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Objective:To explore the clinical value of procalcitonin (PCT) in predicting mortality of patients with acute biliary pancreatitis (ABP).Methods:The clinical data of 196 ABP patients admitted in the emergency department of Ruijin Hospital Affiliated to Shanghai Jiaotong University Medical College from January 2013 to June 2017 were analyzed retrospectively. The enrolled patients were divided into survival group ( n=176) and death group ( n=20) according to clinical outcome, and their clinical characteristics, laboratory results(including WBC, CRP, PCT), APACHEⅡ score, BISAP score, modified Marshall score, SOFA score and CTSI at admission were compared between two groups. The ROC curve and AUC were used to evaluate the effectiveness of PCT and multiple scoring systems in predicting mortality in ABP patients, and the Delong test was used to compare the predictive efficacy of various methods at 1-2 d, 3-4 d, and 5-7 d days after onset. Results:The PCT level, APACHEⅡ score, BISAP score, modified Marshall score, SOFA score, and CTSI of patients in the death group were significantly higher than those in the survival group [6.98(3.12, 13.64) μg/L vs 0.55(0.17, 1.74) μg/L, 12.00(6.00, 18.75) vs 6.00(3.00, 9.00), 3.20±1.47 vs 1.59±1.05, 2.85±0.37 vs 1.96±0.64, 5.50(4.00, 9.50) vs 2.00(1.00, 4.25), 5.05±2.33 vs 3.39±1.74], and all the differences were statistically significant (all P values <0.05). The AUC of PCT for predicting death was 0.881 (95% CI 0.820-0.938)and the cut-off value was 2.44. The predictive value of PCT was similar to that of the modified Marshall score, BISAP score and SOFA score, but higher than that of APACHEⅡ score and CTSI (all P values <0.05). The predictive AUC of PCT at 3-4 days after onset was higher than that of modified Marshall score, BISAP score and SOFA score, and were significantly higher than those at 1-2 days after onset. Conclusions:PCT can be used to predict the mortality of ABP within 7 days of onset. The predictive value of PCT was comparable to the modified Marshall score, BISAP score and SOFA score, and the best predictive time was 3-4 days after onset.
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The literature review on the treatment mechanism of traditional Chinese medicine (TCM) to ovarian cancer reveals that TCM can not only induce the apoptosis of ovarian cancer cell by three ways, namely mitochondrial pathway, death-receptor pathway, ER stress pathway, but also regulate body immunity and drug-tolerance of chemotherapeutics. The advantages of TCM treatment on tumor include relatively more therapeutic targets, less treating resistance, better medicine effect, less side effects, and lower cost. Through the elaborately designed experimental and assessment criteria, the TCM treatment mechanism can be recognized by in vivo and in vitro study.
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Background and purpose: Epithelial ovarian carcinoma is the most malignant tumor in female reproductive system because of its resistance to chemotherapy. Fructose-1, 6-bisphosphatase (FBP1) is a rate-limiting enzyme in gluconeogenesis used to catalyze the hydrolysis of fructose-1, 6-bisphosphate to fructose-6-phosphate and inorganic phosphate, thereby inhibiting the effect of glycolysis in tumor cells. This study aimed to investigate the association between the expression of FBP1 and chemosensitivity. Methods: The expression level of FBP1 in ovarian cancer patients was measured by immunohistochemistry. Results: According to the results of immunohistochemistry in 209 ovarian carcinoma specimens, the percentage of positive FBP1 expression was about 49.3% (103/209). Loss of FBP1 was a negative factor of survival (42.6 months vs 62.1 months, P=0.003). Besides, patients who were sensitive to chemotherapy displayed significantly higher scores of FBP1 expression than patients who were resistant to therapy (P=0.007). Conclusion: The rate-limiting enzyme FBP1 in gluconeogenesis can be used as a biomarker for predicting the chemoresistance and prognosis of ovarian cancer patients.
