1.The impact of centralized volume-based procurement policy on the pharmaceutical industry:Review based on the SCP paradigm
Ying YANG ; Yu-Xin LIU ; Jing MAO ; Zong-Fu MAO
Chinese Journal of Health Policy 2023;16(12):40-48
Objective:To systematically review the impact of Chinese centralized volume-based procurement(VBP)policy on the pharmaceutical industry.Methods:Relevant literature published between January 1,2019 and July 31,2023 were retrieved from the database of CNKI,WanFang data,PubMed,and Web of Science.A thematic analysis framework was constructed for data collation and analysis applying the Structure-Conduct-Performance(SCP)paradigm.Results:Forty-one studies were included,with 10(24.4%),24(58.5%),and 23(56.1%)reporting the dimension of structure,conduct,and performance,covering 10 secondary themes.Literature shows that,in terms of market structure,the market share of bid-winning enterprises increased after VBP policy,and the concentration ratio of pharmaceutical industry promoted;as for enterprise conduct,the R&D investment of both bid-winning and bid-non-winning enterprises increased under policy implementation,and the selling expenses on policy-covered products significantly reduced while policy-uncovered products did not;as for industry performance,the impact of VBP policy on operational performance varies among enterprise,and the initially positive effect on promoting innovative output of bid-winning enterprises was observed.Conclusions:The VBP policy has shown positive effects in optimizing market structure,guiding enterprise conduct,and improving industry performance.To consolidate and expand policy effects,it is recommended to further strengthen the comprehensive management of drug prices,expand the boundaries of the VBP market,and strengthen policy monitoring and tracking research.
2.3- to 24-month Follow-up on COVID-19 with Pulmonary Tuberculosis Survivors after Discharge: Results from a Prospective, Multicenter Study
Ya Jing WANG ; Yu Xing ZONG ; Hui Gui WU ; Lin Yuan QI ; Zhen Hui LI ; Yu Xin JI ; Lin TONG ; Lei ZHANG ; Bo Ming YANG ; Ye Pu YANG ; Ke Ji LI ; Rong Fu XIAO ; Song Lin ZHANG ; Hong Yun HU ; De Hong LIU ; Fang Shou XU ; Sheng SUN ; Wei WU ; Ya MAO ; Qing Min LI ; Hua Hao HOU ; Yuan Zhao GONG ; Yang GUO ; Wen Li JIAO ; Jin QIN ; Yi Ding WANG ; Fang WANG ; Li GUAN ; Gang LIN ; Yan MA ; Ping Yan WANG ; Nan Nan SHI
Biomedical and Environmental Sciences 2022;35(12):1091-1099
Objective Coronavirus disease 2019 (COVID-19) and tuberculosis (TB) are major public health and social issues worldwide. The long-term follow-up of COVID-19 with pulmonary TB (PTB) survivors after discharge is unclear. This study aimed to comprehensively describe clinical outcomes, including sequela and recurrence at 3, 12, and 24 months after discharge, among COVID-19 with PTB survivors. Methods From January 22, 2020 to May 6, 2022, with a follow-up by August 26, 2022, a prospective, multicenter follow-up study was conducted on COVID-19 with PTB survivors after discharge in 13hospitals from four provinces in China. Clinical outcomes, including sequela, recurrence of COVID-19, and PTB survivors, were collected via telephone and face-to-face interviews at 3, 12, and 24 months after discharge. Results Thirty-two COVID-19 with PTB survivors were included. The median age was 52 (45, 59) years, and 23 (71.9%) were men. Among them, nearly two-thirds (62.5%) of the survivors were moderate, three (9.4%) were severe, and more than half (59.4%) had at least one comorbidity (PTB excluded). The proportion of COVID-19 survivors with at least one sequela symptom decreased from 40.6% at 3 months to 15.8% at 24 months, with anxiety having a higher proportion over a follow-up. Cough and amnesia recovered at the 12-month follow-up, while anxiety, fatigue, and trouble sleeping remained after 24 months. Additionally, one (3.1%) case presented two recurrences of PTB and no re-positive COVID-19 during the follow-up period. Conclusion The proportion of long symptoms in COVID-19 with PTB survivors decreased over time, while nearly one in six still experience persistent symptoms with a higher proportion of anxiety. The recurrence of PTB and the psychological support of COVID-19 with PTB after discharge require more attention.
