AIM: To evaluate the cost-utility of iStent inject;with cataract surgery vs cataract surgery alone in patients with mild-to-moderate primary open angle glaucoma(POAG) in the Japanese setting from a public payer’s per...AIM: To evaluate the cost-utility of iStent inject;with cataract surgery vs cataract surgery alone in patients with mild-to-moderate primary open angle glaucoma(POAG) in the Japanese setting from a public payer’s perspective.METHODS: A Markov model was adapted to estimate the cost-utility of iStent inject;plus cataract surgery vs cataract surgery alone in one eye in patients with mild-tomoderate POAG over lifetime horizon from the perspective of Japanese public payer. Japanese sources were used for patients’ characteristics, clinical data, utility, and costs whenever available. Non-Japanese data were validated by Japanese clinical experts. RESULTS: In the probabilistic base case analysis, iStent inject;with cataract surgery was found to be cost-effective compared with cataract surgery alone over a lifetime horizon when using the ￥5 000 000/quality-adjusted life year(QALY)willingness-to-pay threshold. The incremental cost-utility ratio(ICUR) was estimated to be ￥1 430 647/QALY gained and the incremental cost-utility ratio(ICER) was estimated to be ￥12 845 154/blind eye avoided. iStent inject;with cataract surgery vs cataract surgery alone was found to increase costs(￥1 025 785 vs ￥933 759, respectively) but was more effective in increasing QALYs(12.80 vs 12.74) and avoiding blinded eyes(0.133 vs 0.141). The differences in costs were mainly driven by costs of primary surgery(￥279 903 vs ￥121 349). In the scenario analysis from a societal perspective, which included caregiver burden, iStent inject;with cataract surgery was found to dominate cataract surgery alone.CONCLUSION: The iStent inject;with cataract surgery is a cost-effective strategy over cataract surgery alone from the public payer’s perspective and cost-saving from the societal perspective in patients with mild-to-moderate POAG in Japan.展开更多
α-Ketoacids(KAs)are widely used in chronic kidney disease(CKD),but their efficacy is not clear.Therefore,we conducted a systematic review of the benefits of KAs.Two reviewers independently searched MEDLINE,EMBASE,the...α-Ketoacids(KAs)are widely used in chronic kidney disease(CKD),but their efficacy is not clear.Therefore,we conducted a systematic review of the benefits of KAs.Two reviewers independently searched MEDLINE,EMBASE,the Cochrane library(http://www.cochrane.org),CNKI,and Wan Fang databases from inception to May 31,2016 for randomized controlled trials(RCTs)comparing K.As plus low protein diet(LPD)with LPD only on CKD patients.Statistical analyses were performed using both a random effects model and a fixed effects model with Rev Man 5.3,followed by sensitivity analysis.We identified 21 randomized controlled trials that enrolled a total of 1448 patients.726 had received LPD plus KAs and 722 had received only LPD.Compared with simply using of LPD,combining with KAs could decrease serum creatinine(95%CI,0.46-0.96;P〈0.00001),serum cholesterol(95%CI,0.24±3.77;P=0.02),serum LDL cholesterol(95%CI,0.12-0.54;P=0.31),and serum triglyceride(95%CI,0.28--0.83;P=0.02)while increasing serum HDL cholesterol(95%CI,-1.73-0.07;P〈0.00001).Likewise,a decrease in p3(95%CI,0.90-1.26;P〈0.00001)and PTH(95%CI,0.70-1.21;P=0.007)were observed.No hypercalcemia and other ARD or toxicity was reported,which indicated the safety of KAs.Nevertheless,the studies were pooled with considerable heterogeneity.In patients with CKD,there was low-quality evidence suggesting that KAs may perform an additive effect on the improvement of renal function,lipid profile,as well as the correction of calcium-phosphate metabolism disorders.On account of the considerable heterogeneity of the meta-analysis and the costly price and adherence of KAs administration,K.As'roles in the management of mild or moderate CKD patients may need more RCTs of large scale and high quality to confirm.展开更多
A new T-shaped tunnel field-effect transistor(TTFET) with gate dielectric spacer(GDS) structure is proposed in this paper. To further studied the effects of GDS structure on the TTFET, detailed device characteristics ...A new T-shaped tunnel field-effect transistor(TTFET) with gate dielectric spacer(GDS) structure is proposed in this paper. To further studied the effects of GDS structure on the TTFET, detailed device characteristics such as current-voltage relationships, energy band diagrams, band-to-band tunneling(BTBT) rate and the magnitude of the electric field are investigated by using TCAD simulation. It is found that compared with conventional TTFET and TTFET with gate-drain overlap(GDO) structure, GDS-TTFET not only has the minimum ambipolar current but also can suppress the ambipolar current under a more extensive bias range. Furthermore, the analog/RF performances of GDS-TTFET are also investigated in terms of transconductance, gate-source capacitance, gate-drain capacitance, cutoff frequency, and gain bandwidth production. By inserting a low-κ spacer layer between the gate electrode and the gate dielectric, the GDS structure can effectively reduce parasitic capacitances between the gate and the source/drain, which leads to better performance in term of cutoff frequency and gain bandwidth production. Finally, the thickness of the gate dielectric spacer is optimized for better ambipolar current suppression and improved analog/RF performance.展开更多
At present,the mortality rate and disability rate caused by cardiovascular and cerebrovascular diseases are very high in China.Individuals with refractory hypertension are at a greater risk of developing chronic kidne...At present,the mortality rate and disability rate caused by cardiovascular and cerebrovascular diseases are very high in China.Individuals with refractory hypertension are at a greater risk of developing chronic kidney disease,heart failure,stroke and myocardial infarction.Therefore,how to effectively control blood pressure and identify the cause of refractory hypertension is a problem that medical workers need to solve,and it is also the key to prevent cardiovascular disease.In recent years,the government actively supports the development of traditional Chinese medicine.Since the curative effect of traditional Chinese medicine is recognized by the public,the prospect of traditional Chinese medicine in the prevention and treatment of refractory hypertension is considerable,and it is expected to become the main key research direction in the future.展开更多
