OBJECTIVE To evaluate the cost-effectiveness of vitamin D analogue for postmenopausal osteoporotic women in China. METHODS A Markov microsimulation model was developed to analyze the clinical and economic outcomes of eldecalcitol， alfacalcidol and calcitriol for postmenopausal osteoporosis from the healthcare system perspective in China. The clinical parameters required for the model were derived from network meta-analysis， while cost and utility data were primarily obtained from the literature. The cycle length was 1 year ， the time horizon was life time， and the willingness-to-pay threshold was 0.5 times the gross domestic product per capita in China in 2023（44 679 yuan/QALY）. Model uncertainty was tested with one-way sensitivity analysis， probabilistic sensitivity analysis， and scenario analysis. RESULTS The quality-adjusted life years （QALYs） for eldecalcitol were calculated to be 12.03 QALYs， which were higher than those for alfacalcidol （11.94 QALYs） and calcitriol （11.92 QALYs）. Meanwhile， the direct medical cost associated with eldecalcitol treatment amounted to 38 805 yuan， which was lower than that of alfacalcidol （45 173 yuan） and calcitriol （45 821 yuan）. The results of the one-way sensitivity analysis showed that the risk ratio of hip fracture and vertebral fracture had a significant impact on the result. The probabilistic sensitivity analysis and scenario analysis showed the robustness of the findings from the base-case analysis. CONCLUSIONS Compared with alfacalcidol and calcitriol， eldecalcitol is likely to be a cost-effective treatment for postmenopausal osteoporotic women in China.

Objectives:To explore obesity prevalence and its association with dietary patterns among Tibetan pastoralists during the urbanization transition in Qinghai Province.Methods:Using an open cohort study design, 1 003 subjects were enrolled at baseline in 2018, 599 were followed up, and 1 012 were newly recruited in 2022. A total of 1 913 adults over 18 years were included in the study, and a questionnaire survey and health examination were conducted. Factor analysis was used to identify dietary patterns, and a mixed-effects model was used to analyze the association between dietary patterns and obesity.Results:From 2018 to 2022, the prevalence rates of overweight, obesity, and central obesity were 27.6%, 33.8%, and 54.6%, respectively. Age-sex-standardized prevalence of obesity and central obesity increased. Three dietary patterns were identified: the modern pattern was characterized by frequent consumption of pork, poultry, processed meat, fresh fruits, sugary drinks, salty snacks, etcetera; the urban pattern was characterized by frequent consumption of refined carbohydrates, beef and mutton, vegetables and eggs, etcetera; and pastoral pattern featured frequent consumption of tsamba, Tibetan cheese, buttered/milk tea, and whole-fat dairy products. After adjusting for demographic characteristics, socioeconomic status, and lifestyle factors, compared with the T1, subjects in the T3 of urban pattern scores were more likely to be overweight ( OR=2.09, 95% CI: 1.10-3.95) and overweight/obese ( OR=1.23, 95% CI: 1.00-1.51), whereas those in the T3 of pastoral pattern scores had a lower risk of overweight ( OR=0.45, 95% CI: 0.24-0.84), obesity ( OR=0.81, 95% CI: 0.69-0.95), overweight/obesity ( OR=0.75, 95% CI: 0.61-0.91) and central obesity ( OR=0.58, 95% CI: 0.38-0.89). Conclusions:Prevalence of obesity and central obesity was high among Tibetan pastoralists during the urbanization transition. Urban dietary pattern was a risk factor for overweight and overweight/obesity, whereas pastoral dietary pattern was a protective factor for overweight, obesity, overweight/obesity, and central obesity. Tailored interventions are needed to improve local people's health.

