OBJECTIVE To evaluate the cost-effectiveness of adebrelimab combined with chemotherapy versus chemotherapy alone in the first-line treatment of extensive stage small cell lung cancer from Chinese healthcare system perspective. METHODS Using the data obtained from the CAPSTONE-1 trial(230 cases for adebrelimab group, and 232 cases for chemotherapy group), Markov model was created for simulation of the disease development process of the extensive stage small cell lung cancer. The total costs, quality-adjusted life-years(QALYs) and incremental cost-effectiveness ratio(ICER) in each group were calculated. The sensitivity of key parameters was analyzed. RESULTS Compared with pure chemotherapy(etoposide plus carboplatin chemotherapy), the ICER of adebrelimab combined with chemotherapy was 157128.79 yuan·QALY−1 under the situation of charity assistance, and 351367.27 yuan·QALY −1 in the environment of no charity assistance. Sensitivity analysis showed that the utility and the cost of adebrelimab were the main influence parameter. CONCLUSION Adebrelimab combined with chemotherapy regimen has no cost-effective advantage versus chemotherapy alone in the treatment of extensive stage small cell lung cancer under the current economic level of China; the probability of adebrelimab combined with chemotherapy being cost- effectiveness was 44.5% under the situation of charity assistan.

Objective:To study the life characteristics and related risk factors of patients with depression in Shandong Province.Methods:Based on the 2015 mental epidemiological survey database in Shandong Province,a total of 832 patients with depression,807 high-risk individuals with depression,and 819 low-risk individuals were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-Ⅳ)and the Structured Clinical Interview for DSM-Ⅳ-TR Axis I Disorders,Research Version(SCID-I/P).In 2020,SCID-I/P was used for re diagnosis,and the General Health Questionnaire(GHQ-12),Simple Quality of Life question-naire,Pittsburgh sleep quality index(PSQI),Childhood Trauma Questionnaire(CTQ),Social Support Rating Scale(SSRS),Global Pain Scale(GPS),Montreal Cognitive Assessment(MoCA),Simplified Coping Style Question-naire(SCSQ)were used for evaluation.Compare changes in the quality of life of depression patients and construct a risk factor model.Results:Patients with depression had lower scores on the simple quality of life questionnaire at baseline and at retest after 5 years than those in the high-and low-risk groups,those in remission of depression had higher scores on the simple quality of life questionnaire at baseline and at retest after 5 years than those in non-re-mission,and those with new-onset disorder in the high-and low-risk groups had lower scores on the simple quality of life questionnaire at baseline and at retest after 5 years than those with no-onset disorder(Ps＜0.001).Depres-sion diagnosis and PSQI scale scores at baseline negatively predicted at retest after 5 years(β=-0.06,-0.15),while coping style tendencies at baseline positively predicted(β=0.06).The simple quality of life questionnaire at baseline negatively predicted depression diagnosis at retest after 5 years,GHQ-12 scores at retest after 5 years,and PSQI scale scores at retest after 5 years(β=-0.11,-0.17,-0.09),while the simple quality of life question-naire at baseline positively predicted coping style tendencies at retest after 5 years(β=0.13).Depression diagnosis at retest after 5 years,GHQ-12 scores at retest after 5 years,PSQI scale scores at retest after 5 years,coping style tendencies at retest after 5 years,SSRS scale scores,CTQ scale scores,GPS scale scores,and the simple quality of life questionnaire at baseline all influenced the simple quality of life questionnaire at retest after 5 years through ei-ther direct or indirect pathways.Conclusion:It suggest that the quality of life is lower in patients with depression than in the general population.Depression diagnosis,sleep,mental health,pain,social support,childhood trauma and coping are direct and indirect risk factors affecting life.

