Acute upper gastrointestinal （GI） bleeding remains one of the most common encounters in emergency medicine. The increased use of non-steroid anti-inflammatory drugs by the general population and the increased prescr...Acute upper gastrointestinal （GI） bleeding remains one of the most common encounters in emergency medicine. The increased use of non-steroid anti-inflammatory drugs by the general population and the increased prescription of anti-platelet agents and anti-coagulants after cardiovascular interventions and for prevention of cerebral vascular accidents may have aggravated the situation. Significant progress has been made in the past decade or so in the non-surgical management of acute upper GI bleeding emergencies. This article will review the current standard treatment of the most common upper GI bleeding emergencies in adults as supported by evidence- based medicine with practical considerations from the authors＇ own practice experience.展开更多
INTRODUCTION.Depressive disorders are mental illnesses that seriously affect public health.There are approximately 320 million patients with depression worldwide,accounting for 4.4% of the total disease burden.1Depres...INTRODUCTION.Depressive disorders are mental illnesses that seriously affect public health.There are approximately 320 million patients with depression worldwide,accounting for 4.4% of the total disease burden.1Depression leads to social and occupational impairment,diminished quality of life and an elevated risk of death by suicide.展开更多
BACKGROUND:As disasters intensify and professional deficits persist,civil protection is reliant on medical volunteers.With limited physician availability,telemedicine is promising.No system currently empowers lower-qu...BACKGROUND:As disasters intensify and professional deficits persist,civil protection is reliant on medical volunteers.With limited physician availability,telemedicine is promising.No system currently empowers lower-qualified paramedics for physician-delegated telemedicine.Existing telemedicine technology unfits for civil protection.This study aimed to evaluate a modified system at a music festival to simulate disaster situations.METHODS:A tablet-based telemedicine system,integrating vital sign monitoring,was deployed at the "Summerjam" music festival characterized by various medical emergencies.A physician could be contacted via telemedicine or requested onsite.Medical feasibility was rated by patient condition changes,with National Advisory Committee of Aeronautics(NACA) score and Primary Ranking for Initial Orientation in the Rescue service(PRIOR) algorithm for triaging.Technical feasibility was assessed by connection stability,communication,and vital sign transmission.RESULTS:Of 404 treatments,34(8.4%) were performed using telemedicine,49(12.1%) were carried out with a physician onsite.Telemedicine treatments accounted for 40.9% of all treatment in which a physician was involved.Patient conditions varied up to NACA III(moderate disturbance).A variety of internal medical(76.5%) and surgical(23.5%) conditions were addressed,some of which required invasive measures or application of medication.No patients experienced a deterioration in their condition.Despite technical difficulties,treatment was not significantly impacted,confirming technical feasibility.CONCLUSION:The study shows that lower-qualified paramedics can effectively use telemedicine for physician-delegated treatment,suggesting potential applicability to civil protection.Nonetheless,further system robustness improvements and research are needed.展开更多
The emerging messenger RNA(mRNA)nanomedicines have sprung up for disease treatment.Developing targeted mRNA nanomedicines has become a thrilling research hotspot in recent years,as they can be precisely delivered to s...The emerging messenger RNA(mRNA)nanomedicines have sprung up for disease treatment.Developing targeted mRNA nanomedicines has become a thrilling research hotspot in recent years,as they can be precisely delivered to specific organs or tissues to enhance efficiency and avoid side effects.Herein,we give a comprehensive review on the latest research progress of mRNA nanomedicines with targeting functions.mRNA and its carriers are first described in detail.Then,mechanisms of passive targeting,endogenous targeting,and active targeting are outlined,with a focus on various biological barriers that mRNA may encounter during in vivo delivery.Next,emphasis is placed on summarizing mRNA-based organtargeting strategies.Lastly,the advantages and challenges of mRNA nanomedicines in clinical translation are mentioned.This review is expected to inspire researchers in this field and drive further development of mRNA targeting technology.展开更多
BACKGROUND:Tracheal intubation(TI)is a fundamental procedure for securing the airway or assisting ventilation in emergency medicine.Tracheal intubation in the lateral position(TILP)has been utilized in clinical practi...BACKGROUND:Tracheal intubation(TI)is a fundamental procedure for securing the airway or assisting ventilation in emergency medicine.Tracheal intubation in the lateral position(TILP)has been utilized in clinical practice,demonstrating potential advantages in specific scenarios,including emergency settings.However,there is a lack of comprehensive reviews and practical protocols on TILP application.To address this gap,we performed a narrative review,and provided evidence-based recommendations to formulate a practice protocol,to assist clinicians to effectively apply TILP.METHODS:We conducted a narrative review of TILP applications and developed recommendations based on clinical research evidence and clinical experience.Delphi method was used among the TILP consortium to grade the strength of the recommendations and to help reach consensus.The practice protocols were formulated as warranted by advancements in medical knowledge,technology,and practice.RESULTS:This narrative review summarized the current evidence on TILP application,highlighting its safety,efficacy,challenges,and potential complications.In total,24 recommendations and a clinical protocol for TILP application in emergency patients were established.CONCLUSION:TILP is a valuable technique in emergency medicine.We reviewed its application in emergency settings and formulated recommendations along with a clinical practice protocol.Future studies are needed to evaluate the safety and efficacy of TILP,broaden its scope of application,and explore effective training protocols.展开更多
Objective The study of medicine formulas is a core component of traditional Chinese medicine(TCM),yet traditional learning methods often lack interactivity and contextual understanding,making it challenging for beginn...Objective The study of medicine formulas is a core component of traditional Chinese medicine(TCM),yet traditional learning methods often lack interactivity and contextual understanding,making it challenging for beginners to grasp the intricate composition rules of formulas.To address this gap,we introduce Formula-S,a situated visualization method for TCM formula learning in augmented reality(AR)and evaluate its performance.This study aims to evaluate the effectiveness of Formula-S in enhancing TCM formula learning for beginners by comparing it with traditional text-based formula learning and web-based visualization.Methods Formula-S is an interactive AR tool designed for TCM formula learning,featuring three modes(3D,Web,and Table).The dataset included TCM formulas and herb properties extracted from authoritative references,including textbook and the SymMap database.In Formula-S,the hierarchical visualization of the formulas as herbal medicine compositions,is linked to the multidimensional herb attribute visualization and embedded in the real world,where real herb samples are presented.To evaluate its effectiveness,a controlled study(n=30)was conducted.Participants who had no formal TCM knowledge were tasked with herbal medicine identification,formula composition,and recognition.In the study,participants interacted with the AR tool through HoloLens 2.Data were collected on both task performance(accuracy and response time)and user experience,with a focus on task efficiency,accuracy,and user preference across the different learning modes.Results The situated visualization method of Formula-S had comparable accuracy to other methods but shorter response time for herbal formula learning tasks.Regarding user experience,our new approach demonstrated the highest system usability and lowest task load,effectively reducing cognitive load and allowing users to complete tasks with greater ease and efficiency.Participants reported that Formula-S enhanced their learning experience through its intuitive interface and immersive AR environment,suggesting this approach offers usability advantages for TCM education.Conclusions The situated visualization method in Formula-S offers more efficient and accurate searching capabilities compared to traditional and web-based methods.Additionally,it provides superior contextual understanding of TCM formulas,making it a promising new solution for TCM learning.展开更多