3.A time-series prediction and analysis on rural inpatient with cardio-cerebrovascular disease in Wugang
Yu-pan WU ; Liu-yi WEI ; Shuang WANG ; Shan LU ; Bo-rui HU ; Fu-hui TA ; Lei CHEN ; Zong-fu MAO
Chinese Journal of Disease Control & Prevention 2019;23(2):222-226
Objective To establish a predictive model for inpatients of cardio-cerebrovascular disease in rural areas of Wugang through time series analysis, and predict the changing trend of cardio-cerebrovascular disease, so as to offer guidance for the health care resources allocation and prevention and control of cardio-cerebrovascular disease. Methods The seasonal autoregressive integrated moving average model (SARIMA) was constructed based on the monthly number of cases of cardio-cerebrovascular disease in rural areas from January 2013 to December 2016 by Stata 14.0 software, and the predictive effect of the model was verified with the monthly number of inpatients of cardio-cerebrovascular disease in 2017. Results The final fitting model of inpatients of cardio-cerebrovascular disease was SARIMA (2, 1, 1)×(0, 1, 0)12. The residual sequence of the model was diagnosed. Results of Ljung-Box Q test showed that the residual sequence was white noise sequence (Q=11.12, P=0.68). In addition, the 2017 forecast was basically consistent with the observations, the overall relative error was around -1.2%. The results showed that the summer was the peak period of cardiovascular and cerebrovascular hospitalization. Conclusion SARIMA model can accurately predict the number of inpatients of cardio-cerebrovascular disease in Wugang, which can provide data support for the hospital administrator to rationally allocate medical resources in the cardiovascular according to the needs of cardio-cerebrovascular treatment in different months.
4.Mental health status and its influencing factors of the elderly
Jin-song WANG ; Xiao-jun LIU ; Yi-tan HOU ; Mei-kun HE ; Yu-pan WU ; An-ran TAN ; Fang-jie ZHANG ; Zong-fu MAO
Chinese Journal of Disease Control & Prevention 2019;23(3):308-312
Objective To assess the current status and factors associated with the mental health condition of older adults. Methods A convenience sampling survey was conducted using symptom check list 90 (SCL-90) among the Chinese older adults aged 60 or above from January to March, 2018. The older adults aged 80 or above were selected for this study. Chi-square test and binary logistic regression model were used to analyze the influencing factors. Results The total participants were 485. The SCL-90 positive detection rate was 20.21%. The symptoms of the four highest detection rates were somatization (39.38%), others (25.15%), obsessive-compulsive symptoms (24.33%) and depression (22.68%). The older adults with normal BMI (OR=0.537, 95% CI: 0.250-0.857, P=0.027) and lived in county town (OR=0.224, 95% CI:0.075-0.667, P=0.007) showed lower SCL-90 positive detection rate. These who had been educated for 1-5 years (OR=11.092, 95% CI: 4.446-27.671, P<0.001), 6-8 years (OR=9.800, 95% CI: 3.464-27.721, P<0.001), 9~11 years (OR=19.279, 95% CI : 6.722-55.297, P<0.001), 12 years and above (OR=24.321, 95% CI: 7.894-74.929, P<0.001) had higher SCL-90 positive detection rate compared with those who were uneducated. Conclusion The mental health condition of Chinese older adults is mainly influenced by residence place, education level, family income self-evaluation and BMI status.
5.Analysis on health cooperation intentions, demands, advantages and disadvantages among "Belt and Road" countries
Yao WANG ; Chang FU ; Shan LU ; San-Yu GE ; Wen-Jie WANG ; Xiao-Hui LIANG ; Zong-Fu MAO
Chinese Journal of Health Policy 2018;11(10):51-55
Objective: To understand the health cooperation intentions, demands, advantages and obstacles that are being experienced by countries along the Belt and Road,and to provide reference for China to deepen health cooperation with those countries in regard. Methods : A seminar was held at the High Level Symposium to find out about the health cooperation status among the "Belt and Road" countries, whereby the theme was: "Belt and Road for Health Cooperation towards a Health Silk Road". Therefore, a survey was conducted among 217 Chinese and foreign guests who were invited to attend the seminar. 209 questionnaires were valid and the effective rate was 96. 3% after the questionnaire analysis carried out using SPSS22. 0. Results : Research results showed that among the respondents, 91. 7% of the surveyed foreign partners are willing to cooperate in health, while only 73. 2% of the Chinese respondents desired the cooperation. The demands for health cooperation between both countries was mainly about health industry,medical and health services, and infectious disease prevention and control. Both China and foreign countries confirmed that cooperation convenience and long-term partnership were the advantages of health cooperation among Belt and Road countries, while differences were highlighted in preferential policies. The biggest challenge was found to be the cultural differences. Among other disadvantages are the lack of communication platforms, the pressure of laws and regulations, unstable policies, etc. Conclusions : The willingness and broad space to cooperate in health are strong and large forboth China and foreign countries,and they are intending to put much of emphasis on health institutions,medical and health services and prevention and control of infectious diseases in the future. It is hence suggested that health cooperation should make good use of existing advantages of partnership and convenience,and overcome found obstacles in orderto deepen cooperation in the health industry.
