摘要:目的:了解2007~2008年成都地区17家医院生物制品及生化药品的使用状况。方法:采用限定日剂量(DDD)的方法,对成都地区2007~2008年17家医院生物制品及生化药品的销售金额、用药频度(DDDs)等进行统计分析。结果:2007年、2008年成都地区17家医院生物制品及生化药品销售总额分别为7338万元、9786万元;分别占总销售额的4.83%、5.00%。销售金额进入总销售额排名前100位的生物制品及生化药品有:人血白蛋白、胸腺肽、丙种球蛋白、促白细胞生长素和环磷腺苷。环磷腺苷在生物制品及生化药品中的DDDs最高。结论:生物制品及生化药品的价格及供给对其临床使用有较大的限制。Abstract: Objective: To evaluate the current situation and the trend of biological products and biochemical drugs used in Chengdu city in 2007 to 2008. Methods: Consumption of biological products and biochemical drugs used in 17 hospitals of Chengdu city in 2007 to 2008 were analyzed by the way of sum DDD and DDDs ranking. Results: The total cost of the biological products and biochemical drugs used in Chengdu city in was 73.38 and 97.86 million yuan in 2007 to 2008, it accounted for 4.83% and 5.00% of the total cost. Human serum albumin, thymosin, gamma globulin, interleukin promoting growth hormone and adenosine cyclophosphate were the drugs in the first 100 cost list. The DDDs of adenosine cyclophosphate was highest among biological products and biochemical drugs. Conclusion: The cost and supply of biological products and biochemical drugs were great limitations of their clinical application.
Objective To investigate the effects of X-ray dose on the expressions of microRNA-221 （miR-221） and phosphatase and a tensin homolog deleted from chromosome10 （PTEN） in human colorectal carcinoma （CRC） cells. Methods Human CRC-derived cell line， Caco2， was cultured conventionally. The cells were divided into five groups and exposed to different doses of X-ray （0， 2， 4， 6， and 8 Gy） respectively. The total RNA and protein of the Caco2 cells were extracted after irradiation， and the miR-221 and PTEN mRNA expressions were detected by real-time RT-PCR.Moreover， the protein alteration of PTEN in Caco2 cells was detected by Western-blot analysis. Results The radiation dose of X-ray significantly affected the expressions of miR-221 and PTEN protein in human Caco2 cells in a dose-depen-dent manner. Moreover， the miR-221 expression level was up-regulated gradually with the increase of irradiation dose， on the contrary， the PTEN protein expression level was down-regulated gradually （P＜0.01）. Conclusion The radiation dose can affect the miR-221 and PTEN protein expression pattern in CRC cells.
ObjectivesTo investigate the influence of scanning parameters (tube voltages and tube currents) on image quality and corresponding radiation doses with simulated lung nodules in chest CT.MethodsThe anthropomorphic chest phantoms with 12 simulated, randomly placed nodules of different diameters and densities in the chest were scanned by different scanning parameters. The detection rate, degree of nodular deformation, image quality (with both subjective and objective evaluation) and the corresponding radiation doses were recorded and evaluated, and the correlation between nodule detection rate, degree of nodular deformation, radiation dose and image quality using different scanning parameters was analyzed.ResultsThe image quality improved with the increase of tube voltage and tube current (P<0.05). When the tube current was constant, the CT values of the vertebral decreased gradually with the increase of tube voltages (P<0.05); however, significant difference was not detected in CT values of the lung field (P>0.05). When the tube current was 100 mAs, the lung nodules with CT values of +100 HU and −630 HU showed statistical difference when using different tube voltage (P<0.05); but there was no significant difference in nodules of −800 HU (P=0.57). When tube voltage was 100 kV and 120 kV each, it was possible to detect all lung nodules with a detection rate of 100%. The detection rate was 33% and 66% in 3 mm diameter when the tube current was 80 kV/15 mA and 80 kV/20 mA, respectively. The nodules deformation in nodules with a CT value of −630 HU and diameter less than 5 mm was the most prominent (P<0.05). After analyzing the relationship between image quality and radiation doses using different tube voltages, we established a system of correlation equations: 80 kV: Y=2.625X+0.038; 100 kV: Y=14.66X+0.158; 120 kV: Y=18.59X+0.093.ConclusionsThe image quality improves with the increase of tube current and tube voltage, as well as the corresponding radiation doses. By reducing the tube voltage and increasing the tube current appropriately, the radiation doses can be reduced. Follow-up CT examination of pulmonary ground glass nodules should apply the same tube voltage imaging parameters, so as to effectively reduce the measurement error of nodule density and evaluate the change of nodules more accurately.
