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OBJECTIVE To analyze the effects of centralized volume-based procurement policy （hereinafter referred to as “centralized procurement”） on the use of anti-tumor drugs in medical institutions. METHODS The interrupted time series model was used to analyze the changes in the monthly purchase volume and purchase amount of docetaxel， gemcitabine and pemetrexed disodium in a third-grade class-A cancer hospital in Shanxi province from January 2018 to December 2021. RESULTS & CONCLUSIONS After the implementation of the centralized procurement policy， both the selected drugs and the non-selected drugs had different degrees of price reduction， and the price reduction of the selected drugs was far greater than that of the non- selected drugs； average monthly purchase volume and amount of docetaxel decreased significantly in that month after the implementation of the policy， while those of gemcitabine and pemetrexed disodium increased significantly （P＜0.05 or P＜0.01）. After the implementation of the policy， the average monthly purchase volume and amount of gemcitabine showed a downward trend， while those of docetaxel and pemetrexed disodium showed an upward trend （P＜0.05 or P＜0.01）. It is suggested that hospitals should strengthen pharmaceutical administration， and avoid adopting a “one size fits all” approach to non-selected drugs； relevant departments should further expand the collection range of anti-tumor drugs or carry out special collection of anti-tumor drugs， so as to save medical insurance funds and reduce medical expenses.
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Objective To systematically evaluate the effect of metformin on the prognosis of patients with breast cancer. Methods The databases including PubMed, Embase, Cochrane Library, ClinicalTrials, ScineceDirect, CBM, CNKI, Wanfang database and VIP were electronically searched from their inception to April 18, 2018 to collect the studies about the effect of metformin on the prognosis of patients with breast cancer. According to the inclusion and exclusion criteria, two reviewers screened the literatures independently, extracted data and assessed methodological quality. The meta-analysis was performed by using Review Manager 5.1 software. Results A total of 2 randomized controlled trials and 17 cohort studies involving 8929 patients were included. The meta-analysis showed that compared with control group, the metformin group marked increase in pathologic complete remission (pCR) rate (RR=2.97, 95％CI 1.80-4.90, P<0.01) and cancer-specific survival (CSS) time was prolong significantly (RR= 0.70, 95％CI 0.57-0.87, P= 0.001). Subgroup analysis of the overall survival (OS) time according to different areas showed that the metformin group's OS time was prolong significantly (Europe and America studies subgroup: RR=0.75, 95％CI 0.65-0.86, P<0.01; Asian studies subgroup:RR=0.48, 95％CI 0.37-0.61, P<0.001). Conclusion The use of metformin is positive for the prognosis of patients with breast cancer, it may improve the pCR rate, CSS and OS time of patients.
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Objective To investigate the optimum doses of combined chemotherapy with cyclophosphamide (CTX) and cisplatin (DDP).Methods 120 cases of ovarian cancer and malignant lymphoma were divided randomly into 6 groups.Drugs were administered to each group:CTX 500 mg/m2 + DDP 40 mg/m2,CTX 500 mg/m2 + DDP 50 mg/m2,CTX 500 mg/m2 + DDP 60 mg/m2,CTX 600 mg/m2 + DDP 40 mg/m2,CTX 600 mg/m2 + DDP 50 mg/m2,CTX 600 mg/m2 + DDP 60 mg/m2.Drugs were administered intravenously once a week for 2 consecutive weeks.Changes in the efficacy and adverse reaction were compared among the groups.Results There was no significant efficacy difference among the groups (P ＞ 0.05).Leukocyte inhibition rate (72.6 ％ and 79.3 ％,respectively) and damage to lymphocyte were maximal in the high-dose chemotherapy groups (CTX 500 mg/m2 + DDP 60 mg/m2,CTX 600 mg/m2 + DDP 60 mg/m2),and the levels of creatinine,blood urea nitrogen,alanine aminotransferase (ALT) in serum and aspartate aminotransferase (AST) were reduced significantly,whereas the hemogram was within normal range in the lowdose chemotherapy group (CTX500 mg/m2 + DDP 40 mg/m2),and the frequencies of damage to renal function and hepatic function were low.Conclusion The optimum dose of combined chemotherapy with cyclophosphamide and cisplatin was CTX 500 mg/m2 and DDP 40 mg/m2.
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Objective To investigate the pharmacokinetic difference between the combination of cyclophosphamide and cisplatin and single medication.Methods High performance liquid chromatography (HPLC) was used to detect the pharmacokinetic parameters and distribution parameters in tissue of cisplatin and cyclophosphamide.Results The pharmacokinetic curve of the CP regimen showed two-compartment model,and there was no significant difference between the absorption half life of the combination of the two drugs (0.56±0.02,0.72±0.02) and that of single medication (0.92±0.02,1.16±0.12) (t =2.091,t =2.379,both P ＞ 0.05).While the elimination half life of the combination (0.56±0.02,0.72±0.02) was significantly longer compared with that of single medication (0.92±0.02,1.16±0.12) and there were significant differences (t =5.796,t =6.213,both P ＜ 0.05).There was no significant difference of MRT in heart between the disturbution of the combination of the two drugs and that of single medication (t =2.231,t =2.096,both P ＞ 0.05).While there was significantly longer compared with that of single medication and there were significant differences in lung and liver (t =5.976,t =6.270,both P ＜ 0.05).Conclusion When used in combination,the elimination of the drugs is slower,which suggests that the interval and dosage of the drugs should be adjusted to their pharmacokinetic parameters in clinical use to improve effects and lower side effects.
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At present clinic study and use of anti-tumour platinum drug are wide and active. The paper reviews progression of clinic study and use of anti-tumour platinum drug and expects its prospect.
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Objective To study the inhibitory effect of yan xiao capsules on hepatocarcinoma mice. Methods Forty mice were randomly divided into control group ,CTX group,ADM group,trial group. Observe tumour weight ,the span time of tumour-bearing mice, tumour morphology and the mortality rate of ascites cancer cell by direct killing respectively. Results The tumour weight markedly decreased in trial group, the rate of inhibition tumour was 52.0 %(P
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Glutamine is a conditionally essential amino acid. With the further researches on Glutamine, most of the studies demonstrated that glutamine supplements may reduce the severity of side effects and increases the selectivity of therapy for the tumor in oncology therapy while enhancing immune function. Glutamine supplements is safe and effective in cancer therapy, having a good application prospect.