Objective To detect expression of miR-106a-5p in gastric cancer cells and gastric cancer tissue, and to analyze relationship between it’s expression with clinicopathologic characteristics, and in addition, to analyze its target genes and enriched pathway with bioinformatics method. Methods The expressions of miR-106a-5p in the different differentiation of gastric cancer cells AGS (well differentiation), MKN-28 (middle differentiation), HGC-27 (undifferentiation), MGC-803 (low differentiation), BGC-823 (low differentiation), MKN-45 (middle differentiation) and SGC-7901 (middle differentiation), the normal gastric mucosal epithelial cells GES-1, and the gastric cancer tissue and the corresponding adjacent tissue were detected by the real-time fluorescent quantitative PCR. Furthermore, the target genes of miR-106a-5p were predicted by using more than three softwares affiliated to mirWALK web database and the signal pathways of target genes were enriched by DAVID 6.7 software. Results The expressions of miR-106a-5p in the different differentiation degree of the gastric cancer cells (AGS, SGC-7901, MKN-45, MGC-803, BGC-823, and HGC-27) were up-regulated except the MKN-28 cell line as compared with the normal gastric mucosa cell line GES-1 (P<0.010 orP<0.001), and the expression of miR-106a-5p in the gastric cancer tissue was also up-regulated as compared with the corresponding adjacent tissue, the expression of miR-106a-5p in the gastric cancer tissue was associated with the lymph node metastasis or the invasion depth. The results of the bioinformatics analysis showed that the target genes of miR-106a-5p were enriched in the multiple signaling pathways associated with the cancer. Conclusion miR-106a-5p is a molecular marker of high expression in gastric cancer and a potential cancer gene associated with lymph node metastasis and invasion depth.
ObjectiveTo observe the expressions of miR-143-3p in gastric cancer cells and gastric carcinoma tissues with its clinical significance, and to analyze the target genes with enriched pathway by using bioinformatics methods.MethodsThe expressions of miR-143-3p in different differentiation gastric cancer cells and normal gastric mucosa cell line, and the expressions in gastric cancer tissues and adjacent tissues were detected by real-time fluorescent quantitative PCR. In addition, OncomiR and YM500 databases were used to analyze the expression of miR-143-3p in gastric cancer tissues compared with adjacent tissues. Furthermore, the targets of miR-143-3p were predicted by using the software of miRecords website database, and at least three software-supported target genes were chosen to analyze the enriched the signal pathways in which the target gene was involved with DAVID 6.7 software.ResultsThe expressions of miR-143-3p in the different differentiation degree of gastric cancer cells compared with normal gastric mucosa cell line were downregulated (P<0.001), and the expression of miR-143-3p in gastric cancer tissues compared with adjacent tissues was also downregulated (downregulated in 36 cases, upregulated in 18 cases, and no alteration in 4 cases). The expression of miR-143-3p in gastric cancer tissues was associated with lymph node metastasis and invasion depth (P<0.05). Bioinformatics analysis results showed that the target genes of miR-143-3p were enriched in 38 signaling pathways associated with cancer.ConclusionMiR-143-3p is a down-regulated molecular marker in gastric cancer and a potentially clinically related tumor suppressor gene, which may be involved in the cancerous phenotype in carcinogenesis and development of gastric cancer.
Objective To compare the costs of Danmu extract syrup and Xiaoer Chiqiao Qingre granules for the treatment of acute upper respiratory tract infection (AURI) in children. Methods We conducted this prospective cohort study from July 2018 to June 2020. Children with AURI in the pediatric outpatient department and emergency department of West China Second Hospital were enrolled, and were divided into two groups: Danmu extract syrup group (Danmu group) and Xiaoer Chiqiao Qingre granule group (Chiqiao group) according to the treatment. The pharmacoeconomic evaluation took the medical and health system as the research perspective and considered direct medical costs, including registration fees, drug fees, inspection fees, testing fees, and treatment fees. A cost-effectiveness analysis or a cost minimization analysis was adopted according to the results of efficacy between the two groups. Results We enrolled 1 036 children with AURI. After propensity score matching, 252 in the Danmu group and 253 in the Chiqiao group were included. There was no statistically significant difference in the symptom recovery time between the two groups. The cost minimization analysis showed that the total costs (median difference −21.55) and drug costs (median difference −7.24) of the Danmu group were significantly lower than those of the Chiqiao group (P<0.001). The results of the subgroup and sensitivity analyses were consistent with the primary analysis. Conclusion Danmu extract syrup is a cost-saving alternative compared with Chiqiao granules for AURI in children.
