Historical Review and Reflection of American Drug Right to Try Law / 中国药房

OBJECTIVE： To provide a reference for the use and management of unregistered drugs in China. METHODS： A historical review and evaluation was conducted for the legislative process of drug trial rights in the United States， and the differences and links between the drug trial rights and the previous extended sympathetic drug system were compared. RESULTS & CONCLUSIONS： At present， 41 states in the United States have completed the drug right to try law legislation. In 2018， the US Congress passed the federal legislation on drug right to try law. The right to drug right to try law has evolved from the development of sympathetic drugs， both of which are dedicated to establishing a new path beyond clinical trials to facilitate end-stage patients access to research drugs， so both have obvious similarity. However， the drug right to try law is committed to requiring medical decisions to be returned to patients and doctors， and to the exclusion of the US Food and Drug Administration. In the case of extended sympathetic drug system， the US Food and Drug Administration is committed to “balancing the maximum benefit with the minimum damage”. The two are significantly different in terms of supervision， patient criteria， duration， responsibility distribution， and informed consent. The implementation of the right to drug right to try law has brought hope to patients in the end stage， but it has not given them more opportunities for survival； and it is especially important to correctly guide the masses to make choices rationally.

Drug Quality Characterization Consideration of Preparations of Oil Tea Camellia Defatted Cake based on Antithrombotic Effect / 世界科学技术-中医药现代化

This study was aimed to select the best preparation form of medicinal in camellia cake,based on the optimal antithrombotic agents in oil tea camellia defatted cake to establish the foundation of research.The content of effective index component of the oil tea camellia defatted cake preparation was detected by HPLC-PDA.The quality of medicinal preparation from oil tea camellia defatted cake was characterized based on the content,relative quantity,relative ratio of content,yield rate and antithrombotic effect.The results showed that the effect of antithrombotic of three medicinal preparations from oil tea camellia defatted cake was listed in the following descending order of enrichment,ethanol extract,and water extract.The enrichment was the best preparation form of medicinal in oil tea camellia defatted cake preparation with the highest content of effective index components,the lowest extract rate and the lowest dosage.But it had the best effect of antithrombotic.It was concluded that the significant improvement of efficacy was due to the increase of the content of the components in the preparation and the rationality of the proportion.At the same time,analysis of component quality based on basic composition of drug system through the consideration of effective components of type and quantity,composition and other quality factors can further guide the preparation of drugs.

Establishment of Evaluation Index System for the Implementation of National Essential Medicine System in Community Health Service Centers in Shanghai / 中国药房

OBJECTIVE:To provide reference for the construction of suitable evaluation index system for the implementation of National Essential Medicine System in community health service center.METHODS:The frame of evaluation index system was designed by theoretical analysis,literature study and expert interviews methods.Delphi method was used to establish evaluation index system for National Essential Medicine System in Shanghai community health service center.Analytic hierarchy process was adopted to determine the weights of indicators at all levels.RESULTS:The positive coefficients of the two rounds consultations were 88.24％ (15/17) and 86.67％ (13/15).The authority coefficient of structural index,processing index and result index in the first round consultation were 0.68,0.68 and 0.69,respectively,which showed that the authority degree was higher.The coefficient of concordance in the second round consultation was higher than the first round (the indexes of structure,process and result in two rounds consultation were 0.286,0.306,0.193 and 0.345,0.358,0.337,respectively),which indicated the expert opinions were highly consistent.Established evaluation index system consisted of 3 fiust-level indexes,13 second-level indexes and 27 third-level indexes.CONCLUSIONS:The selected experts were representative,the consultation results were reliable,established evaluation index system was rational and the setting of weights was scientific.Also this study was a methodological exploration.

