OBJECTIVE:To provide reference for the establishment of a system of expired medicine recycling in China. METHODS:The experience of developed countries with respect to the system of expired medicine recycling was summed up,and the existing problems about the recycling of expired medicines in China were considered to make suggestions to the establishment of a system of medicine recycling in China. RESULTS & CONCLUSIONS:Generally,the developed countries such as Britain, France,Germany and America treat expired medicines as hazardous wastes in the Environmental Protection Law,Waste Disposal Law and other laws,and have basically standardized the recycling of expired medicines. The projects of recycling expired medi-cines in those countries are usually funded by their governments or enterprises of manufacturing or selling medicines,where the medicines were recycled at designated places or on a regular basis or by post,executed by pharmacists and pharmacies,and then disposed on the basis of classification or burned and buried at dumps. However,currently there are no laws and regulations and spe-cial funds for medicine recycling in China,leading to people’s lacking of enthusiasm to recycle the expired medicines. It is suggest-ed that China should take such measures as soon as possible,including establishing and improving the laws and regulations of ex-pired medicine recycling,distinguishing the reasonably determination and disposition of different types of expired medicines,accel-erating the reform of the medical insurance payment system,giving full play to the pharmacist’s role of medication guidance,and fully increasing information transparency.

Leucine zipper tumor suppressor 2 (LZTS2) is a novel tumor suppressor gene that has been increasingly recognized in recent years. Currently, many studies illustrate that LZTS2 gene, the important candidate tumor suppressor gene, is already involved in the inhibition of tumorigenesis and aberrant proliferation of tumor cells, and other functions of tumor cells. Information from these stud-ies can contribute to the formulation of new strategies for the treatment of tumors.

OBJECTIVE:To provide theoretic support for medicine affordability evaluation in China by studying medicine af-fordability evaluation methods. METHODS:Through introducing the concept and evaluation methods of affordability,the evalua-tion steps of“catastrophic expenditure”and“medicine affordability”in medicine affordability evaluation methods were interpreted systematically. RESULTS & CONCLUSIONS:The catastrophic expenditure and impoverishing effect methods can measure med-icine affordability,but they both have limitations. Catastrophic expenditure evaluation method cannot measure the consequences of a catastrophic expenditure to the family,and ignore the reduction of family income after the occurrence of diseases. Impoverishing effect evaluation method cannot pay attention to originally poor population. These two evaluation methods complement each other, and can more objectively reflect the ability of patients bearing medical expenses,which can provide scientific references for poli-cies of enhancing medicine pricing and reimbursement system.

Promoting equity and access to medicine is important to guarantee health equity. The international communities commonly guarantee equity and access to medicine through free pharmaceutical policy. In most coun-tries, free pharmaceutical policy covers patients who cannot afford, children under 5, pregnant women and elderly people. The free medicines include essential medicines, medicines for chronic and infectious diseases, vaccines, etc. Financing of free medicines comes from health insurance, direct government investment and international aid, and the medicine delivery mainly depends on the public medical institutions. Free pharmaceutical policy in China mainly refers to medicines for infectious diseases and vaccines, and the coverage is narrow. This paper argues that since China has been becoming one of the middle income countries, the amount of free medicines should be in-creased, especially for chronic diseases, such as diabetes, hypertension, etc. The equity and access to medicine in China should be further promoted by providing all essential medicines for free.

Objective:To improve the centralized bidding procurement practice of essential medicine in China. Methods:By using literature review, comparative analysis and field investigation, implementation plans and regula-tions of the centralized bidding procurement of essential medicines in 30 provinces were collected and analyzed. Re-sults:There are differences in the operating organization, scope of implementation, purchasing cycle, bidding pro-curement mode, judgment criteria and other aspects among provinces. Conclusion: The progress of the implementa-tion of the centralized bidding procurement practice of essential medicine under the request of Document No. 56 of the State Council differed greatly among the provinces. The government should adhere to the centralized bidding procure-ment practice of essential medicine, give full play to the advantages of group purchasing, explore approaches of medi-cal insurance institutions participating in the centralized bidding procurement practice, and perfect the assessment of drug quality to assure the quality of essential medicine.

OBJECTIVETo investigate the feasibility of constructing a capsular poly L-lactic acid (PLLA) ureteral stent seeded with autologous urothelial cells using tissue engineering methods.

METHODSThe capsular ureteral stent was constructed by subcutaneously embedding PLLA ureteral stent in the back of beagles for 3 weeks to induce the formation of connective tissue on the surfaces. After decellularization of the stent, the expanded autologous urothelial cells were seeded on the stent. The surface structure and cell adhesion of the stent were observed using HE staining, scanning electron microscope (SEM) and immunocytochemical staining. MTT assay was used to evaluate urothelial cell proliferation on the capsular PLLA ureteral stent and on circumferential small intestinal submucosa graft.

RESULTSHE staining and VIII factor immunohistochemistry revealed numerous capillaries in the connective tissue encapsulating the stent without obvious local inflammatory response. The results of SEM and immunocytochemical staining showed that the capsule contained rich collagenic fibers forming three-dimensional structures, and the seeded autologous urothelial cells could adhere and well aligned on the surface. MTT assay showed normal growth of the cells on the stent as compared with the cells grown on circumferential small intestinal submucosa graft.

CONCLUSIONThe capsular PLLA ureteral stent allows adhesion and proliferation of autologous urothelial cells and shows a potential in applications of constructing tissue-engineered ureter.

Animals ; Bacterial Adhesion ; Cell Proliferation ; Dogs ; Epithelial Cells ; cytology ; transplantation ; Female ; Lactic Acid ; Polyesters ; Polymers ; Stents ; Tissue Engineering ; methods ; Transplantation, Autologous ; Ureter ; surgery ; Urothelium ; cytology

[摘 要] 目的：采用基于中国人群单核苷酸多态性位点开发的同源重组缺陷（HRD）检测工具评估云南地区卵巢癌患者的HRD状态和BRCA1/2基因突变频率并探讨其临床意义。方法：共纳入2021年1月至2023年5月间在云南省肿瘤医院收治的卵巢癌患者248例，HRD状态采用基因组瘢痕评分法（GSS）（主要依据拷贝数的长度、类型、位置及基因组断片）或HRD评分法（杂合性缺失、端粒等位基因失衡及大片段移位等基因组不稳定事件的总和）进行评估，当组织样本的GSS≥50分或HRD评分≥42分者或检测到有害的BRCA1/2基因突变时HRD被定义为阳性。分析患者HRD状态与临床病理特征的关系。结果：248名卵巢癌患者中70.97%的患者HRD呈阳性，其中BRCA1/2基因突变率为30.65%。Ⅲ~Ⅵ期、高级别浆液腺癌的卵巢癌患者具有更高的HRD阳性率（均P<0.01），HRD评分更高的患者其合并其他基因突变的频率也越高（P<0.05）。HRD状态与卵巢癌的病理类型、临床分期和其他基因突变均有关联（均P<0.01）。结论：云南地区卵巢癌患者HRD阳性率较高，HRD阳性的卵巢癌患者可以从聚ADP核糖聚合酶（PARP）抑制剂治疗中获得更大的收益。