Integrated traditional Chinese medicine(TCM)and Western medicine(WM)is a new medical science grounded in the knowledge bases of both TCM and WM,which then forms a unique modern medical system in China.Integrated TCM a...Integrated traditional Chinese medicine(TCM)and Western medicine(WM)is a new medical science grounded in the knowledge bases of both TCM and WM,which then forms a unique modern medical system in China.Integrated TCM and WM has a long history in China,and has made important achievements in the process of clinical diagnosis and treatment.However,the methodological defects in currently published clinical practice guidelines(CPGs)limit its development.The organic integration of TCM and WM is a deeper integration of TCM and WM.To realize the progression of"integration"to"organic integration",a targeted and standardized guideline development methodology is needed.Therefore,the purpose of this study is to establish a standardized development procedure for clinical practice guidelines for the organic integration of TCM and WM to promote the systematic integration of TCM and WM research results into clinical practice guidelines in order to achieve optimal results as the whole is greater than the sum of the parts.展开更多
Since the early 20th century,China has gradually established a clinical,educational,and research system centered around modern scientific medicine,which has now become the dominant force in China's medical and hea...Since the early 20th century,China has gradually established a clinical,educational,and research system centered around modern scientific medicine,which has now become the dominant force in China's medical and health system and services,with the construction and development of the Chinese Academy of Medical Sciences and Peking Union Medical College as the most prominent symbol.The scientific medicine in the new era requires close cooperation across multiple disciplines and fields to build a high-quality and efficient medical and health service system.It also involves combining the excellent traditional Chinese culture with Western medicine to explore a unique path of modern scientific medicine with Chinese characteristics.展开更多
Medicine is a science studying human's health and diseases as well as the regularity between them. Its research subject is human, who possess natural attribute, psychological attribute and social attribute. Theref...Medicine is a science studying human's health and diseases as well as the regularity between them. Its research subject is human, who possess natural attribute, psychological attribute and social attribute. Therefore, medicine is bound to possess humanistic attribute. Rooted in Chinese traditional culture, Traditional Chinese Medicine contains abundant humanistic thoughts, for instance, pursuing the unity of human and nature, advocating the vital importance of life, sticking to the virtue of "medicine being humane art", abiding by the principle of "Benevolence prior to interest", complying with the medical rule of "Respecting peers". These are the very concrete reflections of medical humanistic spirit. In this article we aim to explore the humanistic thoughts contained in Traditional Chinese Medicine, and try to inherit and carry forward the spirit to better relieve the tensions between doctors and patients and improve the quality of medical services.展开更多
ConSidering the limitations of medical science and the risks associated with medical treatments,we need to re-examine the connotation of medical science from the perspective of philosophy.Medical science is the natura...ConSidering the limitations of medical science and the risks associated with medical treatments,we need to re-examine the connotation of medical science from the perspective of philosophy.Medical science is the natural expression of human kindness and human nature of rescuing the dying and healing the wounded.It is a combination of the natural sciences,social sciences,and humanities.From the perspectives of medical philosophy and humanistic care,this article expounds the concepts and ideas of evidence-based,translational,and precision medicine in modern medicine and emphasizes the importance of avoiding new technical bureaucracy,paying attention to achieving a holistic view and systematic understanding,and avoiding biases in development because of the loss of the humanistic spirit in modern medical practice.展开更多
MODERN medical diagnosis and practice heavily rely on biological data and information from patients’ body.The progress of biomedical sensor,material and mathematical technology provided ever-increasing methods to gat...MODERN medical diagnosis and practice heavily rely on biological data and information from patients’ body.The progress of biomedical sensor,material and mathematical technology provided ever-increasing methods to gather data.While providing more choices and more comprehensive picture of patients’ conditions to doctors and practitioners,these progresses also require more labor efforts to read,analyze,and make decisions based on those data.It is very difficult for the medical human resources to grow at a speed that matches such need for diagnosis-related expert knowledge.The shortage of expertise has caused long waiting time for check report and fatal misjudged diagnosis in public health system,and it will compromise our ability to move towards a more precise,more personalized and more efficient future of medicine.展开更多
Louise Erdrich is one of the most important contemporary American writers in America.Her first Novel Love Medicine won most prizes in American literature history.Most researches in America and China on the novel from ...Louise Erdrich is one of the most important contemporary American writers in America.Her first Novel Love Medicine won most prizes in American literature history.Most researches in America and China on the novel from the perspectives of feminism,post- colonialism,ecocriticism.The themes in the novel such as love,home- coming,identity construction have also been discussed.展开更多
The dynamic nature of modern warfare,including threats and injuries faced by soldiers,necessitates the development of countermeasures that address a wide variety of injuries.Tissue engineering has emerged as a field w...The dynamic nature of modern warfare,including threats and injuries faced by soldiers,necessitates the development of countermeasures that address a wide variety of injuries.Tissue engineering has emerged as a field with the potential to provide contemporary solutions.In this review,discussions focus on the applications of stem cells in tissue engineering to address health risks frequently faced by combatants at war.Human development depends intimately on stem cells,the mysterious precursor to every kind of cell in the body that,with proper instruction,can grow and differentiate into any new tissue or organ.Recent reports have suggested the greater therapeutic effects of the anti-inflammatory,trophic,paracrine and immune-modulatory functions associated with these cells,which induce them to restore normal healing and tissue regeneration by modulating immune reactions,regulating inflammation,and suppressing fibrosis.Therefore,the use of stem cells holds significant promise for the treatment of many battlefield injuries and their complications.These applications include the treatment of injuries to the skin,sensory organs,nervous system tissues,the musculoskeletal system,circulatory/pulmonary tissues and genitals/testicles and of acute radiation syndrome and the development of novel biosensors.The new research developments in these areas suggest that solutions are being developed to reduce critical consequences of wounds and exposures suffered in warfare.Current military applications of stem cell-based therapies are already saving the lives of soldiers who would have died in previous conflicts.Injuries that would have resulted in deaths previously now result in wounds today;similarly,today’s permanent wounds may be reduced to tomorrow’s bad memories with further advances in stem cell-based therapies.展开更多
