Dementia and Multimorbidity Trends in Al-Baha, Saudi Arabia: An Analytical Retrospective Study Using Records-Based Data.

BACKGROUND: The prevalence of dementia is escalating significantly, posing a substantial societal burden. Currently, there exists a dearth of comprehensive health data about dementia patients in Saudi Arabia, particularly within Al-Baha City. METHODS: A retrospective case-series study was undertaken to ascertain the prevalence of dementia within the populace of the Al-Baha region, Kingdom of Saudi Arabia. This investigation utilized hospital-based records encompassing individuals exhibiting symptoms or diagnosed with dementia and its related forms across the Al-Baha region. Furthermore, the study aimed to evaluate the burden of comorbidities among dementia patients and document the pharmacological therapeutic interventions administered to manage dementia and its associated concurrent health conditions. RESULTS: Our investigation explored the prevalence rates of various forms of dementia and the accompanying comorbidities among affected individuals. The study spanned from August 2020 to August 2023. Our study encompassed 407 patients diagnosed with Alzheimer's disease (AD), Parkinson's disease, vascular dementia (VaD), or other forms of dementia who were either admitted to or attended tertiary hospitals in Al-Baha. Assessment of the comorbidity burden was conducted using the Charlson Comorbidity Index (CCI). Our findings revealed that among these patients, 13.3% presented with AD, 23.6% with VaD, 33.4% with Parkinson's disease, 15.75% with amnesia, and 14.0% with other types of dementia. The spectrum of comorbidities observed among dementia patients encompassed various conditions, with diabetes mellitus emerging as the predominant comorbidity (19.1%), followed by hypertension (16.4%). Additionally, manifestations of depression were noted in 14% of patients, while 9.82% suffered from paralysis. Chronic conditions such as cancer, chronic obstructive pulmonary disorder (COPD), and cervical spondylosis were also observed among individuals afflicted with dementia and its varied forms. Statistically significant correlations were established between gender, age, nationality, comorbidities, and the prevalence of dementia. Therapeutic interventions in the form of pharmacological treatments were prescribed for dementia patients with comorbidities. Commonly administered medications included Amlod (6.3%), Amlodipine (6.6%), Amlor (5.8%), Aspirin (10.5%), chemotherapeutic drugs (4.4%), Glipizide (8.5%), Lantus (11.3%), Levodopa (23.5%), Metformin (7.8%), acetylcholinesterase inhibitors (6.8%), and Pulmicort (7.86%). These medications aimed to alleviate symptoms associated with dementia and its accompanying comorbidities. CONCLUSIONS: Our investigation underscores the substantial burden of comorbidities experienced by dementia patients. These findings offer crucial insights into the overall health status of individuals grappling with dementia, serving as a catalyst for increased awareness among clinicians and policymakers. Such awareness can drive improvements in medical care and support frameworks tailored to the specific needs of dementia patients.

Gastrointestinal Behçet's disease: Manifestations, diagnosis, and management.

Behçet's disease (BD) is a rare, inflammatory vascular disorder with recurrent oral and genital aphthous ulcers, along with ocular and cutaneous manifestations. Gastrointestinal (GI) BD may involve any portion of the GI tract. However, it is commonly described in the terminal ileum, followed by the ileocecal region. Diagnosis is challenging given lack of pathognomonic tests; therefore, it is based on clinical criteria. Management of intestinal BD includes different classes of medications including corticosteroids, 5-aminosalicylic acid, immunomodulators, and anti-tumor necrosis factor alpha monoclonal antibody agents. In this review, we aim to focus on intestinal BD and provide details of clinical manifestations, diagnosis and therapeutic options of intestinal BD from gastroenterology viewpoint.

Quantitative effects of sodium-glucose cotransporter-2 inhibitors on liver functions in patients with nonalcoholic fatty liver disease.