Objective: To assess the association of single nucleotide polymorphisms (SNPs) in SLCO1B3 gene with prognosis of breast cancer (BC) patients treated with neoadjuvant chemotherapy of TA regimen (taxane and antharcycline drugs). Methods: 439 female BC patients were recruited and treated with neoadjuvant chemotherapy of TA regimen. A blood sample (2 ml) of peripheral blood was collected from each patient before chemotherapy. Tagging SNPs (tag-SNPs) were selected. We investigated the association of tag-SNPs with prognosis, by Sequenom Mass ARRAY system platform, characterizing tag-SNPs. The hazard ratio (HR) and 95% confidence interval (CI) for progression or death were calculated by multivariable-adjusted Cox regression model. Results: Seven tag-SNPs (rs11045689, rs200104106, rs3764006, rs3834935, rs4149117, rs7305323 and rs73241801) were selected for study. Compared with individuals carrying the rs11045689 GG genotype, individuals carrying rs11045689 AA genotype performed worse PFS and OS, with the HR (95% CI) for progression being 1.39 (1.11~1.75) and the HR (95% CI) for death being 1.38 (1.04~1.83). Compared with individuals carrying the rs73241801 CC genotype, individuals carrying rs73241801 TT genotype performed better OS (P=0.041), with the HR (95% CI) for death being 0.65 (0.44~0.94). The number of risk allele was significantly associated with PFS (P=0.012) and OS (P=0.017) of BC patients by accumulation analysis. Compared with individuals carrying one or less than one risk allele, individuals carrying four risk alleles performed worse PFS and OS, with the HR (95% CI) for progression being 1.37 (1.09~1.72) and the HR (95% CI) for death being 1.36 (1.02~1.81). Conclusion The variations of rs11045689 and rs73241801 in SLCO1B3 gene were significantly associated with prognosis of BC patients treated with neoadjuvant chemotherapy of TA regimen, which might serve as biomarkers for predicting prognosis of BC patients treated with neoadjuvant chemotherapy.

Objective To assess the association of single nucleotide polymorphisms ( SNPs) in SLCO1B3 gene with prognosis of breast cancer (BC) patients treated with neoadjuvant chemotherapy of TA regimen (taxane and antharcycline drugs). Methods 439 female BC patients were recruited and treated with neoadjuvant chemotherapy of TA regimen.A blood sample (2 ml) of peripheral blood was collected from each patient before chemotherapy. Tagging SNPs (tag?SNPs) were selected. We investigated the association of tag?SNPs with prognosis, by Sequenom Mass ARRAY system platform, characterizing tag?SNPs. The hazard ratio ( HR ) and 95% confidence interval ( CI ) for progression or death were calculated by multivariable?adjusted Cox regression model. Results Seven tag?SNPs ( rs11045689, rs200104106, rs3764006, rs3834935, rs4149117, rs7305323 and rs73241801) were selected for study. Compared with individuals carrying the rs11045689 GG genotype, individuals carrying rs11045689 AA genotype performed worse PFS and OS, with the HR (95% CI) for progression being 1.39 (1.11～1.75) and the HR (95% CI) for death being 1.38 ( 1.04～1.83). Compared with individuals carrying the rs73241801 CC genotype, individuals carrying rs73241801 TT genotype performed better OS (P＝0.041), with the HR (95% CI) for death being 0.65 (0.44～0.94). The number of risk allele was significantly associated with PFS (P＝0.012) and OS (P＝0.017) of BC patients by accumulation analysis. Compared with individuals carrying one or less than one risk allele, individuals carrying four risk alleles performed worse PFS and OS, with the HR (95%CI) for progression being 1.37 (1.09～1.72) and the HR ( 95% CI) for death being 1.36 (1.02～1.81). Conclusion The variations of rs11045689 and rs73241801 in SLCO1B3 gene were significantly associated with prognosis of BC patients treated with neoadjuvant chemotherapy of TA regimen, which might serve as biomarkers for predicting prognosis of BC patients treated with neoadjuvant chemotherapy.

Objective To assess the association of single nucleotide polymorphisms ( SNPs) in SLCO1B3 gene with prognosis of breast cancer (BC) patients treated with neoadjuvant chemotherapy of TA regimen (taxane and antharcycline drugs). Methods 439 female BC patients were recruited and treated with neoadjuvant chemotherapy of TA regimen.A blood sample (2 ml) of peripheral blood was collected from each patient before chemotherapy. Tagging SNPs (tag?SNPs) were selected. We investigated the association of tag?SNPs with prognosis, by Sequenom Mass ARRAY system platform, characterizing tag?SNPs. The hazard ratio ( HR ) and 95% confidence interval ( CI ) for progression or death were calculated by multivariable?adjusted Cox regression model. Results Seven tag?SNPs ( rs11045689, rs200104106, rs3764006, rs3834935, rs4149117, rs7305323 and rs73241801) were selected for study. Compared with individuals carrying the rs11045689 GG genotype, individuals carrying rs11045689 AA genotype performed worse PFS and OS, with the HR (95% CI) for progression being 1.39 (1.11～1.75) and the HR (95% CI) for death being 1.38 ( 1.04～1.83). Compared with individuals carrying the rs73241801 CC genotype, individuals carrying rs73241801 TT genotype performed better OS (P＝0.041), with the HR (95% CI) for death being 0.65 (0.44～0.94). The number of risk allele was significantly associated with PFS (P＝0.012) and OS (P＝0.017) of BC patients by accumulation analysis. Compared with individuals carrying one or less than one risk allele, individuals carrying four risk alleles performed worse PFS and OS, with the HR (95%CI) for progression being 1.37 (1.09～1.72) and the HR ( 95% CI) for death being 1.36 (1.02～1.81). Conclusion The variations of rs11045689 and rs73241801 in SLCO1B3 gene were significantly associated with prognosis of BC patients treated with neoadjuvant chemotherapy of TA regimen, which might serve as biomarkers for predicting prognosis of BC patients treated with neoadjuvant chemotherapy.

