BACKGROUND: The FAVOR (Comparison of Quantitative Flow Ratio Guided and Angiography Guided Percutaneous Intervention in Patients with Coronary Artery Disease) III China trial demonstrated that percutaneous coronary intervention (PCI) lesion selection using quantitative flow ratio (QFR) measurement, a novel angiography-based approach for estimating fractional flow reserve, improved two-year clinical outcomes compared with standard angiography guidance. This study aimed to assess the cost-effectiveness of QFR-guided PCI from the perspective of the current Chinese healthcare system. METHODS: This study is a pre-specified analysis of the FAVOR III China trial, which included 3825 patients randomized between December 25, 2018, and January 19, 2020, from 26 centers in China. Patients with stable or unstable angina pectoris or those ≥72 hours post-myocardial infarction who had at least one lesion with a diameter stenosis between 50% and 90% in a coronary artery with a ≥2.5 mm reference vessel diameter by visual assessment were randomized to a QFR-guided strategy or an angiography-guided strategy with 1:1 ratio. During the two-year follow-up, data were collected on clinical outcomes, quality-adjusted life-years (QALYs), estimated costs of index procedure hospitalization, outpatient cardiovascular medication use, and rehospitalization due to major adverse cardiac and cerebrovascular events (MACCE). The primary analysis calculated the incremental cost-effectiveness ratio (ICER) as the cost per MACCE avoided. An ICER of ¥10,000/MACCE event avoided was considered economically attractive in China. RESULTS: At two years, the QFR-guided group demonstrated a reduced rate of MACCE compared to the angiography-guided group (10.8% vs . 14.7%, P <0.01). Total two-year costs were similar between the groups (¥50,803 ± 21,121 vs . ¥50,685 ± 23,495, P = 0.87). The ICER for the QFR-guided strategy was ¥3055 per MACCE avoided, and the probability of QFR being economically attractive was 64% at a willingness-to-pay threshold of ¥10,000/MACCE avoided. Sensitivity analysis showed that QFR-guided PCI would become cost-saving if the cost of QFR were below ¥3682 (current cost: ¥3800). Cost-utility analysis yielded an ICER of ¥56,163 per QALY gained, with a 53% probability of being cost-effective at a willingness-to-pay threshold of ¥85,000 per QALY gained. CONCLUSION: In patients undergoing PCI, a QFR-guided strategy appears economically attractive compared to angiographic guidance from the perspective of the Chinese healthcare system. TRIAL REGISTRATION ClinicalTrials.gov , NCT03656848.
Humans ; Cost-Benefit Analysis ; Percutaneous Coronary Intervention/methods* ; Male ; Female ; Coronary Angiography/methods* ; Middle Aged ; Aged ; Coronary Artery Disease/surgery* ; Quality-Adjusted Life Years ; Fractional Flow Reserve, Myocardial/physiology*

Objective:To explore the effects of different surgical methods on the treatment outcomes and prog-nosis in patients with caesarean section scar pregnancy(CSP).Methods:A total of 90 patients with type n or ⅢCSP admitted to Department of Obstetrics and Gynecology,Affiliated Hospital of Jinggangshan University be-tween February 1,2021 and February 1,2022 were selected as the study subjects.They were enrolled in order of inclusion,exclusion criteria,and admission treatment time.According to different treatment methods,they were di-vided into group A(30 cases),group B(30 cases)and group C(30 cases).The group A underwent laparoscopic uterine artery ligation(UAL)+focus excision and repair of scar pregnancy(FER)+uterine cicatricial repair(UCR),group B underwent uterine artery embolization(UAE)+hysteroscopic FER under ultrasonic monitoring,and group C underwent laparoscopic FER+UCR.The intraoperative and postoperative conditions,as well as the incidence of recurrent CSP(RCSP)rate and repregnancy rate during follow-up in the three groups were com-pared.Results:① The intraoperative blood loss,postoperative uterine drainage volume and postoperative VAS score in groups A and B were lower than those in group C,while the operation time and hospitalization cost were higher than those in group C(P＜0.05).The operation time and hospitalization cost in group A were lower than those in group B(P＜0.05).