服务供应链是供应链研究的新领域,服务能力的研究是服务供应链研究中最为重要的一个方面,已有文献主要集中在对物流服务能力的研究,对旅游服务供应链服务能力的研究相对较少。文章利用Meta图模型及旅游服务供应链的服务清单BOS表(Bill o...服务供应链是供应链研究的新领域,服务能力的研究是服务供应链研究中最为重要的一个方面,已有文献主要集中在对物流服务能力的研究,对旅游服务供应链服务能力的研究相对较少。文章利用Meta图模型及旅游服务供应链的服务清单BOS表(Bill of Service)对旅游服务供应链进行建模,同时对服务链的服务能力开展研究,在以旅行社为核心企业的多条服务供应链中选择一条服务能力最大者作为运营链。最后通过计算实例,为旅行社选取最大服务能力的服务链提供决策参考。展开更多
随着药品研发及临床试验成本的不断增加,如何充分利用各类数据指引临床试验高效地开展,以提高新药的研发效率,并制定科学合理的用药方案,具有重要意义。基于模型的荟萃分析(model based meta-analysis,MBMA)是将数学建模与荟萃分析(meta...随着药品研发及临床试验成本的不断增加,如何充分利用各类数据指引临床试验高效地开展,以提高新药的研发效率,并制定科学合理的用药方案,具有重要意义。基于模型的荟萃分析(model based meta-analysis,MBMA)是将数学建模与荟萃分析(meta-analysis)相结合,对多种来源(如临床前和临床各阶段研究数据等)和多个维度(靶标/机制、药代/药效动力学、疾病/适应症、人群特征、给药方案、生物标志物/药效指标/安全性指标等)的信息进行整合,不仅为药物研发各个关键环节的决策制定提供重要依据,也可为临床合理用药以及药物经济学中的成本-效益分析提供有效信息。传统的Meta分析对数据的同质性要求较高,而MBMA通过建模可将不同剂量、不同疗程和不同人群的异质性数据合并分析,从而对药物的剂量效应、时间效应和影响因素进行量化,预测以往研究中不曾涉及的剂量、时间和协变量水平下的药效或安全特征。尽管MBMA的建模和模拟技术与群体药动学/药效学(population pharmacokinetics/pharmacodynamics,Pop PK/PD)相似,但相比Pop PK/PD,MBMA最大的优势是可对文献数据进行充分利用,不仅提高了结论的证据强度,更可回答单个研究不能回答的问题。目前MBMA已成为模型引导的药物研发(model-informed drug development,MIDD)策略中的重要方法之一。本文将就MBMA的应用价值、分析计划、数据采集与处理、分析方法以及报告要点进行说明,旨在为MBMA在新药研发和临床实践中的应用提供参考。展开更多
生理药代动力学(physiologically based pharmacokinetics,PBPK)是定量药理学的主要研究领域之一,其在新药研发和临床医疗实践的各个阶段均发挥着重要作用,包括药物早期开发阶段的人体药动学(pharmacokinetics,PK)预测、临床研究阶段考...生理药代动力学(physiologically based pharmacokinetics,PBPK)是定量药理学的主要研究领域之一,其在新药研发和临床医疗实践的各个阶段均发挥着重要作用,包括药物早期开发阶段的人体药动学(pharmacokinetics,PK)预测、临床研究阶段考察各种生理和病理等因素对PK的影响、特殊人群剂量调整、药物相互作用等。近年来,PBPK模型在工业界的应用越来越广泛,监管机构也认可PBPK模型在药物研发中的积极指导作用。随着模型指导的药物研发的发展和普及,将PBPK模型与其他常用建模方法,包括群体药代动力学(population pharmacokinetics,PopPK)、药代动力学/药效动力学(pharmacokinetic/pharmacodynamic,PK/PD)模型和基于模型的Meta分析(model-based meta-analysis,MBMA)相融合可实现优势互补。本文简介了PBPK的起源、发展和应用现状,并对其与PopPK、PK/PD和MBMA的融合应用进展进行综述。展开更多
AIM： To evaluate the clinical outcomes of patients undergoing hepatectomy with hemihepatic vascular occlusion （HHO） compared with total hepatic inflow occlusion （THO）. METHODS： Randomized controlled trials （RCT...AIM： To evaluate the clinical outcomes of patients undergoing hepatectomy with hemihepatic vascular occlusion （HHO） compared with total hepatic inflow occlusion （THO）. METHODS： Randomized controlled trials （RCTs） co- mparing hemihepatic vascular occlusion and total he- patic inflow occlusion were included by a systematic literature search. Two authors independently assessed the trials for inclusion and extracted the data. A meta- analysis was conducted to estimate blood loss, transfu- sion requirement, and liver injury based on the levels of aspartate aminotransferase （AST） and alanine arni- notransferase （ALT）. Either the fixed effects model or random effects model was used. RESULTS- Four RCTs including 338 patients met the predefined inclusion criteria. A total of 167 patients were treated with THO and 171 with HHO. Metaanalysis of AST levels on postoperative day 1 indicated higher levels in the THO group with weighted mean dif- ference （WMD） 342.27; 95% confidence intervals （CI） 217.28-467.26; P = 0.00001; I2 = 16%. Meta-analysis showed no significant difference between THO group and HHO group on blood loss, transfusion requirement, mortality, morbidity, operating time, ischemic duration, hospital stay, ALT levels on postoperative day 1, 3 and 7 and AST levels on postoperative day 3 and 7. CONCLUSION： Hemihepatic vascular occlusion does not offer satisfying benefit to the patients undergoing hepatic resection. However, they have less liver injury after liver resections.展开更多
