OBJECTIVE To evaluate the cost-utility of disitamab vedotin （DV） combined with toripalimab versus platinum-containing chemotherapy as first-line therapy for locally advanced or metastatic urothelial carcinoma（UC） with human epidermal growth factor receptor 2 （HER2） expression from the perspective of China’s health-care system.METHODS A cost-utility analysis was performed. A three-state partitioned survival model was constructed based on the RC48-C016 trial with a 1-week cycle length. The long-term health benefits [quality-adjusted life years（QALYs）] and costs of disitamab vedotin combined with toripalimab versus platinum-containing chemotherapy as first-line therapy for locally advanced or metastatic UC with HER2 expression were simulated. The simulation time horizon was set to 15 years， and the discount rate was 4.5%. The willingness-to-pay （WTP） threshold was defined as twice China’s per capita gross domestic product（GDP） in 2025 （199 330 yuan/QALY）. The incremental cost-effectiveness ratio （ICER） between the two groups was compared， and one-way sensitivity analysis and probabilistic sensitivity analysis were conducted.RESULTS Compared with platinum-containing chemotherapy regimen， the DV plus toripalimab regimen yielded an additional 1.01 QALYs with an incremental cost of 183 224.45 yuan， and the ICER was 181 728.15 yuan/QALY， which was below the WTP threshold. At the current threshold， the probability that the DV combination regimen had a cost-utility advantage was 79.9%.CONCLUSIONS Taking twice China’s per capita GDP in 2025 as the WTP threshold， DV combined with toripalimab exhibits a cost-utility advantage over platinum-containing chemotherapy as first-line treatment for HER2-expressing locally advanced or metastatic urothelial carcinoma.

Efferocytosis refers to the process of phagocytes engulfing and clearing the cells after programmed cell death. In recent years, an increasing number of studies have shown that the mechanisms of efferocytosis are closely related to drug-induced liver injury, hepatic ischemia-reperfusion injury, viral hepatitis, cholestatic liver diseases, metabolic-associated fatty liver disease, alcoholic liver disease, and other liver disorders. This review summarized the research progress on the role of efferocytosis in liver diseases, with the hope of providing new targets for the prevention and treatment of liver diseases.
Humans ; Liver Diseases/metabolism* ; Animals ; Phagocytosis/physiology* ; Phagocytes ; Efferocytosis

OBJECTIVE To provide suggestions for improving the path and system construction of patient engagement in drug regulation in China.METHODS By reviewing initiatives and experiences from the United States(U.S.),European Union(EU),and Japan in promoting patient engagement,this study summarizes the roles and contributions of patients in the entire drug regulatory process internationally.Combining China's current progress and challenges in patient engagement,specific proposals are formulated to refine regulatory pathways and institutional systems.RESULTS&CONCLUSIONS With growing global emphasis on patient engagement as a regulatory strategy,countries or regions such as the U.S.,EU,and Japan have established clear policies,designated oversight agencies,and developed diversified pathways for patient engagement.Patients contribute to regulatory processes through advisory meetings,direct decision-making roles,and leveraging lived experiences and expertise to optimize drug evaluation and monitoring.In contrast,China's patient engagement remains primarily limited to clinical value-oriented drug development,lacking formal policy guidance.It is recommended that China,based on its existing policy system,further strengthen the construction of a safeguard system for patient engagement,improve the capacity building and pathway models for patient participation in pharmaceutical regulation,and promote the continuous development of patient engagement in pharmaceutical regulation in our country.

Objective To research the effectiveness of deep learning techniques in intelligently diagnosing dental caries and periapical periodontitis and to explore the preliminary application value of deep learning in the diagnosis of oral diseases.Methods A dataset containing 2 298 periapical films,including healthy teeth,dental caries,and peri-apical periodontitis,was used for the study.The dataset was randomly divided into 1 573 training images,233 valida-tion images,and 492 test images.By comparing various neural network models,the MobileNetV3 network model with better performance was selected for dental disease diagnosis,and the model was optimized by tuning the network hyper-parameters.The accuracy,precision,recall,and F1 score were used to evaluate the model's ability to recognize dental caries and periapical periodontitis.Class activation map was used to visualization analyze the performance of the net-work model.Results The algorithm achieved a relatively ideal intelligent diagnostic effect with precision,recall,and accuracy of 99.42%,99.73%,and 99.60%,respectively,and the F1 score was 99.57%for classifying healthy teeth,den-tal caries,and periapical periodontitis.The visualization of the class activation maps also showed that the network model can accurately extract features of dental diseases.Conclusion The tooth lesion detection algorithm based on the Mo-bileNetV3 network model can eliminate interference from image quality and human factors and has high diagnostic accu-racy,which can meet the needs of dental medicine teaching and clinical applications.

Chronic liver disease is the"devil's trilogy"in which the liver progresses from inflammation and fibrosis to liver cirrhosis and hepatocellular carcinoma,which poses a great challenge for hepatologists worldwide.Statins have played a significant role in the treatment of cardiovascular diseases and hyperlipidemia since their introduction,and in recent years,they have also demonstrated the potential to improve hepatic steatosis,exert an anti-inflammatory effect,regulate the phenotype of hepatic stellate cells,reduce portal venous pressure,and improve hepatic microcirculation in chronic liver disease.This article reviews the latest advances in the basic and clinical studies of statins in chronic liver disease,in order to provide new insights into the research,prevention,and treatment of chronic liver disease.