Times are changing, young faces are changing, but the pursuit of better goals and benevolence remains the same. In the Department of Gastroenterology of the First Affiliated Hospital of Dalian Medical University, there is such a group of people, who do not forget their original intentions on the road of practicing medicine and forge ahead.
‖ Technological advances, a blessing for patients
On January 1, 2022, the new version of the national medical insurance drug list was officially implemented, in which the new biological agent usonuxulumab, which has a prominent effect on the treatment of inflammatory bowel disease, was officially entered the medical insurance as one of the 94 drugs successfully negotiated. For Mr. Lee (not his real name) and many people with IBD, this is good news that can't help but be happy. Mr. Lee's Crohn's disease (CD) is a type of inflammatory bowel disease (IBD). Diagnosed last year, it was initially treated with traditional medicines, with little effect. After the relapse, it was decided to be treated with a new biologics, but Mr. Li was hesitant because he could not afford the high price. On January 1 of this year, the new version of the national medical insurance drug catalogue was officially implemented, and Professor Wang Yingde, director of the Department of Gastroenterology of the First Affiliated Hospital of Dalian Medical University, immediately contacted Mr. Li. Mr. Li was re-hospitalized with using usinuzumab biologics, the treatment effect is very good, And Mr. Li is also very happy, and he is currently in the maintenance treatment stage.
According to Professor Wang Yingde, due to the continuous growth of the mainland economy and the continuous changes in the environment in the past ten years, especially the changes in diet, IBD has changed from a rare disease to a common disease of the digestive system. Taking the Department of Gastroenterology of the First Affiliated Hospital of Dalian Medical University as an example, more than 1,000 patients receive treatment due to their serious illness every year. With the increasing number of IBD patients in China, the clinical standard diagnosis and treatment and quality control of IBD are also paying more and more attention. Although endoscopic and pathological examinations supplemented by imaging, genetic testing and other diagnostic methods are developing rapidly, there is still a lack of ideal diagnostic and therapeutic methods. From the perspective of internal medicine treatment, the treatment of IBD is changing from the traditional treatment stage to the biological agent treatment stage, and the traditional drug treatment based on steroid drugs and immunological agents has made good progress in the treatment of IBD, but it is far from meeting the clinical needs. Since the first biologics research and development entered the clinic in 2007, it has gradually entered the second phase, the period of biologics treatment. After these biologics entered the clinic, the therapeutic effect of IBD has been greatly improved, especially in recent years, new biologics such as uszunumab have begun to emerge, making the treatment of biological agents a leapfrog development. Since usonumab has been on the market in the past two years, it has been well received by IBD patients and doctors because of its rapid onset of action, high mucosal healing rate, small side effects, especially its adverse reactions to concurrent tumors. Biologics like usonumab have so many advantages, why aren't they widely used? The main reason is that the price of new biologics is very high when they start, and many patients have to give up because the price is unbearable. In the past two years, from the national to the local government, more and more people have begun to pay attention to small groups like IBD patients. The scope of medical insurance is constantly expanding, more and more good drugs into medical insurance, under the double influence of price reduction and medical insurance reimbursement, the original treatment fee of more than 100,000 yuan a year is now reimbursed after the patient only needs to bear the original 20% or so, which makes most of the patients can afford to use, which is good news for both patients and doctors, patients can afford to use, doctors can choose more treatment plans when treating.
‖ The sun is warm, walking with love
IBD treatment is a long-term and arduous task, in addition to medical treatment, patient self-management is also very important, if the management is not in place or the management effect is not good, then the patient's clinical outcome will not be too good, so in order to help patients do a good job of self-management, the Department of Gastroenterology of the First Affiliated Hospital of Dalian Medical University has carried out many activities and established a patient home public welfare team. Every year on May 19th is World Inflammatory Bowel Disease Day, the Department of Gastroenterology of the First Affiliated Hospital of Dalian Medical University will invite some IBD patients to participate in the sharing, hoping that through mutual exchanges, more young patients can give some confidence and courage. Before the epidemic, the Department of Gastroenterology would give patients an offline lecture every quarter to explain some common symptoms and problems of IBD, such as what should be paid attention to during treatment, and how patients should pay attention to drug side effects. After the lecture, there will also be on-site communication with patients to help them solve some confusions in the treatment process and even in life.
