Objective:To study anti-tumor effect of Dunhuang medical prescription Dabupi Decoction on gastric cancer-bearing mice and effect of Dabupi Decoction combined with oxaliplatin on inflammatory immunity of gastric cancer-bearing mice based on IL-17/NF-κB signaling pathway.Methods:Mouse model of MFC gastric cancer subcutaneously bearing tumor was established and ran-domly divided into model group,oxaliplatin group,high,medium and low doses of Dabupi Decoction combined with oxaliplatin groups[21.58,10.79,5.40 g/(kg·d)],with 10 mice in each group,male and female cage rearing.Administration began after 8 days of inoculation and continued for 14 days;next day after the last administration,eyeball blood was taken,mice were killed,tumor tissues were taken and weighed,and tumor inhibition rate was calculated.ELISA was used to detect contents of IL-17 and IL-6 in mice serum,immunohistochemistry(IHC),RT-qPCR and Western blot were used to detect IL-17,IL-6,NF-κB and p-NF-κB mRNA and protein expressions in mice tumor tissues,respectively.Results:Tumor inhibition rates of oxaliplatin group,high,medium and low doses of Dabupi decoction combined with oxaliplatin groups were 33.02%,52.92%,46.33%and 39.52%,respectively,and tumor quality of each treatment group was significantly lower than that of model group(P<0.01).High,medium and low doses of Dabupi Decoction combined with oxaliplatin groups were higher than that of oxaliplatin group.Compared with model group,contents of IL-17 and IL-6 in serum and expressions of IL-17,IL-6,NF-κB p65 and pNF-κB p65 mRNA and protein in tumor tissues in each treatment group were significantly reduced(P<0.01,P<0.05).Compared with oxaliplatin group,levels of IL-17 and IL-6 in serum and expres-sions of IL-17,IL-6,NF-κB p65 and pNF-κB p65 mRNA and protein in tumor tissues in high and medium doses of Dabupi Decoction combined with oxaliplatin groups were significantly reduced(P<0.01,P<0.05).Conclusion:Dunhuang medical prescription Dabupi Decoction has a certain anti-tumor effect on MFC gastric cancer-bearing mice,which can regulate inflammatory immunity and inhibit occurrence and development of gastric cancer by inhibiting IL-17/NF-κB signaling pathway.

Objective To compare the approval status of orphan drugs in China and the United States(the U.S.)from 2018 to 2022,and to further understand the trends and reasons for the differences in the development of orphan drugs between the two countries.Methods Data on orphan drug approvals in China and the U.S.were retrieved from the National Medical Products Administration of China and the U.S.Food and Drug Administration(FDA),and the number,types,Marketing Authorisation Holder(MAH),target diseases,and new drugs marketed in China and the U.S.were classified and compared.Results From 2018 to 2022,426 approvals of orphan drugs in the U.S.and 63 approvals in China.Average annual growth rates of drug approval numbers in the U.S.and China were-4.81％and 8.38％,respectively.The most common types of orphan drugs approved in both countries were antineoplastic drugs and immunomodulators,of which 235(55.16％)were in the U.S.versus 15 types(23.81％)in China.Among the types of rare diseases targeted by these orphan drugs,the U.S.had the most rare tumor diseases(197 types,46.24％),while China had the most rare neurologrical and psychiatric diseases(22 types,34.92％).The U.S.marketed 36 first-in-class orphan drugs with breakthrough therapeutic value.And China marketed 40 innovative new drugs for the treatment of rare diseases.Conclusion The number of orphan drugs marketed in the U.S.has far surpassed that in China,but has shown a slight downward trend,while an increasing trend in China.The concentration of the domestic orphan drug industry in the U.S.is high,while China's orphan drugs still rely on imports.China has made substantial progress in making domestic innovative drugs for rare diseases,but there is a huge gap between China and the U.S.,especially in terms of advanced technology and innovative drugs.Therefore,intensify efforts should be made in the research and development(R & D)of new drugs for rare diseases in China,and actively participate in global synchronized research and development to achieve win-win cooperation.

