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Abstract Background In 2009, China implemented the national essential medicines system by enacting the National Essential Medicines List 2009. According to the policy of this system, primary health care institutions can only stock and use essential medicines on the prescribed List. Meanwhile, each province can choose to make its own list of supplemented medicines. The goal of the study is to provide suggestions for emerging problems and identify future policy-making trends. Methods In this study, we statistically analyzed the National Essential Medicines List 2009 and lists of supplemented medicines of all 29 provinces. We also examined the rationality of such medicines based on the DELPHI method and literature review, after which we studied the provincial supplements in relation to the national essential medicines system. Results We demonstrated that the National Essential Medicines List 2009 provides a comprehensive coverage of diseases as well as reasonable varieties of drugs for their treatment. The average number of supplemented medicines in 29 provinces is 207, with each medicine included in 2.9 provincial lists on average. Only 2.6% supplemented medicines are included by more than half of the provinces (>15), indicating great regional variance. Among the 32 most frequently supplemented medicines, only 18 meet the selection principles, including two with strict usage restrictions. Conclusion The structure and selection of the National Essential Medicines List 2009 are relatively reasonable. The main problems, however, include the excessive and non-scientific selection of medicines on the supplemented medicines list. The function of the provincial lists of supplemented medicines has not been achieved, which has influenced the effectiveness of the national essential medicines system in China.

We reported a new strategy for efficient phosphate removal from wastewaters, it relies on the discarded Artemia Cyst-shell in-situ growth of Al(OH) 3 nanocluster, the charged amino-acids components of skeleton make available for the small size of Al(OH) 3 formation (< 10 nm) with high activity, and the three-dimensional porous structure of discarded matrix provides fast kinetics and efficient Al(OH) 3 nanoparticles utilization. These hybrid adsorbents exhibit ultrahigh capacity (850.5 mg/g) and fast kinetics (~2 min) by recent ten-years (2011-2020) survey, the superior selectivity against various foreign ions, with a distribution coefficient (K d ) as high as 4820 mL/g, the porous structure and fast kinetics also accelerate the phosphate accessibility, yielding a satisfactory capacity of ~3000 L/kg sorbent (Artemia CS-Al) for the application, even varying at high feeding-speeds. The saturated adsorbent can be readily regenerated and reused without decrease in performance, this technology is promising for mitigating the contamination problem of excess phosphate worldwide., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)