Precision Medicine and Modernization Research on Traditional Chinese Medicine——The Fifth Discussion on the Proposal of Holistic Systems Medicine / 世界科学技术-中医药现代化

The origin of precision medicine was discussed in this article,as well as its advantages and deficiencies at this stage.Tangshen formula was taken as an example to explain a rational and ideal mode of traditional Chinese medical (TCM) precision medicine research under the guidance of TCM theory.In view of the two major problems existing in the TCM modernization research,including the separated strategy among formula-disease-syndrome and independent research approach using genomics,proteomics and metabonomics,critical scientific issues on developing the drug system to biological system research mode and solutions for integrating formula-disease-syndrome were proposed here,and the roadmap and total framework of top design were also provided.The specific methods and the corresponding research results on Tangshen formula at the three stages concluded as formula-disease related,disease-syndrome combinated and formula-disease-syndrome integrated were introduced and summarized.At this time for the innovative breakthrough development of TCM,precision medicine will promote the TCM modernization research,and also will provide a powerful driving force for the establishment of holistic systems medicine.

Animal experiment study of silica nanoparticles labeled peptides with 125 I / 中国生化药物杂志

Objective To study whether the silica nanoparticles can be used as a biomacromolecular carrier of oral drugs.Methods Studyed the influence of the amount of calcium ions on nano silica nanoparticles morphology,the encapsulation rate of silica nanoparticles on proteins or peptides in the presence of different calcium ions,the situation of proteins or peptides released from silica nanoparticles,enzymolysis of protein packaged by silica, silica nanoparticles labeled peptides with 125 I released in mice.Results Experiments showed that the synthetic silica nanoparticles packaged with peptides could smoothly reach the small intestine through the gastric acid in mice, it had potential to be biomacromolecular carrier of oral drug. Conclusion Proteins or peptides is easy to release in alkaline condition,but release few in acidic condition of pH2 (PH of gastric acid).The silica nanoparticles prepared have the potential to be oral drug carrier.

Progress of transdermal drug delivery systems for natural drugs / 中国药学杂志

OBJECTIVE: To summarize the latest research progress in formulations and technologies of transdermal drug delivery system (TDDS) for natural drugs.

Cognition and evaluation of the essential drug system by doctors at township health centers of different ownership systems / 中华医院管理杂志

Objective To understand the comments for the essential drug system by doctors at township health centers in Nantong's six counties and to discuss the effect of implementing the essential drug system to different ownership systems.Methods The survey was made with stratified clusters random sampling method to select township health centers.Questionnaires were filled out by doctors,and leaders of the health bureau and township health centers were interviewed.Results After the implementation of the essential drug system,94.6％of the doctors found that the number of laboratory examinations increased in Rugao,Rudong and Haian.23.2％of the doctors in Tongzhou,Qidong and Haimen found that enthusiasm for work increased.Conclusion The compensation mechanism should be perfected and the financial subsidies should be paid in time.Supervision and management should be strengthened and the grassroots need for medicine be ensured.The skills training should be enhanced and the medical service ability be improved.

Research on the Influences of the Implementing Essential Medicine System on Compensation Mechanism of Primary Medical Institutions：analysis on system dynamics / 中国卫生经济

Objective: To analyze the influences of implementing essential medicine system on primary medical institutions and give suggestions. Methods: Using system dynamics method to construct the compensation mechanism model for primary medical institutions. Compare the growth in revenue and expenditure of primary medical institutions before and after essential medicine system implementation. Results: After the implement of essential medicine system, the growth in total expenditure and total income of primary medical institutions is steadier; when the annual growth rate of government financial subsidies invested more than 13%, the growth in total receipts will keep balance. Conclusion: It’s better to guarantee the government financial subsidies invested in time, raise medical service price properly and establish comprehensive compensation mechanism for implementing compensation mechanism of primary medical institutions.

Analysis and recommendations on sustainable development of the essential drug system at secondary hospitals / 中华医院管理杂志

This paper made systematic description of the three objectives of sustainable development designed for the policy based on the sustainability theory for the health sector.The essential drug system for secondary hospitals comprises the list coverage and allocation percentage of essential drugs,requirements for bidding and purchasing as well as pricing practice; management and conditions of these hospitals,including leadership determination and competency,doctors prescription behavior,and supportive reforms at these hospitals; external policies and social environment,including government financial subsidy,medical service prices adjustment,medical insurance,and the awareness and attitude of the people on essential drugs.