AIM:To evaluate the feasibility and safety of laparoscopic distal pancreatectomy(LDP) compared with open distal pancreatectomy(ODP).METHODS:Meta-analysis was performed using the databases,including PubMed,the Cochrane...AIM:To evaluate the feasibility and safety of laparoscopic distal pancreatectomy(LDP) compared with open distal pancreatectomy(ODP).METHODS:Meta-analysis was performed using the databases,including PubMed,the Cochrane Central Register of Controlled Trials,Web of Science and BIOSIS Previews.Articles should contain quantitative data of the comparison of LDP and ODP.Each article was reviewed by two authors.Indices of operative time,spleen-preserving rate,time to fluid intake,ratio of malignant tumors,postoperative hospital stay,incidence rate of pancreatic fistula and overall morbidity rate were analyzed.RESULTS:Nine articles with 1341 patients who underwent pancreatectomy met the inclusion criteria.LDP was performed in 501(37.4%) patients,while ODP was performed in 840(62.6%) patients.There were significant differences in the operative time,time to fluid intake,postoperative hospital stay and spleen-preserving rate between LDP and ODP.There was no difference between the two groups in pancreatic fistula rate [random effects model,risk ratio(RR) 0.996(0.663,1.494),P = 0.983,I2 = 28.4%] and overall morbidity rate [random effects model,RR 0.81(0.596,1.101),P = 0.178,I2 = 55.6%].CONCLUSION:LDP has the advantages of shorter hospital stay and operative time,more rapid recovery and higher spleen-preserving rate as compared with ODP.展开更多
Objective: The efficacy of preoperative transarterial chemoembolization(TACE) for hepatectomy on hepatocelluar carcinoma(HCC) is still controversial. This study aims to evaluate the efficacy of preoperative TACE on re...Objective: The efficacy of preoperative transarterial chemoembolization(TACE) for hepatectomy on hepatocelluar carcinoma(HCC) is still controversial. This study aims to evaluate the efficacy of preoperative TACE on resectable HCC. Methods: Pubmed, SCI, Medline, EMBASE, Cochrane Datebase, CNKI were searched. The articles that focused on preoperative TACE for resectable HCC, published from 1990 to 2012, were collected by computerized search of literatures and manual search of bibliographies. The relevant clinical trials' data were reviewed by meta-analysis using the random effects model or fixed effect model by heterogeneity. The outcomes were expressed as odds ratio(OR) with 95% confidence intervals(CIs). Results: A total of 1347 patients were included in these 7 studies, the cases were divided into the preoperative TACE group and the non-preoperative TACE group, and there was no difference between the two groups in the 3-year disease-free survival rate, with an odds ratio of 1.14(95% CI = 0.90–1.45, P = 0.27); the 5-year disease-free survival rate in the preoperative TACE group was better than that in the non-TACE group with an odds ratio of 1.35(95% CI = 1.07–1.74, P = 0.02); the 5-year overall survival rate in the preoperative TACE group was higher than that in the non-TACE group with an odds ratio of 0.59(95% CI = 0.46–0.77, P < 0.0001). Conclusion: The present data suggests that preoperative TACE has no different in improving the 3-year disease-free survival rate with non-TACE group for resectable HCC, while it can improve the 5-year disease-free survival rate and the 5-year overall survival rate. More randomized controlled trials using large sample size are needed to provide sufficient evidence to confirm current conclusion.展开更多
