OBJECTIVE:To evaluate the economical efficiency of alogliptin for type 2 diabetes and provide clinical evi-dence for related researches. METHODS:Retrieved from Cochrane Library,Pubmed,EMBase,CNKI,VIP,Wanfang,CBM database up from the start of the database to Mar.,2014,RCTs about alogliptin combined with traditional antidiabetic agents regimen vs. traditional antidiabetic agents regimen in the treatment of type 2 diabetes mellitus were included. Based on the sec-ondary analysis method of literatures,Effectiveness indexes and treatment course were extracted from the literatures,from the perspective of patients,and daily treatment cost was used to calculate the cost;cost-effectiveness analysis was adopted to evalu-ate the economical efficiency of alogliptin combined with traditional antidiabetic agents regimen vs. traditional antidiabetic agents regimen. RESULTS and CONCLUSIONS:6 literatures which met inclusion criteria were included. When alogliptin com-bined with metformin treatment lasted for 12 weeks,the decrease value of HbA1c as effect index showed poor cost-effective-ness;when treatment course increased to 26 weeks,the rate of qualified HbA1c as effect index showed poor cost-effectiveness. When the price of alogliptin decreased by 10% or the effects of trial group was the upper limit of 95%CI,the cost-effective-ness was superior to metformin regimen group. 12 weeks of alogliptin combined with pioglitazone treatment showed better cost-effectiveness than pioglitazone alone using the decrease value of HbA1c as effect;when treatment course increased to 26 weeks,the treatment showed poor cost-effectiveness;when treatment conrse increased to 26 weeks,using the rate of qualified HbA1c as effect indes,the results of sensitirity analysis showed that cost-effectiveness of trial group was better than that of pio-glitazone alone group as the apper limit of 95% CI. When alogliptin combined voglibose treatment lasted for 12 weeks,the de-crease value of HbA1c as effect index showed superior cost-effectiveness to voglibose regimen group. It is suggested to develop alogliptin pharmacoeconomics research based on RCTs and pharmacoeconomics research about improving diabetes patients’ long-term living quality.

Objective To evaluate the effect of percutaneous kyphoplasty (PKP) in the treatment of old osteoporotic vertebral compression fractures with intravertebral clefts.Methods 25 patients (25 vertebrae) suffering from old OVCF with vacuum phenomenon were treated with PKP.There were 8 males and 17 females with an average age of 72.7 years (range,64-84 years) and with an average duration of 7.8 months (range,6-24 months).The height of anterior column and the posterior convex Cobb angle of injured spine were measured on the lateral X-ray film in standing position at pre-operation and post-operation.Clinical symptoms were evaluated by visual analogue scale (VAS).The amount of bleeding and bone cement and complications were recorded.Results All of 25 operations were performed successfully without severe complications.Cement leakage occurred in 5 cases (20％),including 3 cases at the anterior vertebral edge and 2 cases at the lateral vertebra.The surgery time for each vertebra was 35～60 min (mean 42 min),and bone cement volume for each vertebra was 2.0～5.5 ml (mean 3.1 ml).25 patients were followed up for 12 months (range,6-15 months).The VAS score was decreased from (7.44 ± 1.0) preoperatively to (2.36 ± 0.8) day 3 postoperatively and to (2.12 ± 0.7) the last follow-up; the Cobb' s angle was improved from (28.28±3.76) to (23.28±3.76) and (24.32±3.94) respectively; and the anterior vertebral height was increased from (22.48±4.38) mm to (25.80±4.89) mm and (25.24±4.84) mm respectively.There were significant differences in VAS,Cobb's angle,and anterior vertebral height between prre-and post-operation (F=297.84,12.39 and 3.56,P＜0.001 or 0.05),but there were no significant differences in these indicators between day 3 postoperatively and the last follow-up (all P ＞ 0.05).Conclusions PKP is effective in the treatment of old osteoporotic vertebral compression fractures combined with intravertebral clefts.It can relieve pain rapidly and effectively,correct kyphosis,and prevent vertebra collapse.

