International experiences have proved that a smooth health technology assessment ( HTA) decision-making transformation played a key role in maintaining a sustainable health system. Based on the knowledge/decision transformation theory, this paper proposed a novel framework for the analysis of HTA decision transformation models. The framework is the three-stage analysis which includes four stages of pre-cognitive preparation, core decision-making transformation and final results implementation, respectively. Using this analytical framework, this paper ana-lyzed and summarized the empirical experiences of HTA decision transformation in three typical countries including the United States, United Kingdom and Germany. Finally some policy recommendations and relevant concrete meas-ures were proposed to promote the construction of an HTA decision-making transformation system in China.

The chronic non-communicable diseases ( NCDs) cause a very big threat on the health of residents . Therefore , chronic disease management has always been an important part of China's health policy , and hence comes to be the main focus of our work .Through the literature research and related policies analysis , this paper reviews the chronic disease management in China from the macro-policy, meso-coordination between institutions and organiza-tions, and micro-patients and population levels of chronic disease management process to sort out induction .Based on the actual situation of the chronic disease management in China , this paper proposes policy recommendations to fur-ther implement the management of chronic conditions of China .Finally, several development proposals:China's fu-ture chronic disease management works should focus on refining theoretical model and frameworks ;constructing an in-tegrated network through combining the treatment of chronic disease management services with the implementation of healthcare reforms and the tiered-medical systems development; and accelerate the upgrading of chronic disease management's“terminal” capacity-building .

Germany has a similar health insurance system as China, and has already formed standardized management processes as well as efficient decision-making transformation paths for health technology assessment (HTA) that perform well mainly based on three major HTA institutions at the national level.The HTA decision-making transformation system in Germany has proven to be a typical representative in evidence-based decision-making for health policies worldwide.Based on the outcomes of literature analysis and field research, this paper summarizes the paths and methods of Germany's HTA decision-making transformation, and finally proposes several targeted policy recommendations to promote the HTA decision-making transformation in China.

Background and objectiveSurgical resection remains the mainstay of treatment for patients with early-staged thymic tumors, while chemotherapy is most commonly used in stage IV cases. As for locally advanced thymic tumors, especially those unsuitable for surgery, the optimal therapy is still controversial. hTus, we conducted this retrospective study by comparing three nonsurgical treatment modalities to ifnd some clues.Methods hTree treatment modalities were used in 42 pa-tients from October 2000 to December 2010, including radiotherapy (RT) alone, sequential chemoradiation (SCRT) and con-current chemoradiation (CCRT). Objective response rate (ORR), overall survival (OS) and toxicity of the three regimens were compared accordingly.Results The ORR in all 42 patients was 61.9%, and 5-year OS was 46%. The ORR of RT, SCRT and CCRT were 43.8%, 50% and 87.5%, respectively (RTvs SCRT,P=0.692; RTvs CCRT,P=0.009; SCRTvs CCRT,P=0.051). The 5-year OS of RT, SCRT and CCRT were 30%, 50% and 61.9%, respectively (RTvs SCRT,P=0.230; RTvsCCRT,P=0.011; SCRTvs CCRT,P=0.282). Eleven patients developed neutropenia of grade 3-4, with 7 in CCRT group and 4 in SCRT, respec-tively. Nine patients experienced esophagitis of grade 3 with 2 in RT, 3 in SCRT and 4 in CCRT. There were also two cases of grade 3 radiation induced pneumonitis in CCRT group. No life-threatening side effects were noted.Conclusion When used to treat locally advanced thymic tumors unsuitable for surgery, CCRT performed more favorably than RT alone or SCRT in both tumor response and long time survival, but probably with the increasing risk of pulmonary damage. CCRT may offer the best chance of disease control in the management of locally advanced disease.