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Objective To assess the expression level of targeting drug-based molecular biomarkers in ovarian clear cell carcinoma(OCCC)tissues and its clinical significance.Methods A total of 63 OCCC patients included 40 primary OCCC and 23 recurrent OCCC for secondary cytoreductive surgery(SCS),who had received primary surgeries at Fudan University Shanghai Cancer Center between January, 2008 and December, 2015 were enrolled, and immunohistochemistry SP method was used to test human epidermal growth factor receptor (EGFR), human epidermal growth factor receptor-2 (HER2), aurora kinase A (AURKA), breast cancer susceptibility gene 1 (BRCA1), BRCA2 and programmed death-ligand 1 (PD-L1) protein expression in paraffin-embedded tissues. Results The positive rates of EGFR, HER2, AURKA, BRCA1,BRCA2 and PD-L1 in primary and recurrent tumor tissues were respectively 20%(8/40)vs 30%(7/23),22%(9/40)vs 35%(8/23),38%(15/40)vs 35%(8/23),42%(17/40)vs 39%(9/23),20%(8/40)vs 22%(5/23), 25%(10/40)vs 17%(4/23), and there were no significant differences between primary and recurrent OCCC (all P>0.05). χ2-test or Fisher exact analysis revealed that HER2 expression in recurrent tumor tissues had a relationship with chemoresistance (P<0.05), while the expression of other biomarkers showed no significant relationship with chemoresistance (all P>0.05). Further, Kaplan-Meier survival analysis showed that patients with HER2 and AURKA-positive expression had a significantly shorter progression-free survival time in primary OCCC(4 months vs 10 months,log-rank test,P<0.05 for HER2;and 4 months vs 10 months,P<0.05 for AURKA);and a shorter overall survival time after SCS in recurrent OCCC (10 months vs 44 months, P<0.05 for HER2;and 13 months vs 43 months, P<0.05 for AURKA). However,multivariate Cox proportional hazards regression analysis indicated that none of these 6 biomarkers was independent risk factor of progression-free survival time of primary OCCC or overall survival time after SCS for recurrent OCCC (P>0.05). Conclusion HER2 and AURKA could serve as prognostic factors in ovarian clear cell carcinoma.
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OBJECTIVE:To explore price management mechanism of medical service in Macau of China,and to provide refer-ence for the formulation of price management mechanism of medical service in the mainland area of China. METHODS:From two key links of pricing and compensation,price management mechanism of medical service in Macau was introduced. RESULTS &CONCLUSIONS:In respect of pricing,Macau Health Bureau as pricing subject set up guide price for public health institutions by marginal cost pricing,which focused on technology value and labor value of medical staff,and graded pricing for health institu-tions at various levels. In respect of compensation,compensation subjects included government,social security funds,charitable or-ganization,etc. The government provided fixed-rate compensation for citizen by allocating funds for public health institutions,so as to improve compensation level for primary health institutions. The social security funds extended sick benefit to insured patients, and compensated patients at fixed rate. Charitable organization subsidized private health institutions to reduce medical service price. Finally,actual price has been formulated through pricing and compensation links,and the experience is worthy of learning by the mainland of China.
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OBJECTIVE:To provide reference for the price management of medicines in Chinese mainland by inquiring into rel-ative management in Hong Kong. METHODS:Based on the steps of price management and the value chain of medicines in Hong Kong,the management mechanism of medicine pricing,circulation and compensation were researched. RESULTS & CONCLU-SIONS:The prices of the medicines in Hong Kong are mainly determined by the tender between Hospital Authority and the pharma-ceutical suppliers. In circulation,medicine payer as main body in bidding and purchase conducthigh qualitybidding andmasspurchase,and price remained the same in public hospital. On the basis of the purchase price,the price that actually paid by pa-tients is the result of government compensation. Chinese mainland can draw lessons from such drug bidding mode in Hong Kong which will lead health care department to act as the main body in bidding,weaken the relationship between the hospitals and the drug dealers or manufacturers,and expand the government's financial investment in public medical institutions to improve reim-bursement.
