Objective To conduct a multidimensional and multi-level evaluation of the comprehensive clinical value of empagliflozin in the treatment of type 2 diabetes mellitus.Methods Based on the National Essential Medicines List(2018 Edition),dapagliflozin was selected as the control.A comprehensive clinical evaluation index system was established through literature review,focus group interviews and in-depth expert interviews,encompassing six dimensions:safety,efficacy,economy,suitability,innovation,and accessibility.The Delphi method and hierarchical direct weighting method were used to screen indicators and determine their weights.Evidence for each indicator was collected and integrated both qualitatively and quantitatively through literature research,real-world studies,and pharmacoeconomic evaluations.Experts scored the indicators based on the collected evidence,and a total score for the comprehensive clinical evaluation of empagliflozin was calculated by combining these scores with indicator weights,followed by a comparative analysis with dapagliflozin.Results A comprehensive clinical evaluation of empagliflozin in the treatment of type 2 diabetes mellitus was successfully established,consisting of 6 primary indicators,14 secondary indicators,and 41 tertiary indicators.The overall evaluation score for empagliflozin was 90.35,and 89.47 for dapagliflozin.Conclusion The comprehensive clinical value of empagliflozin in the treatment of type 2 diabetes mellitus is slightly higher than that of dapagliflozin.This finding can serve as a reference for rational clinical drug use and related decision-making.

Objective To conduct a multidimensional and multi-level evaluation of the comprehensive clinical value of empagliflozin in the treatment of type 2 diabetes mellitus.Methods Based on the National Essential Medicines List(2018 Edition),dapagliflozin was selected as the control.A comprehensive clinical evaluation index system was established through literature review,focus group interviews and in-depth expert interviews,encompassing six dimensions:safety,efficacy,economy,suitability,innovation,and accessibility.The Delphi method and hierarchical direct weighting method were used to screen indicators and determine their weights.Evidence for each indicator was collected and integrated both qualitatively and quantitatively through literature research,real-world studies,and pharmacoeconomic evaluations.Experts scored the indicators based on the collected evidence,and a total score for the comprehensive clinical evaluation of empagliflozin was calculated by combining these scores with indicator weights,followed by a comparative analysis with dapagliflozin.Results A comprehensive clinical evaluation of empagliflozin in the treatment of type 2 diabetes mellitus was successfully established,consisting of 6 primary indicators,14 secondary indicators,and 41 tertiary indicators.The overall evaluation score for empagliflozin was 90.35,and 89.47 for dapagliflozin.Conclusion The comprehensive clinical value of empagliflozin in the treatment of type 2 diabetes mellitus is slightly higher than that of dapagliflozin.This finding can serve as a reference for rational clinical drug use and related decision-making.

Objective To evaluate the efficacy,safety,and economy of 4 intravenous iron formulations in the treatment of iron deficiency anemia(IDA)by rapid health technology assessment,and to provide evidence for clinical decision-making.Methods PubMed,Embase,the Cochrane Library,CNKI,WanFang,SinoMed,and official websites of international health technology assessment agencies were electronically searched to collect health technology assessment reports,systematic reviews/Meta-analysis,and pharmacoeconomic studies concerning the treatment of IDA with iron sucrose(IS),iron dextran(ID),ferric carboxymaltose(FCM),and iron isomaltoside(IIM)from the inception to August 15,2024.Two researchers independently screened the studies,extracted data and assessed the quality of included studies.The results were then qualitatively described and analyzed.Results A total of 32 studies were included,including one health technology assessment report,16 systematic reviews/Meta-analysis,and 15 pharmacoeconomic evaluations.In terms of effectiveness,FCM had a higher response rate than that of IS(P＜0.05),FCM and IIM had no statistical difference(P＞0.05).Regarding hemoglobin level change,patients treated with FCM had higher hemoglobin levels than those treated with IS(P＜0.05);the improvement in hemoglobin levels between IIM and FCM was inconclusive.In terms of ferritin level change,FCM might be superior to the other three intravenous iron formulations.In terms of safety,the adverse event rates for FCM,IS,ID and IIM were 12.0％,15.3％,12.0％and 17.0％,respectively;IIM was significantly associated with a lower rate of cardiovascular adverse events compared to FCM and IS(P＜0.05);FCM had the highest rate of hypophosphatemia among the four formulations(P＜0.05),and there was no significant difference among IIM,IS and ID(P＞0.05);IIM had a lower risk of severe or serious hypersensitivity reactions compared to FCM and IS.In terms of economy,FCM and IIM had an economic advantage compared to IS.The economic efficiency ranking among IS,ID,and FCM was in the order of FCM,ID,and IS,the economic comparison between FCM and IIM remains inconclusive and needs to be further demonstrated.Conclusion FCM and IIM have good efficacy,safety and economy in the treatment of IDA,but most of the included economy studies based on foreign populations,and domestic economic studies need to be further demonstrated.

