OBJECTIVE To evaluate the long-term clinical effectiveness and cost-effectiveness of 10 commonly used first-line antiretroviral therapy （ART） regimens for HIV-infected patients in China. METHODS PubMed， CNKI， and other databases were searched to collect meta-analyses of ART regimens published between 2015 and 2025， and short-term efficacy data were synthesized. A Markov model was constructed to simulate disease progression in HIV-infected patients and to extrapolate the long-term clinical and economic outcomes of different ART regimens. From the perspective of the healthcare system， life years， total costs， quality-adjusted life years （QALYs）， and incremental cost-effectiveness ratio （ICER） were estimated. Sensitivity analyses were conducted to assess the robustness of the results. RESULTS One network meta-analysis was ultimately included. Long-term extrapolation showed that integrase inhibitor （INSTI） regimens achieved the best clinical outcomes. Compared with efavirenz （EFV）， dolutegravir （DTG） ，raltegravir （RAL） and elvitegravir/cobicistat （EVG/c） increased per-capita life expectancy by 4.47，2.90 and 2.15 years， respectively. The top five regimens in terms of cost-effectiveness were low-dose EFV， DTG， RAL， EVG/c， and rilpivirine （RPV） with ICERs of 4 414.45， 10 618.31， 21 577.71， 24 003.88， and 32 166.84 yuan/QALY compared to the EFV regimen， respectively. CONCLUSIONS Compared with EFV regimen， INSTI regimens （DTG， RAL and EVG/c） demonstrate superior efficacy as first-line ART regimens for HIV-infected patients in China. Low-dose EFV，RPV and these three INSTI regimens show substantial cost-effectiveness advantages.

Sinisan is a classical prescription developed and applied by ancient medical experts and it is first recorded in the Treatise on Cold Damage written by ZHANG Zhongjing in the Eastern Han Dynasty. Later physicians have modified this prescription based on this original one. The bibliometrics methods were used to analyze the key information and research trend of Sinisan. According to the inclusion and exclusion criteria， 69 pieces of effective data were extracted， involving 67 ancient traditional Chinese medicine （TCM） books. The results showed that the name， composition， and decocting methods of Sinisan in later generations were inherited from the original record in the Treatise on Cold Damage. The original plants of medicinal materials used in Sinisan are basically clear. We recommend Bupleuri Radix as the dried root of Bupleurem scorzonerifolium， Paeoniae Radix Alba as the dried root of Paeonia lactiflora， Aurantii Fructus as the dried fruit of Citrus aurantium， Glycyrrhizae Radix et Rhizoma as the dry root and rhizome of Glycyrrhiza uralensis. Raw materials of Bupleuri Radix and Paeoniae Radix Alba， Aurantii Fructus stir-fried with bran， and stir-fried Glycyrrhizae Radix et Rhizoma should be used for preparation of Sinisan. According to measurement system in the Han Dynasty， a bag of Sinisan is composed of 1.25 g Bupleuri Radix， 1.25 g Paeoniae Radix Alba， 1.25 g Aurantii Fructus， and 1.25 g Glycyrrhizae Radix et Rhizoma. The materials should be grounded into coarse powder and taken with a proper amount of rice soup， 3 times a day. Sinisan has the effects of regulating qi movement and harmonizing the liver and spleen. It can be used for treating reversal cold in limbs and cold damage. In modern clinical practice， Sinisan can be used to treat chronic gastritis， irritable bowel syndrome， and dyspepsia. The above research results provide scientific reference for the future research and development of Sinisan.

Objective:To explore the mechanisms of " TongduAnshen " couplet medicines Notopterygii Rhizoma et Radix-Ziziphi Spinosae Semen(TDAS)on chronic unpredictable mild stress(CUMS)model rats.Methods:The rat model of depression were prepared using isolated and CUMS method.The depression-like behavior was detected by sucrose preference test(SPT),the open field test(OFT)and forced swimming test(FST).The pathological changes of hippocampal neurons were observed by HE and Nissl staining.The levels of 5-hydroxytryptamine(5-HT),interleukin 18(IL-18)and interleukin 1 β(IL-1β)were detected by enzyme linked immunosorbent assay(ELISA).The protein expression of NLRP3,ASC,caspase-1 in hippocampus were determined by Western blot.Results:The depression-like behavior of rats in the TDAS-L,TDAS-M and TDAS-H groups was significantly improved(P＜0.05 orP＜0.01);HE and Nissl staining showed that the neurons were arranged neatly,the number of shrunken cells were reduced,the extent of the injury was reduced;the contents of 5-HT in hippocampus of rats increased(P＜0.05 or P＜0.01),the contents of IL-18 and IL-1β in serum decreased(P＜0.01);the expressions of NLRP3,ASC and caspase-1 in hippocampus were decreased(P＜0.01).Conclusion:TDAS can improve depression-like behavior in chronic unpredictable mild stress rats,and its mechanism may be increase the contents of 5-HT,inhibit the expression of NLRP3 signaling pathway,and reduce the content of inflammatory factors.