Female ; Genetic Predisposition to Disease ; HSP70 Heat-Shock Proteins ; genetics ; Humans ; Lung Neoplasms ; genetics ; Male ; Polymorphism, Genetic

Adult ; Aged ; Aged, 80 and over ; Humans ; Middle Aged ; Pneumoconiosis ; diagnostic imaging ; Radiography, Thoracic ; methods ; Tomography, X-Ray Computed ; X-Ray Film

Objective To discuss the feasibility and the effects of percutaneous vertebroplasty (PVP) in the treatment of the osteoporotic compression fracture in theupper and middle thoracic vertebrae.Methods The study included 101 patients.55 cases were treated with PVP (observation group) and 46 cases were treated with conservative treatment (control group).The clinical efficacy of those two different treatment methods was evaluated by the changes of VAS score,ODI score,vertebral height and Cobb angle before versus after treatment.Results VAS and ODI scores at 48 hours and 6 weeks after treatment was significantly lower in observation group than in the control group (all P＜0.05).Although there was no significant difference in VAS and ODI scores between the two groups after 6 months of treatment (both P＞0.05),the anterior and middle vertebral height was decreased and Cobb angle of spine was increased in control group as compared with observation group (both P＜ 0.05).Conclusions PVP is an effective and safe method in the treatment of osteoporotic vertebral compression fractures in upper and middle thoracic vertebrae.The short-and long-term evaluation indexes are better in PVP than in conservative treatment.But the surgery should be proceeded under highly clear perspective equipment by the surgeons with highly level professional technology.Because the surgery is highly risky,surgery should be proceeded with cautions.

Objective To observe the fusion rate by using cage filled with osteophyte in anterior cervical disectomy and fusion.Methods From January 2010 to July 2012,81 patients receiving anterior cervical disectomy and spine fusion underwent treatment with cages containing exclusively autologous osteophyte collected from both anterior and posterior vertebral edges adjacent to the intervertebral space.There were 52 males and 29 females,aged from 55 to 78 years,average 64.1 years in this study.46 patients received one-level fusion,and 35 patients received two-level fusion respectively.Patients were followed up at 3 months,6 months and 1 year after operation.The fusion was evaluated by X-ray film and reconstructive CT.Results The total fusion rate after 3 months of operation was 76.5％ (62/81),the one-level and two-level fusion rate were 78.3％ (36/46) and 74.3％ (26/35),respectively.The total fusion rate after 6 months of operation was 93.8％ (76/81),the one-level and two-level fusion rate were 95.7％ (44/46) and 91.4％ (32/35),respectively.The total fusion rate was 100％ (81/81) after 1 year of operation.No statistically significant difference in fusion rate was found between the two groups.Conclusions The method of using cage filled with osteophyte can acquire ideal fusion rate in one-and two-level anterior cervical disectomy,fusion and plate fixation.

Juvenile idiopathic arthritis(JIA)is the most common rheumatology disease in childhood period with poor prognosis.The biological agents are newly developed drugs with features of clear therapeutic targets and fast effects.But its use in JIA is still limited,so this article focuses on the clinical use experience,timming and sideffects of the biological agents on JIA.

In this study, a combination of metabolomics and network pharmacology was used to study the pharmacodynamic substances and mechanism of action of Yiyi Fuzi powder (YYFZ) on rheumatoid arthritis (RA) rats. The animal experiments were conducted in accordance with the requirements of the Experimental Animal Ethics Committee of Tianjin University of Traditional Chinese Medicine (approval number: TCM-LAEC2021241). The metabolomic analysis using UPLC-Q-TOF/MS technique identified 22 metabolites, including arachidonic acid, tryptophan, linoleic acid, phenylalanine, as significant biomarkers for the treatment of RA with YYFZ, and they were significantly regressed after YYFZ treatment. The analysis of YYFZ blood components also revealed that 11 blood components, including hypaconitine, benzoylhypaconitine, and deoxyaconitine, may be the components that exert direct pharmacological effects in YYFZ in vivo, and further network pharmacological analysis of blood components obtained that YYFZ may exhibit anti-inflammatory effects through acting on PI3K/Akt signaling pathway, estrogen signaling pathway, vascular endothelial growth factor (VEGF) signaling pathway. The results of this study provide implications for the clinical application of YYFZ.

