OBJECTIVE:To explore the feasible program of independent financing for essential medicines. METHODS:Based on the comprehensiveness of national essential medicine system and the value chain of while essential medicines,the feasibility of independent financing to supplying,application and payment was analyzed,and finally the feasible program of independent financ-ing for essential medicines was put forward. RESULTS & CONCLUSIONS:Making full use of financial subsidies,individual con-tribution and medical insurance balance fund,with appropriate supplementary financing can establish the compensation fund. The unified compensation fund is used for providing financial support for fixed-point production of scarce essential medicines;compen-sating production enterprises supplying essential medicines;compensating medical institutions equipped with essential drugs;provid-ing“secondary compensation”to patients purchasing essential medicines. Complete system of financing,supplying,application and payment for medicines should be further designed after“medicine separation”.

OBJECTIVE:To research the effect of price change on pharmaceutical enterprises in China to improve the assess-ment of drug pricing. METHODS:Market share,competitive products’price and substitutes of the elasticity of drug price were an-alyzed to receive the effect of price change on pharmaceutical enterprises. RESULTS:The market share of homogeneous drugs for a same disease had positive correlation with price change,that is to say,if raised the price,its market share was on the rise;in terms of the effects on the price of competitive products and substitutes,the drug price change in an enterprise had a positive effect on the price of competitive products and substitutes. CONCLUSIONS:Price change of drugs has effect on market share and the price of competitive products and substitutes. Therefore,according to the price index,the enterprise can predict the market share and the price of competitive products and substitutes to assess the effect of drug quotation on the enterprise itself and external envi-ronment.

Objective To investigate how internet using (both time and activities)and effortful control would contribute to the sex difference of problematic internet use (PIU).Methods A total of 844 adolescents aged 9-20 years old were selected from Chinese Academy of Sciences twin-sample by simple random sampling,with boys accounting for 45.6％ and girls accounting for 54.4％.The internet using and effortful control were measured using self-report questionnaires in the first time(T1),the problematic internet use were measured after one and half years (T2).The difference and relation of Internet using,effortful control and problematic internet use between boys and girls were measured with Chi-square test,t test and correlation analysis.The moderating effect of sex between internet using and PIU were explored by utilizing regression analysis.The mediation effect of effortful control between sex and PIU were explored with Sobel test.Results The anverage internet time of working day and weekend in boys were 1.52 h and 2.12 h respectively.The average internet time of working day and weekend in girls were 1.49 b and 2.05 h respectively.Significant difference between boys and girls is not existed in the internet time (t=0.541,0.907,P＞0.05).And the boy was inclined to game(x2 =47.669,P＜0.01).The effortful control of boys and girls were 54.09 and 55.76 respectively.The score of boys' and girls' PIU were 22.48 and 20.72 respectively.Boys' effortful control was significantly lower than that of girls (t=-2.879,P＜0.01).The score of boys' PIU was significantly higher than that of girls' (t=3.612,P＜0.01).Adolescents' PIU were significantly correlated with the time,entertainment and social activities (r=0.249,0.175,0.140,P＜0.01).The moderating effect of sex was significant in the relation between internet time and PIU.Significant mediation effect of effortful control existed in the PIU difference between boys and girls(Z=-2.54,P＜0.05).Conclusion Significant mediation effect of effortful control exists in gender and PIU.

Objective: To investigate the influencing factors for social alienation among the elderly patients with type 2 diabetes mellitus (T2DM), so as to provide insights into formulating targeted intervention measures. Methods: T2DM patients aged 60 years and older were selected from Hangzhou First People's Hospital from January to October 2023. Their demographics, diabetes complications were collected using questionnaire surveys, social support level was evaluated using the Social Support Scale, and the stigma was evaluated using the Chinese version of the Type 2 Diabetes Stigma Assessment Scale, and the social alienation was assessed using General Alienation Scale. Factors affecting the social alienation were identified among the elderly patients with T2DM using a multiple linear regression model. Results: A total of 316 elderly patients with T2DM were investigated, including 171 males (54.11%) and 145 females (45.89%), and had a mean age of (69.75±8.12) years. The level of social support was mainly medium, with 162 cases accounted for 51.27%. The average stigma scores were (61.87±12.50) points, and average social alienation scores were (42.09±6.33) points. Multiple linear regression analysis identified educational level (high school/junior college, β'=-0.159; college and above, β'=-0.301), marital status (married persons, β'=-0.236), monthly household income (3 000 Yuan and more, β'=-0.175), diabetes complications (β'=0.192), social support level (medium, β'=-0.210; high, β'=-0.352) and stigma score (β'=0.283) as factors affecting the social alienation among the elderly patients with T2DM. Conclusion The social alienation among the elderly patients with T2DM are associated with educational level, marital status, family income, diabetes complications, social support level and stigma.

