Objective To analyze the incidence of congenital syphilis in four regions of China from 2005 to 2020 and predict its change trend, and to provide a scientific basis for the prevention and control of congenital syphilis. Methods The incidence data of congenital syphilis in eastern, western, central and northeastern China from 2005 to 2020 were collected. The annual change percentage (APC) and average annual change percentage (AAPC) were calculated by Joinpoint software, and the change trend was analyzed. The ARIMA model was established by SPSS26.0 software to predict the incidence from 2021 to 2025. Results From 2005 to 2020, there were 107 504 cases of congenital syphilis, and the incidence reached the peak in 2011, which was 0.90/100 000, and decreased to 0.09/100 000 in 2020. The incidence of congenital syphilis in the eastern, central, western, and northeastern regions of China decreased to 0.07/100 000, 0.06/100 000, 0.12/100 000, and 0.15/100 000 in 2020, respectively. Joinpoint regression analysis found that from 2005 to 2020, the incidence of congenital syphilis showed a downward trend in the whole country (AAPC=-8.68%, t=-5.18, P＜0.05), the eastern region (AAPC=-12.01%, t=-6.81, P＜0.05), the central region (AAPC=-5.45%, t=-2.09, P＜0.05), and the western region (AAPC=-6.05%, t=-3.00, P＜0.05), while the incidence in the northeast region was relatively stable (AAPC=-1.66%, t=-1.18，P＞0.05). The ARIMA (2,2,0) model was constructed to predict that the annual incidence of congenital syphilis from 2021 to 2025 would be 0.06/100,000, 0.03/100,000, 0.02/100,000, 0.01/100,000, and 0.01/100,000, respectively. Conclusion From 2005 to 2020, the incidence of congenital syphilis in China shows an overall downward trend. The western and northeastern regions are the key prevention and control areas, and the work of ^"eliminating mother to child transmission of syphilis^" needs to be continuously promoted.

OBJECTIVE To draw upon the United States’ experience in charging for drug dispensing services and provide reference for designing China’s fee scheme for such services. METHODS Relevant literature and official websites were reviewed to systematically summarize the evolution of dispensing fees in the U.S.， charging methods and standards across different health insurance plans， and factors influencing fee determination. The key characteristics of the U.S. fee system were summarized. Recommendations for improving China’s related practices were then proposed. RESULTS & CONCLUSIONS The U.S. dispensing fee system has undergone four stages of conceptual emergence， model exploration， system establishment， and professional development， forming a prescription-based charging model independent of drug prices. Under a unified federal framework， health insurance programs set a differentiated dispensing fee system based on actual costs and factors such as drug category， pharmacy type， prescription volume， and policy objectives， reflecting pharmacists’ professional value and ensuring sustainable service provision. Although China has recognized dispensing fees at the national level， implementation still faces barriers including insufficient value recognition and pressure on medical insurance payment. Drawing on U.S. experience and considering China’s national context， it is recommended to strengthen empirical research on the value assessment of dispensing services to support medical insurance decision-making； standardize the methodology for dispensing cost measurement and clarify the basis for fee setting by incorporating pharmacists’ professional and technical value as well as public interests； explore differentiated charging models at the provincial level with prescriptions as the basic unit， with emphasis on professional expertise and dispensing risks， and continuously strengthen pharmacists’ professional capacity to facilitate the scientific formulation and effective implementation of dispensing service fee policies.

OBJECTIVE To clarify the institutional logics of the dilemma of the use of national medical insurance negotiation drugs（referred to as “national negotiation drugs”）， and promote the implementation and use of these drugs in medical institutions. METHODS Based on the complex institutional environment in which medical institutions were situated， the theory of multiple institutional logics was used to construct an analytical framework for the behavioral choices of medical institutions， and reveal the mechanism of the difficulty in the use of national negotiation drugs by clarifying the interaction and conflict of multiple logics in this process， so as to put forward some measures. RESULTS & CONCLUSIONS There were contradictions and coupling among the state logic， market logic， social logic and professional logic in the use of national negotiation drugs. In the game of multiple logics， the market logic and professional logic tended to be risk-averse， the failed “pressure-type system” of state logic， and the social logic was weakened， which caused the lack of action in the use of national negotiation drugs with the goal of completing performance evaluations in the current medical institutions. Thus， it is suggested to unbundle the invisible policy restrictions on the use of national negotiation drugs， form the pressure and motivation of medical institutions by incentive and constraint mechanisms， respond to the clinical demand by establishing a green procurement channel， and construct the supervision mechanism on the use of national negotiation drugs by social force， etc.， so as to enhance the effect of the national negotiation drugs.

