Medical institution preparations play an important role in the development of hospitals,being one of the main forms of traditional Chinese medicine clinical characteristic medication,as well as an important carrier fo...Medical institution preparations play an important role in the development of hospitals,being one of the main forms of traditional Chinese medicine clinical characteristic medication,as well as an important carrier for the inheritance and innovation of traditional Chinese medicine.In recent years,the research and development of traditional Chinese medicine preparations has become a hot spot in the research and development of preparations by medical institutions.Traditional Chinese medicine preparations prepared by traditional processes and their entrusted preparation matters have changed from the current licensing management to filing management.The registration model of traditional Chinese medicine preparations has undergone significant changes,emphasizing more on real data and evaluation results from the objective world,respecting traditional medication experience,and emphasizing the inheritance and innovative development of traditional technological experience.In the process of following teachers in the inheritance project of traditional Chinese medicine,we combined the inheritance of traditional Chinese medicine characteristic technology with the research and development practice of traditional Chinese medicine preparations in medical institutions,and focused on the analysis and discussion of technical problems such as prescription screening,dosage form selection,process route design and clinical observation of traditional Chinese medicine preparations,hoping to provide reference for scholars in the same field of traditional Chinese medicine.展开更多
Objectives: The cost-utility analysis of Liraglutide is aimed at evaluating whether Liraglutide is cost-effective or not after Chinese reformation on medical insurance. The analysis is based on the results of clinical...Objectives: The cost-utility analysis of Liraglutide is aimed at evaluating whether Liraglutide is cost-effective or not after Chinese reformation on medical insurance. The analysis is based on the results of clinical trial conducted in Asia. Methods: We applied a Markov model to estimate the quality-adjusted life years, medical cost and incidence of diabetes-related complications for patients receiving the Liraglutide as an add-on to the metformin treatment. Baseline characteristics were taken from a China’s study while the treatment effect is from an Asian study. The related medical cost and utility score were obtained from a local study in China. Having set 30 years’ simulations, the incremental cost-effectiveness ratio was calculated comparing with glimepiride treatment. The ratio would be compared with the willingness to pay for a quality-adjusted-life-year (QALY) which is three times of the GDP per capita in Beijing. Sensitivity analysis was also performed. Result: During a period of 30 years, the base-case analysis which takes discount rate at 3% shows that Liraglutide 1.8 mg results in an average incremental cost of CNY 82,671.49, an improvement in 0.12 QALYs and a reduction of incidence of diabetes-related complications comparing to glimepiride. The associated incremental cost-effectiveness ratio is CNY 688,929.08. Conclusion: Long-term project shows that taking Liraglutide as an add-on to the metformin treatment will lead to increasing quality-adjusted life years and reduction of incidence of diabetes-related complications. When the price of Liraglutide is reduced by 43 percent in China’s yuan, Liraglutide will be cost-effective in China from the healthcare system perspective taking three times of GDP per capita as our WTP threshold.展开更多
Objective:To understand the clinical manifestation of severe acute respiratory syndrome (SARS) and explore its effective treatment with integrative Chinese and western medicine (ICWM). Methods:The data of patients, wh...Objective:To understand the clinical manifestation of severe acute respiratory syndrome (SARS) and explore its effective treatment with integrative Chinese and western medicine (ICWM). Methods:The data of patients, whose diagnosis of SARS had been confirmed were summarized and analyzed, and clinical observation was conducted when the patients were treated with ICWM. Results:In the early stage of the 42 patients, the symptoms revealed were fever in 100% of SARS patients, headache in 92. 9%, aversion to cold in 76. 2%, chest stuffiness in 76. 2% , cough in 73. 8% and myalgia in 88.1%; pulmonary lesion involves >3 lobes in 42. 9%, 2 lobes in 47. 6% and 1 lobe in 9. 5%; 61. 9% of them showed liver function abnormality (increase of ALT or AST), 47. 6% showed elevated myocardial enzyme (CK or CK-MB) , 0. 48% showed an inclination of renal function (higher of BUN or Cr); in their T lymphocyte subsets, 91. 2% (31/34 patients) had lowered CD3 and 76. 5% (26/34 patients) lowered CD4/CD8 ratio. In the mid-late stage, the symptoms were lassitude and weakness in 85. 7%, scare in 81. 0%, short of breath or chest stuffiness in 71. 4%, loss of appetite in 64. 3%;light dark tongue proper in 52. 4%, yellow and white tongue coating in 45. 2%, and yellow thick coating on the middle-root part of the tongue in 21. 4%. Most of them were asymptomatic when discharged from hospital, with 92. 8% of their pulmonary lesion, according to chest film, completely absorbed and liver function, myocardial enzyme and renal function all normalized. However, of the 30 patients who had CD3 reexamination, 70% of the CD3 showed lower than normal range and 36. 7% showed their CD4/CD8 inclined to lower margin, follow-up should be done for these patients. Of the 42 patients, who received western medicine (WM) alone in the early stage and ICWM in the mid-late stage, 10 were severe cases and 3 critical cases, but none of them died. The mean defervescent time was 3. 52±0. 85 days, the time for complete absorption of pulmonary lesion judged by chest X-ray film was 26. 82±5. 98 days, and the mean hospitalization time was 33. 60±4. 37 days. Conclusion:The manifestation of SARS is multifarious, showing that there were damage in multiple organs. The T lymphocyte count percentage and its subsets, CD3 and CD4 /CD8 ratio, are valuable for early diagnosis and follow-up in the rehabilitation stage. Majority of the patients could be clinically cured. Combined treatment of WM and TCM according to syndrome differentiation and psychiatric intervention are beneficial to remit partial symptoms and promote rehabilitation.展开更多
基金Supported by The Third Batch of Traditional Chinese Medicine Famous Doctors Inheritance Implementation Project in Guizhou Province in 2021(QZYYH[2021]106).