②The postoperative vaginal hemostasis time,menstrual recovery time and recovery time of serum β-human chorionic gonadotropin(β-HCG)in groups A and B were shorter than those in group C(P＜0.05).③There was no statistically significant difference in the incidence of postoperative complications such as adhesion,infection,severe bleeding,and lower abdominal pain among the three groups(P＞0.05).④The mean follow-up time after surgery was(17.60±5.61)months,and the incidence of RCSP in group A and group C was lower than that in group B(P＜0.05).The rate of repregnancy in group A,group B and group C was 82.14％(23/28),77.78％(21/27)and 81.48％(22/27),respectively,and there was no significant difference in the rate of repregnancy among the three groups(P＞0.05).Conclusions:Laparoscopic UAL+FER+UCR and UAE+ultrasound monitoring hysteroscopic FER can reduce intraoperative bleeding and promote postoperative re-covery,but the surgery time is prolonged and hospitalization costs are higher;After using UCR treatment,the inci-dence of RCSP is lower.Clinical evaluation should be based on the specific condition,economic conditions,and need to preserve fertility of type Ⅱ and Ⅲ CSP patients,and personalized treatment plans should be developed.

Objective:To explore the effects of different surgical methods on the treatment outcomes and prog-nosis in patients with caesarean section scar pregnancy(CSP).Methods:A total of 90 patients with type n or ⅢCSP admitted to Department of Obstetrics and Gynecology,Affiliated Hospital of Jinggangshan University be-tween February 1,2021 and February 1,2022 were selected as the study subjects.They were enrolled in order of inclusion,exclusion criteria,and admission treatment time.According to different treatment methods,they were di-vided into group A(30 cases),group B(30 cases)and group C(30 cases).The group A underwent laparoscopic uterine artery ligation(UAL)+focus excision and repair of scar pregnancy(FER)+uterine cicatricial repair(UCR),group B underwent uterine artery embolization(UAE)+hysteroscopic FER under ultrasonic monitoring,and group C underwent laparoscopic FER+UCR.The intraoperative and postoperative conditions,as well as the incidence of recurrent CSP(RCSP)rate and repregnancy rate during follow-up in the three groups were com-pared.Results:① The intraoperative blood loss,postoperative uterine drainage volume and postoperative VAS score in groups A and B were lower than those in group C,while the operation time and hospitalization cost were higher than those in group C(P＜0.05).The operation time and hospitalization cost in group A were lower than those in group B(P＜0.05).②The postoperative vaginal hemostasis time,menstrual recovery time and recovery time of serum β-human chorionic gonadotropin(β-HCG)in groups A and B were shorter than those in group C(P＜0.05).③There was no statistically significant difference in the incidence of postoperative complications such as adhesion,infection,severe bleeding,and lower abdominal pain among the three groups(P＞0.05).④The mean follow-up time after surgery was(17.60±5.61)months,and the incidence of RCSP in group A and group C was lower than that in group B(P＜0.05).The rate of repregnancy in group A,group B and group C was 82.14％(23/28),77.78％(21/27)and 81.48％(22/27),respectively,and there was no significant difference in the rate of repregnancy among the three groups(P＞0.05).Conclusions:Laparoscopic UAL+FER+UCR and UAE+ultrasound monitoring hysteroscopic FER can reduce intraoperative bleeding and promote postoperative re-covery,but the surgery time is prolonged and hospitalization costs are higher;After using UCR treatment,the inci-dence of RCSP is lower.Clinical evaluation should be based on the specific condition,economic conditions,and need to preserve fertility of type Ⅱ and Ⅲ CSP patients,and personalized treatment plans should be developed.

