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Serious hazards of transfusion(SHOT)in the United Kingdom has been received reporting of the adverse events of delayed transfusion for more than ten years. Hemovigilance Module Surveillance Protocol in Biovigilance Component in National Healthcare Safety Network in the United States updated the incident codes to include under-transfusion with the creation of a new process code: no blood (NB) and four incident codes in October 2022. This review introduces the monitoring practice of delayed transfusion/under-transfusion in the UK and the USA, makes a suggestion to incorporate delayed transfusion/under-transfusion due to blood shortage into the national health standard on the classification of transfusion reactions and haemovigilance protocol in China, and to do a national survey as well, therefore the real world data and evidences would be obtained and used for further policy making.
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Objective:To evaluate the predictive value of the UK Myeloma Research Alliance Risk Profile(MRP)score based on clinical outcomes in elderly patients with newly diagnosed multiple myeloma(NDMM).Methods:Patients aged ≥65 years with NDMM in our hospital from March 2018 to September 2021 were divided into three groups with low, medium and high risk according to MRP scores.Their therapeutic efficacy, adverse effects, and survival were analyzed.Results:A total of 63 NDMM patients were enrolled with median age of 69 years(65-84 years)and median follow-up of 13.3(1.2-43.4)months.Based on MRP score, there were 22 patients in the low-risk group, 13 cases in medium-risk group, 28 patients in the high-risk group.The median progression-free survival(PFS)time of the three groups was 38.4, 25.1 and 21.2 months respectively, and the estimated 2-year PFS rate was 83.9%, 60.0%, and 45.6%, respectively(all P=0.177). The estimated 2-year overall survival(OS)rate was 100.0%, 90.0%, 74.6%, respectively(all P=0.049). Among patients with grade 2 or above hematological adverse events, there were 20 cases(71.4%), 7 cases(53.8%)and 8 cases(36.4%)in the high-, medium-and low-risk groups, with statistically significant differences( χ2=6.154, P=0.046). Among patients with grade 3 or higher non-hematological adverse events, there were 17 cases(60.7%), 5 case(38.5%)and 5 cases(22.7%)in the high-, medium-and low-risk groups, with statistically statistical significance( χ2=7.389, P=0.025). The patients experiencing interruption, delay or replacement of chemotherapy regimen were 6 cases(46.2%)and 19 cases(67.9%)in the medium-and high-risk groups, which were higher than in the low-risk group(31.8%, χ2=6.543, P=0.038). Conclusions:It is feasible to conduct MRP score in elderly NDMM patients.The MRP score can be used to predict the adverse events of chemotherapy, etc, and has certain value for the prognosis evaluation of patients.
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OBJECTIVE：To provide reference for improving medical insurance reimbursement for multi-indication drugs based on value-based pricing in China. METHODS：The theory and practice of value-based pricing for multi-indication drugs were sorted out，and the value standards and medical insurance reimbursement strategies based on value-based pricing in France，Germany，UK，Italy and Sweden were analyzed，so as to provide the suggestions for medical insurance reimbursement of multi-indication drugs in China. RESULTS & CONCLUSIONS：The realization of value-based pricing first needed to develop a value framework to define，measure and integrate value，and then established a model to convert the total value into price. The overall idea of value-based pricing for multi-indication drugs was consistent，but there were differences in the value standard. In the UK and Sweden， quality-adjusted life years （QALYs） and incremental cost-effectiveness ratios （ICERs） measured by pharmacoeconomicsare used as the value standard. France，Germany and Italy were more focused on the therapeutic value and clinical benefit improvement. As for medical insurance reimbursement strategies，France adopted single weighting method based on expected volume. Germany adopted combination weighting method based on value and volume. UK introduced the Patient Access Schemes and Italy introduced the Managed Entry reements，both based on the nominal reimbursement standard. Sweden adopted independent reimbursement for different indications by different brand names. It is suggested that China can explore the value-based pricing strategies of multi-indication drugs on the basis of the above international experiences，reference and use these variety of medical insurance reimbursement strategies comprehensively. Simultaneously，the information collection mechanism of patients and drug use should be improved to provide data support for the implementation of China’s value-based pricing and reimbursement strategies for multi-indication drugs.
