1.Analysis on the Management Policies of the Second Catalog of Key Monitoring and Rational Use Drug
Wenxi HE ; Dong LIU ; Airong YU ; Linlin ZHAO
Herald of Medicine 2024;43(7):1170-1176
Objective To evaluate the second catalog of the key monitoring and rational use drugs(KMRUD),and to provide a reference framework for medical institutions to develop their own KMRUD catalogs and management policies.Methods A comprehensive search on official websites of national and provincial health administrative departments was conducted using the keywords"key monitoring","rational drug use",and"the second catalog".Announced catalogs and related policy documents pertaining to KMRUD use were collected and systematically organized.Comparative analyses were performed between the national KMRUD catalogs of the first and second batches,as well as between the second batch of provincial KMRUD catalogs and the national standard.Additionally,the adoption and variation of national KMRUD drug management policies across provinces,as well as the uniformity and divergence of provincial KMRUD management policies,were examined.Results The second national KMRUD catalog maintained 7 drug varieties from the first batch,eliminated 13,and introduced 23 new varieties.Of the 24 surveyed provinces,9 modified their provincial catalogs relative to the national second batch KMRUD catalog,resulting in alterations to 66 drug varieties within 10 Anatomical Therapeutic Chemical(ATC)classes,primarily systemic anti-infectives.Several provinces,including Xinjiang,Inner Mongolia,Liaoning,Shanghai,and Qinghai,implemented additional management measures such as the establishment of clinical application guidelines and the clarification of application conditions and principles.Moreover,provinces like Inner Mongolia,Shandong,Jilin,and Heilongjiang expanded their KMRUD management toolbox by developing drug monitoring indicators.The revision of inclusion rules from the first to the second KMRUD catalog has led to the incorporation of numerous essential clinical drugs.The prior protocol of medical institutions excluding drugs unilaterally is no longer viable,as it may disrupt the standard medication supply,potentially raising treatment costs.Conclusion Medical institutions ought to assimilate the updated implications of KMRUD use,draw on established provincial monitoring and management methodologies,enhance clinical application guidelines,and articulate conditions and principles for clinical use.Furthermore,by employing prescription review mechanisms,in-hospital monitoring,evaluation,and advanced warning systems,medical institutions can strategically oversee KMRUD use.
2.Arterial stiffness in subclinical atherosclerosis quantified with ultrafast pulse wave velocity measurements: a comparison with a healthy population using propensity score matching
Xuezhong JIANG ; Weiming GE ; Hui HUANG ; Yating LI ; Xiaojing LIU ; Huiyan PANG ; Rui HE ; Hui WANG ; Zhengqiu ZHU ; Ping HE ; Yinping WANG ; Xuehui MA ; Airong REN ; Bixiao SHEN ; Meijuan WANG
Ultrasonography 2024;43(4):263-271
Purpose:
This study aimed to evaluate changes in ultrafast pulse wave velocity (ufPWV) in individuals with arterial stiffness and subclinical atherosclerosis (subAS), and to provide cutoff values.
Methods:
This retrospective study recruited 231 participants, including 67 patients with subAS. The pulse wave velocity was measured at the beginning and end of systole (PWV-BS and PWVES, respectively) using ultrafast ultrasonography to assess arterial stiffness. The right and left common carotid arteries were measured separately, and laboratory metabolic parameters were also collected. Participants were balanced between groups using propensity score matching (PSM) at a 1:1 ratio, adjusting for age, sex, and waist-to-hip ratio as potential confounders. Cutoff values of ufPWV for monitoring subAS were determined via receiver operating characteristic (ROC) curve analysis.
Results:
PWV-ES, unlike PWV-BS, was higher in the subAS subgroup than in the subAS-free group after PSM (all P<0.05). For each 1 m/s increase in left, right, and bilateral mean PWV-ES, the risk of subAS increased by 23% (95% confidence interval [CI], 1.04 to 1.46), 26% (95% CI, 1.07 to 1.52), and 38% (95% CI, 1.12 to 1.72), respectively. According to ROC analyses, predictive potential was found for left PWV-ES (cutoff value=7.910 m/s, P=0.002), right PWV-ES (cutoff value=6.615 m/s, P=0.003), and bilateral mean PWV-ES (cutoff value=7.415 m/s, P<0.001), but not for PWV-BS (all P>0.05).