BACKGROUND: The present study aimed to explore the quantitative effects of sodium-glucose cotransporter-2 (SGLT-2) inhibitors on liver functions in patients with nonalcoholic fatty liver disease (NAFLD). RESEARCH DESIGN AND METHODS: A total of 4771 patients with NAFLD were included for analysis by means of nonlinear mixed effect modeling, where the change rates of liver functions were taken as the evaluation indexes so as to eliminate the potential baseline effects. RESULTS: For ALT and AST, the Emax of SGLT-2 inhibitors was -17.8% and -13.9%, respectively, and the ET50 was 6.86 weeks and 10 weeks, respectively. Furthermore, the duration time to achieve 25%, 50%, 75%, and 80% Emax were 2.3 weeks, 6.86 weeks, 20.6 weeks, 27.5 weeks in ALT, 3.4 weeks, 10 weeks, 30 weeks, 40 weeks in AST, respectively. Thus, to realize the plateau period (80% of Emax) of SGLT-2 inhibitors on ALT and AST in patients with NAFLD, 100 mg/day canagliflozin (or 10 mg/day dapagliflozin or 10 mg/day empagliflozin) needs to be taken for 20.6 weeks and 30 weeks, respectively. CONCLUSIONS: The present study explored the quantitative effects of SGLT-2 inhibitors on liver functions and recommends a therapeutic regimen in patients with NAFLD.

Acupuncture for Women with Overactive Bladder: Perspective of Traditional Chinese Medicine and Related Mechanism.

Purpose: Overactive bladder (OAB) syndrome is one of the most common diseases in urology and affects quality of life. Although the current treatment for OAB is based on oral medications, there are limitations and many patients have difficulty accepting drug-induced adverse effects. This review aimed to analyze the efficacy of acupuncture and its related mechanisms and provide a preliminary therapeutic regimen. Methods: Two authors independently searched PubMed, Embase, and Cochrane Library up to April 2022. They searched related English literature and extracted the data under a standard form based on the search strategy. Clinical trials which included OAB women with the treatment of acupuncture were included. Common acupuncture alone without other pharmacotherapy, external treatments was in the treatment group. The control interventions may include any active treatments, sham placebo, or no establishment of a control group. Outcomes included 3-day or 24-hour voiding diary, overactive bladder symptom score, etc. The Cochrane risk of bias tool was also used to assess the methodological quality of the randomized controlled trials (RCTs). Results: We analyzed five RCTs and one comparative study on acupuncture for OAB to review and discuss the acupoint location, treatment course, and retention time based on clinical evidence and treatment ideas in traditional Chinese medicine. Additionally, we used the available evidence to reveal and discuss the acupuncture mechanisms for OAB. Acupuncture may regulate bladder function by inhibiting C-fibers, modulating nerve growth factors and reducing spontaneous contractions of the detrusor muscle. Conclusion: Combined with the available evidence, the combination of local acupoints and distal acupoints should be necessary to consider, especially the lumbosacral acupoints, the small abdomen acupoints and the lower limb acupoints. Among them, acupuncture at SP4, CV4 and KI3 are strongly recommended. The treatment course of acupuncture should be no less than 4 weeks and maintain the frequency of acupuncture no less than once a week. The duration of each session should be no less than 20 minutes. In addition, investigations remain necessary to verify acupuncture's efficacy and precise mechanism for OAB treatment in further exploration.

Denosumab treatment for progressive Enneking stage II cervical giant-cell tumor conservatively.

Cervical giant cell tumor of the bone (GCTB) is a rare, primary benign bone tumor in pediatric patients. Surgery remains the primary choice for treating resectable cervical GCTB. Additional adjuvant therapeutic options are available for patients with unresectable cervical GCTB, including the anti-RANKL monoclonal antibody, denosumab. We represented a case incidentally found in a 7-year-old female, who complained severe craniocervical pain, grade 2-3 dysphagia, dysphonia, hypesthesia, and extremity weakness. The patient showed an impressive clinical response to denosumab, both clinically and radiologically, without adverse events or recurrence. To date, this is the youngest patient ever reported to have a progressive Enneking stage II C3 GCTB treated with denosumab alone. Denosumab can be administered as a single and conservative therapy for pediatric patients with unresectable upper cervical GCTB, avoiding the risks and morbidity of surgical and radiative treatment.

A retrospective analysis for the management of oromaxillofacial invasive mucormycosis and systematic literature review.

