OBJECTIVE:To evaluate the cost-effectiveness of Acarbose in the treatment of type 2 diabetes. METHODS:The CORE diabetes model was employed to evaluate the long-term cost-effectiveness of Acarbose in the treatment of type 2 diabetes. RESULTS:Acarbose treatment prolonged patients' life expectancy by 0.27 years and quality-adjusted life expectancy by 0.26 years,but its cost was 17 081 yuan higher than in the control group. The incremental cost-effectiveness ratio was 62 717 yuan per life expectancy gained and 66 633 yuan per quality-adjusted life expectancy gained. An acceptability curve of cost-effectiveness showed that 76% of the patients would regard that Acarbose is cost-effectiveness when a willingness to pay was 100 000 yuan. CONCLUSION:Acarbose has long-term cost-effectiveness in the treatment of type 2 diabetes.

Objective: To investigate the trend in incidence of stroke in Yongkang City, Zhejiang Province from 2015 to 2022, so as to provide the evidence for improving stroke prevention and treatment strategies. Methods: The incidence of stroke in Yongkang City from 2015 to 2022 was collected through the Zhejiang Chronic Disease Monitoring Information System, and standardized by the data of the Chinese National Population Census in 2010. The incidence of stroke in gender-, age- and subtype-specific was analyzed, and the incidence trend of stroke was analyzed by average annual percentage change (AAPC). Results: A total of 22 408 stroke cases were reported in Yongkang City from 2015 to 2022, with crude incidence of 457.97/105 and standardized incidence of 379.55/105. The crude incidence of stroke appeared a tendency towards a rise (AAPC=6.447%, P<0.05). The crude incidence of stroke was higher among males than females (495.97/105 vs. 417.58/105, P<0.05), and the standardized incidence of stroke was higher among males than females (425.29/105 vs. 332.49/105, P<0.05). The average age of stroke cases was (70.74±12.64) years. The crude incidence of stroke appeared a tendency towards a rise with age (P<0.05), and which in residents aged 30 to 44 years showed an increasing trend (AAPC=6.142%,P<0.05). There were 18 040 cases of ischemic stroke (80.51%), 4 121 cases of hemorrhagic stroke (18.39%) and 247 cases of unclassified stroke (1.10%) reported from 2015 to 2022. The crude incidence of ischemic stroke was higher than which of hemorrhagic stroke (368.70/105 vs. 84.22/105, P<0.05). The crude incidence of ischemic stroke appeared a tendency towards a rise (AAPC=7.851%, P<0.05). Conclusions The crude incidence of stroke appeared a tendency towards a rise in Yongkang City from 2015 to 2022, with ischemic stroke as the predominant subtype. Male and the elderly should be given a high priority for stroke control.

In order to expand the capabilities of hospital's traditional ECG device and enhance medical staff's work efficiency, an ECG monitoring system based on internet of things is introduced. The system can monitor ECG signals in real time and analyze data using ECG sensor, PDA, Web servers, which embeds C language, Android systems, .NET, wireless network and other technologies. After experiments, it can be showed that the system has high reliability and stability and can bring the convenience to medical staffs.
Electrocardiography ; Internet ; Monitoring, Physiologic ; Reproducibility of Results ; Wireless Technology

Child ; Diarrhea ; diagnosis ; therapy ; Humans

Objective To evaluate the use of pediatric clinical illness score(PCIS) and pediatric risk of mortality(PRISM) in severe cases in pediatric intensive care unit(PICU). Methods 580 patients were divid-ed into groups according to PICS results, death and the numbers of organ failure. Severity, mortality were ana-lyzed. PRISM scores were also investigated in these groups respectively. Results The PRISM score of the ex-tremely-severe group was higher than that of the severe group and the non-severe group(P<0.01). The mean value of scores in death group was higher than that in survival group(P<0.01). The PRISM scores was in-creasing along with the growing numbers of organ failure (P<0.05). Conclusion Both PCIS and PRISM scores have good clinical value in assessing the severity and risk of death in patients in PICU.

