1.Structure of economic and technical indicator in centralized bidding procurement of essential medicines in China
Zhigang GUO ; Xiaodong GUAN ; Baomin WANG ; Na GUO ; Sheng HAN ; Luwen SHI ; Xiaolin YUE
Chinese Journal of Health Policy 2015;(6):27-33
Objective: To improve the economic and technical indicator’s evaluation system and the essential medicines’ centralized bidding procurement practice in China. Methods:By using the literature analysis, comparative analysis and field survey, we collected and analyzed the implementation plans and regulations for the essential medicines’ centralized bidding procurement in 30 provinces. Results: The quality level classification lacks in preci-sion. The economic and technical indicator’s concentration grade is low, the score and content in each indicator un-reasonably fluctuates in different provinces and these indicators are of low efficiency in bond with their structures for the drug quality evaluation. The quality level indicator lacks in the distinction degree and the government’s unreason-able interference exists in competition. Conclusions and suggestions: The quality levels’ indicator type and number should be simplified. The economic and technical indicators’ function, content, score, weight value and the structure should be normatively and scientifically set to improve the efficiency during the drug quality evaluation and the gov-ernment should strive to play their role in the market.
2.Influencing factors of quantity-based pricing in the essential medicines’ centralized bidding procurement in China
Zhigang GUO ; Dongzhe HONG ; Yi LIU ; Na GUO ; Baomin WANG ; Sheng HAN ; Luwen SHI ; Xiaodong GUAN
Chinese Journal of Health Policy 2015;8(12):1-6
Objective:The paper aims to provide recommendations for improving the essential medicines’ cen-tralized bidding procurement and quantity-based pricing policy. Methods: Based on the documents and literature on essential medicines’ centralized bidding procurement, we analyzed the factors which have a great impact on implemen-tation of the quantity-based pricing in essential medicines’ centralized procurement using the text research, semi-structured interview questionnaire and on-phone interviews. Results:The quantity-based pricing needs to define a ge-neric name and specific dosage form of drugs in the essential medicines’ centralized procurement. Its implementation was mainly influenced by the following factors:the procurement area accessibility, the pharmaceuticals category, dis-ease and drug alternative procurement methods and cycle, the payment and settlement time, and irregularities in the procurement process. Suggestions:During this implementation, we also need to clearly predict the quantity and pro-curement method, set up a proper policy environment for a quantity-based pricing, cancel the price linkage mecha-nism, strictly put into practice the payment deadline, employ a unique billing method and strengthen the information construction for the provincial centralized procurement platform. Some medicines’ quantity-based pricing should be carried out in the chosen pilots for laying a good foundation for its promotion.
3.Comparison and analysis of centralized bidding procurement of essential medicines in Chinese provinces
Xiaodong GUAN ; Zhigang GUO ; Xiaoxiong XIN ; Dongzhe HONG ; Sheng HAN ; Baomin WANG ; Luwen SHI
Chinese Journal of Health Policy 2014;(11):19-23
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.
4.Free pharmaceutical policy to promote equity and access:Its implications for China
Xiaodong GUAN ; Baomin WANG ; Xiaoxiong XIN ; Zhigang GUO ; Sheng HAN ; Luwen SHI
Chinese Journal of Health Policy 2015;(2):54-59
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.
5.Research progress of growth factors in the pathogenesis and developments of myopia
De-Long, SHI ; Jian-Feng, WU ; Guo-Ping, LI ; Hong-Sheng, BI
International Eye Science 2016;16(7):1273-1275
Myopia is one of the most popular eye diseases all over the world. The development of the current understanding of its mechanism is still limited. Many studies indicated that the growth factors closely related to eye development and myopia. Some growth factors with biological activity, such as transforming growth factor ( TGF ), fibroblast growth factor ( FGF ) and epidermal growth factor ( EGF ), have an impact on scleral thickness variation, the regulation of the development of myopia and so on, which plays a non-negligible role in the pathogenesis of myopia. In this paper, the function of various growth factors in myopia will be reviewed.
