1.Health economic evaluation of Chinese population-based screening and opportunistic testing strategies to prevent Helicobacter pylori-related diseases
Qi CHEN ; Ying FANG ; Xiao LIANG ; Hong LU ; Xizhong SHEN
Chinese Journal of Digestion 2021;41(4):234-240
Objective:To conduct health economic evaluation of Chinese population-based screening and opportunistic testing strategies for the prevention of Helicobacter pylori ( H. pylori)-related diseases. Methods:The Markov models of H.pylori infection caused non-ulcer dyspepsia, peptic ulcer (PU) and gastric cancer were established. The cost and effects of the population-based screening, opportunistic testing, and non-intervention strategies in 100 000 population of our country were simulation calculated. Wilcoxon signed rank test was used for statistic analysis. Single factor sensitivity analysis was performed to analyze the impact of single parameter uncertainty on cost-effectiveness. Probability sensitivity was used to analyze the impact of common uncertainty of all parameters on cost-effectiveness. Results:Compared with opportunistic testing strategy and non-intervention strategy, the total cost of population-based screening strategy was reduced by 0.43 million yuan(-6.63 million yuan to 7.19 million yuan) and 4.45 million yuan(-8.60 million yuan to 27.93 million yuan), quality adjusted life years (QALY), life years and asmptomatic months were prolonged by 888.00 (479.86 to 1 574.10) and 3 032.78 (1 756.04 to 5 007.84), 651.82 (294.73 to 1 211.94) and 1 868.64 (1 045.88 to 3 148.34), 28 381.91 (19 109.54 to 43 736.72)and 102 537.13 (58 649.18 to 176 868.77) respectively, gastric cancer, deaths from gastric cancer, deaths from PU and deaths from various causes were reduced by 115 cases(52 cases to 232 cases) and 464 cases(266 cases to 803 cases), 74 cases(33 cases to 148 cases) and 260 cases(149 cases to 453 cases), 46 cases(25 cases to 72 cases) and 369 cases(210 cases to 710 cases), 80 cases(42 cases to 126 cases) and 501 cases(331 cases to 772 cases) respectively, and the differences were statistically significant ( Z=1.99, 10.54, 27.39, 27.39, 27.37, 27.39, 27.39, 27.39, 27.21, 27.28, 27.22, 27.28, 27.38, 27.39, 27.39 and 27.39, all P<0.05). Compared with the non-intervention strategy, the opportunistic testing strategy reduced the total cost by 3.89 million yuan(-2.79 million yuan to 18.18 million yuan), QALY, life years and asymptomatic months were prolonged by 1 764.77 (888.70 to 3 406.62), 1 044.16 (524.46 to 1 912.75) and 62 568.69 (30 054.07 to 129 892.76) respectively, gastric cancer, deaths from gastric cancer, deaths from PU and deaths from various causes were reduced by 311 cases(164 cases to 563 cases), 164 cases (87 cases to 301 cases), 325 cases(162 cases to 644 cases) and 399 cases(234 cases to 684 cases) respectively, and the differences were statistically significant ( Z=14.20, 27.39, 27.38, 27.39, 27.25, 27.25, 27.39 and 27.39, all P<0.01). The results of singlefactor sensitivity analysis showed that the uncertainty of any parameter did not affect the cost-effectiveness of three strategies. The results of probability sensitivity analysis indicated that the probability of cost-effectiveness advantage of the population-based screening strategy was 100% and the common uncertainty of all parameters had no effect on cost-effectiveness. Conclusions:For preventing H.pylori-related diseases, the population-based screening strategy has the lowest average cost and the best average effect. However, non-intervention strategy has the highest average cost and the worst average effect. Population-based screening strategy is worthy of promotion throughout China, and opportunistic testing strategy has a higher clinical practical value.
2.An Preliminary Reform of the Pedagogic Modus in Teaching Pathophysiology
Qi-liang, ZHANG ; Wei, LIU ; Ju-ying, LI
Journal of Shanghai Jiaotong University(Medical Science) 2001;21(2):190-192
Objective To explore the feasibility of transform from the sardine like “cramming” to the “inductive” teaching method with provision of necessary conditions. Methods The medical students in class'97 were picked in random for the trial. New learning materials suitable for self-learning compiled by our department of pathophysiology were distributed into study to test the validity of the inductive approach. The students in this group, after self learning the meaterials, were then examined and their records were compared with those in the control group. Results 31 of 117 volunteer students in the trial participate the examination, and 54.8% of them obtained grades excellent or good (≥80 points), with a record bar surpassing the 608 students of class'96 and 560 students of class'97 (ordinary classes as control groups). Conclusion Students can master the basic knowledge of pathophysiology if proper learning materials are available, on condition they have enough time and good self-learning habits supplemented by necessary lectures and coaching.
