[A multicenter survey of the accessibility of essential medicines for children in China].

Objective: To investigate the availability, prices and affordability of essential medicines in pediatric population across China, in the hope of improving rational use of medicines. Methods: A multicenter cross-sectional survey of medicine prices, availability and affordability was conducted in 17 provinces, municipalities and autonomous region across east, south-central part, west and north of China. Data on 42 medicines used in pediatric population, both original and generic, were collected in 55 public hospitals from May 26 to June 2, 2017. Availability was expressed as the percentage of hospitals with stock of the target medicine on the day of data collection,and median price ratio (MPR) was the ratio of price upon investigation to international reference. Based on national minimum daily wage, affordability represents the number of working days needed to earn the expense which covers a standard course using the target medicine. Statistical software SPSS 13.0 was applied for descriptive analysis of availability, MPR and affordability. Results: Mean Availability of original and generic medicine was 33% and 32%, with median MPR being 5.43 and 1.55. Among the 19 medicines with price information for both original and generic product, the median MPR was 7.73 and 2.04 respectively. Regarding the five medicines used to treat four common pediatric diseases (pneumonia,peptic ulcer, congenital hypothyroidism, refractory nephrotic syndrome), the affordability was 0.63 (0.16-6.17) d for generic medicine, and 1.03 (0.16-11.53) d for its original counterpart. Conclusions: The availability to both original and generic products of the 42 medicines used in pediatric population was low in China. The prices of generic medicines seem to be lower and affordability higher than those of original medicines. There is an urgent need to improve the availability and affordability of pediatric medicines.

[Epidemiological pattern of abnormal urinary fluoride rates in population with occupational fluoride exposure in Shanghai].

Objective: To investigate the epidemiological features of abnormal urinary fluoride rates in population with occupational exposure, and its relationships with age, work years and gender in Shanghai. Methods: A questionnaire survey was conducted respectively in 4 999 exposed workers and 283 non-exposed people during 2012-2015. Their urine samples were collected in plastic bottles and the fluoride ion selective electrode method was used for urinary fluoride level analysis. Logistic regression model was used to estimate associations between the abnormal rates and demographic/socioeconomic status of the study subjects. Results: In the past 4 years, the abnormal urinary fluoride rates (≥1.6 mg/L) in the population with occupational exposure was about 14.38%, it was about 1.43% in the control groups without occupational exposure. Their geometric mean of urinary fluoride content was 0.95 mg/L and 0.46 mg/L, respectively. The incidences of the abnormal rates in those aged ≥50 years and 34-39 years were 19.15% and 22.39%, respectively. The abnormal rate in males was 16.87%, much higher than that in females (6.85%). The abnormal rate had an upward trend along with the increased work years, especially in those with work years of ≥20 years. The abnormal rate was 23.28% in those with work years of ≥20 years and 13.29% in those with work years of <4 years. The relative risk for abnormal urinary fluoride rates was higher in male group, older age group and longer work year group, the odds ratio was 2.28, 1.10 and 1.13, respectively. Conclusions: Serious challenges exist in occupational health supervision. The relevant national standards should be updated as soon as possible. Males, those aged >50 years, and those with longer work years are the risk groups for intervention measures. More efforts are needed, such as strengthening the innovative application of health examination data and the equalization of basic public health service with comprehensive occupational health supervision programs among off-farm workers in the new medical reform.

[Studies on the synthesis of gossypol derivatives and their antifertility action].

PIP: Attempts were made to decrease the toxicity of the male antifertiltiy agents gossypol by structural modifications. 2 groups of Schiff bases of gossypol were prepared by condensation of gossypol with N-alkyl-N-aminopiperazines and N-alkyl-N-aminoethylpiperazines, respectively. The antifertility activities of these synthesized compounds were evaluated on male rats. They were much less toxic than gossypol and did not exhibit significant antifertility activity. (author's)^ieng