OBJECTIVE To evaluate the cost-effectiveness of apatinib combined with adriamycin in the second-line chemotherapy of platinum-resistant recurrent ovarian cancer （OC） from the perspective of the health system in China. METHODS A three-state partitioned survival model was constructed based on the APPROVE clinical trial and related literature data， with a model simulation time frame of 10 years and a 4-week cycle， and both cost and utility values were discounted using a 5% discount rate. Cost and quality-adjusted life years （QALYs） were used as a model output indicator and the incremental cost-effectiveness ratio （ICER） was calculated to evaluate the cost-effectiveness of apatinib combined with adriamycin versus adriamycin chemotherapy in the second-line treatment of platinum-resistant recurrent OC. One-way sensitivity analysis， probability sensitivity analysis and scenario analysis were used to verify the robustness of the base-case analysis results. RESULTS The results of base-case analysis indicated that compared with chemotherapy alone， ICER of patients receiving apatinib combined with adriamycin was 124 678.25 yuan/QALY， which was less than willingness-to-pay （WTP） threshold set in this study [3 times per capita gross domestic product （GDP） of China in 2022 （257 094 yuan）]. The results of scenario analysis showed that， with the extension of the simulation time limit， the ICER of apatinib combined with adriamycin was gradually reduced， and the decline was gradually reduced， but both were less than WTP threshold. The results of single factor sensitivity analysis showed that the factors that had the greatest impact on ICER were the utility value of progression， body surface area， discount rate，and the cost of best supportive treatment， etc. The results of probability sensitivity analysis showed that under WTP threshold set in this study， the economic probability of apatinib combined with adriamycin was about 99%. CONCLUSIONS From the perspective of China’s health system， using three times the per capita GDP in 2022 as the WTP threshold， the combination of apatinib and adriamycin is more cost-effective than adriamycin alone in second-line chemotherapy for platinum-resistant recurrent OC.

To retrieve, evaluate, and integrate evidence related to the operational procedures of ambulatory blood pressure monitoring (ABPM) in adults, aiming to enhance the accuracy and effectiveness of ambulatory blood pressure monitoring.

Objective:To investigate the effect of astragaloside Ⅳ on the apoptosis of thyroid cells in Hashimoto's thyroiditis(HT)rats and Ras homolog gene family member A(RhoA)/Rho-associated coiled-coil containing kinase 2(ROCK2)pathway.Methods:The HT rat model was induced by subcutaneous injection of thyroglobulin combined with high iodine drinking water and randomly divided into model group,astragaloside(80 mg/kg)group,Rhosin(RhoA inhibitor,40 mg/kg)group,astragaloside Ⅳ(80 mg/kg)+ Rhosin(40 mg/kg)group(12 rats in each group),another 12 SD rats were selected and drank water normally and injected the same dose of saline subcutaneously as control group.After the drugs were grouped and processed,the serum anti-thyroglobulin antibody(TGAb),anti-thyroid peroxidase antibody(TPOAb)levels and the inflammatory factors IL-6,IL-17,IL-1β contents were measured by ELISA kits;the pathological changes of thyroid tissue in each group were detected by hematoxylin-eosin(HE)staining;the apopto-sis rate of rat thyroid cells in each group were detected by TUNEL staining;the expressions of RhoA/ROCK2 pathway proteins in thy-roid tissues of rats in each group were detected by Western blot.Results:Compared with the control group,the thyroid follicles in the model group had abnormal structure,some atrophy or disappearance,disordered arrangement,surrounding inflammatory cell infiltra-tion,and obvious pathological damage to the thyroid tissue,the serum TGAb,TPOAb,IL-6,IL-17 and IL-1β levels,thyroid cell apoptosis rate,and thyroid tissue RhoA and ROCK2 protein expression levels were significantly increased(P<0.05);compared with model group,the pathological damage of the thyroid tissue of rats in the drug intervention group were reduced,the serum TGAb,TPOAb,IL-6,IL-17 and IL-1β levels,thyroid cell apoptosis rate,and thyroid tissue RhoA and ROCK2 protein expression levels were decreased(P<0.05);compared with astragaloside Ⅳ group and the Rhosin group respectively,the pathological damage of the thyroid tissue of rats in the astragaloside Ⅳ+Rhosin group were further reduced,the serum TGAb,TPOAb,IL-6,IL-17 and IL-1β levels,thyroid cell apoptosis rate,thyroid tissue RhoA and ROCK2 protein expression levels were decreased(P<0.05).Conclusion:Astragaloside Ⅳ may down-regulate the expression of RhoA/ROCK2 pathway to reduce the inflammatory injury of thyroid tissue,inhib-it thyroid cell apoptosis,and improve the symptoms of HT in rats.