3.Metabolic profile and insulin resistance in patients with OSAS
qi, SHAO ; ying, REN ; shan-kai, YIN ; hong-liang, YI
Journal of Shanghai Jiaotong University(Medical Science) 2006;0(10):-
40/h) and non-severe group(n=15,AHI 5-40/h).Anthropometric measurements,fasting plasma glucose,insulin,blood fat,and CT quantitative measurement of abdominal adipose tissue were recorded. Results Insulin resistance index(HOMA-IR) in patients with OSAS was related to hypoxia independently of obesity variables.The severe group was characterized by more serious metabolic disorders and higher prevalence of metabolic syndrome than the non-severe group.OSAS was positively associated with an increased metabolic disorders risk for the severe group versus the non-severe group(OR=8.8).Using the receiver operating characteristic(ROC) curve analysis,waist circumference had the greatest areas under the ROC curves compared with body mass index and neck circumference.The results of multiple stepwise regression of lowest pulse oxygen saturation(LSpO2)during overnight sleep indicated that neck circumference followed by epworth sleepiness score(ESS) entered the equation(P
4.Effect of Probiotics on Feeding Intolerance in Infants with Very Low Birth Weight
xiang-ying, HE ; qi, LI ; kun, LIANG ; qun-wen, XIAO
Journal of Applied Clinical Pediatrics 1986;0(02):-
Objective To explore effect of probiotics on improving the feeding intolerance in very low birth weight infants(VLBWI). Methods Sixty cases of VLBWI were randomly divided into two groups, 30 infants as therapy group,another 30 infants as control group.All infants in two groups were given aggressive intravenous nutrition and enteral feeding with preterm formulars. At the same time, probiotics were administered combined with preterm formulars to infants in therapy group. Milk amount, gastric residual, initial time of enteral feeding, time required for full enteral feeding and body weight on day 21 after birth were all recorded.Results Rate of no gastric residual increased significantly in therapy group compared with that of control group(t=6.24 P
5.Effect of growth inhibition of diallyl trisulfide on gastric cancer MGC-803 cell line in vitro
Jun PENG ; Qi SU ; Ying SONG ; Liangyun ZHANG ; Xiaoqiu LIANG ;
Chinese Pharmacological Bulletin 1987;0(02):-
AIM To study the effects of growth inhibition of different concentrations of diallyl trisulfide(DATS) on gastric cancer MGC 803 cell line in vitro. METHODS The influence of different concentrations of DATS were examined by MTT assay, clonal formation rates and cell growth curve. RESULTS Suppression and decrease of MGC 803 cell proliferation was found after treatment by DATS in vitro. The inhibitory rates on MGC 803 cell growth of different concentration of DATS,4, 8, 12, 16 and 24 mg?L -1 , were 26%,46%,65%,76% and 89% respectively, and its half inhibitory concentration (IC 50 ) was 8 2 mg?L -1 . The clonal formation rates and clonal formation relative counts of 8, 12, 16 and 24 mg?L -1 were 32 4% and 58 7%,24 8% and 42 5%,19 0% and 33 5%?8 8% and 15 1% respectively.There was significant correlation between dose and effect in all, and the cell growth culve became lower and flatter when concentration of DATS increase gradually. CONCLUSION The effect of growth inhibition of DATS for gastric cancer MGC 803 cell in vitro is remarkable.
6.Quality Standard for Longdan Xiegan Capsule and Longdan Xiegan Soft Capsule
Ying LIU ; Hong LIANG ; Jin QI ; Xintong FU
Chinese Journal of Information on Traditional Chinese Medicine 2013;(10):54-58,59
Objective To establish the quality standards of Longdan Xiegan Capsule and Longdan Xiegan Soft Capsule. Methods Gentianae Radix et Rhizoma, Bupleuri Radix, Scutellariae Radix, Gardeniae Fructus, Alismatis Rhizoma, Angelicae Sinensis Radix, Rehmanniae Radix and Glycyrrhizae Radix et Rhizoma were identified by TLC. Gentiopicrin in Gentianae Radix et Rhizoma, geniposide in Gardeniae Fructus, baicalin in Scutellariae Radix were determined by HPLC. Results The TLC spots developed were clear. Gentiopicrin showed good linear relationship in the range of 0.066 1-0.595 1 mg (r=1.000 0), the average recovery of Capsule was 99.34%(RSD=1.50%), and the average recovery of Soft Capsule was 96.62%(RSD=1.50%). Geniposide showed good linear relationship in the range of 0.076 1-1.369 8 mg (r=0.999 9), the average recovery of Capsule was 101.3% (RSD=1.70%), and the average recovery of Soft Capsule was 100.59%(RSD=0.79%). Baicalin showed good linear relationship in the range of 0.214 4-1.608 mg (r=1.000 0), the average recovery of Capsule was 101.12% (RSD=1.30%), and the average recovery of Soft Capsule was 98.07% (RSD=2.40%). Conclusion The method is simple and reproducible. It can be used to control the quality of Longdan Xiegan Capsule and Longdan Xiegan Soft Capsule.
