Objectives:Economic growth and rapid development of health technology in China have created opportunities to strengthen health technology assessment (HTA) capacity.Over the time,HTA institutions have been established ...Objectives:Economic growth and rapid development of health technology in China have created opportunities to strengthen health technology assessment (HTA) capacity.Over the time,HTA institutions have been established to conduct HTA related work.This study reviewed the current status of HTA in China and analysed the challenges of HTA development in the context of health reform under'new normal'economy.Methods:Literature review and webpage searches were used to document the development of HTA in China.An institutional survey has also been conducted to collect information on the HTA research institutions in China.Results:The number of articles and research projects on HTA were rising and are continuing to rise.HTA development has made substantial progress in China in terms of growing number of research institutions and qualified HTA workforce.However,HTA has notable weaknesses such as low capacity for conducting HTA research,limited experience in HTA researchers,and lack of knowledge translation.Conclusion:Currently,the translation of HTA findings to policy-making is limited and the integration of HTA in the policy-making processes is still in its infancy.The HTA development in China has had opportunities due to demands of health care,health insurance,and health technology as a result of health reform.Capacity building and institutionalization of HTA are urgently needed for further development of HTA in China.展开更多
Although a key tenant of the Sustainable Development Goals is to achieve universal health coverage,the global drug gap persists-cver a third of the global population lack access to essential medicines.Without access t...Although a key tenant of the Sustainable Development Goals is to achieve universal health coverage,the global drug gap persists-cver a third of the global population lack access to essential medicines.Without access to affordable drugs,people have worse health outcomes,higher medical expenses,and productivity loss,pushing them into poverty.Health technology assessments(HTAs)offer an opportunity to decrease the global drug gap and increase access to essential medicines by overcoming barriers to medicine access.These barriers include drug procurement,drug affordability for payers and patients,a patienfs ability to obtain essential medicines,and health system capacity.Using HTAs can therefore close the global drug gap by increasing access to affordable essential medicines.In turn,people have better health outcomes,spend less money on medical care,and can have better productivity.Ultimately,use of HTAs can lift the population out of poverty and force fewer people into poverty by creating better health outcomes at affordable prices.展开更多
Background Health Technology Assessment(HTA)in China has recently expanded from purely academic research to include policy or decision-oriented practice,especially after HTA evidence was used to update the National Re...Background Health Technology Assessment(HTA)in China has recently expanded from purely academic research to include policy or decision-oriented practice,especially after HTA evidence was used to update the National Reim-bursement Drug List for the first time in 2017.This study aims to identify the progress and challenges of HTA develop-ment from 2016 to 2021 and inform policies and decisions to promote further HTA development in China.Methods We conducted a cross-sectional web-based survey with policy makers,researchers and industry-providers in China in 2016 and 2021 respectively.The‘Mapping of HTA Instrument’,was utilized to assess the HTA development across eight domains:Institutionalization,Identification,Priority setting,Assessment,Appraisal,Reporting,Dissemina-tion of findings and conclusions,and Implementation in policy and practice.To reduce the influence of confound-ers and compare the mapping outcomes between the 2016 and 2021 groups,we conducted 1:1 Propensity Score Matching(PSM).Univariate analysis was conducted to compare the differences between the two groups.The overall results were further compared with those of a mapping study that included ten countries.Results In total,212 and 255 respondents completed the survey in 2016 and 2021,respectively.The total score of the HTA development level in China in 2021 was higher than that in 2016 before PSM(89.38 versus 83.96).Follow-ing PSM,183 respondents from the 2016 and 2021 groups were matched.Overall,the mean scores for most indicators in the Institutionalization domain and Dissemination domain in 2021 were higher than those in 2016(P<0.05).The Appraisal domain in 2021 was more explicit,transparent and replicable than that in 2016(t=-3.279,P<0.05).How-ever,the mean scores of most indicators in the Assessment domain were higher in 2016 than those in 2021(P<0.05).Conclusions Our study suggest that the level of HTA development in China progressed significantly from 2016 to 2021.However,before engaging in HTA activities,further efforts are required to enhance the assessment process.For instance,it is important to establish a clear goal and scope for HTA;adapt standardized methodologies for evaluat-ing the performance of systematic reviews or meta-analyses;and provide comprehensive descriptions of the safety,clinical effectiveness,cost,and cost-effectiveness of the assessed technologies,thus improving the development of HTA in China.展开更多
