Health economics evidence plays an important role in linking clinical value evidence with health resource allocation decisions in the development of clinical practice guidelines. It can not only effectively balance clinical effectiveness and economic feasibility but also avoid forming "idealized" recommendations that are detached from the affordability of the healthcare system or the burden-bearing capacity of patients. To promote guideline developers to use health economics evidence more standardizedly and fully, this paper conducts an in-depth analysis of the current application status, existing challenges, access channels, and application processes of health economics evidence in current guidelines, and on this basis, puts forward considerations and suggestions for strengthening and standardizing the application of health economics evidence in China's clinical practice guidelines.

Objective To investigate the correlation between myocardial fibrosis(MF)and left ventricular ejection fraction(LVEF)and myocardial injury markers in heart failure patients via cardiac magnetic resonance(CMR).Methods Seventy-six patients with heart failure were selected,including 32 cases of heart failure with preserved ejection fraction(HFpEF)(HFpEF group),15 cases of heart failure with mid-range ejection fraction(HFmEF)(HFmEF group),and 29 patients of heart failure with reduced ejection fraction(HFrEF)(HFrEF group).Additionally,7 healthy individuals undergoing physical examinations were included(control group).CMR parameters and biological markers for the heart failure groups were collected for all subjects.The differences in native T1 value and extracellular volume fraction(ECV)between the heart failure group and the control group were compared,respectively.The differences in native T1 value,ECV,late gadolinium enhancement(LGE)score,serum creatine kinase-MB(CK-MB),cardiac troponin Ⅰ knockdown(cTnI-KD),and N-terminal pro-brain natriuretic peptide(NT-proBNP)among heart failure subgroups were also compared,respectively.Spearman correlation analysis was used to examine the relationships between MF imaging indicators and LVEF,as well as NT-proBNP levels.Results The differences in native T1 value,ECV,LGE score,and NT-proBNP between the heart failure group and the control group,as well as between the heart failure subgroups were statistically significant(P＜0.05).The native T1 value,ECV,and LGE score in the heart failure group were positively correlated with NT-proBNP,and negatively correlated with LVEF.Conclusion The native T1 value,ECV value and LGE score are correlated with heart failure severity.CMR can detect myocardial injury early in patients with HFpEF and provide valuable information for risk stratification of MF.

Objective To investigate the ameliorative effects and mechanisms of six types of tea(green tea,cyan tea,red tea,white tea,black tea and yellow tea)on metabolic disorders in obesity mice induced by high-fat diet(HFD).Methods Four-week-old male C57BL/6J mice were randomly divided into 8 groups with 7 mice per group.An HFD-induced obese mouse model was established,and the mice in control group maintained on standard diet followed by intragastric administration of different teas for 5 weeks.The body weight,liver weight ratio,fasting blood glucose,and lipid profile of the mice were measured to assess glucose and lipid metabolism.Serum inflammatory factors including IL-6,tumor necrosis factor-alpha(TNF-α)and oxidative stress markers[malondialdehyde(MDA)and superoxide dismutase(SOD)were measured.Additionally,liver histopathology and the expression of key glycolipid metabolism-related genes,adenosine monophosphate-activated protein kinase(AMPK)and carnitine palmitoyltransferase 1(CPT-1),were analyzed to explore underlying mechanisms.Results Cyan tea significantly suppressed weight gain,demonstrating superior weight control.White tea markedly reduced fasting blood glucose levels and decreased the area under the curve of oral glucose tolerance test(OGTT)and insulin tolerance test(ITT),indicating synergistic improvements in glucose metabolism and insulin sensitivity.Yellow tea exhibited exceptional anti-inflammatory and antioxidant effects,reducing hepatic IL-6 and MDA while enhancing SOD activity.Green tea activated the lipid oxidation pathway by upregulating AMPK/CPT-1 expression.All kinds of tea significantly attenuated hepatic lipid droplet accumulation.Conclusion All six types of tea alleviated metabolic disorders by reducing hepatic fat content in obesity mice.However,different types of tea exert their unique effects on improving metabolic disorders through differential mechanisms such as glucose metabolism regulation,lipid oxidation,and anti-inflammatory and antioxidant actions.

Objective To investigate the status of population dynamics and distribution changes of Aedes aegypti in Guangdong Province.Methods Continuous monitoring was conducted from May 2018 to July 2024 in Wushi Town and Qishui Town,Leizhou City,Zhanjiang City,Guangdong Province.Additionally,a survey of the distribution of Ae.aegypti along the Leizhou Peninsula coast was carried out.Results The density of Ae.aegypti in Zhanjiang showed a gradual decline from 2018 to 2024.The last detection of adult Ae.aegypti in Wushi Town was in September 2021,and the last larva was found in October 2023.No Ae.aegypti was detected in Qishui Town during surveys from 2021 to 2024.A survey of 18 coastal villages in the Leizhou Peninsula revealed no detections of Ae.aegypti.Conclusions This study provides a basis for understanding the distribution and population density fluctuations of Ae.aegypti,assessing its invasion risk,and scientifically conducting relevant prevention and control efforts.