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Objective To evaluate and screen the concentration and coordination degree of the opinions of the experts in TCM pediatrics on the preventive method of Practice Guidelines to Prevent Disease for Recurrent Respiratory Tract Infections in Children Prevented by Sachet-Therapy;To formulate scientific and practical methods for perfume pouch wearing in this book. Methods Delphi method was applied to this research. All questionnaires were designed based on the literature research and distributed to more than 30 experts for 3 rounds. And the results in the first two rounds of survey were analyzed. Results Totally 31 and 33 valid questionnaires were received in the first and second time respectively. The experts’ activity index was 88.6% and 93.4% respectively. The perfume pouch wearing methods of Practice Guidelines to Prevent Disease for Recurrent Respiratory Tract Infections in Children Prevented by Sachet-Therapy was set down. And most of the experts shared a positive view on the concentration and coordination degree of this book. Conclusion The experts’ opinions upon this draft are quite positive. The experts are from all over China, and they are quite professional, with representativeness. The perfume pouch wearing methods of Practice Guidelines to Prevent Disease for Recurrent Respiratory Tract Infections in Children Prevented by Sachet-Therapy are generally recognized by the experts. However, there are still some different ideas in terms of some indexes, which need to be further discussed.
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OBJECTIVE:To provide reference for improving the rational drug use of China. METHODS:By referring to In-dia,South Africa and Argentina's policy in this regard,the rational drug policy rules and supporting measures in the national drug policy of these states were analyzed and summarized to put forward related policies for China. RESULTS & CONCLUSIONS:Pro-moting the rational drug use required multi-angle managements towards the supply-side,the demand-side as well as third-party, and relevant supporting measures needed to be improved. Firstly,the managements on the supply-side is particularly important,in-cluding measures such as strengthening prescription management,formulating and implementing the standard treatment guidelines, intensifing the functions of pharmacists,establishing serious irrational drug use and specific diseases medication management sys-tem;then,the demand-side needs the investigation and feedback about the patients with drug use to eliminate irrational drug use, and through the internet and other media to raise public awareness of the medicine information as well;besides,the third-party needs to establish a non-profit organization to regulate pharmaceutical advertisements,and increase information about rational drug use;finally,improving the rational drug policy also needs to improve needs to promote the separation of medicine,reform Medi-care payment and other supporting measures.
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Objective To investigate how internet using (both time and activities)and effortful control would contribute to the sex difference of problematic internet use (PIU).Methods A total of 844 adolescents aged 9-20 years old were selected from Chinese Academy of Sciences twin-sample by simple random sampling,with boys accounting for 45.6％ and girls accounting for 54.4％.The internet using and effortful control were measured using self-report questionnaires in the first time(T1),the problematic internet use were measured after one and half years (T2).The difference and relation of Internet using,effortful control and problematic internet use between boys and girls were measured with Chi-square test,t test and correlation analysis.The moderating effect of sex between internet using and PIU were explored by utilizing regression analysis.The mediation effect of effortful control between sex and PIU were explored with Sobel test.Results The anverage internet time of working day and weekend in boys were 1.52 h and 2.12 h respectively.The average internet time of working day and weekend in girls were 1.49 b and 2.05 h respectively.Significant difference between boys and girls is not existed in the internet time (t=0.541,0.907,P＞0.05).And the boy was inclined to game(x2 =47.669,P＜0.01).The effortful control of boys and girls were 54.09 and 55.76 respectively.The score of boys' and girls' PIU were 22.48 and 20.72 respectively.Boys' effortful control was significantly lower than that of girls (t=-2.879,P＜0.01).The score of boys' PIU was significantly higher than that of girls' (t=3.612,P＜0.01).Adolescents' PIU were significantly correlated with the time,entertainment and social activities (r=0.249,0.175,0.140,P＜0.01).The moderating effect of sex was significant in the relation between internet time and PIU.Significant mediation effect of effortful control existed in the PIU difference between boys and girls(Z=-2.54,P＜0.05).Conclusion Significant mediation effect of effortful control exists in gender and PIU.
