Cost-effectiveness of paclitaxel, doxorubicin, cyclophosphamide and trastuzumab versus docetaxel, cisplatin and trastuzumab in new adjuvant therapy of breast cancer in china.

BACKGROUND: Breast cancer is the most common cancer among women in China. Amplification of the Human epidermal growth factor receptor type 2 (HER2) gene is present and overexpressed in 18-20% of breast cancers and historically has been associated with inferior disease-related outcomes. There has been increasing interest in de-escalation of therapy for low-risk disease. This study analyzes the cost-effectiveness of Doxorubicin/ Cyclophosphamide/ Paclitaxel/ Trastuzumab (AC-TH) and Docetaxel/Carboplatin/Trastuzumab(TCH) from payer perspective over a 5 year time horizon. METHODS: A half-cycle corrected Markov model was built to simulate the process of breast cancer events and death occurred in both AC-TH and TCH armed patients. Cost data came from studies based on a Chinese hospital. One-way sensitivity analyses as well as second-order Monte Carlo and probabilistic sensitivity analyses were performed.The transition probabilities and utilities were extracted from published literature, and deterministic sensitivity analyses were conducted. RESULTS: We identified 41 breast cancer patients at Hangzhou First People's Hospital, among whom 15 (60%) had a partial response for AC-TH treatment and 13 (81.25%) had a partial response for TCH treatment.No cardiac toxicity was observed. Hematologic grade 3 or 4 toxicities were observed in 1 of 28 patients.Nonhematologic grade 3 or 4 toxicities with a reverse pattern were observed in 6 of 29 patients. The mean QALY gain per patient compared with TCH was 0.25 with AC-TH, while the incremental costs were $US13,142. The incremental cost-effectiveness ratio (ICER) of AC-TH versus TCH was $US 52,565 per QALY gained. CONCLUSIONS: This study concluded that TCH neoadjuvant chemotherapy was feasible and active in HER2-overexpressing breast cancer patients in terms of the pathological complete response, complete response, and partial response rates and manageable toxicities.

Analysis on the Clinical Application of Human Serum Albumin in Inpatients in Our Hospital in 2014 / 中国药师

Objective:To evaluate the clinical application of human serum albumin in the inpatients in our hospital to promote its rational use. Methods:Totally 1 183 cases were selected from the inpatients treated with human serum albumin from January to De-cember in 2014, the clinical department, classification of diseases, age distribution and relevant concentration checks of serum albumin in the inpatients were analytically reviewed. Results: Totally 26 clinical departments were involved in the use of human serum albu-min,mainly in the digestive departments and ICU. The elderly patients aged above 65 years accounted for great proportion (47. 68%). In addition, all patients had relevant concentration checks of serum albumin. Conclusion:The patients with digestive diseases tend to have the largest consumption proportion of human serum albumin in our hospital. It is important for physicians to strictly follow the indi-cations of medication in using human serum albumin.

Risk factors and intervention measures of mental disorders in ICU / 中国基层医药

Objective To investigate the risk factors of mental disorders of patients treated in intensive care unit(ICU).Methods Collected from January 2013 to December 2014 ICU stay eligible cases,and analyzed the past history (hypertension,intemperance),previous surgery,mechanical ventilation,date of ICU admission,quality of care, APACHE II score,electrolyte disorder,LVEF,sleep disturbance,PCT,oxygenation index,drug use situation (midazo-lam,opioids)and the clinical care unit the incidence of mental disorders in relationship.Results 568 patients (male 345 cases,female 223 cases),mental disorders group of 157 patients,the clinical incidence rate of 27.6% overall;568 patients were in the sex ratio of 1.55:1,mental disorders group of 157 patients(96 males,61 females),male to female ratio 1.57:1,mean age was (65.5 ±11.2)years;no mental disorders group (249 males,162 females),male to female ratio 1.30:1,mean age was (48.8 ±14.3)years.Logistic regression analysis revealed that coronary heart disease,hypotension,alcohol abuse,surgery,mechanical ventilation,ICU admission time,quality of care,APACHE II score,electrolyte imbalance,ejection fraction,sleep disorders,procalcitonin,oxygenation index,use of midazolam or opioids were among the risk factors of ICU mental disorders.Mechanical ventilation,quality of care,hypotension,alco-hol abuse,and use of midazolam were independent risk factors for ICU mental disorders (all P <0.05).Conclusion ICU inpatients with past history of hypertension and intemperance,use of mechanical ventilation and midazolam should be closely monitored and evaluated,early psycho -psychiatric screening,and take effective measures in time;high -quality care can reduce the incidence of mental disorders in ICU patients significantly.

