Object:The paper aims to analyze Taiwanese experience in pharmaceutical procurement, pharma-ceutical benefits and reimbursement schedule, and make references for the Mainland China. Methods:Through read-ing and analyzing the Taiwanese government policy and the literature published to find out the pharmaceutical pro-curement measures, different medicines’ pricing strategy and its reimbursement mode compared with the Mainland China. Results: Hospitals can purchase medicines based on their own needs, and the purchase price was formed through negotiating with providers and buyers. It has been found that Taiwan only controls the medicines reimburse-ment prices. The international reference pricing is adopted for new medicines, and the originators, bioequivalence/bioavailability generic medicines and general generics reimbursement prices are very high at international reference prices, and need to be weakened in order to fit the requirements. Moreover, the medicine quality is one of the stand-ards considered in case of making decisions on the reimbursement prices. In addition, the reimbursement price is as-sociated with procurement price. When the spread is larger than 30%, the government will adjust the reimbursement to fill the gap. Conclusions: Through the system design and adjustment, the Taiwanese Government have set up a better procurement and reimbursement co-ordination in the pharmaceutical segment, and formed the reasonable prices for the case. The Taiwanese experience can be taken as a reference for the mainland China to refine its procurement reforms and reimbursement policy.

Objective:To investigate the effect of continuous blood purification on the expression of cytokines in pig lungs during MODS.Methods:Twenty-five pigs were randomly divided into model group,control group and high volume hemofiltration(HVHF) group.Blood bio-chemical and organ function indexes were determined.Real-time quantitative PCR was used to determine the expression level of IL-6 mRNA and IL-8 mRNA and TNF-? mRNA. Results:After HVHF,the serum chemical and organ-function indexes were improved and the morbidity and mortality of MODS were much lower than those in model group.The expression level of IL-6 mRNA and IL-8 mRNA and TNF-? mRNA in the lung were reduced significantly compared with model group.And the expression level of cytokines associated mRNA in the lungs was interrelated with the rate of respiratory failure. Conclusion:HVHF could decrease the over-expression of cytokine mRNA in the lung after trauma when used at early period so that pulmonary function would be improved.

Aim To investigate the effects and mecha-nisms of theacrine on high fat diet induced hepatic steatosis in mice. Methods The C57BL/6J mice were fed with high fat diet for consecutive 17 weeks to induce hepatic steatosis and given a treatment of theac-rine for 6 weeks. The liver sections were stained with H&E or Sudan IV, and hepatic TG was determined by commercial analysis kits. Expression of SirT3 and phosphorylation of AMPK and ACC were measured by Western blot. Compound C was used to inhibit the phosphorylation of AMPK in HepG2 cells, and the ex-pressions of proteins were determined after the cells were treated with theacrine. Results Theacrine sig-
nificantly decreased hepatic TG content and ameliora-ted hepatic steatosis in mice. Expression of SirT3 and phosphorylation of AMPK and ACC were up-regulated, respectively. And theacrine still could activate SirT3 and up-regulate the phosphorylation of ACC whatever AMPK was inhibited. Conclusions The activation of ACC by theacrine depends on the phosphorylation of AMPK, but the activation of SirT3 by theacrine is in-dependent of the phosphorylation of AMPK. Theacrine ameliorates high fat diet induced hepatic steatosis in mice probably via SirT3/ AMPK/ ACC pathway.