Health technology assessment is a systematic assessment of the nature and impact of health technology. It is a science that solves the problems of health intervention or health technology on society, economy, organization and ethics. Aiming at the current issues of availability, accessibility, affordability, rationality and safety in the field of medical devices, health technology assessment can systematically evaluate the characteristics, effects and impact of medical devices, and provide evidence-based basis for scientific decision-making. Starting from the current status and challenges of medical device management, this paper introduces the origin and development, basic scope, assessment process and main assessment content of health technology assessment, and introduces the application of health technology assessment in medical device management through case studies, so as to promote development of health technology assessment in the field of medical device management and make medical device management more scientific and standardized.
目的 探讨影响岩斜区脑膜瘤（PCM）预后的相关因素。 方法 回顾分析解放军452医院2005年9月－2009年6月及四川大学华西医院1999年9月－2009年2月110例患者的临床资料及随访结果，通过单因素生存分析及Cox比例风险模型分析探讨影响PCM预后的相关因素。 结果 单因素生存分析发现8种相关因素影响PCM患者的预后，但Cox多因素分析仅发现脑干T2像高信号（OR=5.54，P=0.012）、肿瘤侵入脑干（OR=5.10，P=0.034）、病理高级别（OR=4.03，P=0.011）这3种因素有统计学意义。 结论 脑干T2像高信号、肿瘤侵入脑干、病理高级别可影响岩斜区脑膜瘤患者的预后。
Objective To update and form an instrument for evaluating clinical applicability of guidelines (version 1.0). Methods We updated the systematic review of global guideline clinical applicability evaluation instruments to form the initial item list and carried out Delphi expert consultation to establish the instrument for evaluating clinical applicability of guidelines (version 2.0). Results The general structure of version 2.0 was consistent with that of version 1.0, which included 12 evaluation items belonging to five domains covering accessibility, readability, acceptability, feasibility, and an overall evaluation. Moreover, some new items were added in version 2.0, such as "The guideline does not provide supporting tools or resources and the operation is poor", "After the guideline implementation, the expected effects of diagnosis and treatment do not be achieved", " Medical staff in your workplace believe that the guideline is not necessary because they have sufficient medical experience, etc.", "Lack of authority of the organizations and personnel that developed the guideline" and "Medical staff in your workplace are reluctant to change the original medical practice". Conclusion This study updated and formed an instrument for evaluating clinical applicability of guidelines (version 2.0), which is able to better assess the applicability of new clinical guidelines and greatly promote more appropriate guidelines into practice.
ObjectivesTo systematically review the risk factors of carbapenem-resistant enterobacteriaceae colonization or infection in neonates.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect cohort or case-control studies on the risk factors of carbapenem-resistant enterobacteriaceae colonization or infection in neonates from inception to May 2020. Two reviewers independently screened literature, extracted data, and assessed risk of bias of included studies, and meta-analysis was performed by RevMan5.3 software.ResultsA total of 9 case-control studies involving 759 patients were included. The results of meta-analysis showed that, maternal factors like placental abruption (OR=6.25, 95%CI 1.47 to 26.61, P=0.01), premature rupture of fetal membranes of parturient (OR=5.62, 95%CI 2.63 to 12.00, P<0.000 01), pregnancy-induced hypertension (OR=2.04, 95%CI 1.49 to 2.80, P<0.000 01), carbapenem antibiotics used in mothers (OR=1.77, 95%CI 1.10 to 2.81, P=0.017), neonatal factors like premature delivery (OR=1.96, 95%CI 1.06 to 3.61, P=0.03), mechanical ventilation (OR=2.14, 95%CI 1.01 to 4.55, P=0.05), surgical procedure (OR=14.17, 95%CI 2.46 to 81.70, P=0.003), umbilical vein catheter (OR=1.93, 95%CI 1.20 to 3.11, P=0.007), peripherally inserted central catheter (OR=4.30, 95%CI 1.86 to 9.93, P=0.000 6), nasogastric feeding (OR=4.37, 95%CI 1.44 to 13.29, P=0.009), use of carbapenems (OR=3.04, 95%CI 1.91 to 4.84, P<0.000 01), and admission to NICU (OR=2.78, 95%CI 1.79 to 4.33, P<0.000 01) were the risk factors of carbapenem-resistant enterobacteriaceae colonization or infection in neonates. Breastfeeding (OR=0.30, 95%CI 0.13 to 0.70, P=0.005) was the protective factor of carbapenem-resistant enterobacteriaceae colonization or infection in neonates.ConclusionsThe current evidence shows that maternal factors like placental abruption, premature rupture of fetal membranes, pregnancy-induced hypertension, carbapenem antibiotics used in mothers, and neonatal factors like premature delivery, mechanical ventilation, surgical procedure, umbilical vein catheter, peripherally inserted central catheter, nasogastric feeding, use of carbapenems, and admission to NICU are the risk factors of carbapenem-resistant enterobacteriaceae colonization or infection in neonates; while breastfeeding is the protective factor of carbapenem-resistant enterobacteriaceae colonization or infection in neonates. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the conclusions.
