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Objective:To explore the clinical application value of the dual-layer detector spectral CTA in evaluation of brain perfusion impairment in patients with acute ischemic stroke.Methods:Clinical and imaging data of 35 patients with acute ischemic stroke in Weihai Central Hospital from March 2020 to October 2020 were reviewed retrospectively. All patients underwent head and neck spectral CTA examination and dynamic cerebral perfusion CT examination with dual-layer detector spectral CT. The iodine density map and effective atomic number map were reconstructed using CTA data, and the iodine density and effective atomic number, as well as the cerebral blood volume (CBV) and cerebral blood flow (CBF) values of the hypoperfusion area and the contralateral side were measured and compared; the areas of brain hypoperfusion regions were measured. Pearson′s correlation coefficient was used to analyze the correlation between iodine density values and CBV values, iodine density values and CBF values, effective atomic number values and CBV values, effective atomic number values and CBF values, as well as hypoperfusion area shown on CTA images and displayed on CTP-CBF map.Results:Of all the 35 patients, the iodine density value [(0.22±0.07) mg/ml], effective atomic number value (7.38±0.05), CBV value [(1.9±0.7) ml/100 g] and CBF value [(15.1±5.9) ml/(100 g·min)] of the hypoperfusion area were significantly lower than those of the healthy side [iodine density value (0.44±0.10) mg/ml, effective atomic number value (7.52±0.06), CBV value (3.4±0.7) ml/100 g, CBF value (57±27) ml/(100 g·min); t values were -14.7, -14.5, -11.2, -9.7, respectively, all P<0.001]. No significant difference was found between the hypoperfusion area shown on spectral CTA [(2 292±1 393) mm 2] and shown on CTP-CBF map [(2 290±1 359) mm 2] ( t=-0.076, P=0.944). There was a positive correlation between iodine density value and CBV (affected side: r=0.350, P=0.039, healthy side: r=0.551, P=0.001); a positive correlation was also found between effective atomic number value and CBV (affected side: r=0.488, P=0.003, healthy side: r=0.552, P=0.001); and there was a strong positive correlation between the hypoperfusion area on CTA and that on CTP-CBF ( r=0.993, P<0.001). Conclusion:Dual-layer detector spectral CTA can provide the “one-stop” assessement including head and neck vascular evaluation, as well as the hypoperfution area measument, which can be an alternative rapid method for evaluation of patients with acute ischemic stroke.
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OBJECTIVE：To construct China ’s Insurance Mode for ADR injury compensation model under marketing authorization holder （MAH）system，and to provide reference for reducing the medical disputes caused by ADR damage and protecting the rights and interests of patients. METHODS ：Using the methods of recommendation and “snowball”，the interviewers were invited to conduct semi-structured interviews to obtain qualitative data ，and the results were analyzed by thematic analysis. According to the results of subject analysis ，the ADR injury compensation model was designed from three aspects of insurance type setting，insurance level division and compulsory insurance protection objects ，and the Fuzzy comprehensive evaluation method based on AHP was used to evaluate the model ；questionnaire and multiple factor Logistic regression analysis was adopted to analyze the influential factors of whether drug related institutions were willing to establish ADR injury compensation system. RESULTS：A total of 40 experts were invited and 34 of them completed the interview ，with a response rate of 85.0％. At present ， the problems of ADR injury compensation in China mainly included the difficulties of third-party identification and adducing evidence of ADR injury ，the difficulty of timely and fair settlement of medical disputes caused by ADR injury ，the high cost and long time of handling ADR injury disputes ，and the uncertainty of compensation mode. More than half of the experts interviewed agreed with the compensation mode of insurance . The overall score of established model was 89.50. A total of 640 questionnaires were distributed and 559 valid questionnaires were recovered （204 drug manufacturers ，172 drug distributors and 183 medical institutions）. The effective rate of the questionnaire was 87.3％. Multiple Logistic regression analysis showed that the factors positively correlated with the approval of establishing ADR injury compensation system after the implementation of MAH system in China included the familiarity of ADR staff in drug manufacturing enterprises with ADR related policies （β＝1.697，P＜0.05），the types of drugs operated by pharmaceutical companies （β＝2.987， P＜0.05），the cognitionlevel of medical staff on ADR （β＝ 2.800，P＜0.05）. The working years of medical staff were negatively correlated with the approval of establishing ADR injury compensation system after the implementation of MAH system （ β ＝－ 2.544，P＜0.05）. CONCLUSIONS ：ADR injury compensation model designed in this study is feasible. It has reference value for reducing the economic burden of ADR patients ， treating patients ’health problems caused by ADR injury in time ，and promoting the development of China ’s drug insurance. Main influential factors for the establishment of ADR injury compensation model under MAH system contain the familiarity of ADR staff in drug manufacturing enterprises with ADR related policies ，the types of drugs operated by pharmaceutical companies ，the cognitionlevel of medical staff on ADR ，the types of drugs operated by pharmaceutical companies ，the cognitionlevel of medical staff on ADR.