AIM:To evaluate survival and recurrence after salvage liver transplantation(SLT) for the treatment of hepatocellular carcinoma(HCC) compared with primary liver transplantation(PLT) using a meta-analysis.METHODS:Litera...AIM:To evaluate survival and recurrence after salvage liver transplantation(SLT) for the treatment of hepatocellular carcinoma(HCC) compared with primary liver transplantation(PLT) using a meta-analysis.METHODS:Literature on SLT versus PLT for the treatment of HCC published between 1966 and July 2011 was retrieved.A meta-analysis was conducted to estimate pooled survival and disease-free rates.A fixed or random-effect model was established to collect the data.RESULTS:The differences in overall survival and disease-free survival rates at 1-year,3-year and 5-year survival rates were not statistically significant between SLT group and PLT group(P > 0.05).After stratifying the various studies by donor source and Milan criteria,we found that:(1) Living donor liver transplantation recipients had significantly higher 1-year survival rate,lower 3-year and 5-year survival rates compared with deceased-donor liver transplantation(DDLT) recipients.And in DDLT recipients they had better 1-year and 5-year disease-free survival rate in SLT group;and(2) No difference was seen in 1-year,3-year and 5-year survival rates between two groups who beyond Milan criteria at the time of liver transplantation.CONCLUSION:SLT can be effectively performed for patients with recurrence or deterioration of liver function after hepatectomy for HCC.It does not increase the perioperative mortality and has a similar long-term survival rates compared to PLT.展开更多
Objective To investigate the preventive effect of probiotics on pediatric food allergy. Methods From MEDLINE bibliographical database, we searched and reviewed all randomized controlled trials on the preventive effect...Objective To investigate the preventive effect of probiotics on pediatric food allergy. Methods From MEDLINE bibliographical database, we searched and reviewed all randomized controlled trials on the preventive effects of probiotics on pediatric food allergies up to September 2013 and excluded the studies that do not meet inclusion criteria and extracted the data. Meta-analysis for the results of homogenous studies was performed using RevMan 5.0 and the co-effect was pooled by using fixed-effects model of relative risk(RR) ratios. Results Ten trials published between 2007 and 2012 including 2701 cases were included. Meta-analysis based on included data showed that the preventive effect of prenatal and postnatal probiotic supplementation on food allergies was not significant with the RR=0.88(95% CI: 0.76-1.03). Conclusion Present evidences cannot show in unequivocal terms that prenatal and postnatal probiotic supplementation will prevent food allergic diseases.展开更多
文摘服务供应链是供应链研究的新领域,服务能力的研究是服务供应链研究中最为重要的一个方面,已有文献主要集中在对物流服务能力的研究,对旅游服务供应链服务能力的研究相对较少。文章利用Meta图模型及旅游服务供应链的服务清单BOS表(Bill of Service)对旅游服务供应链进行建模,同时对服务链的服务能力开展研究,在以旅行社为核心企业的多条服务供应链中选择一条服务能力最大者作为运营链。最后通过计算实例,为旅行社选取最大服务能力的服务链提供决策参考。
文摘随着药品研发及临床试验成本的不断增加,如何充分利用各类数据指引临床试验高效地开展,以提高新药的研发效率,并制定科学合理的用药方案,具有重要意义。基于模型的荟萃分析(model based meta-analysis,MBMA)是将数学建模与荟萃分析(meta-analysis)相结合,对多种来源(如临床前和临床各阶段研究数据等)和多个维度(靶标/机制、药代/药效动力学、疾病/适应症、人群特征、给药方案、生物标志物/药效指标/安全性指标等)的信息进行整合,不仅为药物研发各个关键环节的决策制定提供重要依据,也可为临床合理用药以及药物经济学中的成本-效益分析提供有效信息。传统的Meta分析对数据的同质性要求较高,而MBMA通过建模可将不同剂量、不同疗程和不同人群的异质性数据合并分析,从而对药物的剂量效应、时间效应和影响因素进行量化,预测以往研究中不曾涉及的剂量、时间和协变量水平下的药效或安全特征。尽管MBMA的建模和模拟技术与群体药动学/药效学(population pharmacokinetics/pharmacodynamics,Pop PK/PD)相似,但相比Pop PK/PD,MBMA最大的优势是可对文献数据进行充分利用,不仅提高了结论的证据强度,更可回答单个研究不能回答的问题。目前MBMA已成为模型引导的药物研发(model-informed drug development,MIDD)策略中的重要方法之一。本文将就MBMA的应用价值、分析计划、数据采集与处理、分析方法以及报告要点进行说明,旨在为MBMA在新药研发和临床实践中的应用提供参考。
