OBJECTIVE:To provide reference for improving the drug price regulation policy in China. METHODS:Literature research,system comparison and other methods were used to summarize the commonalities and characteristics of drug price regula-tion policy in Germany,Japan and Taiwan area of China,and the successful experience was learned. RESULTS & CONCLU-SIONS:Drug price management in Germany,Japan and Taiwan area of China has their own characteristics. Germany conducted reference price system and new drug pricing mechanism,which was the first country to introduce the reference price system. Japan granted price premiums to innovative drugs,decreased pricing for generic drugs and adjusted drug price again. And Taiwan area of China classified and grouped differential pricing to encourage competition negotiation and regularly investigated drug prices and pric-ing. Germany,Japan and Taiwan area regard medicare pay price as core of drug price management,adopt comprehensive means to regulate the drug price,and pay attention to the monitoring and regular adjustment of market price as well. Price negotiation,phar-macoeconomics and multiple pricing methods are broadly used. Value-based drug pricing system is new trend of price policy re-form. It can be used for reference to improve the drug price regulation system in China.

Objective To investigate the risk factors of reversible posterior leukoencephalopathy syndrome (RPLS) in pre-eclampsia or eclampsia gravida. Methods This study was conducted in the Third Affiliated Hospital of Guangzhou Medical University between January 2013 and March 2016. A total of 100 patients who had no severe neurological diseases and were diagnosed pre-eclampsia or eclampsia, and underwent brain MRI were collected retrospectively. They were divided into 2 groups according to the MRI results, the RPLS group (n=49) and the non-RPLS group (n=51). The medical history, clinical symptoms and the results of laboratory examination were analyzed by the logistic regression, in order to explore the risk factors.Results In single factor analysis, HELLP syndrome, pregnancy associated with other diseases, poor prenatal care, grade 3 hypertension, elevated systolic blood pressure or diastolic blood pressure, elevated WBC, aspartate transaminase (AST), alanine aminotransferase (ALT), uric acid (UA) and lactate dehydrogenase (LDH), decreased platelet (PLT), headache, visual changes, seizures and conscious disturbance were more frequent in the RPLS group than those in the non-RPLS group (all P<0.05). According to the multivariate logistic regression analysis, the elevated WBC (OR=1.291, 95%CI:1.058-1.575, P=0.012), UA (OR=1.008,95%CI:1.001-1.016,P=0.032) and headache (OR=18.260, 95%CI:3.562- 93.607, P=0.000) were the independent risk factors.Conclusions Maternal history, clinical symptoms and some laboratory examinations might help in the early diagnosis of RPLS in pre-eclampsia or eclampsia gravida. Headache, the elevation of WBC and UA were the most significant factors.

Objective To investigate the effect of electroacupuncture (EA) pretreatment on neurological function, and the expression of Toll-like receptor 4 (TLR4) and nuclear factorκB (NF-κB) protein in ischemic penumbra after cerebral ischemia-reperfusion (CIR) injury. Methods A total of 36 male Sprague-Dawley rats were randomly divided into sham group (n=12), model group (n=12) and EA group (n=12). The later two groups were occluded their right middle cerebral arteries for two hours and reperfused. The EA group was pretreated with EA at Baihui (GV20) for two weeks before modeling. They were assessed with modified Neurological Severity Scores (mNSS), the injury in ischemic brain was detected with HE staining, and the expression of TLR4 and NF-κB protein in ischemic penumbra were detected with Western blotting, 24 hours after reperfusion. Results The score of mNSS decreased (P<0.05), the injury of brain tissue ameliorated, and the expression of TLR4 and NF-κB decreased in ischemic penumbra (P<0.05) in EA group compared with those in the model group. Conclu-sion EA pretreatment can reduce the injury and improve the neurological function in rats after CIR by down-regulating the expression of TLR4 and NF-κB protein in ischemic penumbra.

OBJECTIVE:To investigate the condition and characteristics of drug-induced liver injury (DILI) of anti-infective agents and provide reference for the prevention and treatment of anti-infective agents related DILI. METHODS:Based on retrospective analysis,a total of 572 DILI reports of anti-infective agents were collected from PLA ADR monitoring center during 2009 to 2013, and then analyzed statistically in terms of patient’s age and gender,main diagonosis,categories of DILI-inducing drugs,type,route of administration,occurrence time,lab indicator,DILI types and clinical manifestations,the application of liver protective drugs,out-comes,etc. RESULTS:Among 572 DILI cases,there were 412 cases(72.03%)of male patients and 160 cases(27.97%)of female patients,and average age of the patients was(44.54±23.75)years old. ADRs were related to 57 kinds of anti-infective agents in 6 cat-egories. Rifampin was the most frequent in suspected drugs,followed by isoniazid,moxifloxacin,fluconazole,azithromycin,cefurox-ime, cefoperazone/sulbactam, levofloxacin, cefoxitin and voriconazole. Intravenous infusion was the main administration route (74.48%). The occurrence time of ADRs was mainly within two weeks (86.19%). Hepatocellular damage (93.33%) was the main type in 360 cases of ADR for evaluation of liver injury types. The majority of cases(82.17%)were cured or improved after drug with-drawal and symptomatic treatment. CONCLUSIONS:Cephalosporin,fluoroquinolones,antituberculosis and antifungal drugs might be the common agents which caused liver injury. Hepatocellular damage is the most frequent type. Most of patients have a favourable prognosis. Clinical medical staffs should strengthen the awareness of DILI caused by anti-infective agents and ehance the prevetion of it.

Objective To investigate the risk factors for covert hepatic encephalopathy (CHE) in patients with liver cirrhosis and their influence on prognosis. Methods A total of 416 patients with liver cirrhosis who were hospitalized in a grade A tertiary hospital in Chongqing from September 2019 to June 2020 were enrolled in the study, and according to the presence or absence of CHE, they were divided into CHE group with 212 patients and non-CHE group with 204 patients. Clinical data and laboratory examination results were collected, and follow-up was performed for 6 months. The t -test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the chi-square test, the continuous correction chi-square test, and the Mann-Whitney U test were used for comparison of categorical data between groups. Univariate and multivariate logistic regression analyses were used to analyze the risk factors for CHE. Results The incidence rate of CHE was 51%. The univariate analysis showed that age, course of disease, the medical history of hepatic encephalopathy (HE), infection, ascites, electrolyte disturbance, hepatorenal syndrome, Child-Pugh class, prothrombin time, total bilirubin, creatinine, platelet, prothrombin activity, albumin, and Model for End-stage Liver Disease (MELD) score were the influencing factors for CHE (all P < 0.05). The multivariate logistic regression analysis showed that the medical history of HE ( OR =10.848, 95% CI : 4.971-23.674, P < 0.05), transjugular intrahepatic portosystemic shunt (TIPS) ( OR =4.334, 95% CI : 1.203-15.621, P < 0.05), Child-Pugh class ( OR =4.968, 95% CI : 1.299-18.992, P < 0.05), and MELD score ( OR =1.253, 95% CI : 1.161-1.352, P < 0.05) were independent predictive factors for CHE ( P < 0.05). The follow-up study showed that CHE had an effect on the short-or medium-term readmission, HE, and death of patients (all P < 0.05). Conclusion CHE has a relatively high incidence rate and greatly affects the prognosis of patients with liver cirrhosis. The development of CHE should be taken seriously in patients with a past history of HE, a history of TIPS, Child-Pugh class C liver function, and a high MELD score, and identification, screening, and intervention should be performed as early as possible to improve the prognosis of patients with liver cirrhosis.