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OBJECTIVE To evaluate the effectiveness， safety， economy， innovation， suitability and accessibility of recombinant Mycobacterium tuberculosis fusion protein （EC）， and to provide evidence for selecting skin detection methods for tuberculosis infection diagnosis and auxiliary diagnosis of tuberculosis. METHODS The effectiveness and safety of EC compared with purified protein derivative of tuberculin （TB-PPD） were analyzed by the method of systematic review. Cost minimization analysis， cost-effectiveness analysis and cost-utility analysis were used to evaluate the short-term economy of EC compared with TB-PPD， and cost-utility analysis was used to evaluate the long-term economy. The evaluation dimensions of innovation， suitability and accessibility were determined by systematic review and improved Delphi expert consultation， and the comprehensive score of EC and TB-PPD in each dimension were calculated by the weight of each indicator. RESULTS The scores of effectiveness， safety， economy， innovation and suitability of EC were all higher than those of TB-PPD. The affordability scores of the two drugs were consistent， while the availability score of EC was lower than those of TB-PPD. After considering dimensions and index weight， the scores of effectiveness， safety， economy， innovation， suitability， accessibility and the comprehensive score of EC were all higher than those of TB-PPD. CONCLUSIONS Compared with TB-PPD， EC performs better in all dimensions of effectiveness， safety， economy， innovation， suitability and accessibility. However， it is worth noting that EC should further improve its availability in the dimension of accessibility.
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OBJECTIVE:To evaluate the effects of clinical pharmacists participating in disease management of chronic heart failure(CHF). METHODS:A total of 180 CHF inpatients selected from cardiovascular medicine department of our hospital during Jan. 2013 to Dec. 2014 were divided into control group and pharmacist management group according to random number table,with 90 cases in each group. The control group was given routine treatment. The pharmacist management group additionally received indi-vidualized pharmaceutical care,such as pharmaceutical monitoring,psychological counseling,medication education and 6-month follow-up. The comprehensive self-care ability of the 2 groups were compared on admission and on discharge;re-hospitalization and mortality were compared between 2 groups within 6 months after discharged;the patients’NYHA classification,LVEF,plas-ma level of NT-proBNP and quality of life were compared between 2 groups on admission and 6 months after discharge. RE-SULTS:There was no statistical significance in the cognition of patients to disease,self-care ability,medication compliance score and total comprehensive self-care ability score between 2 groups on admission (P>0.05). Each score and total score of 2 groups were better on discharge than on admission,and the pharmacist management group was better than control group,with statistical significance(P0.05). There was no statistical significance in NYHA classification,LVEF,plasma level of NT-proBNP be-tween 2 groups on admission(P>0.05). 6 months after discharge,the above 3 indexes of pharmacist management group as well as NYHA classification and plasma level of NT-proBNP of control group were improved significantly compared to on admission;NYHA classification,LVEF and plasma level of NT-proBNP of pharmacist management group were better than those of control group at corresponding period,with statistical significance (P0.05). 6 months after discharge,each score and total score of 2 groups were all better than on admission,and the pharmacist management group was better than control group, with statistical significance (P<0.05). CONCLUSIONS:The participation of clinical pharmacists in the disease management of CHF can significantly improve comprehensive self-care ability,decrease re-hospitalization rate,ameliorate cardiac function and en-hance the quality of life.
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OBJECTIVE: To analyze the expression profile changes of osteogenic-related genes during spontaneous calcification of rat bone marrow mesenchymal stem cells (BMSCs). METHODS: BMSCs were isolated from 3-day-old healthy Sprague Dawley rats; cells at the 4th generation were used to establish the spontaneous calcification model in vitro. Spontaneous calcification process was recorded by inverted phase contrast microscope observation and alizarin red staining after 7 and 14 days of culture. For gene microarray analysis, cell samples were collected at 0, 7, and 14 days after culture; the differentially expressed genes were analyzed by bioinformatics methods and validated by real-time quantitative PCR (RT-qPCR) assay. RESULTS: Rat BMSCs calcified spontaneously in vitro. When cultured for 7 days, the cells began to aggregate and were weakly positive for alizarin red staining. After 14 days of culture, obvious cellular aggregation and typical mineralized nodules were observed, the mineralized nodules were brightly positive for alizarin red staining. A total of 576 gene probe-sets expressed differentially during spontaneous calcification, corresponding 378 rat genes. Among them, 359 gene probe-sets expressed differentially between at 0 and 7 days, while only 13 gene probe-sets expressed differentially between at 7 and 14 days. The 378 differentially expressed genes were divided into 6 modes according to their expression profiles. Moreover, according to their biological functions, differentially expressed genes related to bone cell biology could be classified into 7 major groups: angiogenesis, apoptosis, bone-related genes, cell cycle, development, cell communication, and signal pathways related to osteogenic differentiation. In cell cycle group, 12 down-regulated genes were linked with each other functionally. Matrix metalloproteinase 13 (Mmp13), secreted phosphoprotein 1 (Spp1), Cxcl12, Mmp2, Mmp3, Apoe, and Itga7 had more functional connections with other genes. The results of genes Spp1, Mgp, Mmp13, Wnt inhibitory factor 1, Cxcl12, and cyclin A2 by RT-qPCR were consistent with that of gene microarray. CONCLUSION: The first 7 days after rat BMSCs were seeded are a key phase determining the fate of spontaneous calcification. Multiple genes related with cell communication, bone-related genes, cell cycle, transforming growth factor-beta signaling pathway, mitogen-activated protein kinase signaling pathway, and Wnt signaling pathway are involved during spontaneous calcification.