Objective To investigate the effect of covered stent on the treatment of Stanford type B aortic dissection and its effect on cardiopulmonary function. Methods From June 2014 to December 2015, sixty-four AD patients treated in our hospital were selected and were divided into the control group(30 cases) and the observation group ( 32 cases) . The control group was treated with conservative treatment while the observation group was treated with covered stent. After treatment,two groups of patients were followed up for at least 24 months to understand the recovery status after treatment and evaluate the effect. . Results The time of hospitalization of the observation group ((26. 10±8. 14) d) was shorter than that of the control group ((33. 89 ±8. 32) d) (t＝4. 963,P＜0. 05),and there was no statistically significant difference in the mortality and complication rate in 30d after operation between the two groups (χ2＝1. 084,0. 015,P＞0. 05); at 24 months after discharge,the survival rate (93. 75%(30/32)),standard rate of blood pressure 93. 75 (30/32) and treatment compliance rate(90. 63 (29/32)) of the observation group were higher than those of the control group (53.33%(16/30); 60.00(18/32);73.33(22/30)) (χ2 ＝ 13.210、10.088、4.771,P＜0.05) . After treatment,the cardiac output((4. 99±0. 53) L/min) and left ventricular ejection fraction((51. 88±3. 64)%) of the observation group were higher than those of the control group((4. 13±0. 13) L/min,(46. 30 ±9. 63)%). The end systolic diameter of left ventricle (( 55. 75 ± 2. 11) mm) and left ventricular end diastolic diameter ((57. 80± 3. 53) mm) of the observation group were less than those of the control group (( 65. 77 ± 2. 21), (64. 54±2. 67) mm). The differences between the two groups were statistically significant(t＝8. 643、3. 054、8. 436、18. 263,P＜0. 05). Conclusion Covered stent is safe and effective in the treatment of Stanford type B aortic dissection.

Objective To demonstrate the imaging characteristics of pancreatic neuroendocrine neoplasm (P-NEN).Methods The CT and MRI findings of 43 cases of P-NEN confirmed by pathology were analyzed,and compared with pathological results.Results Mean size of 43 lesions in 43 P-NEN patients were (25.00± 1.82)mm.Necrosis cystic degeneration were found in 26 lesions.In CT plain scan,15 lesions were isodense,28 lesions were hypodense.All of 43 lesions were hypointensity signal on T1WI;27 lesions were hypointensity signal,16 cases were isointensity signal on T2WI.Twenty-seven lesions showed envelope;30 lesions showed clear outline.In enhancement images,24 lesions were marked enhancement since arterial phase;8 lesions showed delayed enhancement;5 lesions showed centrality enhancement;6 lesions showed wild enhancement.Conclusion P-NEN has some characteristics on CT and MRI scanning,imaging can play an important role in diagnosis for P-NEN.

Objective·To study the hemodynamic parameters of uterine at midluteal phase in patients with early recurrent spontaneous abortion (ERSA) and the effect of aspirin on them. Methods·Transvaginal color Doppler ultrasonography was used to measure the parameters of uterine blood flow and the endometrial thickness at midluteal phase of 271 women with ERSA (ERSA group) and 66 women without a history of recurrent spontaneous abortion (control group). Then ERSA group were administered with aspirin 50 mg/d orally for 2 months and other individualized treatment, and the effect of aspirin on parameters of uterine blood flow and the early pregnancy outcome of them were observed. Results·At midluteal phase, the endometrium was significantly thinner in ERSA group than that in control group. Pulsatility index (PI) of endometrial blood flow and mean PI (mPI), mean resistance index (mRI), and mean systolic/diastolic ratio value (mS/D) of uterine arteries were statistically significantly higher in ERSA group in comparison to control group (P<0.05). Following aspirin treatment, resistance to uterine blood flow reduced significantly in ERSA group (P=0.000), and the endometrial thickness increased in the patients with endometrial thickness less than 7 mm (P=0.000). Only 163 ERSA patients were re-examined by transvaginal color Doppler ultrasonography after aspirin treatment, among whom 136 women was pregnant after individualized treatment. Among these pregnant patients, 97 cases were pregnant for more than or equal to 12 weeks, while 10 cases aborted during the first 12 weeks, and the early pregnancy outcomes of the other 29 cases were still unclear. Conclusion·In comparison with normal fertile women, ERSA patients have significantly higher resistance to uterine blood flow and thinner endometrium. Aspirin can improve uterine blood perfusion, which improves early pregnancy outcome.

