OBJECTIVE:To systematically review the efficacy and safety of Calf spleen extract injection combined with chemo-therapy in the treatment of cancer,and provide evidence-based reference for clinical treatment. METHODS:Retrieved from Co-chrane Library,PubMed,Medline,EMBase,CJFD,Wanfang and VIP Database,randomized controlled trials(RCT)of the effica-cy and safety about Calf spleen extract injection combined with chemotherapy in the treatment of cancer were collected. Meta-analy-sis was performed by using Rev Man 5.0 software after data extract and quality evaluation by Cochrane 5.0. RESULTS:Totally 23 RCT were enrolled,including 1 682 patients. Results of Meta-analysis showed Calf spleen extract injection combined with chemo-therapy in the treatment of cancer can significantly improve the effective rate [OR=2.17,95%CI(1.68,2.81),P<0.001] and im-provement rate of life quality [OR=4.26,95%CI(2.47,7.32),P<0.001] and also reduce the degree rate of WBC and PLT,the inci-dence rate of nausea and emesis,the differences were statistically significant. CONCLUSIONS:Calf spleen extraction injection combined with chemotherapy has good efficacy and safety in the treatment of cancer.

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.

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.

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.

OBJECTIVE:To provide reference for dynamic adjustment of low-cost medicine lists and better guarantee of low-cost supply in those provinces,autonomous regions and municipalities[referred to provinces(autonomous regions or municipali-ties)]. METHODS:The varieties and frequency of medicines in the national and 31 province(autonomous regions or municipali-ties) lists were counted,and the influential factors were analyzed. RESULTS:The National Low-cost Medicine List included 533 varieties of medicines,including 283 western medicines,250 Chinese patent medicines and 60 exclusive varieties. There were total-ly 973 varieties of medicines in the 31 province(autonomous regions or municipalities),including 332 western medicines,630 Chi-nese patent medicines,11 ethnic medicines and 71 protected Chinese medicines. There was no big difference in the varieties be-tween the eastern and western areas,and less in the central areas. Guangxi province had the largest number of selected medicines (345 varieties) and Jiangxi province had the smallest (10 varieties). In all the varieties,Chinese medicines had a larger number than western medicines,and also better concentration. Ketotifen was the most frequent western medicine and Tongbianling capsule was the most frequent Chinese patent medicine,which appeared 30 and 29 times separately. The Provincial Low-cost Medicine Lists and the Essential Medicine Supplement Lists had a poor coincidence rate,and there was a moderate correlation between the varieties and the number of pharmaceutical manufacturers in the province(autonomous regions or municipalities). CONCLUSIONS:The adjustment of low-cost medicine lists should be combined with these in province(autonomous regions or municipalities) near-by,and notice the linkage with national essential medicine system to fundamentally ensure the clinical medication requirements of patients.

Genuine medicinal materials with special characteristics of Traditional Chinese Medicine (TCM), is recognized as high quality medicine. Both ancient records and modern research considered that the origin is an important reason for the formation of genuine medicinal materials. However, blindly transplanting of genuine medicinal materials has led to the quality decline and counterfeit medicines appeared in production or sale progress, which may increase the risk of accidents in TCM. Frequent accidents emerged in Chinese herbal affects its export. What's more, it is a great threat to the medication safety in TCM clinical. There is an urgent need to implement traceability systems of TCM, which could provide convenient information record and traceability of TCM circulation. This paper reviews a variety of technical methods for genuine medicinal materials traceability, and proposed the establishment of genuine medicinal materials traceability system based on two-dimensional code and network database.
Databases, Factual ; Drugs, Chinese Herbal ; chemistry ; economics ; standards ; Medicine, Chinese Traditional

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.

OBJECTIVE:To provide the scientific evidence and reference for improving medical reform. METHODS:Based on background ofSanming Medical Reform,self-designed questionnaires were used to investigate the cognition and satisfaction of local patients. The results of investigation were analyzed statistically. RESULTS:A total of 275 paper questionnaires were sent out and all were collected;345 electronic questionnaires were sent out by Wechat and all collected. Among 620 questionnaires,372 valid questionnaires were collected with effective rate of 60.00%. More patients(31.45%)thought the cost of treatment decreased, and less (22.31%) thought the cost increased. The proportion of high-income people who thought cost reduced was significantly higher than the proportion of low-income people (P=0.018). 27.42% of patients believed shortage of drugs,and tertiary hospi-tals were more prone to drug shortage than other medical institutions(P=0.062). The patients'satisfaction with medical staff and healthcare reform were both high(86.56% and 79.03%),but the satisfaction of rural patients was lower than that of urban patients (P=0.051). Understanding of patients onSanming Medical Reformwas in low level. Only 20.70% of the patients fully under-stood or generally understood ofSanming Medical Reform. The patients who thought the skills of medical staff were improved (40.32%)were more than those who thought the skills of medical staff were reduced(5.91%). CONCLUSIONS:Most patients are satisfied withSanming Medical Reform,and agree the achievements;but some problems are not solved,such as the shortage of some drugs,lack of grass-roots medical personnel,not understand medical policy.

Objective To explore the expressions of matrix metalloproteinase-9 (MMP-9) and tissue inhibitors of matrix metalloproteinase-1 (TIMP-1) after focal cerebral ischemia-repeffusion injury in rats. Methods Totally 40 Wistar rats were randomly divided into 2 groups: sham-operated group and iscbemia-reperfusion group. A middle cerebral artery occlusion model was constructed in the 25 rats with Longa's method. The expressions of MMP-9 and TIMP-1 were investigated with immunohistochemistry and HE staining at 6, 24, 48, 72 h and 7 d of reperfusion following 2 h ischemia. Results MMP-9 began to be expressed at 6 h reperfusion, and was obviously increased at 24 h and reached the peak level at 48 h, and then, the expression of MMP-9 began to decrease at 72 h to a low level at 7 d. TIMP-1 positive cells began to arise at 6 h reperfusion, peaked at 24 h, decreased at 48 h and remained a low level at 7 d. The expressions of MMP-9 and TIMP-1 were mainly located in vascular endothelial cells, neurons and gitter cells. The expressions of MMP-9 and TIMP-1 were negative in sham-operated group. Conclusion The expressions of MMP-9 and TIMP-1 are induced to increase by focal cerebral ischemia-reperfusion, and vascular endothelial injury may be the main cause to the high expressions of MMP-9 and TLMP-1.

Objective To evaluate the changes of nerve conduction velocity in degenerative rabbit sciatic nerve authograft induced by 60Co irradiation after orthotopic replantation. Methods A 30-mm-long segment was severed from normal adult rabbit sciatic nerve and exposed to 60Co irradiation at the dose of 350 Cry to induce neural degeneration. The nerve segment was then replanted orthotopicaily, and the nerve conduction velocity was determined using electrophysiological test at 4, 6 and 8 months after the replantation. Results At 6, 8 months after the replantation, the nerve conduction velocity in the degenerative nerve autograft showed no significant difference from that in normal sciatic nerve (P>0.05). But at 4 months after the replantation, the nerve conduction velocity in the autograft was significantly lower than the normal velocity (P<0.05). Conclusion The nerve conduction velocity can be obtained by replantation of a long (3 mm) degenerative nerve segment due to 60Co irradiation.