Background: Over-proliferation of airway smooth muscle cell (ASMC) is one of the important contributors to airway remodeling in asthma. The aim of this study was to investigate the effect of Shenmai injection (SMI) on the proliferation of the rat ASMC in asthma. Methods: Rats were randomly divided into three groups: the control group, the asthma group, and the SMI treatment group. Reverse transcription-polymerase chain reaction (RT-PCR) and immunocytochemistry staining were used to detect the mRNA and protein expression of transient receptor potential vanilloid 1 (TRPV1) and proliferating cell nuclear antigen (PCNA) in rat ASMC respectively. Intracellular Ca²⁺ concentration ( [Ca²⁺]i ) in rat ASMC were measured with Fluo-3/AM by confocal microscopy. The proliferation was detected by MTT assay. Results: Compared with the control group, the asthma group showed an increased expression of TRPV1 and [Ca²⁺]i in rat ASMC. The expression of PCNA and absorbance of MTT assay in asthma rat ASMC was also significantly increased. SMI could significantly decrease the expression of TRPV1 channel and [Ca²⁺]i in the asthmatic rat ASMC. Furthermore, the expression of PCNA and absorbance of MTT assay in asthmatic rat ASMC was significantly reduced after SMI treatment. Conclusions: SMI may prevent asthma-induced ASMC over-proliferation probably by inhibiting the expression of TRPV1 channel, which regulates the intracellular calcium concentration.

Background: The international Phase 3 LAURA trial (NCT03521154) demonstrated that the use of osimertinib following chemoradiotherapy markedly improved survival outcomes in unresectable stage III NSCLC with epidermal growth factor receptor (EGFR) mutations. Considering the high cost of targeted therapy, the popularization of osimertinib in clinical practice should be considered comprehensively in terms of cost and efficacy. This study was to investigate the cost-effectiveness of osimertinib for unresectable stage III EGFR-mutated NSCLC without disease progression after chemoradiotherapy from the perspective of payers in the USA and China. Methods: The main health outcomes were evaluated by measuring life-years (LYs), quality-adjusted life-years (QALYs), incremental cost-effectiveness ratio (ICER), and incremental net health benefit (INHB). An integrated Markov model with three separate health states over a 15-year horizon was established. The sensitivity of the model was assessed, and subgroup analyses were conducted. Results: Compared with placebo in stage III EGFR-mutated NSCLC after chemoradiation, osimertinib [$898,107 (3.70 QALYs) and $49,565 (3.49 QALYs)] increased costs (efficacy) by $178,953 (0.56 QALYs) in the USA and $17,872 (0.51 QALYs) in China. The corresponding ICERs were $322,308/QALY and $35,186/QALY, respectively, with an INHB of −0.63 and 0.06 QALYs. The sensitivity analysis showed that the results were influenced significantly by progression-free survival. Conclusions: In China, treatment with osimertinib rather than placebo appears to be an effective and economically accessible option for patients with stage III EGFR-mutated NSCLC with no disease progression after chemoradiotherapy. This applied especially to the eastern and central economic regions of China but not the USA currently.