PURPOSE: Mucormycosis is a type of fatal infectious disease, rarely involved in the oromaxillofacial region. This study aimed to describe a series of 7 cases with oromaxillofacial mucormycosis and to discuss the epidemiology, clinical features, and treatment algorithm thereof. METHODOLOGY: Seven patients in the author's affiliation have been treated. They were assessed and presented as per their diagnostic criteria, surgical approach, and mortality rates. Reported cases of mucormycosis originally happened in craniomaxillofacial region were synthesized through a systematic review so as to better discuss its pathogenesis, epidemiology, and management. RESULTS: Six patients had a primary metabolic disorder, and one immunocompromised patient had a history of aplastic anemia. The criteria for a positive diagnosis of invasive mucormycosis were based on clinical presentation of signs and symptoms, and a biopsy for microbiological culture and histopathologic analysis. Each patient used antifungal drugs and five of them also underwent surgical resection at the same time. Four patients died due to the unregulated spread of mucormycosis, and one patient died owing to her main disease. CONCLUSIONS: Although uncommon in clinical practice setting, mucormycosis should be of great concern in oral and maxillofacial surgery, due to the life-threatening possibility of this disease. The knowledge of early diagnosis and prompt treatment is of utmost importance for saving lives.

CDK inhibitors from past to present: A new wave of cancer therapy.

Deregulation of the cell cycle machinery, which has been linked to dysregulation of cyclin-dependent kinases (CDKs), is a defining characteristic of cancer, eventually promoting abnormal proliferation that feeds tumorigenesis and disease development. In this regard, several CDK inhibitors (CDKIs) have been developed during the last few decades (1st, 2nd, and 3rd generation CDKIs) to inhibit cancer cell proliferation. 1st and 2nd generation CDKIs have not received much clinical attention for the treatment of cancer patients because of their limited specificity and high toxicity. However, the recent development of combination strategies allowed us to reduce the toxicity and side effects of these CDKIs, paving the way for their potential application in clinical settings. The 3rd generation CDKIs have yielded the most promising results at the preclinical and clinical levels, propelling them into the advanced stages of clinical trials against multiple malignancies, especially breast cancer, and revolutionizing traditional treatment strategies. In this review, we discuss the most-investigated candidates from the 1st, 2nd, and 3rd generations of CDKIs, their basic mechanisms of action, the reasons for their failure in the past, and their current clinical development for the treatment of different malignancies. Additionally, we briefly highlighted the most recent clinical trial results and advances in the development of 3rd generation FDA-approved selective CDK4/6 inhibitors that combat the most prevalent cancer. Overall, this review will provide a thorough knowledge of CDKIs from the past to the present, allowing researchers to rethink and develop innovative cancer therapeutic regimens.

The Impact of Inhaler Device Regimen in Patients with Asthma or COPD.

Many inhaler devices with varying handling requirements for optimal use are available for the treatment of asthma and chronic obstructive pulmonary disease (COPD). Patients may be prescribed different device types for reliever and maintenance medications, which may lead to confusion and suboptimal device use. We aimed to understand whether simplifying inhaler regimens by employing a single device type in patients who use multiple devices or prescribing a device with which a patient was already experienced could improve clinical and economic outcomes in asthma and COPD management. A targeted literature search was performed and additional articles were identified through hand searching citations within screened publications. A total of 114 articles were included in the final review. Findings suggest that simplifying inhaler regimens by applying the same type of inhaler for concomitant inhaled medications over time minimizes device misuse, leading to improved clinical outcomes and reduced health care use in patients with asthma or COPD. Physicians should consider a patient's suitability for a device and training needs when prescribing an inhaled medication and before changing the medication type or dose, especially when suboptimal treatment outcomes are observed. Further research is required to determine whether consistent use of the same device type is associated with better treatment adherence and persistence in patients with asthma or COPD. Nevertheless, this literature review identified clinical benefits and reduced health care use with simplified inhaler regimens.

'Teaching: individual' to improve adherence in hypertension and type 2 diabetes.