Regenerative medicine(RM) is an emerging interdisciplinary field of research and China has developed the research quickly and impressed the world with numerous research findings in stem cells,tissue engineering,active...Regenerative medicine(RM) is an emerging interdisciplinary field of research and China has developed the research quickly and impressed the world with numerous research findings in stem cells,tissue engineering,active molecules and gene therapy.Important directions are induced differentiation of induced pluripotent stem and embryo stem cells as well as somatic stem cell differentiation potential and their application in trauma,burns,diseases of aging and nerve regeneration.The products Activ Skin and bone repair scaffolds have been approved and are applied in the clinic,and similar products are being studied.About 10 engineered growth-factor drugs for repair and regeneration have been approved and are used in the clinic.Gene therapy,therapeutic cloning and xenotransplantation are some of the strategies being studied.However,China needs to develop standards,regulations and management practices suitable for the healthy development of RM.Aspects that should be strengthened include sound administrative systems,laws,and technical specifications and guidelines;conservation of stem cell resources;emphasis on training and retention of talented stem cell researchers;and reasonable allocation of resources,diversification of investment and breakthroughs in key areas.Finally,broad and deep international cooperation is necessary.展开更多
Advances in stem cell science and potential clinical applications have brought clinical medicine closer to the actualization of Regenerative Medicine—an extension of transplantation of organs and cells and implantati...Advances in stem cell science and potential clinical applications have brought clinical medicine closer to the actualization of Regenerative Medicine—an extension of transplantation of organs and cells and implantation of bioprosthetics and biodevices. The goal of such therapeutics will be intervention prior to onset of severe individual disability, enhance organ function and enhance patient performance status without incurring the economic impacts of standard organ transplantation. Regenerative Medicine is already demonstrating proof of principle or efficacy in restora- tion of myocardial contractility, joint mobility and function, immune competence, pulmonary function, immunologic self- tolerance, motor function and normal hemoglobin production with the next targets—diabetes mellitus (type I and type II), neurologic injury, hepatic dysfunction preparing to enter trials. Expenditures on health care needs of an aging U.S. citizenry approximate 20-25% ($3 trillion) of U.S. GDP currently and may to grow to 40% of U.S. GDP by 2025. As the potential of Regenerative Medicine is clinically realized, the societal impact and economic benefits will be disproportionately magnified in the economies of industrialized nations. The experi- ence of the Department of Health and Human Services (HHS), United Network for Organ Sharing (UNOS), the National Bone Marrow Donor Registry (NBMDR), and the National Vaccine Injury Compensation Programs (NVICP) can help ensure that as Regenerative Medicine strives to achieve clinical benefits while avoiding decimation of therapeutic options by product liability and medical malpractice concerns—concerns that crippled the U.S. vaccine manufacturing industry until the creation of the NVICP. The first 50 years of organ/cell/tissue transplantation demonstrates that clinical reality of allogeneic and autologous transplantation can antedate complete understanding of the basic science underlying successful transplantation. Product liability and medical malpractice liability have not impeded the development and growth of organ/cell/tissue transplanta- tion despite increased risks of infection, malignancy and cardiovascular disease in transplant recipients. Currently, human transplantation is only performed using FDA/CBER-approved, non-embryonic stem cells from peripheral blood, bone marrow or umbilical cord blood. Federal legislation passed in 2005 (HR2520 and S1317: The Bone Marrow and Cord Blood Cell Transplantation Program) authorizes the Secretary of Health and Human Services acting through the Director of HRSA to ensure uniform stem cell units distribution and outcomes monitoring via the federally-designated C.W. Bill Young Cell Transplant Program. Historically in the U.S., human biological therapies (vaccines, organ transplant and stem cell transplant) have re- quired federal protections to ensure continued distribution, fair access and avoidance of inhibitory product liability via protections afforded under the “stewardship” of the Secretary of Health and Human Services. The National Childhood Vaccine Injury Act of 1986 established the NVICP to equitably and expeditiously compensate individuals, or families of individuals, who have been declared injured by vaccines, thereby stabilizing a once imperiled vaccine supply by substan-tially reducing the threat of liability for vaccine companies, physicians, and other health care professionals who administer vaccines. Vaccines were the first biologics administered to U.S. citizens en masse and presage stem cell therapeutics (which may similarly be administered to millions) will similarly necessitate that a Stem Cell Injury Compensation Program (SCICP) will also need to be in place to demonstrate an intention to do good, an understanding that industry may do well, but that the health care consumer has a right of protection—all recognized from the outset. The Federal Tort Claims Act (FTCA) addresses liability claims via the Executive, Judicial and Legislative branches of Government, providing an um- brella of liability protection to other participants in the stem cell unit “chain of custody” under the FTCA—similar to the protection from product liability seen in organ and stem cell transplantation for the past 40-50 years. Efficacious development of regenerative medicine capabilities will mandate controlled access must first be provided for individuals with life-threatening diseases without therapeutic options or unable to benefit from or receive proven therapeutic options (ALS, cardiomyopathy and deemed not a candidate for heart transplantation, IDDM with hypoglyce- mic unawareness and no allogeneic source of traditional islet cell replacement available via HRSA) and mandates the prompt adoption of business and legal principles to ensure that the fate of the vaccine manufacturing industry does not become the fate of the stem cell therapeutics industry. If legal and regulatory concerns consume an increasing percentage of health care dollars that could be focused upon innovation, the Regenerative Medicine model will have not realized its full potential. The Diabetes Transplantation/Regenerative Medicine Model is the first organ to cell transplant model outside of oncology to demonstrate the regenerative medicine paradigm. Since all human tissues can be already recapitulated by human stem cells and key patent holders already exist, outlet or distribution of “more-than-minimally-manipulated stem cell units” as an IND approved under FDA/CBER guidelines can be accomplished via the current HHS/HRSA/Dept of Trans- plant methodology. As cardiovascular stem cell researchers develop human therapeutics utilizing more-than-minimally- manipulated stem cell products, they could be afforded protections from product liability historically enjoyed by the transplant community. Extending the Diabetes Transplant/Regenerative Medicine Model to the more than 5 million Americans with chronic heart failure, cell-based therapies to regenerate myocardial contractility could fill an existing void and be delivered in conjunction with and consistent with existing distribution of organs and tissues via HRSA/Department of Transplantation.展开更多