OBJECTIVE To analyze the compatible stability of commonly used intravenous drugs in the intensive care units （ICU）， and to provide a reference for improving medication safety in clinic. METHODS The commonly used intravenous drugs in the ICU of Hebei General Hospital were investigated and confirmed in April 1-30， 2022， and used as keywords to retrieve the relevant literature about compatible stability from PubMed， CNKI， Wanfang Data and other databases， and manually filtered with Micromedex database at the same time. Then， the compatible stability results of the included literature were analyzed descriptively. RESULTS Totally 32 commonly used intravenous drugs and 39 mixed infusion combinations were collected from ICU of this hospital. A total of 40 studies were included， only 2 studies followed all quality requirements； 18 studies validated their methods to guarantee correct reproducibility； 33 studies evaluated physical stability， including precipitate formation and pH changes； 32 studies evaluated chemical compatibility， mainly content/concentration changes. A total of 666 possible two-drug combinations were obtained from the included literature， of which 254 combinations of stability data were available， including 176 were stable， 68 were unstable， and 10 were contradictory. Totally 412 combinations had no stability results. Among two-drug combinations in ICU of this hospital， 42 combinations were stable， 14 combinations were unstable， and 2 combinations were contradictory. CONCLUSIONS The pH， solvent， excipients and preparation concentration are the factors that affect the stability. There are drug combinations with unstable compatibility of commonly used intravenous drugs in ICU of this hospital. The stability study methods are limited， and the stability data cannot meet the actual clinical needs.

The vagina contains at least a billion microbial cells,dominated by lactobacilli.Here we perform metagenomic shotgun sequencing on cervical and fecal samples from a cohort of 516 Chinese women of reproductive age,as well as cervical,fecal,and salivary samples from a second cohort of 632 women.Factors such as pregnancy history,delivery history,cesarean section,and breastfeeding were all more important than menstrual cycle in shaping the microbiome,and such information would be necessary before trying to interpret differences between vagino-cervical micro-biome data.Greater proportion of Bifidobacterium breve was seen with older age at sexual debut.The relative abundance of lactobacilli especially Lactobacillus crispatus was negatively associated with pregnancy history.Potential markers for lack of menstrual regularity,heavy flow,dysmenor-rhea,and contraceptives were also identified.Lactobacilli were rare during breastfeeding or post-menopause.Other features such as mood fluctuations and facial speckles could potentially be predicted from the vagino-cervical microbiome.Gut and salivary microbiomes,plasma vitamins,metals,amino acids,and hormones showed associations with the vagino-cervical microbiome.Our results offer an unprecedented glimpse into the microbiota of the female reproductive tract and call for international collaborations to better understand its long-term health impact other than in the settings of infection or pre-term birth.

Objective The aim of this study was to investigate the expression of miR-455-5p in epithelial ovarian cancer and its effect on the development of epithelial ovarian cancer. Methods The miRNA expression data of normal ovarian epithelial tis-sues and epithelial ovarian cancer tissues GSE83693 were downloaded from the GEO database. Differential expression analysis was used to obtain differential expression data of miRNAs in epithelial ovarian cancer. The expression of miR-455 -5p was analyzed whether there is difference expression between normal ovarian epithelium and epithelial ovary cancer tissues; qRT-PCR was used to verify the differential expression prediction results; bio-informatics software was used to analyze the KEGG pathway enrichment and GO gene function annotation of miR-455-5p target genes,and to explore the disorders of dyregulated miR-455-5p in the devel-opment of epithelial ovarian cancer. Results A total of 101 cases of differentially expressed miRNAs were screened,34 cases were up-regulated and 67 cases were down-regulated. Among them,miR-455-5p was down-regulated significantly(P<0. 01),and the different fulds were -2. 9019. The results of qRT-PCR showed that the expression of miR-455-5p in epithelial ovarian cancer cells(SKOV-3,OVCAR-3 and A2780)was significantly lower than that in normal ovarian epithelial cells(IOSE-80),and the dif-ferential expression was statistically significant(P<0. 05). The results of KEGG pathway enrichment analysis showed that miR-455-5p regulated target genes mainly involved in five pathways,including TGF-β signaling pathway,Hippo signaling pathway,ECM-receptor interaction,transcriptional dysregulation pathway in cancer,and chronic granule cellular leukemia,which were associated with tumors. GO functional annotation analysis showed that the target genes regulated by miR-455-5p in the above pathway was mainly involved in protein phosphorylation,promoted cell proliferation and migration,inhibited apoptosis,promoted epithelial-mesenchymal transition,regulated transcription and regulated cell cycle,etc. ,which associated with tumorigenesis. Conclusion The expression of miR-455-5p is down-regulated in epithelial ovarian cancer. The miR-455-5p target genes are involved in the pathogenesis and function of epithelial ovarian cancer,and are associated with the development of epithelial ovarian cancer.

