1.A novel estrogen receptor expression stratification(low/moderate/high)based on Chinese population provides more accurate prognosis prediction for HR+/HER2-early breast cancer patients
Chengfang WANG ; Yuqin ZHOU ; Yanling ZHANG ; Xiaowei QI ; Yi ZHANG
Journal of Army Medical University 2025;47(22):2792-2804
Objective To stratify the estrogen receptor(ER)positive while human epidermal growth factor receptor 2(HER2)negative breast cancer patients by the expression level of ER,providing new evidence for prognostic prediction and guiding precision endocrine therapy(ET)for those with different ER expression levels.Methods A retrospective cohort study was conducted on 1 962 ER-positive/HER2-negative breast cancer patients treated in our department from January 1,2013 to December 31,2018.X-tile was used to calculate the optimal cutoff point of ER expression level,and then based on the results,they were divided into low(1%~10%),moderate(11%~30%),and high expression(31%~100%)groups.After propensity score matching(PSM)was performed to balance baseline characteristics,their prognostic outcomes were compared and the responses to ET were analyzed in the groups.Cox proportional risk regression model was applied to analyze the prognostic factors,and subgroup analysis was further performed.Results After PAM,129(11.5%)were assigned into a low ER expression group,151(13.5%)and 840(75%)into moderate and high ER expression groups,respectively.Statistical differences were observed in disease-free survival(DFS)and overall survival(OS)among the 3 groups(P=8e-6,P=8e-14).In the low ER expression group,the patients treated with selective estrogen receptor modulators(SERMs)showed no significant differences in DFS and OS than those treated with aromatase inhibitors(AIs)(P>0.05).However,the patients from the moderate and high ER expression groups demonstrated significantly better DFS when treated with AI than with SERM(P=0.02,P=0.03).Multivariate analysis showed that compared with the moderate ER expression group,the high ER expression group exhibited significantly lower risk of disease recurrence/metastasis(HR=0.62,95%CI:0.43~0.88,P=0.009)and risk of death(HR=0.49,95%CI:0.26~0.93,P=0.03).Subgroup analysis revealed that when compared with the high ER expression group,the moderate ER expression group exhibited notably worse DFS in the following subgroups:oral SERM,non-breast-conserving surgery,lymph node metastasis,TNM stage Ⅱ,and chemotherapy,and shorter OS in the subgroups of oral SERM,non-breast-conserving surgery,lymph node metastasis,TNM stage Ⅱ subgroup,and chemotherapy.Conclusion Taking ER expression of 11%~30%as an independent stratification criterion can guide more accurate prognostic assessment and more rational ET selection in ER-positive/HER2-negative breast cancer patients.
2.Drug prophylaxis evidence-based regimens for venous thromboembolism after joint replacement
Xiaowei FENG ; Na GUO ; Baozhen WANG ; Jie CHENG ; Yuchen TANG ; Jun QI ; Zhiqiang DONG
China Pharmacy 2024;35(22):2799-2807
OBJECTIVE To sort out drug prophylaxis regimens for venous thromboembolism (VTE) in adult patients after artificial joint replacement, and provide a basis for clinic. METHODS Databases and related official websites were searched according to the “6S” model, including the National Institute for Health and Clinical Excellence (NICE), the Scottish Intercollegiate Guidelines Network (SIGN), the Guidelines International Network (GIN), the National Guidelines Clearinghouse (NGC), PubMed, Embase, CNKI, Wanfang database and SinoMed, to search for guidelines, expert consensuses, systematic evaluations, randomized controlled trials, and cohort studies about preventing VTE in adult patients after artificial joint replacement from the inception until December 2023. Literature that met the inclusion criteria were selected, and the quality evaluation of the literature was completed by 2 researchers independently; the evidence rating was performed by using the Joanna Briggs Institute (JBI) evidence pre-classification and evidence rank system (2014 edition). RESULTS A total of 36 articles were included in the study, which were categorized into 9 areas of risk assessment, post-assessment prophylaxis, medication selection, medication method, duration of medication prophylaxis, medication prophylaxis observation points, contraindications to drug prophylaxis, response to bleeding, and health education, which were summarized to form 37 pieces of evidence on the pharmacological prophylaxis for postoperative VTE in patients who underwent artificial joint replacement. CONCLUSIONS The evidence of drug prophylaxis for postoperative VTE in patients who underwent artificial joint replacement summarized in this study is comprehensive, with certain scientific reference and practicality, which can provide clinical pharmacists with a scientific evidence-based basis for perioperative VTE prophylaxis management.
