OBJECTIVE:To discuss the economic effects of different therapeutic schemes in the treatment of the same illness.METHODS:202 cases receiving cisplatin chemotherapy were randomly divided into three groups according to the preventing schemes received:group Ⅰ,sulpiride;groupⅡ,ondansetron;groupⅢ,metoclopramide.Data was evaluated using pharmacoeconomic cost-effectiveness analysis.RESULTS:The effective rate of sulpiride was 87.1%,expense of one therapeutic course being 93.30 yuans and increase of 1% effective rate costed 1.07 yuans.The effective rate of ondansetron was 93.5%,expense of one therapeutic course being 448.26 yuans and increase of 1% effective rate costed 4.79 yuans.The effective rate of metoclopramide was 57.5%,expense of one therapeutic course being 54.33 yuans and increase of 1% effective rate costed 0.94 yuans.CONCLUSION:The sulpiride scheme is the most rational one.

Objectives To investigate the alterations of homotopic connectivity in unilateral temporal lobe epilepsy (TLE). Methods Resting-state functional MR imaging data were acquired from patients with unilateral temporal lobe epi?lepsy (n=43) [21 left temporal lobe epilepsy(LTLE) and 22 right temporal lobe epilepsy(RTLE)] and normal controls (NC) (n=20). The functional connectivity between any pair of symmetric interhemispheric voxels (i.e., functional homotopy) was measured by voxel-mirrored homotopic connectivity (VMHC). Results Compared with NC group, the LTLE patients showed decreased functional connectivity in the bilateral supplementary motor areas(t=-3.35), middle temporal gyri (t=-3.50), medial frontal gyri(t=-3.20)and inferior parietal lobules(t=-3.66), and increased interhemispheric func?tional connectivity in the bilateral angular gyri(t= 3.03), occipital gyri(t= 4.25) and superior parietal gyri(t= 3.62). Compared with control subjects, RTLE patients exhibited decreased functional connectivity in the bilateral middle tempo?ral gyri(t=-4.26), precentral gyri(t=-3.29), as well as increased interhemispheric functional connectivity between bi?lateral inferior occipital gyri(t=3.22),parahippocampa gyri(t=3.32), cerebellum(t=3.50). Conclusions There are al?terations of the functional synchronization and coordination in the two hemispheres in unilateral TLE patients.

Purpose To investigate the alterations of homotopic functional connectivity and interhemispheric structural connectivity in patients with unilateral temporal lobe epilepsy (unilateral TLE).Materials and Methods Resting-state functional MR imaging data were acquired from patients in the first affliated hospital of Guang Zhou Medical University who were enrolled from Oct.2013 to Oct.2015 with unilateral temporal lobe epilepsy (n=43) [21 left TLE(LTLE) and 22 right TLE(RTLE)] and normal controls (NC) (n=24).We mainly concerned about the functional connectivity between any pair of symmetric interhemispheric voxels which were measured by voxel-mirrored homotopic connectivity (VMHC).Structural magnetic resonance images were acquired in 10 LTLE patients,16 RTLE patients and 20 NCs.Homotopic regions showing abnormal functional connectivity in patients were adopted as regions of interest for DTI.The FA values were compared between groups.Two-sample t test were used.Results Compared with NC group,the LTLE patients showed increased interhemispheric functional connectivity among the bilateral angular gyri,occipital gyri and superior parietal gyri,and decreased functional connectivity between the bilateral supplementary motor areas,middle temporal gyri,medial frontal gyri and inferior parietal lobules.Compared with control subjects,RTLE patients exhibited increased interhemispheric functional connectivity among bilateral inferior occipital gyri,parahippocampa gyri,cerebellum,as well as decreased functional connectivity among the bilateral middle temporal gyri,precentral gyri and inferi or frontalgyri.Statistical results indicated that the FA value of the commissural fiber bundles connecting the bilateral hippocampal gyri was smaller in RTLE patients than NC patients (t=10.55,P＜0.01).The FA value of the association fibers connecting the bilateral hippocampal gyrus had no significant difference between the LTLE group and NC group.Conclusion The increase or decrease of VMHC value in some brain regions in TLE suggested that there were changes in the functional synchronization and coordination in the two hemispheres in patients with unilateral TLE.In the RTLE patients,some brain regions which had abnormal interhemispheric functional connectivity also had structural damage.

OBJECTIVE:To provide reference for the rational utilization of narcotic drugs in cancer pain patients. METH-ODS:In retrospective survey,2275 prescriptions of narcotic drugs for cancer pain patients in outpatient and emergency depart-ment of our hospital during 2014-2016 were analyzed statistically in respects of general information,drug amount,consumption sum and DDDs,etc. RESULTS:The proportion of male patients and female patients with cancer pain in our hospital were 65.63%and 34.37% within 3 years,mainly aged 21-90. The consumption amount and sum of narcotic drugs in our hospital increased year by year. Dosage forms were mainly tablet. The consumption amount,sum and DDDs of Morphine hydrochloride sustained-release tablets took up the first places among narcotic drugs. And those of Pethidine hydrochloride injection were the lowest. CONCLU-SIONS:The utilization of narcotic drugs is rational in outpatient and emergency department of our hospital on the whole. Morphine preparations are the predominant analgesic drugs for patients with cancer pain.