Objective:To explore the effects of different surgical methods on the treatment outcomes and prog-nosis in patients with caesarean section scar pregnancy(CSP).Methods:A total of 90 patients with type n or ⅢCSP admitted to Department of Obstetrics and Gynecology,Affiliated Hospital of Jinggangshan University be-tween February 1,2021 and February 1,2022 were selected as the study subjects.They were enrolled in order of inclusion,exclusion criteria,and admission treatment time.According to different treatment methods,they were di-vided into group A(30 cases),group B(30 cases)and group C(30 cases).The group A underwent laparoscopic uterine artery ligation(UAL)+focus excision and repair of scar pregnancy(FER)+uterine cicatricial repair(UCR),group B underwent uterine artery embolization(UAE)+hysteroscopic FER under ultrasonic monitoring,and group C underwent laparoscopic FER+UCR.The intraoperative and postoperative conditions,as well as the incidence of recurrent CSP(RCSP)rate and repregnancy rate during follow-up in the three groups were com-pared.Results:① The intraoperative blood loss,postoperative uterine drainage volume and postoperative VAS score in groups A and B were lower than those in group C,while the operation time and hospitalization cost were higher than those in group C(P＜0.05).The operation time and hospitalization cost in group A were lower than those in group B(P＜0.05).②The postoperative vaginal hemostasis time,menstrual recovery time and recovery time of serum β-human chorionic gonadotropin(β-HCG)in groups A and B were shorter than those in group C(P＜0.05).③There was no statistically significant difference in the incidence of postoperative complications such as adhesion,infection,severe bleeding,and lower abdominal pain among the three groups(P＞0.05).④The mean follow-up time after surgery was(17.60±5.61)months,and the incidence of RCSP in group A and group C was lower than that in group B(P＜0.05).The rate of repregnancy in group A,group B and group C was 82.14％(23/28),77.78％(21/27)and 81.48％(22/27),respectively,and there was no significant difference in the rate of repregnancy among the three groups(P＞0.05).Conclusions:Laparoscopic UAL+FER+UCR and UAE+ultrasound monitoring hysteroscopic FER can reduce intraoperative bleeding and promote postoperative re-covery,but the surgery time is prolonged and hospitalization costs are higher;After using UCR treatment,the inci-dence of RCSP is lower.Clinical evaluation should be based on the specific condition,economic conditions,and need to preserve fertility of type Ⅱ and Ⅲ CSP patients,and personalized treatment plans should be developed.

Objective:To explore the effects of different surgical methods on the treatment outcomes and prog-nosis in patients with caesarean section scar pregnancy(CSP).Methods:A total of 90 patients with type n or ⅢCSP admitted to Department of Obstetrics and Gynecology,Affiliated Hospital of Jinggangshan University be-tween February 1,2021 and February 1,2022 were selected as the study subjects.They were enrolled in order of inclusion,exclusion criteria,and admission treatment time.According to different treatment methods,they were di-vided into group A(30 cases),group B(30 cases)and group C(30 cases).The group A underwent laparoscopic uterine artery ligation(UAL)+focus excision and repair of scar pregnancy(FER)+uterine cicatricial repair(UCR),group B underwent uterine artery embolization(UAE)+hysteroscopic FER under ultrasonic monitoring,and group C underwent laparoscopic FER+UCR.The intraoperative and postoperative conditions,as well as the incidence of recurrent CSP(RCSP)rate and repregnancy rate during follow-up in the three groups were com-pared.Results:① The intraoperative blood loss,postoperative uterine drainage volume and postoperative VAS score in groups A and B were lower than those in group C,while the operation time and hospitalization cost were higher than those in group C(P＜0.05).The operation time and hospitalization cost in group A were lower than those in group B(P＜0.05).②The postoperative vaginal hemostasis time,menstrual recovery time and recovery time of serum β-human chorionic gonadotropin(β-HCG)in groups A and B were shorter than those in group C(P＜0.05).③There was no statistically significant difference in the incidence of postoperative complications such as adhesion,infection,severe bleeding,and lower abdominal pain among the three groups(P＞0.05).④The mean follow-up time after surgery was(17.60±5.61)months,and the incidence of RCSP in group A and group C was lower than that in group B(P＜0.05).The rate of repregnancy in group A,group B and group C was 82.14％(23/28),77.78％(21/27)and 81.48％(22/27),respectively,and there was no significant difference in the rate of repregnancy among the three groups(P＞0.05).Conclusions:Laparoscopic UAL+FER+UCR and UAE+ultrasound monitoring hysteroscopic FER can reduce intraoperative bleeding and promote postoperative re-covery,but the surgery time is prolonged and hospitalization costs are higher;After using UCR treatment,the inci-dence of RCSP is lower.Clinical evaluation should be based on the specific condition,economic conditions,and need to preserve fertility of type Ⅱ and Ⅲ CSP patients,and personalized treatment plans should be developed.