Educational interventions with a multifaceted approach have proven effective to improve adherence to therapeutic regimens in people with chronic diseases. The present study aimed to evaluate the efficacy of a nursing intervention involving individual teaching compared with usual care to improve adherence with therapeutic regimens in people with hypertension and/or type-2 diabetes mellitus (T2DM). This was a parallel randomised two-arm clinical trial in 200 patients from a primary care programme. After 6 months of follow-up, there was a significant improvement in treatment adherence with a score of 0.87 (95% CI 0.30 to 1.44) on a 13 point scale, and an average reduction in systolic blood pressure (SBP) of 3.79 mmHg (95% CI: -6.85 to -0.73) in the intervention group, but not in glycated haemoglobin (HbA1c) levels (-0.16% 95% CI: -0.41 to 0.09). The individual teaching intervention was effective in improving therapeutic adherence and improving blood pressure values among the participants from the primary care programme.

Self-management with the therapeutic regimen in patients with ventricular assist device (VAD) support - a scoping review.

BACKGROUND: Ventricular assist device (VAD) implantation has become an established treatment strategy for the increasing number of patients with advanced heart failure. Adequate patient self-management becomes essential to prevent adverse events, which could diminish expected outcomes and survival for patients on VAD support. OBJECTIVES: The aim of this study was to provide an overview of the current state of evidence concerning self-management in VAD patients through a systematized search and mapping of the literature. METHODS: Following the scoping review process, a comprehensive literature search (PubMed, PsychInfo), tabular synthesis of included articles, and data analysis of synthesized findings were performed. RESULTS: Overall, twenty articles were included. Results describe the complexity of regular self-management tasks and give direction for specific self-management training. CONCLUSIONS: This article represents the first comprehensive overview of available evidence suggesting the need for development and implementation of evidence-based, patient self-management curricula with therapeutic regimen for VAD patients.

Dietary Chitosan Nanoparticles: Potential Role in Modulation of Rainbow Trout (Oncorhynchus mykiss) Antibacterial Defense and Intestinal Immunity against Enteric Redmouth Disease.

Bio-nanotechnology employing bio-sourced nanomaterial is an emerging avenue serving the field of fish medicine. Marine-sourced chitosan nanoparticles (CSNPs) is a well-known antimicrobial and immunomodulatory reagent with low or no harm side effects on fish or their human consumers. In this study, in vitro skin mucus and serum antibacterial activity assays along with intestinal histology, histochemical, and gene expression analyses were performed to evaluate the impact of dietary CSNPs (5 g kg-1 dry feed) on rainbow trout resistance against 'enteric redmouth' disease. Two treatment conditions were included; short-term prophylactic-regimen for 21 days before the bacterial challenge, and long-term therapeutic-regimen for 21 days before the challenge and extended for 28 days after the challenge. Our results revealed higher antibacterial defense ability and positive intestinal histochemical and molecular traits of rainbow trout after dietary CSNPs. The prophylactic-regimen improved trout health while the therapeutic regimen improved their disease resistance and lowered their morbidity. Therefore, it is anticipated that CSNPs is an effective antibacterial and immunomodulatory fish feed supplement against the infectious threats. However, the CSNPs seem to be more effective in the therapeutic application rather than being used for short-term prophylactic applications.

Network Meta-analysis of the Efficacy and Safety of Different Regimens in the Treatment of Refractory Kawasaki Disease / 中国药房