There are certain limitations in the current clinical evaluation methods and evaluation modes of new Chinese herbal medicines for syndromes， and there is a lack of a clinical evaluation system that meets the characteristics of traditional Chinese medicine （TCM）. Based on the characteristics of TCM "syndrome differentiation and treatment" and "correspondence of formulas and syndromes"， the target design model， hypothesis and its scope of application are proposed on the basis of the combination of diseases and syndromes. On the basis of fully considering the dual factors of diseases and syndromes， we distinguished the "centre of the target"， "middle ring" and "outer ring" through the differences of different signs and symptoms in people with same syndrome， in order to determine the degree of conformity of the syndrome. Then， the population with same syndrome could be analysed according to the "centre of the target"， "middle ring" and "outer ring"， so as to achieve the precise positioning of new Chinese herbal medicines for syndromes， and try to provide research ideas and methods for syndrome differentiation and treatment of TCM and precise intervention.

Objective To analyze the retrieval rate of inferior vena cava filter(IVCF)and its safety,and to make a histological analysis of the filter attachment substances.Methods The clinical data of 234 patients with IVCF,who were admitted to Affiliated Tenth People's Hospital,Tongji University,to retrieve IVCF between June 2020 and May 2023,were retrospectively analyzed.The retrieval success rate,complications and filter attachment substances were statistically analyzed,and the nature of the attachment substances was examined by using histological staining.Results The retrieval success rate in the 234 patients was 91.03％(213/234).In 17 patients the retrieval of IVCF was abandoned due to the filter capturing the thrombus,and in 4 patients the retrieval of IVCF failed due to tilting of the filter.No complications such as vena cava perforation,symptomatic pulmonary embolism and hemorrhage occurred in all patients during perioperative period.Of the 213 patients whose filter was successfully removed,the filter attachment substances was found in 156 patients.Histological staining of the filter attachment substances demonstrated that the main component of these substances was a mixed thrombus with a small amount of cellulose degeneration.Further analysis revealed that the incidence of filter attachment substances in ≤14-day group was lower than than that in＞14-day group,and the difference between the two groups was statistically significant(x2=6.791,P=0.009);and the incidence of filter attachment substances in the non-anticoagulant group was lower than that in the anticoagulant group,and the difference between the two groups was statistically significant(x2=7.774,P=0.005).Conclusion The retrieval rate of retrievable IVCFs is quite high and the retrieval procedure carries less complications,therefore,it is safe to use retrievable IVCFs in clinical practice.However,the formation of tiny thrombosis within the filter after the placement of filter cannot be ignored,which should be seriously considered in the clinical work.

Objective To investigate the readmission of male schizophrenia patients in a hospital of Zhoushan and its influencing factors,and to build a nomogram model.Methods A total of 183 male schizophrenics patients admitted to the Second People's Hospital of Zhoushan from January to December 2022 were analyzed retrospectively.Patients were divided into readmission group (hospitalization frequency ≥ 2 times) and non-readmission group (hospitalization was once) based on the number of hospitalization.Perform univariate analysis on the data of two groups of patients using t test or x2 test.Multivariate Logistic regression model was used to investigate the influencing factors of readmission in schizophrenia patients within one year,and a nomogram prediction model was established.Results The rate of readmission was 49.18％ in 183 schizophrenic patients.Course of disease,duration of first hospitalization,and history of tobacco and alcohol consumption were independent risk factors for readmission (P<0.05).The area under the curve (AUC) of the receiver operating characteristic curve in the column chart model is 76.53.Conclusion The readmission rate of male schizophrenia patients in the Second People's Hospital of Zhoushan is high,and the course of disease,duration of first hospitalization,and history of tobacco and alcohol consumption are independent risk factors for the readmission of schizophrenia patients within one year.The establishment of the nomogram prediction model is expected to evaluate the high risk factors for the readmission of schizophrenia patients and implement targeted interventions to improve the quality of life of patients.

