1.A model study of blood in urine(bladder cancer)during scorching humid fever in MNU-induced SD rats
Tuo CHANG ; Jie WANG ; Nan LI ; Tianqi WANG
Chinese Journal of Comparative Medicine 2023;33(12):49-54
Objective To investigate the modeling process and model establishment rate of the N-methyl-N-nitrosourea(MNU)-induced lower jiao dampness-heat syndrome uremia bladder cancer(BC)model.Methods Batch samples were collected by bladder perfusion(MNU).HE staining and pathological observation of pathological tissues were carried out at six time points before,during,and after modeling to understand the formation and development of bladder carcinoma in situ.Results The experimental process was smooth,and no obvious urinary tract bleeding in rats occurred during the operation.Using this modeling technique,considerable bladder tumors were formed after week 8,and obvious epithelial hyperplasia,damage and large-scale tumor formation were observed in the bladder of rats in the model group.Conclusions MNU induces an SD rat bladder cancer model with obvious model establishment and low mortality.The experimental data provide a reference to establish,improve and apply the bladder cancer model.
2.Assessing Abdominal Aortic Aneurysm Progression by Using Perivascular Adipose Tissue Attenuation on Computed Tomography Angiography
Shuai ZHANG ; Hui GU ; Na CHANG ; Sha LI ; Tianqi XU ; Menghan LIU ; Ximing WANG
Korean Journal of Radiology 2023;24(10):974-982
Objective:
Recent studies have highlighted the active and potential role of perivascular adipose tissue (PVAT) in atherosclerosis and aneurysm progression, respectively. This study explored the link between PVAT attenuation and abdominal aortic aneurysm (AAA) progression using computed tomography angiography (CTA).
Materials and Methods:
This multicenter retrospective study analyzed patients with AAA who underwent CTA at baseline and follow-up between March 2015 and July 2022. The following parameters were obtained: maximum diameter and total volume of the AAA, presence or absence of intraluminal thrombus (ILT), maximum diameter and volume of the ILT, and PVAT attenuation of the aortic aneurysm at baseline CTA. PVAT attenuation was divided into high (> -73.4 Hounsfield units [HU]) and low (≤ -73.4 HU). Patients who had or did not have AAA progression during the follow-up, defined as an increase in the aneurysm volume > 10 mL from baseline, were identified. Kaplan–Meier and multivariable Cox regression analyses were used to investigate the association between PVAT attenuation and AAA progression.
Results:
Our study included 167 participants (148 males; median age: 70.0 years; interquartile range: 63.0–76.0 years), of which 145 (86.8%) were diagnosed with AAA accompanied by ILT. Over a median period of 11.3 months (range: 6.0–85.0 months), AAA progression was observed in 67 patients (40.1%). Multivariable Cox regression analysis indicated that high baseline PVAT attenuation (adjusted hazard ratio [aHR] = 2.23; 95% confidence interval [CI], 1.16–4.32; P = 0.017) was independently associated with AAA progression. This association was demonstrated within the patients of AAA with ILT subcohort, where a high baseline PVAT attenuation (aHR = 2.23; 95% CI, 1.08–4.60; P = 0.030) was consistently independently associated with AAA progression.
Conclusion
Elevated PVAT attenuation is independently associated with AAA progression, including patients of AAA with ILT, suggesting the potential of PVAT attenuation as a predictive imaging marker for AAA expansion.
3.International Experience and Enlightenment of Medical Insurance Reimbursement for Multi-indication Drugs Based on Value-based Pricing
Zhanjing DAI ; Tianqi XUE ; Guiyuan XIANG ; Feng CHANG ; Yun LU
China Pharmacy 2021;32(2):139-145
OBJECTIVE:To provide reference for improving medical insurance reimbursement for multi-indication drugs based on value-based pricing in China. METHODS:The theory and practice of value-based pricing for multi-indication drugs were sorted out,and the value standards and medical insurance reimbursement strategies based on value-based pricing in France,Germany,UK,Italy and Sweden were analyzed,so as to provide the suggestions for medical insurance reimbursement of multi-indication drugs in China. RESULTS & CONCLUSIONS:The realization of value-based pricing first needed to develop a value framework to define,measure and integrate value,and then established a model to convert the total value into price. The overall idea of value-based pricing for multi-indication drugs was consistent,but there were differences in the value standard. In the UK and Sweden, quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs) measured by pharmacoeconomicsare used as the value standard. France,Germany and Italy were more focused on the therapeutic value and clinical benefit improvement. As for medical insurance reimbursement strategies,France adopted single weighting method based on expected volume. Germany adopted combination weighting method based on value and volume. UK introduced the Patient Access Schemes and Italy introduced the Managed Entry reements,both based on the nominal reimbursement standard. Sweden adopted independent reimbursement for different indications by different brand names. It is suggested that China can explore the value-based pricing strategies of multi-indication drugs on the basis of the above international experiences,reference and use these variety of medical insurance reimbursement strategies comprehensively. Simultaneously,the information collection mechanism of patients and drug use should be improved to provide data support for the implementation of China’s value-based pricing and reimbursement strategies for multi-indication drugs.
4.Clinical outcomes of transcatheter aortic valve implantation in oncology versus non-oncology patients with severe aortic stenosis: A systematic review and meta-analysis
Yumeng SONG ; Tianqi CHANG ; Yiyu GU ; Yinan XU ; Mingyang ZHANG ; Yutong WANG ; Tingbo JIANG
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery 2022;29(05):634-641
Objective To compare the clinical outcomes of transcatheter aortic valve implantation (TAVI) in oncology and non-oncology patients with severe aortic stenosis (AS). Methods A computer-based search in PubMed, The Cochrane Library, EMbase, CBM, CNKI and Wanfang databases from their date of inception to December 2021 was performed, together with reference screening, to identify eligible clinical trials. Two investigators screened the articles, extracted data, and evaluated quality independently. RevMan 5.3 and Stata 12.0 softwares were used for meta-analysis. Results The selected 8 cohort studies contained 57 988 patients, including 12 335 cancer patients and 45 653 non-cancer patients. The results of meta-analysis showed that in patients with cancer, the 30-day mortality [OR=0.74, 95%CI (0.65, 0.84), I2=0%, P<0.000 01], stroke [OR=0.87, 95%CI (0.76, 0.99), I2=0%, P=0.04] and acute kidney injury [OR=0.81, 95%CI (0.76, 0.85), I2=49%, P<0.000 01] were lower than those in patients without cancer. The 1-year mortality [OR=1.46, 95%CI (1.15, 1.86), I2=62%, P=0.002] and late mortality [OR=1.51, 95%CI (1.24, 1.85), I2=61%, P<0.000 1] were higher in patients with cancer. Conclusion It is effective and safe in cancer patients with severe AS undergoing TAVI. However, compared with patients without cancer, it is still high in long-term mortality, and further study of the role of TAVI in cancer patients with AS is necessary.