Objective To evaluate the cost?effectiveness of seasonal influenza vaccination, compared to no vaccination, for the elderly aged ≥60 years old in China. Methods A static life?time Markov model is conducted to simulate the Chinese elderly population aged≥60 years old. Taking the health care system perspective, one?year analytic cycle length is used for each influenza season. The model was assumed to be repeated until the individual reaches 100 years old. Three interventions were evaluated, including no vaccination, annual trivalent influenza vaccination, and annual quadrivalent influenza vaccination. Using the threshold of 3 times GDP per capita per Quality?adjusted life year (QALY) (193 932/QALY), the incremental cost?effectiveness ratio (ICER) was calculated to compare the cost?effectiveness of every two interventions.Model inputs like data for costs and utilities were from studies on Chinese population if they were available. QALY was used to measure health utility. One?way sensitivity analysis and probabilistic sensitivity analysis were adopted to quantify the level of confidence of the model output. Results The total influenza associated costs of no vaccination would be 603 CNY per person, while the total costs of annual trivalent vaccination would be 1 027 CNY. Using trivalent vaccine would result in 0.007 QALY gained per person compared to no vaccination, with an increased cost of 424 CNY per person. The ICER of trivalent vaccination over no vaccination for all the elderly population in China would be 64 026 CNY per QALY gained, which was less than the threshold of 3 times GDP per capita. The total costs of annual quadrivalent vaccination would be 1 988 CNY. Using quadrivalent vaccine would result in 0.008 additional QALY gained per person compared to no vaccination, with an increased cost of 1 385 CNY per person. The ICER of quadrivalent vaccination over no vaccination would be 174 081 CNY per QALY gained, which was less than the threshold of 3 times GDP per capita. Conclusion Vaccinating elderly population would improve health utilities at higher health care costs for the elderly. Using the threshold of 3 times GDP per capita per QALY (193 932/QALY), both trivalent and quadrivalent vaccination would be cost?effective compared to no vaccination in elderly Chinese population.

Objective To evaluate the cost?effectiveness of seasonal influenza vaccination, compared to no vaccination, for the elderly aged ≥60 years old in China. Methods A static life?time Markov model is conducted to simulate the Chinese elderly population aged≥60 years old. Taking the health care system perspective, one?year analytic cycle length is used for each influenza season. The model was assumed to be repeated until the individual reaches 100 years old. Three interventions were evaluated, including no vaccination, annual trivalent influenza vaccination, and annual quadrivalent influenza vaccination. Using the threshold of 3 times GDP per capita per Quality?adjusted life year (QALY) (193 932/QALY), the incremental cost?effectiveness ratio (ICER) was calculated to compare the cost?effectiveness of every two interventions.Model inputs like data for costs and utilities were from studies on Chinese population if they were available. QALY was used to measure health utility. One?way sensitivity analysis and probabilistic sensitivity analysis were adopted to quantify the level of confidence of the model output. Results The total influenza associated costs of no vaccination would be 603 CNY per person, while the total costs of annual trivalent vaccination would be 1 027 CNY. Using trivalent vaccine would result in 0.007 QALY gained per person compared to no vaccination, with an increased cost of 424 CNY per person. The ICER of trivalent vaccination over no vaccination for all the elderly population in China would be 64 026 CNY per QALY gained, which was less than the threshold of 3 times GDP per capita. The total costs of annual quadrivalent vaccination would be 1 988 CNY. Using quadrivalent vaccine would result in 0.008 additional QALY gained per person compared to no vaccination, with an increased cost of 1 385 CNY per person. The ICER of quadrivalent vaccination over no vaccination would be 174 081 CNY per QALY gained, which was less than the threshold of 3 times GDP per capita. Conclusion Vaccinating elderly population would improve health utilities at higher health care costs for the elderly. Using the threshold of 3 times GDP per capita per QALY (193 932/QALY), both trivalent and quadrivalent vaccination would be cost?effective compared to no vaccination in elderly Chinese population.

Recombinant activated factor VII (rFVIIa) is a novel therapeutic agent for life-threatening massive gastrointestinal bleeding. We report a case of massive gastrointestinal bleeding in a 78-year-old female patient with respiratory and renal failure. After failure of management of the bleeding with routine pharmacotherapy, we gave the patient rFVIIa injection at the dose of 20 µg/kg and the bleeding was rapidly controlled. Adverse side effects of the drug were not observed in this patient.
Aged ; Factor VIIa ; therapeutic use ; Female ; Gastrointestinal Hemorrhage ; drug therapy ; Humans ; Recombinant Proteins ; therapeutic use ; Renal Insufficiency ; Respiratory Insufficiency