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UK Biobank (UKB) is a forward-looking epidemiological project with over 500, 000 people aged 40 to 69, whose image extension project plans to re-invite 100, 000 participants from UKB to perform multimodal brain magnetic resonance imaging. Large-scale multimodal neuroimaging combined with large amounts of phenotypic and genetic data provides great resources to conduct brain health-related research. This article provides an in-depth overview of UKB in the field of neuroimaging. Firstly, neuroimage collection and imaging-derived phenotypes are summarized. Secondly, typical studies of UKB in neuroimaging areas are introduced, which include cardiovascular risk factors, regulatory factors, brain age prediction, normality, successful and morbid brain aging, environmental and genetic factors, cognitive ability and gender. Lastly, the open challenges and future directions of UKB are discussed. This article has the potential to open up a new research field for the prevention and treatment of neurological diseases.
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Biological Specimen Banks , Brain , Neuroimaging , United KingdomABSTRACT
OBJECTIVE：To provide reference for improving the continuing education system for licensed pharmacists in China by learning from the mature experience of the continuing education system of licensed pharmacists in the UK. METHODS ： Literature research method was adopted to summarize and analyze the organizational structure ，specific contents and implementation methods of the continuing education system for licensed pharmacists in the UK by combing the English and Chinese literatures ， official policies and reports of the continuing education system for licensed pharmacists in the UK. The suggestions and reflections were put forward to improve the continuing education system of licensed pharmacists in China. RESULTS & CONCLUSIONS ：The management organization of continuing education system for licensed pharmacists in the UK is mainly UK Association of Boards of Pharmacy，the organizations of which provide continuing education include pharmacy associations ，pharmaceutical education institutions，pharmaceutical colleges and universities. Continuing education system of licensed pharmacists in the UK is relatively perfect，including personal needs analysis ，systematic continuing education courses ，self-education and evaluation reflection of licensed pharmacists ，forming a systematic circulation system ；continuing education is carried out for pharmacists in different practicing fields ，with equal emphasis on theory and practice. In terms of continuing education ，the UK focuses on face-to-face ， one-to-one training ，and provides many free continuing education courses. Compared with the UK ，the continuing education system of licensed pharmacists in China still has some gaps. For example ，the self-education and self-evaluation awareness of licensed pharmacists is not strong ，the content and form of continuing education lack of pertinence and practicality ，and the re-registration management of pharmacists ’practicing qualifications is more formalistic. It is recommended that licensed pharmacists in China establish the concept of self-education ，strengthen the practicality of continuing education for pharmacists ，carry out refined continuing education for pharmacists in different fields of practice ，and strengthen the management of re-registration of licensed pharmacists，so as to form a systematic and effective circulation system for continuing education of licensed pharmacists in China.
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The blood donation, component preparation and manufacturing, laboratory, issuing and quality control were studied and compared between the UK and China, in order to learn British experience in the clinical practice and blood services. The age limits of blood donors, blood collection units, donation times per year, laboratory items, and the types(volumes) of component preparation and manufacturing in the UK are more superior than those in China. In addition, the blood quality monitoring and regarding indicators are more scientific and reasonable in the UK. The full reimbursement of clinical blood expenses for patients has been realized in the UK. The British experience in continuous safeguard of the blood safety and balance of requirement and availability contributes to the constant and scientific development of British blood services over the years, and is worthy of references.