Objective:To explore the application effect of the goal-oriented and task checklist-driven method based on higher-order thinking in operating room nursing teaching.Methods:We assigned 240 nursing students who interned in the operating room of China-Japan Union Hospital of Jilin University from March 2019 to January 2023 were into control group and observation group according to the order of admission. The control group received traditional teaching, while the observation group received goal-oriented and task checklist-driven teaching based on higher-order thinking. At the end of the internship, the two groups were compared in terms of theory and skill assessment scores, comprehensive teaching feedback, and nursing quality assessment scores. SPSS 22.0 was used to perform the t-test and χ2 test. Results:In the observation group, the scores of basic theory assessment, surgical nursing assessment, basic nursing skill assessment, and operating room nursing skill assessment were (92.69±7.90) points, (93.42±7.62) points, (92.05±7.41) points, and (94.14±7.53) points, respectively, while in the control group, the scores were (85.63±7.71) points, (84.41±6.16) points, (83.86±7.53) points, and (85.05±8.13) points, respectively, showing significant differences between the two groups ( P<0.001). The observation group had significantly higher percentages of positive teaching feedback than the control group ( P<0.05). The total score and the scores of individual domains of nursing quality were significantly higher in the observation group than in the control group ( P<0.001). Conclusions:The application of the goal-oriented and task checklist-driven learning model based on higher-order thinking in operating room nursing teaching can effectively enhance the core professional competencies and higher-order clinical thinking ability of student nurse interns, thereby improving nursing quality.

Objective:To observe the correlation between the expressions profile of cytokeratin 19/glypican 3 (CK19/GPC3) and recurrence of hepatocellular carcinoma after interventional therapy.Methods:Clinical and pathological information of 251 eligible cases with hepatocellular carcinoma who underwent interventional therapy in You'an Hospital from November 2007 to May 2016 were retrospectively collected. Univariate and multivariate Cox regression analysis was used to analyze the relevant risk factors that may affect their prognosis. Kaplan-Meier survival analysis was used to draw the survival curve. Log-rank test was used to compare the difference in survival rates between the groups.Results:Kaplan-Meier univariate analysis showed that histological grade, CK19/GPC3 expression profile, alpha-fetoprotein level and Hep Parl were closely related to tumor recurrence. Multivariate Cox regression analysis showed CK19/GPC3 expression profile ( HR = 1.634, 95% CI: 1.041 ~ 2.564, P = 0.033), histological grade ( HR = 1.445, 95% CI: 1.037 ~ 2.014, P = 0.030), alpha-fetoprotein level ( HR = 1.410, 95% CI: 1.042 ~ 1.908, P = 0.026), Hep Parl ( HR = 0.570, 95% CI: 0.349 ~ 0.930, P = 0.025) were the four independent factors for prediction of recurrence after interventional therapy. Conclusion:Hepatocellular carcinoma patients with CK19 +/GPC3 + and CK19 -/GPC3 + phenotypes who meet the Milan criteria have a higher risk of recurrence after interventional therapy than CK19 -/GPC3 - phenotypes.

Objective: To explore the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection who received entecavir alone or in combination with anluohuaxianwan for 78 weeks. Methods: Patients with chronic HBV infection were randomly treated with entecavir alone or in combination with anluohuaxian for 78 weeks. Ishak fibrosis score was used for blind interpretation of liver biopsy specimens. The improvement in liver fibrosis condition before and after the treatment was compared. Student's t test and non-parametric test (Mann-Whitney U-Test and Kruskal-Wallis test) were used to analyze the measurement data. The categorical variables were analyzed by Chi-square test method and Spearman’s rank correlation coefficient was used to test bivariate associations. Results: Liver fibrosis improvement rate after 78 weeks of treatment was 36.53% (80/219) and the progression rate was 23.29% (51/219). The improvement of liver fibrosis was associated to the degree of baseline fibrosis and treatment methods (P < 0.05). The improvement rate of hepatic fibrosis in patients treated with anluohuaxianwan combined with entecavir at baseline F < 3 (54.74%, 52/95) was significantly higher than that in patients treated only with entecavir (33.33%, 16/48), P = 0.016 and the progression rate of hepatic fibrosis (13.68%, 13/95) was lower than that in patients treated alone (18.75%, 9/48), P = 0.466. In patients with baseline F < 3, the proportion of patients with improved and stable liver fibrosis in the combined treatment group (68.1%, 32/47) was higher than that in the treatment group alone (51.7%, 15/29). Conclusion Combined anluohuaxianwan and entecavir treatment can significantly improve the improvement rate of liver fibrosis in patients with chronic hepatitis B virus infection. Furthermore, it has the tendency to improve the stability rate and reduce the rate of progression of liver fibrosis.

