hypoxia inducible factor is expressed highest in the nucleus pulposus which has the lowest oxygen concentration in the intervertebral disc. The effects of HIF include the regulation of nucleus pulposus differentiation and development, maintenance of the survival, energy metabolism, and anabolism of nucleus pulposus cells, and maintenance of the stability of extracellular matrix. ConclusionHIF plays a vital role in the development and differentiation of intervertebral disc and maintenance of physiological function, which may become a target for the research of the mechanism and the treatment of intervertebral disc degeneration.
In 2019, the national government issued the document "Implementation Plan for Supporting the Construction of the Boao Lecheng International Medical Tourism Pilot Area", which allowed the use of innovative drugs and medical devices in medical institution of Boao Lecheng. These medical products had been designed to meet urgent clinical requirements and had been approved by regulatory authorities overseas. Through the use of these medical products, real-world data were generated in the routine clinical practice, based on which real-world evidence might be produced for regulatory decision-making by using scientific and rigorous methods. In March 2020, the first medical device product using domestic real-world data was approved, suggesting that the real-world data initiative in Boao Lecheng achieved initial success. This work also provided important experience for promoting the practice of medical device regulatory decision-making based on real-world evidence in China. Here, we shared the preliminary experiences from the study on the first approved medical device product and discussed the issues on developing a real-world data research framework in Boao Lecheng in attempt to offer insights for future studies.
Alternative splicing plays an important role in the pathogenesis, diagnosis, treatment and prognosis of autoimmune diseases. Alternative splicing is universal and non-preferred in autoimmune diseases, and exon skipping is the most common type in alternative splicing types. The occurrence and development of autoimmune diseases can be influenced by the 5′ splicing, 3′ splicing, number change of exons, splicing affected by the single nucleotide polymorphism and the variance of gene expression levels. Moreover, different single nucleotide polymorphisms of the same gene can affect the development of various autoimmune diseases. This review summarizes the role of different forms of alternative splicing in various autoimmune diseases, and aims to provide a basis for further study of the conditions in different development stages of autoimmune diseases and the regulatory mechanism of different levels of splicing isoforms.