Responding to the increasing demand for privacy encryption in image-based medical big data, it is of great importance of proposing an innovative framework of coded-based privacy-preserving segmentation technology, and exploring the implementation pathways to facilitate the practical application of this technology from a collaborative perspective of technology and policy legislation.

To develop a privacy protection technology framework tailored for image-based medical big data, and propose policy and legislative coordination strategies to advance the technology's adoption, in order to enhance the healthcare informatization service system by combining technological innovation with policy support.

Construct the innovative framework for privacy preserving segmentation technology in medical image big data by literature review, theoretical analysis, technology framework development, experimental validation, and policy analysis, and then propose the policy and legislative coordination strategies.

We successfully construct the innovative framework for privacy preserving segmentation technology in medical image big data and though the effectiveness verification, and propose specific policy and legislative recommendations addressing the inadequacies of existing laws and regulations in areas such as cloud data processing, liability attribution, technical standards, and special data protection.

Coded-based innovative framework for privacy preserving segmentation technology in medical image big data can enable effective sharing and utilization of image-based medical data by safeguarding patient's privacy, significantly enhance the data security and privacy protection level, and the proposing of corresponding policy and legislative coordination strategies offers novel insights and approaches to secure governance in this domain.

Intensive county medical community plays an important role in improving the ability of primary medical service. As its service body, family doctor team provides quality soil for integrated service development. However, previous studies lack exploration and summary of relevant service models.

To summarize the integrated service model of family doctor team in the compact county medical community.

From July 2023 to November 2023, 62 family doctor team members in Dancheng City, Anyang City and Gongyi City of Henan Province were interviewed about integrated service practice by using semi-structured interview and key event technology.

Four themes of integrated services are analyzed and further refined, they were subject, content, process, and obstacles of integrated services. Drawing on the physiological structure of "squid", this paper proposed "squid model" to describe the integrated service mode of the county family doctor team, emphasizing the core command role of the county medical community, the coordinating role of the family doctor management office, and the service antenna function of the county and village third-level family doctor team and village doctor.

"Squid model" provides an intuitive framework for understanding and optimizing this service model. The integrated service model of county family doctor team shows the characteristics of diversified subject participation and all-round service content integration, but it still faces certain obstacles.

All regions in China are actively promoting the reform of the prepaid payment method for the total amount of medical insurance in the context of the integrated medical community. However, the integration of DRG/DIP payment and the total amount payment policy within the integrated medical community is still in the exploratory stage. Although there have been studies on the cost control effect and cost control mechanism of the composite medical insurance payment method, there is still room for expansion.

To analyze the synergistic mechanism and effects of capitation prepayment and DRG payment in the compact county-level medical consortium.

In July 2023, a field survey was conducted in Yindu District. The convenience sampling method was used to select key informants within the integrated medical community for semi-structured interviews (n=28). The interview outline covered medical insurance payment reform policies and measures, incentive mechanisms, work perceptions and optimization suggestions, etc. Based on the holistic governance theory, the thematic framework analysis method was used to analyze the interview data to build a coordination mechanism framework for the prepaid payment for the total number of people and the DRG payment in the integrated medical community in Yindu District. Meanwhile, policy documents closely related to the construction of the integrated medical community and medical insurance reform in Yindu District published from January 2017 to July 2024 were retrieved (n=18) to supplement relevant policy background information.

A thematic framework with 4 analytical themes, namely policy behavior, supervision behavior, service behavior and incentive mechanism, covering 12 sub-themes was formed. The medical insurance payment reform plays a key guiding role in the governance framework of the integrated medical community. There was a sequential compliance relationship between the prepaid payment for the total number of people and the DRG payment. The coordination mechanism between the prepaid payment for the total number of people and the DRG payment within the integrated medical community was achieved through mutual supplementation, improvement of policy behavior, supervision behavior and the incentive mechanism for service behavior. Both were indispensable for realizing resource integration and the goal of "health-centered" in the integrated medical community.

