Collective pharmaceutical procurement in China may have unintended consequences in supply and pricing

The collective pharmaceutical procurement was launched in China in 2018 to reduce the prices of selected drugs, by pooling the demands of member cities and granting the contract to the manufacturer with the lowest bid. We found the procurement significantly decreased the prices of most drugs. We also identified significant price increases on some drugs, indicating that manufacturers of these drugs may have strong market power to manipulate prices. The “winner-takes-all” principle applied in the procurement may further increase the market power of winning manufacturers by expanding their respective market shares. They may take the advantage of the market power to increase drug prices in the long-run. The continuously lowering price-caps may force the losing bidders to exit the market. A careful assessment of the unintended consequences of the collective procurement is warranted

Clinical effects research of the excision of pterygium combined with limbal epithelial autograft with conjunctival grafting on recurrent pterygium

AIM: To observe the clinical effects of the excision of pterygium combined with limbal epithelial autograft with conjunctival grafting on recurrent pterygium. <p>METHODS: Totally 84 patients(84 eyes)with first recurrent pterygium were allocated two groups: excision pterygium with limbal epithelial autograft with conjunctival(group A, 43 cases with 43 eyes)and excision of pterygium with conjunctival autograft(group B, 41 cases with 41 eyes), the post-operative follow-up period of 12 months, we analyzed the repair time of epithelium, tear break-up time(1 month and 3 months), Schirmer l test(1 month and 3 months), corneal fluorescence staining test(1 month and 3 months), and recurrent rate. <p>RESULTS: The group A had a shorter repair time of epithelium and lower recurrent rate, compared with the group B, which had statistically significant difference(<i>P</i><0.05), but there was no statistically significant difference in the tear break-up time, corneal fluorescence staining test and the Schirmer l test in 1 month and 3 months between the two groups(<i>P</i>>0.05). <p>CONCLUSION:Limbal epithelial autograft with conjunctival transplantation is a convenient, safe, effective method for the treatment of recurrent pterygium

A Model of Workflow Composition for Emergency Management

AbstractThe common-used workflow technology is not flexible enough in dealing with concurrent emergency situations. The paper proposes a novel model for defining emergency plans, in which workflow segments appear as a constituent part. A formal abstraction, which contains four operations, is defined to compose workflow segments under constraint rule. The software system of the business process resources construction and composition is implemented and integrated into Emergency Plan Management Application System

Activation of Orexin 1 Receptors in the Paraventricular Nucleus Contributes to the Development of Deoxycorticosterone Acetate-Salt Hypertension Through Regulation of Vasopressin

Salt-sensitivity is a major factor in the development of hypertension. The brain orexin system has been observed to play a role in numerous hypertensive animal models. However, orexin’s role in the pathology of salt-sensitive hypertension (SSH) remains to be adequately explored. We assessed the impact of orexin hyperactivity in the pathogenesis of the deoxycorticosterone acetate (DOCA) – salt rat model, specifically through modulation of Arginine Vasopressin (AVP). Adult male rats were separated into three groups: vehicle control, DOCA-salt, and DOCA-salt+OX1R-shRNA. DOCA-salt rats received subcutaneous implantation of a 21-day release, 75 mg DOCA pellet in addition to saline drinking water (1% NaCl and 0.2% KCl). DOCA-salt+OX1R-shRNA rats received bilateral microinjection of AAV2-OX1R-shRNA into the paraventricular nucleus (PVN) to knockdown function of the Orexin 1-Receptor (OX1R) within that area. Following 2-week to allow full transgene expression, a DOCA pellet was administered in addition to saline drinking solution. Vehicle controls received sham DOCA implantation but were given normal water. During the 3-week DOCA-salt or sham treatment period, mean arterial pressure (MAP) and heart rate (HR) were monitored utilizing tail-cuff plethysmography. Following the 3-week period, rat brains were collected for either PCR mRNA analysis, as well as immunostaining. Plasma samples were collected and subjected to ELISA analysis. In line with our hypothesis, OX1R expression was elevated in the PVN of DOCA-salt treated rats when compared to controls. Furthermore, following chronic knockdown of OX1R, the hypertension development normally induced by DOCA-salt treatment was significantly diminished in the DOCA-salt+OX1R-shRNA group. A concurrent reduction in PVN OX1R and AVP mRNA was observed in concert with the reduced blood pressure following AAV2-OX1R-shRNA treatment. Similarly, plasma AVP concentrations appeared to be reduced in the DOCA-salt+OX1R-shRNA group when compared to DOCA-salt rats. These results indicate that orexin signaling, specifically through the OX1R in the PVN are critical for the onset and maintenance of hypertension in the DOCA-salt model. This relationship is mediated, at least in part, through orexin activation of AVP producing neurons, and the subsequent release of AVP into the periphery. Our results outline a promising mechanism underlying the development of SSH through interactions with the brain orexin system

High throughput 16SrRNA gene sequencing reveals the correlation between Propionibacterium acnes and sarcoidosis

Sequences of the unique OTUs. (XLS 3616 kb