Objective · To investigate the status of depression and anxiety in patients with recurrent spontaneous abortion (RSA) and the possible influence factors and to provide theoretical support for further psychological intervention. Methods · RSA patients and women with no history of RSA were invited to complete a questionnaire, including basic information, Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS). All data were analyzed by SPSS. Results · Of all 1064 cases included in this study, 725 were RSA cases, 217 cases with one spontaneous abortion and 122 in control group with no history of spontaneous abortion. Our results showed that both RSA patients and patients with one spontaneous abortion have significantly higher SDS and SAS scores than control group. Furthermore, non-pregnant RSA patients with lower education level, lower household income and 3-5 years of marriage have significantly higher levels of depression and anxiety. Patients with multiple miscarriages (≥4), history of induced abortion and no live birth, score significantly higher in SDS. Conclusion · Whether pregnant or not, RSA patients are much easier to become depressive and anxious, which may be associated with education level, household income, length of marriage, numbers of pregnancy losses and previous live birth. Women with one spontaneous abortion also show a significant higher tendency of depression and anxiety. These patients should be given proper psychological intervention if necessary.

OBJECTIVETo explore the inhibition effect and mechanism of N-acetyl-seryl-aspartyl-lysyl-proline (Ac-SDKP)on myofibroblast differentiation via regulating acetylated tubulin α (Ac-Tub α)in vivo and in vitro.

METHODSSilicotic model were made by SiO2 douched and divided into 6 groups as follows: control (4w, 8w)group, silicotic model (4w, 8w)group and post-or pre-treatment by Ac-SDKP group. Pulmonary fibroblasts were divided into 5 groups: (1) control; (2) Ang II; (3) Ang II+Ac-SDKP; (4) Ang II+Valsartan; (5) Ang II+TCS histone deacetylase (HDAC)6 20b. The localization of Ac-Tub α and α-smooth muscle actin (SMA) were observed by immunohistochemical (IHC) and immunofluorescence staining. The protein levels of Ac-Tub α, α-SMA, collagen type I (col I) and HDAC6 were measured by western blot.

RESULTSIn silicotic nodules and interstitial fibrosis area, positive expression of α-SMA, a classical marker of myofibroblast, was ob-served by IHC, accompanied with absence expression of Ac-Tub α. Furthermore, Ac-SDKP post-treatment could attenuate the levels of col I, α-SMA and HDAC6 to 48.39%, 52.63% and 70.18% compared with the silicotic 8w group respectively. And in Ac-SDKP pre-treatment group, compared with the silicotic 8w group, these protein levels were decreased to 32.26%, 64.91% and 54.39% respectively (P<0.05). The up-regulation of Ac-Tub α was found in Ac-SDKP post-and pre-treatment and increased to 3.00 and 2.90 folds compared with the silicotic 8w group. Compared with control group, the levels of α-SMA, HDAC6 and col I in Ang II group were up-regulated to 1.66, 3.56 and 4.00 folds accompanied with down-regulation of Ac-Tub by 44.44% (P<0.05). Pre-treatment with Valsartan, TCS HDAC6 20b or Ac-SDKP could inhibited all this changes induced by Ang II in vitro.

CONCLUSIONAc-SDKP can inhibit the myofibroblast differentiation and collagen deposition via sup-press HDAC6 and up-regulate the expression of Ac-Tub α in vivo and in vitro.

Actins ; metabolism ; Animals ; Cell Differentiation ; drug effects ; Collagen Type I ; metabolism ; Disease Models, Animal ; Fibroblasts ; cytology ; Lung ; pathology ; Myofibroblasts ; cytology ; drug effects ; Oligopeptides ; pharmacology ; Rats ; Silicon Dioxide ; toxicity ; Silicosis ; drug therapy ; Tubulin ; metabolism