ObjectiveTo summarize the evaluation tools for the implementation effect of clinical practice guidelines (CPGs), to inform and support the evidence-based development of a general tool for the evaluation of implementation effect of CPGs. MethodsSeven biomedical literature databases, including PubMed, Embase and CNKI, and two academic websites, were searched from establishment to June 2022. Theoretical and empirical research on the evaluation tools of the implementation effect of CPGs were included. Two researchers independently screened literature and extracted data according to the inclusion and exclusion criteria. Based on the Implementation Science RE-AIM theoretical framework, an evaluation framework and a list of alternative items of the implementation effect of the CPGs were initially drawn up by thematic synthesis methods. ResultsA total of 208 articles were included, and 8 mature evaluation tools related to the implementation effect of guidelines were selected. Current research on the evaluation of the implementation effect of CPGs mainly focused on single diseases, with concern of the cognition, attitude and compliance of users to CPGs, and the process of the implementation of CPGs and factors affecting the implementation effect of CPGs. There were limitations such as a lack of evaluation on the terminal effect of the implementation of CPGs, the rare use of mature theoretical frameworks, the use of single evaluation perspectives, and inclusion of limited evaluation dimensions. The initial proposed evaluation framework contains a list of alternative items with 6 primary indicators, 12 secondary indicators and 41 tertiary indicators. ConclusionCurrently, there is a lack of a comprehensive, multi-perspective, mature theory based, general tool for the evaluation of implementation effect of CPGs. The framework and the list of alternative items for the evaluation of implementation effect of CPGs based on the implementation science RE-AIM theory can inform and support the development of a tool for the evaluation of implementation effect of CPGs.
Rational drug use is a global concern. As one of the highest risk groups for drug use, children's rational drug use has always been concerned. Based on the previous research results of the research group, we developed evaluation indicator systems for assessing rational drug use to treat community-acquired pneumonia and primary nephrotic syndrome in children and proton pump inhibitors in pediatric intensive care units and finished empirical research. This study further summarizes and expounds the construction ideas of rational drug use evaluation indicators for children based on diseases or drugs, and provides a reference for constructing children's rational drug use evaluation indicators.
ObjectiveTo evaluate the efficacy, safety, and economics of omalizumab for the treatment of pediatric asthma through a rapid health technology assessment (HTA). MethodsThe search was conducted on INAHTA website and databases such as PubMed, Embase, Cochrane Library, SinoMed, CNKI, VIP, and WanFang Data from inception to August 2024. Literature screening, quality evaluation, and data extraction were conducted independently by two investigators. An interview was conducted to consult the medication and treatment opinions of doctors and patients to investigate its clinical application. ResultsA total of 28 articles, including HTA articles (4), SR/Meta analyses (18), and pharmacoeconomics articles (6) were included. Omalizumab could reduce the incidence of clinical exacerbations, decrease the number of asthma attacks/days with asthma symptoms, and improve the quality of life. The results of the safety evaluation showed that omalizumab could reduce the rate of serious adverse events, especially those related to worsening asthma. Foreign pharmacoeconomic studies showed ICER ranging from £30 109 to £78 009. A pharmacoeconomic study in China found an ICER of $211 217/QALY for omalizumab, which were both above the pre-set thresholds. ConclusionOmalizumab is a treatment for patients who suffer from moderate to severe persistent allergic asthma or moderate to severe allergic asthma. It has been found to improve disease symptoms without increasing serious adverse events. However, it is not considered cost-effective due to its high price.