Community rehabilitation has much in common with primary health care. While providing primary health care for key groups, primary health care institutions will be of great significance if they can accurately provide rehabilitation services to people in need, reduce their degree of dysfunction, improve their quality of life, and realize the functional positioning of "rehabilitation at the grassroots level". This paper focuses on the coordinated development of community rehabilitation and primary health care, proposes several strategies in service delivery, service cooperation, and service financing, in order to provide references for the expansion of rehabilitation capabilities in primary health care institutions, and hopes to contribute to higher general public health standards and reduced medical expenditures.
Lifestyle Medicine, which emerged in the 1980s, is an interdisciplinary discipline involving various fields such as medicine, nutrition, exercise science, epidemiology, psychology, etc. It serves as a crucial bridge between public health promotion and clinical treatment, and plays a significant role in preventing, treating, and rehabilitating various diseases. This paper presents a comprehensive review of the definition, connotation, origin, development, and evaluation tools for assessing the effectiveness of Lifestyle Medicine. The findings reveal that Lifestyle Medicine aligns remarkably well with the principle of traditional Chinese medicine (TCM) regarding disease prevention and treatment. Despite notable research advancements in chronic disease management in China, the field of lifestyle medicine is still at an early stage of development. However, there remains a lack of specific, quantified, and standardized guidelines for implementing lifestyle interventions as well as clinical protocols and evaluation systems. The localization of Lifestyle Medicine in China still needs to consider local conditions, while increasing national policy support to establish a national data monitoring system and decision support system. Emphasizing health equity and optimising resource allocation across different regions are also essential aspects to be considered. Furthermore, integrating the advantages of TCM, including of its characteristic therapies, simplicity and cost-effectiveness, will promote the application and dissemination of Lifestyle Medicine for preventing and managing chronic diseases, thereby enhancing overall population health.
The diagnosis and treatment of medically unexplained symptoms (MUS) is complex and the cost of medical resources is large. MUS is a challenging clinical problem in general practice. The field of MUS is still in the preliminary stage of exploration in China. In this review, we systematically and comprehensively discuss the current challenges of MUS in the aspects of the concept, epidemiological characteristics, pathogenesis, diagnosis and treatment. We also propose some possible countermeasures combined with the actual situation. This article shows that there is no consensus on the concept, mechanism and diagnostic of MUS, suggesting the urgent need to draft relevant clinical guidelines and construct clinical pathways. At present, general practitioners have insufficient ability in the understanding, diagnosis and treatment of MUS, therefore, it is necessary to strengthen the training of MUS competence for general practitioners. More prospective, multi-center and multidisciplinary studies are needed to explore the characteristics and treatment strategies of MUS. This article provides a reference for general practitioners to understand and manage MUS scientifically and effectively.
Post-stroke patients are often left with different degrees of functional impairment, and in the process of returning from the medical institution to the community and home, it is necessary for medical institutions at all levels to cooperate and interact, so as to form a good full-cycle rehabilitation closed loop. At present, the application of full-cycle stroke rehabilitation is progressing, but some resistance still exists. This articel is based on the concept of full-cycle rehabilitation for stroke, combined with the current situation of the development of community-based rehabilitation, we also think about the development of the full-cycle rehabilitation and community-based rehabilitation link for stroke. The article emphasizes the importance of "community-based inflection-point rehabilitation" and the need to establish standards of community-based rehabilitation. Moreover, the article also mentions the need to emphasize the full-cycle stage of rehabilitation for stroke patients, explore the development strategy of community-based rehabilitation, and effectively improve the quality of life in community and family.
The primary healthcare system is key to achieving a health equity. In China, great obstacles are challenged by imbalanced medical resources, shortage of primary healthcare providers, and the prevention and treatment of chronic diseases. Artificial intelligence large language models have demonstrated strong advantages in the medical system. This article deeply explored the application of large language models in the primary healthcare system and the challenges. The large language models are expected to assist the diagnosis and treatment of common diseases in grassroot medical institutions, promote intelligent health education and chronic disease management, underpin primary health services in the undeveloped and remote areas, stimulate the leapfrog development of general medicine, and accelerate the industrialization of large language models in general diagnosis and treatment and primary health services, thus providing important support for the construction of healthy China.