Objective To analyze the risk factors of cerebral microbleeds (CMBs) in acute cerebral infarction patients. Methods We consecutively included 255 acute cerebral infarction patients who were admitted in Neurology Department of the First Affiliated Hospital of Fujian Medical University from January 2014 to December 2016. According to the number and location of CMBs, the patients were divided into infratentorial, cortical and deep cerebral groups, each of which included non-mild and moderate-severe subgroups. The differences of the level of glomerular filtration rate (eGFR) and some common arteriosclerotic risk factors were analyzed between subgroups, and the multiple logistic regression analysis was performed. Results A total of 140 subjects (54.9%) had CMBs. In the infratentorial group, the proportion of patients who were with low eGFR level in the moderate-severe CMBs subgroup was higher than in the non-mild CMBs subgroup (P=0.024). The low eGFR level (OR=3.874, 95% CI:1.261～11.901, P=0.018) and the long duration of hypertension (OR=2.128, 95%CI: 1.004～4.510, P=0.018) were the independent risk factors of the moderate-severe infratentorial CMBs. Conclusion The low eGFR level and long duration of hypertension are risk factors for the moderate and severe infratentorial CMBs after acute ischemic stroke.

Objective To investigate the feasibility and safety of laparoscopic combined with choledochoscopy for choledocholithotomy and primary suture. Methods 82 patients who underwent laparoscopic combined with choledochoscopy for choledocholithotomy and primary suture from Hechi People's Hospital from June 2016 to August 2018 were enrolled as study objects. They were divided into study group and control group according to the different treatment methods of common bile duct incision. 40 patients in the study group underwent primary suture of the common bile duct and 42 patients in the control group underwent T-tube drainage. The surgical outcomes and complications of the 2 groups were compared. Results All the patients in the two groups were operated smoothly and there were no cases of conversion to open surgery. The operation time, intraoperative blood loss, postoperative ambulation time, time of removal of abdominal drainage tube, and hospitalization time were lower in the study group than those in the control group, but the difference was not statistically significant (P>0.05). The incidence of electrolyte disturbance, postoperative recovery time, and hospitalization cost in the study group were lower than those in the control group, and the difference was statistically significant (P<0.05). The incidence of surgical complications in the study group was lower than that in the control group, but the difference was not statistically significant (P>0.05). Conclusion Laparoscopic combined with choledochoscopy for choledocholithotomy and primary suture in the treatment of intrahepatic and extrahepatic bile duct stones has good curative effect, rapid recovery, less internal environment disorder and low hospitalization cost. It is safe and feasible.