Impacts of the zero price margin for drugs on the revenue-expenditure structure of primary healthcare organizations / 中华医院管理杂志

ObjectiveTo probe into the influence of the zero price margin for drugs on the revenue-expenditure structure at primary healthcare organizations.MethodsOne of the pilot districts experimenting with this system in Ningbo city was earmarked as the research object.Within this district,the data of their revenue,expenditure and surplus were collected from 20 primary healthcare organizations prior to and after the zero price margin for drugs was in place for classification analysis.ResultsThe percentage of service revenue among the total revenue has dropped from 68.34％ before the system was in place to 65.44％ after,reducing 4.24％.The percentage of drug revenue has dropped from 71.68％ before to 63.57％ after,reducing 11.31％.The percentage of service surplus has dropped from 15.81％ before to - 23.07％ after,reducing 245.94％.The total standard workload has increased 61.77％.Average medical expense per outpatient and per inpatient has reduced 32.85％ and 57.18％,from 71.44yuan and 2642.08 yuan before to 48.33 yuan and 1131.28 yuan after respectively.ConclusionThe deficit rise and higher percentage of drug revenue at primary healthcare organizations deserve attention.A comprehensive reform is recommended to establish a regular government financial support mechanism,further adjust the revenue-expenditure structure,set up the system of rational drug use,and effectively reduce the medical expense of patients.

On the trials of essential drug system in Dongtai county, Jiangsu province / 中华医院管理杂志

The paper introduced the trials and experiences acquired in carrying out the essential drug system in Dongtai city, Jiangsu province, probing into specific practices of improving such a system and deepening the medical and healthcare reform. Practices prove as advocated by the author that the building and betterment of an essential drug system characterized of "Zero price margin" in unified bidding, procurement and distribution. Such a system can not only alleviate the financial burden of diseases of the people, but also enhance clinical drug use safety, encourage rational use of healthcare resources, and promote patient satisfaction in the end.

Effects of Essential Drug System on Primary Medical Institutions / 中国药房

OBJECTIVE: To analyze the effects of Essential Drug Systems on primary medical institutions. METHODS: According to related regulations for primary medical institutions in Suggestions on the Implementation of National Essential Drug Systems, the problems on the implementation of Essential Drug System were analyzed and discussed. RESULTS: The concepts of essential drug were not promulgated widely. Present essential drug supply guarantee system had limitation and essential drug distribution was kept at low level. Essential drug quality guarantee system had not been established and compensation supporting measures weren’t carried out completely. Above problems affected the implementation of Essential drug system in primary medical institutions. CONCLUSIONS: Government should set up multi-channel compensation mechanism and comprehensive evaluation mechanism for drug bidding, and select distribution enterprise rationally. Government also should increase the proportion of medical cost reimbursement in primary medical institution and improve the propaganda of National Essential Drug System.

Analysis on the Importance of Basic Medical Insurance System to the Implementation of Essential Drug System / 中国药房

OBJECTIVE: To provide reference for the implementation of Essential Drug System. METHODS: According to the contents of Essential Drug System and Basic Medical Insurance System in the New Medical Reform, the relationship between Essential Drug System and Basic Medical Insurance was analyzed. RESULTS: Essential Drug System and Basic Medical Insurance System were important aspects of New Medical Reform in China, which complemented each other. Basic Medical Insurance System improved the implementation of Essential Drug System, while Essential Drug System promoted the realization of policy targets of Basic Medical Insurance System. CONCLUSION: Basic Medical Insurance System should play a promotion role in the implementation of Essential Drug System.

Investigation on the Difficulties of Implementation of National Essential Drug System / 中国药房

OBJECTIVE: To provide reference for medical system reform in China. METHODS: According to Primary Medical Institutions Part of National Essential Drugs List (2009 edition), relevant aspects and reality of medical system reform and in China, policy connotation of Essential Drug System were analyzed to investigate the difficulties of implementation of Essential Drug System. RESULTS & CONCLUSION: Several problems should be resolved to implement essential drug system effectively, such as benefit assignment and financial support. The implementation of national essential drug system requires various efforts to achieve the goal of Medical Reform.

