OBJECTIVE To systematically review the pharmacoeconomic evaluation literature about proprotein convertase subtilisin/kexin type 9 （PCSK9） inhibitors for the prevention of cardiovascular disease in patients with hypercholesterolemia， and to provide a reference for clinical treatment， health decision-making and future follow-up research. METHODS Retrieved from English and Chinese databases such as PubMed and CNKI， the pharmacoeconomic literature about PCSK9 inhibitors （evolocumab and alirocumab） for the prevention of cardiovascular disease in patients with hypercholesterolemia was collected from the establishment of the database to October 8， 2023. The quality of the included literature was assessed with Consolidated Health Economic Evaluation Reporting Standards 2022 （CHEERS 2022） scale. The descriptive analysis was performed for basic information， model structure， related parameters， sensitivity analysis and the results of included studies. RESULTS & CONCLUSIONS A total of 29 literature were included， with overall good quality. The evaluation mainly adopted the Markov model from the healthcare system， payer and societal perspective. The effectiveness and utility data mainly came from the previous studies； the direct cost was mainly considered with a discount rate of 1.5%-5.0% per year， while the willingness-to-pay threshold was often set at 1-3 times the gross domestic product per capita. Most health output indicators were measured in life years and quality-adjusted life years. The sensitivity analysis of most studies demonstrated the robustness and the main influential factor was the drug cost. Most Chinese studies showed that PCSK9 inhibitor was not cost-effective for the prevention of cardiovascular disease in patients with acute coronary syndrome， myocardial infarction and atherosclerotic cardiovascular disease. It was cost-effective to use PCSK9 inhibitors for the prevention of cardiovascular disease only in specific groups， such as patients with triple vessel disease， patients with newly diagnosed acute coronary syndrome and low-density lipoprotein cholesterol≥100 mg/dL. Future research should refer to the CHEERS 2022 scale to improve the design， and strive to select large-scale， high-quality data to enhance the quality of reports and the transparency of health decisions， so as to more accurately assess the cost-effectiveness of PCSK9 inhibitors.

OBJECTIVE To evaluate the econo mical efficiency of ensatinib i n the first-line treatment of anaplastic lymphoma kinase（ALK）positive-advanced non-small cell lung cancer （NSCLC），so as to provide reference for China ’s medical insurance decision-making and rational drug use in clinic. METHODS A three-state partitioned survival model was constructed from the perspective of China ’s health system ，based on the data of the international multi-center phase Ⅲ clinical trial （eXalt3 trail），with simulation time limit of 10 years，cycle period of 30 days. The economical efficiency of ensatinib was compared with that of crizotinib（standard treatment ）in the first-line treatment of ALK positive-advanced NSCLC. The incremental cost-effectiveness ratio （ICER） was calculated with quality-adjusted life years （QALYs） as utility index. The stability of basic analysis results was validated through uncertainty analysis. RESULTS The basic analysis results showed that compared with crizotinib group ， incremental cost per capita of ensatinib group was －343 370.36 yuan，incremental utility per capita was 0.76 QALYs，ICER was －454 292.25 yuan/QALY，which was far lower than the willingness-to-pay （WTP）threshold of 1 time of China ’s per capita gross domestic product （GDP，80 976 yuan）in 2021. The results of univariate sensitivity analysis showed that progression-free survival （PFS）status utility ，progression of disease （PD）status utility and subsequent treatment cost of crizotinib had a greater impact on ICER，but these parameters could not cause the reversal of basic analysis results. Probabilistic sensitivity analysis showed that with 1 time of China ’s per capita GDP in 2021 as the WTP threshold ，the probability of ensatinib group ’s treatment possessed economical efficiency was 100％. In the situational analysis ，ICER obtained by changing the ensatinib group ’s follow-up treatment regimen was －217 671.43 yuan/QALY，which was far below WTP threshold. CONCLUSIONS For Chinese patients with ALK positive-advanced NSCLC ，compared with commonly used the first-line treatment （crizotinib），ensartinib is economical and absolutely dominant.