Metabolic heterogeneity plays a central role in sustaining uncontrolled cancer cell proliferation and shaping the tumor microenvironment(TME),which significantly compromises the clinical outcomes and responses to ther...Metabolic heterogeneity plays a central role in sustaining uncontrolled cancer cell proliferation and shaping the tumor microenvironment(TME),which significantly compromises the clinical outcomes and responses to therapy in head and neck squamous cell carcinoma(HNSCC)patients.This highlights the urgent need to delineate the intrinsic heterogeneity and biological roles of metabolic vulnerabilities to advance precision oncology.The metabolic heterogeneity of malignant cells was identified using single-cell RNA sequencing(scRNA-seq)profiles and validated through bulk transcriptomes.Serine–glycine-one-carbon(SGOC)metabolism was screened out to be responsible for the aggressive malignant properties and poor prognosis in HNSCC patients.A 4-SGOC gene prognostic signature,constructed by LASSO-COX regression analysis,demonstrated good predictive performance for overall survival and therapeutic responses.Patients in the low-risk group exhibited greater infiltration of exhausted CD8+T cells,and demonstrated better clinical outcomes after receiving immunotherapy and chemotherapy.Conversely,high-risk patients exhibited characteristics of cold tumors,with enhanced IMPDH1-mediated purine biosynthesis,resulting in poor responses to current therapies.IMPDH1 emerged as a potential therapeutic metabolic target.Treatment with IMPDH inhibitors effectively suppressed HNSCC cell proliferation and metastasis and induced apoptosis in vitro and in vivo by triggering GTP-exhaustion nucleolar stress.Our findings underscore the metabolic vulnerabilities of HNSCC in facilitating accurate patient stratification and individualized precise metabolic-targeted treatment.展开更多
The innate immune system has a primary role in defending against external threats,encompassing viruses,bac-teria,and fungi,thereby playing a pivotal role in establishing robust protection.Recent investigations have sh...The innate immune system has a primary role in defending against external threats,encompassing viruses,bac-teria,and fungi,thereby playing a pivotal role in establishing robust protection.Recent investigations have shed light on its importance in the progression of tumors,with a particular emphasis on lung cancer.Among the various signaling pathways implicated in this intricate process,the cGAS-STING pathway emerges as a signifi-cant participant.Cyclic GMP-AMP synthase(cGAS)discerns free DNA and activates the stimulator of interferon genes(STING),subsequently culminating in the secretion of cytokines and exerting inhibitory effects on tumor development.Consequently,researchers are increasingly interested in creating anticancer drugs that specifically target the cGAS-STING pathway,offering promising avenues for novel therapeutic interventions.The objective of this review is to present a comprehensive overview of the ongoing research on the cGAS-STING signaling path-way within the realm of lung cancer.The primary emphasis is on understanding its involvement in lung cancer development and assessing its viability as a target for innovative therapeutic options.展开更多
文摘Objectives:Economic growth and rapid development of health technology in China have created opportunities to strengthen health technology assessment (HTA) capacity.Over the time,HTA institutions have been established to conduct HTA related work.This study reviewed the current status of HTA in China and analysed the challenges of HTA development in the context of health reform under'new normal'economy.Methods:Literature review and webpage searches were used to document the development of HTA in China.An institutional survey has also been conducted to collect information on the HTA research institutions in China.Results:The number of articles and research projects on HTA were rising and are continuing to rise.HTA development has made substantial progress in China in terms of growing number of research institutions and qualified HTA workforce.However,HTA has notable weaknesses such as low capacity for conducting HTA research,limited experience in HTA researchers,and lack of knowledge translation.Conclusion:Currently,the translation of HTA findings to policy-making is limited and the integration of HTA in the policy-making processes is still in its infancy.The HTA development in China has had opportunities due to demands of health care,health insurance,and health technology as a result of health reform.Capacity building and institutionalization of HTA are urgently needed for further development of HTA in China.
基金support from“A Demonstration Program on Health Technology Assessment in China”by China Medical Board(Grant 19-318).
文摘Although a key tenant of the Sustainable Development Goals is to achieve universal health coverage,the global drug gap persists-cver a third of the global population lack access to essential medicines.Without access to affordable drugs,people have worse health outcomes,higher medical expenses,and productivity loss,pushing them into poverty.Health technology assessments(HTAs)offer an opportunity to decrease the global drug gap and increase access to essential medicines by overcoming barriers to medicine access.These barriers include drug procurement,drug affordability for payers and patients,a patienfs ability to obtain essential medicines,and health system capacity.Using HTAs can therefore close the global drug gap by increasing access to affordable essential medicines.In turn,people have better health outcomes,spend less money on medical care,and can have better productivity.Ultimately,use of HTAs can lift the population out of poverty and force fewer people into poverty by creating better health outcomes at affordable prices.
基金supported by China Medical Board(CMB)under Grant 19-318,A Demonstration Program on Health Technology Assessment in China.
