ABSTRACT
Objective:To construct a value evaluation framework for high-value medical consumables,providing a guidance for medical insurance access and hospital access management scenarios in China.Methods:It conducted literature review,qualitative in-terviews and quantitative surveys.A total of 12 experts were invited for qualitative interviews,while 100 experts from four fields of health technology assessment,medical insurance,hospital management,and clinical practice participated in the quantitative survey.Through those process,it generated the composition of the value framework and the scoring of each item.Differences in ratings be-tween different scenarios and experts were analyzed through chi-square tests.The recommendation level for each item was graded.Re-sults:A comprehensive value evaluation framework for high-value medical consumables was established,which included 6 core dimen-sions,comprised 16 items for secondary dimensions and 50 items for tertiary dimensions.It showed significant differences between the medical insurance access and hospital access scenarios,as well as among different fields of experts in the same scenario.furthermore,grading the items in two scenarios.The medical insurance access scenario had 8 highly recommended items,and the hospital access scenario had 24 highly recommended items.Conclusion:Value evaluation should encourage multi-dimensional assessments and inter-disciplinary participation,continually improving the management of high-value medical consumables in medical insurance and hospital access.
ABSTRACT
Gastric cancer has high morbidity and mortality, and limited treatment options for advanced cancer. In recent years, with the advent of targeted drugs (including VEGFR-2 antagonists, anti-HER-2 antibodies) and immunotherapeutics (such as anti-CTLA-4 antibodies, anti-PD-1/PD-L1 antibodies), the efficacy of advanced gastric cancer has been increased. Currently, the clinical data of PD-1 and its ligand PD-L1 inhibitors have achieved phased success, but which factors affect the efficacy of PD-1/PD-L1 immune checkpoint inhibitors immunotherapy, and how to select the benefited patient population and establish the prognosis evaluation system are the urgent problems to be solved. Therefore, this review elaborated the factors affecting the immunotherapy effects of PD-1/PD-L1 inhibitors from the aspects of systemic chemotherapy, intestinal microbiota, MSI, Hp infection, Epstein-Barr virus, TMB, and tumor infiltrating lymphocytes, in order to provide new ideas for clinical work.
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Objective Serum indicators of oxidative protein damage (OPD) were analyzed to explore the effect on renal MMP/TIMP system of OPD in diabetic nephropathy. Methods AOPP levels and PCO levels were measured by modified Witko-Sarsat's method and 2, 4-dinitrophenylhydrazine spectrophotometric method, expression of serum MMP-2 were determined by ELISA, and MMP-2 activity were detected by zymography . Results AOPP levels of group DN1, group DN2 were higher than those of group DM(78.23±19.30 vs 61.25±12.13,101.59±30.22 vs 61.25±12.13,F＝41.988,P＜0.01). PCO levels of group DN1 and group DN2 were higher than those of group DM (0.84±0.03 vs 0.66±0.02,1.05±0.05 vs 0.66±0.02,F＝205.763,P＜0.01). Pearson correlation analysis indicated AOPP and PCO were positively correlated with the expression (r＝0.460,0.480,P＜0.05) and activity (r＝0.385,0.560,P＜0.05) of serum MMP-2. Multiple stepwise regression analysis showed that AOPP and PCO were major influential factors of serum MMP-2 expression (P＜0.05,P＜0.01) and activity(P＜0.01,P＜0.05). Conclusions OPD might be involved in the imbalance of renal matrix metabolism, which was correlated with the development of diabetic nephropathy.
ABSTRACT
OBJECTIVE To analyze the changes in clinical behaviors in the recent 10 years among patients with diabetes combined infection,including incidence of diabetic′s concurrent infections, the infective sites,the pathogen spectrum,the danger of infections and so on,we could do better in preventing and curing the diabetic′s concurrent infections.METHODS Using retrospective methods,the diabetic patients with concurrent infection were divided into two groups,712 patients in 1995-1999 as the first group,986 patients in 2000-2005 as the second group,were respectively calculated and compared their average age,sex distribution,the average course of diseases,the fasting blood sugar,glycosylated hemoglobin,the incidence of infection,and the distribution in body systems.RESULTS The diabetic patients′ average course in the second group(10.82?9.83 years) prolonged a little than the first(P