Conclusion
PWV-ES measured using ultrafast ultrasonography was significantly higher in individuals with subAS than in those without. Specific PWV-ES cutoff values showed potential for predicting an increased risk of subAS.
3.Arterial stiffness in subclinical atherosclerosis quantified with ultrafast pulse wave velocity measurements: a comparison with a healthy population using propensity score matching
Xuezhong JIANG ; Weiming GE ; Hui HUANG ; Yating LI ; Xiaojing LIU ; Huiyan PANG ; Rui HE ; Hui WANG ; Zhengqiu ZHU ; Ping HE ; Yinping WANG ; Xuehui MA ; Airong REN ; Bixiao SHEN ; Meijuan WANG
Ultrasonography 2024;43(4):263-271
Purpose:
This study aimed to evaluate changes in ultrafast pulse wave velocity (ufPWV) in individuals with arterial stiffness and subclinical atherosclerosis (subAS), and to provide cutoff values.
Methods:
This retrospective study recruited 231 participants, including 67 patients with subAS. The pulse wave velocity was measured at the beginning and end of systole (PWV-BS and PWVES, respectively) using ultrafast ultrasonography to assess arterial stiffness. The right and left common carotid arteries were measured separately, and laboratory metabolic parameters were also collected. Participants were balanced between groups using propensity score matching (PSM) at a 1:1 ratio, adjusting for age, sex, and waist-to-hip ratio as potential confounders. Cutoff values of ufPWV for monitoring subAS were determined via receiver operating characteristic (ROC) curve analysis.
Results:
PWV-ES, unlike PWV-BS, was higher in the subAS subgroup than in the subAS-free group after PSM (all P<0.05). For each 1 m/s increase in left, right, and bilateral mean PWV-ES, the risk of subAS increased by 23% (95% confidence interval [CI], 1.04 to 1.46), 26% (95% CI, 1.07 to 1.52), and 38% (95% CI, 1.12 to 1.72), respectively. According to ROC analyses, predictive potential was found for left PWV-ES (cutoff value=7.910 m/s, P=0.002), right PWV-ES (cutoff value=6.615 m/s, P=0.003), and bilateral mean PWV-ES (cutoff value=7.415 m/s, P<0.001), but not for PWV-BS (all P>0.05).
Conclusion
PWV-ES measured using ultrafast ultrasonography was significantly higher in individuals with subAS than in those without. Specific PWV-ES cutoff values showed potential for predicting an increased risk of subAS.
4.Arterial stiffness in subclinical atherosclerosis quantified with ultrafast pulse wave velocity measurements: a comparison with a healthy population using propensity score matching
Xuezhong JIANG ; Weiming GE ; Hui HUANG ; Yating LI ; Xiaojing LIU ; Huiyan PANG ; Rui HE ; Hui WANG ; Zhengqiu ZHU ; Ping HE ; Yinping WANG ; Xuehui MA ; Airong REN ; Bixiao SHEN ; Meijuan WANG
Ultrasonography 2024;43(4):263-271
Purpose:
This study aimed to evaluate changes in ultrafast pulse wave velocity (ufPWV) in individuals with arterial stiffness and subclinical atherosclerosis (subAS), and to provide cutoff values.
Methods:
This retrospective study recruited 231 participants, including 67 patients with subAS. The pulse wave velocity was measured at the beginning and end of systole (PWV-BS and PWVES, respectively) using ultrafast ultrasonography to assess arterial stiffness. The right and left common carotid arteries were measured separately, and laboratory metabolic parameters were also collected. Participants were balanced between groups using propensity score matching (PSM) at a 1:1 ratio, adjusting for age, sex, and waist-to-hip ratio as potential confounders. Cutoff values of ufPWV for monitoring subAS were determined via receiver operating characteristic (ROC) curve analysis.
Results:
PWV-ES, unlike PWV-BS, was higher in the subAS subgroup than in the subAS-free group after PSM (all P<0.05). For each 1 m/s increase in left, right, and bilateral mean PWV-ES, the risk of subAS increased by 23% (95% confidence interval [CI], 1.04 to 1.46), 26% (95% CI, 1.07 to 1.52), and 38% (95% CI, 1.12 to 1.72), respectively. According to ROC analyses, predictive potential was found for left PWV-ES (cutoff value=7.910 m/s, P=0.002), right PWV-ES (cutoff value=6.615 m/s, P=0.003), and bilateral mean PWV-ES (cutoff value=7.415 m/s, P<0.001), but not for PWV-BS (all P>0.05).
