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Hemophilia is a hereditary bleeding disorder where the only effective treatment is factor replacement therapy. The main contradiction of hemophilia in China is the contradiction between the increasing demand for quality of life of hemophilia patients and insufficient medical insurance, medical treatment and medicine. Expensive treatment costs are the main reason for patients to 'be impoverished due to illness' and 'return to poverty due to illness'. This article analyzes the current status of the hemophilia aid system through the existing literature data and existing patient aid projects. Cooperation of social insurance, social relief and high-quality medical services is critical to a complete hemophilia comprehensive medical aid system, so that hemophilia patients can receive standardized diagnosis and treatment, and try to achieve the close quality of life as normal.

In 2018, hemophilia, one of the first ones, entered into the catalogue of Rare Disease in China. However, drug accessibility and affordability have been the challenges for hemophilia patients. Therefore, a comprehensive evaluation of the cost and efficacy of hemophilia drugs is essential to push forward the appropriate application of hemophilia drugs. In the article, we have teased out the existing process of the review and approval of hemophilia drugs; have examined the procedures for the drug entry into the medical insurance policy; have systematically searched the pharmacoeconomic evaluation studies of hemophilia in published literature in both China and overseas; and have comprehensively analyzed the quality, the content of evaluation, and challenges of pharmacoeconomic studies of hemophilia in China. At last, we discuss the prospect for the future based on the following three aspects: developing a special model of hemophilia, obtaining the health utility from various sources, and establishing the threshold of willingness to pay for rare diseases, hoping to provide reference and examples to the research into pharmacoeconomic evaluation of hemophilia in China.

Accurately evaluating the flow characteristics in fracture intersections is important to advance the understanding of groundwater flow and solute transport in crossed rock fractures. However, mainly two-dimensional (2D) intersection models have been adopted in previous studies, and the influence of intersection angles and related three-dimensional (3D) effects (channel flow and transverse flow) on the fracture seepage and the solute transport is still neglected. In this study, the 3D crossed fracture models, coupled with various intersection angles, were established through the intersection of two rough-walled fractures. The characteristic parameters of the fluid flow and the solute transport under different inlet velocity conditions were calculated by the Navier–Stokes equation and the advective–diffusion equation, respectively. The results indicated that the intricate geometry of the intersection in 3D rough-walled models led to channeling flows, which subsequently impacted mixing behavior depending on velocity. Due to the presence of channeling flows, the velocity ratio at the outlet was different from that of a 2D fracture as the inlet hydraulic conditions evolved. The coefficient matrices describing nonlinear flow behavior in different fracture intersection angles were quantified simultaneously. The reallocation of fluid pathways induced by intersecting angles affects mixing behavior by influencing the geometrical structure of fracture intersections. Moreover, the breakthrough curves and solute mixing process were significantly dependent on the intersection angle and the inlet velocity. In the linear region, the mixing ratio is random due to the intersection of heterogeneous, while in the nonlinear region, the mixing ratio decreases with the increase in water flow. Above all, the correlation established in this study between hydraulic parameters and the intersection angle parameter can enhance their efficacy in predicting solute transport in fractured rocks. [ABSTRACT FROM AUTHOR]

Introduction: An increased bleeding tendency has been shown in female haemophilia carriers compared to healthy females. Bleeding assessment tools (BATs) have mainly been performed in western cultures. It is unclear how they perform in populations with different healthcare, health/wellness concepts and awareness, as well as family planning practices. Aim: To (a) describe and compare the bleeding symptoms in carriers with healthy females, particularly for bleeding after surgical abortion and intrauterine device (IUD) placement which are performed frequently for family planning in China; (b) quantify scores of International Society on Thrombosis and Haemostasis Bleeding Assessment Tool (ISTH‐BAT) and Chinese‐BAT (C‐BAT) developed to include surgical abortion and IUD placement as separate categories in Chinese haemophilia carriers; (c) correlate bleeding scores (BS) with factor levels. Methods: We conducted a multicentre, cross‐sectional study on obligate haemophilia carriers and healthy controls using ISTH‐BAT and C‐BAT. Results: We enrolled 125 haemophilia carriers and 106 controls. Carriers, compared to controls, had significantly higher median BS (3 vs 1 by both ISTH‐BAT and C‐BAT) and lower factor level (63.5 vs 101.8 IU/dL). Bleeding after surgical abortion and IUD placement was significantly associated with carrier status. Bleeding scores from neither ISTH‐BAT nor C‐BAT showed significant correlation with factor levels. Conclusion: Haemophilia carriers in China experienced abnormal bleeding. Unique to the Chinese carriers is significant bleeding after surgical abortion (3rd highest incidence of bleeding symptom) and IUD placement (4th highest). However, both ISTH‐BAT and C‐BAT exhibited no correlation between BS and factor levels in this population and neither could identify carriers with low factor level (of <50 IU/dL). [ABSTRACT FROM AUTHOR]