In a compact medical community, capitation prepayment and DRG payment systems, by establishing integration mechanisms and incentive structures, can synergize policy efforts, influence policy implementation behaviors, oversight activities, and the service delivery practices of healthcare institutions at all levels. Together, these factors contribute to the achievement of a "health-centered" goal.

The construction of compact county medical health community has entered the stage of comprehensive promotion. There are huge opportunities and challenges to improve the coverage and construction level of the compact county-level medical community. This researchsummarized relevant policies and literature at home and abroad, and analyzed the related era background of the development of compact county medical health community and the key influencing factors of their development, sort out the key barrier factors such as payment methods, management systems, service models and information sharing as well as their internal logical relationships, and put forward targeted countermeasures. The construction of compact county medical health community need the scientific integration of medical and health resources within county area. Meanwhile, it is necessary to formulate prepaid plan of population-based global budget and rational formulation in a scientific and rational manner. Moreover, multiple barriers such as payment barriers, institutional barriers, service barriers and information. barriers need to be removed, blockages need to be cleared, broken links need to be connected, and difficulties need to be overcome, so as to eshape the ecology of the medical service system, truly implement the concept of health-centeredness, and enable county residents to enjoy high-quality, continuous and efficient medical and health services.

Health co-prosperity is the conceptual interpretation and application extension of the logic of common prosperity in the field of health. Building a digital collaborative health governance model between Chinese and western medicine based on the advantages of digital reform is the "Zhejiang Model" of health co-prosperity and helps to achieve the goal of high-quality full life cycle medical and health services. This article is based on the collection of relevant policies on the digital collaboration between Chinese and western medicine during the construction of the Common Prosperity Demonstration Zone in China and Zhejiang Province. It elaborates on the definition and connotation of health co-prosperity, and selects the digital Chinese and western coordinated health governance model of provincial, grassroots platforms, and medical institutions in Zhejiang Province as a specific case to explain the theme and path of the system design logic, grassroots platform logic, and institutional service logic of health co-prosperity, to provide reference and suggestions for the innovative construction and optimization of the collaborative health governance model between Chinese and western medicine.

At present, the collaboration of general practice and speciality has been applied to the diagnosis, treatment and management of various chronic diseases in the community based on the technical support of disease diagnosis and treatment and the implementation of hierarchical diagnosis and treatment. Based on the patient-centered, systematic and holistic thinking characteristics of general practice, the general practice team of Yangpu Hospital Affiliated to Tongji University explored and practiced a more comprehensive, in-depth and effective collaboration model of general practice and speciality around the multi-dimensional construction of 'six ones'. The construction of 'six ones' was based on the collaboration of general practice and speciality between general hospitals and community health service centers. Taking osteoarthritis (OA), a common chronic disease in the community, as an example, its contents and characteristics were as follows. (1) Establishment of a multidisciplinary team: the established team could rely on the basis of the three-dimensional integrated health care system of the general hospitals, to give play to the liaison and coordination role of general practice department in general hospitals, refine and coordinate the multidisciplinary division of labor; (2) Improvement of a set of diagnosis and treatment processes: improve a set of hierarchical diagnosis and treatment process for diseases based on scientific evidence, and evaluate the effectiveness of the diagnosis and treatment process, so that it could help to improve patients' symptoms and quality of life; (3) Development of an APP: the developed APP could cover multiple functions such as hierarchical diagnosis and management of OA patients, doctor-patient communication, popularization of science, appointment registration, and could record the complete diagnosis and treatment data in the exclusive information platform; (4) Designing a set of publicity and promotion programs: Publicize the program in multiple scenarios such as disease diagnosis and treatment, health examination and consultation in general hospitals and communities through a variety of forms of text, pictures and videos; (5) Establishment of a case database: establish a specific disease database for OA patients, continuously follow up patients and implement hierarchical management of the collected data, so as to provide more cases with general characteristics; (6) Construction of a set of curricula: the curriculum is built around OA specialties, including "bone pain as an undifferentiated disease in general practice" and "chronic disease management of OA", the course is conducted in the form of problem-oriented learning, outpatient consultation and teaching round demonstration, which was for multi-level training of undergraduate, graduate and continuing education. Taking the 'six ones' construction of OA management in the community as an example, the practice of the collaboration of general practice and speciality for the management of chronic disease based on the thinking of general practice suggests the potential of comprehensive, in-depth cooperation and mutual promotion between the two sides in multiple dimensions of medicine, teaching and research, as well as the effectiveness of optimizing and integrating the team, technology and information support related to hierarchical disease management for promoting the physical and mental health of patients.