Adhesive intestinal obstruction is the most common type of ileus, and conserva-tive treatment serves as its preferred treatment option. In the course of conservative treatment, gastrointestinal decompression will relieve symptoms, prevent ileus progression and promote gas-trointestinal function recovery, which has significant clinical effects. Currently, decompression effects of nasointestinal tubes and nasogastric tubes are controversial. There is a previous Meta-analysis evaluating decompression effects of these two methods, but this analysis includes non-randomized controlled trial and lacks research about Chinese patients. Therefore, the authors con-duct a Meta-analysis to evaluate decompression effects of nasointestinal tubes versus nasogastric tubes for adhesive intestinal obstruction.

Objective:To examine the effect of physical activity (PA) on the incident risk of stroke among adults aged 40 years and above.Methods:The baseline data including PA and demographic characteristics were obtained from the Adult Chronic Disease Surveillance with population representativeness in Ningbo in 2015. The follow-up data of interested health outcomes from 2015 to 2019 were retrieved from a population-based Integrated Noncommunicable Disease Collaborative Management System in Ningbo. The two databases were matched to form a queue. PA was divided into three levels of low-intensity, moderate-intensity, and vigorous-intensity according to the metabolic equivalents (METs) spent per week. Cox regression model was used to calculate the hazard ratio ( HR) and 95% confidence interval. Results:A total of 3 353 subjects were included at baseline survey in 2015. Until Dec 31, 2019, there had been 31 stroke events had occurred since then, with accumulative incidence rate of 242/100 000, and an average follow-up time of (50.28±2.54) months. When adjusted for gender, age, education level, smoking status, alcohol consumption, BMI and hypertension, multivariate Cox regression analysis showed that greater PA was associated with a 37.9% reduction of incidence of stroke ( HR=0.621,95% CI:0.393-0.983). Compared with those who had low-intensity PA, those who were with vigorous-intensity. PA appeared associated with a 63.1% decrease in the incidence of stroke ( HR=0.369, 95% CI: 0.139-0.976). However, there was no statistical significance with moderate-intensity PA ( HR=0.712,95% CI:0.323-1.569), noticed. Conclusions:Greater PA is likely to reduce the incidence of stroke. Our findings indicated that people should be encouraged to increase the PA level and developing a healthy supportive environment in the community.

By means of literature review and comparative study, the paper studied the organization and policy system of emergency drug administration in the U.S. As found by the authors, that the U.S. has established a horizontal and vertical organizational structure system centering on the Department of Health and Human Services. This system covers a series of policy and legal regulations, such as the research and development, procurement, storage, emergency use, and clinical treatment of emergency medical products. In consideration of the experience of emergency drug administration in the U.S. and problems existing in China's current system in command and management, departmental coordination, resource allocation, and legal system construction of emergency drug, it is suggested that China should establish a core organization for emergency drug command and management, and improve relevant legal system. China also needs to focus on enhancing capabilities of local medical emergency rescue and information transmission, in order to establish a coordinated, well-organized, resource-sharing system of drug emergency administration in the country.

Based on the patient,bundled payment was known as episode-based payment,which pay the overall treatment cost on a or multiple medical service providers.In the current,there were 3 main bundled payment model in the United States,including confirm service,Prometheus and service improvement payment.The series of research showed that,bundled payment could decrease the cost of medical service based on keeping even improving medical service quality.Based on diagnosis related groups (DRGs),bundled payment increased total prepayment control and introduced the calculation method on cost prepayment ratio and potential avoidable allowance and reward for complication.The cost control based on the evidence and the incentive mechanism based on the encourage were all worth for references.

Improving the spatial agglomeration level of regional pharmaceutical industry is an important measure to promote the competitive ability of national industry.We used three evaluation indicators,Spatial Gini Coefficient,Location Concentration Ratio and Agglomeration Index,was to calculate the degree and speed of regional agglomeration of pharmaceutical industry from 2011 to Oct 2015.At present,China's pharmaceutical industry has formed spatial concentration,particularly concentrates in Shandong,Jiangsu and Guangdong.And the chemical pharmaceutical industry mainly concentrates in Shandong, Jiangsu,Guangdong and Beijing;Chinese traditional medicine industry concentrates in Shandong,Sichuan,Jilin and Jiangxi;biopharmaceutical industry concentrates in Shandong,Jiangsu,Henan.From the point of view of development speed,the agglomeration speeds of bio-pharmaceutical and traditional medicine industry are accelerating compared with the shrink of chemical pharmaceutical industry.Three provinces of the greatest growing speed of agglomeration for chemical,traditional medicine and bio-pharmaceutical industry are Jilin,Tibet and Jiangxi, respectively.Agglomeration growth of biopharmaceutical industry in western region is prominent.This paper suggests that the national government should play a leading role in the development of regional cluster for pharmaceutical industry.Some effective measures should be taken which include formulating the supporting policies of enterprise cluster,establishing the incentive system of drug innovation and optimizing the industrial portfolio in order to promote the formation of regional sustainable competitive advantage through agglomeration effect.