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This study assessed the potential impacts of climate change on potato production in the United Kingdom. Climate change actions are becoming a nightmare for growers worldwide, and the British potato industry is not an exception. Extreme weather conditions were experienced in 2006, 2012, and 2018, respectively. Thus, this study identified the future climate risk associated with major potato producing regions in the UK using the recent climate projection weather data (UKCP18) based on RCP 8.5. In total, the study considered seven (7) regions with a minimum average of 3000 hectares of potato planted area in the past five years. Findings showed that drought, high temperatures, and prolonged precipitation caused significant yield and quality loss in the past, with a likelihood of causing a more harmful impact in the future. The analysis revealed a hotter (Tmax ≥ 25°C, Tmin ≥ 15°C) and drier (1-1.5 mm day-1) summer most especially in the EE, EM, SW, WM, and YH as well as a warmer (Tmax& Tmin 6-10°C) and wetter winter (5 mm day-1 on average) in Scotland and North West England respectively. Future climate is predicted to hinder land preparation and harvesting operation in the Northern regions while the EE, EM, SW, WM, and YH would be faced with drought, with irrigation and water demand increasing by 20-30% as evapotranspiration also increases by 20-30% in 2050-2080. Irrigated potatoes are predicted to double its current spatial coverage in the future. The study identified suitable adaptation measures and strategies required to reduce the impacts of climate change on the British potato industry.
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OBJECTIVE：To provide reference for improving the efficiency of medicine regulation in China. METHODS ：The legal nature and functional scope ，regulatory objectives ，methods and legal elements of UK Medicine and Healthcare Products Regulatory Agency （MHRA），and the implementation and effectiveness of the drug regulatory effectiveness improvement plan in the UK were analyzed to put forward the enlightenment for China. RESULTS & CONCLUSIONS ：MHRA belongs to the enforcement agency of UK Department of Health and Social Care ，and its legal responsibility is borne by the Minister of Health. Its functions include the supervision of medicine ，medical devices ，blood transfusion products. Its objectives include the administrative supervision of medicine and medical devices ，the provision of medical information to patients ，and the encouragement of pharmaceutical enterprises to develop new and effective products. Its supervision methods include the supervision of administrative legislation and regulations ，drug early warning ，admission to market and administrative agreement ；the legal elements as openness ， transparence，cooperation and participation guarantee the legitimacy of regulatory actions. MHRA launched the medicine regulatory performance improvement plan in 2005，aiming to reduce unnecessary medicine regulatory burden and achieve moderate ， risk-based，targeted and cost-effective drug regulation. This plan makes medicine regulatory agencies improve efficiency ，reduce burden of pharmaceutical enterprises and protect patients ’health rights and interests. Our country can learn from the experience of MHRA regulatory practice in the UK ，establish modern regulatory concepts such as from passive regulation to active regulation ， from post supervision to risk supervision ，from administrative guidance to cooperative management ，so as to strengthen regulatory responsibility，make full use of modern information technology and big data technology ，so as to improve the efficiency of drug regulation in China and effectively safeguard the public health rights and interests.
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OBJECTIVE：To provide re ference for promoting the self-regulation development of China ’s pharmaceutical industry. METHODS ：Through in-depth analysis of the self-regulation system of the UK pharmaceutical advertising industry ，this paper focused on the procedures and characteristics of the self-regulation of the UK pharmaceutical advertising industry ，and proposed the suggestions for improving the self-regulation system of China ’s pharmaceutical industry. RESULTS & CONCLUSIONS： Since the 1980s，the self-discipline of the pharmaceutical advertising industry in the UK has officially established its legitimacy in 2012，and distinguished the operation procedures of prescription only medicine and over-the-counter. The characteristics of the self-regulation of the pharmaceutical advertising industry in the UK are to issue guidelines to guide the industry self-regulation ， select appropriate industry associations to become self-regulation institutions ，promote the effective connection between government supervision and industry self-regulation ，and ensure the continuous and effective communication between the government and industry associations. It is suggested that China should develop the guidelines for guiding industry associations to carry out self-regulation，focus on cultivating self-regulation capabilities of industry associations ，establish a cohesive mechanism between government supervision and industry self-regulation ，and build a platform for ensuring continuous and effective communication between the two parties ，thus promoting the development of self-regulation system in the pharmaceutical industry.
