Cost-Effectiveness Analysis of Camrelizumab Plus Chemotherapy vs. Chemotherapy Alone as the First-Line Treatment in Patients With IIIB-IV Non-Squamous Non-Small Cell Lung Cancer (NSCLC) Without EGFR and ALK Alteration from a Perspective of Health - Care System in China.

Objective: The CAMEL clinical trial (412 patients were randomly assigned to either camrelizumab plus chemotherapy (n = 205) or chemotherapy alone (n = 207)) demonstrated that camrelizumab plus chemotherapy (CC) improved the overall survival time (OS) and progression-free survival time (PFS) of patients with metastatic nonsquamous non-small cell lung cancer (non-sq NSCLC) without epidermal growth factor receptor (EGFR) or anaplastic lymphoma kinase (ALK) mutations (EGFRm and ALKm) vs. chemotherapy (C) alone. Our objective was to conduct a cost-effectiveness analysis of CC vs. C from a perspective of health - care system in China with a lifetime horizon to identify whether it will be cost-effective. Materials and Methods: A partitioned survival model (PSM) was applied for patients with IIIB-IV non-sq NSCLC without EGFRm and ALKm. Transition parameters and proportions of three health states were derived from the CAMEL trial. The model was designed using a lifetime horizon, a 21-day cycle, and a 5% discount rate of costs and outcomes. It was deemed cost-effective in China if the incremental cost-effectiveness ratio (ICER) value is less than $32,457 per quality adjusted life-year (QALY). Deterministic and probabilistic sensitivity analyses were performed to verify the influence of parameter uncertainty on the results. Results: In the base-case analysis, we found that the ICER of CC compared with C is $-7,382.72/QALY which meant that CC had lower costs and better outcomes. The results of the sensitivity analyses demonstrated that the result was robust for the ICERs never transcending the willingness-to-pay (WTP) threshold. Conclusion: Camrelizumab plus chemotherapy is an obviously cost-effective therapeutic regime for patients of IIIB-IV non-sq NSCLC without EGFRm and ALKm in China at a $32,457 WTP threshold.

Analysis of Heavy Metals in Foodstuffs and an Assessment of the Health Risks to the General Public via Consumption in Beijing, China.

Consumption of foodstuffs is the most likely route for human exposure to heavy metals. This study was designed to investigate the toxic metals (cadmium (Cd), lead (Pb), chromium (Cr), arsenic (As), and mercury (Hg)) concentrations in different foodstuffs (cereals, vegetables, fruits, fish, and meat) and then estimate the potential health risks of toxic metals via consumption to the local residents in Beijing, China. Most of the selected toxic metal levels in the foodstuffs were lower than the maximum allowable concentrations of Pb, Cr, Cd, As, and Hg for Chinese foodstuffs recommended in the China National Food Safety Standard. The health risks associated with the toxic metals Pb, Cr, Cd, As, and Hg were assessed based on the target hazard quotients (THQs) proposed by the United States Environmental Protection Agency (US EPA). The THQ values of the foodstuffs varied and were 0.03⁻0.29 for Cr, 0.02⁻0.23 for Pb, 0.01⁻0.33 for Cd, 0.01⁻0.06 for As, and 0.00⁻0.04 for Hg, not exceeding the maximum level of 1. The total THQ (TTHQ) values were 0.88 for vegetables, 0.57 for cereals, 0.46 for meat, 0.32 for fish, and 0.07 for fruits. This indicates that the risk contribution from vegetable intake (38.8%) was significant in comparison to that from other foodstuffs. The TTHQ values were 0.96 for Cr, 0.54 for Pb, 0.50 for Cd, 0.19 for As, and 0.09 for Hg, suggesting that Cr was a major risk contributor (41.7%) for the local residents of Beijing, which should attract great attention. However, the THQ/TTHQ values were all below 1, suggesting no health risks to the local population through consumption. Furthermore, dietary weekly intakes (WIs) were also calculated and the values were all lower than the proposed limit of Provisional Tolerable Weekly Intakes (PTWI) established by the the Food and Agriculture Organization of the United Nations (FAO) and the World Health Organization (WHO). This suggests no additional health risks as well as consistency with the THQ results.

Assessment of Typical Heavy Metals in Human Hair of Different Age Groups and Foodstuffs in Beijing, China.

Human hair of different age groups and foodstuff samples were collected in Beijing, China. The concerned metals-Cd, Cr, Pb, As, and Hg-were analyzed, and the metal levels in relation to age, gender, and dietary intake were further assessed. Results showed the highest level of the metals was shown by Pb, with an average concentration of 1.557 ± 0.779 mg/kg, followed by Cr (0.782 ± 0.394), Hg (0.284 ± 0.094), As (0.127 ± 0.078), and Cd (0.071 ± 0.032), following a decreasing order of Pb > Cr > Hg > As > Cd, which were all below the upper limit of normal values in China. The heavy metal concentrations varied greatly among different age groups, and higher concentrations for Cd, Cr, Pb, and As appeared in female hair, whereas higher Hg concentration were found in male hair, suggesting that age and gender were not crucial factors for assessing metal concentrations in human hair. The ingestion of cereals and vegetables were the main route by which heavy metals in the environment create hazardous health effects for local inhabitants, but the estimated metal intakes through food consumption were all lower than the proposed limit of Provisional Tolerable Weekly Intake (PTWI), indicating that heavy metals posed no health risks for the inhabitants. Furthermore, little relationship was found between metal intakes and the corresponding metal levels in hair. Nevertheless, the results of this study can be used to analyze the internal heavy metal burden in the resident population of Beijing area and can also serve as reference for further studies.

Chemiluminescence assay for the sensitive detection of iodide based on extracting Hg2+ from a T-Hg(2+)-T complex.

A simple and sensitive chemiluminescence assay for iodide (I(-)) detection was reported, which was based on iodide extracting Hg(2+) from DNA featuring a stem-loop structure containing T-Hg(2+)-T. Specifically, Hg(2+) induced random coiled G-rich single-strand DNA to form a stem-loop structure containing T-Hg(2+)-T. Because the binding of Hg(2+) and I(-) is much stronger than that of Hg(2+) and thymine (T), I(-) could extract Hg(2+) from the stem-loop structure, releasing the DNA, which then bound with K(+) and transformed into a K(+)-stabilized G-quadruplex (with hemin as a cofactor), which catalyzed the H(2)O(2)-mediated oxidation of luminol. The produced chemiluminescence as a sensing signal was applied to sensitively and selectively detect iodide with a detection limit of 12 nM. This system exhibited the first DNAzyme-based iodide sensor. Finally, the sensor was successfully applied for iodide detection in real lake water samples.