6.Research on the status and implication of the health cooperation between China and countries along " Belt and Road"
Yao WANG ; Wen-Jie WANG ; Chang FU ; Xiao-Hui LIANG ; Zong-Fu MAO
Chinese Journal of Health Policy 2018;11(10):56-61
Objective:To summarize and analyze the status of health cooperation achievement strategies between China and the countries along the "Belt and Road",determine the implications thereof, and provide reference for future practical cooperation between the China and those countries in the field of health. Methods : The relevant literature was retrieved from the research database from articles published in both Chinese and English during the period from 2013 to 2017, and the literature research method was used to summarize the status quo of health cooperation. Results : According to the exclusion criteria, 116 articles were selected. The analysis showed that the main research focus falls in the following seven aspects for both domestic and foreign scholars : The dissemination of Chinese medicine culture promotes international cooperation in Chinese medicine; the prevention and control of infectious diseases needs to further strengthen the construction of international mechanisms; the health services and systems requiremutual learning from international experience; health industry has broad prospects for development; health emergency cooperation encounters the problem of inadequate coordination mechanisms and language barriers; the research on health development assistance goes deep; and health professionals training focuses on training mode. Conclusions: The existing research topics were of great coverage in range and had the highest attention to Chinese medicine,yet least considered talent cultivation. The research showed that cooperation in various health departments emphasized on international experience and the joint participation of the government and civil society. However, the research on laws and regulations, international conventions and practices, and different families' cooperation requirements related with health cooperation mechanisms need to be further strengthened.
7.Correlation of visfatin and endothelin with subclinical hypothyroidism in patients with cerebral infarction
cun Zong CHEN ; sha Sha FU ; yi Jin CHEN ; rong Zu WU ; xiong Mao FU
Journal of Medical Postgraduates 2017;30(10):1053-1056
Objective Few studies are reported on the relationship of subclinical hypothyroidism ( SCHT ) with visfatin and endothelin .This study aimed to investigate their relationship in patients with cerebral infarction . Methods A total of 200 cerebral in-farction patients treated in The Second Affiliated Hospital of Hainan Medical University from January 2011 to July 2017 were divided in-to a control ( with normal thyroid function , n=40 ) , a mild SCHT ( with thyroid-stimulating hormone TSH <10 mIU/L, normal free triiodothyronine FT3 and normal free thyroxine FT4, n=60), a se-vere SCHT (with TSH≥10 mIU/L, normal FT3 and normal FT4, n=60) , and a clinical hypothyroidism ( CHT ) group ( with TSH ≥4 mIU/L, decreased FT3 and decreased FT4, n=40).The mild SCHT patients were subdivided into medication group A and non-medication group A, and the severe SCHT patients into medication group B and non-medication group B, 30 in each group, those in the medica-tion groups A and B treated by routine therapy plus oral levothyrocine , and those in the non-medication groups A and B by routine ther-apy only.We recorded the age, gender, body mass index, blood pressure, blood glucose, blood lipid, and thyroid function of the pa-tients, and compared the levels of visfatin and endothelin among different groups . Results The level of visfatin was significantly ele-vated in the severe SCHT and CHT groups as compared with the controls ([46.3±10.1] and [49.5±13.6] vs [40.2±9.7] ng/mL, P<0.05), and so was it in medication group B as compared with non-medication group B at 6 months after treatment ([42.9±6.4] vs [39.3±5.5] ng/mL, P<0.05). Conclusion Visfatin is closely related with thyroid hormone in cerebral infarction patients with se -vere subclinical hypothyroidism .Examination of thyroid function is necessary for cerebral infarction patients for the sake of early detec -tion of severe subclinical hypothyroidism and timely intervention .
8.Host contributions to Ebola virus replication, transcription and translation:research advances
Zhong-Yi WANG ; Ying-Ying FU ; Jia-Ming LI ; Zhen-Dong GUO ; Zong-Zheng ZHAO ; Chun-Mao ZHANG ; Jun QIAN ; Lin-Na LIU
Military Medical Sciences 2017;41(11):938-941
Ebola virus(EBOV) disease,the fatality rate of which is as high as 25%-90%,can be transmitted by contac t between human and non-human primates.Early studies of the virus focused on the functions of viral proteins.Recently,the focus of research of EBOV has been switched to the host interaction factors during the process of virus reproduction.In this review,advances in studies on host contributions to EBOV replication,transcription and translation are summarized in order to enhance our understanding of contributions of the host to the virus reproduction process and provide reference for research strategies and new antiviral drugs.