3.Trend and Flow Analysis of the Total Cost of Traditional Chinese Medicine in China Based on the Institutional Flow Approach
Xueyun TIAN ; Zhi WANG ; Shanshan XIAO ; Zixuan DAI ; Zi YANG ; Sijia QI ; Xiaowei MAN
Chinese Health Economics 2024;43(9):40-43
Objective:To analyze the total expendition,developmental changes and flow of the total cost of traditional Chinese medicine(TCM)in China from 2016 to 2021,and to study the development of the total cost of TCM in different medical institutions.Methods:Institutional flow method and case-base aggregation method were used to account for the total TCM costs.Results:From 2016 to 2021,the total amount of total TCM costs flowed to TCM-type hospitals was the highest in China,the proportion of total TCM costs in primary healthcare organizations was increased,and TCM-type clinics and outpatient clinics were developed more rapidly.The share of Chinese medicine drug costs in total Chinese medicine costs has been declined,and the share of county hospitals in their total health costs has been risen overall Conclusion:In the future,it would increase the TCM investment,attach importance to the development of TCM services in non-Chinese medicine hospitals,improve the capacity of primary Chinese medicine services,continue to consolidate the policy of"strengthening the primary",and maintain the rapid development of Chinese medicine clinics and outpatient clinics;the value of Chinese medicine technical labor should be emphasized,and the driving force of county hospitals should be brought into full play.
4.Trend and Flow Analysis of the Total Cost of Traditional Chinese Medicine in China Based on the Institutional Flow Approach
Xueyun TIAN ; Zhi WANG ; Shanshan XIAO ; Zixuan DAI ; Zi YANG ; Sijia QI ; Xiaowei MAN
Chinese Health Economics 2024;43(9):40-43
Objective:To analyze the total expendition,developmental changes and flow of the total cost of traditional Chinese medicine(TCM)in China from 2016 to 2021,and to study the development of the total cost of TCM in different medical institutions.Methods:Institutional flow method and case-base aggregation method were used to account for the total TCM costs.Results:From 2016 to 2021,the total amount of total TCM costs flowed to TCM-type hospitals was the highest in China,the proportion of total TCM costs in primary healthcare organizations was increased,and TCM-type clinics and outpatient clinics were developed more rapidly.The share of Chinese medicine drug costs in total Chinese medicine costs has been declined,and the share of county hospitals in their total health costs has been risen overall Conclusion:In the future,it would increase the TCM investment,attach importance to the development of TCM services in non-Chinese medicine hospitals,improve the capacity of primary Chinese medicine services,continue to consolidate the policy of"strengthening the primary",and maintain the rapid development of Chinese medicine clinics and outpatient clinics;the value of Chinese medicine technical labor should be emphasized,and the driving force of county hospitals should be brought into full play.