Background:Military medicine is a research field that seeks to solve the medical problems that occur in modern war conditions based on public medicine theory.Methods:We explore the main research topics of military hea...Background:Military medicine is a research field that seeks to solve the medical problems that occur in modern war conditions based on public medicine theory.Methods:We explore the main research topics of military health and medical research in the Web of Science?core collection(Wo SCC)from 2007 to 2016,and the goal of this work is to serve as a reference for orientation and development in military health and medicine.Based on Cite Space III,a reference co-citation analysis is performed for 7921 papers published in the Wo SCC from 2007 to 2016.In addition,a cluster analysis of research topics is performed with a comprehensive analysis of high-yield authors,outstanding research institutions and their cooperative networks.Results:Currently,the research topics in military health and medicine mainly focus on the following seven aspects:mental health diagnoses and interventions,an army study to assess risk and resilience in service members(STARRS),large-scale military action,brain science,veterans,soldier parents and children of wartime,and wound infection.We also observed that the annual publication rate increased with time.Wessely S,Greenberg N,Fear NT,Smith TC,Smith B,Jones N,Ryan MAK,Boyko EJ,Hull L,and Rona RJ were the top 10 authors in military health and medicine research.The top 10 institutes were the Uniformed Services University of the Health Sciences,the United States Army,the United States Navy,Kings College London,Walter Reed National Military Medical Center,Boston University,Walter Reed Army Institute of Research,Walter Reed Army Medical Center,Naval Health Research Center,and the VA Boston Healthcare System.Conclusion:We are able to perform a comprehensive analysis of studies in military health and medicine research and summarize the current research climate and the developmental trends in the Wo SCC.However,further studies and collaborations are needed worldwide.Overall,our findings provide valuable information and new perspectives and shape future research directions for further research in the area of military health and medicine.展开更多
Drugs of plant origin have received much attention due to their enormous potential for the prevention and treatment of cancer. Recent progress in the study of anticancer drugs originating from plants and traditional m...Drugs of plant origin have received much attention due to their enormous potential for the prevention and treatment of cancer. Recent progress in the study of anticancer drugs originating from plants and traditional medicines in China is reviewed in this paper, with particular emphasis on taxol, daidzein, acetyl boswellic acid,curcumin and ginsenosid Rh2.展开更多
BACKGROUND： Emergency medicine was inaugurated, as an official specialty in China, only25 years ago, and its growth in clinical practice and academic development since that time have beenremarkable.METHODS： This pap...BACKGROUND： Emergency medicine was inaugurated, as an official specialty in China, only25 years ago, and its growth in clinical practice and academic development since that time have beenremarkable.METHODS： This paper is a critical and descriptive review on current situations in emergencymedicine in China, based on the literature review, personal observations, interviews with manyChinese emergency medicine doctors and experts, and personal experience in both China and USA.RESULTS： The current practice of emergency medicine in China encompasses three areas： prehospitalmedicine, emergency medicine, and critical care medicine. Most tertiary emergency departments（EDs） are structurally and functionally divided into several clinical areas, allowing the ED itself to functionas a small independent hospital. While Chinese emergency physicians receive specialty training througha number of pathways, national standards in training and certifi cation have not yet been developed. As aresult, the scope of practice for emergency physicians and the quality of clinical care vary greatly betweenindividual hospitals. Physician recruitment, diffi cult working conditions, and academic promotion remain asmajor challenges in the development of emergency medicine in China.CONCLUSION： To further strengthen the specialty advancement, more government leadershipis needed to standardize regional training curriculums, elucidate practice guidelines, provide fundingopportunities for academic development in emergency medicine, and promote the development of asystem approach to emergency care in China.展开更多
BACKGROUND:Despite the fact that traditional Chinese medicine(TCM) has been developed and used to treat acute and urgent illness for many thousands of years.TCM has been widely perceived in western societies that TCM ...BACKGROUND:Despite the fact that traditional Chinese medicine(TCM) has been developed and used to treat acute and urgent illness for many thousands of years.TCM has been widely perceived in western societies that TCM may only be effective to treat chronic diseases.The aim of this article is to provide some scientific evidence regarding the application of TCM in emergency medicine and its future potential.METHODS:Multiple databases(PubMed,ProQuest,Academic Search Elite and Science Direct) were searched using the terms:Traditional Chinese Medicine/ Chinese Medicine,Emergency Medicine,China.In addition,three leading TCM Journals in China were searched via Oriprobe Information Services for relevant articles(published from 1990—2012).Particular attention was paid to those articles that are related to TCM treatments or combined medicine in dealing with intensive and critical care.RESULTS:TCM is a systematic traditional macro medicine.The clinical practice of TCM is guided by the TCM theoretical framework- a methodology founded thousands of years ago.As the methodologies between TCM and Biomedicine are significantly different,it provides an opportunity to combine two medicines,in order to achieve clinical efficacy.Nowadays,combined medicine has become a common clinical model particular in TCM hospitals in China.CONCLUSIONS:It is evident that TCM can provide some assistance in emergency although to combine them in practice is still its infant form and is mainly at TCM hospitals in China.The future effort could be put into TCM research,both in laboratories and clinics,with high quality designs,so that TCM could be better understood and then applied in emergency medicine.展开更多
BACKGROUND: In Iran, few studies have evaluated emergency medicine as a career option. In the present study, we aimed to find out how Iranian emergency-medicine specialists view their specialty as a career.METHODS: Fo...BACKGROUND: In Iran, few studies have evaluated emergency medicine as a career option. In the present study, we aimed to find out how Iranian emergency-medicine specialists view their specialty as a career.METHODS: Following a qualitative study, a Likert-scale questionnaire was developed. Iranian emergency physician specialists who had at least two years' job experience were contacted via email. A uniform link to a Web-based survey and a cover letter that explained the survey were sent to the recipients. We used the Kruskal-Wallis test and post hoc analysis to determine the differences between demographic subgroups.RESULTS: A total of 109 eligible responses were received, a response rate of 72.63%. Of the responders, 57.8% were 30–40 years of age, 86.2% were male, 86.2% were single, 84.4% were faculty members and 90.8% had fewer than 10 years' job experience. The main problems occurring during the career of Iranian emergency physicians were: insuffi cient income, inadequate recognition of the specialty by the community, inadequate union support, insecurity in the emergency wards, overcrowding, job stresses and night shifts. Despite insufficiency of income, Iranian emergency physicians(EPs) did not care about the financial benefits of patient care. Academic activity had positive effects on the perspectives of Iranian emergency physicians regarding their careers.CONCLUSION: Iranian emergency physicians and leaders in emergency medicine should struggle to improve the present situation, aiming at an ideal state.展开更多
文摘Acute upper gastrointestinal （GI） bleeding remains one of the most common encounters in emergency medicine. The increased use of non-steroid anti-inflammatory drugs by the general population and the increased prescription of anti-platelet agents and anti-coagulants after cardiovascular interventions and for prevention of cerebral vascular accidents may have aggravated the situation. Significant progress has been made in the past decade or so in the non-surgical management of acute upper GI bleeding emergencies. This article will review the current standard treatment of the most common upper GI bleeding emergencies in adults as supported by evidence- based medicine with practical considerations from the authors＇ own practice experience.