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OBJECTIVE： To provide reference for constructing ADR damage relief system in China. METHODS： Questionnaire survey was conducted among 217 pharmaceutical manufacturers in Shaanxi province by census method. Fisher’s exact test， Pearson χ2 test and multivariate Logistic regression analysis were used to analyze the factors effecting construction of ADR damage relief systerm unter marketing authorization holder （MAH） system， and the interaction among various factors. RESULTS： A total of 217 drug manufacturers were investigated in this study （217 questionnaires were sent out）. 209 questionnaires were collected and 204 valid questionnaires were screened out with recovery rate of 94.01％. Totally 9 independent influential factors screened by Fisher’s exact test and Pearson χ2 test had a significant impact on the attitude of building ADR damage relief system under MAH system， i.e. the last year’s earnings of enterprises， the proportion of pharmaceutical technicians， whether to set up R&D departments， whether to obtain new drugs/generic drugs in recent 3 years， whether to actively carry out post-marketing safety evaluation of drugs， whether ADR commissioners are familiar with ADR-related policies in MAH system， cognition about whether MAH system promotes the development of pharmaceutical industry， the development direction of enterprises after the full implementation of MAH， cognition about the lack of legal basis for ADR damage relief （P＜0.05）. Multivariate Logistic regression analysis showed that whether the ADR specialist was familiar with the ADR-related policies in MAH system was the main influential factor for constructing ADR damage relief system under the MAH system （P＝0.044）. It was positively correlated with the attitude of approving the construction of ADR damage relief system under MAH system （B＝1.697）. CONCLUSIONS： The pharmaceutical manufacturers， in which ADR specialists who are familiar with the ADR-related policies in the MAH system， are more inclined to agree to constructing ADR damage relief system under MAH system.
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Objective:To study the degree of recognition about the protection of traditional knowledge of Chi-nese medicine and its influencing factors among Shaanxi University of Chinese Medicine students and provide scien-tific evidence for improving relevant policies.Methods: 1,162 college students were chosen by stratified cluster sampling from Shaanxi University of Chinese Medicine and questionnaires were surveyed among them.Rank sum test and multiple linear regression model were used to explore the related factors on degree of recognition about the protection of traditional knowledge of Chinese medicine.Results: The overall cognition-scoring rate was 36.55％,and subscales in descending order by scoring rate were loss of traditional knowledge of Chinese medicine,international and domestic related protection systems.There were significant differences in scores between age groups,majors,grades,place of origin,family monthly income per capita,parents'educational background,moti-vation of applying for medical school,and whether they had taken the protection of traditional knowledge of Chinese medicine courses(P<0.05).Conclusion:The overall cognition-scoring rate among Shaanxi University of Chi-nese Medicine students was generally low.In order to motivate students to protect traditional knowledge of Chinese medicine and promote a healthy development of Chinese medicine,measures from national institution and school education should be conducted.
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Objective:To investigate and analyze the attitude and its influencing factors of traditional knowledge of Chinese medicine among students in a Traditional Chinese Medicine ( TCM) college in Shaanxi Province, and provide scientific evidence for improving the relevant institution and policies. Method:A stratified cluster sampling method was used to conduct a questionnaire survey of 1,162 students in a TCM college in Shaanxi Province. Rank sum test and multiple linear regression model were used to explore the factors affecting the attitude of students. Result:The score of attitudes towards TCM protection was(43. 09 ± 6. 50), while specialty, parental education, family members' attitudes towards TCM, evaluation of courses in TCM, had taken related courses or not, clinical practice or internship experience of TCM, and the score of correlative knowledge were the influencing factors of attitudes ( P<0 . 05 ) . Conclusion:Students of this school had a relatively positive attitude towards the protection of traditional knowledge of Chinese medicine. In order to cultivate the fresh troop for the development of TCM, it is suggested that the system of TCM courses and textbooks should be reformed so as to improve students' enthusiasm for protecting traditional knowledge of Chinese medicine and establishing a special institution.
