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This study aims to evaluate the effectiveness and economic efficiency of Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray in the treatment of chronic rhinosinusitis(CRS). The randomized controlled trial(RCT) of Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray in the treatment of CRS was searched against EMbase, PubMed, Cochrane Library, CNKI, VIP, SinoMed, and Wanfang. The efficacy, nasal mucociliary transport time, and safety of the therapy above in the treatment of CRS were analyzed with single-group rate and Meta-analysis, and the economy and sensitivity were evaluated from the perspective of payer. A total of 9 RCTs were included, including 1 145 patients. Meta-analysis showed that compared with Triamcinolone Acetonide Nasal Spray alone, Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray in the treatment of CRS patients increased the effective rate(RR=1.17, 95%CI[1.11, 1.24], P<0.000 01) and shortened the nasal mucociliary transport time(MD=-3.32, 95%CI[-5.86,-0.78], P=0.01), there was no significant difference in the incidence of adverse reactions between the two groups. The incremental cost-effectiveness analysis showed that the treatment costs of the control group and the observation group were 44.15 yuan and 1 044.96 yuan, respectively. In the Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray treatment group, 75.48 yuan was spent to improve the effective rate of CRS by 1%. The one-way sensitivity analysis indicated the days of treatment, the RR of Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray, the price of unit preparation of Biyuan Tongqiao Granules, and the effective rate of Triamcinolone Acetonide Nasal Spray alone had great influence on the incremental cost-effectiveness ratio. In conclusion, Biyuan Tongqiao Granules combined with Triamcinolone Acetonide Nasal Spray improves the therapeutic effect on CRS. The probabilistic sensitivity analysis showed that when the willingness to pay was greater than 7 920 yuan(less than 0.1 of GDP per capita 8 098 yuan), the combined therapy was economically superior to the control. Due to the limited number of articles published, it is necessary to carry out a real-world clinical trial of Biyuan Tongqiao Gra-nules and Triamcinolone Acetonide Nasal Spray in the treatment of CRS, so as to compare the cost-effectiveness of Biyuan Tongqiao Granules and Triamcinolone Acetonide Nasal Spray.
Subject(s)
Humans , Triamcinolone Acetonide/adverse effects , Nasal Sprays , Cost-Effectiveness Analysis , Sinusitis/drug therapy , Chronic DiseaseABSTRACT
Objective To develop a tracking monitor for patient vital signs after CT and MRI enhanced scanning so as to execute auto alarm in case of patient discomfort and allergic reactions.Methods The monitor composed of a sub machine,a principal machine and a large-screen display used ultra-low power digital blood oxygen plate LPDSPO2V1.4 and fingertip sensor to acquire data on blood oxygen saturation and heart rate,the acquired data were transmitted to the principal machine with NRF24L01 wireless transmission module, and then the principal machine executed data auto analysis, storage, auto alarm for out-of-limit data and sent the data to the display.Results The monitor could be used for checking blood oxygen saturation and heart rate as well as implement early warning against allergic reactions.One-year trials proved that there were no death in case 87 cases of minor allergic reactions and 3 severe ones occurred.Conclusion The monitor proves its safety and efficiency by decreasing the incidence rate of severe reactions after CT and MRI enhanced scanning,and thus is worthy promoting clinically.
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Objective To ascertain the perchlorate contamination level in commercial foods and health risks so as to provide reference for perchlorate standard formulation and risk management.Methods Perchlorate risk survey was done on commercial foods in Shanghai;in combination with the survey results of residents'' food consumption,the exposure assessment on the presence of perchlorate in commercial food was performed by probability assessment approach.Results A total of 80 food samples from 8 food categories were analyzed,including grain,vegetables,fruits,dairy products,meat,eggs,aquatic products and teaand perchlorate detection rate was 78.8% with a mean value as 13.0±26.4 μg/kg.The highest mean value of perchlorates was 59.0±51.9 μg/kg in tea,and the lowest mean value was 3.4±2.3 μg/kg in fruits.With protection of human life and health as the maximum principle (there were supposed to be no losses of perchlorate during food processing),it was found that the estimated average dietary intake of perchlorate from the 8 food categories was 0.25 μg/kgbw.However,the 95 percentile exposure estimates reached up to 0.44 μg/kgbw,which exceeded the tolerable daily intake value of 0.3μg/kgbw established by European Food Safety Authority for healthy adults.Therefore,potential health risk may exist to certain groups of people.Conclusion Due to its high water-solubility,degradation of perchlorate in food processing probably occurs to certain extent.Therefore,there is need to carry out further actual exposure study.