Inhibitive effect of tea polyphenol on the growth of human nasopharyngeal carcinoma cell xenograft in nude mice / 重庆医学

Objective To evaluate the inhibitive effect of tea polyphenol on the growth of human nasopharyngeal carcinoma HONE1 cell xenograft in nude mice ,and to explore the underlying mechanisms .Methods Tumor model was established by subcu‐taneous inoculation of nasopharyngeal carcinoma cell HONE1 into nude mice ,was used to evaluate the antitumor effect of tea poly‐phenol in vivo .The expression levels of VEGF were detected by real‐time PCR and western blot .Results The growth of xenograft in nude mice was significantly suppressed after application of tea polyphenol at a dose‐dependent manner .To compare with control group ,the inhibition rates were 18 .82% (P<0 .05) and 47 .66% (P<0 .05)when treated at low and high dose respectively ,With in‐creased concentration of TP ,the inhibition rates increased .Real‐time fluorescence quantitative‐PCR and western blot results showed that the expression of VEGF decreased at a dose‐dependent manner .The change of high dose group was obviously ,the difference was statistically significant(P<0 .05) .Conclusion Tea polyphenol could significantly inhibit the growth of human nasopharyngeal carcinoma HONE1 cell xenograft in nude mice ,probably by down regulating the VEGF protein level to inhibit tumor angiogenesis effects .

Tumor suppressive effect and relative mechanisms of tea polyphenol on nasopharyngeal carcinoma cells / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the effect and mechanism of tea polyphenol (TP) on the proliferation, apoptosis, migration and invasion of nasopharyngeal carcinoma(NPC) cell line HONEl.@*METHOD@#After treated with different concentration of tea polyphenol, CCK-8 assay, fluorescent staining, cell scratching assay and transwell assay were applied to detect the effect of tea polyphenol on the HONE1 cells. Furthermore, the expression of protein VEGF was investigated by flow cytometry assay.@*RESULT@#It was found that tea polyphenol could inhibit NPC cell proliferation significantly in a dose-dependent manner, however, little impact was observed in normal nasopharyngeal epithelial cell line NP69. Furthermore, it was demonstrated by fluorescent staining assay that tea polyphenol could induce NPC cell apoptosis, and cell scratching assay and transwell assay showed that tea polyphenol could inhibit cell migration and invasion.@*CONCLUSION@#Tea polyphenol can significantly inhibit cell proliferation, induce cell apoptosis and decreased the migration and invasion ability of NPC cells in vitro. Tea polyphenol might be a tumor suppressor of NPC cells.

A Surveys on clinical interns' mastery and understanding status of medical core systems / 中华医学教育探索杂志

Objective To investigate clinical interns' mastery and understanding status of medical core systems in order to provide reference for formulating training programs. Methods The questionnaires including medical core systems trained and self-assessment and test paper were de-signed. Then survey was carried out among 188 clinical interns of Grade 2009 of Zunyi Medical Col-lege at the end of training. All data were obtained, collected and analyzed with Excel and a SPSS 17.0. The result was described with percentage. Results ①78/41.34% and 117/62.33% clinical interns accepted training of medical core systems respectively before or during clinic training. 74/39.43%hos-pitals or 70/37.30% departments were systematically trained by medical core systems and the propor-tion of teachers who systematically or non-systematically explained medical core systems for clinical interns was 42/22.29%and 61/32.37%respectively.②The clinical interns who mastered first diagnosis responsibility systems, patient communication system, and systems of discussing difficult cases were 178/94.68%, 178/90.43%or 168/89.36%. The clinical interns who mastered rescue systems in critically ill patients, surgical classification management systems and audit system in clinical blood transfusion were 84/44.68%, 67/35.64%or 34/18.28%respectively.③8/6.90%interns fully grasped the core system of the medical situation. 165/87.71% and 165/83.43% clinical interns believed medical core systems should be mastered and 157 interns (83.43%) thought that mastering medical core system can help them better adapt to clinical medical work. Conclusion Systematic training of medical core system should be enhanced for clinical interns and mastering medical core systems is better for their future.

The protecting effects and mechanisms of Baicalin and Octreotide on heart injury in rats with SAP.

PURPOSE: To observe the protecting effects and mechanisms of Baicalin and Octreotide on heart injury in rats with severe acute pancreatitis (SAP). METHODS: The SAP rat models were randomly divided into the model group, Baicalin-treated group, Octreotide treated group, and sham operation group. The contents of some inflammatory indexes in blood were determined. The rat mortality, pathological changes of heart, the changes of NF-kappaB, P-Selectin, Bax, Bcl-2, and Caspase-3 protein expression levels as well as apoptotic index were observed in all groups, respectively, at 3 hours, 6 hours, and 12 hours after operation. RESULTS: The survival rate of model group was less than treated groups at 12 hours, difference was significant. The contents of some inflammatory indexes of the treated groups were lower than those of the model group to various degrees at different time points. The pathological myocardial changes under light microscope were milder in treated groups than in model group. The changes of NF-kappaB, P-Selectin, Bax, Bcl-2, and Caspase-3 protein expression levels in all groups were different. There was only a case of myocardial cell apoptosis in an Octreotide-treated group at 6 hours. CONCLUSION: Baicalin and Octreotide have protecting effects on heart injury of rats with SAP.