1.Digital subtraction angiography typing used in prognostic prediction of femoral neck fracture
Hao YOU ; Yang LIU ; Minghui LI ; Shengwen ZHU ; Fangzhou CHEN ; Lei WU
Chinese Journal of Orthopaedic Trauma 2012;14(1):27-30
Objective To investigate the value of femoral neck fracture(FNF) typing by digital subtraction angiography(DSA) in prognostic prediction of the fracture healing. Methods From June 2005 to June 2008,45 patients were admitted to our hospital for treatment of single femoral neck fracture.They were 26 males and 19 females,aged from 26 to 60 years(average,45.4 years).Their fractures were all typed according to DSA results.Type Ⅰ ( 15 patients) were DSA pictures which showed 3 to 6 supporting band vascular images crossing the fracture line.Type Ⅱ(14 patients) were DSA pictures which showed one to 2 supporting band vascular images crossing the fracture line.Type Ⅲ(16 patients) were DSA pictures which showed no supporting band vascular images crossing the fracture line.All cases underwent close reduction and internal fixation with cannulated screws under C-arm fluoroscopy.The prognoses of all the patients were evaluated according to their symptoms and imaging examinations in terms of avascular necrosis of femoral head (ANFH) and fracture healing. Results All the patients obtained an average follow-up of 36.7 months (from 24 to 60 months).In patients of DSA type Ⅰ,the ANFH rate and nonunion rate were respectively 0 and 13.3% (2/15).In patients of DSA type Ⅱ,the ANFH rate and nonunion rate were respectively 7.1% (1/14) and7.1%(1/14).In patients of DSA type Ⅲ,the ANFH rate and nonunion rate were respectively 100% (16/16) and 0.The ANFH rate following FNF treatment was negatively related to age and the vascular number showed by DSA.The nonunion ratewas positively related to age but not significantly associated with the vascular number showed by DSA. Conclusion DSA has a significant value in predicting the prognosis for patients with femoral neck fracture.
2.Systematic Analysis of Economic Evaluation of Listed PD- 1/PD-L1 Inhibitors in China
Yue MA ; Shengwen ZHU ; Lei SUN ; Xin GUAN ; Pingyu CHEN ; Hongchao LI
China Pharmacy 2021;32(15):1885-1893
OBJECTIVE:To provide reference for the selection of more economical programmed death- 1(PD-1)/programmed death-ligand 1(PD-L1)inhibitors for National Medical Insurance List and the quality improvement of related economic evaluation. METHODS:Retrieved from CNKI ,VIP,Wanfang database ,PubMed,Web of Science and Ovid Embase ,economic evaluation studies including listed PD- 1/PD-L1 inhibitors of China were collected during the inception to Oct. 2020. CHEERS checklist was used to evaluate the quality of the included literatures ,and the methodological characteristics and economic evaluation results of the included studies were analyzed systematically. RESULTS :A total of 14 literatures were included ,all of which were model-based and with moderate or high quality. However ,there were still some deficiencies in the included literatures ,mainly manifesting as the insufficient reports on the reasons for setting or selecting model parameters ,as well as the great uncertainty of clinical effect data and utility value. Only 3 of the 8 PD-1/PD-L1 inhibitors listed in China were involved in the included literatures. Compared with chemotherapy or targeted therapy plan ,9 literatures(64.29%)showed that the therapy plan containing PD- 1/PD-L1 inhibitors was not cost-effective. CONCLUSIONS :The economic evidence of domestic PD- 1/PD-L1 inhibitors is lacking ,the higher price of imported PD- 1/PD-L1 inhibitors lead to poor economic performance. The existing economic evaluations has some shortcomings in methodological application and parameter selection. Pharmaceutical enterprises should fill in the data gaps and adjust the pricing strategy,researchers should improve the standardization of research ,and medical insurance decision-making departments should improve the judgment on the quality of economic evidences ,so as to promote more economical drugs to be included in the National Medical Insurance List.