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Background: Axillary Ultrasound is an important tool in assessing regional lymph node status in women who are node negative clinically as many of them will prove to have axillary lymph node involvement on histopathology. The aim of the present study was to establish the role of axillary ultrasound in preoperative assessment of lymph node status in women with carcinoma breast and to correlate the findings of axillary ultrasound with the histopathology of resected axillary nodes.Methods: Forty patients (all women) were included in this study and the preoperative axillary ultrasound was done to know the status of axillary lymph nodes and the findings were correlated with histopathological findings of the resected nodes.Results: The sensitivity of axillary ultrasound was found to be 66.67%, specificity was 87.5%, accuracy 75%, positive predictive value (PPV) of 88.89% and negative predictive value of 63.4%.Conclusions: Axillary ultrasound is very important tool in assessing preoperative axillary lymph node status in patients with carcinoma breast. It is also important in assessment after inadequate axillary dissection and for follow up of non-treated axilla.
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This paper introduced the training system in obstetrics and gynecology(O&G) in the UK and the MRCOG exam organized by the Royal College of Obstetricians and Gynecologists.Comparisons between the O&G specialists training systems of China and UK found that China should better link the resident training and specialists training for a better posteducational medical education system.China should also try to build a China-UK O&G specialist training program to keep pace with the time,for more O&G specialists of international perspectives in China.
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@#In order to provide enlightening experience for the establishment of reasonable and diversified orphan drugs into the reimbursement system in China, the official websites of the National Institute for Health and Care Excellence(NICE)and the National Health Service(NHS)in the UK were inspected, collecting and summarizing the relevant documents, on the inclusion of orphan drugs into the reimbursement system. Relevant literatures were analyzed with theoretical studies on the accessibility of medicines for patients with rare diseases. In the NHS system, the inclusion of orphan drugs into the reimbursement system in the UK can be achieved mainly through seven routes, with three routes that are evaluated by NICE(MTA, STA and HST)and four are directly managed by the NHS(specialized commissioning, CDF, IFRs, CtE). Through the analysis of the inclusion of orphan drugs into the reimbursement system and the various problems in the UK, we have found some enlightening experience for the establishment of the reimbursement system for orphan drugs in China.
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In the United Kingdom,undergraduate education of geriatric medicine focuses on helping students understand or describe relevant contents,with only a few ability requirements.At most medical schools,the teaching of geriatric medicine is integrated with other clinical curriculums,such as mental health and internal medicine.The pedagogy of geriatric medicine that consists of formal and informal ones,tends to become varied and has some innovations in terms of simulation education,interdisciplinary education,and student-centered education.Based on the relevant experience in the UK,it is suggested that China should study and formulate the teaching requirements of geriatrics for undergraduate clinical medicine specialty in order to standardize and promote related work.Medical colleges and universities can better integrate geriatric knowledge into the existing curriculum system,constantly innovate geriatric teaching methods,actively use simulation teaching,student-centered education and other ways to improve the teaching effect.
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OBJECTIVE: To learn from the implementation experience of UK Strategy for Rare Diseases, and to provide reference for the formulation of the rare disease guarantee strategy in China. METHODS: The background, status quo and content of UK Strategy for Rare Diseases were introduced; its implementation experience was analyzed and summarized to provide enlightenment to the construction of relevant mechanism in China. RESULTS & CONCLUSIONS: British government took measure like strengthening the collection of message, improving service quality and uniting patient organization for patient empowerment, while spreading advanced disease screening and gene detection technology, developping training in diagnosis and treatment of rare disease and encouraging patients to participate in the research. The comprehensive and perfect guarantee system of rare disease had been formed. British experience is worth learning. Our country should construct comprehensive guarantee framework of rare disease, support patient organizations, improve service system for patient and strengthen rare disease research to provide health guarantee for rare disease patients.
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According to the official website of the Department of Health & Social Care,Mainly media and Independent research sector in UK and the literature analysis,it obtained related information about PFI in the UK's National Health Service(NHS).Through the description of status quo of the development of Private Finance Initiative(PFI) programs,it analyzed the existential issues,influences and improvement measures,so as to provide references for China's Public-Private Partnership(PPP)/PFI programs.
