RESUMO
Objective:To compare the cost-effectiveness of hospitalized Chinese patients undergoing nucleic acid screening strategies for hepatitis B and hepatitis C, immunological screening strategy, and no screening strategy under different willingness to pay (WTP). The results might aid to decision-making for the optimal strategy.Methods:In this study, nucleic acid screening, immunological screening and no screening were used as screening strategies, and China′s GDP in 2021 (80 976 yuan) was used as the threshold of WTP to construct a Markov model. After introducing parameters related to the diagnosis and treatment of hepatitis B and C in inpatients, a cohort population of 100 000 inpatients was simulated by TreeAge Pro 2021 software, the total cost, total health effects, incremental cost-effectiveness ratio and average cost-effectiveness ratio of different screening strategies were calculated, and cost-effectiveness analysis was conducted. Univariate and probabilistic sensitivity analysis were used to assess the impact of parameter uncertainty on the final results.Results:Compared with the non-screening strategy, the incremental total cost of the hepatitis B immunological screening strategy for cohort patients was 11 049 536 yuan, and the incremental cost-effectiveness ratio was 24 762 yuan/quality-adjusted life years (QALY), while the total incremental cost of nucleic acid screening was 19 208 059 yuan, and the incremental cost-effectiveness ratio was 29 873 yuan/QALY; the incremental cost-effectiveness ratio of nucleic acid screening and immunological screening was 45 834 yuan/QALY. Compared with the non-screening strategy, the incremental cost-effectiveness ratio of hepatitis C immunological screening strategy was 5 731 yuan/QALY, the incremental cost-effectiveness ratio of nucleic acid screening strategy was 8 722 yuan/QALY, the incremental cost-effectiveness ratio of nucleic acid screening and immunological screening was 45 591 yuan/QALY. The results of probabilistic sensitivity analysis showed that when the cost of nucleic acid testing exceeded 214.53 yuan, it was not cost-effective to perform hepatitis B nucleic acid screening under the WTP as 1 fold GDP. When the cost of nucleic acid testing exceeded 132.18 yuan, it was not cost-effective to conduct hepatitis C screening under the WTP as 1 fold GDP.Conclusions:Nucleic acid screening strategy can achieve more cost-effectiveness and is worthy of vigorous promotion. Compared with no screening, both the nucleic acid and immunological screening strategies are cost-effective, and hepatitis nucleic acid screening is the optimal strategy for hospitalized patients.
RESUMO
Objective:This multi-centre study was conducted to assess the efficacy of various preoperative/pre-transfusion screening methods for blood transmitted disease.Methods:From July 2021 to December 2021, plasma samples of patients admitted to 10 hospitals were collected for screening preoperative/pre-transfusion blood transmitted disease. Nucleic acid detection technology was used to detect hepatitis B virus (HBV) DNA, hepatitis C virus (HCV) RNA and human immunodeficiency virus (HIV)(1+2) RNA, and the results were compared with the immuno-serological methods. χ 2 test and Kappa test were used to analyze the efficacy of these two methods. Results:A total of 8 655 valid specimens were collected from 10 hospitals. There was a statistically significant difference in the positive detection rate of HCV between the two methods ( P<0.001). There was no significant difference in the positive detection rate of HBV and HIV assessed by the two methods ( P>0.05), but the number of positive cases detected by HBV DNA and HIV RNA (218 and 4 cases) was significantly higher than the corresponding serological results (216 and 2 cases). At the same time, there were HBV, HCV and HIV immuno-serological omissions by the immuno-serological methods, among which 28 cases were HBsAg negative and HBV DNA positive, 2 cases were HCV antibody negative and HCV RNA positive, and 2 cases were HIV antigen/antibody negative and HIV RNA positive. In addition, in the 66 samples with inconsistent results from the two detection methods, 83.3% (55/66), 68.2% (45/66), 63.6% (42/66) and 62.1% (41/66) of patients aged was>45 years, tumor, surgery and male, respectively. Conclusions:Compared with immuno-serological tests, nucleic acid tests have the advantage in terms of sensitivity on detecting HBV, HCV and HIV infection and could reduce missed detection. The risk of transmission can be reduced by adding HBV, HCV, and HIV nucleic acid tests to preoperative/pre-transfusion immuno-serological tests screening for patients over 45 years of age and tumor patients.