OBJECTIVE: To investigate the spatiotemporal patterns and socioeconomic factors influencing the incidence of tuberculosis (TB) in the Guangdong Province between 2010 and 2019. METHOD: Spatial and temporal variations in TB incidence were mapped using heat maps and hierarchical clustering. Socioenvironmental influencing factors were evaluated using a Bayesian spatiotemporal conditional autoregressive (ST-CAR) model. RESULTS: Annual incidence of TB in Guangdong decreased from 91.85/100,000 in 2010 to 53.06/100,000 in 2019. Spatial hotspots were found in northeastern Guangdong, particularly in Heyuan, Shanwei, and Shantou, while Shenzhen, Dongguan, and Foshan had the lowest rates in the Pearl River Delta. The ST-CAR model showed that the TB risk was lower with higher per capita Gross Domestic Product (GDP) [Relative Risk ( RR), 0.91; 95% Confidence Interval ( CI): 0.86-0.98], more the ratio of licensed physicians and physician ( RR, 0.94; 95% CI: 0.90-0.98), and higher per capita public expenditure ( RR, 0.94; 95% CI: 0.90-0.97), with a marginal effect of population density ( RR, 0.86; 95% CI: 0.86-1.00). CONCLUSION The incidence of TB in Guangdong varies spatially and temporally. Areas with poor economic conditions and insufficient healthcare resources are at an increased risk of TB infection. Strategies focusing on equitable health resource distribution and economic development are the key to TB control.
Humans ; China/epidemiology* ; Incidence ; Bayes Theorem ; Spatio-Temporal Analysis ; Tuberculosis/epidemiology* ; Socioeconomic Factors

Objective:To evaluate the efficacy of shockwave therapy,acupuncture,hyperthermia,biofeedback therapy,elec-trical nerve stimulation,magnetotherapy and ultrasound therapy in the treatment of chronic prostatitis/chronic pelvic pain syndrome(CP/CPPS),and to provide evidence-based support for clinical decision-making.Methods:Two researchers independently searched PubMed,Web of Science,Embase,Cochrane Library,CNKI,Wanfang,VIP and Chinese Biomedical Literature databases for randomized controlled trials(RCTs)on the effects of different interventions on CP/CPPS from the establishment of the databases to August 2024.We evaluated the quality of the included literature and extracted the relevant data according to the Cochrane Handbook for Systematic Reviews of Interventions,followed by network meta-analysis using Revman 5.3,R 4.33 and Stata17 software.Results:A total of 25 RCTs involving 1 794 cases were included.The results of network meta-analysis showed that electrical nerve stimulation,shockwave therapy,biofeedback therapy,magnetotherapy,ultrasound therapy and acupuncture were significantly superior to conventional medication and placebo in the total NIH-CPSI scores(P＜0.05),and so were electrical nerve stimulation and shock-wave therapy to acupuncture and hyperthermia(P＜0.05),magnetic therapy to hyperthermia,and ultrasound therapy to placebo(P＜0.05).Shockwave therapy,biofeedback therapy,electrical nerve stimulation,magnetotherapy and ultrasound therapy achieved re-markably better clinical efficacy than conventional medication and placebo in the treatment of CP/CPPS,and so did shockwave therapy than electrical nerve stimulation,hyperthermia,ultrasonic therapy,magnetotherapy and acupuncture.Conclusion:For the treat-ment of CP/CPPS,electrical nerve stimulation is advantageous over the other interventions in improving total NIH-CPSI scores,and shockwave therapy is advantageous in relieving pain symptoms and clinical efficacy.This conclusion,however,needs to be further veri-fied by more high-quality clinical studies.

Objective To investigate the ameliorative effects and mechanisms of six types of tea(green tea,cyan tea,red tea,white tea,black tea and yellow tea)on metabolic disorders in obesity mice induced by high-fat diet(HFD).Methods Four-week-old male C57BL/6J mice were randomly divided into 8 groups with 7 mice per group.An HFD-induced obese mouse model was established,and the mice in control group maintained on standard diet followed by intragastric administration of different teas for 5 weeks.The body weight,liver weight ratio,fasting blood glucose,and lipid profile of the mice were measured to assess glucose and lipid metabolism.Serum inflammatory factors including IL-6,tumor necrosis factor-alpha(TNF-α)and oxidative stress markers[malondialdehyde(MDA)and superoxide dismutase(SOD)were measured.Additionally,liver histopathology and the expression of key glycolipid metabolism-related genes,adenosine monophosphate-activated protein kinase(AMPK)and carnitine palmitoyltransferase 1(CPT-1),were analyzed to explore underlying mechanisms.Results Cyan tea significantly suppressed weight gain,demonstrating superior weight control.White tea markedly reduced fasting blood glucose levels and decreased the area under the curve of oral glucose tolerance test(OGTT)and insulin tolerance test(ITT),indicating synergistic improvements in glucose metabolism and insulin sensitivity.Yellow tea exhibited exceptional anti-inflammatory and antioxidant effects,reducing hepatic IL-6 and MDA while enhancing SOD activity.Green tea activated the lipid oxidation pathway by upregulating AMPK/CPT-1 expression.All kinds of tea significantly attenuated hepatic lipid droplet accumulation.Conclusion All six types of tea alleviated metabolic disorders by reducing hepatic fat content in obesity mice.However,different types of tea exert their unique effects on improving metabolic disorders through differential mechanisms such as glucose metabolism regulation,lipid oxidation,and anti-inflammatory and antioxidant actions.