6.Relationship between the Ratio of Plasma Adrenomedullin/Endothelin-1 and Neuron-Specific Enolase in Full-Term Neonates with Hypoxic-Ischemic Encephalopathy
shi-fa, ZHANG ; ming-xiong, ZHOU ; shuang-gen, MAO ; chang-sheng, DOU ; guo-cheng, XU
Journal of Applied Clinical Pediatrics 1986;0(02):-
Objective To explore the relationship of the ratio of plasma adrenomedullin(AM)and endothelin-1(ET-1)with serum concentration of neuron-specific enolase(NSE)in full-term neonates with hypoxic-ischemic encephalopathy(HIE).Methods Plasma concentrations of AM,ET-1 and serum NSE from 32 full-term neonates with HIE were detected by radioimmunoassay(RIA)on the 1,3 and 7 d after parturition,30 neonates in the corresponding periods in our hospital were employed as controls.The infants with HIE were divided into mild,moderate or severe group in terms of diagnostic standard of HIE.Results 1.Plasma concentrations of AM and ET-1 in newborns with mild,moderate or severe HIE were significantly higher than that of control group at 1 d after life with a decline from 3-7 d(Pa
7.Study on toxicity mechanism(s) of ifosfamide in suspending cultured rat hepatocytes
chang, SHI ; Ming-yang, LIAO ; Qiao-Zhen, GUO ; He-Zhang, SHENG
Bulletin of The Academy of Military Medical Sciences 2001;25(1):27-30
Objective:To study the toxicity mechanism(s) of ifosfamide(Ifo) in suspending cultured rat hepatocytes.Methods:Hepatocytes of adult rat were isolated using two-step perfusion method and cultured suspendingly. Cell viability,intracellular enzyme leakage, contents of sulfhydryl groups and MDA contents of hepatocytes were examined 3 hours after ifosfamide was administered at 5,10,20 mmol/L. Surface and ultrastructure of hepatocytes were also observed. Results:Cell viability and TSH,NPSH,PSH contents of hepatocytes significantly declined, and LDH,AST activities in media increased due to the leakage of intracellular enzymes. The decrease in PSH content was ascribed to depletion of TSH. The higher the dose was, the more serious these changes became. However, MDA contents of the hepatocytes were not found increased at any ifo dose groups. In pathological examination, “bulla" formation was found on the surface of the hepatocytes, deformation,swelling even vacuolation of mitochondria and dilation of rough,smooth endoplasmic reticulum were also observed. Conclusions:Ifo has toxic effect on suspending cultured rat hepatocytes. The decrease in sulfhydryl groups contributes to the hepatotoxicity induced by Ifo.
8.1H NMR based metabonomics study on the antidepressant effect of genipin in rat hippocampus.
Guo-Jiang PENG ; Bi-Yun SHI ; Jun-Sheng TIAN ; Shan GAO ; Xue-Mei QIN
Acta Pharmaceutica Sinica 2014;49(2):209-216
The purpose of this study is to explore depression metabolic markers in rat hippocampus and to investigate the anti-depressant effect of genipin and its mechanisms using nuclear magnetic resonance (NMR) metabonomics. Chronic unpredictable mild stress (CUMS) procedure was conducted to establish the depressive rat model. At the beginning of the third week, genipin low dose (25 mg x kg(-1)), middle dose (50 mg x kg(-1)), high dose (100 mg x kg(-1)), and venlafaxine (50 mg x kg(-1)) were given to the CUMS rats separately once daily for two weeks except control and model groups. Rat hippocampus was analyzed by 1H NMR based metabonomics after drug administration for 2 weeks. Significant differences in the metabolic profile of rat hippocampus of the CUMS treated group and the control group were observed with metabolic effects of CUMS including decreasing in glycine and N-acetylaspartate, increasing in inositol, glutamate, lactate, glutamine, taurine and alanine. Genipin showed ideal antidepressive effects at a dose of 50 mg x kg(-1) in rats, decrease of inositol, glutamate, lactate, alanine were observed, while glycine and N-acetylaspartate were increased. Important influence has been found on normal nervous system function of these significant changed metabolites, which suggests that the antidepressant effect of genipin may be played by enhancing the activity of neurons in hippocampus, repairing and improving the function of the neuron. The metabonomics approach is an effective tool for the investigation of the anti-depressant effect and pharmacologic mechanisms of genipin.