RESUMO
Objective:To explore clinical value of nucleic acid detection for hepatitis B virus (HBV) screening in hospitalized patients.Methods:This cross-sectional study collected and analyzed plasma samples from patients admitted to 10 domestic medical institutions from July 2021 to December 2021. Serological immunoassay and nucleic acid screening were used to simultaneously detect hepatitis B markers such as hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb), hepatitis B e Antigen (HBeAg), hepatitis B e antibody (HBeAb), hepatitis B core antibody (HBcAb),and HBV DNA. Statistical analysis was performed on the serology, nucleic acid test results and clinical information of the patients.Results:Of the 8 655 collected samples, HBsAg was positive in 216 (2.50%) samples,HBV DNA was positive in 238 (2.75%) samples ( P>0.05); 210 (2.43%) samples were positive for both HBsAg and HBV DNA, 28 (0.32%) were HBsAg negative and HBV DNA positive, 6 cases (0.07%) were HBsAg positive and HBV DNA negative. Conclusion:These results indicate that the HBV DNA testing is equally effective as hepatitis B virus serological detection for hepatitis B virus screening in hospitalized patients.
RESUMO
Objective T o explore the relationship betw een the change rules of volatile organic com pounds (V O C s) in rat m uscle and postm ortem interval (PM I). Methods A total of 120 healthy rats w ere divided random ly into 12 groups (10 for each group). A fter the rats w ere sacrificed by cervical dislocation, the bodies w ere kept at (25±1)℃. R at m uscle sam ples w ere separately obtained at 12 PM I points, including 0, 0.5, 1, 2, 3, 4, 5, 6, 7, 8, 9 and 10 d. T he V O C s in rat m uscles w ere collected, detected and ana-lyzed by headspace solid-phase m icroextraction (H S-SPM E ) coupled to gas chrom atography-m ass spec-trom eter (G C-M S ). Results In total, 15 species of V O C s w ere identified, including 9 arom atic com-pounds, 3 sulfur com pounds, 2 aliphatic acids and 1 heterocyclic com pound. T he species of V O C s in-creased w ith PM I: no species w ere detected w ithin 1 day, 3 species w ere detected on day 2, 9 on day 3, 11 on day 4, 14 from day 5 to 7, and 15 from day 8 to 10. T otal peak area of 15 species of V O C s w as significantly correlated to PM I (adjusted R2=0.15-0.96): the regression function w as y=-17.05 x2+164.36 x-246.36 (adjusted R2=0.96) from day 2 to 5, and y=2.24 x+101.13 (adjusted R2=0.97) from day 6 to 10. Conclusion T he change rules of V O C s in rat m uscle are helpful for PM I estim ation.
