生物化学是临床医学专业的一门重要基础课程，其教学质量可直接影响临床医学生物的培养目标。文章探讨了“新医科”背景下生物化学课程的教学改革，从思政元素融入课堂、教学手段的改革、开放实验平台的搭建和课程考核的改革等方面入手，着力培养学生自主学习的能力，解决临床问题的能力和提升科研素养。

      For students who majored in clinical medicine，biochemistry is a crucial foundation course，and the teaching quality of which directly influence the educational objectives of clinical medicine students．In this study，we explored the teaching reformation methods of biochemistry course under the background of New Medicine．We integrated ideological elements into classroom teaching，and used various teaching methods in the classroom，built an open experiment platform and innovated course assessment mode，for trying to improve the students’ ability of self-study，clinical problems resolving and scientific literacy．

《流行病学》作为公共卫生与预防医学的主干课程,对于培养高质量公共卫生人才至关重要。在大数据、人工智能和互联网技术迅猛发展的时代背景下,传统的单一教学模式已无法满足现代医学教育的需求。线上线下混合教学模式逐渐成为高等医学教育的主要教学方式。这种模式结合了线上资源的丰富性和线下课堂的互动性,能够拓展教学内容,提高学生的自主学习能力。通过大数据分析和人工智能技术,可以提供个性化学习体验和实时反馈,优化教学效果。然而,这一模式在实际应用中仍面临诸如资源整合不够、师生互动不足等挑战。文章以广州医科大学为例,分析了《流行病学》课程中混合教学模式的优势与不足,并提出了针对性的改进建议。通过这些建议,旨在提升混合教学模式的有效性,为未来教学改革提供新的思路和参考。

Epidemiology,as a core course in public health and preventive medicine,is crucial for training high-quality public health professionals．With the rapid development of big data,artificial intelligence,and internet technologies,traditional single-mode teaching methods no longer meet the demands of modern education．The blended learning model,combining online and offline teaching,has gradually become a primary method in higher medical education．This model integrates the richness of online resources with the interactivity of offline classes,expanding instructional content and enhancing students' self-directed learning abilities．By leveraging big data analysis and artificial intelligence,personalized learning experiences and real-time feedback can be provided to optimize teaching effectiveness．However,this model still faces challenges such as inadequate resource integration and insufficient teacher-student interaction in practical application．This study uses a medical university as a case study to analyze the advantages and limitations of the blended learning model in epidemiology courses and proposes targeted improvement suggestions．The aim is to enhance the effectiveness of blended learning and provide new insights and references for future teaching reforms．

目的 比较广东云浮市进行药品专区执行国家药品集中采购(GPO)前后呼吸系统疾病患儿住院医疗费用,分析其住院医疗费用的影响因素。方法 选择云城区2019—2020年0~14岁城乡儿童呼吸系统疾病住院患儿,采用单因素和多元回归统计方法分析住院医疗费用的影响因素。结果 呼吸系统疾病儿童平均住院医疗费用国家集采前(4 872.38元)高于国家药品集采后(4 620.25元,P<0.05),药费分别占参保及参合患儿住院医疗费用的35.35%和27.39%,统筹支付费用参保与参合儿童分别占46.85%和57.59%。年龄、住院天数、转归、有无合并症、疾病分类、应用GPO药物、入院分类为呼吸系统疾病患儿住院医疗费用的共同影响因素,其中住院医疗费用随着患儿年龄增加、转归良好及应用GPO药物费用而减少,为负性联系;余住院天数、有无合并症、疾病分类、入院分类则与住院总费用有着正性联系。结论 提高患儿的转归,缩短平均住院日,做好药品专区及集中采购工作可降低儿童呼吸系统疾病的住院费用。

Objective To compare the inpatient medical expenses of children with respiratory diseases before and after the implementation of national group purchasing organization(GPO) in Yunfu City, Guangdong Province, and analyze the influencing factors of inpatient medical expenses. Methods The hospitalized children aged 0~14 with respiratory diseases from 2019 to 2020 in Yuncheng district implemented the GPO were selected. The influencing factors of hospitalization expense were analyzed by single factor and multiple regression statistical methods. Results The average hospitalization expense of children with respiratory diseases before the GPO implemented (4 872.38 yuan) was higher than after (4 620.25 yuan, P<0.05); the drug expense accounted for 35.35% and 27.39% of the hospitalization expense of the insured urban and rural children, and integrated payment accounted for 46.85% and 57.59%. Age, hospitalization days, outcome, comorbidities, disease classification, application of GPO drugs and admission classification were the common influencing factors of hospitalization expense of children with respiratory diseases. Hospitalization expense decreased with the increase of age, good outcome and application of GPO drugs, which was a negative correlation. And there was a positive relationship between the rest factors and the total cost of hospitalization. Conclusions To improve the outcome of children, shorten the average length of stay, doing a good job in drug zone and group procurement can reduce the hospitalization cost of children with respiratory diseases.

       目的    为构建更加健全和可靠的医保体系，制定有效、公平和可持续的医保支付方式提出建议。方法     对医保支付方式及各地医保支付方式改革的实践进行综合比较，总结改革的效果和经验。结果     通过引入绩效导向的支付机制、推动综合付费方式、细化按疾病阶段付费、结合互联网医疗、强化数据能力、健全监管等方面推进医保支付方式改革。结论     医保支付方式是规范医疗机构和医生医疗服务的重要手段，结合浙江省、广东省广州市等省市积极探索疾病诊断相关分组、按病种分值付费等医保支付方式，改革需要综合考虑医疗体制、经济发展水平、人口结构等各方利益和多个因素，通过综合实施，构建更加有效、公平和可持续的医保支付方式。

       Objective  Provide suggestions for building a more sound and reliable medical insurance system，and developing effective，fair and sustainable medical insurance payment methods．Methods  The  payment methods of medical insurance and the practice of medical insurance payment reform in various regions were comprehensively compared the effectiveness and experience of the reform were summarized．Results  The reform of medical insurance payment mode was promoted by introducing performance-oriented payment mechanism，promoting comprehensive payment mode，refining payment by disease stage，combining Internet medicine，strengthening data capability，improving supervision，etc．Conclusions  The payment method of medical insurance is an important means to standardize the medical services of medical institutions and doctors．In combination with the active exploration of Diagnosis Related Groups，Diagnosis  Intervention Packet and other medical insurance payment methods in provinces and cities such as Zhejiang and Guangzhou Guangdong．The  reform needs to comprehensively consider the interests and multiple factors of the medical system，economic development level，population structure，etc．To build a more effective，fair，and sustainable medical insurance payment method through comprehensive implementation．