Objective To investigate the effect of problem-based learning health education for patients with prostate cancer.Methods A total of 64 prostate cancer patients were selected from January 2013 to December 2015 in our hospital, and were divided into control group and observation group according to the random number table method, with 32 cases in each group.The control group was given oral education combined with routine health education, and the observation group was given problem-based learning(PBL) health education.Prostate cancer knowledge such as clinical symptoms, risk factors, screening methods by self-made evaluation scale were compared;Life quality measurement scale by European Cancer Research and Treatment Organization were used to evaluate the quality of life;Pulmonary complications including bladder neck sclerosis and vesiculitis, epididymitis, and postoperative compliance in medication, regular check were compared.Results Awareness rate of clinical symptoms, risk factors, screening methods of prostate cancer knowledge in the observation group was significantly higher than of the control group (P<0.05);Overall function, emotional function, body function, role function, cognitive function in the two groups were statistically significant differences(P<0.05);The incidence of postoperative complications was lower, and compliance rate was higher in the observation group than that in the control group (P<0.05).Conclusion PBL health education can help patients to independently and effectively grasp the knowledge of health education, and improve the quality of life of patients with prostate cancer.

Objective To investigate the effect of problem-based learning health education for patients with prostate cancer.Methods A total of 64 prostate cancer patients were selected from January 2013 to December 2015 in our hospital, and were divided into control group and observation group according to the random number table method, with 32 cases in each group.The control group was given oral education combined with routine health education, and the observation group was given problem-based learning(PBL) health education.Prostate cancer knowledge such as clinical symptoms, risk factors, screening methods by self-made evaluation scale were compared;Life quality measurement scale by European Cancer Research and Treatment Organization were used to evaluate the quality of life;Pulmonary complications including bladder neck sclerosis and vesiculitis, epididymitis, and postoperative compliance in medication, regular check were compared.Results Awareness rate of clinical symptoms, risk factors, screening methods of prostate cancer knowledge in the observation group was significantly higher than of the control group (P<0.05);Overall function, emotional function, body function, role function, cognitive function in the two groups were statistically significant differences(P<0.05);The incidence of postoperative complications was lower, and compliance rate was higher in the observation group than that in the control group (P<0.05).Conclusion PBL health education can help patients to independently and effectively grasp the knowledge of health education, and improve the quality of life of patients with prostate cancer.

Objective To analyze the clinical manifestations and treatment of acquired syphilis in children.Methods A retrospective analysis was conducted.The clinical data on 14 patients with acquired syphilis collected from July 2007 to December 2010 were assessed.Results Among the 14 cases,10 were secondary syphilis,2 early latent syphilis,and 2 late latent syphilis.Seven of the patients had been misdiagnosed as other diseases.All the patients had a history of close contact with syphilis patients or having mouth-to-mouth feeding history after chewing food by adult patients with syphilis.Both rapid plasma reagin (RPR) test and Treponema pallidum haemagglutination assay (TPHA) were positive in all the patients.The skin lesions were mainly located in the oral cavity mucosa and rarely in the trunk,which included leukoplakia,mucosal wet papules,and pustules.Conclusions Acquired syphilis in children is often clinically misdiagnosed or ignored.For children presenting with atypical skin rashes,especially for those having close contact with active syphilis patients,acquired syphilis should be suspected.

Objective To retrospectively assess the clinical manifestations and treatment of secondary syphilis with ocular impairment as the initial symptom. Methods Clinical data were retrospectively analyzed on secondary syphilis with ocular impairment as the initial symptom collected from September 1998 to October 2008. Results There were 11 syphilitic patients presenting acute ocular impairment as their initial manifestation. Skin eruptions developed simultaneously with ocular impairment in 2 patients, following ocular impairment in 9 patients. All patients were positive for rapid plasma reagent test (RPR) and treponema pallidum haemagglutination assay (TPHA), but negative for HIV. Of these patients, 9 suffered from uveitis (iridocyclitis, choroiditis or panuveitis), 2 from optic neuritis; 3 had unilateral ocular involvement, 8 had bilateral ocular involvement. After treatment with injected penicillin or ceftriaxone sodium, 9 patients experienced complete visual recovery, 2 partial visual recovery. Conclusions Ocular impairment occurs in patients with secondary syphilis at a low incidence, with no characteristic clinical manifestations. For patients who have no response to conventional ocular therapy, ocular syphilis should be considered and serological examination for syphilis is recommended.

Objective To analyze the phenotypes of lymphocytes in cerebrospinal fluid derived from the patients with neurosyphilis. Methods Samples of cerebrospinal fluid from 12 patients with neurosyphilis and 20 patients with latent syphilis were collected and analyzed by flow cytometry for CD4 and CD25 expression. Results There was a significant increase in the number of white blood cells in the cerebrospinal fluid of patients with neurosyphilis. FACS analysis showed that most leukocytes were lymphocytes predominated with CD4 + T cells in neurosyphilis patients which were almost 4 times more than that in latent syphilis. However, there was a significant decrease in the proportion of CD4+ CD25high regulatory T cells (Tr) in neurosyphilis patients compared with that in latent syphilis patients. Conclusion A dramatic increase in CD4+ T cell frequency suggested its pathogenic role in neurosyphilis, whereas a decrease in CD25high Tr frequency indicated that CD4 + CD25high Tr cells might play an important role in immune homeostasis of central nervous system.

