Cost-utility analysis of add-on vericiguat for the treatment of chronic heart failure with reduced ejection fraction in China.

OBJECTIVE: This study aimed to evaluate the cost-utility of the addition of vericiguat for treating chronic heart failure (CHF) in China from the healthcare payer's perspective. METHODS: A Markov model was built to estimate the cost and utility of treating CHF using vericiguat plus standard treatment (vericiguat group) vs. standard treatment alone (standard treatment group). The clinical parameters (mortality of cardiovascular and hospitalization rate of HF) were calculated according to the VICTORIA clinical trial. The HF cost and utility data were obtained from the literature published in China. One-way sensitivity analysis and probability sensitivity analysis were performed. RESULTS: According to the 13-year model, vericiguat was more expensive (155599.07 CNY vs. 259396.83 CNY) and more effective (4.41 QALYs vs. 4.54 QALYs). The incremental cost-utility ratio (ICUR) was 802389.27 CNY per QALY. One-way sensitivity analysis revealed that cardiovascular mortality in the two groups was the parameter that had the greatest impact on the results. The GDP per capita in 2022 in China was 85,700 CNY. The probability sensitivity analysis (PSA) showed that the probability of vericiguat being cost-effective was only 41.7% at the willingness-to-pay (WTP) threshold of 3 times GDP per capita (257,100 CNY). CONCLUSIONS: In China, the treatment of CHF with vericiguat is not cost-effective. The drug price could decrease to 145.8 CNY, which could be considered cost-effective.

Highly Effective Hybrid Copper(I) Iodide Cluster Emitter with Negative Thermal Quenched Phosphorescence for X-Ray Imaging.

The low efficiency triplet emission of hybrid copper(I) iodide clusters is a critical obstacle to their further practical optoelectronic application. Herein, we present an efficient hybrid copper(I) iodide cluster emitter (DBA)4 Cu4 I4 , where the cooperation of excited state structure reorganization and the metallophilicity interaction enables ultra-bright triplet yellow-orange emission with a photoluminescence quantum yield over 94.9 %, and the phonon-assisted de-trapping process of exciton induces the negative thermal quenching effect at 80-300 K. We also investigate the potential of this emitter for X-ray imaging. The (DBA)4 Cu4 I4 wafer demonstrates a light yield higher than 104  photons MeV-1 and a high spatial resolution of ≈5.0 lp mm-1 , showing great potential in practical X-ray imaging applications. Our new copper(I) iodide cluster emitter can serve as a model for investigating the thermodynamic mechanism of photoluminescence in hybrid copper(I) halide phosphorescence materials.

Room-Temperature Magnetic Field Effect on Excitonic Photoluminescence in Perovskite Nanocrystals.

Magnetic-field-enhanced spin-polarized electronic/optical properties in semiconductors are crucial for fabricating various spintronic devices. However, this spin polarization is governed by weak spin exchange interactions and easily randomized by thermal fluctuations; therefore, it is only produced at cryogenic temperatures, which severely limits the applications. Herein, a room-temperature intrinsic magnetic field effect (MFE) on excitonic photoluminescence is achieved in CsPbX3 :Mn (X = Cl, Br) perovskite nanocrystals. Through moderate Mn doping, the MFE is enhanced by exciton-Mn interactions, and through partial Br substitution, the MFE is stabilized at room temperature by exciton orbital ordering. The orbital ordering significantly enhances the g-factor difference between electrons and holes, which is evidenced by a parallel orbit-orbit interaction among excitons generated by circular polarized laser excitation. This study provides a clear avenue for engineering spintronic materials based on orbital interactions in perovskites.

Protective effect of Astragaloside IV against sepsis-induced acute lung injury in rats.

The study aimed to explore the protective effects of AS-IV against sepsis-induced ALI. Sepsis was induced by cecal ligation and puncture (CLP) method in Sprague Dawley rats. Rats were randomly assigned into five groups: animals undergoing a sham CLP (sham group); animals undergoing CLP (CLP group); animals undergoing CLP and treated with AS-IV at 2.5 mg/kg bw (low-dose AS-IV [L-AS] group), at 5 mg/kg bw (mid-dose AS-IV [M-AS] group), and at 10 mg/kg bw (high-dose AS-IV [H-AS] group). At 6 h, 12 h and 24 h post-CLP surgery, six rats were respectively sacrificed to collect blood and lung tissue samples. The levels of arterial blood gas index, lung water content, protein level and leukocyte counts (total amount, neutrophils and lymphocytes) in bronchoalveolar lavage fluid (BALF) and cytokines such as TNF-α and IL-6 in BALF were measured at each time point in different groups. HE-staining and optical microscopy were performed to examine the pathological changes in lungs. The 72 h-survival rate of each group was also recorded. PaO2 was decreased significantly, while the lung water content, BALF protein level, cell numbers, BALF cytokine TNF-α and IL-6 levels were increased significantly for CLP group as compared with sham group. Moreover, pathological injury was observed in lung tissue indicating the successful sepsis-induced ALI model. Speaking of the effect of AS-IV, we founded that, compared with the CLP group, the AS-IV treatment groups could significantly alleviate all the above negative changes exited in the CLP group in a dose-dependent manner. What's more, the pathological injury was also gradually improved by AS-IV treatment compared with the CLP rats. AS-IV exerts its protective effect against sepsis-induced ALI in rats via improving pulmonary ventilation function, decreasing the permeability of alveolar epithelium and capillary as well as repressing lung inflammation.

The medicinal potential of natural products for the development of anti- influenza agents.

Influenza neuraminidase (NA) is an important target for designing anti-influenza drugs. By now, three inhibitors, zanamivir, oseltamivir and peramivir have been approved. However, in recent years, the potential threat of influenza pandemics and constant emergence of new drug-resistant influenza virus strains have weaken the defensive role of the current anti-influenza drugs. From another point of view, in this review we focused on some novel NA inhibitors which were mainly derived from natural products that had a variety of structural scaffolds, such as flavonoids, xanthones and diarylheptanoids. Besides interfering the function of NA, some of these compounds also can potently inhibit the replication of influenza virus. It is hoped that these compounds could be the source of leads and provide a guide for discovering new potent anti-influenza virus agents.