Objective:To evaluate the sleep disorders in patients with Parkinson′s disease (PD) with different onset sides, and to analyze the correlation between PD kinesia-onset side and sleep disorders.Methods:A total of 658 patients with primary PD admitted to the Special Outpatient Department of Parkinson′s disease in Fujian Medical University Union Hospital from January 2015 to March 2021 were collected. According to the onset side of motor symptoms, they were divided into the left group (313 cases) and the right group (345 cases). The medical history collection and physical examination were conducted to evaluate the motor symptoms, non-motor symptoms [Non-Motor Symptom Scale (NMSS)], depression state and cognitive function of the patients. Parkinson′s Disease Sleep Sclale-2 (PDSS-2) and the Rapid Eye Movement Sleep Behavior Disorder Screening Questionnaire (RBDSQ) were used to evaluate and analyze their sleep status, and comparisons were made between groups. Binary multivariate Logistic regression analysis was used to access the risk factors associated with sleep disorders in Parkinson′s disease.Results:The scores of daytime fatigue [2.00(0, 4.00)] and unexplained limb pain [4.00(0, 4.00)] in NMSS assessment of PD patients in the left onset group were significantly higher than those in the right onset group [1.00(0, 3.00), Z=-2.545, P=0.001; 2.00(0, 4.00), Z=-2.797, P=0.005]. There was no significant difference in the total score of PDSS-2 between the two groups, but there were significant differences in limb restlessness, periodic limb activity, muscle spasm and early drowsiness between the two groups. In the evaluation of rapid eye movement sleep behavior disorder (RBD), the total score of RBDSQ in the left onset group [2.00(0, 4.00)] was significantly higher than that in the right onset group [1.00(0, 3.00), Z=-4.363, P<0.001]. The incidence of dream content, nocturnal behavior, nocturnal exercise, self-injury and bed partner in dream, abnormal behavior at night, nighttime awakening, dream memory and sleep disorder in the left onset group was also higher than that in the right onset group. In addition, binary multivariate Logistic regression showed that PD-related sleep disorders were associated with onset of advanced age ( OR=1.037, 95% CI 1.018-1.057, P<0.001), course of disease ( OR=1.014, 95% CI 1.010-1.018, P<0.001) and onset of abnormal postural gait ( OR=1.505,95% CI 1.058-2.141, P=0.023). RBD in patients with PD was associated with left onset ( OR=2.215,95% CI 1.395-3.515, P=0.001), advanced age onset ( OR=1.045,95% CI 1.019-1.072, P=0.001) and course of disease ( OR=1.014,95% CI 1.009-1.019, P<0.001). Conclusions:PD patients with left onset are more likely to have sleep disorders such as limb restlessness, periodic limb activity, muscle spasm and early drowsiness. At the same time, the incidence and severity of RBD in patients with left onset of PD are significantly higher than those of patients with right onset of PD. The onset side of motor symptoms of PD is an important factor affecting sleep disorders, and the onset of left side may be a risk factor for PD patients with RBD.

Objective: To evaluate the cost-effectiveness of seasonal influenza vaccination, compared to no vaccination, for the elderly aged ≥60 years old in China. Methods: A static life-time Markov model is conducted to simulate the Chinese elderly population aged ≥60 years old. Taking the health care system perspective, one-year analytic cycle length is used for each influenza season. The model was assumed to be repeated until the individual reaches 100 years old. Three interventions were evaluated, including no vaccination, annual trivalent influenza vaccination, and annual quadrivalent influenza vaccination. Using the threshold of 3 times GDP per capita per Quality-adjusted life year (QALY) (193 932/QALY), the incremental cost-effectiveness ratio (ICER) was calculated to compare the cost-effectiveness of every two interventions.Model inputs like data for costs and utilities were from studies on Chinese population if they were available. QALY was used to measure health utility. One-way sensitivity analysis and probabilistic sensitivity analysis were adopted to quantify the level of confidence of the model output. Results: The total influenza associated costs of no vaccination would be 603 CNY per person, while the total costs of annual trivalent vaccination would be 1 027 CNY. Using trivalent vaccine would result in 0.007 QALY gained per person compared to no vaccination, with an increased cost of 424 CNY per person. The ICER of trivalent vaccination over no vaccination for all the elderly population in China would be 64 026 CNY per QALY gained, which was less than the threshold of 3 times GDP per capita. The total costs of annual quadrivalent vaccination would be 1 988 CNY. Using quadrivalent vaccine would result in 0.008 additional QALY gained per person compared to no vaccination, with an increased cost of 1 385 CNY per person. The ICER of quadrivalent vaccination over no vaccination would be 174 081 CNY per QALY gained, which was less than the threshold of 3 times GDP per capita. Conclusion Vaccinating elderly population would improve health utilities at higher health care costs for the elderly. Using the threshold of 3 times GDP per capita per QALY (193 932/QALY), both trivalent and quadrivalent vaccination would be cost-effective compared to no vaccination in elderly Chinese population.