基金funded by the Construction Project of the"Flagship"Department of Chinese and Western Medicine Coordination(LiuL/2024-221)the 2024 Medical Service and Security Capacity Improvement Project(National Clinical Key Specialty Construction)(LiuL/Huwei Medical/2024-65)+5 种基金the Shanghai Traditional Chinese Medicine Standardization Project(LiuL/No.2023JSP03)the Shanghai Key Discipline Construction Project of Traditional Chinese Medicine(Clinical)(LiuL/2024-No.3)the Shanghai Technical Standardization Management and Promotion Project(LiuL/No.SHDC22023212)the Shanghai Municipal Health Commission Traditional Chinese Medicine Research Project(2022)(LiuL/No.2022Cx004)Clinical research project of Shanghai Health Commission-Youth Project(LW/No.20214Y0056)Shanghai Institute of Traditional Chinese Medicine for Mental Health(LW/No.SZB2023201).
文摘INTRODUCTION.Depressive disorders are mental illnesses that seriously affect public health.There are approximately 320 million patients with depression worldwide,accounting for 4.4% of the total disease burden.1Depression leads to social and occupational impairment,diminished quality of life and an elevated risk of death by suicide.
基金funded by the German Federal Office of Civil Protection and Disaster Assistance as part of the Tele SAN project (FKZ:41201/425)。
文摘BACKGROUND:As disasters intensify and professional deficits persist,civil protection is reliant on medical volunteers.With limited physician availability,telemedicine is promising.No system currently empowers lower-qualified paramedics for physician-delegated telemedicine.Existing telemedicine technology unfits for civil protection.This study aimed to evaluate a modified system at a music festival to simulate disaster situations.METHODS:A tablet-based telemedicine system,integrating vital sign monitoring,was deployed at the "Summerjam" music festival characterized by various medical emergencies.A physician could be contacted via telemedicine or requested onsite.Medical feasibility was rated by patient condition changes,with National Advisory Committee of Aeronautics(NACA) score and Primary Ranking for Initial Orientation in the Rescue service(PRIOR) algorithm for triaging.Technical feasibility was assessed by connection stability,communication,and vital sign transmission.RESULTS:Of 404 treatments,34(8.4%) were performed using telemedicine,49(12.1%) were carried out with a physician onsite.Telemedicine treatments accounted for 40.9% of all treatment in which a physician was involved.Patient conditions varied up to NACA III(moderate disturbance).A variety of internal medical(76.5%) and surgical(23.5%) conditions were addressed,some of which required invasive measures or application of medication.No patients experienced a deterioration in their condition.Despite technical difficulties,treatment was not significantly impacted,confirming technical feasibility.CONCLUSION:The study shows that lower-qualified paramedics can effectively use telemedicine for physician-delegated treatment,suggesting potential applicability to civil protection.Nonetheless,further system robustness improvements and research are needed.
基金supported by the National Key Research and Development Program of China(2022YFA1105304)the National Natural Science Foundation of China(T2225003 and 61927805)+5 种基金the Nanjing Medical Science and Technique Development Foundation(ZKX21019)the Clinical Trials from Nanjing Drum Tower Hospital(2022-LCYJ-ZD-01)the Jiangsu Funding Program for Excellent Postdoctoral Talent(2023ZB032)the Natural Science Foundation of Jiangsu Province(BK20240223)the Project of Institute of Chinese Medicine of Nanjing University(ICM2024011)the Aid Project of Nanjing Drum Tower Hospital Health,Education&Research Foundation.
文摘The emerging messenger RNA(mRNA)nanomedicines have sprung up for disease treatment.Developing targeted mRNA nanomedicines has become a thrilling research hotspot in recent years,as they can be precisely delivered to specific organs or tissues to enhance efficiency and avoid side effects.Herein,we give a comprehensive review on the latest research progress of mRNA nanomedicines with targeting functions.mRNA and its carriers are first described in detail.Then,mechanisms of passive targeting,endogenous targeting,and active targeting are outlined,with a focus on various biological barriers that mRNA may encounter during in vivo delivery.Next,emphasis is placed on summarizing mRNA-based organtargeting strategies.Lastly,the advantages and challenges of mRNA nanomedicines in clinical translation are mentioned.This review is expected to inspire researchers in this field and drive further development of mRNA targeting technology.
基金National Natural Science Foundation of China(U24A20714 to XMF and 82102238 to PC)。
文摘BACKGROUND:Tracheal intubation(TI)is a fundamental procedure for securing the airway or assisting ventilation in emergency medicine.Tracheal intubation in the lateral position(TILP)has been utilized in clinical practice,demonstrating potential advantages in specific scenarios,including emergency settings.However,there is a lack of comprehensive reviews and practical protocols on TILP application.To address this gap,we performed a narrative review,and provided evidence-based recommendations to formulate a practice protocol,to assist clinicians to effectively apply TILP.METHODS:We conducted a narrative review of TILP applications and developed recommendations based on clinical research evidence and clinical experience.Delphi method was used among the TILP consortium to grade the strength of the recommendations and to help reach consensus.The practice protocols were formulated as warranted by advancements in medical knowledge,technology,and practice.RESULTS:This narrative review summarized the current evidence on TILP application,highlighting its safety,efficacy,challenges,and potential complications.In total,24 recommendations and a clinical protocol for TILP application in emergency patients were established.CONCLUSION:TILP is a valuable technique in emergency medicine.We reviewed its application in emergency settings and formulated recommendations along with a clinical practice protocol.Future studies are needed to evaluate the safety and efficacy of TILP,broaden its scope of application,and explore effective training protocols.