文摘AIM: To evaluate the cost-utility of iStent inject;with cataract surgery vs cataract surgery alone in patients with mild-to-moderate primary open angle glaucoma(POAG) in the Japanese setting from a public payer’s perspective.METHODS: A Markov model was adapted to estimate the cost-utility of iStent inject;plus cataract surgery vs cataract surgery alone in one eye in patients with mild-tomoderate POAG over lifetime horizon from the perspective of Japanese public payer. Japanese sources were used for patients’ characteristics, clinical data, utility, and costs whenever available. Non-Japanese data were validated by Japanese clinical experts. RESULTS: In the probabilistic base case analysis, iStent inject;with cataract surgery was found to be cost-effective compared with cataract surgery alone over a lifetime horizon when using the ￥5 000 000/quality-adjusted life year(QALY)willingness-to-pay threshold. The incremental cost-utility ratio(ICUR) was estimated to be ￥1 430 647/QALY gained and the incremental cost-utility ratio(ICER) was estimated to be ￥12 845 154/blind eye avoided. iStent inject;with cataract surgery vs cataract surgery alone was found to increase costs(￥1 025 785 vs ￥933 759, respectively) but was more effective in increasing QALYs(12.80 vs 12.74) and avoiding blinded eyes(0.133 vs 0.141). The differences in costs were mainly driven by costs of primary surgery(￥279 903 vs ￥121 349). In the scenario analysis from a societal perspective, which included caregiver burden, iStent inject;with cataract surgery was found to dominate cataract surgery alone.CONCLUSION: The iStent inject;with cataract surgery is a cost-effective strategy over cataract surgery alone from the public payer’s perspective and cost-saving from the societal perspective in patients with mild-to-moderate POAG in Japan.
文摘α-Ketoacids(KAs)are widely used in chronic kidney disease(CKD),but their efficacy is not clear.Therefore,we conducted a systematic review of the benefits of KAs.Two reviewers independently searched MEDLINE,EMBASE,the Cochrane library(http://www.cochrane.org),CNKI,and Wan Fang databases from inception to May 31,2016 for randomized controlled trials(RCTs)comparing K.As plus low protein diet(LPD)with LPD only on CKD patients.Statistical analyses were performed using both a random effects model and a fixed effects model with Rev Man 5.3,followed by sensitivity analysis.We identified 21 randomized controlled trials that enrolled a total of 1448 patients.726 had received LPD plus KAs and 722 had received only LPD.Compared with simply using of LPD,combining with KAs could decrease serum creatinine(95%CI,0.46-0.96;P〈0.00001),serum cholesterol(95%CI,0.24±3.77;P=0.02),serum LDL cholesterol(95%CI,0.12-0.54;P=0.31),and serum triglyceride(95%CI,0.28--0.83;P=0.02)while increasing serum HDL cholesterol(95%CI,-1.73-0.07;P〈0.00001).Likewise,a decrease in p3(95%CI,0.90-1.26;P〈0.00001)and PTH(95%CI,0.70-1.21;P=0.007)were observed.No hypercalcemia and other ARD or toxicity was reported,which indicated the safety of KAs.Nevertheless,the studies were pooled with considerable heterogeneity.In patients with CKD,there was low-quality evidence suggesting that KAs may perform an additive effect on the improvement of renal function,lipid profile,as well as the correction of calcium-phosphate metabolism disorders.On account of the considerable heterogeneity of the meta-analysis and the costly price and adherence of KAs administration,K.As'roles in the management of mild or moderate CKD patients may need more RCTs of large scale and high quality to confirm.
基金Project supported by the National Natural Science Foundation of China(Grant Nos.61306116 and 61472322)
文摘A new T-shaped tunnel field-effect transistor(TTFET) with gate dielectric spacer(GDS) structure is proposed in this paper. To further studied the effects of GDS structure on the TTFET, detailed device characteristics such as current-voltage relationships, energy band diagrams, band-to-band tunneling(BTBT) rate and the magnitude of the electric field are investigated by using TCAD simulation. It is found that compared with conventional TTFET and TTFET with gate-drain overlap(GDO) structure, GDS-TTFET not only has the minimum ambipolar current but also can suppress the ambipolar current under a more extensive bias range. Furthermore, the analog/RF performances of GDS-TTFET are also investigated in terms of transconductance, gate-source capacitance, gate-drain capacitance, cutoff frequency, and gain bandwidth production. By inserting a low-κ spacer layer between the gate electrode and the gate dielectric, the GDS structure can effectively reduce parasitic capacitances between the gate and the source/drain, which leads to better performance in term of cutoff frequency and gain bandwidth production. Finally, the thickness of the gate dielectric spacer is optimized for better ambipolar current suppression and improved analog/RF performance.
文摘At present,the mortality rate and disability rate caused by cardiovascular and cerebrovascular diseases are very high in China.Individuals with refractory hypertension are at a greater risk of developing chronic kidney disease,heart failure,stroke and myocardial infarction.Therefore,how to effectively control blood pressure and identify the cause of refractory hypertension is a problem that medical workers need to solve,and it is also the key to prevent cardiovascular disease.In recent years,the government actively supports the development of traditional Chinese medicine.Since the curative effect of traditional Chinese medicine is recognized by the public,the prospect of traditional Chinese medicine in the prevention and treatment of refractory hypertension is considerable,and it is expected to become the main key research direction in the future.
