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OBJECTIVE To boost access to medical insurance for drugs and improve the accessibility and affordability of drugs. METHODS The current status of the application of international and domestic drug Managed Entry Agreement （MEA）were investigated through literature research method and other methods ，and analyzed comparatively from the aspects of the scope of agreement drugs ，the types of agreements and the content of the agreement ，etc. The problems existing in the application of drug MEA in China were summarized to put forward the suggestions. RESULTS & CONCLUSIONS The UK ，Australia and Italy had rich experience in the application of drug MEA ，and the operation management mechanism were complete. The scope of drugs included in MEA in these countries were relatively broad and the types of agreements were relatively diversified. In China ，drugs included in MEA were mainly oncology drugs and rare disease drugs. The types of agreements mainly included “finance-based agreements”and effect guarantee/effect-based payment in individual-level of“performance-based agreements ”. China ’s evidence collection platform was imperfect and lacked standardized process of MEA. It is suggested that stakeholders should consider increasing the types of drugs ，diversified types of agreements ，improving the accuracy and continuity of evidence collection ， establishing a standardized process for MEA.
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Objective:To investigate the diagnostic efficacy of inflammatory biomarkers [neutrophil/lymphocyte (NLR), monocyte/lymphocyte (MLR), platelet/lymphocyte (PLR)] combined with tumor markers [carbohydrate antigen (CA)125, CA199] in mature cystic teratoma (MCT) patients possess torsion.Methods:The clinical data of patients with MCT diagnosed by surgery and pathology in the third Affiliated Hospital of Sun Yat-Sen University from March 2013 to October 2019 were retrospectively analyzed. A total of 31 MCT patients with torsion were included in observation group , another 101 MCT patients without torsion were assigned to the control group.Clinical characteristics and the levels of NLR, MLR, PLR, CA125, CA199 were assessed and analyzed.Results:The inflammatory biomarkers (NLR, MLR, PLR) and tumor markers (CA125) in the observation group were higher than those in the control group ( P<0.05). Univariate regression analysis was used to screen variables with statistical significance, including NLR, PLR, CA125 and CA199 ( P<0.05), and multivariate logistic regression was used to construct a prediction model for diagnose MCT patients with torsion , which combined NLR and CA199 ( P<0.05). The area under curve (AUC) of NLR, PLR, CA125, CA199 and the combined prediction models of NLR and CA199 were 0.83, 0.72, 0.69, 0.60 and 0.86, respectively. Among them, the joint prediction model of NLR and CA199 had the highest diagnostic efficiency, with a sensitivity of 77.42% and a specificity of 82.18% ( P<0.05). In the observation group, the accuracy of combined prediction model of NLR and CA199 in the diagnosis of MCT pedicle torsion was higher than that of ultrasound (87.10% vs 61.29%), but according to the clinical symptoms and ultrasonic examination, 90.32% of the patients were diagnosed as MCT pedicle torsion. Conclusions:The inflammatory biomarkers and tumor markers have useful clinical significance in the diagnosis of MCT with torsion, especially the combine measurement of NLR and CA199. Associated with the patient's symptoms, signs, examination included doppler ultrasound may assist in improving the diagnostic accuracy .
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Objective@#To explore the effect of shared care model on diabetes management among patients with type 2 diabetes mellitus (T2DM), therefore, to establish a more efficient education and management model for patients with T2DM.@*Methods@#Through convenient sampling, a total of 210 patients with T2DM were recruited from the outpatient clinic of the endocrinology center at Luhe Hospital, Capital Medical University, Beijing, from August to October, 2017. Patients were equally divided into two groups (n=105/group): intervention group and control group.The intervention group completed 103 cases and the control group 100 cases.The intervention group adopted the shared care education model, while the control group followed the conventional education management model. The follow up time of the intervention group was 12 months. The levels of glycosylated hemoglobin (HbA1c), Body Mass Index (BMI) and diabetes self-management behaviors were collected at baseline and at 12-months and compared between two groups. Measurement data were examined by t-test and rank-sum test; Count data were examined by chi square test, P<0.05 was thought to be statistically significant.@*Results@#At 12-month following the implementation of the management models, the HbAlc and BMI of the intervention group were (6.47 ± 0.66)%, (22.28 ± 2.41) kg/m2, and those of the control group were (6.90 ± 0.61)%, (23.49 ± 1.59) kg/m2, respectively. There were significant differences between the two groups (t=-4.63, 0.00, P< 0.01). The intervention group had healthy diet, exercise, self-blood sugar monitoring, blood sugar monitoring in compliance with doctor's advice, self-foot examination and medication scores of (6.08 ± 1.34), (6.06 ± 1.59), (5.18 ± 2.00), (5.28 ± 1.99), (4.64 ± 2.54), (6.80 ± 0.55) respectively, while the control group had (5.43 ± 1.71), (5.46 ± 1.89), (4.27 ± 1.64), (4.23 ± 1.64), (3.57 ± 2.74), (5.30 ± 2.68) respectively. There were significant differences between the two groups (t=-4.03--2.73, P<0.05).@*Conclusion@#Compared with the traditional education and management model, the shared care model with a multi-disciplinary approach is more patient-centered, and could provide systematic, standardized and personalized management for patients with T2DM and showed greater improvement in diabetes management.
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Objective To explore the effect of shared care model on diabetes management among patients with type 2 diabetes mellitus (T2DM), therefore, to establish a more efficient education and management model for patients with T2DM. Methods Through convenient sampling, a total of 210 patients with T2DM were recruited from the outpatient clinic of the endocrinology center at Luhe Hospital, Capital Medical University, Beijing, from August to October, 2017. Patients were equally divided into two groups (n=105/group): intervention group and control group.The intervention group completed 103 cases and the control group 100 cases.The intervention group adopted the shared care education model, while the control group followed the conventional education management model. The follow up time of the intervention group was 12 months. The levels of glycosylated hemoglobin (HbA1c), Body Mass Index (BMI) and diabetes self-management behaviors were collected at baseline and at 12-months and compared between two groups. Measurement data were examined by t-test and rank-sum test; Count data were examined by chi square test, P<0.05 was thought to be statistically significant. Results At 12-month following the implementation of the management models, the HbAlc and BMI of the intervention group were (6.47 ± 0.66)%, (22.28 ± 2.41) kg/㎡, and those of the control group were (6.90 ± 0.61)%, (23.49 ± 1.59) kg/㎡, respectively. There were significant differences between the two groups (t=-4.63, 0.00, P<0.01). The intervention group had healthy diet, exercise, self-blood sugar monitoring, blood sugar monitoring in compliance with doctor's advice, self-foot examination and medication scores of (6.08 ± 1.34), (6.06 ± 1.59), (5.18 ± 2.00), (5.28 ± 1.99), (4.64 ± 2.54), (6.80 ± 0.55) respectively, while the control group had (5.43 ± 1.71), (5.46 ± 1.89), (4.27 ± 1.64), (4.23 ± 1.64), (3.57 ± 2.74), (5.30 ± 2.68) respectively. There were significant differences between the two groups (t=-4.03--2.73, P < 0.05). Conclusion Compared with the traditional education and management model, the shared care model with a multi-disciplinary approach is more patient-centered, and could provide systematic, standardized and personalized management for patients with T2DM and showed greater improvement in diabetes management.