7.Effect of TRF1,TRF2 and telomeric stability on As_2O_3 induced MGC803 cell apoptosis
Yang ZHANG ; Xiaoqiu LIANG ; Qi SU ; Ying SONG ; Jianguo CAO
Chinese Pharmacological Bulletin 2003;0(07):-
Aim To study the effect of As_2O_3(arsenic trioxide) on the expressions of telomeric repeat binding factor1,2 and telomeric stability of human gastric cancer MGC803 cells, and explore the mechanism of cell apoptosis. Method MGC803 cell growth inhibition was measured with MTT assay. Apoptosis was analyzed with flow cytometry. Influence on chromosome distal end was analyzed with chromosome end-end fusion analysis. Expressions of TRF1 and TRF2 were determined with Western blot analysis. Results MTT assay showed that As_2O_3 clearly inhibited the growth of MGC803 cells, depending on time and dosage. The apoptosis rates were significantly higher than those of the control group in a concentration and time-dependent manner. These changes were not found in the control group. After disposal with 5 ?mol?L -1 As_2O_3, chromosome fusion rate was obviously increased in 48 h. After 48 h of disposal with 5 ?mol?L -1 As_2O_3, the TRF1 of MGC803 cells was up-regulated while TRF2 was down-regulated. Conclusion As_2O_3 induced chromosome fusion and MGC803 cells apoptosis through up-regulating expressin of TRF1 and down-regulating expressin of TRF2.
9.The Effect of Dexamethasone on the Chemosensitivity of Colon Carcinoma Cells to L-OHP and 5-Fu Treatment
Jinming ZHOU ; Daping ZHONG ; Qi ZHOU ; Qiuping PENG ; Feng PAN ; Ying HE ; Xue WANG ; Houjie LIANG
Chinese Journal of Clinical Oncology 2010;37(3):142-145
Objective: To examine the expression of glucocorticoid receptor in human colon cancinoma tis-sues and call lines and to explore the survival of colon cancer cell lines treated with dexamethasone alone or in combination with 5-Fu and L-OHP in a way of dexamethasone pretreatment or co-administration in vitro.Methods: The expression of glucocorticoid receptor was detected in 61 cases of colon cancer tissue samples and 4 types of colon cancer cell lines by immunohistochemistry. Apoptosis was detected by Hoechst33342 staining and flow cytometry. MTT assay was employed to detect the chemosensitivity of colon carcinoma cells to L-OHP and 5-Fu with dexamethasone pretreatment for 24 hours or co-administretion. Results: Positive GR expression was found in 57.3% colon cancer tissue samples and in Lovo and HCT-116 cell lines, not in HT-29 and SW-480. Apoptosis was detected in GR-expressed Lovo and HCT-116 cells at 72 hours after 1×10~(-4)mol/L Dex treatment, and the rates of apoptosis were higher than those in the control groups without Dex (P<0.01),GR-negative cells, HT-29 and SW-480 even treated with 1 × 10~(-4)mol/L Dex for 72 hours. Pretreatment and co-administration for Lovo cells with 1×10~(-4)mol/L Dex could decrease the IC50 of L-OHP from 13.7±1:1.3μg/mL to 5.9±0.6μg/mL and 4.8±0.7μg/mL, respectively. IC50 of 5-Fu was decreased from 72.2±8.1 μg/mL to 21.1±4.1μg/mL and 18.6±4.0μg/mL, respectively. Conclusion: There is expression of glucocorticoid receptor in part of colon carcinoma tissue samples and cell lines. Apoptosis does occur in GR-expressed Lovo and HCT-116 cells induced by dexamethasone in vitro. Pretreatment for 24h and co-administration with Dex can increase the chemosensitivity of Lovo cells to L-OHP and 5-Fu.
10.Clinical value of Serum CK-18 M30 levels in patients with nonalcoholic steatohepatitis
Fengxiang QI ; Yong JIANG ; Ying ZHANG ; Yuqiang MI ; Liang XU ; Guodong SONG
The Journal of Practical Medicine 2016;32(18):3019-3022
Objective To detect the level of serum fragmented cytokeratin 18 (CK-18 M30) in patients with nonalcoholic steatohepatitis (NASH), to explore the relationship between the expression of CK-18 M30 and NASH. Methods 33 healthy people as control group, 24 nonalcoholic simple fatty liver (NAFL) patients, and 21 NASH patients were included in this study. CK-18 M30, ALT, AST and GGT were detected in all patients’ vein blood. NAFLD activity points (NAS) was examined in biopsy specimens of NAFL patients and NASH patients. Pearson correlation was applied to analyze the correlations between serum CK-18 M30, ALT, AST, GGT and the NAS of liver tissue in NASH group. Results Serum CK-18 M30 level of healthy control, NAFL and NASH group were (96.557 2 ± 41.226 8)U/L, (104.321 7 ± 45.167 3)U/L, (263.125 5 ± 61.578 1)U/L respectively. Serum CK-18 M30 level in NASH patients positively correlated with both NAS of liver tissue and serum ALT, which correlation coefficient r values were 0.601 5 and 0.420 6. Conclusion The concentration of serum CK-18 M30 could be used as a marker in the diagnosis of NASH.