1.Expression of Galectin-3 in peritoneal dialysate and its clinical significance
Ling YAO ; Xiaoqi SHAO ; Mengmeng HE ; Qiufeng WANG ; Pei ZHANG
Acta Universitatis Medicinalis Anhui 2024;59(5):889-893
Objective To observe the expression of Galectin-3 in peritoneal dialysis (PD) fluid in patients with different dialysis ages, and to conduct correlation analysis with vascular endothelial growth factor (VEGF) , fi-bronectin (FN) and related clinical indicators.Methods A total of 109 PD patients who were regularly followed up in the department of nephrology were divided into four groups according to different peritoneal dialysis ages.The concentrations of Galectin-3, VEGF and FN were determined by enzyme-linked immunosorbent assay.The expres-sion of Galectin-3 in peritoneal dialysate of the 4 groups was compared, the correlation with VEGF, FN and clinical related indexes was analyzed, and the correlation was analyzed by Spearman test.Results The concentration of VEGF in peritoneal dialysis patients in group D significantly increased (P<0.05) .Galectin-3 expression levels were positively correlated with VEGF (r =0.358 , P =0.022) , but not significantly correlated with FN (r =0.121, P=0.452).Galectin-3 was positively correlated with clinical indicators parathyroid hormone (PTH) (r=0.201, P=0.037), C-reactive protein (CRP) (r=0.357, P<0.001), left ventricular posterior wall dimensions (LVPWD) (r=0.213, P=0.026), and negatively correlated with clinical indicators total cholesterol (TC) (r=-0.316, P=0.001).Conclusion The concentration of Galectin-3 in the dialysate of long-term peritoneal dialy-sis patients is significantly elevated, indicating that the expression of galectin-3 increases with the extension of peri-toneal dialysis time, suggesting that the detection of galectin-3 levels may be helpful for the evaluation of early peri-toneal fibrosis.The positive correlation with VEGF may suggest its role in promoting peritoneal angiogenesis and fi-brosis.Moreover, it is positively correlated with clinical indicators PTH, CRP and LVPWD, suggesting that it has certain clinical guiding significance on microinflammatory state and myocardial remodeling.
2.Cost-utility analysis of sintilimab combined with chemotherapy in first-line treatment of advanced,recurrent or metastatic esophageal squamous cell carcinoma
Qiuping CHEN ; Mingyi SHAO ; Rongrong ZHANG ; Xiaoqi CHEN
China Pharmacy 2023;34(3):345-349
OBJECTIVE To evaluate the cost-effectiveness of sintilimab combined with chemotherapy than single-use chemotherapy in the first-line treatment of advanced, recurrent or metastatic esophageal squamous cell carcinoma (ESCC) from the perspective of health system of our country, and provide reference for rational use of drug in clinic. METHODS Based on ORIENT-15 study data, TreeAge Pro 2011 software was used to establish a three-state Markov model of non-progressive survival (PFS), disease progression and death for cost-utility analysis. The model period was 3 weeks, the research time limit was 10 years, and the discount rate was 5%. The main outputs of the model were total cost, quality-adjusted life year (QALY) and incremental cost-effectiveness ratio (ICER). The 1-3 times of China’s GDP per capita in 2021 was taken as the threshold of willing- ness to pay (WTP). The uncertainty of the parameters was analyzed by single factor sensitivity analysis and probability sensitivity analysis, and the cost-effectiveness of the two schemes was discussed under three situations: different discount rates, comparison with other similar treatment schemes and charitable drug donation schemes. RESULTS The results of basic analysis showed that compared with chemotherapy plan alone, the ICER of sintilimab combined with chemotherapy was 64 208.75 yuan/QALY, which was less than WTP threshold. The results of single factor sensitivity analysis show that PFS state utility value, cycle cost of sintilimab and discount rate had relatively great influence on the results. Probability sensitivity analysis showed that when WTP≥120 000 yuan, the economic probability of sintilimab combined with chemotherapy plan was 100%. The results of situational analysis showed that sintilimab combined chemotherapy was more cost- effective than single-use chemotherapy. CONCLUSIONS Sintilimab combined with chemotherapy is more cost-effective than single-use chemotherapy in the first-line treatment of advanced, recurrent or metastatic ESCC.
3.Efficacy Evaluation of Biejiajianwan in the Treatment of Primary Liver Cancer Based on Real-world Data of Traditional Chinese Medicine
Jingwen WANG ; Mingyi SHAO ; Yu FU ; Xiaoqi CHEN ; Ruixia ZHAO ; Yunfei XING ; Rongrong ZHANG ; Yunxia ZHAO ; Man LI ; Fanlei SHAO
Chinese Journal of Experimental Traditional Medical Formulae 2023;29(5):158-164
ObjectiveTo evaluate the efficacy and influencing factors of Biejiajianwan in the treatment of primary liver cancer based on real-world data of traditional Chinese medicine (TCM). MethodClinical diagnosis and treatment data of patients with primary liver cancer admitted to five Grade-A tertiary hospitals in Henan Province from January 2015 to December 2020 were collected from the medical electronic database. The patients treated with Biejiajianwan for ≥30 days were assigned to the exposure group and those without treatment with Biejiajianwan or treated with Biejiajianwan for <30 days to the non-exposure group. The propensity score matching model was used to balance confounding factors between the two groups according to the 1∶1 genetic matching method. Kaplan-Meier method was used for survival analysis and survival curve plotting. Log-rank was used to test the difference in survival rate between the two groups. Univariate analysis of Biejiajianwan in the treatment of primary liver cancer was performed by Log-rank test combined with the Kaplan-Meier method. The factors with statistical significance (P<0.05) were combined with unbalanced factors by the propensity score matching model, and at the same time, clinical common sense and relevant prognostic factors by literature search were considered, which were subjected to multivariate analysis by Cox proportional hazards regression model. ResultA total of 2 207 electronic cases were collected,including 174 cases in the exposure group (Biejiajianwan group) and 2 033 cases in the non-exposure group. After propensity score matching, there were 174 cases in the exposure group and 174 cases in the non-exposure group. The Kaplan-Meier method was used for survival analysis on the matched data, and the Log-rank test results showed that the survival rate of patients with primary liver cancer in the Biejiajianwan group was higher than that in the control group (χ2=12.193, P<0.01). Cox proportional hazards regression model analysis showed that the regression coefficient of Biejiajianwan was -0.916 4 with the hazard ratio (HR) [95% confidence interval (CI)]=0.4 (0.239 5-0.668 0), P<0.01, and the regression coefficient of radiofrequency ablation treatment was -0.976 5 with HR (95% CI)=0.376 6 (0.172 8-0.821 1, P<0.05). Fibrinogen (FIB) abnormal regression coefficient was 0.481 4 with HR (95% CI)=1.618 4(1.022 0-2.562 9),P<0.05. ConclusionBiejiajianwan can prolong the survival period of patients with primary liver cancer. Radiofrequency ablation is an independent protective factor for Biejiajianwan in the treatment of primary liver cancer,while abnormal FIB are independent risk factors for Biejiajianwan in the treatment of primary liver cancer.