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Background and purpose:Cervical cancer remains the second leading cause of death in gynecologic malignancies partially because of resistance to chemotherapy. Bufalin, a component of the traditional Chinese medicine Chansu, has been widely used in cancer treatment in China. This study aimed to investigate the effects of bufalin on inhibiting the proliferation of ME180 and C33A and explore its possible mechanism.Methods:The cytostatic effects of bufalin on ME180 and C33A cells were evaluated by CCK8 assay (cell counting kit-8). Glucose levels in ME180 and C33A cells were measured using glucose assay kit. Then the alterations of GLUT1 (glucose transporter 1) and HK2 (hexokinase 2) gene expression were detected by quantitative real-time polymerase chain reaction (qRT-PCR). The expressions of proto-oncogene C-MYC and HIF1α (hypoxia-inducible factor 1α) were determined by Western blot.Results:According to the results of CCK-8, bufalin can significantly inhibit the proliferation of carcinoma cells ME180 and C33A (P=0.027,P=0.018). Test on glycometabolism indicated that glucose uptake in cells treated with bufalin decreased (P=0.034,P=0.036). Results from real-time PCR showed that the expression of glycometabolism related indicators GLUT1 (P=0.019) and HK2 (P=0.016) levels were signiifcantly down-regulated in bufalin treated group. Western blot showed that the expression of C-MYC and HIF1αin cells with bufalin treatment was down-regulated markedly.Conclusion:Bufalin can inhibit the proliferation of the cervical carcinoma cells ME180 and C33A through inhibition of their glucose metabolism.
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OBJECTIVE:To research the effect of price change on pharmaceutical enterprises in China to improve the assess-ment of drug pricing. METHODS:Market share,competitive products’price and substitutes of the elasticity of drug price were an-alyzed to receive the effect of price change on pharmaceutical enterprises. RESULTS:The market share of homogeneous drugs for a same disease had positive correlation with price change,that is to say,if raised the price,its market share was on the rise;in terms of the effects on the price of competitive products and substitutes,the drug price change in an enterprise had a positive effect on the price of competitive products and substitutes. CONCLUSIONS:Price change of drugs has effect on market share and the price of competitive products and substitutes. Therefore,according to the price index,the enterprise can predict the market share and the price of competitive products and substitutes to assess the effect of drug quotation on the enterprise itself and external envi-ronment.
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OBJECTIVE:To explore the feasible program of independent financing for essential medicines. METHODS:Based on the comprehensiveness of national essential medicine system and the value chain of while essential medicines,the feasibility of independent financing to supplying,application and payment was analyzed,and finally the feasible program of independent financ-ing for essential medicines was put forward. RESULTS & CONCLUSIONS:Making full use of financial subsidies,individual con-tribution and medical insurance balance fund,with appropriate supplementary financing can establish the compensation fund. The unified compensation fund is used for providing financial support for fixed-point production of scarce essential medicines;compen-sating production enterprises supplying essential medicines;compensating medical institutions equipped with essential drugs;provid-ing“secondary compensation”to patients purchasing essential medicines. Complete system of financing,supplying,application and payment for medicines should be further designed after“medicine separation”.
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<p><b>OBJECTIVE</b>By collecting and analyzing the laryngeal cancer related genes and the miRNAs, to build a comprehensive laryngeal cancer-related gene database, which differs from the current biological information database with complex and clumsy structure and focuses on the theme of gene and miRNA, and it could make the research and teaching more convenient and efficient.</p><p><b>METHODS</b>Based on the B/S architecture, using Apache as a Web server, MySQL as coding language of database design and PHP as coding language of web design, a comprehensive database for laryngeal cancer-related genes was established, providing with the gene tables, protein tables, miRNA tables and clinical information tables of the patients with laryngeal cancer.</p><p><b>RESULTS</b>The established database containsed 207 laryngeal cancer related genes, 243 proteins, 26 miRNAs, and their particular information such as mutations, methylations, diversified expressions, and the empirical references of laryngeal cancer relevant molecules. The database could be accessed and operated via the Internet, by which browsing and retrieval of the information were performed. The database were maintained and updated regularly.</p><p><b>CONCLUSION</b>The database for laryngeal cancer related genes is resource-integrated and user-friendly, providing a genetic information query tool for the study of laryngeal cancer.</p>