文摘生理药代动力学(physiologically based pharmacokinetics,PBPK)是定量药理学的主要研究领域之一,其在新药研发和临床医疗实践的各个阶段均发挥着重要作用,包括药物早期开发阶段的人体药动学(pharmacokinetics,PK)预测、临床研究阶段考察各种生理和病理等因素对PK的影响、特殊人群剂量调整、药物相互作用等。近年来,PBPK模型在工业界的应用越来越广泛,监管机构也认可PBPK模型在药物研发中的积极指导作用。随着模型指导的药物研发的发展和普及,将PBPK模型与其他常用建模方法,包括群体药代动力学(population pharmacokinetics,PopPK)、药代动力学/药效动力学(pharmacokinetic/pharmacodynamic,PK/PD)模型和基于模型的Meta分析(model-based meta-analysis,MBMA)相融合可实现优势互补。本文简介了PBPK的起源、发展和应用现状,并对其与PopPK、PK/PD和MBMA的融合应用进展进行综述。
文摘AIM： To evaluate the clinical outcomes of patients undergoing hepatectomy with hemihepatic vascular occlusion （HHO） compared with total hepatic inflow occlusion （THO）. METHODS： Randomized controlled trials （RCTs） co- mparing hemihepatic vascular occlusion and total he- patic inflow occlusion were included by a systematic literature search. Two authors independently assessed the trials for inclusion and extracted the data. A meta- analysis was conducted to estimate blood loss, transfu- sion requirement, and liver injury based on the levels of aspartate aminotransferase （AST） and alanine arni- notransferase （ALT）. Either the fixed effects model or random effects model was used. RESULTS- Four RCTs including 338 patients met the predefined inclusion criteria. A total of 167 patients were treated with THO and 171 with HHO. Metaanalysis of AST levels on postoperative day 1 indicated higher levels in the THO group with weighted mean dif- ference （WMD） 342.27; 95% confidence intervals （CI） 217.28-467.26; P = 0.00001; I2 = 16%. Meta-analysis showed no significant difference between THO group and HHO group on blood loss, transfusion requirement, mortality, morbidity, operating time, ischemic duration, hospital stay, ALT levels on postoperative day 1, 3 and 7 and AST levels on postoperative day 3 and 7. CONCLUSION： Hemihepatic vascular occlusion does not offer satisfying benefit to the patients undergoing hepatic resection. However, they have less liver injury after liver resections.
基金Supported by The key project grant from the Science and Technology Department of Zhejiang Province,No.2011C13036-2
文摘AIM:To evaluate the feasibility and safety of laparoscopic distal pancreatectomy(LDP) compared with open distal pancreatectomy(ODP).METHODS:Meta-analysis was performed using the databases,including PubMed,the Cochrane Central Register of Controlled Trials,Web of Science and BIOSIS Previews.Articles should contain quantitative data of the comparison of LDP and ODP.Each article was reviewed by two authors.Indices of operative time,spleen-preserving rate,time to fluid intake,ratio of malignant tumors,postoperative hospital stay,incidence rate of pancreatic fistula and overall morbidity rate were analyzed.RESULTS:Nine articles with 1341 patients who underwent pancreatectomy met the inclusion criteria.LDP was performed in 501(37.4%) patients,while ODP was performed in 840(62.6%) patients.There were significant differences in the operative time,time to fluid intake,postoperative hospital stay and spleen-preserving rate between LDP and ODP.There was no difference between the two groups in pancreatic fistula rate [random effects model,risk ratio(RR) 0.996(0.663,1.494),P = 0.983,I2 = 28.4%] and overall morbidity rate [random effects model,RR 0.81(0.596,1.101),P = 0.178,I2 = 55.6%].CONCLUSION:LDP has the advantages of shorter hospital stay and operative time,more rapid recovery and higher spleen-preserving rate as compared with ODP.