OBJECTIVE To provide reference for clarifying the action and development direction of China ’s drug safety governance. METHODS Based on governance theory ，an analysis framework of “Motivation-Sharing-Performance and Feedback ” was established to explain the mechanism of cross-sector collaboration governance of drug safety. By constructing the action framework of national drug safety governance of “3 stages+1 incubation period ”，the connotation of each stage and possible challenges were analyzed ，and improvement suggestions were put forward. RESULTS & CONCUSIONS The obstacles that restricted the effectiveness of drug safety governance in China were mainly due to insufficient information ，resource mobilization and power sharing. Therefore ，the“basic collaboration stage ”should expand the scope of information sharing and involve non-governmental entities ；the“legislative coordination stage ”should focuse on the provision of formal legal systems so that non-governmental forces can play a necessary role in governance activities ；the“deepening of the coordination stage ”should promote the formal integration of social forces into governance system ，and truly realize the transition from “passive participation ” to self-management. It is recommended to continuously improve the construction of drug safety governance system in China in terms of governance norms ，communication mechanisms ，capacity development based on a holistic perspective.

Objective To investigate the clinical efficacy of ziprasidone in the treatment of first-episode schizophrenia.Methodsfrom January 2014 to June 2016to receive the treatment of patients with first-episode schizophrenia in 156 cases as the research object in the psychiatric hospital, which were randomly divided into two groups, the control group were given risperidone treatment, the observation group was treated with ziprasidone treatment, compared two groups of clinical curative effect of the treatment of patients after.ResultsThe patients in the observation group the total effective rate was 97.4%, the control group total effective rate was 89.7%;group after treatment in patients with negative symptoms score were significantly lower than the control group, with statistical significance between the two groups (P<0.05).ConclusionThe application of ziprasidone in the treatment of first-episode schizophrenia has achieved good clinical efficacy, the total effective rate of treatment is higher, and the negative symptoms are effectively controlled.

Objective To explore the feasibility and safety of carotid artery stenting (CAS) via right transradial approach (TRA).Methods A retrospective analysis was made on 46 cases undergoing the CAS via right TRA.Patients were divided into the right carotid artery group (RCA),bovine left carotid artery group (B-LCA),nonbovine carotid artery group (NB-LCA) according to the lesion location.Low TRA or high TRA were selected to overcome the difficulties of insufficient supporting power,using techniques such as catheter looping and retrograde engagement technique(CLRET).Results CAS were successful in all cases (100％),the differences of the operation time and fluoroscopy time among RCA group,B-LCA group and NB-LCA group were not significant.In NB-LCA group,CLRET were applied in 10 cases (55.56％,10/18),includeing 8 cases with type Ⅲ aortic arch(100％,8/8)and 2 cases with type Ⅱ aortic arch (33.33％,2/6).The CLRET prolonged the operation time and fluoroscopy time [(39.45 ±7.27) min vs.(30.80±4.66) min;(11.84 ± 2.05) min vs.(9.91 ± 1.45) min,P ＜0.05).There was no cerebrovascular events and puncture point complications in perioperative period.Conclusion Right transradial approach for carotid artery stenting is safe and technically feasible,especially in RCA stenosis and LCA stenosis with type Ⅰ or Ⅱ aortic arch.

Objective:This paper intends to provide reference for consummation of biosimilar registration poli-cies in China. Methods:This paper evaluates the performance of Japanese registration regulation policies on biosimi-lars by analyzing the procedure and reviewing the features of biosimilars. Results and Conclusions:According to the findings of the present investigation, the availability and affordability of biosimilars have been improved, and the bio-medicine industry has achieved great development. On the other hand, it's recommended that the guideline for the de-velopment and evaluation of biosimilars should be amended on the principle of appropriate simplification, which means to simplify the research and development procedure and exempt partial application dossier. Besides, the regis-tration procedures should be adopted continuously to ensure the stability of biosimilars' R&D and registration.