0.05)was found in the 2 groups.The costs of the 2 groups were 3270.84 yuan and 10 873.20 yuan respectively,and the cost-effectiveness rates were 37.38 and 117.55 respectively.Conclusion:Scheme A is an effective,safe and economical scheme in the treatment of CHB.

Objective To investigate the expression and clinicalsignificance of neutrophils heparin binding protein (HBP) and CD64 in the chronic obstructive pulmonary disease to explore the clinical value. Methods From March 2015 to December 2015 , 197 patients with chronic obstructive pulmonary disease (COPD), 223 patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) and 265 healthy persons were recruited in this study. 223 patients with AECOPD were divided into two groups based on bacteria concentration in lower respiratory. Infection group was defined as patients with bacteria concentration exceeded 107 cfu/mL group. The rest of patients were in the non-bacterial infection group. Flow cytometry was used to analyzeexpression of CD64 and convert to index of CD64. Enzyme-linked immunosorbent assay (ELISA) was used to analyze expression of HBP. PCT, hs-CRP and WBC were measured at the same time. Results CD64 , HBP , CRP , WBC and PCT were highly expressed inthe acute exacerbation of chronic obstructive pulmonary patients than those in the chronic obstructive pulmonary patients and healthy group (P<0.01). CD64, HBP , CRP , WBC and PCT were highly expressed inthe acute exacerbation of chronic obstructive pulmonary bacterial infection group patients before treatment than thenon-bacterial infection group (P<0.01). HBP, CD64, CRP , WBC and PCT decline dramatically inthe AECOPDbacterial infection group patients after treatment , which were close to the levels in non-bacterial infection group.When the intercept value of CD64 index was defined as 4.0, the sensitivity to diagnose AECOPD bacterial infection was 92.2% with specificity of 86.2%. When the intercept value of HBP index was defined as 49 ng/mL , the sensitivity to diagnose AECOPD bacterial infection was 87.3% with specificity of 92.3%. Therefore, 4.0 of CD64 index and 49ng/ml of HBP index could be used as sensitive indicator of AECOPD detectedby bacterial infections. Conclusion HBP,CD64 were highly expressed in the acute exacerbation of chronic obstructive pulmonary patients than the those of chronic obstructive pulmonary patients and healthygroup, and decline dramatically after treatment. HBP and CD64 has high sensitivity and specificity to diagnose AECOPD bacterial infection. HBP and CD64 could be used as the indicators of auxiliary diagnosis of acute exacerbation of chronic obstructive pulmonary disease and to guide the clinical medication.

Objective:To develop lipiodol-containing calcium alginate microspheres (LAMs) for embolization,and study the characterization for emoblization and the radiopacity. Methods:LAMs were prepared by dripping method. The preparation of LAMs was optimized by orthogonal experiment which involved effects of three factors (the volume ratio of lipiodol to the external aqueous solution,airflow rate,and the weight pushing the injector) at three levels on the responses to the size,polydisperse index and entrapment efficiency of LAMs. The morphology of LAMs was observed under microscope. The elasticity of LAMs was investigated by texture analyzer. The capability injected through catheter of LAMs was monitored by video spinning-drop tensionmeter. The radiopacity of LAMs was measured by X-ray imaging system after LAMs were injected into vas of a rat. Results:The optimal condition for preparation of LAMs was:the volume ratio of lipiodol to the external aqueous solution was 3∶ 10,airflow rate was 40 g/mL and the weight pushing the injector was 100 g. According to the optimized condition,LAMs were prepared and characterized. The mean diameter of LAMs was (493.9?42.6) ?m,the polydisperse index was 1.02 and the entrapment efficiency was (88.97?1.09)%. The LAMs were with round shape and smooth surface in view of photograph of microscope. The maximum average load was (1.09?0.18) N when LAMs were compressed to 60%. The LAMs were injected through catheter without much difficulty. The radiopacity of LAMs in rats was demonstrated to be visible under X-ray photography system. Conclusion:The radiopaque LAMs developed are suitable for the arterial embolization,with round shape,proper size,good elasticity,easy handling character and visible property under X-ray imaging. The radiopaque embolic agent is supposed to be useful for emoblization therapy.