Objective To investigate the effects of functional electrical stimulation (FES) on motor function and the expression of bromodeoxyuridine (Brdu) + and glial fibrillary acid protein (GFAP) + in the subventricular zone (SVZ) of rats with acute cerebral infarction,and to explore it's mechanism. Methods A rat model of cerebral infarction was established using Longa's technique for middle cerebral artery occlusion (MCAO) with an intraluminal filament.The rats were randomly divided into a FES group,a placebo stimulation group and a control group.In each group,rats were randomly allocated into 1 d,3 d,7 d and 14 d subgroups (6 rats/subgroup).Superficial electrodes were pasted on the paralyzed forelimbs of rats in the FES group for connecting with the FES instrument,and FES treatment was carried out with a current of 4-5 mA for 15 min on the third day after the MCAO operation to produce extension of the wrist and the digits of the paralyzed forelimb.The rats in the placebo stimulation group were pasted with electrodes,but no FES was administered and they received no other treatment.Neurological deficits were evaluated using the modified neurological severity score (mNSS) before treatment and on the 1 st,3rd,7th,and 14th day after treatment. BrdU and GFAP positive cells in the SVZ were detected by immunofluorescence techniques.Results After 7 or 14 days the motor function of rats in the FES group had improved significantly compared with the placebo stimulation and control groups.Compared with the other two groups,the expression levels of BrdU+ and GFAP+ cells in the ischemic SVZ in the FES group were significantly higher at the 3rd,7th and 14th day.Conclusion FES can improve motor function after acute cerebral infarction and also promote the proliferation and differentiation of neural stem cells in the SVZ.

Objective To construct a recombinant adeno-associated virus(rAAV)vector containing a human anti-epidermal growth factor receptor(anti-EGFR)single-chain variable fragment antibody gene,and observe its inhibitory effects on pancreatic cancer cell lines.Methods Human anti-EGFR single-chain variable fragment antibody gene was inserted into the Kpn I and Bgl Ⅱ sites to construct a rAAV-anti EGFR vector,and then rAAV1-EGFP group and rAAV1-anti EGFR group were established.The expression of anti-EGFR antibody was observed.Antibody expression was detected by Western blot,and the inhibition and apoptosis rates of human pancreatic cancer cell lines(PCT-3,SW1990,Capan-1,ASPC-1,MiaPaCa-2 and PANC-1 cells)were detected by CCK-8 assay and flow cytometry,respectively.All data were analyzed using the t test.Results The results of Western blot assay demonstrated that anti-EGFR antibody was expressed in 6 pancreatic cancer cell lines.The inhibition rates of rAAV1-EGFP and rAAVl-anti EGFR on pancreatic ASPC-1 cells were 1.1%± 2.4% and 15.1%±3.5%,respectively,with a significant difference between the 2 groups(t =6.598,P ＜0.05).The apoptosis rates of PANC-1 cells were 7.0% ± 3.0% in the rAAV1-EGFP group and 1 1.4% ± 2.5% in the rAAV1-anti EGFR group,with no significant difference between the 2 grouvs(t = 1.952,P ＞0.05).The apoptosis rates of SW1990,ASPC-1,Capan-1,PCT-3,MiaPaCa-2 cells were 1.1% ± 0.8%,1.5% ± 0.7%,1.7% ± 1.2%,1.1%±0.7% and 2.2% ± 1.1% in the rAAV1-EGFP group,and 17.6% ± 2.2%,46.9% ± 3.9%,20.0% ±2.8%,12.1% ± 1.6% and 31.1% ±2.5% in the rAAV1-anti EGFR group,respectively,with significant differences between the 2 groups(t = 12.208,19.846,10.405,10.909,18.327,P ＜0.05).Conclusions A rAAV-anti EGFR vector with human anti-EGFR single-chain variable fragment antibody gene was constructed.Anti-EGFR antibody has obvious inhibition effects on pancreatic cancer cell lines.

Objective To study the effects of low-frequency electrical stimulation(LFES)on motor function and the expression of glia fibrillary acidic protein(GFAP)around cerebral infarction sites in rats.Methods Fifty-four male adult Sprague-Dawley rats were randomly divided into a LFES group,a placebo group and a sham operation group(18/group).All groups were randomly divided into 3 treatment groups.A rat model of middle cerebral artery occlusion(MCAO)was established using intraluminal filament occlusion.Treatment was carried out 3 d after the operation.Rats in the LFES treatment groups were stimulated with LFES for 3,7 or 14 days (10 min/d);the placebo groups were treated in the same way without electric stimulation;the sham operation subgroups didn't receive any therapy.Scores on a beam-walking test,a rotating pole test and a screen test were assessed at each time point mentioned above.Expression of GFAP was also assessed using immunohistochemcal techniques.Results The paralysed limbs recovered motor function better in the LFES groups than in the control groups.GFAP-positive cells were more numerous at the margins of the infarction area in the treated groups than in the control groups.Conclusions LFES might increase the expression of GFAP,which might be an important mechanism in improving brain plasticity after cerebral ischemia,aiding the recovery of the central nervous system and rebuilding its functioning.

