OBJECTIVE:To compare the therapeutic effect,adversere reactions and cost-effectiveness between granisetron and ondansetron in preventing nausea and vomiting caused by cancer chemotherapy.METHODS:Using pharmacoeconomic co_st-effectiveness analysis,the relevant therapeutic indices were evaluated.RESULTS:The effective rates of granisetron in preventing nausea and vomiting were 83.6% and 86.8% with an average cost of 210.48 yuans in a therapeutic couse,the cost-ef_fective ratio being 251.77 and 242.37,and those of ondansetron were 72.9% and 83.7% with an average cost of 381.35 yuans,the cost-effective ratio being 523.11 and 456.62.CONCLUSION:Granisetron can effectively prevent nausea and vomiting caused by cancer chemotherapy,and its cost-effective ratio is superior to that of ondansetron.

ObjectiveTo study the relation ship between progressive cerebral infarction and thyroid hormone level,and analyze the risk factors of progressive cerebral infarction.MethodsThe thyroid hormone,triglyceride esters and fasting glucose levels of 48 patients with progressive cerebral infarction,138 patients with non-progressive cerebral infarction and 60 healthy subjects as control group were measured.ResultsCompared with the patients with non-progressive cerebral infarction,serum T3 of patients with progressive cerebral infarction was lower( P ＜0.05),and the levels of triglyceride ( TG),C-reactive protein ( CRP),and fasting blood glucose were higher ( all P ＜ 0.01 ).ConclusionPatients with progressive cerebral infarction were in a low level of thyroid hormones,and the increasing levels of TG,CRP,and fasting blood glucose were risk factors for progressive cerebral infarction.

Objective To investigate the protective effect of c-jun N-terminal kinase (JNK)inhibitor SP600125 against acute liver failure in mice.Methods Fifty-five male C57/BL6 mice were divided into control group (n =30) and SP600125 group (n =25).The animals were given an intraperitoneal injection of D-galactosamine (D-GalN,400 mg/kg body weight)/lipopolysaccharide (LPS,30 μg/kg body weight).The control group and SP600125 group were given 10％ dimethyl sulfoxide (15 mL/kg body weight) or SP600125 (75 mg/kg body weight) subcutaneously 12 h and 1 h before D-GalN/LPS administration,respectively.D GalN/LPS induced mouse JNK activation was detected by immunohistochemistry for phospho JNK (p-JNK).D-GalN/LPS induced mouse liver cell apoptosis was detected by immunohistochemistry for Caspase-3 and TdT-mediated-dUTP nick endlabeling (TUNEL).Serum alanine transaminase (ALT) level was tested to assess liver injury.Survival rate of mice within 24 h after D-GalN/LPS administration was observed.The comparison between groups was done by t test and survival rate was analyzed by Kaplan-Meier method.Results JNK activity in liver tissues,as indicated by observation of p-JNK positive cells by immunohistochemistry,was diminished 4 h after D-GalN/LPS administration in SP600125 group.Reduced Caspase-3 activity was observed 6 h after D-GalN/LPS administration in SP600125 group (as indicated in immunohistochemistry by Caspase-3 positive cells).Mice in SP600125 group showed significantly lower TUNEL-positive cell count than control group (43.0±24.5 vs 194.7±73.8; t=9.743,P=0.000).Serum ALT level 6 h after D-GalN/LPS administration was (24.0±54.7) U/L in SP600125 group,which was significantly lower than that in control group [(1234.4±478.4) U/L; t=4.734,P=0.0015].SP600125 also significantly improved the survival rate within 24 h after D-GalN/LPS administration (4/5 vs 1/10； x2=5.225,P=0.0223).Conclusions JNK inhibitor SP600125 exerts protective effects against D-GalN/LPS induced acute liver failure in mice by suppressing JNK activation and hepatocyte apoptosis.

This article summarizes the components,the formation and development of carotid atherosclerotic plaque,the factors affecting the stability of plaque,the mechanisms of plaquecaused ischemic cerebrovascular disease as well as the diagnosis of plaques and the treatmentstatus.