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OBJECTIVE:To provide reference for the development of community pharmacists in China. METHODS:Accord-ing to reviewing the practice in the responsibility development of community pharmacists in USA,UK,Australia,relevant experi-ence was summarized and relevant suggestions were put forward. RESULTS & CONCLUSIONS:Responsibility development of community pharmacists in USA,UK,Australia had made great progress,and their levels of practice and their own quality also made continuously improvement. Besides,they made certain achievements in prevention of chronic disease,minor illness manage-ment in community pharmacy,drug use review and prescription drug intervention,and health mission pharmacy,etc. In China, our government should promote the transforming of the responsibility of community pharmacists by considering the differences of re-gions in stage and step by step,encourage pharmacists actively and orderly expand the business scope,actively explore from sys-tem and develop multiple authentication,and steadily improve the service skills of pharmacists. Meanwhile,domestic pharmacies and pharmacists should take the initiative to change the concept to get ready for the coming changes.
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Dental education in United Kingdom has been amongst the best in the world with years of experience.General Dental Council (GDC) is the sole competent authority for dentistry in the UK.GDC produces guidance on dental education and lead the inspections and monitoring for dental schools.Postgraduate Dental Deans are responsible for the provision and quality management of the education and training of dental graduates during 2 years' foundation training and 3-5 years' specialty training.There are similarities between UK dental education system and Chinese system in school education and continuing education.It is worthy of reference for the dental education in China in terms of the training system of dental residents and specialists in the United kingdom.
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The EU is a key export market of Chinese materia medica (CMM). Following "The Traditional Herbal Medicinal Products Directive" (2004/24/EC) of EU, the UK enacted the restriction law on the sales of traditional herbs, which made the sales of CMM more difficult in the EU market. The prime reason is that the production or registration of CMM is difficult to meet the standards of the EU relevant technical regulations. In particular, the excess of heavy metals in CMM becomes a very serious problem which has not only influenced its quality and reputation but also has hindered the CMM to the world. By means of analyzing the relevant directives and standards of heavy metals in herbal management of EU, we analyze the impact of the UK ban on CMM exports in depth, and propose the countermeasures of CMM companies, so we can accelerate the internationalization of CMM.
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The UK Ebola-countering Operation in Sierra Leone from September 2014 to November 2015 called Operation Gritrock and its countermeasures were briefly introduced , such as the national strategy , aero-maritime deployment , self medical support , base-oriented training and international cooperation .A comparative analysis was made of operations of the same type between the UK and China in terms of mission-orientation, command and control , deployment timeline , past experience, deployment routes, logistics and assistance effects.Four implications for China′s military function construction in future international disaster relief operations were also summarized at the strategic , operational and tactical levels .
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Objective:To observe the efficacy and safety of intrapleural injection with urokinase ( UK) in the treatment of tubercu-lous pyothorax. Methods:Totally 120 patients with tuberculous pyothorax were randomly divided into two groups. The vomicae in the control group were rinsed with 5% sodium bicarbonate, and those in the observation group were treated with UK. The total effective rate, symptom relief time, closure time of vomicae, pleural thickness changes and adverse reactions were observed in the two groups. Results:The total effective rate of the control group and the observation group respectively was 81. 7% and 98. 3%, which showed sta-tistically significant difference (P<0. 01). The symptom remission time and the pus cavity closure time of the observation group were shorter than those of the control group (P<0. 05). The pleural thickness of the observation group was thinner than that of the control group at the end of the treatment (P<0. 05). The incidence of adverse drug reactions in the observation group was significantly higher than that in the control group (P<0. 01). Conclusion:The curative effect of UK in the treatment of tuberculous pyothorax is better than that of sodium bicarbonate, however, it is necessary to pay attention to monitoring such adverse reactions as bleeding, low heat and the others.