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Objective To evaluate the implementation of the national essential medicine system in Shaanxi Province.Methods Using a standardized methodology (2008 Edition) developed by the World Health Organization(WHO) and Health Action International(HAD,data on the prices and availability of 38 essential medicines were collected from 120 primary,secondary and tertiary public hospitals in ten cities of Shaanxi Province from March to May 2012.Results The availability of essential medicines is generally low at public hospitals in Shaanxi province,as the average availability of originator brands is but 5.9％,and that of generics of the lowest prices is but 23.9％,while this availability at tertiary hospitals is higher than hospitals of lower levels.The procurement prices of originator drugs within essential medicines are distinctly higher than the international reference prices for the originator brands,and slightly higher for the lowest priced generics.The procurement prices at primary care hospitals are slightly lower than that of other hospitals.Retail prices of essential medicine are not significantly different among regions of different income levels.Affordability of originator brands is poor,while that of their generic equivalents is good.Conclusion The government is recommended to adjust the national essential medicine list,expand the variety of essential medicine moderately,improve the medicine pricing mechanism,and deepen public hospitals reform.
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Objective To investigate the clinical value of chest low-dose CT (LDCT) combined with computer-aided detection (CAD) system for lung cancer screening in high risk population. Methods Two hundred and nineteen healthy candidates underwent 64-slice LDCT scan. All images were reviewed in consensus by two radiologists with 15 years of thoracic CT diagnosis experience. Then the image data were analyzed with CAD alone. Finally images were reviewed by two radiologists with 5 years of CT diagnosis experience with and without CT Viewer software. The sensitivity, false positive rate of CAD for pulmonary nodule detection were calculated. SPSS 11.5 software and Chi-square test were used for the statistics. Results Of 219 candidates ,104(47.5% )were detected with lung nodules. There were 366 true nodules confirmed by the senior radiologists. The CAD system detected 271 (74.0%)true nodules and 424 false-positive nodules. The false-positive rate was 1.94/per case. The two junior radiologists indenfifid 292(79.8%), 286(78.1%) nodules without CAD and 336 (91.8%), 333 (91.0%) nodules with CAD respectively. There were significant differences for radiologists in indentifying nodules with or without CAD system (P<0.01). Conclusions CAD is more sensitive than radiologists for indentifying the nodules in the central area or in the hilar region of the lung. While radiologists are more sensitive for the peripheral and sub-pleural nodules,or ground glass opacity nodules, or nodules smaller than 4 mm. CAD can not be used alone. The detection rate can be improved with the combination of radiologist and CAD in LDCT screen.
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OBJECTIVE: To propose feasible strategies for the pharmaceutical development in the West of China METHODS:To analyse the pharmaceutical industry,pharmaceutical business,traditional Chinese medicine and current national pharmaceutical situation,and the existing problems in the West RESULTS & CONCLUSION:A series of strategies concerning the pharmaceutical development in the West are brought forth in order to promote the healthy development of the pharmaceutical industry there ,including ideology strategy,sustainability strategy,innovation strategy,talent strategy,policy strategy,methodology strategy,management strategy,patent strategy,and brand strategy
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OBJECTIVE:To provide reference for Chinese pharmaceutical retail chain enterprises in making marketing strategy.METHODS:According to the organization and operational model of Chinese pharmaceutical retail chain enterprises,their practicable marketing strategy was discussed.RESULTS & CONCLUSION:Chinese pharmaceutical retail chain enterprises should make practicable and feasible marketing strategy to promote market competition ability basing on self-condition.
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OBJECTIVE:To seek for the countermeasures to standardize the administration of medical consultation service in the retail pharmacy.METHODS:To analyse the existing problems of the consultation service in the retail pharmacy.RESULT_S&CONCLUSION:We suggest that the consultation service should be carried out by speciallyassigned persons,CIS should be introduced,computer network should be manipulated and a standardized administration system should be established.Only in this way can the quality of service be raised and the security of medication of the public be ensured.