RESUMO
Objective To explore the possibility and value of the anterior uterocervical angle ( ACA) and cervical length for prediction of preterm birth in second trimester with the transperineal ultrasound . Methods This study retrospectively reviewed the relevant medical records of single birth primiparas undergoing prenatal ultrasonographic evaluation in Wuxi People′s Hospital Affiliated to Nanjing Medical University from January 2016 to December 2016 . The pregnant women were divided into preterm group and term group according to the pregnancy outcomes ( with or without preterm birth) . The ACA and cervical length of these pregnancies were measured in the second trimester ( between 22 -24 weeks gestation) with the transperineal ultrasound . Results A total of 1064 pregnant women were enrolled in the study ,with 84 cases in preterm group ( 78 .9％ ,84/1064) and 980 cases in term group ( 92 .11％ ,980/1064) . Age of women in the two groups had no statistics difference( P =0 .86) . The mean ACA and cervical length of preterm group were ( 112 .48 ± 15 .83)° and ( 30 .94 ± 6 .32) mm ,and the mean ACA and cervical length of term group were (103 .52 ± 13 .78)° and (37 .28 ± 6 .74)mm ,there were statistically difference( P <0 .05) . The area under ROC curve of the ACA was 0 .882 ,of the cervical length was 0 .664 ,the corresponding cutoff value were 113°and 27 mm ,respectively . The sensitivity of the ACA and cervical length in predicting preterm birth were 86 .90％ and 71 .43％ ,the specificity were 75 .00％ and 62 .14％ ,the accuracy were 75 .94％ and 62 .66％ ,respectively . Conclusions The ACA is an objective and effective indicator to predict preterm birth in the second trimester with transperineal ultrasound . The diagnostic value of measuring the ACA is better than that of measuring the cervical length in the same period .
RESUMO
Background and purpose:Senescent cancer-associated ifbroblasts (CAFs) in tumor microenvi-ronment are known to mediate the invasion and radio- or chemo-resistance of epithelial cancers. The inflammatory cytokine IL-6 derived from CAFs may promote the invasion and radio-resistance of epithelial cervical cancer. However, the detailed mechanism is not clear. This study aimed to investigate the effects of IL-6 on CAFs senescence, cervical cancer cell invasiveness and radio-resistance.Methods:CAFs from cervical cancer, normal ifbroblasts (NFs) from nor-mal cervical tissues, and cervical cancer cell lines including HeLa, Siha and ME180 were used in this study. Different treatments of cells with IL-6 and inhibitors of STAT3 and Notch were conducted to investigate the alterations of cellular senescence, STAT3/Notch signaling, cell invasiveness, and radiotherapy-induced apoptosis by using cell staining, immunolfuorescence, Western blot, and lfow cytometery.Results:This study found that the conditioned medium (CM) of CAFs or IL-6 could activate the STAT3 and Notch signaling to promote cellular senescence and cervical cancer cell invasiveness. Co-culture of cervical cancer cells HeLa or Siha along with CAFs also increased the invasiveness of can-cer cells, but further treatments of cells by addition of an IL-6 antibody or the inhibitors of STAT3 (S31-201) or Notch (DAPT) blocked the cancer cell invasion. Meanwhile, this study also found that STAT3 functions at the upstream of the Notch signaling to up-regulate Jagged-1, one of the key ligands of Notch in ifbroblasts or epithelial cancer cells through IL-6-mediated autocrine or paracrine pathways, which eventually confers the radio-resistance of cervical cancer cells/tissues.Conclusion:CAFs in tumor microenvironment could induce cervical cancer cell invasiveness and radio-re-sistance through IL-6/STAT3-mediated Notch activation, and that targeting of the STAT3/Notch signaling-associated molecules may improve the effcacy of radiotherapy for cervical cancer.
RESUMO
Objective To study the effective methods for extraction of clenbuterol from biological material. Methods Clenbuterol in blood samples was extracted with 5 different methods,the extracts from various extraction methods were determined by gas chromatography-mass spectrometry(GC-MS?雪. The efficiency of 5 extraction methods was compared with each other. Results The standard curve showed good linear relationship with a range from 0.01-10.0 mg/L clenbuterol hydrochloride(r=0.999 9?雪. The detection limit was 0.005 mg/L. After adding 1.0 ?g/ml clenbuterol hydrochloride into blood sample,the blood sample was immersed and extracted in 0.01 mol/L HCl and absolute alcohol.The extracts were extracted by chloroform at pH value of 11. The average recovery and RSD of this method were 96.5% and 5.21% respectively(n=6?雪. Conclusion The method showed easy operation and reliable results ,it was suitable for determination of clenbuterol in biological material without deviation.
