Objective To study the effect of three different kinds of intervenient measures for TB control on the disease burden of TB patients. Method The estimating method of disability adjusted life years(DALY) as recommended by the WHO was used to assess the disease burden of TB patients. Result The average disease burden of new and retreated TB patients covered by the international TB program(ITP) was the lightest, with the loss of 0.31 DALY and 0.62 DALY respectively; the average disease burden of new and retreated TB patients covered by the national TB program(NTP) was intermediate, with the loss of 0.42 DALY and 0.59 DALY respectively; and the average disease burden of new and retreated TB patients from areas using conventional TB therapy(CTT) was the heaviest, with the loss of 0.61 DALY and 0.91 DALY respectively. From a social perspective, the average yearly loss of DALY per thousand TB patients in the ITP, NTP and CTT areas was respectively 16.42, 33.6 and 37.36, with the loss in the NTP areas being 2.05 times as much as that in the ITP areas and the loss in the CTT areas being 2.28 times as much as that in the NTP areas. Conclusion ITP was far superior to NTP and CTT in reducing the disease burden of TB patients, achieving better results both from the perspective of TB patients and the society.

Objective To study the effect of different intervenient measures for TB control on disease financial burden. Method A survey was conducted of the expenses incurred on 1 700 new and retreated TB patients from areas covered by the World Bank project, the Ministry of Public Health project, and non project areas where intervenient measures were also taken. The method of economic estimation was used to explore the disease financial burden carried by the patients families and society. Result The average family disease financial burden is as follows: 1 735 yuan for a new case and 2 755.99 yuan for a retreated case in the international TB program(ITP); 2 669.27 yuan for a new case and 3 530.17 yuan for a retreated case in the national TB program(NTP); and 6 787.02 yuan for a new case and 7 276.10 yuan for a retreated case in the non project areas using conventional TB therapy(CTT). The average social disease financial burden is as follows: 4 735.55 yuan in ITP; 6 471.91 yuan in NTP; and 10 919.96 yuan in CTT. Conclusion The disease financial burden was the lowest in ITP, highest in CTT, and intermediate in NTP.

Objective To study the cost effectiveness, cost utility and cost benefit of three programs for TB control, viz. the World Bank TB project, the Ministry of Public Health TB project and measures taken by non project areas. Method A survey was conducted in TB prevention and treatment institutions in 17 counties of 6 provinces with regard to the course of disease, expenditure for treatment and financial burden of 1 700 new and retreated TB patients. Result The World Bank project, wherein the strategies of directly observed treatment and short course chemotherapy were adopted, proved to be a low input and high output program with low capitalized cost and significant effectiveness, utility and benefit. Suggestion A new round of TB control projects ought to be started so as to achieve the sustainable development of TB prevention and treatment programs and to achieve the goals of the nation in this aspect.

AIM: To study the changes of K + channels of outer hair cells in guinea pig cochlea with streptomycin ototoxicity. METHODS: Auditory brainstem responses (ABR) and whole-cell patch clamp techniques were used.RESULTS: (1) The body weight of guinea pigs with streptomycin ototoxicity decreased significantly; (2) The ABR threshold markedly increased in streptomycin group (Ⅱ,Ⅲ);(3)The number of dissociated outer hair cells of guinea pigs (Ⅱ,Ⅲ) was lower than that of control (Ⅰ); (4) Streptomycin decreased the Ca 2+ -sensitive K + currents and delayed outward K + currents distinctly; (5) There was no significant difference of K + currents between Ⅰ and Ⅱ/Ⅲ. CONCLUSION: These results suggest that the inhibition of K + channels is the basis of streptomycin ototoxicity, but not the direct reason for cell death.

