Bloodletting puncture in the treatment of acute ischemic stroke: protocol for a mixed-method study of a multi-center randomized controlled trial and focus group.

This study is to investigate the effectiveness and safety of bloodletting puncture (BP) for acute ischemic stroke (AIS) when used in combination with standard treatment, as well as the patients' feelings and attitudes toward the treatment. This is a mixed method research which includes a multi-center, superiority, randomized controlled clinical trial, and focus group interview. A total of 360 AIS participants will be enrolled. They will be randomized into one of the following two groups for 7 d: (a) BP with standard treatment group (n = 180); (b) standard treatment group (n = 180). The primary outcome will be National Institute of Health stroke scale (NIHSS) score at day 7 after treatment. Secondary outcomes will be changes of Glasgow Coma Scale score, NIHSS score, mRS and Traditional Chinese Medicine syndrome score from baseline to 7, 14, and 30 d after treatment, recurrence rate and all-cause mortality rate within 30 d, and the safety assessments. The focus group will be conducted with a purposive sample of 1-2 acupuncturists and 1-2 patients respectively at each center at 7 and 30 d after treatment. We designed a mixed method study to evaluate the effect of BP, an acupuncture therapy for patients with AIS. If the findings of this study confirm the effectiveness of BP to reduce the NIHSS score and other related outcomes and patients are willing to accept the therapy, we believe this study will help the implementation of this therapy in clinical practice, and provide new evidence for the treatment of AIS.

Research on Dual-channel Pricing Strategy of Pharmaceutical Retailing Considering Medical Insurance Payment Policy / 中国药房

OBJECTIVE：To provide reference for the drug retailers when making dual-channel pricing decisions in China. METHODS：Based on the analysis of the existing literature and the characteristics of drug supply chain ，taking the dual-channel drug retailers as the research object ，the effects of medical insurance payment policy ，consumers’risk aversion factor and inconvenience cost on consumers ’decision-making behavior were considered ，and dual-channel pricing strategy model for drug retailers was constructed. The reverse induction method was adopted to analyze and solve the model ，obtain the optimal pricing and optimal profit function of the drug retailer. The numerical simulation was adopted to simulate and analyze the effects of consumer medical insurance payment utility ，risk aversion factor and inconvenience cost on drug retailer dual-channel pricing and profits. RESULTS：When the utility of medical insurance payment increased ，the pricing of drugstores and the total profit of dual-channel of drug retailers would increase ；while consumers ’risk aversion factor and inconvenience cost showed a U-shaped trend with retailer ’s dual-channel total profits. In addition ，compared with existing e-commerce platforms ，retailers could make more profits by building their own e-commerce platforms. CONCLUSIONS ：Medical insurance payment policy has a great impact on the profits of dual-channel drug retailers. Drug retailers should continue to pay attention to the trend of relevant national policies and ensure their own profits by adjusting pricing in time. When medical insurance payment utility is in low level ，dual-channel drug retailers can ensure market demand by reducing the retail price of drugstores ，and should use flexible sales strategies to attract consumers. For consumers’risk aversion and inconvenience cost ，drug retailers can adopt strategies such as providing distribution services for consumers with high inconvenience cost.