OBJECTIVE：To systematically evaluat e the efficacy and safety of different regimens in the treatment of refractory Kawasaki disease ，and to provide evidence-based reference for clinical treatment. METHODS ：Retrieved from PubMed ，Embase， Cochrane Library ， CNKI， VIP， Wanfang database ，randomized controlled trials （RCTs）and cohort studies about different therapeutic regimens in the treatment of refractory 84206032。E-mail：liuyingzryy@163.com Kawasaki disease were collected during the inception to March 2021. After selecting the literature and extracting the data ，the quality of RCT was evaluated by modified Jadad scale ，and the quality of cohort st udy was evaluated by NOS scale. Network Meta-analysis was performed by using Stata 16.0 software. RESULTS ：A total of 29 literatures were included ，involving 15 RCTs and 14 cohort studies. A total of 3 112 patients and 12 therapeutic regimens were involved ，including twice IVIG ，twice IVIG+hormone，twice IVIG+ulinastatin ，first IVIG ，first time IVIG+hormone ，first time IVIG+cyclosporine ，first time IVIG+ etanercept，hormone，hormone+ulinastatin，ulinastatin，infliximab and placebo. The results of network Meta-analysis showed that in terms of the incidence of coronary artery injury （CAL），twice IVIG+hormone was significant lower than hormone ，and first time IVIG +etanercept was significant lower than first time IVIG （P＜0.05）. The sorting results of network Meta-analysis showed that area under cumulative ranking curve of CAL incidence in ascending order was hormone ＜ulinastatin＜twice IVIG ＜first time IVIG＜first IVIG+hormone ＜twice IVIG+hormone ＜infliximab＜first time IVIG+cyclosporin ＜first time IVIG+etanercept. In terms of the incidence of ADR ，compared with twice IVIG+ hormone and hormone ，twice IVIG and first time IVIG+etanercept were decreased significantly ；infliximab was significantly lower than hormone （P＜0.05）. The sorting results of network Meta-analysis showed that area under cumulative ranking curve of ADR incidence in ascending order was hormone ＜twice IVIG+hormone ＜first time IVIG+hormone ＜first time IVIG+cyclosporin ＜first time IVIG ＜twice IVIG ＜first time IVIG+etanercept ＜infliximab. In terms of the serum level of CRP ，compared with twice IVIG ，twice IVIG+hormone ，twice IVIG+ulinastatin and hormone were decreased significantly；twice IVIG+hormone was significantly lower than first time IVIG ；twice IVIG+ulinastatin were all significantly lower than twice IVIG+hormone ，hormone，hormone+ulinastatin，first time IVIG ，first time IVIG+hormone and ulinastatin （P＜0.05）. The sorting results of network Meta-analysis showed that area under cumulative ranking curve of serum CRP level in ascending order was first time IVIG ＜first time IVIG+hormone ＜twice IVIG ＜hormone+ulinastatin＜ulinastatin＜infliximab＜hormone＜twice IVIG+hormone＜twice IVIG+ulinastatin. In terms of improving persistent fever duration ，there was no statistical difference between pairwise treatment measures （P＞0.05）. The sorting results of network Meta-analysis showed area under cumulative ranking curve of persistent fever time in ascending order was first time IVIG ＜placebo＜first time IVIG+cyclosporine ＜hormone＜twice IVIG+ hormone＜twice IVIG ＜ulinastatin＜infamliximab. CONCLUSIONS ：The first time IVIG+etanercept has the best effect in reducing the incidence of CAL. Infliximab possesses a relatively low incidence of ADR and the best antipyretic effect. Twice IVIG + ulinastatin has the best anti-inflammatory effect.

Triple-negative breast cancer molecular subtyping and treatment progress.

Triple-negative breast cancer (TNBC), a specific subtype of breast cancer that does not express estrogen receptor (ER), progesterone receptor (PR), or human epidermal growth factor receptor 2 (HER-2), has clinical features that include high invasiveness, high metastatic potential, proneness to relapse, and poor prognosis. Because TNBC tumors lack ER, PR, and HER2 expression, they are not sensitive to endocrine therapy or HER2 treatment, and standardized TNBC treatment regimens are still lacking. Therefore, development of new TNBC treatment strategies has become an urgent clinical need. By summarizing existing treatment regimens, therapeutic drugs, and their efficacy for different TNBC subtypes and reviewing some new preclinical studies and targeted treatment regimens for TNBC, this paper aims to provide new ideas for TNBC treatment.

A short overview on mycophenolic acid pharmacology and pharmacokinetics.