Discussion on the Defects of National Essential Drug System in Our Country and Its Improvement / 中国药房

OBJECTIVE:To provide suggestion for full implementation and improvement of the national essential drug system in our country. METHODS:To analyze the defects of the Implementation process of national essential drug system in our country, and make recommendations for improvement. RESULTS & CONCLUSON: The system has been put into effect for one year; There were some performances and obvious defects in the national essential drug system in our country. Obviously, the problems of bid inviting and circulation were serious. And because of the low level of primary medical institution, it obstructed the pursue of system, we must vigorously promote and improve it, and to meet the people's demand of drugs.

Analysis on the Significance of Eliminating Obstructive Factors During Implementation of Essential Drug System Based on Game Theory:with Public Medical Institutions as Study Core / 中国药房

OBJECTIVE:To provide reference for the establishment of coordinative mechanism among different interest groups during the implementation of essential drug system. METHODS:Based on game theory,game behaviors of various interest groups were studied with public medical institution as study core. Behavior relationships among various interest groups were ensured to find out equilibrium point of interests. RESULTS & CONCLUSIONS:In the implementation process of National Essential Drug System,great importance should be attached to the study on game phenomena and behavior among various interest groups to make sure implementation of National Essential Drug System.

Analysis of Essential Drug System from the Point of View System Allocation / 中国药房

OBJECTIVE: To provide reference for the implementation of essential drug system. METHODS: Relevance system allocation theory of institutional economics was applied to analyze essential drug system in China. RESULTS & CONCLUSION: Only coupling among internal systems of essential drug system form, can the gap of system be eliminated to realize the target of essential drug system.

Focus on the National Essential Drug System / 中国药房

OBJECTIVE:To provide reference for promoting the development of medical and health care in China.METHO-DS:The development process of national essential drug system was reviewed and analyzed and the experience of WHO was drawn on to design the future of national essential drug system in China.RESULTS & CONCLUSION:WHO proposed the concept of national essential drugs and recommended medical institutions to establish drug and therapeutics committee and to prepare "Standard Treatment Guidelines" and "National Formulary" for management of rational use of national essential drug.While essential drug system and basic medical security system have been worked out in China,their impacts of them are not satisfactory because of weak enforcement. "National Essential Drugs List ? The Part for Primary Health Care and Health Institutions" (2009 version) and National Formulary Indicate.The Part of Chemicals and Bidogical Products were published,and they are symbols of the re-beginning of national essential drug system.

National Formulary Interpretation / 中国药房

OBJECTIVE:To analyze and summery the characteristics and clinical guiding significance of National Formulary?The Part of Chemicals and Biological Products(2010 version).METHODS:Literatures at home and abroad were retrieved and literature review method was applied for analysis.RESULTS&CONCLUTION:National Formulary?The Part of Chemicals and Biological Products(2010 version) includes four parts,i.e.general part,special part,national appendix and index.It represents as authority,guideline and Chinese characteristics as well as cultural and distribution characteristics professionally.Comprehensive and typical National Formulary is also characterized with timeliness because it is revised regularly.It had been written scientifically and freely and serves as standard for clinical drug use to improve diagnostic and therapeutic level,safety and development of drug use.

Preliminary Study on the Establishment of Performance Indicator System for Evaluating National Essential Drug System in China / 中国药房

OBJECTIVE:To explore the establishment of performance indicator system for evaluating national essential drug system in China.METHODS:Reference to the field of health policy performance evaluation research and practice at home and abroad.WHO indicators for evaluating national drug policies,and a qualitative study on the theory and approach of policy evaluation was conducted.RESULTS & CONCLUSION:To establish a China-specific performance evaluation indicator system,policy goals should be specified,and evaluation criterions and policy components should be also defined firstly.An indicator system framework of national essential drug system which based on WHO recommendatory indicators should be proposed accordingly.But detailed indicators should be established based on field research and experts counseling.