Objective To investigate the correlation between myocardial fibrosis(MF)and left ventricular ejection fraction(LVEF)and myocardial injury markers in heart failure patients via cardiac magnetic resonance(CMR).Methods Seventy-six patients with heart failure were selected,including 32 cases of heart failure with preserved ejection fraction(HFpEF)(HFpEF group),15 cases of heart failure with mid-range ejection fraction(HFmEF)(HFmEF group),and 29 patients of heart failure with reduced ejection fraction(HFrEF)(HFrEF group).Additionally,7 healthy individuals undergoing physical examinations were included(control group).CMR parameters and biological markers for the heart failure groups were collected for all subjects.The differences in native T1 value and extracellular volume fraction(ECV)between the heart failure group and the control group were compared,respectively.The differences in native T1 value,ECV,late gadolinium enhancement(LGE)score,serum creatine kinase-MB(CK-MB),cardiac troponin Ⅰ knockdown(cTnI-KD),and N-terminal pro-brain natriuretic peptide(NT-proBNP)among heart failure subgroups were also compared,respectively.Spearman correlation analysis was used to examine the relationships between MF imaging indicators and LVEF,as well as NT-proBNP levels.Results The differences in native T1 value,ECV,LGE score,and NT-proBNP between the heart failure group and the control group,as well as between the heart failure subgroups were statistically significant(P＜0.05).The native T1 value,ECV,and LGE score in the heart failure group were positively correlated with NT-proBNP,and negatively correlated with LVEF.Conclusion The native T1 value,ECV value and LGE score are correlated with heart failure severity.CMR can detect myocardial injury early in patients with HFpEF and provide valuable information for risk stratification of MF.

Objective To compare the pharmacokinetic profiles of the two teriflunomide tablets in healthy Chinese subjects under fasting and fed conditions and to evaluate their bioequivalence and safety.Methods A randomized,open,single-dose,parallel trial design was used to enroll 31 and 32 healthy Chinese male subjects in the fasting and fed groups,who were randomized to a single oral dose of 14 mg of either reference or test preparation of teriflunomide tablets.The plasma concentrations of teriflunomide were determined using liquid chromatography-tandem mass spectrometry method,and Phoenix WinNonlin 8.1 software was used to calculate pharmacokinetic parameters and perform bioequivalence analysis.Results Subjects received a single oral dose of the reference and test formulations of teriflunomide.The main pharmacokinetic parameters of teriflunomide in the fasting group were as follows:Cmax were(2.14±0.27)and(2.27±0.33)μg·mL-1,AUC0-72h were(105.70±11.20)and(107.72±11.77)μg·mL-1·h,tmax was 1.49 and 0.99 h;the main pharmacokinetic parameters of teriflunomide in the fed group were as follows:Cmaxwere(1.83±0.17)and(1.75±0.22)μg·mL-1,AUC0-72h were(102.66±9.18)and(101.57±13.01)μg·mL-1·h,tmax was 4.01 and 4.99 h.The 90％confidence intervals for the geometric means of Cmax and AUC0-72h for reference and test preparations in the fasting and fed groups were in the range of 80％to 125％.Conclusion The pharmacokinetic characteristics of the 2 formulations were similar under fasting and fed administration conditions,with good bioequivalence and safety;Postprandial administration may delay the time to peak of the drug.

Objective To explore the curative effect of indobufen combined with clopidogrel and its influences on platelet activity and coagulation function in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods According to different treatment methods,patients with AMI were divided into treatment group and control group.The control group was given clopidogrel(75 mg,qd)and aspirin(0.1 g,qd),while treatment group was given clopidogrel(75 mg,qd)and indobufen tablets(0.1 g,bid).All were treated for 1 month.The curative effect,platelet count(PLT),mean platelet volume(MPV),prothrombin time(PT),fibrinogen(FIB)and D-dimer(D-D)before and after treatment,and adverse events within 1 month after medication were compared between the two groups.Results There were 38 cases in treatment group and 43 cases in control group.After treatment,curative effect in treatment group and control group were 97.37％and 86.05％,PLT were(167.89±43.62)× 109·L-1 and(183.73±49.81)× 109·L-1,MPV were(11.86±2.31)and(10.97±2.16)fl,FIB levels were(2.53±0.61)and(2.78±0.72)g·L-1,D-D levels were(0.20±0.06)and(0.22±0.07)mg·L-1,PT were(12.82±2.35)and(12.26±2.28)s,the difference was not statistically significant(all P＞0.05).The incidence of adverse drug reactions in treatment group and control group were 2.63％and 11.63％,and the difference was statistically significant(P＜0.001).Conclusion Indobufen combined with clopidogrel has the comparable curative effect and good anti-platelet aggregation effect as aspirin,and indobufen has higher safety.So it is recommended as the medication regimen for AMI patients after PCI.