Reduced SARS-CoV-2 infection risk is associated with the use of Seven-Flavor Herb Tea: A multi-center observational study in Shanghai,China

ObjectiveOmicron, a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variant, is responsible for numerous infections in China. This study investigates the association between the use of Seven-Flavor Herb Tea (SFHT) and the risk of SARS-CoV-2 infection to develop precise and differentiated strategies for control of the coronavirus disease 2019 (COVID-19).MethodsThis case-control study was conducted at shelter hospitals and quarantine hotels in China. A total of 5348 laboratory-confirmed COVID-19 patients were enrolled between April 1 and May 31, 2022, while 2190 uninfected individuals served as healthy controls. Structured questionnaires were used to collect data on demographics, underlying diseases, vaccination status, and use of SFHT. Patients were propensity-score-matched using 1:1 nearest-neighbor matching of the logit of the propensity score. Subsequently, a conditional logistic regression model was used for data analysis.ResultsOverall, 7538 eligible subjects were recruited, with an average age of [45.54 ± 16.94] years. The age of COVID-19 patients was significantly higher than that of uninfected individuals ([48.25 ± 17.48] years vs [38.92 ± 13.41] years; t = 22.437, P < 0.001). A total of 2190 COVID-19 cases were matched with uninfected individuals at a 1:1 ratio. The use of SFHT (odds ratio = 0.753, 95% confidence interval: 0.692, 0.820) was associated with a lower risk of SARS-CoV-2 infection compared to untreated individuals.ConclusionOur findings suggest that taking SFHT reduces the risk of SARS-CoV-2 infection. This is a useful study in the larger picture of COVID-19 management, but data from large-sample multi-center, randomized clinical trial are warranted to confirm the finding.Please cite this article as: Zhang SX, Chen XX, Zheng Y, Cai BH, Shi W, Ru M, Li H, Zhang DD, Tian Y, Chen YL. Reduced SARS-CoV-2 infection risk is associated with the use of Seven-Flavor Herb Tea: A multi-center observational study in Shanghai, China. J Integr Med. 2023; 21(4):369–376.     

Engineered platelets-based drug delivery platform for targeted thrombolysis

Thrombolytic agents have thus far yielded limited therapeutic benefits in the treatment of thrombotic disease due to their short half-life, low targeting ability, and association with serious adverse reactions, such as bleeding complications. Inspired by the natural roles of platelets during thrombus formation, we fabricated a platelet-based delivery system (NO@uPA/PLTs) comprising urokinase (uPA) and arginine (Arg) for targeted thrombolysis and inhibition of re-embolism. The anchoring of uPA to the platelet surface by lipid insertion increased the thrombotic targeting and in vivo circulation duration of uPA without disturbing platelet functions. Nitric oxide (NO) generated by the loaded Arg inhibited platelet aggregation and activation at the damaged blood vessel, thereby inhibiting re-embolism. NO@uPA/PLTs effectively accumulated at the thrombi in pulmonary embolism and carotid artery thrombosis model mice and exerted superior thrombolytic efficacy. In addition, the platelet delivery system showed excellent thrombus recurrence prevention ability in a mouse model of secondary carotid artery injury. The coagulation indicators in vivo showed that the platelet-based uPA and NO co-delivery system possessed a low hemorrhagic risk, providing a promising tool for rapid thrombolysis and efficient inhibition of posttreatment re-embolism.     

多适应证药物医保准入和定价策略境外经验及启示

文章对境外国家或地区多适应证药物在医保准入和定价策略进行综述,为我国多适应证药物医保准入路径模式、医保支付标准测算方法提出建议。从境外经验来看,医保准入模式包括所有适应证同时准入、单个适应证序贯准入。医保评估模式包括准入前评估、准入后评估。医保定价方法包括签订价格协议、基于每种适应证的价值制定的加权平均价格、基于首个适应证制定初始价格,后续根据预算影响调整价格等。我国应基于目前的医保准入体系,进一步探索和细化多适应证药物的医保准入路径和相应的医保支付标准测算方法,促进医保精细化管理。     

德国创新药品医保准入机制

德国通过一系列政策规范了创新药品医保准入流程,在提升患者创新药品的可及性的同时,也降低了医保基金的支付压力,在这一过程中有诸多值得我国学习的地方。而我国创新药品准入机制一直处于探索发展阶段,基于创新药品医保准入的全流程,总结了德国的医保准入机制,包括监管的组织架构、医保准入及支付流程、新增适应症的价格调整机制等,同时结合我国创新药品准入现状,建议我国可引入创新药品谈判仲裁机制、支付模式过渡机制、新增适应症量价加权平均算法机制,为我国现行创新药品准入与支付制度提供国际实践借鉴经验。     

二代测序法用于非小细胞肺癌突变基因检测的经济学评价

目的：分析与传统基因检测技术相比，二代测序法用于非小细胞肺癌突变基因检测的经济性。方法：对国际二代测序法用于非小细胞肺癌的经济学评价进行系统综述。从卫生体系视角出发，构建决策树模型，测算二代测序法 （8基因突变联合检测） 对比荧光实时定量PCR法 （3基因突变联合检测） 的成本-效果，并进行敏感性分析。结果：纳入4篇研究，其中2篇研究认为与传统基因检测技术相比，二代测序法用于非小细胞肺癌的突变基因检测具有一定的经济性，但仍需要结合具体情况进一步研究。模型研究结果表明，对比荧光实时定量PCR法 （3基因突变联合检测），采用二代测序法 （8基因突变联合检测），非小细胞肺癌患者多存活1年所需要增加的诊断成本为97 501.18元，以3倍人均GDP为阈值时，具有成本-效果。结论：二代测序法用于非小细胞肺癌突变基因检测具有一定经济性，但未来仍需要更新数据和结果。     

荷兰养老护理模式对我国老年护理发展的思考

2012年4月至5月,笔者作为中荷社区卫生合作项目第五期学员赴荷兰进行为期两周的考察和学习,了解荷兰社会概况、福利政策、健康保健体系等。学习期间我们参观了全科医生工作站、医院、学校、康复中心、老年公寓、老年护理中心和养老院,跟随当地护士到患者家中开展家庭护理(home care)。现将荷兰卫生保健体系、家庭护理特点及对我国老年护理发展的启示,介