Objective To investigate the advances and clinical efficacy evaluation method on neoadjuvant chemotherapy in patients with gastric cancer. Methods Literatures on the advances and clinical efficacy evaluation method on neoadjuvant chemotherapy in patients with gastric cancer were reviewed and analyzed. The agreement between computed tomography (CT), endoscopic ultrasound (EUS), magnetic resonance imaging (MRI) and positron emission tomography (PET) and the results of histopathology and survival was analyzed.Results CT and EUS were the method of efficacy evaluation commonly used at present, but the evaluation indexes and criteria were controversial, and the criteria for solid tumors seemed to be not feasible for gastric cancer. Diffusionweighted imaging (DWI) method needed more investigation, while PET held advantage in early selection of patients without response accurately.Conclusion There is no uniform standard for clinical efficacy evaluation yet, so an integration of diverse imaging methods may be the best choice to improve the accuracy of neoadjuvant chemotherapy in patients with gastric cancer.
Interpretation of the complete scientific connotation of functional foods accurately prior to approval and registration based on animal tests and small sample size human food tests is challenging. Further technical evaluation after market introduction should be carried out on safety, health function and other aspects of those widely used commercial scale production products. According to the analysis report on the consumption situation of post-marketing population submitted when applying for product registration extension since the implementation of the functional food registration and filing management measures more than 3 years ago, the post-marketing evaluation report of functional food still lacks systematic and perfect evidence support. Based on the successful experience of evidence-based medicine and post-marketing evaluation evidence, this paper analyzes the post-marketing evaluation content, evidence source construction, evidence classification and classification of functional food, and puts forward the preliminary idea of constructing post-marketing evaluation evidence body of functional food safety and health function technology from multiple view points, so as to provide insights into evidence system research in this field in the future.
The results of clinical studies are usually described with statistical data. When we conduct systematic reviews of clinical studies it is important that the statistical methods used in the original research are evaluated. By doing so, we can assess the validity and reliability of the evidence.
ObjectiveIn the context of Healthy China construction, physical-medical integration, as an important way to optimize the allocation of health resources, plays a key role in solving the series of health problems in the process of China’s development and promoting the improvement of the health level of the whole people. This paper aims to carry out a systematic evaluation on physical-medical integration policies in China. MethodsThis paper took 18 physical-medical integration policies issued at the national level from 2016 to 2022 as the research object, used the text mining method to process policy texts, constructed PMC index model, made quantitative evaluation of related policies, and put forward corresponding policy suggestions based on the results. ResultsThe results showed that the physical-medical integration policies in China was relatively perfect in the aspects of policy openness, policy function and policy evaluation, but it still needed to be optimized from the aspects of policy prescription, policy nature, participating subject, policy perspective and policy tools. ConclusionIn the future policy making, it is necessary to improve the policy design, build the mechanism of multi-subject collaborative governance, and adjust the application structure of policy tools, so as to further improve the policy system of physical-medical integration in China and help realize the strategic goal of Healthy China.
Objective To evaluate the quality of controlled trials on 131I therapy for thyroglobulin positive and radioactive iodine negative metastases（131I WBS-/Tg+）. Methods We electronically searched MEDLINE (1966 to Mar. 2004), EMBASE (1984 to 2003), The Cochrane Central Register of Controlled Trial, CENTRAL (Issue 2, 2004), CBMdisc (1978 to 2004) and CNKI (1994 to 2004), and handsearched 5 radiotherapy and endocrinology journals (Jan. 1980 to Apr. 2003). The methodological quality of included studies was assessed by using quality assessment criteria of the Cochrane systematic review guideline. Results Three non-randomized controlled trials were included. One was historical controlled trial, and two prospective trials. The sample sizes of three trials were 26, 60 and 70 respectively without mentioning the calculation base. The comparability of baseline was mentioned but not comparable across the trials. No double blind studies were used in the assessment of 131I efficacy. The time of follow-up varied from 2 to 15 years. None studies mentioned the side effects of 131I therapy for 131I WBS-/Tg+ metastases. Only two studies applied statistical methods properly. Conclusions Problems about allocation of groups, double blind, sample size, and follow-up period continue to exist in published controlled trials. RCT or prospective controlled trials of high quality are urgently needed in order to define the efficacy and safety of 131I therapy for 131I WBS-/Tg+ metastases.
In order to improve the management of medical technology and ensure the safety, efficiency, and economy of medical devices, we introduce the current situation and future of clinical medical engineering technology evaluation from eight aspects: evaluation standard, evaluation of technical performance, evaluation of reliability, evaluation of clinical application, evaluation of health economy, evaluation of service system, technology maturity, and human factor engineering. The evaluation of clinical medical engineering technology is still in the initial stage, and it is necessary to speed up the establishment of standardization system and evaluation criterion for all kinds of equipment evaluation.
