OBJECTIVE: To provide information about the reforming basic insurance drug list in China, especially in Shanghai for reference.METHODS: To introduce development of drug classified management in China and compare different experiences in the management of OTC drugs' reimbursement in Sweden, Germany, Netherlands and Fenland .RESULTS & CONCLUSION: The inclusion criteria of OTC drugs' reimbursement must be identified.OTC drugs within the insurance drug list should be equated with Rx drugs and those out of the insurance drug list should be fixed with favourable prices.

The paper undertakes a study of equity in the distribution of health resources in China by means of the Theil Index. The results indicate that equity in the distribution of hospital beds, doctors, and nurses between the various provinces is taking a turn for the better. The improvement of equity in the distribution of hospital beds and doctors is mainly due to the improvement in the eastern regions while the central and western regions still maintain the status quo, with supply basically meeting demand. The improvement of equity in the distribution of nurses, however, is due to the simultaneous improvement in the eastern, central and western regions, yet demand exceeds supply.

Objective To explore the related factors of the relapse of schizophrenics in unwell developed economic areas.Methods To analyze 718 schizophrenics by single and multiple stepwise regression analyses to explore whether relapse of schizophrenia was related to those factors.Results 2.8％ experienced one time relapse, 14.2％ experienced two times relapse and 83％ three times. The rate of schizophrenic relapse was in turn correlated with treatment compliance, treatment intervention, marriage, clinical features, psychological stress,social support, the way of forming disease, medical expenses and condition of access to medical care. Conclusions More attention should be paid to the factors causing schizophrenic relapse and wider measures of prevention and treatment should be taken.

Objective To find out the relationship between ambulatory pulse pressure (24 h PP) and left ventricular hypertrophy (LVH) and the enlarged diameter of aortic root (AOD) in aged pati ents with essential hypertension.Methods 118 aged patients with essential hypertension we r e examined by ambulatory blood pressure (ABP) and echocardiography,the different index of ABP and left ventricular mass index (LVMI) and AOD were measured.The p atients were divided into group A (24 h PP≥60 mmHg) and group B (24 h PP

Objective To evaluate the therapeutic effects and side effects of MMF on severe SLE patients compared with CTX.Method All 106 severe SLE patients were randomly allocated to 2 groups:MMF treatment group (53 patients):1 5 g/d for 3 months,1 0 g/d for following 3 months,and then 0 5～0 75 g/d;IVCTX treatment group:0 75 g/m 2 per month for 6～12 months.Prednisone was used in all patients.Clinical and laboratory parameters including SLE DAI,Hb,platelet,urine protein,albumin,SCr,aCL,ANA and anti dsDNA were observed.Results After 3 month treatment,all clinical and laboratory parameters were significantly improved in MMF group,while only partial parameters were improved in CTX group.Hb and platelet increased and urine protein and anti dsDNA decreased faster in MMF group than in CTX group.At month 6 the clinical and laboratory parameters improved significantly in both groups ( P

Objective Hypothyroidism may have adverse effects on the post-operative outcomes. We evaluated the outcomes of coronary artery bypass grafting (CABG) in patients who had both coronary artery disease (CAD) and hypothyroidism.Methods Among 1347 patients undergoing CABG between September 2002 and June 2009, hypothyroidism was diagnosed in 21 patients (Group A, with 6 men and 15 women) and treated with thyroxin replacement therapy. The average age of patients in group A was(60.4 ± 10.2). Hypothyroidism was identified with tests for thyroid functions. CABG in 4 patients was performed with extracorporeal circulation, three of them received on-pump beating heart CABG, and in 17 patients was performed with off pump CABG( OPCAB). CABG was performed following the improvement of FT3, FT4 and TSH with the use of levothyroxine for all patients in group A Twenty patients with CAD in the absence of hypothyroidism ( group B) served as control, 4 of these patients underwent CABG with extracorporeal circulation. Data of thyroid function and hemodynamics pre-, post- and during operation were analyzed. Results Serum thyroid hormones, such as FT3, were measured with sensitive and specific radioimmunoassays peri-operatively. In the patients receiving CABG without extraorporeal circulation, the mean serum FT3 concentrations were ( 1. 39 ± 0. 36 ) pg/ml pre-operatively and ( 1.29 ± 0. 32 ) pg/ml post-operatively ( P = 0.18 ) for 17 cases in group A, and were (2.28 ±0.36)pg/ml and (2.19 ±0.34) pg/ml respectively (P =0.24)for 16 cases in Group B. In the patients receiving CABG with extracorporeal circulation, the mean serum FT3 concentrations were( 1.53 ±0.51 )pg/ml pre-operatively and (0.85 ± 0.40) pg/ml post-operatively ( P = 0. 04 ) for 4 cases in group A, and were ( 2.08 ± 0.24) pg/ml vs. ( 1.96 ±0. 26) pg/ml ( P = 0. 26 ) for 4 cases in group B. The CIs of patients in group A and group B were ( 2.7 ± 1.4)L · min-1 · m-2 vs. (2.8 ±1.5) L · min-1 · m-2, P=0.53). One patients with severe hypothyroidism and underwent CABG with extracorporeal circulation in Group A died of refractory bradycardia after failure in heart resuscitation. Twenty survivors in group A underwent coronary artery bypass on-beating heart. All survivors had improvement in cardiac function during 2to 30 months of follow-up, their preoperative ejection fraction (EF) was 0.48 ± 0.17 and follow-up EF was 0.55 ± 0. 21. All 20 patients in group B were alive. There was no significant difference between group A and B in hemodynamics, prognosis, duration of hospitalization [( 12.2 ±4.7 ) day vs. ( 10. 1 ± 3.9 ) day, P = 0.17], time to extubation [( 17.6 ± 9. 1 ) h vs.(15.1 ± 13.7) h, P =0.12]. Conclusion CABG in patients with both CAD and hypothyroidism is relatively safe. Proper peri-operative nanagement, combined with on-beating heart techniques of CABG, may decrease the operation risks. Off pump CABG had little effect on serum concentrations of FT3. Peri-operative thyroid replacement therapy was critical for patients with hypothyroidism. Patients with severe hypothyroidism who underwent CABG with extracorporeal circulation were at high risk.