OBJECTIVE:To provide reference for the price management of medicines in Chinese mainland by inquiring into rel-ative management in Hong Kong. METHODS:Based on the steps of price management and the value chain of medicines in Hong Kong,the management mechanism of medicine pricing,circulation and compensation were researched. RESULTS & CONCLU-SIONS:The prices of the medicines in Hong Kong are mainly determined by the tender between Hospital Authority and the pharma-ceutical suppliers. In circulation,medicine payer as main body in bidding and purchase conducthigh qualitybidding andmasspurchase,and price remained the same in public hospital. On the basis of the purchase price,the price that actually paid by pa-tients is the result of government compensation. Chinese mainland can draw lessons from such drug bidding mode in Hong Kong which will lead health care department to act as the main body in bidding,weaken the relationship between the hospitals and the drug dealers or manufacturers,and expand the government's financial investment in public medical institutions to improve reim-bursement.

OBJECTIVE:To explore price management mechanism of medical service in Macau of China,and to provide refer-ence for the formulation of price management mechanism of medical service in the mainland area of China. METHODS:From two key links of pricing and compensation,price management mechanism of medical service in Macau was introduced. RESULTS &CONCLUSIONS:In respect of pricing,Macau Health Bureau as pricing subject set up guide price for public health institutions by marginal cost pricing,which focused on technology value and labor value of medical staff,and graded pricing for health institu-tions at various levels. In respect of compensation,compensation subjects included government,social security funds,charitable or-ganization,etc. The government provided fixed-rate compensation for citizen by allocating funds for public health institutions,so as to improve compensation level for primary health institutions. The social security funds extended sick benefit to insured patients, and compensated patients at fixed rate. Charitable organization subsidized private health institutions to reduce medical service price. Finally,actual price has been formulated through pricing and compensation links,and the experience is worthy of learning by the mainland of China.

Objective To evaluate and screen the concentration and coordination degree of the opinions of the experts in TCM pediatrics on the preventive method of Practice Guidelines to Prevent Disease for Recurrent Respiratory Tract Infections in Children Prevented by Sachet-Therapy;To formulate scientific and practical methods for perfume pouch wearing in this book. Methods Delphi method was applied to this research. All questionnaires were designed based on the literature research and distributed to more than 30 experts for 3 rounds. And the results in the first two rounds of survey were analyzed. Results Totally 31 and 33 valid questionnaires were received in the first and second time respectively. The experts’ activity index was 88.6% and 93.4% respectively. The perfume pouch wearing methods of Practice Guidelines to Prevent Disease for Recurrent Respiratory Tract Infections in Children Prevented by Sachet-Therapy was set down. And most of the experts shared a positive view on the concentration and coordination degree of this book. Conclusion The experts’ opinions upon this draft are quite positive. The experts are from all over China, and they are quite professional, with representativeness. The perfume pouch wearing methods of Practice Guidelines to Prevent Disease for Recurrent Respiratory Tract Infections in Children Prevented by Sachet-Therapy are generally recognized by the experts. However, there are still some different ideas in terms of some indexes, which need to be further discussed.

OBJECTIVE:To provide reference for improving the rational drug use of China. METHODS:By referring to In-dia,South Africa and Argentina's policy in this regard,the rational drug policy rules and supporting measures in the national drug policy of these states were analyzed and summarized to put forward related policies for China. RESULTS & CONCLUSIONS:Pro-moting the rational drug use required multi-angle managements towards the supply-side,the demand-side as well as third-party, and relevant supporting measures needed to be improved. Firstly,the managements on the supply-side is particularly important,in-cluding measures such as strengthening prescription management,formulating and implementing the standard treatment guidelines, intensifing the functions of pharmacists,establishing serious irrational drug use and specific diseases medication management sys-tem;then,the demand-side needs the investigation and feedback about the patients with drug use to eliminate irrational drug use, and through the internet and other media to raise public awareness of the medicine information as well;besides,the third-party needs to establish a non-profit organization to regulate pharmaceutical advertisements,and increase information about rational drug use;finally,improving the rational drug policy also needs to improve needs to promote the separation of medicine,reform Medi-care payment and other supporting measures.