Objective This study aims to conduct a multi-dimensional quantitative evaluation of three rapid-acting insulin analogues, aspart (Novolog), lispro (Humalog), and glulisine (Apidra) to provide references for the selection of these drugs in medical institutions. Methods The recommended methods from the "Quick guideline for drug evaluation and selection in Chinese medical institutions (the second edition)" were employed to evaluate the pharmaceutical characteristics, effectiveness, safety, cost-effectiveness, and other attributes of the three rapid-acting insulin analogues. Results The total scores of insulins aspart (Novolog), lispro (Humalog), and glulisine (Apidra) were 73.5, 80.4, and 70.9, respectively. Insulin lispro (Humalog) had the highest score, demonstrating a prominent advantage in both effectiveness and cost-effectiveness dimensions. Conversely, insulin glulisine (Apidra) had the lowest score, with ratings in effectiveness and safety dimensions lower than those of the other two rapid-acting insulin analogs. Conclusion When selecting rapid-acting insulin analogs, healthcare institutions can choose one or more insulins, aspart (Novolog), lispro (Humalog), or glulisine (Apidra), all of which are strongly recommended, with priority given to insulin lispro (Humalog), which has the highest total score.
ObjectiveTo systematically review the health economic evaluation studies in which externalities of antibacterial drug uses were identified.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect health economic evaluation studies in which externalities of antibacterial drug uses were identified from inception to December 31st, 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Descriptive analysis was then performed.ResultsA total of 14 studies were included. Negative externalities and their impacts on costs and/or effectiveness were examined in 13 literature, and positive externalities in terms of an improvement in disease control were included in only one study. No study was found in which both negative and positive externalities were included. The methods used to quantify negative externalities included: only costs associated with drug resistance per prescription or per unit were calculated; both costs and health impacts associated with the second/third line treatments followed a treatment failure (due to drug resistance) were calculated using a decision tree. In one study in which positive externalities were measured, both health gain and cost reduction from an improvement in disease control (as a benefit of antibacterial drug uses) were calculated by constructing a dynamic model at the population level.ConclusionsWe propose that both the positive and negative externalities should be included in health economic evaluation. This can be achieved by measuring the relevant costs and health impacts in a broader perspective, using a disease-transmission dynamic model. In addition, to achieve an improved health utility measurement, disability-adjusted-life years rather than quality-adjusted-life years should be encouraged for use. Finally, both costs and effectiveness should be discounted.
The purpose of this study is to compare the differences among neck muscle fatigue evaluation algorithms and to find a more effective algorithm which can provide a human factor quantitative evaluation method for neck muscle fatigue during bending over the desk. We collected surface electromyography signal of sternocleidomastoid muscle of 15 subjects using wireless physiotherapy Bio-Radio when they bent over the desk using memory pillows for 12 minutes. Five algorithms including mean power frequency, spectral moments ratio, discrete wavelet transform, fuzzy approximation entropy and the complexity algorithms were used to calculate the corresponding muscle fatigue index. The least squares method was used to calculate the corresponding coefficient of determination R2 and slope k of the linear regression of the muscle fatigue metric. The coefficient of determination R2 evaluates anti-interference ability of algorithms. The maximum vertical distance Lmax which is obtained by the Kolmogorov-Smirnov test for the slopes k evaluates the ability to distinguish fatigue of algorithms. The results indicate that in the aspect of anti-interference ability, the fuzzy approximation entropy has the largest R2 when using memory pillows with different heights. When the fuzzy approximate entropy is compared with average power frequency or the discrete wavelet transform, the differences are significant (P < 0.05). In terms of distinguishing the degree of fatigue, the approximate entropy is still the largest, with a maximum of 0.496 7. Fuzzy approximation entropy is superior to other algorithms in ability of anti-interference and distinguishing fatigue. Therefore, fuzzy approximation entropy can be used as a better evaluation algorithm in the evaluation of cervical muscle fatigue.
Objective To analyze acupuncture resources in the Cochrane Database of Systematic Reviews (CDSR). Methods We identified acupuncture literature from CDSR (2008 year) electronically. W analyzed this literature by research time date, author, study contents, and conCochrane Library usions.?Results?? ? We initially found 82 articles. Finally, we identified 67 systematic reviews. The number of acupuncture articles has increased all over the world with higher growth rate in China than overseas. The disease spectrum of acupuncture treatment increased widely, focusing on nervous system diseases and pain diseases. Eight articles (25.8%) definitely supported the efficacy of acupuncture. Twenty two articles (71%) considered the efficacy of acupuncture as uncertain owning to insufficient evidence. Just one article expressed that acupuncture treatment was ineffective according to current evidence.