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.

The phenomenon of non-standard treatment of diabetes patients in rural areas is particularly serious. Diabetes health management is focused on preventing and controlling diabetic complications in rural areas of China, as well as lowering disability and death rates.

To explore the effects of O2O peer mentor collaborative health management on the risk perception and diabetes management self-efficacy in rural patients with non-standard diabetes treatment.

A total of 90 diabetic patients with non-standard treatment in Lamadian Town, Ranghulu District, Daqing City from April to November 2023 were selected as the study subjects by convenience sampling method, and randomly assigned 45 patients to the experimental group and 45 to the control group. The experimental group adopted O2O peer mentor collaborative health management scheme, the intervention lasted for 6 months, and the control group adopted conventional chronic disease health management. A comparison was made between the two groups' risk perception and self-efficacy in managing their diabetes.

The study was concluded with 42 cases in the experimental group and 41 instances in the control group. Following the intervention, the experimental group and control group had scores on the diabetes risk perception scale of (43.86±7.00) and (32.56±4.24), there was a statistically significant difference between them (t=8.864, P<0.001). Similarly, the experimental group and control group had scores on the diabetes management self-efficacy scale of (100.45±16.74) and (75.54±13.82), there was a statistically significant difference between them (t=7.384, P<0.001) .

The O2O peer mentor collaborative health management program can effectively improve the risk perception and diabetes management self-efficacy of rural patients with non-standard diabetes treatment, and improve their health management level.

Holistic integrative medicine, abbreviated as HIM, has been officially proposed since 2012. Its theoretical system has been continuously improved, and its practical methods have become increasingly diverse, becoming an inevitable choice and path for the medical development in the new era. This article demonstrates ten major propositions for HIM, elaborating on the connotation and extension of HIM from the perspectives of epistemology and methodology, in order to achieve the transformation and adaptive evolution of modern medicine.

The imbalance between the supply and demand of pediatric medical resources and health management services in our country has been a long-standing issue, primary healthcare institutions are particularly prominent in this context. How to achieve integration and optimization of pediatric medical resources at the grassroots medical and health institutions is an urgent problem that needs to be addressed. This article primarily summarizes and analyzes the concept and framework of integrated health management services for children, including children's health assessment, early intervention, long-term follow-up, and case studies and practical experiences. Through a review of domestic and international literature, it concludes feasible models of integrated health services for children. This review suggests that integrated health management services have broad potential and promising applications, providing personalized and efficient health management and intervention for children.

The key task in China's medical and health field during the "14th Five-Year Plan" period is to realize treatment-prevention integration and innovate the mechanism of treatment-prevention integration.

This paper analyzes the implementation mechanism of treatment-prevention integration under the background of integrated service system construction, and provides reference for exploring the path of medical and prevention integration adapting to the strategy of "Healthy China".

