ABSTRACT
OBJECTIVE To sort out reform policy for basic medical insurance designated retail pharmacy （referred to as designated retail pharmacy） in China， and to provide reference for the improvement of the policy under the new situation of mutual- aid mechanism for covering outpatient bills. METHODS The policy texts on designated retail pharmacies issued by ministries and commissions of the State Council and departments directly under the State Council were collected from December 1998 to June 2023. The content analysis and social network analysis were adopted to construct a three-dimensional analytical framework based on the policy subject， the policy tool， and the policy process， in order to quantitatively analyze the policies on reforming designated retail pharmacies. RESULTS & CONCLUSIONS The reform policy of designated retail pharmacies can be roughly divided into three stages： germination， exploration and development， and in-depth promotion. The use of policy tools is dominated by environment-oriented tools， and the cooperation network of policy subjects presents a “head-body-tail” chain structure. With the advancement of policy reforms， the number of policy subjects showed a trend of decline followed by growth， the number of policy documents showed an upward trend， emphasizing the use of tools such as the construction of the pharmacist system， the flow of prescriptions， the payment of medical insurance， and the management of “dual-channels” and “outpatient co-ordination”. It is suggested that in terms of policy formulation， all policy subjects should adhere to top-level design， grasp the characteristics of the stage of policy development， and adjust the use of policy tools according to local and timely conditions； we should also strengthen cooperation and communication， improve policy formulation efficiency， achieve policy coordination， and continuously improve policies for designated retail pharmacies.
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Objective To investigate the role of herpesvirus infection and the activation of Th cell subsets in rheumatoid arthritis (RA) patients.Methods Polymerase chain reaction (PCR) was used to determine herpes viral (HSV 1,HSV 2,EBV,CMV) DNA in whole blood (WB) and serum samples.ELISA used for measuring serum levels of IFN ? and IL 4.Results ① Thirty two WB samples and 32 serum samples from RApatients were tested for the viral DNA types.Of them 2 WB samples were positive for HSV 1 DNA and 1 serum sample did.In normal control samples one serum sample was positive for CMV DNA.There was no significant difference in rate of detection between control group and test group.② Comparing serum levels of IFN ? and the ratio of IFN ?/IL 4,it was found that RA patients had significantly higher values than the normal controls.Increased values directly correlated with severity of disease.[in RA patients IFN ? (21?33) pg/ml.TFN ?/IL 4 (25?20),in normal controls IFN ? (10 1?2 6) pg/ml, IFN ?/IL 4 (17?8)].Conclusion ① The rate of detection of herpes viral (EBV,CMV,HSV 1,HSV 2) DNA does not correlate with RA significantly.② Increased serum levels of Th1 derived inflammatory cytokine (IFN ?) and the impaired production of anti inflammatory Th2 derived cytokines (IL 4) indicate impaired activation of Th1 and Th2 in RA patients and may account for the chronic arthritis.
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One patient with congenital epidermolysis bullosa combined with pachyonychia was reported, and followed up for 11 years. The pedigree of the patient was investigated, and the loci of HLA-A, B antigens of 16 members of the pedigree were determined. The results showed that there were 60 members in the pedigree, among them 24 members had different kinds of skin diseases : 4 cases of epidermolysis bullosa combined with pachyonychia, 9 eases of albopapuloid form of epidermolysis hullosa combined with pachyonychia, 2 cases of icthyosis and 9 cases of pachyonychia simplex. The result of HLA-A, B antigens analysis of 16 members of the pedigree showed no evidence of the genes of these patients linked with HLA-A, B antigens.
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OBJECTIVE To understand the status of gastroscope contamination.METHODS The bacterial(cultivation) of samples derived from inside and outside gastroscope after using was conducted.RESULTS There were heavy(contaminations) inside and(outside) gastroscope after using.Except for normal microbial populations(existing) on pharynx nasalis,many(conditional) pathogenic bacteria had been detected,such as Streptococcus pyogenes,Moraxella catarrhalis,and(nonzymocyte).CONCLUSIONS Many species of bacteria are detected inside and outside(gastroscope) after using.They are normal microbial populations in pharynx nasalis and some conditional pathogenic bacteria.It is (necessary) to strengthen regulation of gastroscope cleaning and disinfection. We should follow Technological Regulations of Disinfection(Ministry of Health,2004) to clean and disinfect endoscope strictly in order to avoid(hospital) acquired infection due to insufficient cleaning and disinfection.