Aim To study the effects of ganoderma lu-cidum polysaccharides and metformin on myocardial fi-brosis of type 2 diabetic rats and its mechanism. Methods SD rats were fed with high fat diet for 4 weeks, and then were injected with streptozotocin (30mg·kg-1 ) to replicate type 2 diabetic model. The diabetic rats were randomized into normal control group,diabetes group, ganoderma lucidum polysaccha-rides group ( 600 mg · kg-1 ) , metformin group ( 600 mg·kg-1 ) , and combination group( ganoderma lucid-um polysaccharides 300 mg·kg-1 +metformin 300 mg ·kg-1 ) . After 12 weeks’ treatment,the levels of fast-ing serum glucose were determined and the extent of myocardial fibrosis was observed by Picro-sirius red staining. The contents of AGEs in serum were deter-mined by fluorescence spectrophotometer. The activities of CAT and GSH-Px in myocardium were detected. Im-munohistochemical method and Western blot were used to detect myocardial tissue AGEs and CTGF protein ex-pression. Results Combination group could repress patho-proceeding of myocardial fibrosis efficiently, im-prove the activity of CAT and GSH-Px in myocardium and lower the concentration of AGEs in serum, as well as reduce the expression of AGEs and CTGF in myo-cardium. Conclusions Ganoderma lucidum polysac-charides and metformin could prevent myocardial fibro-sis. The possible mechanism may be related to repress-ing oxidative stress of myocardium, lowering serum AGEs and down regulating AGEs and CTGF of myocar-dium.

Objective To evaluate long-term changes in health-related quality of life (QOL) of patients with local advanced prostate cancer after intensity modulated radiotherapy (IMRT) combined with androgen deprivation therapy.Methods The patients who met the criteria for this study were enrolled and were treated with IMRT combined with androgen deprivation.The total dose of radiation was 68.2Gy(2.2Gy per fraction).QOL was evaluated before and 3,12,36,48 and 60 months after treatment using the Expanded Prostate Cancer Index Composite(EPIC),a validated tool that assesses four primary domains (urinary,bowel,sexual and hormonal).Results From 2002 to 2007,87 patients were enrolled.At each follow-up time point,the number of cases was 87,87,86,81,75,65,56 and 47,respectively.The median follow-up time was 76.8 months.Compared with baseline assessment,all of four domain scores were declined in follow-up assessments.The mean score of urinary,bowel and hormonal domains were significantly reduced.At 3 months after treatment,the scores of bowel domain were lowest,in which the total,function and symptom scores were 75.7,78.4 and 72.8,respectively.However,there was no statistically significant difference in the mean sexual domain score.The mean change scores in urinary incontinence and obstructive were-13.0±8.3 and-6.12±3.9,respectively.Conclusions IMRT combined with androgen deprivation therapy was well tolerated in patients with local advanced prostate cancer.QOL was decreased in urinary,bowel and hormonal toxicity,most of which could be tolerated in five years.

Objective To construct a mutant strain of Streptococcus mutans ( S.mutans ) with clpC-deletion and to investigate the role of clpC gene in genetic competence.Methods The fragment of clpC gene and the kanamycin resistant cassette flanked by two loxP sites were amplified by PCR.The purified fragment of clpC gene was cloned into pMD-19T simple vector to construct pCKX1.The pCKX1 vector was digested with ClaⅠ/EcoRⅠ, then blunted and introduced into lox71-KMR-lox66 to obtain pCKX2 vector via homologous recombination.The pCKX2 vector was linearized with SalⅠ and transformed into S.mutans UA159 strain.The positive strains constructed via homologous recombination were screened with kanamycin and transformed with the thermosensitive plasmid pCrePA.The KMR cassette was excised after incubating at 30℃ for 48 hours.Then the pCrePA plasmid was removed after overnight incubating at 37℃for the prepara-tion of clpC-deletion mutant.Total RNA were extracted from the S.mutans UA159 strain and the clpC-dele-tion mutant strain respectively, and then reverse transcribed into first strand cDNA.The target gene frag-ments were amplified by RT-PCR and analyzed by the agarose gel electrophoresis and sequencing.After be-ing verified by PCR and sequencing, the S.mutans UA159 strain and the clpC-deletion mutant strain were re-spectively transformed with E.coli-S.mutans shuttle vector pDL276 to observe the competence development induced by the competence-stimulating peptide (CSP).Results The PCR and sequencing results showed that the pCKX2 vector and the mutant strain with clpC-deletion were constructed successfully via homologous recombination.No clpC gene was detected in the clpC-deletion mutant as indicated by RT-PCR analysis.The formation of competent clpC-deletion mutant was delayed and the competence state was prolonged as com-pared with its parent strains.Conclusion The clpC gene negatively regulated the formation of competent S.mutans.