This study is to establish physiologically based pharmacokinetic (PBPK) models of famitinib in rat and monkey, and then to predict the pharmacokinetics and tissue distribution of famitinib in human based on the PBPK models. According to published paper, previous studies and the chemical properties of famitinib predicted by ACD/ADME suite and SimCYP, the PBPK models of rat and monkey were established and optimized using GastroPlus. And then, the PBPK models were applied to predict the pharmacokinetic and tissue distribution of famitinib in human. The results showed that the PBPK models of rat and monkey can fit the observed data well, and the AUC0-∞, ratios of observed and calculated data in rat and monkey were 1.00 and 0.97, respectively. The AUC0-∞, ratios of observed and predicted data in human were 1.63 (rat to human) and 1.57 (monkey to human), respectively. The rat and monkey PBPK models of famitinib were well established, and the PBPK models were applied in predicting pharmacokinetic of famitinib in human successfully. Hence, the PBPK model of famitinib in human could be applied in future drug-drug interaction study.
Animals ; Antineoplastic Agents ; pharmacokinetics ; Haplorhini ; Humans ; Indoles ; pharmacokinetics ; Models, Biological ; Pyrroles ; pharmacokinetics ; Rats ; Receptor Protein-Tyrosine Kinases ; antagonists & inhibitors ; pharmacokinetics ; Tissue Distribution

ObjectiveTo evaluate the diagnostic performance of CTCA in predicting myocardial perfusion defects through comparative analysis between MPI defects and severity of coronary stenosis on CTCA.MethodsFour hundred and seventy-eight patients who underwent CTCA and 99Tcm-MIBI MPI in the same period were analyzed retrospectively.According to the severity of coronary stenosis judged by visual evaluation of the vessel diameter,the patients were divided into five groups:no stenosis,mild stenosis,moderate stenosis,severe stenosis and total occlusion.MPI results were classified as negative or positive for perfusion defects,and the prevalence of perfusion defects in every group was calculated per-patient and per-vessel basis.The cut-off of stenotic severity for predicting myocardial perfusion defects was designated as 50％ or 75％,with MPI as standard reference.True positive,true negative,false positive and false negative statistics were thus determined separately on patient and vessel basis.The diagnostic performance for CTCA were calculated and compared.Pearson Chi-square and its partition tests or Fisher exact test were used to compare ordinal variables.ResultsFifty-eight patients showed myocardial perfusion defects.Either by patientbased or vessel-based analysis,the prevalence of myocardial perfusion defects showed an increasing trend with greater coronary artery stenosis in each group,and there were statistical differences among them (x2 =116.62 and 483.83,both P ＜ 0.05).On patient-based analysis,sensitivity ( SN),specificity ( SP),positive predictive value( PPV),negative predictive value(NPV) and accuracy (AC) for CTCA predicting myocardial perfusion defects were 62.1 ％ ( 36/58 ) and 34.5％ ( 20/58 ) (x2 =8.84,P ＜ 0.05 ),84.5％(355/420) and 97.1％ (408/420) (x2 =40.16,P ＜0.05),35.6％ (30/101) and 62.5％ (20/32) (x2 =7.19,P＜0.05),94.2％ (355/377) and 91.5％ (408/446) (x2 =2.18,P ＞0.05),81.8％ (391/478)and 89.5 ％ (428/478) (x2 =11.66,P ＜ 0.05 ) when the cutoff was set to 50％ and 75％,respectively.On vessel-based analysis,the SN,SP,PPV,NPV and AC for CTCA predicting myocardial perfusion defects were 58.8％ (40/68) and 30.9％ (21/68) (x2 =10.73,P ＜ 0.05),95.9％ (1768/1844) and 99.0％ (1826/1844) (x2 =36.72,P ＜ 0.05 ),34.5％ (40/116) and 53.8％ (21/39) (x2 =4.59,P ＜0.05 ),98.4％ (1768/1796) and 97.5％ ( 1826/1873 ) (x2 =4.14,P ＜ 0.05 ),94.6％ ( 1808/1912 ) and 96.6％ ( 1847/1912 ) (x2 =10.31,P ＜ 0.05 ),respectively.ConclusionsThe prevalence of myocardial perfusion defects correlates positively with the severity of coronary stenosis seen on CTCA.CTCA may predict perfusion defects with high SP and NPV.However,the PPV of CTCA in predicting myocardial perfusion defects is poor when the stenosis cut-off is set at 50％.It is significantly improved when the cutoff value is set at 75 ％.