The increasing prevalence of chronic diseases globally poses major challenges to the health of societies and individuals. Managing chronic diseases requires long-term treatment and monitoring, placing demands on patients' lifestyles. With the aging of the population and changes in lifestyle, chronic disease prevention and control are becoming more and more important. In recent years, as scientific and technological innovation in the field of healthcare develops in depth, and the application of artificial intelligence in healthcare has gradually become one of the important strategic directions of the country, the traditional method of chronic disease management relies too much on the offline communication between the doctor and the patient, which leads to the doctor not being able to maintain long-term and effective communication and follow up with the patient, and the patient may not be able to be detected and monitored by the doctor in a timely manner when his or her condition changes. In addition, the traditional chronic disease management approach is usually a generalized approach that fails to adequately consider the individual differences of each patient. Given the limitations of traditional chronic disease management methods, this study aims to provide more convenient and efficient primary care services using intelligent robots. Through personalized health management plans, assisted medical diagnosis, and timed medication reminders, the intelligent robot is committed to improving patients' quality of life, reducing the pressure on healthcare resources, and promoting the development of intelligent healthcare management globally.
The outbreak of COVID-19 has had a huge impact globally. After the infection, a considerable number of patients have been affected by a series of lingering symptoms or sequelae with strong heterogeneity, which we temporarily refer to as long COVID. Compared to the well-studied cardiovascular complications caused by COVID-19 during the acute phase, the cardiovascular sequelae in long COVID require greater attention. This review includes the clinical manifestations, mechanisms, and principles of diagnosis and management of cardiovascular sequelae in long COVID, aiming to improve the disease's understanding and reduce its harm scientifically.
Atrial fibrillation (AF) is the most common arrhythmia in cardiovascular disease, and it often coexists and interacts with sick sinus syndrome. In the past, pacemaker implantation combined with antiarrhythmic drugs was preferred for symptomatic atrial fibrillation with long interval treatment. However, in recent years, more and more studies have shown that compared with pacemaker implantation, radiofrequency ablation can reduce the hospitalization rate related to tachycardia, effectively control atrial fibrillation, and improve patient prognosis and hospitalization rate of heart failure. However, some patients present intrinsic sinus node dysfunction (SND), and SND may progress and worsen in some patients with atrial fibrillation. Therefore, the first-line treatment strategy for patients with atrial fibrillation with long interval remains controversial. This article reviews the selection of long-term intermittent treatment strategies for atrial fibrillation.
Building a high-quality and efficient people centered integrated care system with Chinese characteristics crucial for implementing the Healthy China strategy and essential for the high-quality development of the healthcare system. This article proposes that a people centered integrated care system should center on health, with efficient triage of urgent and non-urgent cases, linkage between different healthcare levels, and a synergy of prevention and treatment. The development of medical services requires collaboration between public medical and health institutions and societal forces. To construct such a system, transformation is necessary in seven key areas: service system, service concept, individual service decision-making, doctor-patient relationship, service mode, payment mechanism, and regulatory assessment. The key is to promote the strengthening, extension, and integration of the healthcare system and public health service system. This article highlights the importance of management system reform and the full use of information technology, stating that the core aim of building a peo-ple centered integrated care system is to meet the comprehensive health needs of the population, establish a rational and orderly medical framework, and ultimately support the creation of a robust health system in China.
This paper systematically reviewed the process of primary health care development of China over the past 45 years, and summarized the achievements of primary health care based on data related to primary health care draw from 2010-2012 China Health Statistics Year book, 2013-2017 China Health and Family Planning Statistical Yearbook and 2018-2022 China Health Statistics Year book. Data of the infant mortality rate, maternal mortality rate, and average life expectancy were from the World Bank in China and upper middle income countries in 2023. The development of primary health care of China was summarized into four phases, and the achievements included the improvement of the primary health care network, coverage expansion of basic health insurance, the increase of funding and coverage of basic public health services, the steady improvement of family doctor contracts, and the continuous improvement of women's and children's health, with major health indicators ranking among the top upper middle-income countries. The current challenges include the unbalanced development of infrastructure construction in the primary medical and health system, the decline in the proportion of medical insurance funds, the lack of vitality of the management system, the low level of remuneration and imperfect incentive system. This paper summarizes the enlightenment of international experience for China's primary health care, and puts forward the future development directions and strategies.