Although offline activities have decreased due to the epidemic, online activities have never stopped. Last year, the First Affiliated Hospital of Dalian Medical University held a "Patient Education Week" online, with more than 1,000 people on the line, and many patients said that they were very much looking forward to such activities. For patients, this kind of activity can teach them how to treat the disease correctly, how to do a good job in diet, exercise, psychology and other self-management.
In the process, there are many moving real cases. Professor Wang Yingde recalled that six years ago, a 19-year-old girl suffered from Crohn's disease, and the price of biologics was still relatively expensive at that time, because the economic conditions were not very good, and patients could not afford high treatment costs. After learning of the situation, initiated by Dr. Chen of the Department of Gastroenterology, the IBD team cooperated to carry out a fundraising activity for the patients, and in just a few days, with the help of the medical staff of the department and the public, they raised 50,000 or 60,000 yuan of treatment fees, so that the patients could use biological agents for treatment in a timely manner, and the patient's condition was quickly controlled after treatment. At present, the patient is in good condition, and the weak little girl who was weak at that time has now become a big girl who is also working in the clinical frontline as a nursing staff.
‖ have both ability and political integrity, and the mantle is passed on
From Professor Wang Yingde's introduction, we learned that the treatment of IBD is not something that one or two people can do, and there must be a team, so the Department of Gastroenterology of the First Affiliated Hospital of Dalian Medical University has long established a multidisciplinary joint diagnosis and treatment platform for inflammatory bowel disease (IBD-MDT), and the team members include general surgery, radiology, rheumatology and immunology, nutrition, pathology, ultrasound, and even pediatrics. With the joint efforts of the team, missed diagnosis and misdiagnosis were reduced and the treatment effect was improved. At the same time, in order to continue to develop well in the discipline, IBD-MDT has a collocation of old, middle and young people, and also attaches importance to the training of young doctors. In order to help the growth of young doctors, the hospital will send some young doctors to high-level hospitals at home and abroad for training and study every year, and strive to synchronize with the most advanced treatment methods at home and abroad. From 2015 to 2021, in a total of 6 years, the team has 12 doctors to study in hospitals at home and abroad, including domestic hospitals such as Peking Union Medical College and Shanghai Jiaotong University, as well as foreign hospitals such as cleveland Clinic in the United States, Yale University School of Medicine in the United States, and Florilla University School of Medicine in the United States. After returning from school, these cutting-edge and advanced diagnostic methods and treatment techniques will soon be applied to patient treatment, and have achieved good results in the clinic. At the same time, the hospital often organizes young doctors to conduct academic seminars, especially when encountering difficult and severe cases, all departments will participate in and discuss together what questions there are in the diagnostic process, and whether there is a better treatment plan... Everyone communicates with each other and makes progress together. Each physician will summarize the results of clinical diagnosis and treatment and research, and write a paper for publication. At present, in domestic and foreign journals, fifty or sixty papers have been published. In the process of applying for research, young physicians continuously improve their scientific research level and research ability, which in turn plays a positive role in clinical diagnosis and treatment.
Professor Wang Yingde emphasized: "Cultivate a team of young physicians who have the ability, knowledge, love and patience, so that they can think of what the patient thinks, the urgency of the patient, and truly consider the patient..." Although IBD is not yet curable, as long as patients and doctors cooperate with each other and work together, with the continuous improvement of diagnosis and treatment methods, we are fully capable of controlling this disease, so that patients can return to normal work and life like normal people. ”
Clinicians are constantly working hard to diagnose and treat patients, while functional support departments are also actively exploring innovations in services. According to Gao Nannan, director of the Medical Insurance Department of the First Affiliated Hospital of Dalian Medical University, the Dalian Medical Insurance Bureau took the lead in carrying out the dual-channel drug supply measures of the designated hospital and the designated pharmacy as early as 2017, and implemented a unified payment policy in the designated drug purchase unit, which not only provides more feasible choices for patients to buy drugs, but also allows patients to reduce the hard work of running back and forth. After the implementation of the national medical insurance policy, the Ministry of Medical Insurance responded positively, immediately applied for a medical insurance account for the responsible doctors, assisted the doctors to do a good job of high-value drugs first identified and then enjoyed reimbursement, taking ussonumab as an example, now about 30 patients per month have done the identification of high-value drugs, which simplifies the medical treatment process and improves the patient's medical experience.
