ABSTRACT
OBJECTIVE：To summarize key factors and shortcomings of essential medicine policy in China from 2009-2019， and to provide reference for the formulation and improvement of follow-up policy. METHODS ：Through the official websites such as National Health Commission and Chinese government website ，as well as other policy searching websites ，using“essential medicine”as key words，related policy texts were collected. Rothwell classification method was used to construct the analysis framework of essential medicine policy. The contents of policy texts were classified and coded by Excel 2013 software，and the codes were classified into the essential medicine related policy analysis framework. The descriptive analysis was carried out by SPSS 22.0 software，and the essential medicine policy was analyzed according to data distribution characteristics ，and the results were explained. Corresponding suggestions were put forward. RESULTS ：A total of 15 essential medicine policy texts were screened and obtained. X-dimension of the analysis framework of essential medicine policy included 3 types of basic policy tools ， Incorporat - counting for environmental effects and statistical noise in ing the operating environment into a nonparametric mea - data game formulations and interpretations for data envelopsupply-oriented ，environment-oriented and demand-oriented tools ；Y-dimension was the essential medicine policy objectives of accessibility，quality and rational use. From X-dimension ，the frequencies of above 3 basic policy tools use were 20.12％ ， 66.46％，13.41％，and the environmental policy tools were the most frequently used ；from Y-dimension ，the frequencies of above 3 objectives were 43.90％，32.93％，23.17％，the frequency of accessibility was the highest. The test results showed that there was statistical significance in the use frequency of X-dimension in Y-dimension （χ2＝11.719，P＝0.025＜0.05）. CONCLUSIONS ：The use frequency ratio of different essential medicine policy tools is different ，so it is necessary to reduce the frequency ratio of environmental policy tools ；there are differences in the internal structure of policy tools ，so it is necessary to optimize the structural allocation among policy tools ，and pay attention to the construction of demand-oriented tools . It is suggested that the accessibility of essential medicine should be enhanced ，and the connection between essential medicine list and medical insurance list should be strengthened；great importance should be attached to drug quality and drug quality supervision ；the scope of rational use of essential medicine should be clarified ，and the supervision responsibility of relevant government departments such as NMPA should be strengthened.
ABSTRACT
OBJECTIVE@#To explore the effect and indications of radiofrequency ablation for the treatment of obstructive sleep apnea-hypopnea syndrome.@*METHOD@#Multilevel temperature-controlled radiofrequency therapy of soft palate, uvula, inferior turbinate, and tonsils were applied to 74 adults with obstructive sleep apnea-hypopnea syndrome (OSAHS). There were 16 mild, 23 moderate, and 35 severe cases respectively in this study. Evaluation of mucosal injury and effect of radiofrequency therapy on pain, speech and swallowing were performed early after operation. The volume of targets and length of soft palate and uvula were measured three months after operation. Polysomnography, Epworth Sleepiness Scale and Snoring Scale Score questionnaires were reevaluated six months after operation and compared with the results of pre-operation. Treatment outcome measurements were mainly based on polysomnography.@*RESULT@#By our definition, 5 of 74 patients (6.76%) have been cured and 42 of 74 (56.76%) had improved totally. Mean Apnea-Hypopnea Index (AHI) decreased significantly and mean lowest oxygen saturation value increased significantly postoperatively (P < 0.01). The total effective rate of the patients, whose obstructive sites were all treated by radiofrequency, was remarkably higher than that of the ones, whose obstructive sites were only partly treated by radiofrequency (P < 0.01). The total effective rate of the former was 72.92%. Patients showed a significant decrease in mean score on ESS and SSS postoperatively (P < 0.01). No significant complications were observed in most patients. There were little influence on pain, speech and swallowing. The volume or length of targets decreased obviously three months after operation.@*CONCLUSION@#Radiofrequency can reduce the volume of tissue. The short-term outcomes of radiofrequency were satisfying if obstructive sites had been all treated. This study demonstrates that the characters of radiofrequency are as follows: minimally invasive, safe, efficient, repeatable and multilevel applicable. Temperature-controlled radiofrequency therapy is a safe and effective procedure for hypertrophic infraturbinal when used separately, or as a part of a the combined approach for complex syndromes.