Objective The aim of this study was to investigate the expression of microRNA-150(miR-150)in human epi-thelial ovarian cancer cells and its effect on proliferation,apoptosis,invasion and metastasis of human epithelial ovarian cancer cells. Methods The expression level of miR-150 in cells from each treatment group was detected by Real-Time PCR(qRT-PCR);effects of proliferation,apoptosis,invasion and metastasis of epithelial ovarian cancer cells was investigated by MTT,flow cytometry, and transwell assays. Results Compared with normal ovarian epithelial cells(T29),the expression of miR-150 was significantly de-creased in epithelial ovarian cancer cells(A2780 and OVCAR3)(P<0. 01); After transfection miR-150 mimic,the expression of miR-150 in A2780 and OVCAR3 cells was significantly increased(P<0. 01);After 3 d of transfection,the OD values of the miR-150mimicgroup(A2780:1.12±0.03;OVCAR3:1.91±0.03)werelowerthanthatintheblankgroup(A2780:2.35±0.09;OVCAR3:2.63 ±0.07)and the miR-150 NC group(A2780:2.18 ±0.07;OVCAR3:2.43 ±0.11)(P<0.01);The apoptotic rate in the miR-150 mimic group(A2780:16. 10 ± 0. 58% ;OVCAR3:15. 16 ± 1. 30% ) were significantly increased when compared to the blank group(A2780:10. 07 ± 0. 66%;OVCAR3:3. 81 ± 0. 24%) and the miR -150 NC group(A2780:10. 36 ± 1. 08%;OVCAR3:4.89 ±0.07%)(P<0.01);The number of transmembrane cells in the miR-150 mimic group(A2780:38.67 ±2.03;OVCAR3:28. 67 ± 2. 03)was higher than that in the blank group(A2780:76. 30 ± 7. 45;OVCAR3:55. 67 ± 3. 18)and the miR-150 NC group(A2780:74. 33 ± 5. 78;OVCAR3:56. 33 ± 3. 84)(P<0. 01). Conclusion The decreased expression of miR-150 in epi-thelial cancer cells may be one of the mechanisms of proliferation,invasion and metastasis of epithelial ovarian cancer. Up-regulation of miR-150 may inhibit the proliferation of epithelial ovarian cancer cells and promote apoptosis to reduce the abilities of invasion and metastasis in epithelial ovarian cancer cells.

Objective:To determine and investigate the stability of ginkgo biloba extract injection from three different manufactur-ers respectively in 0.9% NaCl infusion and 5% glucose infusion under different conditions (room temperature, high temperature and light). Methods:Ginkgo biloba extract injection was mixed with the two kinds of infusions,and then divided into the normal tempera-ture group,the high temperature group and the light group. The appearance,insoluble particles,pH and content of flavonoids after the relevant treatment were investigated. The appearance and insoluble particles were tested according to the characteristics of the inspec-tion method described in Chinese Pharmacopoeia(2015 edition,volume IV,the general rule),and the content of flavonoids was detec-ted by HPLC-UV. Results:All the mixed solutions were yellow. No significant changes were found in the appearance,pH value,in-soluble particles and contents of quercetin and isorhamnetin in all the mixed solutions in 24 h. The pH value of the mixed solution with 5% glucose infusion was lower than that with 0.9% NaCl infusion,and all the pH values met the standard in Chinese Pharmacopeias. The kaemphenol content in the injection from Shenwei pharmaceutical company was higher than that from the other manufacturers, while the content of kaemphenol in all the injections was within the standard range. Conclusion:The quality of Ginkgo biloba extract injection from the three different manufacturers is stable under different conditions.

Objective:To evaluate the efficacy of acarbose combined with metformin in the treatment of type 2 diabetes with hyper-lipidemia. Methods:A retrospective study was adopted. A total of 2000 patients with type 2 diabetes and hyperlipidemia from general practice in the center were enrolled, and among them, 1050 patients were treated with acarbose, and the other 950 ones were treated with acarbose combined with metformin. After 3-month treatment, the therapeutic effect and adverse drug reactions were compared be-tween the groups. The changes of blood glucose and blood lipid were observed before and after the treatment. Results:The total effec-tive rate was 94. 83% in the combined group, which was significantly higher than that in the control group (72. 38%, P<0. 05). Af-ter the treatment, the blood glucose levels of both groups significantly decreased (P<0. 05), and the decrease in the combined group was more significant than that in the control group (P<0. 05). After the treatment, the serum lipid levels of both groups were signifi-cantly improved (P<0. 05), and the improvement in the combined group was much better than that in the control group (P<0. 05). There was no statistically significant difference in the incidence of drug reactions between the groups (P>0. 05). Conclusion:Acar-bose combined with metformin in the treatment of type 2 diabetes with hyperlipidemia can significantly improve blood glucose levels and blood lipid levels, and the clinical efficacy should be affirmed.