|China Plan for Chinese patients! A protocol passed by SJTUSM on medical specialists|
As the most populous country, China more than 70 visits per year, with the world‘s most diverse clinical resources, however, domestic clinical diagnosis and treatment schemes are basically adopted abroad. For “health” in China, established the no correlation between, what is missing?
In Shanghai, clinical medicine ranked first, had more than 10 affiliated hospital of Shanghai jiaotong university school of medicine, relying on the plateau peak discipline construction plan of Shanghai in recent years, the first “short board” try how to repair. In partial research physicians, clinical full-time researcher team oriented project training, academician of Chinese academy of sciences, dean Chen guoqiang platform cheer for them, “let’s doctor from training experiment in mice and cells, SCI papers, apply for natural fund, into using clinical resources to solve the problem of a pile of clinical, obtain a number of clinical research.”
That is to say, the clinical doctor‘s research not only in the laboratory, and want to be in bed. So-called world-class medical disciplines, is creating more adjust measures to local conditions, vary from person to person, the specification of the diagnosis and treatment plan in accordance with the Chinese characteristics, with China’s plans on disease of the people.
Pointer to reverse clinical medical research
Under the attaches great importance to the scientific research atmosphere, even many amateurs know the three major international journal: “science,” nature “cell”. However, little imagine in the world-class medical school inside the event horizon, the “big three” just focus on basic research, and the four top medical journals is the New England journal of medicine, the lancet journal of the American medical association the British medical journal. From diagnostic criteria to surgery paradigm, the research results can directly guide clinical application. The name of the Chinese researchers frequently appeared in the “big three”, but few hair in the “big four” within a year on a high level.
At this point, Chen guoqiang has been “stimulus”. In a visit to a German university affiliated hospital, he found that only the year the other party in the New England journal of medicine, the lancet published 7 papers. Compared with the only five centuries of foreign hospital beds, Shanghai jiaotong university school of medicine each big hospital has 17000 beds, but the clinical resource advantage, it seems, are still not transformed into winning.
According to the national natural science fund committee review results released in the summer of 2016, when the jiaotong university school of medicine were granted 505 fund projects, the number 7 consecutive years ranked the first medical college, and direct funding of 232 million yuan. School of medicine, however, did not “lie” in these funds mainly on basic research projects, because most of them still cannot be directly used for clinical diagnosis and treatment, is not entirely the adoption standard of world class school of medicine, so must reverse pointer to scientific research of the discipline of clinical medicine.
The “short board” is also common in China. Academician Chen guoqiang said that the field of clinical diagnosis and treatment is still in the “importer” stage, so far, high quality, large sample, multi-center clinical research for the international guidelines adopted completely is relatively rare.
To explore Chinese medicine “new national standard”
Genetic background different, way of life is different, different social environment, can not always follow the “west wind”, will China‘s healthy cause long-term dependence on other countries’ standards. Push the Chinese medicine in the international medical standard discourse system, it is accepted by more and more Chinese clinicians.
In fact, the nation‘s top awards winner Wang Zhenyi academician, having high mortality in leukemia, acute myelocytic leukemia (APL) in the diagnosis and treatment, early pioneering application all trans retinoic acid for differentiation treatment, get 80% to 90% response rate. Retinoic acid was in the treatment of skin disease, it is “old drugs with new” clinical research, to prove effective for APL. In the end, the presence of Shanghai institute of hematology, Chen zhu, sai-juan Chen and others, will all trans retinoic acid and similar “arsenic arsenic agent combined with the use of” created “Shanghai” targeted therapy of two drugs together, so that the APL became the first basic cure acute myeloid leukemia.
Junior doctors is exploring. Nowadays, suffering from uremia, in addition to the kidney transplant, must do dialysis. Among them, the abdomen through solution inside the small tube inside the abdominal cavity, liquid injection about 2 liters of abdominal, daily exchange for several times in vivo and in vitro. But the problem is coming, the day to move many bags to drain fluid? Renji hospital kidney branch chief physician, doctoral supervisor MouShan introduction, according to the international clinical guidelines, depends on a key indicators, urea nitrogen clearance, the original is 2.0, them need four or five bags of liquid to drain. Can foreigners “big”, unlike the Chinese size, domestic clinical index “1.7” is feasible?
As an jiaotong university medical school first research physician, Fang Hui waiting for two years, major hospitals in Shanghai in 500 cases of sample multi-center clinical research, confirmed the Chinese version of the standard is scientific, can reduce the frequency to drain fluid exchange, reduce the financial burden on patients. Because a day reduced to three bags, medical costs alone can save about 40 yuan per day. At present, the basic medical institutions around the abdomen through scheme has adopted the “new gb”.
Fang Hui et al. Clinical research is not an end, they are still in the tracking of patients, through five years or ten years follow-up, we will further improve the therapy, making it more safe and effective.
Intersection to solve clinical problems
Frontline doctors in clinical research at the same time, the medical school researchers also need to do for clinical basic research. To this end, Shanghai jiaotong university school of medicine started by application, the selection mechanism, and in the domestic first to establish the “double hundred” talent sequence, support special focus, let the first hundred “research physician” with hundreds of “clinical” professional researchers formed cross fusion system, each should have the innovation ability of liberation, two-way transformation of research results.
According to the new mechanism, and partial system to motivate and guide. Each research physician, Shanghai jiaotong university school of medicine pay 100000 yuan allowance each year, the hospital to form a complete set of 100000 yuan. Give 500000 yuan per person at the same time, the medical school, hospital and form a complete set of 500000 dollars, as its millions of scientific research funds. Hundreds of clinical professional researchers, but also enjoy such allowances.
The doctor prescribed knife this lifetime is always limited, and the research of the operation paradigm is replicable promotion. Last year, the party secretary of Shanghai jiaotong university school of medicine, the ministry of education “cheung kong scholars” project, led by xian-qun fan orbital surgical reconstruction key technological system of “the creation and application”, obtains the national scientific and technological progress second prize, has been applied in the whole country. His students, nine yuan, deputy director of ophthalmology ren-bing jia, Ph.D., the selected the first batch of research physician, who specializes in eye socket eye tumor disease clinical research. Ren-bing jia a famous cancer center as a visiting scholar in the United States, between scientific research and clinical observe them constantly exhumation of translational medicine particularly strong consciousness, a year has participated in more than 60 academic lectures, many of which are just finish operation lecturer doctors - even before surgery clothing could change.
Xian-qun fan, professor of SJTUSM, said the implementation of the “double hundred” talent plan will focus on providing hospital culture is good at from clinical found that the problem of talent team, through full-time clinical doctors and researchers’ teamwork, complete the transformation process from a hospital - laboratory circle, and to break the barriers between affiliated hospital. It aims to let different hospital medical hospital the same discipline, discipline and discipline, the joint research between complete focus on specific clinical problems, to carry out multicenter, large sample randomized controlled study, earnestly to solve practical problems, and to provide treatment and guidelines.