OBJECTIVE： To investigate the current situation of medication safety in 24 public medical institutions（referred to as “hospital”） from Linyi city and the differences in medication safety between urban and rural areas. METHODS： ISMP self-assessment scale [including 10 key elements （Ⅰ-Ⅹ，such as “Ⅰ patient’s information” “Ⅱ drug information”）， 20 key characteristics and 270 evaluation projects] developed by Institute of Safe Medication Practices was used to investigate 24 hospitals in Linyi city. The implementation rates of 10 key elements in urban and rural hospitals were analyzed statistically， and the top 10 evaluation projects were listed for the key elements with the lowest implementation rate. The key elements and top 10 evaluation projects with the largest difference in the implementation rate were compared between urban and rural hospitals. Radar maps were used for comparison and analysis intuitively. RESULTS： A total of 24 hospitals were surveyed， including 12 in urban and 12 in rural areas； there were significant differences in the implementation rate of 10 key factors among 24 hospitals； the elements with the highest implementation rate were “Ⅶ environmental factors， workflow and staffing pattern”（56.55％）；the elements with the lowest implementation rate was “Ⅱ drug information” （26.77％）. Among 33 evaluation projects of “Ⅱ drug information”， the implementation rate of No. 36 project （12.50％， related to opioids） was the lowest. Among the implementation rates of 10 key elements in 12 urban hospitals and 12 rural hospitals， the key elements with the greatest difference was “Ⅳ drug label， packaging and naming” （differing by 44.44％，59.72％ vs. 15.28％）； Among“Ⅸ patient education”evaluation project with the greatest gap， there was the greatest difference in No. 199 project （related to patients’ active participation in medication， 58.33％ in urban， 4.17％ in rural）. CONCLUSIONS： The results of medication safety investigation in 24 hospitals from Linyi city show that all the item in each hospital needs to be improved expecially in the implementation of “Ⅱ drug information”. Rural hospitals should strengthen medication education for patients.

Microglia play a crucial role in inflammation after cerebral ischemia.A large number of studies have shown that microglia are highly plastic cells that can assume different phenotypes and functions in response to specific microenvironmental signals.Microglia can be polarized into the classically activated proinflammatory M1 phenotype or the alternatively activated anti-inflammatory M2 phenotype,and play different roles in ischemic injury.Irnhibiting M1 while stimulating M2 may be a new approach for the treatment of ischemic stroke.

Inflammation plays an important role in the pathophysiological mechanism of acute ischemic stroke.CD200 expressed in neurons interacts with CD200 receptor (CD200R) on microglia cells.It can inhibit microglia activation and alleviate the inflammation after cerebral ischemic injury.This article reviews the roles of CD200 and CD200R in the activation of microglia after cerebral ischemia.

OBJECTIVETo evaluate the effect of Fuzheng Quxie granule (FQG) on immune cells and cytokines of populations susceptible to respiratory viral infection.

METHODSOne thousand four hundred and two subjects selected from 25 hospitals in Shanghai between May and June in 2003, were divided into the FQG group treated with FQG and the control group treated with placebo. Serum levels of interleukin 2 (IL-2), interleukin 4 (IL-4), gamma-interferon (gamma-IFN), blood lymphocyte subsets (CD3+ , CD4+, CD8+), B-cell count and natural killer cell (NK) percent ratio were measured in 130 of the FQG group and 120 of the control group before treatment, by the end of the 2nd week and two weeks after treatment.

RESULTSBy the end of the 2nd week of treatment, as compared with before treatment, the levels of IL-2, gamma-IFN, and NK percent in the FQG group increased significantly (P < 0.05), while IL-4 and CD3+, CD4+, CD8+ and B-cell count were unchanged. Besides, levels of Th1/Th2 ratio markedly increased at the end of the 2nd week and two weeks after treatment, in comparing with that before treatment and in the control group (P<0.05).

CONCLUSIONFQG could improve immune function of population susceptible to respiratory viral infection certain extent.

Adult ; CD4-CD8 Ratio ; Double-Blind Method ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Interferon-gamma ; Interleukin-2 ; blood ; Interleukin-4 ; blood ; Killer Cells, Natural ; immunology ; Male ; Middle Aged ; Phytotherapy ; Respiratory Tract Infections ; prevention & control ; Virus Diseases ; prevention & control