Alanine
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metabolism
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Animals
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Antidepressive Agents
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isolation & purification
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pharmacology
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Aspartic Acid
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analogs & derivatives
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metabolism
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Behavior, Animal
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drug effects
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Chronic Disease
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Depression
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drug therapy
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metabolism
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physiopathology
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Gardenia
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chemistry
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Glutamic Acid
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metabolism
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Glycine
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metabolism
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Hippocampus
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drug effects
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metabolism
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Inositol
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metabolism
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Iridoids
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isolation & purification
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pharmacology
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Lactic Acid
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metabolism
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Magnetic Resonance Spectroscopy
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Male
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Metabolomics
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Plants, Medicinal
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chemistry
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Rats
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Rats, Sprague-Dawley
9.Studies on digestive enzyme activity of Whitmania pigra in different months old.
Hong-zhuan SHI ; Hong LIU ; Qiao-sheng GUO ; Jia WANG ; Fei LIU ; Meng-meng LI
China Journal of Chinese Materia Medica 2015;40(14):2796-2799
Studies on the variation of amylase, lipase and lrotease activity of Whitmania pigra in 0-6 months old using 3, 5-dinitro- salicylic acid colorimetry, right-nitrophenyl palmitate ester (ρ-NPP) colorimetry and folin-phenol method. The results showed that pro- tease activity remained low before 1.5 months old and with the highest activity in 2 months old, but after showing a small peak in 4 months, alkaline protease rapid declined. Amylase was low at born, then gradually increased the activity of the highest in 2.5 months old. Lipase with a strong vitality at birth, then 1 month with minimum and 2 months peaked, but appeared a small peak in 4 months old. In summary, only lipase exhibits strong activity at birth, lipase with the strongest activity in the digestive tract during develop- ment. Protease, lipase and amylase with the strongest activity at 2-3 months old, but were decreased after 4 months old.
Age Factors
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Amylases
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metabolism
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Animals
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Leeches
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enzymology
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Lipase
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metabolism
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Peptide Hydrolases
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metabolism
10.Dosimetric study of three dimension therapy plans in patients with squamous cell carcinoma of tongue receiving postoperative intensity-modulated radiotherapy or conventional radiotherapy
Hai-sheng, HU ; Chao, YAN ; Hui-feng, SHI ; Zhong-he, WANG ; Ming, GUO
Journal of Shanghai Jiaotong University(Medical Science) 2009;29(6):698-701
Objective To evaluate the dose distribution in clinical target volume (CTV) and organs-at-risk (OARs) in three dimension therapy plans in patients with squamous cell carcinoma of tongue receiving postoperative intensity-modulated radiotherapy (IMRT) or conventional radiotherapy (CRT) by dosimetric study. Methods Thirty-five patients with squamous cell carcinoma of tongue were divided into CRT group(n=17) and IMRT group(n=18). All patients underwent head-and-neck immobilization with a thermoplastic mask and planning CT scan, and target volume and OARs were contoured. Dose calculation and plan optimization were performed. All three dimension plans passed quality assurance before treatment. The dosimetry of therapy plans with IMRT or CRT in target volume and OARs dose distribution was compared by dose-volume histogram (DVH), conformity index (CI) and homogeneous index (HI). Results There were significant differences in D95 (isodose line to cover 95 percent target volume), CI, HI, minimum dose and maximum dose in CTV of therapy plans between patients with IMRT and CRT(P < 0.01), and there was no significant difference in mean dose of CTV(P > 0.05). The radiation dose on salivary glands (both parotid glands and contralateral submandibular gland) in patients with IMRT was significantly lower than that in patients with CRT(P < 0.01). Conclusion Compared with dose distribution of CRT plans, there are more advantages in improving dose distribution at the target volume and sparing salivary glands in IMRT therapy plans in patients with squamous cell carcinoma of tongue.