OBJECTIVE:To provide reference for rational use of antibiotics in the clinic of our hospital. METHODS:Drug re-sistance of Gram-negative bacillus in the inpatients of our hospital were analyzed retrospectively during May 2013-Dec. 2015 as well as the situation of producing metallo-β-lactamase(MBLs). RESTUTS:A total of 2089 strains of Gram-negative bacillus were detected in our hospital during 2013-2015,among which there were 1456 strains of enterobacteria (69.70%) and 633 strains of non-fermentative bacteria,mainly involving Escherichia coli,Pseudomonas aeruginosa,Klebsiella pneumoniae,Acinetobacter bau-mannii and Enterobacter cloacae. A total of 406 strains of carbapenems-resistant bacteria were detected (19.44%),including 367 strains of non-fermentative bacteria and 39 strains of enterobacteria. The resistant rates of carbapenems-resistant strains to 16 antibi-otics were all higher than 50%,but those of non-carbapenems-resistant strains were in relative low level. Except for aztreonam,re-sistant rates of carbapenems-resistant strains to other 15 antbiotics were all higher than those of non-carbapenems-resistant strains, with statistical significance(P<0.05). A total of 36 strains of producing MBLs were detected(8.87%),including 13 strains of pro-ducing MBLs drug-resistant P. aeruginosa and 23 strains of producing MBLs drug-resistant A. baumannii;producing MBLs drug re-sistant enterobacteria had not been found. CONCLUSIONS:Gram-negative bacillus are mainly enterobacteria in our hospital;car-bapenems-resistant strains are mainly non-fermentative bacteria,resistant rate of them are commonly higher than that of non-drug-re-sistant strain. The situation of producing MBLs is serious,and enzyme producing strains are mainly non-fermentative bacteria. It is necessary to strengthen drug resistance of pathogen and enzyme producing strain monitoring,avoid the generation and spreading of drug-resistant strains due to irrational use of antibiotics.

Objective To design an emergency medical rescue-simulation system,and to provide reference for optimizing rescue strategy and medical resource allocation by simulating different rescue conditions. Methods Firstly，Stateflow was used to build the main simulation unit，which included arrival of the wounded, classification of the wounded (emergent [type A] and non-emergent [type B])，and medical treatment modules， and then the related event and response function were appended. Secondly，the system parameter input unit and character display unit were set up in Simulmk. Finally two different medical treatment strategies (strategy 1:type B wounded waiting for treatment in the rescue module with least waiting patients strategy 2 :type B wounded waiting for treatment in the rescue module with least workload) were simulated and the corresponding rescue strategies were analyzed. Results The system could simulate the medical rescue process of different strategies. The type A wounded could be rescued in a timely manner in both strategies. Type B wounded had a shorter waiting time in strategy 1，but the rescuers had a heavy work load; while they had a longer waiting time in strategy 2，and the rescuers had a lighter work load. Conclusion We have successfully designed a simulation system for emergency medical rescue and its feasibility and effectiveness are verified. Different rescue strategies have their respective advantages and disadvantages in the waiting time and work load, and the two strategies can be combined in practice in order to achieve a dynamic balance between the waiting time of the wounded and the work load of the rescuers.

Objective To apply computer simulation technology for simulating the emergency medical rescue of different conditions and optimizing the rescue strategy and resource allocation. Methods Firstly, according to the characteristics of the arrival of the wounded and the state of injury, four alternative strategies were formulated and simulated. Secondly, the optimal strategy was determined by waiting time of the wounded and the working intensities of rescue unit. Finally, the reasonable suggestions for the rescue strategy and rescue force allocation were put forward by simulation analysis of the relationship between the arrival rate of wounded and the number of rescue units. Results First-leave-first-served and the select-units strategy could effectively reduce the waiting time of the wounded and the working intensity of the rescue unit. When the arrival rate of class A(B) of the wounded increased, the total number of rescue units increased at the same time under the premise of meeting the requirements of the medical rescue, with the number of A(B) rescue units increasing more rapidly. Conclusion By simulating the emergency medical rescue process using different strategies, the optimal rescue strategy can be determined; the number of the rescue units is closely related to the arrival rate of the wounded; estimating the arrival rate of the wounded and the average treatment time can provide reference for rescue force allocation.