Taking 2018 as the time node, relevant literature was searched on CNKI and Wanfang Data Knowledge Service Platform with keywords of "treatment-prevention integration" "medical and prevention coordination" "combination of prevention and treatment" and literatures on case policies, measures and implementation effects of integrated service systems such as medical alliance. Finally, 18 literatures and 15 cases were selected. Based on the rainbow model, system integration, organizational integration, professional integration, service integration, functional integration and normative integration were determined as condition variables from macro, meso and micro levels and supporting factors, and the effect of treatment-prevention integration was determined as result variable. QCA was adopted to explore the implementation mechanism of medical and preventive integration under the background of integrated service system construction.

There were four configuration paths that could effectively improve the effect of treatment-prevention integration, and the four paths were in line with the multi-layer integrated path and the medium-micro integrated path respectively. The following results were obtained: (1) It was more effective to carry out treatment-prevention integration relying on the integrated service system, and there are multiple paths that can effectively improve the effect of treatment-prevention integration under the integrated service system; (2) Service integration plays a fundamental role in improving the effect of medical and preventive integration; (3) The setting of relevant policy indicators for improving the system integration, professional integration and functional integration of treatment-prevention integration is not perfect.

(1) Relying on the construction of integrated service system to promote the improvement of treatment-prevention integration effect; (2) Give full play to the basic guarantee role of service integration; (3) Make reference to the successful experience of multi-level integration cases, set policy indicators at macro, meso and micro levels in a balanced manner, and improve the integration of system integration, professional integration and supporting elements.

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.

To better address the problems and challenges facing primary health care services in China, China's National Health Commission and the Gates Foundation have been collaborated to implement primary health care projects in areas such as Shanxi Province, Hubei Province, and part of the rural areas of Henan Province from 2017 to 2022. The overall goal of the project is to explore an effective model for basic health care services and to contribute to health poverty alleviation, which will enhance experience sharing within China and benefit other developing countries.

To summarize the experience of implementing person-centered integrated health management project in rural populations with priority diseases, represented by hypertension and diabetes.

The collection of information and data for the person-centered integrated health management project encompassed multiple sources, including hospital information system, statistical reporting information, basic public health information system, qualitative interviews, patient surveys, physician surveys and quality surveys of medical records. Descriptive statistical analysis as well as before-and-after comparisons were used as the main evaluation methods.

The proportion of patients with hypertension and diabetes under standardized management increased steadily, the average hospitalization cost of inpatients decreased, with a gradual increase in healthy living behaviors and a significant improvement medication adherence. In terms of health outcomes, the control rate of hypertension improved significantly but the control rate for blood glucose did not change significantly.

The service concept and capacity of person-centered integrated health management for priority diseases have been significantly improved. The relevant measures have been transformed into policies to be promoted and implemented in the project areas. Various types of experts are the key factors in promoting the implementation of the project, the sustainability of the measures needs to be maintained.

One of the important reasons for the slow progress of hierarchical diagnosis and treatment since its implementation is the lack of comprehensiveness in the analysis of multiple subjects and stakeholders.

To explore mechanism innovation solutions that combine both top-down and bottom-up paths by analyzing the interest relationships among diverse stakeholders in the hierarchical medical diagnosis and treatment system, and facilitate collaborative governance among diverse stakeholders through policy innovation and path innovation, to optimize the order of hierarchical patient flow.

From October 10, 2022, to March 20, 2023, two advanced urban districts in China (S district in X city and H district in N city) were selected as typical research areas. A total of 36 different stakeholders (involving municipal health administrative departments, tertiary hospital administrators, tertiary hospital specialists, community health service center administrators, general practitioners, health social workers, and patients) were selected as the study subjects for the in-depth interviews through snowball and purposive sampling methods. The stakeholder theory analysis method was employed to analyze the interests and constraints among the seven major stakeholder groups and their constraints on the healthy development of the order of hierarchical medical diagnosis and treatment, and explore the dilemma of the mechanism of hierarchical diagnosis and treatment. Furthermore, textual analysis of interview records of typical stakeholders in the pilot and non-pilot areas of the implementation of health social workers and community smart health huts in S district in X city and H district in N city was conducted to compare the effects before and after the implementation.

