Objective In order to discuss the rationality of clinical use of medication and the strategies of serious adverse reactions(SADR),the reports of SADRs caused by nedaplatin for injection were summarized and analyzed.Methods Methods Serious adverse reactions to all medicines reported to the National Adverse Reaction Monitoring Centre(NARMC)in Tongji Hospital Affiliated to Tongji Medical College,Huazhong University of Science and Technology from January 2012 to December 2021 were collected,and a retrospective analysis of 90 patients among those cases with SADR after nedaplatin injection was carried out.Results The occurrence of SADRs was not related to the gender.In monotherapy with nedaplatin,the rate of serious adverse effects was high with the first use of nedaplatin(74.3%).The incidence of adverse reactions was highest within 30 minutes and 2-14 days,including severe allergic reaction(34.4%)and grade Ⅱ-Ⅳ myelosuppression(51.2%),respectively.Drug withdrawal and symptomatic treatment were often the preferred treatment methods in clinical practice.Conclusion While using nedaplatin as a chemotherapy regimen,especially for the first time,patients should be closely monitored for the occurrence of severe anaphylaxis within 30 minutes and severe bone marrow suppression within 2 weeks.A rescue emergency plan for resuscitation and regular checking of the hemogram should be made to prevent the occurrence of serious adverse reactions.
Objective To study the relationship between health investment and economic growth in China.Methods An empirical study was conducted using threshold effect models and instrumental variable methods.Results Human capital investment in health sector can promote economic growth more than physical capital investment.Conclusion More human capital investment,such as the number of health personnel,should be added in the future health investment,and physical capital investment,such as the number of beds,should be controlled.The eastern region should increase health investment related to the elderly,which is more conducive to regional economic growth,while the central region should also increase health investment in physical capital such as the number of beds,while the western region should increase health investment in both aspects,which is more conducive to economic growth,because the economic development is relatively slow.
Objective To provide medical institutions with expert recommendations for the rational off-label use of key monitored drugs and to guide healthcare professionals in further standardizing the application of national monitored drugs.Methods The research design for reaching expert consensus on the rational clinical use of national monitored drugs beyond their approved indications followed the guidelines of the World Health Organization(WHO).A systematic search was conducted to extensively collect common issues related to the off-label use of the second batch of national monitored drugs in various provinces.The Delphi method was used to survey experts and identify common off-label use items for the key monitored drugs.Literature research and expert experience were utilized to collate and form relevant body of evidence,and quality evaluation was carried out in accordance with the GRADE approach.Consensus was reached again through the Delphi method regarding the recommended advice and evidence level,which ultimately led to the formation of the"Expert Consensus on the Rational Clinical Use of Nationally Monitored Drugs Beyond Their Approved Indications."Results A survey questionnaire was conducted among 60 experts through an online survey,and a consensus on off-label use items was reached using the Delphi method,covering drug categories such as proton pump inhibitors,antibiotics,glucocorticoids,and other medications.A total of 37 clinical issues were identified,resulting in a total of 38 recommended pieces of advice.Conclusion This consensus provides a reference and supplement for medical institutions to develop clinical application norms and prescription(medical order)review rules for national monitored drugs,to ensure the effectiveness and safety of their use.It further improves the quality of medical services,reduces the risk of adverse events related to national monitored drugs,promotes rational drug use.
Objective To comprehensively evaluate the quality of Croci Stigma from different regions by using the entropy weighted TOPSIS,and to provide evidence for the quality evaluation and regions selection of Croci Stigma.Methods The contents of picrocrocin,crocin I,crocin II and crocin III were determined by HPLC wavelength switching method.The total content of four components,loss on drying,total ash,absorbance and extract were chosen as detection indexes for Croci Stigma,and the weight was calculated by entropy weight method,and the indexes were statistically analyzed by TOPSIS method.The quality of Croci Stigma was comprehensively evaluated.Results The analysis results of entropy weighted TOPSIS method showed that the mean values of relative closeness(Ci)values of Croci Stigma from Zhejiang,Tibet,Anhui,Jiangsu provinces and shanghai city were 0.654,0.396,0.426,0.326 and 0.341,respectively.Overall,the quality of Croci Stigma in Zhejiang province was the highest.Conclusion The established entropy weighted TOPSIS method is objective,comprehensive and effective,which can be used for the comprehensive quality evaluation of Croci Stigma.
Objective To evaluate the differences in efficacy,safety and economics of vancomycin hydrochloride for injection between two manufacturers based on real-world data.Methods A total of 6 757 cases of intravenous use of vancomycin hydrochloride for injection from different manufacturers between January 1,2013 and December 31,2019 in the Affiliated Drum Tower Hospital of Nanjing University Medical School were retrospectively analyzed,and 5308 cases were matched by 1∶1 propensity score method,including 2 654 cases in the group A(domestic drug group)and 2 654 cases in group B(the innovator drug group).The differences in efficacy and safety between the two groups were compared.Cost-effectiveness analysis was used to compare the drug economics of the two groups.Results There were no significant differences in clinical cure rate,bacterial clearance rate,and incidence of adverse events between the two groups(P>0.05).In terms of economics,the average cost of vancomycin per capita,average daily cost of vancomycin and average cost of antibiotics per capita were significantly different between the two groups(P<0.05),and the cost of group B was higher than that of group A.Conclusion The efficacy and safety of vancomycin hydrochloride for injection were consistent between the two manufacturers.