Objective To explore the predictive efficacy of three machine learning algorithms for carotid plaque stability in patients with cerebral infarction.Methods The clinical data of 500 pa-tients with cerebral infarction were retrospectively analyzed.Univariate analysis and multivariate anal-ysis were used to determine the predictive factors entering the model.The prediction model of carotid plaque stability in patients with cerebral infarction was constructed based on nomogram,decision tree and random forest respectively.The enrolled patients were randomly divided into training set and test set according to the ratio of 7∶3.Sensitivity,specificity,accuracy,recall,accuracy and area under the curve(AUC)were used to compare the application efficiency of the model.Results The AUC of the nomogram model for evaluating the stability of carotid plaque in patients with cerebral infarction in the training set was 0.910(95％CI,0.950 to 0.983),the sensitivity was 0.910,the specificity was 0.917,the accuracy was 0.886,the recall rate was 0.910,and the accuracy rate was 0.914.The AUC of the decision tree model for evaluating the stability of carotid plaque in patients with cerebral infarction in the training set was 0.932(95％CI,0.903 to 0.961),the sensitivity was 0.903,the specificity was 0.922,the accuracy was 0.891,the recall rate was 0.903,and the accuracy rate was 0.914.The AUC of the random forest model for evaluating the stability of carotid plaque in patients with cerebral infarction in the training set was 0.984(95％CI,0.970 to 0.998),the sensitivity was 0.972,the specificity was 0.995,the accuracy was 0.993,the recall rate was 0.972,and the ac-curacy was 0.986.Conclusion The model based on the random forest algorithm has a better pre-diction effect and stability in evaluating the stability of carotid plaque in patients with cerebral infarc-tion,and its prediction efficiency is better than that of the Nomogram and decision tree.

Objective To explore the predictive efficacy of three machine learning algorithms for carotid plaque stability in patients with cerebral infarction.Methods The clinical data of 500 pa-tients with cerebral infarction were retrospectively analyzed.Univariate analysis and multivariate anal-ysis were used to determine the predictive factors entering the model.The prediction model of carotid plaque stability in patients with cerebral infarction was constructed based on nomogram,decision tree and random forest respectively.The enrolled patients were randomly divided into training set and test set according to the ratio of 7∶3.Sensitivity,specificity,accuracy,recall,accuracy and area under the curve(AUC)were used to compare the application efficiency of the model.Results The AUC of the nomogram model for evaluating the stability of carotid plaque in patients with cerebral infarction in the training set was 0.910(95％CI,0.950 to 0.983),the sensitivity was 0.910,the specificity was 0.917,the accuracy was 0.886,the recall rate was 0.910,and the accuracy rate was 0.914.The AUC of the decision tree model for evaluating the stability of carotid plaque in patients with cerebral infarction in the training set was 0.932(95％CI,0.903 to 0.961),the sensitivity was 0.903,the specificity was 0.922,the accuracy was 0.891,the recall rate was 0.903,and the accuracy rate was 0.914.The AUC of the random forest model for evaluating the stability of carotid plaque in patients with cerebral infarction in the training set was 0.984(95％CI,0.970 to 0.998),the sensitivity was 0.972,the specificity was 0.995,the accuracy was 0.993,the recall rate was 0.972,and the ac-curacy was 0.986.Conclusion The model based on the random forest algorithm has a better pre-diction effect and stability in evaluating the stability of carotid plaque in patients with cerebral infarc-tion,and its prediction efficiency is better than that of the Nomogram and decision tree.

The onset of primary hepatic carcinoma (PHC) is usually occult, and early symptoms are not obvious. Most patients are at advanced stages of disease at diagnosis, and the prognosis is poor. Paraneoplastic syndrome (PNS) refers to the clinical manifestations indirectly caused by tumor metabolites or abnormal immune reactions that cannot be explained by the primary lesion, local tumor spread or distant metastasis. Hypercholesterolemia, hypercalcemia and hypoglycemia are the most commonly seen clinical presentations of PNS in PHC patients. Adequate understanding of PNS is of great importance in early diagnosis and treatment of PHC. In this review, we summarized the clinical manifestations and prognostic mechanisms of PNS in patients with PHC.

As we learn more about parasites in ancient civilizations, data becomes available that can be used to see how infection may change over time. The aim of this study is to assess how common certain intestinal parasites were in China and Korea in the past 2000 years, and make comparisons with prevalence data from the 20th century. This allows us to go on to investigate how and why changes in parasite prevalence may have occurred at different times. Here we show that Chinese liver fluke (Clonorchis sinensis) dropped markedly in prevalence in both Korea and China earlier than did roundworm (Ascaris lumbricoides) and whipworm (Trichuris trichiura). We use historical evidence to determine why this was the case, exploring the role of developing sanitation infrastructure, changing use of human feces as crop fertilizer, development of chemical fertilizers, snail control programs, changing dietary preferences, and governmental public health campaigns during the 20th century.
Ascaris ; Asian Continental Ancestry Group ; China ; Civilization ; Fasciola hepatica ; Feces ; Fertilizers ; Humans ; Korea ; Mummies ; Parasites ; Prevalence ; Public Health ; Sanitation ; Snails ; Trichuris

In this study we take a closer look at the diseases that afflicted Japanese police officers who were stationed in a remote mountainous region of Taiwan from 1921 to 1944. Samples were taken from the latrine at the Huabanuo police outpost, and analyzed for the eggs of intestinal parasites, using microscopy and ELISA. The eggs of Eurytrema sp., (possibly E. pancreaticum), whipworm and roundworm were shown to be present. True infection with Eurytrema would indicate that the policemen ate uncooked grasshoppers and crickets infected with the parasite. However, false parasitism might also occur if the policemen ate the uncooked intestines of infected cattle, and the Eurytrema eggs passed through the human intestines. These findings provide an insight into the diet and health of the Japanese colonists in Taiwan nearly a century ago.
Animals ; Asian Continental Ancestry Group ; Cattle ; Diet ; Eggs ; Enzyme-Linked Immunosorbent Assay ; Grasshoppers ; Gryllidae ; Humans ; Intestines ; Microscopy ; Ovum ; Parasites ; Police ; Taiwan ; Toilet Facilities