Objective To investigate the application opportunity and effect of B-Lynch suture in severe postpartum hemorrhage during cesarean section. Methods One hundred patients with high risk to postpartum hemorrhage were randomly divided into two groups. Group A was given with preventive treatment by B-Lynch suture after the placenta was born. Group B was given with traditional treatment, such as kneading the uterus, pressing, "8" suture, stuffing with gauze first. B-Lynch suture was used after the failure of traditional treatment or the amount of bleeding was over 400 ml.At the same time, another 50 patients without severe postpartum hemorrhage were selected as control (group C). Observed the difference of the amount of bleeding during different time, the operation time and comphcations among the three groups. Results The amount of bleeding during operation and 2 h after childbirth in group A [(266.00±29.90),(301.33±40.30) ml] were obviously less than those in group B[(512.67±202.12), (554.17±201.78)ml](P<0.01). The operation time in group A [(33.73±2.28)min] was shorter than that in group B [(49.33±10.40) min] (P<0.01). The incidence rate of severe postpartum hemorrhage in group A (6%, 3/50) was lower than that in group B (64%, 32/50) (P<0.01). Every parameter in group A was similar with group C. There were no serious complications during and after operation. Conclusions The preventive use of B-Lynch suture in patients with high risk to postpartum hemorrhage attains much better effects, and depresses the incidence rate of severe postpartum hemorrhage, and also improves the living quality. B-Lynch suture should be. used widely in patients with high risk to postpartum hemorrhage preventively.

OBJECTIVE:To compare between the HPLC method and gravimetric analysis in the determination of the content of sodium new Houttuyfonte injection.METHODS:The content of sodium new Houttuyfonte injection was determined by HPLC and gravimetric analysis respectively.HPLC condition: Zorba extent-C18 column(250 mm?4.6 mm,5 ?m) detected by UV(286 nm),and the mobile phase consisted of methanol-water-tetrabutyl ammonium hydroxide(70:30:0.3).The procedure of gravimetric analysis was in line with state drug standard.RESULTS: The determination results were notably different between the two methods.CONCLUSION:Gravimetric analysis showed no specificity in the determination of sodium new Houttuyfonte injection.

Objective To intervene and appraise the health literacy of diabetic patients entering contracts with family doctors in pilot communities,and learn the effect and feasibility of health literacy management by family doctors for diabetic patients.Methods By means of community intervention study and questionnaire survey,560 diabetic patients as mentioned above in Shanghai were subject to a baseline assessment on their health literacy,followed by management and routine follow-up on their diabetic health literacy.At the end of six months of comprehensive intervention,their health literacy was appraised again to observe the effects of such management.Results Six months of guidance and management found the average scoring of the health literacy of these patients 23.46 over the baseline,an increase of 36.8% of the patients in their compliance of the four basic diabetic diet behaviors,and an increase of 27.8% of them in regular and quantitative exercises.Conclusions It is feasible for community family doctors to carry out the health literacy management for diabetic patients contracted,and health literacy management can change the awareness and behaviors of such patients to some extent.

OBJECTIVE:To select a technique for preparation of fluconazole for injection and to establish a method for determination of its content.METHODS:The formula was selected on the basis of pH value and species of solution adjuvant.The content was determined by HPLC.RESULTS:The preparation was stable when pH value was between6.5～8.5,and its clarity could be increased by propylene glycol.The detectable concentration of fluconazole showed a good linear correlation in the range of40～200?g/ml.The average recovery was100.37%,RSD=1.37%(n=3).CONCLUSION:The fluconazole for injection prepared by the present technique is stable in quality and the method for content determination is accurate and practicable.

Objective To explore a venipuncture method that can reduce the pain, improve the suc-cess rate of puncture as well as reduce vascular injury. Methods Self-controlled method was applied in 200 patients, needle tips with 20～25°,31～40°,41～50°, 51～60°, > 60° angles on the top of the blood ves-sels,the inclined plane of the needle parallel to the longitudinal axis of the blood vessel (that was,the in-clined plane to the left or right) or traditional method with upward of needle tips were adopted, the observa-tion group and the control group were divided according to different methods, pain and success rate of puncture were compared. Results There were differences between the two groups,results of the observa-tion group were better than those of the control group (except when > 60°, success rate showed no differ-ence). Conclusions Venipuncture with needle tip parallel to the longitudinal axis of the blood vessels can significantly reduce pain in patients, improve the success rate of puncture and reduce the vascular in-jury, which were superior to the traditional venipuncture method. Whatever method is chosen, 51～60° is the best angie into the vessel.