Conclusion
PWV-ES measured using ultrafast ultrasonography was significantly higher in individuals with subAS than in those without. Specific PWV-ES cutoff values showed potential for predicting an increased risk of subAS.
5.Arterial stiffness in subclinical atherosclerosis quantified with ultrafast pulse wave velocity measurements: a comparison with a healthy population using propensity score matching
Xuezhong JIANG ; Weiming GE ; Hui HUANG ; Yating LI ; Xiaojing LIU ; Huiyan PANG ; Rui HE ; Hui WANG ; Zhengqiu ZHU ; Ping HE ; Yinping WANG ; Xuehui MA ; Airong REN ; Bixiao SHEN ; Meijuan WANG
Ultrasonography 2024;43(4):263-271
Purpose:
This study aimed to evaluate changes in ultrafast pulse wave velocity (ufPWV) in individuals with arterial stiffness and subclinical atherosclerosis (subAS), and to provide cutoff values.
Methods:
This retrospective study recruited 231 participants, including 67 patients with subAS. The pulse wave velocity was measured at the beginning and end of systole (PWV-BS and PWVES, respectively) using ultrafast ultrasonography to assess arterial stiffness. The right and left common carotid arteries were measured separately, and laboratory metabolic parameters were also collected. Participants were balanced between groups using propensity score matching (PSM) at a 1:1 ratio, adjusting for age, sex, and waist-to-hip ratio as potential confounders. Cutoff values of ufPWV for monitoring subAS were determined via receiver operating characteristic (ROC) curve analysis.
Results:
PWV-ES, unlike PWV-BS, was higher in the subAS subgroup than in the subAS-free group after PSM (all P<0.05). For each 1 m/s increase in left, right, and bilateral mean PWV-ES, the risk of subAS increased by 23% (95% confidence interval [CI], 1.04 to 1.46), 26% (95% CI, 1.07 to 1.52), and 38% (95% CI, 1.12 to 1.72), respectively. According to ROC analyses, predictive potential was found for left PWV-ES (cutoff value=7.910 m/s, P=0.002), right PWV-ES (cutoff value=6.615 m/s, P=0.003), and bilateral mean PWV-ES (cutoff value=7.415 m/s, P<0.001), but not for PWV-BS (all P>0.05).
Conclusion
PWV-ES measured using ultrafast ultrasonography was significantly higher in individuals with subAS than in those without. Specific PWV-ES cutoff values showed potential for predicting an increased risk of subAS.
6.Arterial stiffness in subclinical atherosclerosis quantified with ultrafast pulse wave velocity measurements: a comparison with a healthy population using propensity score matching
Xuezhong JIANG ; Weiming GE ; Hui HUANG ; Yating LI ; Xiaojing LIU ; Huiyan PANG ; Rui HE ; Hui WANG ; Zhengqiu ZHU ; Ping HE ; Yinping WANG ; Xuehui MA ; Airong REN ; Bixiao SHEN ; Meijuan WANG
Ultrasonography 2024;43(4):263-271
Purpose:
This study aimed to evaluate changes in ultrafast pulse wave velocity (ufPWV) in individuals with arterial stiffness and subclinical atherosclerosis (subAS), and to provide cutoff values.
Methods:
This retrospective study recruited 231 participants, including 67 patients with subAS. The pulse wave velocity was measured at the beginning and end of systole (PWV-BS and PWVES, respectively) using ultrafast ultrasonography to assess arterial stiffness. The right and left common carotid arteries were measured separately, and laboratory metabolic parameters were also collected. Participants were balanced between groups using propensity score matching (PSM) at a 1:1 ratio, adjusting for age, sex, and waist-to-hip ratio as potential confounders. Cutoff values of ufPWV for monitoring subAS were determined via receiver operating characteristic (ROC) curve analysis.