5.Trend and Flow Analysis of the Total Cost of Traditional Chinese Medicine in China Based on the Institutional Flow Approach
Xueyun TIAN ; Zhi WANG ; Shanshan XIAO ; Zixuan DAI ; Zi YANG ; Sijia QI ; Xiaowei MAN
Chinese Health Economics 2024;43(9):40-43
Objective:To analyze the total expendition,developmental changes and flow of the total cost of traditional Chinese medicine(TCM)in China from 2016 to 2021,and to study the development of the total cost of TCM in different medical institutions.Methods:Institutional flow method and case-base aggregation method were used to account for the total TCM costs.Results:From 2016 to 2021,the total amount of total TCM costs flowed to TCM-type hospitals was the highest in China,the proportion of total TCM costs in primary healthcare organizations was increased,and TCM-type clinics and outpatient clinics were developed more rapidly.The share of Chinese medicine drug costs in total Chinese medicine costs has been declined,and the share of county hospitals in their total health costs has been risen overall Conclusion:In the future,it would increase the TCM investment,attach importance to the development of TCM services in non-Chinese medicine hospitals,improve the capacity of primary Chinese medicine services,continue to consolidate the policy of"strengthening the primary",and maintain the rapid development of Chinese medicine clinics and outpatient clinics;the value of Chinese medicine technical labor should be emphasized,and the driving force of county hospitals should be brought into full play.
6.Trend and Flow Analysis of the Total Cost of Traditional Chinese Medicine in China Based on the Institutional Flow Approach
Xueyun TIAN ; Zhi WANG ; Shanshan XIAO ; Zixuan DAI ; Zi YANG ; Sijia QI ; Xiaowei MAN
Chinese Health Economics 2024;43(9):40-43
Objective:To analyze the total expendition,developmental changes and flow of the total cost of traditional Chinese medicine(TCM)in China from 2016 to 2021,and to study the development of the total cost of TCM in different medical institutions.Methods:Institutional flow method and case-base aggregation method were used to account for the total TCM costs.Results:From 2016 to 2021,the total amount of total TCM costs flowed to TCM-type hospitals was the highest in China,the proportion of total TCM costs in primary healthcare organizations was increased,and TCM-type clinics and outpatient clinics were developed more rapidly.The share of Chinese medicine drug costs in total Chinese medicine costs has been declined,and the share of county hospitals in their total health costs has been risen overall Conclusion:In the future,it would increase the TCM investment,attach importance to the development of TCM services in non-Chinese medicine hospitals,improve the capacity of primary Chinese medicine services,continue to consolidate the policy of"strengthening the primary",and maintain the rapid development of Chinese medicine clinics and outpatient clinics;the value of Chinese medicine technical labor should be emphasized,and the driving force of county hospitals should be brought into full play.
7.Trend and Flow Analysis of the Total Cost of Traditional Chinese Medicine in China Based on the Institutional Flow Approach
Xueyun TIAN ; Zhi WANG ; Shanshan XIAO ; Zixuan DAI ; Zi YANG ; Sijia QI ; Xiaowei MAN
Chinese Health Economics 2024;43(9):40-43
Objective:To analyze the total expendition,developmental changes and flow of the total cost of traditional Chinese medicine(TCM)in China from 2016 to 2021,and to study the development of the total cost of TCM in different medical institutions.Methods:Institutional flow method and case-base aggregation method were used to account for the total TCM costs.Results:From 2016 to 2021,the total amount of total TCM costs flowed to TCM-type hospitals was the highest in China,the proportion of total TCM costs in primary healthcare organizations was increased,and TCM-type clinics and outpatient clinics were developed more rapidly.The share of Chinese medicine drug costs in total Chinese medicine costs has been declined,and the share of county hospitals in their total health costs has been risen overall Conclusion:In the future,it would increase the TCM investment,attach importance to the development of TCM services in non-Chinese medicine hospitals,improve the capacity of primary Chinese medicine services,continue to consolidate the policy of"strengthening the primary",and maintain the rapid development of Chinese medicine clinics and outpatient clinics;the value of Chinese medicine technical labor should be emphasized,and the driving force of county hospitals should be brought into full play.