Purpose To examine the regulatory effect of recombinant human fibroblast growth factor-21 on the expression of liver X receptor α and glucose transporter protein 1 in the type 2 diabetes mellitus rats.Methods The rat models of type 2 diabetic mellitus were divided into four groups at random, ic. rhFGF-21 every day, after eight weeks of these treatment, Inspect the fasting blood glucose (FBG), fructosamine(FA), triglyceride(TG), T-cholesterol(TC), high density lipoprotein cholesterol(HDL-C) and low density lipoprotein cholesterol(LDL-C) of these rats, then detecting the mRNA expression of LXRα and GLUT1 by RT-PCR.Results (1) rhFGF-21 can reduce blood glucose steadily to near normal levels in diabetic rats. (2) The expression of LXRα and GLUT1 level was significantly higher in the rhFGF-21 treatment group than that in the model group. (3) rhFGF-21 megadoses and middle doses decreased FA, TG, TC,and LDL-C and elevated HDL-C.Conclusion rhFGF-21 could regulate the mRNA expression of LXRα and GLUT1 in diabetes rats, increase basal level glucose transport, then reduce blood glucose, improve lipid metabolize dysfunction.

OBJECTIVE:To study the hypoglycemic effects of Insulin self-microemulsion for parenteral administration on mod-el rats with type 1 diabetes in vivo. METHODS:Rats were treated with streptozotocin(50 mg/kg)to reproduce model with type 1 diabetes,ip. The model rats were randomly divided into model group (normal saline),positive control group (Insulin injection 2.25 u/kg) and self-microemulsion low,medium and high dose groups (Insulin self-microemulsion 4.5,9 and 18 u/kg);and 10 normal rats were involved in sham-operation group (normal saline). Anesthesia and operation were conducted for all rats. Positive control group was administrated,ip;other rats were parenterally administrated. The blood glucose levels in groups were detected be-fore and after 15-600 min administration. Glucose tolerance test was conducted for the rats in normal control group,model group without glucose,model group with glucose and microemulsion group (Insulin self-microemulsion 9 u/kg). All group were given glucose except model group without glucose. RESULTS:Compared with sham-operation group,the blood glucose levels in model group within 0-240 min were increased,with significant difference(P<0.05). Compared with model group,there was hypoglyce-mic trend in positive control group after 15 min,the blood glucose levels within 30-480 min were decreased,the hypoglycemic peak was 36%,and the peak time was 30 min;there was also hypoglycemic trend in microemulsion low,medium and high dose groups after 30 min,the blood glucose levels within 45-360 min were decreased,hypoglycemic peak was 18%-21%,and the peak time was 90-120 min,with significant differences (P<0.01 or P<0.05). All rats had glucose absorption peak except for model group without glucose in glucose tolerance test,and glucose of rats in microemulsion group reached its peak and then quickly de-creased. CONCLUSIONS:Insulin self-microemulsion can obviously reduce the blood glucose of model rats with type 1 diabetes.

Objective To evaluate the reliability of lactate clearance rate in evaluating the efficacy of early fluid resuscitation in the patients with severe sepsis.Methods One hundred and forty-two patients with severe sepsis,aged 28-87 yr,were enrolled in the study.Isotonic crystalloid fluid was infused after admission to ICU to maintain central venous pressure ≥ 8 mmHg,mean arterial pressure ≥ 65 mmHg,central venous oxygen saturation (ScvO2) ≥ 70％,and urine output ≥ 0.5 ml·kg 1 ·h-1 within 6 h.The patients were divided into 2 groups according to the treatment outcome:survival group and death group.Immediately before fluid resuscitation and at 6,12 and 24 h after fluid resuscitation,blood samples were collected from the central vein for blood gas analysis and ScvO2 was recorded.Blood samples were collected from the peripheral vein for determination of the concentration of lactate and lactate clearance rate was calculated.Results Compared with survival group,the lactate clearance rate was significantly decreased at 6,12 and 24 h after fluid resuscitation,and no significant change in ScvO2 was found in death group.Conclusion Lactate clearance rate can evaluate the efficacy of early fluid resuscitation in the patients with severe sepsis.

