Efficacy, safety, and cost-effectiveness analysis of Cerebrolysin in acute ischemic stroke: A rapid health technology assessment.

This study conducts a rapid health technology assessment to systematically evaluate the effectiveness, safety, and cost-effectiveness of Cerebrolysin as an adjunctive therapy for acute ischemic stroke to provide evidence-based medicine for clinical decisions of Cerebrolysin. All systematic reviews/meta-analyses, pharmacoeconomic studies, and health technology assessment reports of Cerebrolysin for the treatment of acute ischemic stroke before August 17, 2023, were retrieved from PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, Wanfang, Weipu, Sinomed database and the official website of health technology assessment. According to the inclusion and exclusion criteria, 2 researchers independently carried out screening, data extraction, and quality evaluation and descriptively analyzed the results of the included studies. A total of 14 pieces of literature were incorporated, comprising 8 systematic reviews/meta-analyses and 6 pharmacoeconomic studies. In terms of effectiveness, compared to control groups, the use of Cerebrolysin as a treatment for acute ischemic stroke demonstrates certain advantages, including enhancement in total efficacy rate, neurological function, upper limb motor dysfunction, and facilitation of the recovery of activities of daily living. Especially in patients with moderate to severe acute ischemic stroke, Cerebrolysin has demonstrated the ability to enhance neurological function recovery and ameliorate disabilities. Regarding safety, adverse reactions were mild or comparable to those in the control group. The primary findings of economic studies reveal that advocating for the use of Cerebrolysin offers certain cost-effectiveness advantages. Cerebrolysin contributes to improved clinical efficacy and evaluation indexes while demonstrating favorable safety and economic benefits.

[Size distribution characteristics of particulate mercury on haze and non-haze days].

With the rapid economic development, China suffers from the severe haze and atmospheric mercury pollution. Particulate mercury transport has an important significance in its global cycle. In order to investigate the distribution characteristics of particulate mercury, 12 degrees Nano-moudi (6.2-9.9 µm, 3.1-6.2 µm, 1.8-3.1 µm, 1.0-1.8 µm, 0.56-1.0 µm, 0.32-0.56 µm, 0.18- 0.32 µm, 0.10-0.18 µm, 0.056-0.10 µm, 0.032-0.056 µm, 0.018-0.032 µm, 0.010-0.018 µm) impactor was used to measure the size distributions of atmospheric particulate mercury on both haze and non-haze days in Shanghai. The results indicated that particulate mercury levels were positively correlated with those of the particles. The average concentration of particulate mercury (0.31 ng x m (-3)) on haze days was 2-3 times than that on non-haze days (0.11 ng x m(-3)). The mass size distributions of aerosols and particulate mercury showed bimodal distributions. The peak shifted from 0.56-1.0 µm and 3.1-6.2 µm on haze days to 0.32-0.56 µm and 3.1-6.2 µm on non-haze days. The particles with aerodynamic diameter smaller than 1 µm which could stay for a long time and transport for a long distance, had higher particulate mercury concentrations. The average contribution of particulate mercury to total PM aerosol were higher on haze days (0.029 ng x µg(-1)) than on non-haze days (0.015 ng x µg(-1)), indicating that secondary particles typically grew faster than mercury during the haze pollution events. The particulate mercury concentration in accumulation mode was 2.06 ng x m(-3) on haze days, while it was 0.55 ng x m(-3) on non-haze days. The large increase of the accumulation mode particles was a main reason for the formation of haze. Emissions from the coal burning as well as road surface dust and dust from long-range transport accounted for the serious pollution on haze days.