文摘Objective: The efficacy of preoperative transarterial chemoembolization(TACE) for hepatectomy on hepatocelluar carcinoma(HCC) is still controversial. This study aims to evaluate the efficacy of preoperative TACE on resectable HCC. Methods: Pubmed, SCI, Medline, EMBASE, Cochrane Datebase, CNKI were searched. The articles that focused on preoperative TACE for resectable HCC, published from 1990 to 2012, were collected by computerized search of literatures and manual search of bibliographies. The relevant clinical trials' data were reviewed by meta-analysis using the random effects model or fixed effect model by heterogeneity. The outcomes were expressed as odds ratio(OR) with 95% confidence intervals(CIs). Results: A total of 1347 patients were included in these 7 studies, the cases were divided into the preoperative TACE group and the non-preoperative TACE group, and there was no difference between the two groups in the 3-year disease-free survival rate, with an odds ratio of 1.14(95% CI = 0.90–1.45, P = 0.27); the 5-year disease-free survival rate in the preoperative TACE group was better than that in the non-TACE group with an odds ratio of 1.35(95% CI = 1.07–1.74, P = 0.02); the 5-year overall survival rate in the preoperative TACE group was higher than that in the non-TACE group with an odds ratio of 0.59(95% CI = 0.46–0.77, P < 0.0001). Conclusion: The present data suggests that preoperative TACE has no different in improving the 3-year disease-free survival rate with non-TACE group for resectable HCC, while it can improve the 5-year disease-free survival rate and the 5-year overall survival rate. More randomized controlled trials using large sample size are needed to provide sufficient evidence to confirm current conclusion.
文摘AIM:To evaluate survival and recurrence after salvage liver transplantation(SLT) for the treatment of hepatocellular carcinoma(HCC) compared with primary liver transplantation(PLT) using a meta-analysis.METHODS:Literature on SLT versus PLT for the treatment of HCC published between 1966 and July 2011 was retrieved.A meta-analysis was conducted to estimate pooled survival and disease-free rates.A fixed or random-effect model was established to collect the data.RESULTS:The differences in overall survival and disease-free survival rates at 1-year,3-year and 5-year survival rates were not statistically significant between SLT group and PLT group(P > 0.05).After stratifying the various studies by donor source and Milan criteria,we found that:(1) Living donor liver transplantation recipients had significantly higher 1-year survival rate,lower 3-year and 5-year survival rates compared with deceased-donor liver transplantation(DDLT) recipients.And in DDLT recipients they had better 1-year and 5-year disease-free survival rate in SLT group;and(2) No difference was seen in 1-year,3-year and 5-year survival rates between two groups who beyond Milan criteria at the time of liver transplantation.CONCLUSION:SLT can be effectively performed for patients with recurrence or deterioration of liver function after hepatectomy for HCC.It does not increase the perioperative mortality and has a similar long-term survival rates compared to PLT.
文摘Objective To investigate the preventive effect of probiotics on pediatric food allergy. Methods From MEDLINE bibliographical database, we searched and reviewed all randomized controlled trials on the preventive effects of probiotics on pediatric food allergies up to September 2013 and excluded the studies that do not meet inclusion criteria and extracted the data. Meta-analysis for the results of homogenous studies was performed using RevMan 5.0 and the co-effect was pooled by using fixed-effects model of relative risk(RR) ratios. Results Ten trials published between 2007 and 2012 including 2701 cases were included. Meta-analysis based on included data showed that the preventive effect of prenatal and postnatal probiotic supplementation on food allergies was not significant with the RR=0.88(95% CI: 0.76-1.03). Conclusion Present evidences cannot show in unequivocal terms that prenatal and postnatal probiotic supplementation will prevent food allergic diseases.