Objective:To explore the effects of different surgical methods on the treatment outcomes and prog-nosis in patients with caesarean section scar pregnancy(CSP).Methods:A total of 90 patients with type n or ⅢCSP admitted to Department of Obstetrics and Gynecology,Affiliated Hospital of Jinggangshan University be-tween February 1,2021 and February 1,2022 were selected as the study subjects.They were enrolled in order of inclusion,exclusion criteria,and admission treatment time.According to different treatment methods,they were di-vided into group A(30 cases),group B(30 cases)and group C(30 cases).The group A underwent laparoscopic uterine artery ligation(UAL)+focus excision and repair of scar pregnancy(FER)+uterine cicatricial repair(UCR),group B underwent uterine artery embolization(UAE)+hysteroscopic FER under ultrasonic monitoring,and group C underwent laparoscopic FER+UCR.The intraoperative and postoperative conditions,as well as the incidence of recurrent CSP(RCSP)rate and repregnancy rate during follow-up in the three groups were com-pared.Results:① The intraoperative blood loss,postoperative uterine drainage volume and postoperative VAS score in groups A and B were lower than those in group C,while the operation time and hospitalization cost were higher than those in group C(P＜0.05).The operation time and hospitalization cost in group A were lower than those in group B(P＜0.05).②The postoperative vaginal hemostasis time,menstrual recovery time and recovery time of serum β-human chorionic gonadotropin(β-HCG)in groups A and B were shorter than those in group C(P＜0.05).③There was no statistically significant difference in the incidence of postoperative complications such as adhesion,infection,severe bleeding,and lower abdominal pain among the three groups(P＞0.05).④The mean follow-up time after surgery was(17.60±5.61)months,and the incidence of RCSP in group A and group C was lower than that in group B(P＜0.05).The rate of repregnancy in group A,group B and group C was 82.14％(23/28),77.78％(21/27)and 81.48％(22/27),respectively,and there was no significant difference in the rate of repregnancy among the three groups(P＞0.05).Conclusions:Laparoscopic UAL+FER+UCR and UAE+ultrasound monitoring hysteroscopic FER can reduce intraoperative bleeding and promote postoperative re-covery,but the surgery time is prolonged and hospitalization costs are higher;After using UCR treatment,the inci-dence of RCSP is lower.Clinical evaluation should be based on the specific condition,economic conditions,and need to preserve fertility of type Ⅱ and Ⅲ CSP patients,and personalized treatment plans should be developed.