During the epidemic period, in order to reduce the impact of the epidemic on medical treatment and facilitate patients to seek medical treatment, the hospital has carried out many convenient measures, such as prescribing a three-month diagnosis and treatment prescription for patients with high-value drugs; using electronic reports as a qualification retention for hospitalized patients; and implementing temporary procurement to ensure the needs of patients. Whether it is a clinician or a functional support department, everyone is trying to provide as good a service as possible to patients. With the advancement of medical insurance policies, more and more people have enjoyed the benefits of national medical insurance, and medical institutions are constantly pursuing higher standards to provide more convenient services for patients.
Every life should be valued, no matter how many problems, how difficult, there must be people like them, will not be troublesome, not afraid of hard work, put the patient's health and life first, with hard work and sweat to explore the path full of hope.
Introduction of IBD Center of the First Affiliated Hospital of Dalian Medical University
Dalian Medical University First Affiliated Hospital Gastroenterology IBD Diagnosis and Treatment Center has won the title of National IBD Diagnosis and Treatment Regional Center, is one of the only 4 diagnosis and treatment centers in the three eastern provinces, as a member of the "national team", the Department of Gastroenterology of the First Affiliated Hospital of Dalian Medical University has opened IBD special outpatient clinics according to sub-specialties, established IBD multidisciplinary joint diagnosis and treatment platform (IBD-MDT), established Dalian IBD Diagnosis and Treatment Alliance, Northeast IBD Leukocyte Adsorption Treatment Center, IBD Health Education Base of Liaoning Provincial Health Education Demonstration Base. IBD subspecialty has held the 9th China Dalian IBD Summit Forum, invited well-known experts at home and abroad to conduct academic exchanges, and improved the level of diagnosis and treatment of IBD in Dalian. At present, the level of IBD diagnosis and treatment of the Department of Gastroenterology of the First Affiliated Hospital of Dalian Medical University is in the first-class level in northeast China and the advanced level in china.
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Professor Wang Yingde
Professor, Chief Physician, Doctoral Supervisor, Postdoctoral Supervisor
Director of the Department of Gastroenterology, the First Affiliated Hospital of Dalian Medical University
Member of the Inflammatory Enterology Group of the Digestive Disease Branch of the Chinese Medical Association
Member of the Integration and Collaboration Group of the Digestive Disease Society branch of the Chinese Medical Association
Member of the Gastroenterologists Branch committee of the Chinese Medical Doctor Association
Member of digestive disease branch of China Medical Promotion Association
Co-chair of the Chinese Alliance for Multidisciplinary Joint Diagnosis and Treatment of Inflammatory Bowel Disease
Member of the Standing Committee of the IBD Professional Committee of the Beijing Medical Reward Foundation
Vice Chairman of the Gastroenterology Branch of Liaoning Medical Association
Deputy Leader of IBD Group of Digestive Branch of Liaoning Medical Association
Member of the Standing Committee of the Internal Medicine Branch of Liaoning Medical Doctor Association
Former chairman of the Digestive Branch of Dalian Medical Association
Leader of the IBD Group of the Digestive Branch of Dalian Medical Association
Professor Zhang Qifang
High South Long South
Director of the Medical Insurance Department of the First Affiliated Hospital of Dalian Medical University
Standing Director of Liaoning Provincial Health Workers Association
Member of the Medical Insurance Committee of Liaoning Provincial Hospital Association
Liaoning Provincial Branch of the Youth Committee of the Medical Insurance Committee of the Chinese Hospital Association
Expert Committee Member
The first hospital medical insurance management of Liaoning Pharmaceutical Association
Member of the Professional Committee
Expert of Dalian Medical Security Think Tank
Dalian Medical Security Research Association Hospital Medical Insurance Committee
Vice Chairman