Immunosuppressive therapy is used in solid organ transplant treatment, and mycophenolic acid (MPA) is one of the immunosuppressive drugs most used worldwide. It is a potent, selective, non-competitive, and reversible inosine monophosphate dehydrogenase (IMPDH) inhibitor that acts to inhibit guanine synthesis. To improve solubility, MPA is used as the prodrug mycophenolate mofetil (MMF) or as an enteric-coated mycophenolate sodium salt (EC-MPS). It is metabolized into mycophenolic acid phenyl glucuronide (MPAG), the inactive and major metabolite, and into acyl glucuronide (AcMPAG), pharmacologically active. In kidney transplantation, combined immunosuppressive therapy with cyclosporine (CsA) and tacrolimus (Tac) is widely used, showing beneficial effects. This paper aimed to review papers published in the last two decades and discuss factors that can interfere with the pharmacokinetics of MPA. Data collected confirm that MPA plasma levels should be monitored to evaluate immunosuppressive therapy since pharmacokinetics can be influenced by factors such as interpatient variability, coadministration of other immunosuppressive agents, post-transplant period, renal function, and dose. However, to perform drug monitoring, costs and facility may be limitations. Monitoring MPAG together with MPA would be a great improvement in therapy as it represents a big part of MPA levels and can be related to the increase of adverse effects.

Holistic Nursing Upon the Knowledge on Care During Myelosuppression among Cancer Patients.

BACKGROUND: A study was conducted to assess the effectiveness of holistic nursing intervention upon the knowledge regarding care during myelosupression among patients with cancer at a selected hospital in Chennai, India. METHODS: A quantitative research approach of quasi experimental non-equivalent with control group before -after design (non randomized) was used. The investigator included 204 participants by using purposive sampling technique which included 102 each in study and comparison group. Pre-test was done before the intervention of holistic nursing to both comparison and study group participants. Holistic nursing intervention was implemented for study group whereas comparison group received routine care. Post test was done by using the structured questionnaire after 1month. The responses from the participants were coded and statistically analyzed by using descriptive and inferential statistics. RESULTS: The knowledge scores obtained by study group was significantly higher (13.32+2.94) when compared to comparison group (8.12+2.04). There was a statistically significant difference between study and comparison group participants, at p< 0.001. With regard to the dimensions of knowledge related to disease condition and signs and symptoms were higher in the study group when compared to the comparison group. The difference was statistically significant at p.

Treatment of hypopharyngeal carcinoma complicated with diabetic nephropathy: a case report and literature review.

For elderly cancer patients with diabetic nephropathy, severe renal insufficiency leads to a very high risk of chemotherapy. Physicians and pharmacists must consider both the benefits of cancer treatment and the impact of antineoplastic drugs on patients' residual renal function, and choose appropriate chemotherapy regimens to balance the efficacy and safety of drugs. We report a case of a patient who presented with dysphagia and sore throat with serum creatinine of 169 µmol/L and fasting blood glucose of 7.9 mmol/L on admission. The main diagnosis was hypopharyngeal carcinoma with diabetic nephropathy. The clinical pharmacist reviewed the literature and analyzed the pharmacological and pharmacokinetic characteristics of anti-tumor drugs in patients, and adjusted the chemotherapy regimen and dose according to the renal function of patients. To the best of our knowledge, this is the first reported case of hypopharyngeal carcinoma with severe renal insufficiency treated successfully with multimodality therapy in China. The purpose of this case is to optimize the anti-tumor treatment regimen and drug dose adjustment of hypopharyngeal carcinoma with severe renal insufficiency, so as to provide a reference for clinicians and clinical pharmacists to use drugs rationally.

Drug resistance in non-small cell lung Cancer (NSCLC): Impact of genetic and non-genetic alterations on therapeutic regimen and responsiveness.

The discovery of genetic alterations, that can be targeted therapeutically, has launched a new era for lung cancer research and personalized therapy. However, not all the identified new genetic driver mutations are therapeutically targetable due to high toxicity profile. On the other hand, those genetic alterations that could be pharmacologically targeted, are often subject of alternative mutations that lead to drug resistance, which represents one of the major clinical limitation. Mechanisms of acquired resistance in oncogene-driven malignancies occur after additional genetic alterations of the primary oncogene. In this scenario, the secondary genetic alteration can lead to up-regulation of bypass-signaling pathways, changes in tumor histology or alterations in drug metabolism, that are able to promote drug resistance with an ensuing lower survival rate of the patient. Another aspect to be considered is that non-genetically mutated patients still have poor pharmacological options and therefore still represent an unmet medical need. Therefore, identifying mechanisms underlying both drug resistance in genetically mutated patients and novel therapeutic alternatives for non-mutated NSCLC patients is still an area of intense investigation.