Objective:To explore the effects of different surgical methods on the treatment outcomes and prog-nosis in patients with caesarean section scar pregnancy(CSP).Methods:A total of 90 patients with type n or ⅢCSP admitted to Department of Obstetrics and Gynecology,Affiliated Hospital of Jinggangshan University be-tween February 1,2021 and February 1,2022 were selected as the study subjects.They were enrolled in order of inclusion,exclusion criteria,and admission treatment time.According to different treatment methods,they were di-vided into group A(30 cases),group B(30 cases)and group C(30 cases).The group A underwent laparoscopic uterine artery ligation(UAL)+focus excision and repair of scar pregnancy(FER)+uterine cicatricial repair(UCR),group B underwent uterine artery embolization(UAE)+hysteroscopic FER under ultrasonic monitoring,and group C underwent laparoscopic FER+UCR.The intraoperative and postoperative conditions,as well as the incidence of recurrent CSP(RCSP)rate and repregnancy rate during follow-up in the three groups were com-pared.Results:① The intraoperative blood loss,postoperative uterine drainage volume and postoperative VAS score in groups A and B were lower than those in group C,while the operation time and hospitalization cost were higher than those in group C(P＜0.05).The operation time and hospitalization cost in group A were lower than those in group B(P＜0.05).②The postoperative vaginal hemostasis time,menstrual recovery time and recovery time of serum β-human chorionic gonadotropin(β-HCG)in groups A and B were shorter than those in group C(P＜0.05).③There was no statistically significant difference in the incidence of postoperative complications such as adhesion,infection,severe bleeding,and lower abdominal pain among the three groups(P＞0.05).④The mean follow-up time after surgery was(17.60±5.61)months,and the incidence of RCSP in group A and group C was lower than that in group B(P＜0.05).The rate of repregnancy in group A,group B and group C was 82.14％(23/28),77.78％(21/27)and 81.48％(22/27),respectively,and there was no significant difference in the rate of repregnancy among the three groups(P＞0.05).Conclusions:Laparoscopic UAL+FER+UCR and UAE+ultrasound monitoring hysteroscopic FER can reduce intraoperative bleeding and promote postoperative re-covery,but the surgery time is prolonged and hospitalization costs are higher;After using UCR treatment,the inci-dence of RCSP is lower.Clinical evaluation should be based on the specific condition,economic conditions,and need to preserve fertility of type Ⅱ and Ⅲ CSP patients,and personalized treatment plans should be developed.

Objective:To explore the effects of different surgical methods on the treatment outcomes and prog-nosis in patients with caesarean section scar pregnancy(CSP).Methods:A total of 90 patients with type n or ⅢCSP admitted to Department of Obstetrics and Gynecology,Affiliated Hospital of Jinggangshan University be-tween February 1,2021 and February 1,2022 were selected as the study subjects.They were enrolled in order of inclusion,exclusion criteria,and admission treatment time.According to different treatment methods,they were di-vided into group A(30 cases),group B(30 cases)and group C(30 cases).The group A underwent laparoscopic uterine artery ligation(UAL)+focus excision and repair of scar pregnancy(FER)+uterine cicatricial repair(UCR),group B underwent uterine artery embolization(UAE)+hysteroscopic FER under ultrasonic monitoring,and group C underwent laparoscopic FER+UCR.The intraoperative and postoperative conditions,as well as the incidence of recurrent CSP(RCSP)rate and repregnancy rate during follow-up in the three groups were com-pared.Results:① The intraoperative blood loss,postoperative uterine drainage volume and postoperative VAS score in groups A and B were lower than those in group C,while the operation time and hospitalization cost were higher than those in group C(P＜0.05).The operation time and hospitalization cost in group A were lower than those in group B(P＜0.05).②The postoperative vaginal hemostasis time,menstrual recovery time and recovery time of serum β-human chorionic gonadotropin(β-HCG)in groups A and B were shorter than those in group C(P＜0.05).③There was no statistically significant difference in the incidence of postoperative complications such as adhesion,infection,severe bleeding,and lower abdominal pain among the three groups(P＞0.05).④The mean follow-up time after surgery was(17.60±5.61)months,and the incidence of RCSP in group A and group C was lower than that in group B(P＜0.05).The rate of repregnancy in group A,group B and group C was 82.14％(23/28),77.78％(21/27)and 81.48％(22/27),respectively,and there was no significant difference in the rate of repregnancy among the three groups(P＞0.05).Conclusions:Laparoscopic UAL+FER+UCR and UAE+ultrasound monitoring hysteroscopic FER can reduce intraoperative bleeding and promote postoperative re-covery,but the surgery time is prolonged and hospitalization costs are higher;After using UCR treatment,the inci-dence of RCSP is lower.Clinical evaluation should be based on the specific condition,economic conditions,and need to preserve fertility of type Ⅱ and Ⅲ CSP patients,and personalized treatment plans should be developed.