The results of the in-depth interviews showed that four main dimensions, including the degree of interest, willingness to implement, the extent of impact by implementation, and the influence on implementation, are the major factors affecting the implementation of hierarchical medical diagnosis and treatment by the seven major stakeholder groups. These seven stakeholder groups hold varying interest positions and play different roles in facilitating or obstructing the implementation of the hierarchical medical diagnosis and treatment. The difficulty of forming a collaborative mechanism among diverse stakeholders is the key to the problem. In pilot areas, through the implementation of the community smart health huts and health social workers, and the resulting medical-social collaboration, the relevance of the seven major stakeholder groups can be enhanced and the hierarchical medical diagnosis and treatment order can be improved.

The community smart health huts serve as a physical space for the new medical-social collaboration mechanism, while health social workers act as the connectors and enablers of this new mechanism. With the help of the new carrier of community smart health huts and the new power of health social workers, the construction of a new path of medical-social collaboration centered on health social work can realize the front entrance of medical treatment and play the role of"energy enhancer"to form the order of hierarchical medical diagnosis and treatment.

Multimorbidity increases the burden of disease and treatment for patients, which is becoming an essential research issue in the field of public health and primary care. As medical research advances, the understanding of how to deal with the challenge of multimorbidity is undergoing a profound shift, the most significant of which is the focus on the potential influence of social and environmental factors on disease clustering and development. Syndemic theory provides a new perspective for exploring the clustering of multiple conditions, as well as their interaction with social and environmental factors, which is of great significance for analyzing the interaction of chronic comorbidities at the social and environmental levels, and contributing to improve health outcomes of vulnerable populations. However, there is a lack of introduction and research on this theory in China. This article mainly reviews the basic concepts and viewpoints of the syndemic theory, as well as the classical models proposed by foreign scholars, analyzes the common disease synergistic factors with previous research findings, and puts forwards suggestions and countermeasures for general practitioners in China to improve the quality of managing multimorbidity.

Cancer is a significant global public health issue. With the continuous increase in cancer incidence rates and the prolonged survival time of cancer patients, the number of cancer survivors is also steadily rising. Cancer survivors face complex challenges in terms of physical, psychological, and social care, and their care services require effective coordination and integration across disciplines, sectors, and domains. Establishing integrated care model for cancer survivors has become an important strategy for addressing the challenges of survivorship care globally. However, the development of cancer survivorship care in China has been relatively lagging. This article synthesizes and summarizes the conceptual frameworks, characteristics and practical application of several representative integrated care models for survivorships. Based on China's healthcare service system, recommendations for designing and implementing integrated care strategies for cancer survivorships in China are proposed from five aspects: establishing consensus, pilot testing and exploration, workforce development, strengthening primary care, and policy support.

Addressing current health challenges requires the integrated and continuous health care services. The collaboration between primary care providers (PCPs) and medical specialists other than general practice is the most common means of achieving this objective. The patterns and effect of collaborative working between different disciplines has a direct impact on the quality of integrated service delivery, which is critical to improving patient health outcomes.

To systematically review the characteristics of studies related to collaboration patterns between PCPs and medical specialists, contents of collaboration patterns and effects reported by the authors by using scoping review methods.

On September 3 in 2022, PubMed, EmBase, Web of Science, CNKI, and Wanfang Data Knowledge Service Platform were searched for literature related to collaboration between PCPs and medical specialists from inception to the date of search. The characteristics of literature, collaboration patterns and effects were extracted. The elemental decomposition of collaboration patterns was performed based on Mulave 'Gearing Up' model and the contents of collaboration patterns were integrated and demonstrated using content analysis method.