8.Trend and Flow Analysis of the Total Cost of Traditional Chinese Medicine in China Based on the Institutional Flow Approach
Xueyun TIAN ; Zhi WANG ; Shanshan XIAO ; Zixuan DAI ; Zi YANG ; Sijia QI ; Xiaowei MAN
Chinese Health Economics 2024;43(9):40-43
Objective:To analyze the total expendition,developmental changes and flow of the total cost of traditional Chinese medicine(TCM)in China from 2016 to 2021,and to study the development of the total cost of TCM in different medical institutions.Methods:Institutional flow method and case-base aggregation method were used to account for the total TCM costs.Results:From 2016 to 2021,the total amount of total TCM costs flowed to TCM-type hospitals was the highest in China,the proportion of total TCM costs in primary healthcare organizations was increased,and TCM-type clinics and outpatient clinics were developed more rapidly.The share of Chinese medicine drug costs in total Chinese medicine costs has been declined,and the share of county hospitals in their total health costs has been risen overall Conclusion:In the future,it would increase the TCM investment,attach importance to the development of TCM services in non-Chinese medicine hospitals,improve the capacity of primary Chinese medicine services,continue to consolidate the policy of"strengthening the primary",and maintain the rapid development of Chinese medicine clinics and outpatient clinics;the value of Chinese medicine technical labor should be emphasized,and the driving force of county hospitals should be brought into full play.
9.Trend and Flow Analysis of the Total Cost of Traditional Chinese Medicine in China Based on the Institutional Flow Approach
Xueyun TIAN ; Zhi WANG ; Shanshan XIAO ; Zixuan DAI ; Zi YANG ; Sijia QI ; Xiaowei MAN
Chinese Health Economics 2024;43(9):40-43
Objective:To analyze the total expendition,developmental changes and flow of the total cost of traditional Chinese medicine(TCM)in China from 2016 to 2021,and to study the development of the total cost of TCM in different medical institutions.Methods:Institutional flow method and case-base aggregation method were used to account for the total TCM costs.Results:From 2016 to 2021,the total amount of total TCM costs flowed to TCM-type hospitals was the highest in China,the proportion of total TCM costs in primary healthcare organizations was increased,and TCM-type clinics and outpatient clinics were developed more rapidly.The share of Chinese medicine drug costs in total Chinese medicine costs has been declined,and the share of county hospitals in their total health costs has been risen overall Conclusion:In the future,it would increase the TCM investment,attach importance to the development of TCM services in non-Chinese medicine hospitals,improve the capacity of primary Chinese medicine services,continue to consolidate the policy of"strengthening the primary",and maintain the rapid development of Chinese medicine clinics and outpatient clinics;the value of Chinese medicine technical labor should be emphasized,and the driving force of county hospitals should be brought into full play.
10.Trend and Flow Analysis of the Total Cost of Traditional Chinese Medicine in China Based on the Institutional Flow Approach
Xueyun TIAN ; Zhi WANG ; Shanshan XIAO ; Zixuan DAI ; Zi YANG ; Sijia QI ; Xiaowei MAN
Chinese Health Economics 2024;43(9):40-43
Objective:To analyze the total expendition,developmental changes and flow of the total cost of traditional Chinese medicine(TCM)in China from 2016 to 2021,and to study the development of the total cost of TCM in different medical institutions.Methods:Institutional flow method and case-base aggregation method were used to account for the total TCM costs.Results:From 2016 to 2021,the total amount of total TCM costs flowed to TCM-type hospitals was the highest in China,the proportion of total TCM costs in primary healthcare organizations was increased,and TCM-type clinics and outpatient clinics were developed more rapidly.The share of Chinese medicine drug costs in total Chinese medicine costs has been declined,and the share of county hospitals in their total health costs has been risen overall Conclusion:In the future,it would increase the TCM investment,attach importance to the development of TCM services in non-Chinese medicine hospitals,improve the capacity of primary Chinese medicine services,continue to consolidate the policy of"strengthening the primary",and maintain the rapid development of Chinese medicine clinics and outpatient clinics;the value of Chinese medicine technical labor should be emphasized,and the driving force of county hospitals should be brought into full play.

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