Objective To explore value of multidisciplinary team (MDT) model in diagnosis and treatment of patients with advanced special thyroid cancer who lost chance of operation. Method Two patients with the advanced special thyroid cancer who lost chance of operation were treated by low dose apatinib (250 mg/d) after the MDT discussion. Results One medullary thyroid cancer patient with the compressing of the trachea for mediastinal metastatic lymphadenopathy and inability to lie down underwent the multiple surgical treatment, the therapeutic effect was poor. Then low dose apatinib (250 mg/d) was performed, the patient could supine, breathe smoothly, and move freely, whose life quality was obviously improved, the mediastinal lymph nodes reduced and no serious drug toxicity occurred on month 1 after the treatment. One undifferentiated thyroid cancer patient with the lung metastasis, hemoptysis, and tumor invasion resulted in the inability to lie down and having difficulty in breathing, these symptoms still existed and more pleural effusion occurred after the resection of the invaded trachea. Then low dose apatinib (250 mg/d) was performed, the patient could supine, the pleural effusion disappeared, the hemoptysis stopped, the breathing was smooth, and could do some minor housework, no drug toxicity occurred on month 1 after the treatment. Conclusion After MDT discussion, low dose apatinib in treatment of advanced special thyroid cancer is reliable and safe and has a good short-term effect, which could be used as a new remedy, but long-term effect should be further researched by increasing case samples and a long-term following-up.
Objective To investigate the effect of the synthetic bone morphogenetic protein 2 (BMP-2)derived peptide on the osteogenic induction in the marrow mesenchymal stem cells (MSCs）and to evaluate the osteoinductivity and dosedependence of the BMP-2 derived peptide in vitro. Methods MSCs of 4-week old Wistar rats were separated and cultured. In the 3rd passage, the conditional culture medium was changed, in which the BMP-2-derived peptide in the following doses was added: 300,200, 100, 50, and 0 μg/ml, respectively (Groups A-E). The activity of alkaline phosphatase (ALP）and the amount of calciumdeposition were meassured at 5，10，15 and 20 days during the culture with the conditional culture medium. The real-time fluorescent quantitative polymerase chain reaction (FQ-PCR) was performed to measure the mRNA expressions of collagen type Ⅰ, osteopontin (OPN), and osteocalcin（OCN）and to measure the osteoinductivity of the BMP-2-derived peptide in the different concentrations.Results Under the inverted phase contrast microscope, MSCs cultured in the conditional culture medium for 3-4 days were changed in shape, from long fusiform to short fusiform or polygon. As the concentration of the BMP-2-derived peptide increased, the time for MSCs to change into the osteoblasts decreased. There was a significantly greater level of the ALP activity and amount of the calcium deposition in Groups A and B than in the other groups（Plt;0.05）. However,there was no significant difference between Group A and Group B （Pgt;0.05）. Theresult of FQPCR showed that after MSCs were cultured in the different doses of theconditional culture medium for 14 days, the mRNA expressions of collagen type Ⅰ, OPN andOCN were at higher levels. An increasing order in the level of the cycle threshold (Ct) was found in the following groups: Agt;Bgt;Cgt;D. Almost no expression was found in Group E. The Ct levels were significantly greater in Groups A and B thanin Groups C and D（Plt;0.05）. However, there was no significant difference between Group A and Group B （Pgt;0.05）.ConclusionThe BMP-2-derived peptide can greatly promote differentiation of MSCs into the osteoblasts, the promotion of osteogenesis has a dosedependent pattern, and the best inducing dosage is 200 μg/ml.