文摘Objective The study of medicine formulas is a core component of traditional Chinese medicine(TCM),yet traditional learning methods often lack interactivity and contextual understanding,making it challenging for beginners to grasp the intricate composition rules of formulas.To address this gap,we introduce Formula-S,a situated visualization method for TCM formula learning in augmented reality(AR)and evaluate its performance.This study aims to evaluate the effectiveness of Formula-S in enhancing TCM formula learning for beginners by comparing it with traditional text-based formula learning and web-based visualization.Methods Formula-S is an interactive AR tool designed for TCM formula learning,featuring three modes(3D,Web,and Table).The dataset included TCM formulas and herb properties extracted from authoritative references,including textbook and the SymMap database.In Formula-S,the hierarchical visualization of the formulas as herbal medicine compositions,is linked to the multidimensional herb attribute visualization and embedded in the real world,where real herb samples are presented.To evaluate its effectiveness,a controlled study(n=30)was conducted.Participants who had no formal TCM knowledge were tasked with herbal medicine identification,formula composition,and recognition.In the study,participants interacted with the AR tool through HoloLens 2.Data were collected on both task performance(accuracy and response time)and user experience,with a focus on task efficiency,accuracy,and user preference across the different learning modes.Results The situated visualization method of Formula-S had comparable accuracy to other methods but shorter response time for herbal formula learning tasks.Regarding user experience,our new approach demonstrated the highest system usability and lowest task load,effectively reducing cognitive load and allowing users to complete tasks with greater ease and efficiency.Participants reported that Formula-S enhanced their learning experience through its intuitive interface and immersive AR environment,suggesting this approach offers usability advantages for TCM education.Conclusions The situated visualization method in Formula-S offers more efficient and accurate searching capabilities compared to traditional and web-based methods.Additionally,it provides superior contextual understanding of TCM formulas,making it a promising new solution for TCM learning.
基金supported by the National Natural Science Foundation of China(82174230)the Fundamental Research Funds for the Central Universities(2042022kf1213)。
文摘Integrated traditional Chinese medicine(TCM)and Western medicine(WM)is a new medical science grounded in the knowledge bases of both TCM and WM,which then forms a unique modern medical system in China.Integrated TCM and WM has a long history in China,and has made important achievements in the process of clinical diagnosis and treatment.However,the methodological defects in currently published clinical practice guidelines(CPGs)limit its development.The organic integration of TCM and WM is a deeper integration of TCM and WM.To realize the progression of"integration"to"organic integration",a targeted and standardized guideline development methodology is needed.Therefore,the purpose of this study is to establish a standardized development procedure for clinical practice guidelines for the organic integration of TCM and WM to promote the systematic integration of TCM and WM research results into clinical practice guidelines in order to achieve optimal results as the whole is greater than the sum of the parts.
基金Supported by the Study on Chen Zhiqian's Public Health Thought Theory and Practice in Urban and Rural Areas(No.:3332022175).
文摘Since the early 20th century,China has gradually established a clinical,educational,and research system centered around modern scientific medicine,which has now become the dominant force in China's medical and health system and services,with the construction and development of the Chinese Academy of Medical Sciences and Peking Union Medical College as the most prominent symbol.The scientific medicine in the new era requires close cooperation across multiple disciplines and fields to build a high-quality and efficient medical and health service system.It also involves combining the excellent traditional Chinese culture with Western medicine to explore a unique path of modern scientific medicine with Chinese characteristics.
文摘Medicine is a science studying human's health and diseases as well as the regularity between them. Its research subject is human, who possess natural attribute, psychological attribute and social attribute. Therefore, medicine is bound to possess humanistic attribute. Rooted in Chinese traditional culture, Traditional Chinese Medicine contains abundant humanistic thoughts, for instance, pursuing the unity of human and nature, advocating the vital importance of life, sticking to the virtue of "medicine being humane art", abiding by the principle of "Benevolence prior to interest", complying with the medical rule of "Respecting peers". These are the very concrete reflections of medical humanistic spirit. In this article we aim to explore the humanistic thoughts contained in Traditional Chinese Medicine, and try to inherit and carry forward the spirit to better relieve the tensions between doctors and patients and improve the quality of medical services.
文摘ConSidering the limitations of medical science and the risks associated with medical treatments,we need to re-examine the connotation of medical science from the perspective of philosophy.Medical science is the natural expression of human kindness and human nature of rescuing the dying and healing the wounded.It is a combination of the natural sciences,social sciences,and humanities.From the perspectives of medical philosophy and humanistic care,this article expounds the concepts and ideas of evidence-based,translational,and precision medicine in modern medicine and emphasizes the importance of avoiding new technical bureaucracy,paying attention to achieving a holistic view and systematic understanding,and avoiding biases in development because of the loss of the humanistic spirit in modern medical practice.
文摘MODERN medical diagnosis and practice heavily rely on biological data and information from patients’ body.The progress of biomedical sensor,material and mathematical technology provided ever-increasing methods to gather data.While providing more choices and more comprehensive picture of patients’ conditions to doctors and practitioners,these progresses also require more labor efforts to read,analyze,and make decisions based on those data.It is very difficult for the medical human resources to grow at a speed that matches such need for diagnosis-related expert knowledge.The shortage of expertise has caused long waiting time for check report and fatal misjudged diagnosis in public health system,and it will compromise our ability to move towards a more precise,more personalized and more efficient future of medicine.
文摘Louise Erdrich is one of the most important contemporary American writers in America.Her first Novel Love Medicine won most prizes in American literature history.Most researches in America and China on the novel from the perspectives of feminism,post- colonialism,ecocriticism.The themes in the novel such as love,home- coming,identity construction have also been discussed.
基金the Ministry of Higher Education Malaysia(MOHE),National Defence University of Malaysia for the approved FRGS/2/2013/SKK01/UPNM/02/1 and PRGS/2/2015/SKK07/UPNM/02/1 funds.
文摘The dynamic nature of modern warfare,including threats and injuries faced by soldiers,necessitates the development of countermeasures that address a wide variety of injuries.Tissue engineering has emerged as a field with the potential to provide contemporary solutions.In this review,discussions focus on the applications of stem cells in tissue engineering to address health risks frequently faced by combatants at war.Human development depends intimately on stem cells,the mysterious precursor to every kind of cell in the body that,with proper instruction,can grow and differentiate into any new tissue or organ.Recent reports have suggested the greater therapeutic effects of the anti-inflammatory,trophic,paracrine and immune-modulatory functions associated with these cells,which induce them to restore normal healing and tissue regeneration by modulating immune reactions,regulating inflammation,and suppressing fibrosis.Therefore,the use of stem cells holds significant promise for the treatment of many battlefield injuries and their complications.These applications include the treatment of injuries to the skin,sensory organs,nervous system tissues,the musculoskeletal system,circulatory/pulmonary tissues and genitals/testicles and of acute radiation syndrome and the development of novel biosensors.The new research developments in these areas suggest that solutions are being developed to reduce critical consequences of wounds and exposures suffered in warfare.Current military applications of stem cell-based therapies are already saving the lives of soldiers who would have died in previous conflicts.Injuries that would have resulted in deaths previously now result in wounds today;similarly,today’s permanent wounds may be reduced to tomorrow’s bad memories with further advances in stem cell-based therapies.