文摘Background Health Technology Assessment(HTA)in China has recently expanded from purely academic research to include policy or decision-oriented practice,especially after HTA evidence was used to update the National Reim-bursement Drug List for the first time in 2017.This study aims to identify the progress and challenges of HTA develop-ment from 2016 to 2021 and inform policies and decisions to promote further HTA development in China.Methods We conducted a cross-sectional web-based survey with policy makers,researchers and industry-providers in China in 2016 and 2021 respectively.The‘Mapping of HTA Instrument’,was utilized to assess the HTA development across eight domains:Institutionalization,Identification,Priority setting,Assessment,Appraisal,Reporting,Dissemina-tion of findings and conclusions,and Implementation in policy and practice.To reduce the influence of confound-ers and compare the mapping outcomes between the 2016 and 2021 groups,we conducted 1:1 Propensity Score Matching(PSM).Univariate analysis was conducted to compare the differences between the two groups.The overall results were further compared with those of a mapping study that included ten countries.Results In total,212 and 255 respondents completed the survey in 2016 and 2021,respectively.The total score of the HTA development level in China in 2021 was higher than that in 2016 before PSM(89.38 versus 83.96).Follow-ing PSM,183 respondents from the 2016 and 2021 groups were matched.Overall,the mean scores for most indicators in the Institutionalization domain and Dissemination domain in 2021 were higher than those in 2016(P<0.05).The Appraisal domain in 2021 was more explicit,transparent and replicable than that in 2016(t=-3.279,P<0.05).How-ever,the mean scores of most indicators in the Assessment domain were higher in 2016 than those in 2021(P<0.05).Conclusions Our study suggest that the level of HTA development in China progressed significantly from 2016 to 2021.However,before engaging in HTA activities,further efforts are required to enhance the assessment process.For instance,it is important to establish a clear goal and scope for HTA;adapt standardized methodologies for evaluat-ing the performance of systematic reviews or meta-analyses;and provide comprehensive descriptions of the safety,clinical effectiveness,cost,and cost-effectiveness of the assessed technologies,thus improving the development of HTA in China.
基金supported by grants from the GuangDong Basic and Applied Basic Research Foundation(No.2023A1515030121,No.2021A1515111020,No.2023A1515010246)the National Natural Science Foundation of China(No.82273148,No.82103555,No.82301086)the Science and Technology Projects in Guangzhou(No.202206080009)。
文摘Metabolic heterogeneity plays a central role in sustaining uncontrolled cancer cell proliferation and shaping the tumor microenvironment(TME),which significantly compromises the clinical outcomes and responses to therapy in head and neck squamous cell carcinoma(HNSCC)patients.This highlights the urgent need to delineate the intrinsic heterogeneity and biological roles of metabolic vulnerabilities to advance precision oncology.The metabolic heterogeneity of malignant cells was identified using single-cell RNA sequencing(scRNA-seq)profiles and validated through bulk transcriptomes.Serine–glycine-one-carbon(SGOC)metabolism was screened out to be responsible for the aggressive malignant properties and poor prognosis in HNSCC patients.A 4-SGOC gene prognostic signature,constructed by LASSO-COX regression analysis,demonstrated good predictive performance for overall survival and therapeutic responses.Patients in the low-risk group exhibited greater infiltration of exhausted CD8+T cells,and demonstrated better clinical outcomes after receiving immunotherapy and chemotherapy.Conversely,high-risk patients exhibited characteristics of cold tumors,with enhanced IMPDH1-mediated purine biosynthesis,resulting in poor responses to current therapies.IMPDH1 emerged as a potential therapeutic metabolic target.Treatment with IMPDH inhibitors effectively suppressed HNSCC cell proliferation and metastasis and induced apoptosis in vitro and in vivo by triggering GTP-exhaustion nucleolar stress.Our findings underscore the metabolic vulnerabilities of HNSCC in facilitating accurate patient stratification and individualized precise metabolic-targeted treatment.
基金supported by the National Natural Science Foundation of China(Nos.82373320,82072568)the Shanghai Shenkang Hospital Development Center(No.SHDC12020110)+1 种基金the Shanghai Pulmonary Hospital Fund(No.fkzr2403)the National Key Research and Development Program of China(No.2023YFC2508603)。
文摘The innate immune system has a primary role in defending against external threats,encompassing viruses,bac-teria,and fungi,thereby playing a pivotal role in establishing robust protection.Recent investigations have shed light on its importance in the progression of tumors,with a particular emphasis on lung cancer.Among the various signaling pathways implicated in this intricate process,the cGAS-STING pathway emerges as a signifi-cant participant.Cyclic GMP-AMP synthase(cGAS)discerns free DNA and activates the stimulator of interferon genes(STING),subsequently culminating in the secretion of cytokines and exerting inhibitory effects on tumor development.Consequently,researchers are increasingly interested in creating anticancer drugs that specifically target the cGAS-STING pathway,offering promising avenues for novel therapeutic interventions.The objective of this review is to present a comprehensive overview of the ongoing research on the cGAS-STING signaling path-way within the realm of lung cancer.The primary emphasis is on understanding its involvement in lung cancer development and assessing its viability as a target for innovative therapeutic options.