ObjectiveTo develop reporting guideline for dose-response meta-analysis (DMA), so as to help Chinese authors to understand DMA better and to promote the reporting quality of DMA conducted by them. MethodPubMed, EMbase, The Cochrane Library, CNKI, and WanFang Data were searched from Jan 1st 2011 to Dec 30th 2015 to collect DMA papers published by Chinese authors. The number of these publications by years, whether and what kind of reporting guideline was used, and whether the DMA method claimed in these publications was correct were analysed. Then we drafted a checklist of items for reporting DMA, and organized a discussion meeting with experts from the fields of DMA, evidence-based medicine, clinical epidemiology, and clinicians to collect suggestions for revising the draft reporting guideline for DMA. ResultsOnly 33.73% of the publications clarified it is a DMA on the title and 48.02% of them reported risk of bias. Almost 38.49% of the publications didn't use any reporting guidelines. Fourteen of them claimed an incorrect use of methodology. We primarily took account for 47 potential items related to DMA based on our literature analysis results and existing reporting guidelines for other types of meta-analyses. After the discussion meeting with 6 experts, we revised the items, and finally the G-Dose checklist with 43 items for reporting DMA was developed. ConclusionThere is a lack of attention on reporting guidelines in Chinese authors and evidence suggests these authors may be at risk of incomplete understanding on reporting guidelines. It is strongly recommended to use reporting guidelines for DMA and other types of meta-analyses in Chinese authors.
Therapeutic effect of fixed-dose combination therapy (Polypill) for cardiovascular disease is a hot spot in the field of cardiovascular medicine. A variety of Polypill have been developed for the prevention and treatment of cardiovascular disease, and a plenty of clinical evidence of Polypills for cardiovascular disease has been accumulated all over the world. In this paper, we raise ideas and expectation about research & development thinking of Polypill and Chinese herbal compound prescription based on a meta-analysis of efficacy and safety of Polypill in the prevention of cardiovascular disease (published in JAMA in Nov. 2014) as well as main clinical research literature in this field in recent years.
Dose-response meta-analysis, an important tool in investigating the relationship between a certain exposure and risk of disease, has been increasingly applied. Traditionally, the dose-response meta-analysis was only modelled as linearity. However, since the proposal of more powerful function models, which contains both linear, quadratic, cubic or more higher order term within the regression model, the non-linearity model of dose-response relationship is also available. The packages suit for R are available now. In this article, we introduced how to conduct a dose-response meta-analysis using dosresmeta and mvmeta packages in R.
ObjectiveTo discuss the value of dual-source CT Flash scanning in reducing the dose of radiation in 3D cardiac imaging. MethodWe collected 60 patients from March to August 2014 who should undergo cardiac 3D CT scanning before radiofrequency ablation. They were randomly divided into group A and B with 30 in each. Patients in group A underwent flash technology scanning, while those in group B accepted conventional retrospective electrocardiography-gated scanning. CARE Dose techniques were used to collect data. Scanning parameters were the same for both groups:collimation was 128×0.6 mm, reconstruction thickness was 0.75 mm, reconstruction interval was 0.7 mm, and field of view was 180-200 mm. After image acquisition, we measured the CT values and noise of left atrium and various branches of the pulmonary veins (upper left, lower left, upper right, and lower right). Statistical software was used for the two groups of images to analyze the carrier noise ratio (CNR), signal noise ratio (SNR), blinded scores, computed tomography dose index (CTDIvol), and dose-length product (DLP) of the left atrium and pulmonary vein. ResultsCNR and SNR of the left atrium and various pulmonary veins between the two groups had no significant differences (P>0.05) . Blinded scores between the two groups were not significantly different (P>0.05) . CTDIvol in group A and group B was respectively (2.92±0.38) and (20.15±12.09) mGy, with a significant difference (t=?7.803, P<0.001) . DLP of group A was (59.30±6.67) mGy·cm, significantly lower than that in group B [(334.43±216.71) mGy·cm] (t=?6.591, P<0.001) . Flash-efficient radiation dose was (0.83±0.94) mSv in group A, far below that in group B [(4.53±3.03) msv], and the difference was statistically significant (t=?6.684, P<0.001) . ConclusionsDual-source CT Flash technology applied in 3D cardiac scanning can reduce radiation dose as well as meet the needs of image diagnosis.