基金supported by the National Nature Science Foundation of China(81171812,81272105,81121004,81230041,and 81171798)the National Basic Science and Development Programme(973 Programme,2012CB518105)+2 种基金the National Science and Technology Major Project(2011ZXJ07104B-03B)the Health and Medical Treatment Collaborative Innovation Major Special Projects of Guangzhou(No.201508020253)the Science and Technology Key Project of Guangdong Province(2014B020212010)
文摘Regenerative medicine(RM) is an emerging interdisciplinary field of research and China has developed the research quickly and impressed the world with numerous research findings in stem cells,tissue engineering,active molecules and gene therapy.Important directions are induced differentiation of induced pluripotent stem and embryo stem cells as well as somatic stem cell differentiation potential and their application in trauma,burns,diseases of aging and nerve regeneration.The products Activ Skin and bone repair scaffolds have been approved and are applied in the clinic,and similar products are being studied.About 10 engineered growth-factor drugs for repair and regeneration have been approved and are used in the clinic.Gene therapy,therapeutic cloning and xenotransplantation are some of the strategies being studied.However,China needs to develop standards,regulations and management practices suitable for the healthy development of RM.Aspects that should be strengthened include sound administrative systems,laws,and technical specifications and guidelines;conservation of stem cell resources;emphasis on training and retention of talented stem cell researchers;and reasonable allocation of resources,diversification of investment and breakthroughs in key areas.Finally,broad and deep international cooperation is necessary.
文摘Advances in stem cell science and potential clinical applications have brought clinical medicine closer to the actualization of Regenerative Medicine—an extension of transplantation of organs and cells and implantation of bioprosthetics and biodevices. The goal of such therapeutics will be intervention prior to onset of severe individual disability, enhance organ function and enhance patient performance status without incurring the economic impacts of standard organ transplantation. Regenerative Medicine is already demonstrating proof of principle or efficacy in restora- tion of myocardial contractility, joint mobility and function, immune competence, pulmonary function, immunologic self- tolerance, motor function and normal hemoglobin production with the next targets—diabetes mellitus (type I and type II), neurologic injury, hepatic dysfunction preparing to enter trials. Expenditures on health care needs of an aging U.S. citizenry approximate 20-25% ($3 trillion) of U.S. GDP currently and may to grow to 40% of U.S. GDP by 2025. As the potential of Regenerative Medicine is clinically realized, the societal impact and economic benefits will be disproportionately magnified in the economies of industrialized nations. The experi- ence of the Department of Health and Human Services (HHS), United Network for Organ Sharing (UNOS), the National Bone Marrow Donor Registry (NBMDR), and the National Vaccine Injury Compensation Programs (NVICP) can help ensure that as Regenerative Medicine strives to achieve clinical benefits while avoiding decimation of therapeutic options by product liability and medical malpractice concerns—concerns that crippled the U.S. vaccine manufacturing industry until the creation of the NVICP. The first 50 years of organ/cell/tissue transplantation demonstrates that clinical reality of allogeneic and autologous transplantation can antedate complete understanding of the basic science underlying successful transplantation. Product liability and medical malpractice liability have not impeded the development and growth of organ/cell/tissue transplanta- tion despite increased risks of infection, malignancy and cardiovascular disease in transplant recipients. Currently, human transplantation is only performed using FDA/CBER-approved, non-embryonic stem cells from peripheral blood, bone marrow or umbilical cord blood. Federal legislation passed in 2005 (HR2520 and S1317: The Bone Marrow and Cord Blood Cell Transplantation Program) authorizes the Secretary of Health and Human Services acting through the Director of HRSA to ensure uniform stem cell units distribution and outcomes monitoring via the federally-designated C.W. Bill Young Cell Transplant Program. Historically in the U.S., human biological therapies (vaccines, organ transplant and stem cell transplant) have re- quired federal protections to ensure continued distribution, fair access and avoidance of inhibitory product liability via protections afforded under the “stewardship” of the Secretary of Health and Human Services. The National Childhood Vaccine Injury Act of 1986 established the NVICP to equitably and expeditiously compensate individuals, or families of individuals, who have been declared injured by vaccines, thereby stabilizing a once imperiled vaccine supply by substan-tially reducing the threat of liability for vaccine companies, physicians, and other health care professionals who administer vaccines. Vaccines were the first biologics administered to U.S. citizens en masse and presage stem cell therapeutics (which may similarly be administered to millions) will similarly necessitate that a Stem Cell Injury Compensation Program (SCICP) will also need to be in place to demonstrate an intention to do good, an understanding that industry may do well, but that the health care consumer has a right of protection—all recognized from the outset. The Federal Tort Claims Act (FTCA) addresses liability claims via the Executive, Judicial and Legislative branches of Government, providing an um- brella of liability protection to other participants in the stem cell unit “chain of custody” under the FTCA—similar to the protection from product liability seen in organ and stem cell transplantation for the past 40-50 years. Efficacious development of regenerative medicine capabilities will mandate controlled access must first be provided for individuals with life-threatening diseases without therapeutic options or unable to benefit from or receive proven therapeutic options (ALS, cardiomyopathy and deemed not a candidate for heart transplantation, IDDM with hypoglyce- mic unawareness and no allogeneic source of traditional islet cell replacement available via HRSA) and mandates the prompt adoption of business and legal principles to ensure that the fate of the vaccine manufacturing industry does not become the fate of the stem cell therapeutics industry. If legal and regulatory concerns consume an increasing percentage of health care dollars that could be focused upon innovation, the Regenerative Medicine model will have not realized its full potential. The Diabetes Transplantation/Regenerative Medicine Model is the first organ to cell transplant model outside of oncology to demonstrate the regenerative medicine paradigm. Since all human tissues can be already recapitulated by human stem cells and key patent holders already exist, outlet or distribution of “more-than-minimally-manipulated stem cell units” as an IND approved under FDA/CBER guidelines can be accomplished via the current HHS/HRSA/Dept of Trans- plant methodology. As cardiovascular stem cell researchers develop human therapeutics utilizing more-than-minimally- manipulated stem cell products, they could be afforded protections from product liability historically enjoyed by the transplant community. Extending the Diabetes Transplant/Regenerative Medicine Model to the more than 5 million Americans with chronic heart failure, cell-based therapies to regenerate myocardial contractility could fill an existing void and be delivered in conjunction with and consistent with existing distribution of organs and tissues via HRSA/Department of Transplantation.