A total of 420 relevant papers were included, of which 214 (51.0%) were committed to evaluating the effects of collaboration patterns, but specific contents of collaboration patterns could be extracted from 82 (19.5%) papers. The distinctive characteristics revealed by the extraction of limited information on the details of collaboration patterns included clear and formalized collaboration patterns, evidence-based guidelines/norms support for collaborative service contents, information systems and dedicated coordinators support for the collaboration between PCPs and specialists. Among the 82 papers, a total of 54 (65.9%) papers clearly reported indicators of effect, of which 90.7% (49/54) reported positive impact on service delivery and outcomes, ranging from service provision process, service utilization and health-related outcome indicators, however, higher proportion (90.7%, 49/54) of studies reporting positive effects could not exclude the presence of publication bias.

When collaboration patterns between PCPs and medical specialists other than general practice are implemented in integrated health services, it is necessary to ensure that approaches and contents of collaboration are specified, as well as the focus on the support of information systems and coordinators. Intervention studies related to health system and policy should emphasize describing the details of intervention design and implementation processes. Methodological quality assessment and meta-analysis are necessary to conduct in future studies on this topic.

Cognitive impairment can lead to a decline in cognitive function, depression, and loneliness, as well as decreased self-efficacy and quality of life in older adults.

To investigate the effects of non-pharmacological integrated interventions on cognitive function, depression, loneliness, self-efficacy, and quality of life in older adults with mild cognitive impairment.

Based on risk factors for cognitive impairment, a non-pharmacological integrated intervention program was developed in five dimensions of cognitive training, physical exercise, emotional management, social connection, and healthy lifestyle habits. Using a single-subject A-B-A experimental design, a 3-month intervention, which was conducted once a week for 60 minutes, was performed in three elderly individuals with mild cognitive impairment from June to December 2021. The Montreal Cognitive Assessment (MoCA), Geriatric Depression Scale-15 (GDS-15), 12-item Short Form Health Survey (SF-12), General Self-Efficacy Scale (GSES), and De Jong Gierveld Loneliness Scale (DJGLS) were administered to the 3 older adults at baseline, 3 months of the intervention, and 3 months after the intervention, to assess the scores of each scale from the 5 dimensions of cognitive function, self-efficacy, quality of life, depression, and loneliness, the changes in the scores were analyzed. A semi-structured interview was conducted 3 months after the intervention to evaluate the intervention effects in terms of cognitive function, quality of life, depression, self-efficacy, and loneliness dimensions.

The 3 older adults included in the study were 74, 70, 73 years old, all married, living with their spouses and grandchildren. The three older adults had MoCA scores of 21, 22, and 24 at baseline, 28, 26, and 27 at 3 months of intervention, and 25, 19, and 23 at 3 months after intervention; GSES scores were 25, 30, and 27 at baseline, 29, 29, and 30 at 3 months of intervention, and 28, 31, and 28 at 3 months after intervention. SF-12 scores were 69, 32, and 51 at baseline, 81, 81, and 83 at 3 months of intervention, and 78, 38, and 59 at 3 months after intervention. The GDS-15 scale scores were 4, 8, and 2 at baseline, 2, 6, and 1 at 3 months of intervention, and 1, 8, and 4 at 3 months after intervention. The DJGLS scores were 8, 7, and 8 at baseline, 5, 5, and 4 at 3 months of intervention, and 5, 5, and 7 at 3 months after intervention. Semi-structured interview data indicated improvement in all five dimensions of cognitive function, quality of life, depression, loneliness, and self-efficacy of the subjects.

For older adults with mild cognitive impairment, it is of great significance to perform a non-pharmacological integrated intervention in terms of cognitive training, physical exercise, emotional management, social connection, and healthy lifestyle habits. The MoCA, SF-12, GDS-15, and DJGLS scores of older adults with mild cognitive impairment improved at 3 months of intervention, while the GSES scores improved at 3 months after intervention. GSES scores were not as effective after the intervention. All dimension scores showed a decreasing trend at 3 months after the intervention.

