Evaluating vonoprazan and tegoprazan for gastroesophageal reflux disease treatment in Chinese Healthcare: an EVIDEM framework analysis.

BACKGROUND: In Chinese healthcare settings, drug selection decisions are predominantly influenced by the Pharmacy & Therapeutics Committee (PTC). This study evaluates two recently introduced potassium-competitive acid blockers, vonoprazan (VPZ) and tegoprazan (TPZ), utilizing the Evidence and Value: Impact on DEcisionMaking (EVIDEM) framework. METHODS: The study employed the 10th edition of EVIDEM, which includes a core model with five domains and 13 criteria. Two independent expert panels were involved: the PTC expert panel, tasked with assigning weights using a 5-point scale, defining scoring indicators, examining the evidence matrix, scoring, and decision-making; and the evidence matrix expert panel, responsible for conducting a systematic literature review, creating the evidence matrix, and evaluating the value contributions of VPZ and TPZ. RESULTS: The analysis estimated the value contributions of VPZ and TPZ to be 0.59 and 0.54, respectively. The domain of 'economic consequences of intervention' showed the most significant variation in value contribution between the two drugs, followed by 'comparative outcomes of intervention' and 'type of benefit of intervention'. CONCLUSION: Employing the EVIDEM framework, VPZ's value contribution was found to be marginally superior to that of TPZ. The EVIDEM framework demonstrates potential for broader application in Chinese medical institutions.

Nanorod-like Bimetallic Oxide for Enhancing the Performance of Supercapacitor Electrodes.

Supercapacitors are widely used in many fields owing to their advantages, such as high power, good cycle performance, and fast charging speed. Among the many metal-oxide cathode materials reported for supercapacitors, NiMoO4 is currently the most promising electrode material for high-specific-energy supercapacitors. We have employed a rational design approach to create a nanorod-like NiMoO4 structure, which serves as a conductive scaffold for supercapacitors; the straightforward layout has led to outstanding results, with nanorod-shaped NiMoO4 exhibiting a remarkable capacity of 424.8 F g-1 at 1 A g-1 and an impressive stability of 80.2% capacity preservation even after 3500 cycles, which surpasses those of the majority of previously reported NiMoO4 materials. NiMoO4//AC supercapacitors demonstrate a remarkable energy density of 46.31 W h kg-1 and a power density of 0.75 kW kg-1. This synthesis strategy provides a facile method for the fabrication of bimetallic oxide materials for high-performance supercapacitors.

Successful management of severe hypoglycemia induced by total parenteral nutrition in patients with hepatocellular injury: Three cases reports.

BACKGROUND: Glucose imbalance is common in total parenteral nutrition (TPN). Hypoglycemia seems to be less frequent than hyperglycemia, but it influences the clinical outcome to a greater extent. Therefore, it should be effectively prevented and treated. However, there is no relevant report on how to treat hypoglycemia caused by TPN in patients with liver cell injury. CASE SUMMARY: We present three patients with liver cell injury who developed severe hypoglycemia during or after TPN infusion. The causes of severe hypoglycemia and glucose-raising strategies were discussed. According to the physiological characteristics of the hepatocellular injury, the ratio of nutrition components prescribed in TPN was appropriately adjusted for the three cases. We simultaneously reduced the dose of insulin and fat emulsion, and increased the dose of glucose in TPN. The blood glucose level was restored to normal range and clinical symptoms were eliminated. CONCLUSION: When hypoglycemia occurs during or after TPN in patients with hepatocellular injury, physicians need to simultaneously reduce insulin and fat emulsion, and increase glucose, and correct severe hypoglycemia in time to reduce its adverse consequences.

Changes in the intestinal microbiota of multiple myeloma patients living in high­altitude and cold regions analyzed using 16s rRNA high­throughput sequencing.

Multiple myeloma (MM) is a plasma cell clonal disease and these plasma cells can survive in the gut. The intestinal microbiota is a complex ecosystem and its dysfunction can release persistent stimulus signals that trigger genetic mutations and clonal evolution in the gut. The present study analyzed the intestinal microbiota in fecal samples of MM patients in high-altitude and cold regions of China using 16s rRNA sequencing and analyzed significantly enriched species at the phylum and genus levels. Although no significant difference in the alpha diversity was observed between the MM and control groups, a significant difference was noted in the beta diversity. A total of 15 significant differential bacteria at the genus level were found between the two groups, among which Bacteroides, Streptococcus, Lactobacillus and Alistipes were significantly enriched in the MM group. The present study also constructed a disease diagnosis model using Random Forest analysis and verified its accuracy using receiver operating characteristic analysis. In addition, using correlation analysis, it demonstrated that the composition of the intestinal microbiota in patients with MM was associated with complement levels. Notably, the present study predicted that the signaling and metabolic pathways of the intestinal microbiota affected MM progression through Kyoto Encyclopedia of Genes and Genomes functional analysis. The present study provides a new approach for the prevention and treatment of MM, in which the intestinal microbiota may become a novel therapeutic target for MM.

Elastic Polyurethane as Stress-Redistribution-Adhesive-Layer (SRAL) for Directly Integrated High-Energy-Density Flexible Batteries.

The low mechanical reliability and integration failure are key challenges hindering the commercialization of geometrically flexible batteries. This work proposes that the failure of directly integrating flexible batteries using traditional rigid adhesives is primarily due to the mismatch between the generated stress at the adhesive/substrate interface, and the maximum allowable stress. Accordingly, a stress redistribution adhesive layer (SRAL) strategy is conceived by using elastic adhesive to redistribute the generated stress. The function mechanism of the SRAL strategy is confirmed by theoretical finite element analysis. Experimentally, a polyurethane (PU) type elastic adhesive (with maximum strain of 1425%) is synthesized and used as the SRAL to integrate rigid cells on different flexible substrates to fabricate directly integrated flexible battery with robust output under various harsh environments, such as stretching, twisting, and even bending in water. The SRAL strategy is expected to be generally applicable in various flexible devices that involve the integration of rigid components onto flexible substrates.