Current Situation and Deficiencies of Economics Evaluation for Pediatric Therapeutic Regime in China / 中国药房

OBJECTIVE： To provide reference for improving the economics evaluation studies for pediatric therapeutic regime in China. METHODS： By searching the literature published in domestic journals from Jan. 1st， 2009 to Dec. 31th， 2018， the current situation of the measurement of cost （including time range， cost calculation） and health output （including outcome indicators and measurement scales） were explored. Combined with relevant literature at home and abroad， the deficiencies of economics evaluation for pediatric therapeutic regime in terms of cost measurement and health outcome measurement were summarized in China， and the corresponding research prospects were put forward. RESULTS & CONCLUSIONS： Totally 140 related literatures were finally included. In terms of cost measurement， short-term （≤1 year） research accounted for the highest proportion （109 literatures， 77.86％）. Cost calculation mostly had no clear research perspective （125 literatures， 89.29％）. It did not involve the cost of child productivity. The main shortcomings were unclear time range， incomplete cost calculation （lack of productivity， hidden cost） and so on. In terms of health output measurement， 103 （73.57％） used cost-effectiveness analysis， 23 （16.43％） used cost-benefit analysis， and only 4 （2.86％） related to the use of measurement scales. Main shortcomings included that the difficulty in obtaining outcome indicators， lack of child health output measurement scale and so on. Based on this， it is suggested that related demands should be complied before conducting economics evaluation research， we should clarify the research angle， formulate unified and standardized cost measurement methods， rationally select technical analysis methods and health outflow indicators according to research purposes and disease characteristics， and develop appropriate measurement scales according to the physiological and psychological characteristics of children in different age groups. At the same time， future studies can report on the status of family members when reporting on children's related conditions， and conduct an economic evaluation of therapeutic regimen in the family unit.

The clinical significance of MGMT promoter methylation in the treatment and progno-sis of glioma patients / 中国肿瘤临床

Adjuvant temozolomide-based chemotherapy has become the standard of care for most postoperative glioma patients. However, a large proportion of these patients do not respond to temozolomide. DNA repair enzyme O6-methylguanine-DNA methyl-transferase (MGMT) promoter methylation has emerged as an important molecular marker in patients with gliomas. It is associated with prognosis and resistance to alkylated drugs such as temozolomide. MGMT promoter methylation is the key mechanism of MGMT gene silencing, thereby inhibiting DNA repair and increasing the sensitivity of chemotherapy. We reviewed current data on the prog-nostic and predictive relevance of MGMT testing and clinical trials, summarized the clinical application of MGMT promoter methyla-tion, in order to provide reference for the individualized treatment of glioma patients.

Retrospective analysis of the clinical characteristics of retinal vein occlusion in the nearby five years / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To retrospectively analyze the clinical change of retinal vein occlusion inpatients of the Second People's Hospital of Foshan in the nearby five years.<p>METHODS: The data of inpatients in the Second People's Hospital of Foshan were collected by the term “retinal vein occlusion”from 2013-01-01 to 2017-12-31. Retrospective analysis of the details for the disease.<p>RESULTS: Totally 351 patients with retinal vein occlusion were admitted and treated for 473 times in five years. Elder with systemic disease(hypertension, diabetes and renal inadequacy)was more common. The hospital days were significantly statistical difference among five years with the shortest days in 2017. The prevalence of RVO was growing year by year, especially for BRVO, with statistical difference between 2017 and the other four years(<i>P</i><0.005). Treatments for RVO were mainly including retinal laser, intravitreal injection or both combined. There was significantly statistical difference about the rate of intravitreal injection among five years(<i>P</i><0.05)with the lowest one in 2013.“1+PRN” therapeutic regimen was more tolerable for patients than “3+PRN”.<p>CONCLUSION: BRVO is growing more sharply than CRVO in the nearby five years. Retinal laser combined with“1+PRN”intravitreal injection is the main therapeutic regimen for RVO in our hospital.