Objective:To explore the effects of different surgical methods on the treatment outcomes and prog-nosis in patients with caesarean section scar pregnancy(CSP).Methods:A total of 90 patients with type n or ⅢCSP admitted to Department of Obstetrics and Gynecology,Affiliated Hospital of Jinggangshan University be-tween February 1,2021 and February 1,2022 were selected as the study subjects.They were enrolled in order of inclusion,exclusion criteria,and admission treatment time.According to different treatment methods,they were di-vided into group A(30 cases),group B(30 cases)and group C(30 cases).The group A underwent laparoscopic uterine artery ligation(UAL)+focus excision and repair of scar pregnancy(FER)+uterine cicatricial repair(UCR),group B underwent uterine artery embolization(UAE)+hysteroscopic FER under ultrasonic monitoring,and group C underwent laparoscopic FER+UCR.The intraoperative and postoperative conditions,as well as the incidence of recurrent CSP(RCSP)rate and repregnancy rate during follow-up in the three groups were com-pared.Results:① The intraoperative blood loss,postoperative uterine drainage volume and postoperative VAS score in groups A and B were lower than those in group C,while the operation time and hospitalization cost were higher than those in group C(P＜0.05).The operation time and hospitalization cost in group A were lower than those in group B(P＜0.05).②The postoperative vaginal hemostasis time,menstrual recovery time and recovery time of serum β-human chorionic gonadotropin(β-HCG)in groups A and B were shorter than those in group C(P＜0.05).③There was no statistically significant difference in the incidence of postoperative complications such as adhesion,infection,severe bleeding,and lower abdominal pain among the three groups(P＞0.05).④The mean follow-up time after surgery was(17.60±5.61)months,and the incidence of RCSP in group A and group C was lower than that in group B(P＜0.05).The rate of repregnancy in group A,group B and group C was 82.14％(23/28),77.78％(21/27)and 81.48％(22/27),respectively,and there was no significant difference in the rate of repregnancy among the three groups(P＞0.05).Conclusions:Laparoscopic UAL+FER+UCR and UAE+ultrasound monitoring hysteroscopic FER can reduce intraoperative bleeding and promote postoperative re-covery,but the surgery time is prolonged and hospitalization costs are higher;After using UCR treatment,the inci-dence of RCSP is lower.Clinical evaluation should be based on the specific condition,economic conditions,and need to preserve fertility of type Ⅱ and Ⅲ CSP patients,and personalized treatment plans should be developed.

Objective:To evaluate the influence of a moisturizer containing oat kernel oil for xeroderma and water content of the stratum corneum in children.Methods:From September to December 2022, 30 children with xeroderma were treated in the Dermatology Department of Tongzhou Maternal and Child Health Hospital of Beijing; 13 were males and 17 were females, and the age was 7.33±2.63 years. This was a single-center self-controlled trial. All children applied the moisturizer on the dry skin of the bilateral limbs two time per day for 14 days, and were followed up at 7 days and 14 days. Efficacy was evaluated according to the water content of the stratum corneum, visual scale, xerosis severity scale (XSS), Specified Symptom Sum Score (SRRC), Visual Analog Scale (VAS) and so on. and side-reactions were recorded.Results:After application of the moisturizer, the median of water content in the stratum corneum was 49.00 (33.83, 87.25), 48.84 (32.58, 100.34) at 7 d and 14 d respectively, showing significant increases compared with that at baseline (median 26.51 (16.00, 47.75) ( Z=-3.075, Z=-2.911, P<0.01). The visual scale, XSS, SRRC and VAS showed that compared with the baseline at 7 d, 14 d, the skin dryness and pruritus scores improved significantly ( Z=-4.424, -4.150, -3.943, -4.400; Z=-4.744, -4.409, -4.260, -4.409, P<0.01). Conclusions:The application of this moisturizer containing oat kernel oil could effectively improve skin dryness and the water content of the stratum corneum without serious adverse reactions.