Objective:To explore the mechanisms of " TongduAnshen " couplet medicines Notopterygii Rhizoma et Radix-Ziziphi Spinosae Semen(TDAS)on chronic unpredictable mild stress(CUMS)model rats.Methods:The rat model of depression were prepared using isolated and CUMS method.The depression-like behavior was detected by sucrose preference test(SPT),the open field test(OFT)and forced swimming test(FST).The pathological changes of hippocampal neurons were observed by HE and Nissl staining.The levels of 5-hydroxytryptamine(5-HT),interleukin 18(IL-18)and interleukin 1 β(IL-1β)were detected by enzyme linked immunosorbent assay(ELISA).The protein expression of NLRP3,ASC,caspase-1 in hippocampus were determined by Western blot.Results:The depression-like behavior of rats in the TDAS-L,TDAS-M and TDAS-H groups was significantly improved(P＜0.05 orP＜0.01);HE and Nissl staining showed that the neurons were arranged neatly,the number of shrunken cells were reduced,the extent of the injury was reduced;the contents of 5-HT in hippocampus of rats increased(P＜0.05 or P＜0.01),the contents of IL-18 and IL-1β in serum decreased(P＜0.01);the expressions of NLRP3,ASC and caspase-1 in hippocampus were decreased(P＜0.01).Conclusion:TDAS can improve depression-like behavior in chronic unpredictable mild stress rats,and its mechanism may be increase the contents of 5-HT,inhibit the expression of NLRP3 signaling pathway,and reduce the content of inflammatory factors.

Objective:Using primary care chronic disease management as a case,it aims to explore an economic incentive model for integrated primary healthcare services based on value pricing.Additionally,practical needs and implementation recommendations are proposed.Methods:With the help of the health technology assessment framework,it proposes that integrated health services can be priced through service effectiveness and service utility,and develops an economic incentive model with value pricing at its core based on the patient-centered incentive model for innovative healthcare services,including financing,payment,appraisal,and distribution,and puts forward feasible suggestions in the light of the needs and actuality of primary integrated services in China.Conclusion and Recommendation:The value-based pricing model for integrated health services serves as a theoretical foundation for the transformation of primary healthcare service functions and the enhancement of service dynamics,aligning with China's value-oriented service procurement strategy.This research contributes to the academic discourse by providing localized insights and a scholarly tone,contributing to the advancement of knowledge in the field.

Objective:In order to further enrich and improve the pricing strategy of chronic disease health management services in China.Methods:A discrete choice test was used to investigate the willingness to pay for personalized health service packages for chronic disease patients in Wuhou District,Chengdu City,as a representative of personalized health service packages for primary healthcare institutions,with integration as a utility indicator and blood pressure/glucose control rate as an effect indicator,which was used as a basis for pricing.Results:A total of 238 valid questionnaires were considered.According to conditional logit regression analysis,respondents were willing to pay 147.13 yuan/year to improve service package integration from low to high,and 177.12 yuan/year to improve blood pressure/blood sugar from one day a week(low level)to seven days a week(high level),but there was no significant willingness to pay for other improvements.Conclusion:It is discovered that there is a comparable willingness to pay for health management services to patients with chronic diseases in Chinese community in terms of service utility and effect,and it is proposed that the value of service experience be included in primary health management pricing.

Objective:To explore the difficulties and methods of value-based pricing of healthcare services,and to provide references for the price management of healthcare services in China.Methods:Based on the analysis of literature and policy,the operational methods of value-based pricing are clarified,and the international application experience of value-based pricing is reviewed.Comprehensive field research and interviews are conducted to analyze the difficulties in applying value-based pricing to healthcare services.Results:Currently,there are no mature theories and methods for value-based pricing of healthcare services,and there are also many practical difficulties in financing,payment,assessment and evaluation policies.Conclusion:In the future,it should consider incorporating service experience into the value framework independently of utility,and take"service utility"as the basis for pricing healthcare services,and select relevant indicators for measurement.At the same time,the price of healthcare services should take into account the willingness to pay of multiple parties,and stakeholders need to work closely together to form a consensus on value.

Objective:Compared to pricing based on input value,pricing based on output can better motivate service outcomes towards expectations and enhance input-output efficiency.The path of outcome value-oriented pricing for healthcare services is explored to provide a theoretical foundation for the value-based pricing of healthcare services.Methods:The concepts,methods and international experience of value pricing are sorted out.Results:Outcome-based pricing in healthcare services is divided into effect and utility,and is classified into four categories based on the different emphasis on the effect and utility of healthcare services.Conclusion:Services with a strong emphasis on effectiveness can draw inspiration from the Quantified Quality of Life(QALY)results in the medical technology field,while services with a strong emphasis on utility may require the development of new utility scales for service evaluation.

Objective:Using primary care chronic disease management as a case,it aims to explore an economic incentive model for integrated primary healthcare services based on value pricing.Additionally,practical needs and implementation recommendations are proposed.Methods:With the help of the health technology assessment framework,it proposes that integrated health services can be priced through service effectiveness and service utility,and develops an economic incentive model with value pricing at its core based on the patient-centered incentive model for innovative healthcare services,including financing,payment,appraisal,and distribution,and puts forward feasible suggestions in the light of the needs and actuality of primary integrated services in China.Conclusion and Recommendation:The value-based pricing model for integrated health services serves as a theoretical foundation for the transformation of primary healthcare service functions and the enhancement of service dynamics,aligning with China's value-oriented service procurement strategy.This research contributes to the academic discourse by providing localized insights and a scholarly tone,contributing to the advancement of knowledge in the field.

Objective:In order to further enrich and improve the pricing strategy of chronic disease health management services in China.Methods:A discrete choice test was used to investigate the willingness to pay for personalized health service packages for chronic disease patients in Wuhou District,Chengdu City,as a representative of personalized health service packages for primary healthcare institutions,with integration as a utility indicator and blood pressure/glucose control rate as an effect indicator,which was used as a basis for pricing.Results:A total of 238 valid questionnaires were considered.According to conditional logit regression analysis,respondents were willing to pay 147.13 yuan/year to improve service package integration from low to high,and 177.12 yuan/year to improve blood pressure/blood sugar from one day a week(low level)to seven days a week(high level),but there was no significant willingness to pay for other improvements.Conclusion:It is discovered that there is a comparable willingness to pay for health management services to patients with chronic diseases in Chinese community in terms of service utility and effect,and it is proposed that the value of service experience be included in primary health management pricing.