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Tumor necrosis factor-alpha (TNF-α) has been found to be centrally involved in the development of ischemia-reperfusion injury (IRI)-induced inflammation and apoptosis. Knockdown of TNF-α gene using small interfering RNA (siRNA) may protect renal IRI. Renal IRI was induced in mice by clamping the left renal pedicle for 25 or 35 min. TNF-α siRNA was administered intravenously to silence the expression of TNF-α. The therapeutic effects of siRNA were evaluated in terms of renal function, histological examination, and overall survival following lethal IRI. A single systemic injection of TNF-α siRNA resulted in significant knockdown of TNF-α expression in ischemia-reperfusion injured kidney. In comparison with control mice, levels of BUN and serum creatinine were significantly reduced in mice treated with siRNA. Pathological examination demonstrated that tissue damage caused by IRI was markedly reduced as a result of TNF-α siRNA treatment. Furthermore, survival experiments showed that nearly 90% of control mice died from lethal IRI, whereas more than 50% of siRNApretreated mice survived until the end of the eight-day observation period. We have demonstrated for the first time that silencing TNF-α by specific siRNA can significantly reduce renal IRI and protect mice against lethal kidney ischemia, highlighting the potential for siRNA-based clinical therapy.
Subject(s)
Animals , Humans , Mice , Apoptosis , Disease Models, Animal , Genetic Therapy , Inflammation , Genetics , Pathology , Therapeutics , Kidney , Wounds and Injuries , Pathology , RNA, Small Interfering , Genetics , Reperfusion Injury , Genetics , Pathology , Therapeutics , Tumor Necrosis Factor-alpha , GeneticsABSTRACT
<p><b>OBJECTIVE</b>To investigate the severity of early myocardial injury in rats with 30% full thickness burn at plateau and the protective effects of Rhadiola Astragalus Codonopsis Compound (RACC) on the rat myocardial injury.</p><p><b>METHODS</b>One hundred and four Wistar rats with 30% full thickness burn were randomly divided into RACC application (R, n = 48) and scalding group 1 (S, n = 48), and another 8 healthy Wistar rats as control group 2 (C, n = 8). Four ml of RACC was garaged into the rat stomach in R and 4 ml isotonic saline in S groups respectively, but no treatment in C group. Blood samples from the aorta were harvested in 3, 6, 12, 24, 48 and 72 postburn hours (PBH) for blood gas analysis and for the determination of the changes in myocardial enzymes. Rat heart was harvested for pathomorphological examination.</p><p><b>RESULTS</b>The rat myocardial tissue injury in R and S groups was obvious at 3 PBH and ameliorated gradually thereafter, up to the degree in C group at 72 PBH. The serum levels of myocardial enzymes in R and S groups were significantly higher than those in C group (P < 0.01). Whereas the enzymes in R group were much lower than those in S group (P < 0.01). It was indicated by blood gas analysis that the pH in R and S groups was lower than that in C group (P < 0.05), while that in R group at 12 - 24 PBH was higher than that in S group (P < 0.05). In addition, the base excess in R and S groups was lower than that in C group (P < 0.01), while that in R group at 6 PBH was higher than that in S group (P < 0.05 approximately 0.01). The PaCO2 in R and S groups was evidently lower than that in C group (P < 0.05 approximately 0.01), while that in R group at 48 PBH was no different to that in C group (35.70 +/- 4.23 mmHg vs 37.50 +/- 6.53 mmHg, P > 0.05). The PaO2 in R and S groups at 3 approximately 24 PBH was higher than that in C group and decreased gradually (P > 0.05). There was no difference in SaO2 among 3 groups (P > 0.05).</p><p><b>CONCLUSION</b>RACC exhibited beneficial to the protection of rat heart from myocardial injury at plateau induced by severe burn.</p>