文摘Medical institution preparations play an important role in the development of hospitals,being one of the main forms of traditional Chinese medicine clinical characteristic medication,as well as an important carrier for the inheritance and innovation of traditional Chinese medicine.In recent years,the research and development of traditional Chinese medicine preparations has become a hot spot in the research and development of preparations by medical institutions.Traditional Chinese medicine preparations prepared by traditional processes and their entrusted preparation matters have changed from the current licensing management to filing management.The registration model of traditional Chinese medicine preparations has undergone significant changes,emphasizing more on real data and evaluation results from the objective world,respecting traditional medication experience,and emphasizing the inheritance and innovative development of traditional technological experience.In the process of following teachers in the inheritance project of traditional Chinese medicine,we combined the inheritance of traditional Chinese medicine characteristic technology with the research and development practice of traditional Chinese medicine preparations in medical institutions,and focused on the analysis and discussion of technical problems such as prescription screening,dosage form selection,process route design and clinical observation of traditional Chinese medicine preparations,hoping to provide reference for scholars in the same field of traditional Chinese medicine.
文摘Objectives: The cost-utility analysis of Liraglutide is aimed at evaluating whether Liraglutide is cost-effective or not after Chinese reformation on medical insurance. The analysis is based on the results of clinical trial conducted in Asia. Methods: We applied a Markov model to estimate the quality-adjusted life years, medical cost and incidence of diabetes-related complications for patients receiving the Liraglutide as an add-on to the metformin treatment. Baseline characteristics were taken from a China’s study while the treatment effect is from an Asian study. The related medical cost and utility score were obtained from a local study in China. Having set 30 years’ simulations, the incremental cost-effectiveness ratio was calculated comparing with glimepiride treatment. The ratio would be compared with the willingness to pay for a quality-adjusted-life-year (QALY) which is three times of the GDP per capita in Beijing. Sensitivity analysis was also performed. Result: During a period of 30 years, the base-case analysis which takes discount rate at 3% shows that Liraglutide 1.8 mg results in an average incremental cost of CNY 82,671.49, an improvement in 0.12 QALYs and a reduction of incidence of diabetes-related complications comparing to glimepiride. The associated incremental cost-effectiveness ratio is CNY 688,929.08. Conclusion: Long-term project shows that taking Liraglutide as an add-on to the metformin treatment will lead to increasing quality-adjusted life years and reduction of incidence of diabetes-related complications. When the price of Liraglutide is reduced by 43 percent in China’s yuan, Liraglutide will be cost-effective in China from the healthcare system perspective taking three times of GDP per capita as our WTP threshold.
文摘Objective:To understand the clinical manifestation of severe acute respiratory syndrome (SARS) and explore its effective treatment with integrative Chinese and western medicine (ICWM). Methods:The data of patients, whose diagnosis of SARS had been confirmed were summarized and analyzed, and clinical observation was conducted when the patients were treated with ICWM. Results:In the early stage of the 42 patients, the symptoms revealed were fever in 100% of SARS patients, headache in 92. 9%, aversion to cold in 76. 2%, chest stuffiness in 76. 2% , cough in 73. 8% and myalgia in 88.1%; pulmonary lesion involves >3 lobes in 42. 9%, 2 lobes in 47. 6% and 1 lobe in 9. 5%; 61. 9% of them showed liver function abnormality (increase of ALT or AST), 47. 6% showed elevated myocardial enzyme (CK or CK-MB) , 0. 48% showed an inclination of renal function (higher of BUN or Cr); in their T lymphocyte subsets, 91. 2% (31/34 patients) had lowered CD3 and 76. 5% (26/34 patients) lowered CD4/CD8 ratio. In the mid-late stage, the symptoms were lassitude and weakness in 85. 7%, scare in 81. 0%, short of breath or chest stuffiness in 71. 4%, loss of appetite in 64. 3%;light dark tongue proper in 52. 4%, yellow and white tongue coating in 45. 2%, and yellow thick coating on the middle-root part of the tongue in 21. 4%. Most of them were asymptomatic when discharged from hospital, with 92. 8% of their pulmonary lesion, according to chest film, completely absorbed and liver function, myocardial enzyme and renal function all normalized. However, of the 30 patients who had CD3 reexamination, 70% of the CD3 showed lower than normal range and 36. 7% showed their CD4/CD8 inclined to lower margin, follow-up should be done for these patients. Of the 42 patients, who received western medicine (WM) alone in the early stage and ICWM in the mid-late stage, 10 were severe cases and 3 critical cases, but none of them died. The mean defervescent time was 3. 52±0. 85 days, the time for complete absorption of pulmonary lesion judged by chest X-ray film was 26. 82±5. 98 days, and the mean hospitalization time was 33. 60±4. 37 days. Conclusion:The manifestation of SARS is multifarious, showing that there were damage in multiple organs. The T lymphocyte count percentage and its subsets, CD3 and CD4 /CD8 ratio, are valuable for early diagnosis and follow-up in the rehabilitation stage. Majority of the patients could be clinically cured. Combined treatment of WM and TCM according to syndrome differentiation and psychiatric intervention are beneficial to remit partial symptoms and promote rehabilitation.