Background and purpose: Epithelial ovarian carcinoma is the most malignant tumor in female reproductive system because of its resistance to chemotherapy. Fructose-1, 6-bisphosphatase (FBP1) is a rate-limiting enzyme in gluconeogenesis used to catalyze the hydrolysis of fructose-1, 6-bisphosphate to fructose-6-phosphate and inorganic phosphate, thereby inhibiting the effect of glycolysis in tumor cells. This study aimed to investigate the association between the expression of FBP1 and chemosensitivity. Methods: The expression level of FBP1 in ovarian cancer patients was measured by immunohistochemistry. Results: According to the results of immunohistochemistry in 209 ovarian carcinoma specimens, the percentage of positive FBP1 expression was about 49.3% (103/209). Loss of FBP1 was a negative factor of survival (42.6 months vs 62.1 months, P=0.003). Besides, patients who were sensitive to chemotherapy displayed significantly higher scores of FBP1 expression than patients who were resistant to therapy (P=0.007). Conclusion: The rate-limiting enzyme FBP1 in gluconeogenesis can be used as a biomarker for predicting the chemoresistance and prognosis of ovarian cancer patients.

Background The suppression of retinal angiogenesis is one of primary treatment targets for retinal vascular diseases,so seeking the intervention targets of retinal neovascularization is a hot research.Studies showed that insulin-like growth factor 1 (IGF-1) can promote the growth and restrain the apoptosis of vascular endothelial cells.However,whether IGF-1 is an intervention target for the treatment of retinal vascular diseases is unelucidated.Objective This study was to address the effects of IGF-1 on the migration,apoptosis and capillary tube formation of human retinal vascular endothelial cells (HRECs) and mechanism.Methods HRECs were cultured in vitro,and the cells in the exponential phase were prepared for subsequent experiments.The expression of IGF-1R mRNA in the cells was examined using reverse transcriptase PCR assay.Different concentrations of IGF-1 were added in the medium based on the difference of tests.The relative free-cell area difference (△S) after test was measured by Photoshop CS4 software and compared among 0,10 and 200 ng/ml IGF-1 groups 12 and 24 hours after cell scratching,respectively.The cell apoptotic rate was assayed by flow cytometry and compared between 0 ng/ml IGF-1 group and 1 000 ng/ml IGF-1 group,and the number of capillary tubes was examined by Matrigel test and assessed among 0,10,100 and 200 ng/ml IGF-1 groups 24 hours after addition of IGF-1.The expressions of platelet derived growth factor (PDGF)-BB mRNA and caspase-3 mRNA in the cells of the 0,500 and 1 000 ng/ml IGF-1 groups were detected by real-time fluorescence quantitative PCR after adding IGF-1 for 6 hours.Results Cultured cells grew well and attached 90％ confluence 2-3 days after incubation,and IGF-1R mRNA was positively expressed in the cells.In 12 and 24 hours after scratching,the relative migrating area of the cells was gradually reduced with the increase of IGF-1 contents.The △S was (4.83 ± 0.61) × 105 μm2 in the 200 ng/ml IGF-1 group,which was significantly larger than (3.28±0.64) ×105 μm2 in the 0 ng/ml IGF-1 group 24 hours after stretching (t=-3.707,P=0.021).The apoptotic rate in the 0 ng/ml IGF-1 group and 1 000 ng/ml IGF-1 group was (18.77±2.37) ％ and (12.05 ±0.88) ％,with a significant difference between them (t =2.869,P =0.046).The number of intact tubes was significantly increased in the 200 ng/ml IGF-1 group compared with the 0 ng/ml IGF-1 group ([20.33±2.83]/well vs.[17.94± 1.96]/well;t =-2.940,P =0.042).Compared with 0 ng/ml IGF-1 group,the relative expression level of PDGF-BB mRNA was elevated and that caspase-3 mRNA was evidently reduced in the 1 000 ng/ml IGF-1 group (t=-3.489,P =0.025;t =7.287,P =0.002).Conclusions IGF-1 can promote the migration and angiogenesis of HRECs and inhibit the apoptosis of HRECs.These effects of IGF-1 probably are associated with the up-regulation of PDGF-BB and down-regulation of caspase-3 in the cells.