Objective To assess the clinical presentations and treatment of neurosyphilis with mania as the first manifestation. Methods A retrospective study was performed. Clinical data on neurosyphilis patients with mania as the first manifestation collected from July 2009 to June 2010 were analyzed. Results Twenty cases of neurosyphilis were included in this study, which were all misdiagnosed as schizophrenia, anxiety,cerebral infarction, etc. All the patients had manic symptoms at onset, such as irritability, bad temper, impulsive behavior, disturbance in thinking, and so on. Some patients also suffered from a marked decrease in memory, calculation and cognitive ability. Rapid plasma reagin (RPR) test, Treponema pallidum hemagglutination (TPHA)test and cerebrospinal fluid (CSF) venereal disease research laboratory (VDRL) test were positive in all the patients. Varying degrees of symptomatic improvement was achieved after anti-syphilis and anti-psychotic treatment. CSF was retested in 13 patients 3 months after the end of treatment, and CSF VDRL titer decreased in 10 patients, remained unchanged in 2 patients, and turned negative in 1 patient. Conclusions Neurosyphilis lacks distinctive clinical characteristics. For patients with poor response to conventional antipsychotic therapy,neurosyphilis should be considered, and serology and cerebrospinal fluid tests for syphilis are warranted.

Objective:To study the infuence of chemotherapy combined with thymopetidum on cellular immunity of the patients with late gastrointestinal malignant tumor.Method:80 cases in the present study were divided into two groups:treatment group(40 cases treated by thymopetidum and chemotherapy) and controlled group(40 cases treated by chemotherapy only).25 cases without malignant tumors were grouped as a normal group.The activity of T-lymphocyte subgroup and its cytokines as IL-2(Th_1 ) and IL-10(Th2) in the peripheral blood of the treatment group were investigated before the treatment and on the tenth day after the treatment for two cycles.A statistical study was done between the two groups.Result:Before the treatment,T-lymphocyte subset(CD_3~+.CD_4~+ and the ratio of CD_4~+/CD_8~+ ) and IL-2 of the patients with gatrointestinal malignant tumor were lower than those of the normal group.The values of CD_8~+ and IL-10 were obviously increased,compared with those of the normal group.After the treatment for two cycles,CD_3~+,CD_4~+ and the ratio of CD_4~+ /CD_8~+ were higher respectively than those before the treatment in the two groups,and the changes in the tested group were higher than those in the controlled group.IL-2 of the tested group was lower respectively and its IL-10 was higher than before the treatment,but there was no significant difference for the controlled group.The efficiency of the tested group was higher than that of the controlled group.Conclusion:The immunity of T-lymphocyte subgroup was suppressed in the patients with gastrointestinal malignant tumor and the expression of Th2 type cytokines was enhanced.The cellular immunity of patients was improved by killing tumor cells and removing the immunosuppressive agents after the chemotherapy together with thymopetidum.

Objective To investigate the expression of Th1/Th2 cytoki nes in early symptomatic syphilitic lesions and its relationship with the sero-c onversion of RPR test in patients with syphilis. Methods The expression of Th1/Th2 cytokines in lesions from 30 patients with early symptomatic syphilis was i mmunohistochemically detected with ABC method. The serum titers of RPR test in t hese patients were measured in 1, 3, 6, 9 and 12 months after routine benzathine penicillin treatment. Results Among 10 cases of primary syphilis, the express ion of both Th1 and Th2 cytokines in the lesions was found in 9 cases, while onl y Th1 cytokine expression was observed in the remainder case; and the sero-conve rsion of RPR test occurred in all 10 cases during the follow-up period. Among 20 cases of secondary syphilis, Th1/Th2 cytokines expressed in the lesions in 16 c ases, and only Th2 cytokines expressed in 4 cases; and the sero-conversion of RP R test was found in 12 cases during the follow-up period. The expression of Th1 cytokines in early syphilitic lesions was positively correlated with the sero-co nversion of RPR test. The higher the expression of IFN- the more likely the s ero-conversion of RPR test. Conclusion The early activation and persistence of the expression of Th1 cytokines may play an important role in the clearance of pathogens.