Results:
PWV-ES, unlike PWV-BS, was higher in the subAS subgroup than in the subAS-free group after PSM (all P<0.05). For each 1 m/s increase in left, right, and bilateral mean PWV-ES, the risk of subAS increased by 23% (95% confidence interval [CI], 1.04 to 1.46), 26% (95% CI, 1.07 to 1.52), and 38% (95% CI, 1.12 to 1.72), respectively. According to ROC analyses, predictive potential was found for left PWV-ES (cutoff value=7.910 m/s, P=0.002), right PWV-ES (cutoff value=6.615 m/s, P=0.003), and bilateral mean PWV-ES (cutoff value=7.415 m/s, P<0.001), but not for PWV-BS (all P>0.05).
Conclusion
PWV-ES measured using ultrafast ultrasonography was significantly higher in individuals with subAS than in those without. Specific PWV-ES cutoff values showed potential for predicting an increased risk of subAS.
7.Establishment of a new diagnostic model for significant liver tissue damage in patients with chronic hepatitis B virus infection in the immune tolerance phase
Donghui WANG ; Suwen JIANG ; Airong HU ; Xiaojun SHI ; Dedong ZHU ; Zheyun HE ; Chenqian ZHU ; Lukan ZHANG
Chinese Journal of Infectious Diseases 2022;40(5):275-280
Objective:To establish and evaluate a new diagnostic model for significant liver tissue damage in patients with chronic hepatitis B virus (HBV) infection in the immune tolerance phase.Methods:The clinical data of 275 chronic HBV infection patients in the immune tolerance phase who underwent liver biopsy from January 2015 to November 2020 in the Hwa Mei Hospital, University of Chinese Academy of Sciences were included. According to the liver pathological changes, patients were divided into
8.Liver histopathological changes in chronic HBV infection patients with alanine aminotransferase at different upper limits of normal value
Wangyi XUAN ; Suwen JIANG ; Airong HU ; Xiaojun SHI ; Dedong ZHU ; Zheyun HE ; Lukan ZHANG
Chinese Journal of Clinical Infectious Diseases 2022;15(3):193-199
Objective:To investigate the pathological characteristics in chronic HBV infection patients with different upper limits of alanine aminotransferase (ALT) normal values and the influencing factors of liver tissue injury.Methods:The clinical data of 667 chronic HBV infection patients with ALT<40 U/L and HBV DNA loads >30 IU/mL who received liver biopsy in Zhenhai District Hospital of Traditional Chinese Medicine and Hwa Mei Hospital from January 2014 to December 2020 were retrospectively analyzed. The enrolled patients were divided into ALTⅠ group (<30 U/L for males, <19 U/L for females), ALTⅡ group (≥30 U/L and <35 U/L for males, ≥19 U/L and <25 U/L for females) and ALT Ⅲ group (≥35 U/L and <40 U/L for males, ≥25 U/L and <40 U/L for females). According to the degree of liver inflammation (G) and fibrosis stage (S), the enrolled patients were divided into non-significant damage group (G<2 and S<2) and significant damage group (≥G2 or/and ≥S2). Ridit analysis was used to compare the G/S composition ratio among three ALT groups, Logistic regression was used to analyze the risk factors of liver injury, the receiver operating characteristic curve (ROC) and the area under the curve (AUC) were used to analyze the optimal diagnostic threshold of ALT.Results:There were significant differences in the composition ratio of G and S among the three ALT groups( χ2=13.926 and 14.702, both P<0.001). The constituent ratios of significant liver pathological damage in the three groups of ALT levels were 26.05% (99/380), 32.03% (41/128) and 46.54% (74/159), respectively( χ2=21.596, P<0.001). Multivariate logistic regression analysis showed that high white/globulin ratio and PLT counts( OR=0.246 and 0.986, both P<0.001)were the protective factors for liver tissue injury; while negative HBcAg staining and elevated ALT and GGT levels ( OR=3.797, 1.053 and 1.013, P<0.001 or <0.05) were the risk factors of liver injury. ROC curve demonstrated the ALT threshold of liver tissue damage in male and female patients were 25.6 U/L and 25.5 U/L. Conclusions:In chronic HBV infection patients with normal ALT, with the increase of ALT level, the degree of liver tissue pathological damage may become more severe. The study demonstrates that it is necessary to lower the ALT threshold for protecting patients from liver tissue pathological damage.