9.Association of the H770H of PR gene polymorphism with susceptibility to endometriosis
Ting MAO ; Xiping LUO ; Xiaochang TAN ; Xuefang JIANG ; Yufeng WANG ; Yuxin HUANG ; Xin ZHAO ; Yonggui FU ; Xingqiang RAO ; Lili ZONG
Chinese Journal of Obstetrics and Gynecology 2015;(3):194-197
Objective To investigate the association of PR gene exon 5 region H770H (rs1042839) single nucleotide polymorphism (SNP) with the genetic susceptibility to endometriosis (EM) in southern Han Chinese women. Methods Totally 431 EM patients and 499 non-EM women were collected and separated into EM group and control group, that all cases were confirmed by operation and pathology. A case-control study was performed in EM and control groups to evaluate the association of these SNP with the susceptibility to EM by using a fluorescent quantitative PCR-based high resolution melting (HRM) method. Results The C and T of PR H770H allele frequencies among the EM and control groups were 97.9%(844/862), 2.1% (18/862) and 99.4% (992/998), 0.6% (6/998), respectively. The CC, CT and TT of PR H770H genotype frequencies among the EM and control groups were 95.8%(413/431), 4.2%(18/431), 0 and 98.8%(493/499), 1.2%(6/499), 0, respectively. There were statistical significances in the PR H770H alleles and genotypes distributions between the two groups (χ2=7.386, P=0.007;χ2=8.135, P=0.004). Carrying allele C reduced the risk of EM (OR=0.986, 95%CI: 0.976-0.996), while carrying allele T enhanced the risk of EM (OR=3.319, 95%CI: 1.323-8.325); carrying genotype CC reduced the risk of EM 0.970 time (OR=0.970, 95%CI: 0.949-0.991), whereas carrying genotype CT enhanced the risk of EM 3.473 times (OR=3.473, 95%CI:1.391-8.671). Conclusion There is significant association between the polymorphism of PR H770H and genetic susceptibility to EM in southern Han Chinese women.
10.Association of P53 gene polymorphisms with susceptibility to endometriosis.
Yuxin HUANG ; Lili ZONG ; Jianghai LIN ; Yonggui FU ; Zehuan LIU ; Ting MAO ; Jun ZENG ; Yufeng WANG ; Xin ZHAO
Chinese Journal of Medical Genetics 2013;30(3):335-339
OBJECTIVETo assess the association of a single nucleotide polymorphism(SNP) in tumor suppressor gene P53 with the risk of endometriosis (EM) in Han Chinese women.
METHODSFor 460 EM patients, 113 patients with endometrial carcinoma and 530 matched unrelated controls, a rs1042522(C/G) SNP of the P53 gene was genotyped by polymerase chain reaction-single strand polymorphism (PCR-SSP) and DNA sequencing.
RESULTSA significant difference has been detected in the distribution of rs1042522 alleles and genotypes between the EM patients and controls (P< 0.01). Allele G has increased the risk of EM by 1.209 times, while allele C has reduced this risk by 0.837 times. Compared with GG genotype, GC and CC genotypes have both increased the risk for EM (OR=2.073, 95%CI: 1.521-2.820, and OR=1.930, 95%CI: 1.363-2.733, respectively). Significant differences were also detected in the distribution of rs1042522 alleles and genotypes between endometrial carcinoma patients and controls (P< 0.01). Allele G has increased the risk to endometrial carcinoma by 1.311 times, while allele C has reduced this risk by 0.757 times. Compared with GG genotypes, individuals with GC and CC genotypes are more likely to be affected with endometrial carcinoma (OR=2.778, 95%CI: 1.585-4.870, and OR=2.864, 95%CI: 1.557-5.263, respectively).
CONCLUSIONOur study has suggested a significant association between the rs1042522(G/C) polymorphism and susceptibility to EM in Han Chinese women. The mechanism of EM is similar to carcinoma from genetics point of view.
Alleles ; Asian Continental Ancestry Group ; Base Sequence ; China ; Endometrial Neoplasms ; genetics ; Endometriosis ; genetics ; Female ; Gene Frequency ; Genetic Predisposition to Disease ; Genotype ; Humans ; Odds Ratio ; Polymorphism, Single Nucleotide ; Tumor Suppressor Protein p53 ; genetics

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