Objective To establish a rabbit model of facial skin lifting and to evaluate the skin lifting effects of absorbable soft tissue plastic belt, and to provide experimental basis for clinical application of this plastic belt.Methods 36 Japanese white rabbits were randomly divided into model control group (n=6) and plastic belt lifting group (n=30). The model control group received only facial skin resection surgery, while the plastic belt lifting group had facial skin resection and plastic belt implantation.The changes of rabbit general status, skin lifting effects, performance of plastic belt and pathological changes of subcutaneous tissue after implantation were determined during the 4 weeks after surgery. Results The rabbit skin wound was healed within 3-7 days after surgery without infection.Meanwhile, the plastic belts did not show shifting or rupture, and only whitening around the perforations was observed in the two groups.Compared with the model control group, the MA and MB distances in the plastic belt lifting group were significantly lower ( P<0.01 ) , while the biological tension of plastic belts in the facial skin lifting rabbit models was significantly increased with the extension of time after implantation (P<0.01), and the biological tension was 18.62 N at 4 weeks after transplantation. In addition, the tensile intensities of perforations and plate in the two groups were significantly reduced at 4 weeks postoperatively (P<0.01), the tensile intensity of perforations and plate in the two groups were maintained at 35.07 N and 53.31 N, respectively, and the perforations/plate tensile intensity ratio of the two groups remained unchanged during 4 weeks after transplantation ( P >0.05 ) .Moreover, the molecular weight ( Mw ) , peak molecular weight ( Mp ) , Z molecular weight (Mz) and viscosity were gradually decreased along with the time passing after implantation (P<0.01), and its dispersion Mz/Mw ratio was also gradually decreased from 2 weeks after implantation (P<0.01), and no obvious pathological changes were found after subcutaneous implantation of the plastic belts.Conclusions We have successfully established a facial skin lifting rabbit model, and the plastic belt can obviously lift the facial skin fascia system and keep intact more than 4 weeks in the body.Therefore, this plastic belt can be applied for anti-wrinkle facial soft tissue lifting against the skin damage caused by aging.

Objective To analyze the toxicity of dose adjusted-BEACOP (DA-BEACOP,classic CHOP regimen plus etoposide and (or) bleomycin with or without rituximab) regimen for poor-prognosis lymphoma.Methods 89 patients with poor-prognosis lymphoma who had been treated in-patient at Peking University Third Hospital during August 2002 and February 2012 were retrospectively studied.All patients received at least 1 cycle of DA-BEACOP regimen.Results 3-4 grade adverse events were observed in 74 (83.1％) patients,most of which was myelosuppression (73 cases,82.0 ％).There was not death related with the treatment.Compared to male patients,female patients suffered higher rates of grade 3-4 of toxicity (94.2 ％,33/35 vs 75.9 ％,41/54) (P =0.024).The rate of grade 3-4 of hematological toxicity in patients who were pretreated with ≥3 cycles of chemotherapy than that in patients receiving≤2 cycles of chemotherapy (95.9 ％,47/49 vs 75.0 ％,30/40) (P =0.004),while the rate of 3-4 hematological toxicity in pret-radiotherapy posed patients was higher than that in their counterparts who did not receive radiotherapy (95.9 ％,47/49 vs 75.0 ％,30/40) (P =0.022).Conclusion The DA-BEACOP regimen showed manageable toxicity in patients with poor-prognosis lymphoma.

BACKGROUND:For pediatric patients with aplastic anemia in China, it is difficult to find human leucocyte antigen-matched sibling donors that are mostly replaced by parental donors.
OBJECTIVE:To retrospectively analyze the clinical efficacy and safety of parental haploidentical peripheral blood hematopoietic stem cel transplantation in children with relapsed and refractory severe aplastic anemia.
METHODS:Seventeen children with relapsed and refractory severe aplastic anemia who had no matched sibling or unrelated donor and failed to respond to immunosuppressive therapy were subjected to parental haploidentical peripheral blood hematopoietic stem cel transplantation. A conditioning regimen of fludarabine+cyclophosphamide+rabbit anti-human thymocyte immunoglobulin antibody and the triple therapy of methotrexate, cyclosporine A and mycophenolate mofetil were applied to prevent graft-versus-host disease.
RESULTS AND CONCLUSION: (1) Of the 17 children, 16 cases (94%) reached hematopoietic reconstitution, and the median time of neutrophils≥ 0.5×109/L and platelets≥ 20×109/L was 13 (11-15) days and 17 (12-28) days, respectively. (2) Incidence of acute graft-versus-host disease was 47% (8 of 17 cases), including 29% (5/17) of grades I-II and 18% (3/17) of grades III-IV. Incidence of chronic graft-versus-host disease was 41% (7/17). (3) With a median folow-up duration of 268 (43-753) days, the overal survival rate was 70.6% (12/17). Five dead cases (29%) belonged to transplantation-related death, including one case of fungal skin infections, one case of graft-versus-host disease, three cases of severe lung infection. No relapse case was reported. These findings indicate that if there are no matched sibling or unrelated donors and the immunosuppression effect is poor, parental haploidentical peripheral blood hematopoietic stem cel transplantation is a safe and effective salvage treatment for children with relapsed and refractory severe aplastic anemia.