OBJECTIVE:To fathom American pharmaceutical benefit managers(PBMs).METHODS:The development of PBMs in America was reviewed and the role they played in American pharmaceutical management was analyzed.RESULTS:PBMs,whose strength was increasing,did play a role in curbing the increase of drug expenses though their place was still somewhat controversial.CONCLUSION:PBMs in American sets a good example for other countries including China to follow.

[Objective]To understand the changes of children's blood lead levels and intelligence quotient (IQ) andthe effects of automobile exhaust on the prevelance rates of respiratory symptoms of children. [Methods] 151 pupilsof Y primary school in urban area were selected as exposure group, 160 pupils of Z primary school in Pudong districtwere selected as control group. The health questionaire survey and health examination were carried out amongpupils. The peripheral blood lead levels of the forth finger were determined. The IQ was determined by combinedRaven's Test. The data were statistically analzed by EPI Info and SAS statistic softwares. [Results] Significant differ-ences of blood lead levels were observed between exposure group and control group. The blood lead levels (x) negatively correlated with children's IQ (y) (y= 120. 11--0. 129x) . The prevelance rates of sore and uncomfortable feelings and foreign body sensation in throat and cough of exposure group were significantly higher than those in controlgroup. The ORs of corresponding symptoms were 1.71, 2, 64 and 2. 92 respectively. The multiple linear regressionanalysis showed that exposure to automobile exhaust and the distances from the residential region to street with heavytraffic were the main factors affecting the children's peripheral blood lead levels and the prevelance of respiratorysymptoms. [Conclusion] Further control of the emission of automobile exhaust and reasonable planning of location ofresidential areas were the main measures to control the prevelance of lead poisoning and its related diseases of children.

BackgroundSchizophrenia and the use of antipsychotic medications are identified to be the likely contributors to the development of metabolic syndrome （MS） and cardiovascular disease， and jeopardize the prognosis of schizophrenia. Therefore， effectively preventing or reducing the risk of developing MS in patients with schizophrenia is critical. ObjectiveTo explore the efficacy of aripiprazole combined with olanzapine for male schizophrenia patients and its effect on MS， so as to provide a certain reference for the selection of antipsychotic drugs for schizophrenia patients. MethodsMale patients （n=80） who were hospitalized in The Third People's Hospital of Meizhou from February to June 2023 and fulfilling the International Classification of Diseases， tenth edition （ICD-10） diagnostic criteria for the schizophrenia were enrolled， and grouped using random number table method， each with 40 cases. Study group was treated with aripiprazole combined with olanzapine， while control group was given aripiprazole monotherapy. The treatment lasted for 6 continuous weeks in both groups. At the baseline， Positive and Negative Symptom Scale （PANSS） score， MS-related indices ［fasting plasma glucose （FPG）， hemoglobin A1c （HbA1c）， body mass index （BMI）， waist-to-hip ratio （WHR）， lipid profile］， S100 calcium-binding protein B （S100B） and high sensitivity C-reactive protein （hs-CRP） were recorded. Then the PANSS scores at the end of the 2^nd， 4^th and 6^th week of treatment， the Clinical Global Impression （CGI） scores at the end of the 2^nd and 6^th week of treatment， as well as the MS-related indices， S100B， hs-CRP， Treatment Emergent Symptom Scale （TESS） score and Rating Scale for Extrapyramidal Side Effects （RSESE） score at the end of the 6^th week of treatment were recorded in all participants. ResultsAnalysis on PANSS score revealed a significant group effect， time effect and group×time interaction effect （F=18.092， 634.780， 2.917， P<0.05 or 0.01）. Analysis on CGI score revealed a significant group effect and time effect （F=20.492， 99.190， P<0.01）. At the end of the 6^th week of treatment， study group detected lower serum concentrations of HbA1c and triglyceride （TG） compared with control group （t=-3.495， -3.293， P<0.05）. The post-treatment hs-CRP level was lower in study group than that in control group （t=-3.916， P<0.05）. Study group scored lower on TESS compared with control group （t=-4.684， P<0.01）. ConclusionAripiprazole combined with olanzapine can effectively alleviate psychotic states in male schizophrenia patients， and the combination therapy yields less impact on MS-related indices than olanzapine monotherapy. ［Funded by Meizhou Science and Technology Plan Project （number， 2022B116）］