OBJECTIVE:To provide references for the controlling of reimbursement of medicare drug expenditure in urban employees in China.METHODS:Referenced experiences were summed up from classified drug reimbursement acts in other countries and areas stated in the literature review.RESULTS&CONCLUSION:It is a common international policy to clas?sify drugs by quality and adopt different reimbursement ratio;most of the countries and areas would exclude the reimburse?ments of over-the-counter drugs;the purpose of classified drug payment and reimbursement was to increase the users'payment thereby to lessen the burden of the authorities on the expenditure of social medicare drugs;concerning the controlling of drug expenditure,measures only taken from the aspects of price setting,ratio of reimbursement and quantity of drug con?sumption can that be effective;analysis about advantages and disadvantages should be considered in the making of the re?forming policies about establishing pharmaceutical reference prices and setting up prescription fee and etc.

Objective To observe the curative effect of condyloma acuminatum patients treated with differences of bacilli phlei injection after fulfufized and the effect of immunity function. Methods We compared curative effect and peripheral blood T lymphocyte subpopulation in the treatment group( 55 cases, 8 weeks, prior and posttreatment with differences of bacilli phlei only) and the control group (50 cases, 8 weeks, prior and post-treatment with recombinant human interferon α-2b only). Results Compared with the control group (24.0 %/41.7 % ), the treatment group(47.3 %/11.5 % ) had advantage in the terms of cure rate and relapse rate( P＜0.05 ). CD+3, CD+4 ,CD4+/CD+8 increased and CD+8 decreased in two groups after treatment. CD+3 , CD+4, CD+4/CDs+ were significantly increased in treatment group compared with the control group after treatment(P＜0.05), but CD+8 had no obvious difference in two groups(P＞0.05). Conclusion Differences of bacilli phlei injection can prevent relapse of condyloma acuminatum and increase immunity function of patients.

Objective To evaluate the efficacy and safety of intravenous thrombolysiswith urokinase combined with emergency interventional therapy acute myocardial infarction(AMI).Methods 128 patients with AMI were randomized to thrombolysis plus PCI group and primary PCI group,the patency rate of infarct related artery(IRA) before intervention,the procedural success rate,the incidence of bleeding complications and acute ischemic events during hospitalization and the left ventricular ejection function(LVEF) measured by echocardiography before discharge were compared.Results The IRA patency rate in the thombolysis plus PCI group(65.7%) was significantly higher than that in the primary PCI group(24.3%)(P

Objective To determine chlamydia pneumoniae(Cpn) DNA and inclusion bodies in peripheral blood mononuclear cell(PBMC) of coronary heart disease.Methods The PBMC were isolated by low permeate hemolysis method.The presence of Cpn-DNA and inclusion bodies were determined by nest-PCR and directed immunofluorescence(DIF) in 150 cases with CHD and 55 non CHD(control group,CG).Results Cpn DNA positive rates were 32.7%(49/150) in CHD and 1.8%(1/55) in CG,simultaneity inclusion bodies were detected 13.3%(20/150) in CHD and 1.8%(1/55) in CG.The positivity rates of Cpn-DNA and inclusion bodies in CHD groups were significantly higher than those in control group.Conclusion Chlamydia pneumoniae DNA and inclusion bodies are present in PBMC among the significant proportion of CHD patients.PBMC sample can be collected easily and trustworthily.