Objective Satellite cells(SCs) transplant was tried to treat myocardium infarction(MI) in human.Methods 10 patients who affected by coronary artery disease(CAD) and MI were selected.A piece of muscle was taken away from their quadriceps femoris 2 weeks before surgical operation.SCs were extracted,purified,cultured by modified Dorfman method,and then transplanted into the MI area by intramyocardial injection after CABG.EKG,UCG,99cTc-SPECT cardiac blood pool imaging,18F-FDG myocardial perfusion imaging were examined before operation and 3 months after operation.The cell metabolism status in the MI area were observed and LVEF were measured and analyzed by paired-samples t test with SPSS13.0 statistics software.Results After cultured in vitro for3 days,SCs were spindleshaped,and sticked to walls.SCs growth was stasis,fused into each other,and formed myotube when the cells were delayed to divide Petri dish or the concentration of fetus bovine serum(FBS) in the culture medium was reduced.Average 2.7 blood vessel bypass were established in these patients.SCs were transplanted merely in one patient whose coronary arteries were extensively sclerosed.No patients died in hospital.Heart function of these patients were recovered to NYHA I 3 months after operation.Their symptoms of angina pectoris were disap peared and quality of life was improved obviously.The cell metabolism activity was appeared again in the MI area 3 months after operatio(including the patient without CABG).LVEF were increased(9.70±4.17)% than preoperation.There is significant deviation between them(P<0.01).Conclusions Autograft of SCs can be alive in the MI area,and SCs can improve the heart function by participating the heart's systole and diastole activity directly or by altering cardiac compliance and stimulating the blood capillary proliferation.

Objective To investigate the effect of VIP on gut barrier function in rats with acute neerotizing panereatitis (ANP). Methods Fifty four SD rats were randomly divided into three groups: sham operated (SO) group,ANP group and VIP group. Each group was subdivided into 1h, 6h and 12h subgroup after the models were established and each subgroup had 6 rats. The models of ANP were indueed by retrograde injection of 4% sodium taurocholate into the pancreatic duet. VIP group was induced by 5 nmol VIP intraperitoneal injection within 5 minutes after the establishment of ANP model. The serum VIP and intestinal homogenate VIP were detected with ELISA. The serum endotoxin was tested by MB-80 microbes dynamic detecting system. The expression of TNF-α, IL-6, IL-10 mRNA in gut mncosa were determined by RT-PCR.Intestinal samples were harvested for pathological examination. Results The intestinal structure was significantly damaged in ANP group, and the extent of pathological changes were ameliorated in VIP group.The serum and intestinal homogenate VIP levels 6h after the establishment of ANP model were (49. 582 ±3. 735) pg/ml and (87. 731 ±4.601 ) pg/g pro, respectively, which were significantly lower than that of SO group (P ＜ 0.05 ). 12 h after the establishment of SAP model, the serum and intestinal homogenate VIP levels in ANP group were (65. 192 ± 5. 785) pg/ml and ( 110. 978 ± 6. 420) pg/g pro, respectively, which were significantly higher than that of SO group. The serum endotoxin, expression of TNF-α, IL-6, IL-10 mRNA in gut mucosa were(29.570 4-5.127)pg/ml,0.861 ±0.081,1.150 ±0.187 and 0.786±O.102,respectively,which were significantly higher than those of SO group(P＜0.05).The serum endotoxin,expression of TNF-α,IL-6 in gut mucosa in VIP group 6h after establishment of ANP model were(20.486 ±2.81 1)pg/ml,0.707±0.095 and 0.889±0.136,respectively,which were significantly lower than those of ANP group(P＜0.05).The expression of IL-10 mRNA in VIP group was 0.992 ±0.126,which was significantly higher than that of ANP group(P＜0.05).Conclusions VIP had significant protective effects on gut barrier function in rats with ANP.

