1.CT and MRI Findings of Intracranial Chondrosarcomas
Zhongfu XIE ; Jinliang DU ; Jinxi QIN ; Song JIN ; Shimin CUI
Journal of Practical Radiology 2000;0(02):-
Objective To study CT and MRI features of intracranial chondrosarcomas. Methods CT and MRI of 3 cases with intracranial chondros arcomas proved by pathology were retrospectively analyzed.Results CT scans showed the tumors were lobular mass, per itumoral edema were not serious, intratumorous calcification and bone invasion w ere seen in 2 cases.MRI showed that tumor had low to intermediate signal intensi ty or hypointensity on T 1WI, high signal intensity on T 2WI. On contrast enha nced MRI,the center of lesions which was low signal intensity on T 2WI was no e nhancement, but there was observable enhancement at periphery of tumors.Conclusion Intracranical chondrosarcomas are often orgina ted from synchondrosis of the skull base,the lesions are often associated with c alcification, and bone invasion, the accurate dignosis should depend on microsco pic examination and immunohistochemical staining.
2.The Influence of Non-High-Density Lipoprotein Cholesterol on the Efficacy of Genotype-Guided Dual Antiplatelet Therapy in Preventing Stroke Recurrence
Qin XU ; Xia MENG ; Hao LI ; Xuewei XIE ; Jing JING ; Jinxi LIN ; Yong JIANG ; Yilong WANG ; Xingquan ZHAO ; Zixiao LI ; Liping LIU ; Anxin WANG ; Yongjun WANG
Journal of Stroke 2024;26(2):231-241
Background:
and Purpose Non-high-density lipoprotein cholesterol (non-HDL-C), which represents the total cholesterol content of all pro-atherogenic lipoproteins, has recently been included as a new target for lipid-lowering therapy in high-risk atherosclerotic patients in multiple guidelines. Herein, we aimed to explore the relationship between non-HDL-C level and the efficacy and safety of ticagrelor-aspirin versus clopidogrel-aspirin in preventing stroke recurrence.
Methods:
This study comprised a post hoc analysis of the CHANCE-2 (Ticagrelor or Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events II) trial, from which 5,901 patients with complete data on non-HDL-C were included and categorized by median non-HDL-C levels, using a cutoff of 3.5 mmol/L. The primary efficacy and safety outcomes were recurrent stroke and severe or moderate bleeding within 90 days.
Results:
Ticagrelor-aspirin significantly reduced the risk of recurrent stroke in patients with low non-HDL-C (71 [4.8%] vs. 119 [7.7%]; adjusted hazard ratio [HR] 0.54; 95% confidence interval [CI], 0.40–0.74), but not in those with high non-HDL-C (107 [7.3%] vs. 108 [7.6%]; adjusted HR, 0.88; 95% CI, 0.67–1.16), compared with clopidogrel-aspirin (P for interaction=0.010). When analyzed as a continuous variable, the benefit of ticagrelor-aspirin for recurrent stroke decreased as non-HDL-C levels increased. No significant differences in the treatment assignments across the non-HDL-C groups were observed in terms of the rate of severe or moderate bleeding (5 [0.3%] vs. 8 [0.5%] in the low non-HDL-C group; 4 [0.3%] vs. 2 [0.1%] in the high non-HDL-C group; P for interaction=0.425).
Conclusion
CHANCE-2 participants with low non-HDL-C levels received more clinical benefit from ticagrelor-aspirin versus clopidogrel-aspirin compared to those with high non-HDL-C, following minor ischemic stroke or transient ischemic attack.
3.Inspiration from International Experience on Risk Sharing Agreements of Medical Insurance Access for CAR-T Products
Wei LI ; Huli QIN ; Jinxi DING ; Jiaming LI ; Qirui XIA
China Pharmacy 2021;32(24):2957-2962
OBJECTIVE:To learn from the experience of foreign listed chimeric antigen receptor T lymphocyte (CAR-T) products in signing risk sharing agreements in medical insurance access ,so as to provide references for relevant decisions of medical insurance departments in China. METHODS :Taking 9 risk sharing agreements of CAR-T products marketed in the United Kingdom,France,Italy and Germany as samples ,the international experience of medical insurance payment of CAR-T products were analyzed from six dimensions ,such as agreement types ,monitoring indicators ,data collection metho ds,agreement periods , payment conditions and payment methods. Some suggestions were put forward for the medical insurance access of these products in China. RESULTS & CONCLUSIONS :Four sample countries generally signed risk sharing agreements of medical insurance access (financial agreement and performance-based agreement )with pharmaceutical enterprises ;the indicators such as progressive disease and progression-free survival were collected by using data collection system or clinical research data ,so as to monitor the efficacy and safety of CAR-T products. The agreement periods and payment conditions were determined according to different agreement types;“medical insurance advance payment ”or“pharmaceutical enterprise advance payment ”combined with “staged payments ” were adopted for risk control. Solving the risk of medical insurance funds caused by “efficacy uncertainty ”is the core issue of CAR-T product access. The induction of risk sharing agreements may be the way to solve this problem ,and the scientific design of the various elements of risk sharing agreements is a prerequisite to ensure that the agreement is operational.