基金supported financially by the Project of the“12th FiveYear”for Medical Scientific and Technology(CWS11L050)of the PLAthe Science and Technology Development Fund of China Academy of Engineering Physics(wss-2014-03).
文摘Background:Military medicine is a research field that seeks to solve the medical problems that occur in modern war conditions based on public medicine theory.Methods:We explore the main research topics of military health and medical research in the Web of Science?core collection(Wo SCC)from 2007 to 2016,and the goal of this work is to serve as a reference for orientation and development in military health and medicine.Based on Cite Space III,a reference co-citation analysis is performed for 7921 papers published in the Wo SCC from 2007 to 2016.In addition,a cluster analysis of research topics is performed with a comprehensive analysis of high-yield authors,outstanding research institutions and their cooperative networks.Results:Currently,the research topics in military health and medicine mainly focus on the following seven aspects:mental health diagnoses and interventions,an army study to assess risk and resilience in service members(STARRS),large-scale military action,brain science,veterans,soldier parents and children of wartime,and wound infection.We also observed that the annual publication rate increased with time.Wessely S,Greenberg N,Fear NT,Smith TC,Smith B,Jones N,Ryan MAK,Boyko EJ,Hull L,and Rona RJ were the top 10 authors in military health and medicine research.The top 10 institutes were the Uniformed Services University of the Health Sciences,the United States Army,the United States Navy,Kings College London,Walter Reed National Military Medical Center,Boston University,Walter Reed Army Institute of Research,Walter Reed Army Medical Center,Naval Health Research Center,and the VA Boston Healthcare System.Conclusion:We are able to perform a comprehensive analysis of studies in military health and medicine research and summarize the current research climate and the developmental trends in the Wo SCC.However,further studies and collaborations are needed worldwide.Overall,our findings provide valuable information and new perspectives and shape future research directions for further research in the area of military health and medicine.
文摘Drugs of plant origin have received much attention due to their enormous potential for the prevention and treatment of cancer. Recent progress in the study of anticancer drugs originating from plants and traditional medicines in China is reviewed in this paper, with particular emphasis on taxol, daidzein, acetyl boswellic acid,curcumin and ginsenosid Rh2.
文摘BACKGROUND： Emergency medicine was inaugurated, as an official specialty in China, only25 years ago, and its growth in clinical practice and academic development since that time have beenremarkable.METHODS： This paper is a critical and descriptive review on current situations in emergencymedicine in China, based on the literature review, personal observations, interviews with manyChinese emergency medicine doctors and experts, and personal experience in both China and USA.RESULTS： The current practice of emergency medicine in China encompasses three areas： prehospitalmedicine, emergency medicine, and critical care medicine. Most tertiary emergency departments（EDs） are structurally and functionally divided into several clinical areas, allowing the ED itself to functionas a small independent hospital. While Chinese emergency physicians receive specialty training througha number of pathways, national standards in training and certifi cation have not yet been developed. As aresult, the scope of practice for emergency physicians and the quality of clinical care vary greatly betweenindividual hospitals. Physician recruitment, diffi cult working conditions, and academic promotion remain asmajor challenges in the development of emergency medicine in China.CONCLUSION： To further strengthen the specialty advancement, more government leadershipis needed to standardize regional training curriculums, elucidate practice guidelines, provide fundingopportunities for academic development in emergency medicine, and promote the development of asystem approach to emergency care in China.
文摘BACKGROUND:Despite the fact that traditional Chinese medicine(TCM) has been developed and used to treat acute and urgent illness for many thousands of years.TCM has been widely perceived in western societies that TCM may only be effective to treat chronic diseases.The aim of this article is to provide some scientific evidence regarding the application of TCM in emergency medicine and its future potential.METHODS:Multiple databases(PubMed,ProQuest,Academic Search Elite and Science Direct) were searched using the terms:Traditional Chinese Medicine/ Chinese Medicine,Emergency Medicine,China.In addition,three leading TCM Journals in China were searched via Oriprobe Information Services for relevant articles(published from 1990—2012).Particular attention was paid to those articles that are related to TCM treatments or combined medicine in dealing with intensive and critical care.RESULTS:TCM is a systematic traditional macro medicine.The clinical practice of TCM is guided by the TCM theoretical framework- a methodology founded thousands of years ago.As the methodologies between TCM and Biomedicine are significantly different,it provides an opportunity to combine two medicines,in order to achieve clinical efficacy.Nowadays,combined medicine has become a common clinical model particular in TCM hospitals in China.CONCLUSIONS:It is evident that TCM can provide some assistance in emergency although to combine them in practice is still its infant form and is mainly at TCM hospitals in China.The future effort could be put into TCM research,both in laboratories and clinics,with high quality designs,so that TCM could be better understood and then applied in emergency medicine.
文摘BACKGROUND: In Iran, few studies have evaluated emergency medicine as a career option. In the present study, we aimed to find out how Iranian emergency-medicine specialists view their specialty as a career.METHODS: Following a qualitative study, a Likert-scale questionnaire was developed. Iranian emergency physician specialists who had at least two years' job experience were contacted via email. A uniform link to a Web-based survey and a cover letter that explained the survey were sent to the recipients. We used the Kruskal-Wallis test and post hoc analysis to determine the differences between demographic subgroups.RESULTS: A total of 109 eligible responses were received, a response rate of 72.63%. Of the responders, 57.8% were 30–40 years of age, 86.2% were male, 86.2% were single, 84.4% were faculty members and 90.8% had fewer than 10 years' job experience. The main problems occurring during the career of Iranian emergency physicians were: insuffi cient income, inadequate recognition of the specialty by the community, inadequate union support, insecurity in the emergency wards, overcrowding, job stresses and night shifts. Despite insufficiency of income, Iranian emergency physicians(EPs) did not care about the financial benefits of patient care. Academic activity had positive effects on the perspectives of Iranian emergency physicians regarding their careers.CONCLUSION: Iranian emergency physicians and leaders in emergency medicine should struggle to improve the present situation, aiming at an ideal state.