9. Effects of ABT-737 on the growth and angiogenesis of ovarian cancer cells in the co-culture of TAMs and SKOV3 cells
Yao YAO ; Min XIA ; Cong HOU ; Airong HE
Chinese Journal of Clinical Pharmacology and Therapeutics 2022;27(2):144-153
AIM: To explore the effect of Bcl-2 small molecule inhibitor ABT-737 on the growth and angiogenesis mimicry of SKOV3 cells in a co-culture system of Tumour-associated macrophages (TAMs) and human ovarian cancer cells SKOV3. METHODS: PMA and IL-4 was used to induce THP-1 cells into TAMs cells in vitro; MTT method was used to detect the cell survival rate of SKOV3 cells after 24 hours of treatment with different concentrations of ABT-737 culture medium; a co-culture system of SKOV3 cells and TAMs cells was established; the experimental groups were divided into control group, SKOV3+ABT-737 group (containing 5.0 μmol/L ABT-737 cultured cells), TAMs+SKOV3 group (SKOV3 cells co-cultured with TAMs cells), TAMs+SKOV3+ABT-737 group (SKOV3 cells Co-cultured with TAMs cells, and added ABT-737 containing 5.0 μmol/L), cells after 24 h was collected, MTT method was used to detect cell survival rate, EdU staining for cell proliferation, ranswell chamber experiment for cell migration and invasion, Flowcytometry for cell apoptosis, the vascular mimicry experiment for the ability of cells to form blood vessels, Western blot for the expression of vascular endothelial growth factor (VEGF), matrix metalloproteinase-2 (MMP-2) and MMP-9 in cells. RESULTS: THP-1 cells were successfully induced for TAMs cells; the survival rate of SKOV3 cells decreased under the action of ABT-737 (P<0.01); compared with the control group, the survival rate of SKOV3 cells in the SKOV3+ABT-737 group decreased, the number of EdU-labeled positive cells decreased, the number of cell migration and invasion also decreased, the rate of apoptosis increased, and the duct branches decreased, The protein expression of VEGF, MMP-2, MMP-9 decreased (P<0.01); Compared with the TAMs+SKOV3 group, the cell survival rate of the TAMs+SKOV3+ABT-737 group decreased, the number of EdU-labeled positive cells and the number of cell migration and invasion also decreased, the apoptosis rate increased, and the duct branches decreased. At the same time, the protein expression of VEGF, MMP-2, MMP-9 decreased (P<0.01). CONCLUSION: ABT-737 can inhibit SKOV3 cell proliferation, metastasis, apoptosis and angiogenesis in a co-culture system, and affect tumor progression.
10.Comparison of clinicopathological features for indications of different types of antiviral therapy in chronic hepatitis B
Suwen JIANG ; Airong HU ; Xiaojun SHI ; Dedong ZHU ; Zheyun HE ; Chenqian ZHU ; Lukan ZHANG
Chinese Journal of Hepatology 2022;30(10):1050-1055
Objective:To compare and analyze the clinicopathological features and significance for indications of different types of antiviral therapy in chronic hepatitis B (CHB).Methods:Clinical data of 861 CHB cases who received liver biopsy, had hepatitis B virus (HBV) DNA-positive (> 30 IU/ml) and met the indications for antiviral therapy from January 2014 to December 2019 were included. Liver pathological changes and their correlation with clinical characteristics were compared and analyzed. According to different data, t-test, analysis of variance, nonparametric test, χ2 test, Ridit and logistic regression analysis were used for statistical analysis. Results:Most of the cases (72.24%) had remarkable pathological damage. The degree of liver fibrosis was higher in the normal than the abnormal group ( P<0.001). 17.54% cases had hepatic steatosis. The vast majority of cases (97.33%) had positive hepatitis B surface antigen (HBsAg), while only 50.87% had positive hepatitis B core antigen (HBcAg). The positive correlation factors affecting the severity of liver histopathology were alkaline phosphatase level, while the negative correlation factors were positive HBcAg staining, albumin and platelet level. The degree of liver inflammation and fibrosis had statistically significant differences with different HBcAg staining levels ( χ2=44.142 and 102.386, respectively; P<0.001), and the severity was more apparent in the negative group. Conclusion:There exist differences in clinicopathological features for indications of different types of antiviral therapy in patients with CHB. Liver function test range is inconsistent with degrees of hepatic histological severity. The positive and intensity of liver tissue HBcAg staining, and albumin and alanine aminotransferase levels have negative correlation with disease severity.

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