Objective To observe the changes of plasminogen activator inhibitor-1(PAI-1)mRNA expression in experimental lung iniury and to evaluate the effect of inhaled nitric oxide(NO)on PAI-1 mRNA expression.Methods In this study,acute lung injury rat model was established by lipopolysaccharide(LPS)-induced endotoxemia followed by a second LPS attack via intratracheal injection.Eighty-nine SD male rats aged 4～5 week were randomly assigned to three groups:saline control(C-A)group,LPS-A group attacked by LPS,LPS-NO group treated by nitric oxide.Realtime PCR was used to study the expression of PAI-1 mRNA in the lung.Histopathological lung injury score was evaluated.Results In LPS group,the histopathological lung injury score values were significantly higher than that of C-A group at 2 h[(3.10±0.38)vs(1.12±0.84)](P＜0.05)and the score values after 2 h were higher than that of LPS group at 2 h(P＜0.05).PAI-1 mRNA in lung increased gradually in LPS groups at 2 h,4 h,8 h,16 h,24 h(P＜0.05)and decreased at 48 h(P＞0.05).The PAI-1 mRNA decreased in LPS-NO groups at 4h(P＜0.05).Conclusion The study above demonstrates that PAI-1 mRNA expression is early elevated in rats with endotoxin-induced acute lung injury.Decreased PAI-1 mRNA expression is associated with the efficacy of inhaled nitric oxide.

BACKGROUND: Resent studies demonstrate that sciatica is caused by inflammatory reaction of nucleus pulposus, and dorsal root ganglion (DRG) is in involved in this process; however, its pathophysiological changes remain poorly understood. OBJECTIVE: To explore pathogenesis of sciatica related to nucleus pulposus protrusion without mechanical compression. METHODS: Totally 24 male SD rats were randomly divided into the experimental group and control group, with 12 rats in each group, The coccygeal intarvartebral discs of rats were opened to obtain 5 coccygeal nucleus pulposus, mixed with 50 μL physiological saline to prepare suspension. Rats in the experimental group were prepared non-compressive models by injecting suspension to the epidural cavum of rats. Meantime, the same volumes of physiological saline were injected into rats in the control group. The rat hind paw mechanical withdrawal thresholds were measured, pain-related behavior and dorsal root ganglion morphology were observed. RESULTS AND CONCLUSION: In the absence of mechanical pressure, disappearance of the nucleolus, degeneration of the nuclear membrane and significant hyperalgesia derived by auto-transplantation of nucleus pulposus to the epidural cavum of rats were observed. Dorsal root ganglion cells often had hyperemia, edema and intracytoplasmic vacuoles, with large and irregular nuclei. Prominent Nissl bodies were not seen. The Inflammatory reaction derived by autograft nucleus pulpcsus is an important factor in DRG injury and sciatica.

Objective To investigate the protective effects of vasoactive intestinal peptide(VIP) on gut barrier in rats with severe acute pancrititis(SAP)and its mechanisms.Methods Fifty-four SD rats were randomly divided into sham operated(So)group,SAP group and VIP group.The model of SAP was induced by retrograde injection of 4%sodium taurocholate into the bili-pancreatic duct.The rats in VIP group were intraperitoneal injected with VIP of 5×10-9 nmol 5 minutes after model established.The endotoxin in plasma was measured at 1,6 and 1 2 hour.The expression of Toll-like receptor(TLR)4 in gut mucosa was examined using RT-PCR and immunohistochemistry and mucosa tissue were detected using electroscopic examination.Results The concentration of endotoxin in plasma and expression of TLR4 were both increased at 1 hour and reached peak at 1 2 hour in SAP group compared with SO group(no expression of TLR4),but were decreased in VIP group.A correlation was found between endot6xin and expression of TLR4.The electroscopic examination showed that the pathological injury in intestine was severe in SAP group than that in VIP group.Conclusion The protective effect of VIP in gut barrier function may contribute tO down-regulation of TLR4 expression in gut mucosa.