Ophthalmology rotation is an integral part of standardized training for general practitioners. The duration of ophthalmology training is only half a month in whole 33-month general practice residency training. The main objective of training for general practice residents is to master the basic clinical skills of ophthalmology, to be able to accurately and timely identify eye diseases, especially those requiring urgent treatment, and to prevent the loss of visual function. This article introduces our teaching experience in ophthalmology training for general practice residents accumulated since 2014. We suggest that the trainees should pre-examine patients independently, play a role of standard patients and receive consultation from teachers. We developed a simple patient assessment form for primary care doctors, the patient who got 10 or more points of the form, should be referred to ophthalmological specialists.

Since the performance appraisal of national tertiary public hospitals was carried out, higher requirements have been put forward for the operation and management of hospitals. Under the premise of ensuring the quality of medical service and medical safety, how to save hospital operating costs and improve the efficiency is an urgent problem for hospital managers. Supported by information upgrading, a tertiary hospital in Guangzhou reformed the treatment process and carried out pre-hospitalization in surgical departments. Data showed that pre-hospitalization can significantly shorten the length of stay, reduce hospitalization costs, and improve the operation efficiency of the hospital.

PURPOSE: At this time, there is uncertainty regarding whether allergen avoidance is the most appropriate strategy for managing or preventing allergies. The purpose of this study was to evaluate the effectiveness of allergen avoidance in the prevention of allergic symptoms in previously sensitized patients and newborns that have the potential to develop allergies. METHODS: We performed online searches of articles published from January 1980 to December 2012 in PubMed and The Cochrane Central Register of Controlled Trials, and selected articles involving randomized controlled trials (RCTs) and allergen avoidance. The parameters used to determine allergenic potential in newborns included the risk ratio (RR) of eczema, asthma, rhinitis, wheeze, and cough. The methods employed to evaluate previously sensitized patients were the standardized mean difference (SMD) of forced expiratory volume in 1 second (FEV1) and peak expiratory flow rate (PEFR). Data quality was assessed using the Jadad scale. RESULTS: A total of 14 RCTs were identified. Meta-analysis demonstrated that allergen avoidance for newborns did not reduce the subsequent incidence of allergic diseases (eczema, P=0.21; rhinitis, P=0.3; cough, P=0.1) but significantly reduced the incidence of asthma and wheezing in high-risk infants (asthma, P=0.03; wheeze, P=0.0004). However, previously sensitized patients who reduced their exposure to known allergens did not show improvement in their lung functions (FEV1, P=0.3; PEFR morning, P=0.53; PEFR evening, P=0.2; PEFR, P=0.29). CONCLUSIONS: Allergen avoidance may not always be successful in preventing allergic symptoms. However, rigorous methodological studies are required to confirm this hypothesis.
Allergens ; Asthma ; Cough ; Eczema ; Forced Expiratory Volume ; Humans ; Hypersensitivity ; Incidence ; Infant* ; Infant, Newborn ; Lung ; Methods ; Odds Ratio ; Peak Expiratory Flow Rate ; Data Accuracy ; Respiratory Sounds ; Rhinitis ; Uncertainty

Objective: To investigate effects of functional training on physical and cognitive function in 4-5 years old children, so as to provide a reference for the research on development of children s physical and cognitive functions. Methods: The 173 participants aged 4-5 were enrolled from 6 kindergartens in Xicheng District, Beijing and were divided into experimental (n=94) and control groups (n=79) by randomized digital tables. The experimental group were asked to receive a 18 week special designed functional movement training, which were not performed to the control group. The two groups were tested with physical and cognitive assessments before and after the intervention, and the results were compared pre/post in individual group and between groups with t tests. Results: Compared with control group, the score of standing long jump among children in the experimental group was improved by 5.72%, and that of feet jump was improved by 23.79%, that of 10-meter-shuttle run was improved by 13.95%, that of simple reaction was by 20.34%, and that of attention was by 18.96%, and all the improvement was of statistical significance(t=-2.75, 6.68, 10.79, 5.07, 4.32, P<0.01). Conclusion Both physical and cognitive functions were enhanced by the functional physical training in 4-5 year-old children.