With the gradual shift in the disease spectrum, chronic non-communicable diseases (hereafter referred to as "chronic diseases") have become a serious threat to health and economic development in China and globally. Due to various pathogenic factors and a long course of disease, patients with chronic diseases often have a chronic disease accumulation state of individuals suffering from two or more chronic diseases at the same time, referred to as multimorbidity. The problem of multimorbidity is becoming increasingly prominent with a younger trend. The effective integration of fragmented and discontinuous health services, which are disease-centered and treatment-based, is of great significance in addressing this problem. This paper reviewed the current research status and development trends of multimorbidity health service integration at home and abroad, and analyzed the shortcomings of the current researches and practices of integrated health care of multimorbidity. It is proposed that constructing a personalized integrated service model centered on patients with multimorbidity and exploring the quantitative evaluation practice of integrated health care of multimorbidity in the real world are the development direction of future research on multimorbidity integrated services, providing reference for realizing the efficient and sustainable integration mechanism of multimorbidity services among medical institutions in China.

The continuous increase in the prevalence of comorbidities has severe challenges to population health management, and the World Health Organization (WHO) recommends the development of integrated medical care models to cope with the pressure of health management of patients with comorbidities. In this paper, we constructed an integrated management model for geriatric comorbidities under medical association based on PDSA theory, in order to continuously improve the management ability and effect in the reciprocal cycle of "plan-execute-research-act". The model consists of four key elements, including management team, management process, management tools and management effect. Based on previous intervention research, the model integrates patient-centered care, multidisciplinary team, patient self-management and other intervention methods, and relies on big data technology to establish a decision support platform, thus realizing the whole life cycle health management of patients with comorbidities.

Coordinated regional health development aims to optimize resource allocation by constructing a well-structured and functional regional collaborative system to provide continuous medical services, and to leverage the unique features and strengths of medical centers and community health centers within a region via fully integrating resources and sharing information. However, current available systems for assessing coordinated regional health development mainly focus on outcomes, which are relatively non-diversified and unsystematic, thus further research is required to fill this gap.

We aimed to construct an evaluation system for coordinated regional health development, to provide scientific evidence for evaluating the coordinated development capacities of regions.

We collected essential factors related to coordinated regional health development through a literature review and semi-structured interviews, and used them to construct a draft version of the Coordinated Regional Health Development Assessment System (CRHDAS) . Then we selected 19 experts who were familiar with coordinated regional health development (engaging in general medicine, medical education, administrative management, and public health management) from Shanghai to attend two rounds of online combined with offline Delphi questionnaire surveys from December 2020 to March 2021 to determine the weights of the indicators and test the logical consistency of the weights of indicators at each level using Analytic Hierarchy Process. After that, we established the final version of CRHDAS.

The effective response rate and authoritative coefficient were 95.0% and 0.87, respectively, for the first round of survey, and were 100.0% and 0.92, respectively, for the second round of survey. The CRHDAS consists of four first-level indicators (with corresponding weights of 0.387, 0.296, 0.187 and 0.130) , 12 second-level indicators, and 31 third-level indicators. The consistency ratios for the weights of three levels of indicators are <0.100.

The CRHDAS is of high-level scientificity and practicality, which can help identify problems and deficiencies of the collaboration mode between community health centers, providing a theoretical and practical basis for guiding coordinated regional health practice in the future.

General medicine and sleep medicine are two emerging clinical disciplines in China. They have many common things with complementarity in their own developments, and some crossovers in academic development of disciplines and talent training. The China National Accreditation Service for Conformity Assessment has opened up a way for general practitioners to engage in sleep medicine, which may be a basis and a necessity for sound cooperative development of general medicine and sleep medicine. We analyzed the basis and necessity of the cooperative development of general medicine and sleep medicine, introduced relevant experiences of Nanjing Medical University Affiliated Wuxi People's Hospital in the co-construction of general medicine and sleep medicine, and invited relevant experts to discuss the current issues.