The theory of public goods was used to analyze the characteristics and status quo of emergency drug supply in China,holding such drugs as public goods.Based on the public-private partnership(PPP) model,the authors proposed to optimize the existing commanding mechanism,inventory system,information management system and supply system of emergency drugs.We recommended the establishment of an emergency drug supply assurance system,featuring leadership of local governments,and participation of pharmaceutical enterprises and hospitals,in which these entities are assigned with clear-cut emergency supply roles to ensure efficient supply of such drugs in the country.

Objective: To investigate the relationship among depression, anxiety, stress and addictive substance use behavior in secondary vocational students. Methods: Cluster sampling method and the Adolescent Health-related Behaviors Questionnaire were used to collect demographic characteristics, psychological symptoms, and addictive substance usage among 5 935 students in nine vocational schools in Chongqing, Zhaoqing, Ningbo, and Taiyuan. Multivariate logistic regression analysis was used to analyze the relationship between the addictive substance use behavior and psychological factors. Results: The detection rates of depression, anxiety and stress were 46.5% (n=2 762), 58.7% (n=3 483), and 29.8% (n= 1 770), respectively. The prevalence of addictive substances was 74.8% (n=4 440), traditional drugs was 0.8% (n=50), new drugs was 2.8% (n=166), other addictive drugs was 4.1% (n=241). Multivariate logistic regression analysis showed that compared with the normal psychological states of secondary vocational students, the OR value of mild depression tendency alcohol and tobacco use behavior of secondary vocational students was 1.45; the OR values of mild anxiety, moderate anxiety, severe anxiety and very serious anxiety were 1.46, 1.46, 1.71, and 1.83, respectively; the traditional drugs use behaviors were 5.51, and 2.61, respectively, for the severe anxiety and very serious anxiety. Compared with the normal psychological state of secondary vocational students, the OR values of the severe anxiety and very severe anxiety were 2.56, and 2.66, respectively, for severe anxiety and very serious anxiety. Compared with normal psychological status of secondary vocational students, the OR values of mild, moderate, severe, and very severe anxiety were 2.14, 2.47, 2.39, and 3.45, respectively; all P values <0.05. Conclusion Anxiety and mild depression were risk factors of tobacco and alcohol use in secondary vocational students; severe and above anxiety were the risk factors of drug use in secondary vocational students; anxiety was the risk factor for other addictive drug use in secondary vocational students.

Objective:To systematically evaluate the influence of the implementation of essential drug policy ( EDP) on prescrip-tion use rate of antibiotics in primary hospitals. Methods:Based on CNKI, Wanfang and VIP of China journal databases, all litera-tures were adopted including the data of the prescription use rate of antibiotics in primary hospitals. RevMan5. 3 and Stata 12. 0 soft-ware were used to conduct the Meta analysis. Results:Totally 43 literatures were included in the study according to the evaluation se-lection criteria. After the implementation of EDP, the prescription use rate of antibiotics in primary hospitals was decreased, and com-pared with that before the implementation of EDP, the risk difference value was significant [RD= -0. 03,95%CI( -0. 04,-0. 03), P<0. 000 01], while the use rate was still high (46. 16%). The result of Egger’s test indicated the publication bias of the 43 litera-tures was not significant (P=0. 571). However, there was high heterogeneity(I2 =94%,P<0. 000 01)among the different studies. Based on the classification of hospital type and different areas, the results of sub-group analysis showed the differences of study methods in the literatures and regional implementation measures of EDP contributed to the high heterogeneity among the different studies. Con-clusion:In order to reduce the heterogeneity of studies, a unified evaluation criteria for the research quality of the cross-section survey should be established. And special policies related to EDP should be taken to effectively decrease the use rate of antibiotics in primary hospitals.