RESUMO
Elevated low density lipoprotein cholesterol (LDL-C) is a major risk factor for cardiovascular disease.Studies show that proprotein convertase subtilisin/kexin type 9 (PCSK9) is a circulation enzyme and serves a pivotal function in the degradation of low density lipoprotein receptor,which contributes to the decrease in hepatic cholesterol uptake and increase in circulating LDL-C.PCSK9 inhibitor can significantly elevate the surface of low density lipoprotein receptor of liver cells and bond more LDL-C to decrease the level of LDL-C.Thus PCSK9 has emerged as a popular target for the development of new cholesterol lowering drugs and therapeutic intervention of cardiovascular disease.In this article,the history,mechanism of action,metabolic effects of PCSK9 and the clinical outcomes of PCSK9 inhibitors will be briefly reviewed.
RESUMO
Elevated low density lipoprotein cholesterol (LDL-C) is a major risk factor for cardiovascular disease. Studies show that proprotein convertase subtilisin/kexin type 9 (PCSK9) is a circulation enzyme and serves a pivotal function in the degradation of low density lipoprotein receptor, which contributes to the decrease in hepatic cholesterol uptake and increase in circulating LDL-C. PCSK9 inhibitor can significantly elevate the surface of low density lipoprotein receptor of liver cells and bond more LDL-C to decrease the level of LDL-C. Thus PCSK9 has emerged as a popular target for the development of new cholesterol lowering drugs and therapeutic intervention of cardiovascular disease. In this article, the history, mechanism of action, metabolic effects of PCSK9 and the clinical outcomes of PCSK9 inhibitors will be briefly reviewed.
RESUMO
Objective:This study aimed to evaluate the impacts of the separation between revenue and expendi-ture on the outcome of the payment policy"fix out of pocket". Methods: Using descriptive analysis, difference in difference(DID) model based on data from Wanning county where the new policy has been carried out,Ledong coun-ty where has not,including claim data and hospital utilization data from Nov 2010 to Oct 2014. We also supplemen-ted and interpreted the results of quantitative analysis combined with qualitative data from the interview recording ma-terial;Results:As for the two most common hospitalized diseases(hypertension and pneumonia),the number of in-patient visits in primary medical institutions didn't change respectively. From DID model, the policy only increased out of pocket(OOP) in Wanning by 11% and 28% and decreased average medical expense in Qionghai by 66% and 67% respectively. Conclusion:The separation between revenue and expenditure make the"fix out of pocket"pay-ment policy have better performance on the control of medical expense.