OBJECTIVE:To analyze the cost of three schemes in treatment of unstable angina pectoris METHODS:88 patients with unstable angina pectoris were divided into three groups:group Ⅰ was given isosorbide,asprin,nifedipine and nitroglycerin;group Ⅱ was given isosorbide,asprin,nifedipine,nitroglycerin and red sage injection and group Ⅲ was given isosorbide,asprin,nifedipine,nitroglycerin and puerarin;then using pharmacoeconomic method,cost-effectiveness analysis was carried out RESULTS:The efficacy in the group Ⅱ and group Ⅲ was higher than that in group Ⅰ(P0 05),and the E/C(effectiveness/cost) of the three groups were 15 98,18 02 and 33 40 respectively Compared with group Ⅰ,?C/?E of group Ⅱ and Ⅲ were 24 66,83 90 respectively;Compared with group Ⅱ,?C/?E of group Ⅲ was 643 60 CONCLUSION:The scheme for group Ⅱ is the best one

ER, PR, HER-2 are signiifcant biological markers in guiding the choice of treatment and evaluating clinical prognosis. As the progression of tumor cells, the expressions of these receptors in recurrent tumors may be different from primary tumors. Nowadays clinicians have realized the necessity of receptor detection in the metastatic lesions. This article summarized the current research status on the above issues.

Objective To explore the term efficacy and the influence on the immune function and hemotology toxicity of Shenqi-Fuzheng injection to advanced gastric cancer patients combined with SP chemotherapy.Methods 53 patients with advanced gastric cancer were randomly divided into an observation group (26 cases) and a control group (27 cases).All patients were treated in the oncology department of the Chinese People's Liberation Army 264th Hospital during 2010.1 ～2012.6.The observation group accepted SP chemotherapy plus Shenqi-Fuzheng injection and the control group was treated with SP chemotherapy.After 2 cycles of chemotherapy the term efficacy was evaluated,cellular immune function index and hemotology adverse reaction were observed.Results The objective response rate (RR) between the treatment group and the control group had no difference (x2=0.024,P＞0.05).After 2 cycles of treatment,CD3+ (64.09±7.59)％,CD4+ (44.17±6.09)％,CD8+ (27.60±7.64)％,CD4+/CD8+ (1.63±0.66) and NK(28.07±7.28)％ in the observation group were higher than the control group [accordingly (54.64 ± 6.39) ％,(35.01 ± 6.05) ％,(24.29 ±7.41) ％,(1.30 ± 0.72),(25.06 ± 7.24) ％,(P＜ 0.05)].The incidence of leukocyte decline in the observation group was 19.23％,and 44.44％ in the control group.There was significant difference (P＜0.05).Conclusion Shenqi-Fuzheng injection plus SP chemotherapy can improve the cellular immune function and the tolerance to chemotherapy and reduce hemotology adverse of patients with advanced gastric cancer.

Objective To investigate the etiology and the efficacy of endoscopic management of acute recurrent pancreatitis. Methods Patients with acute pancreatitis (AP) who were admitted in Changhai Hospital from January 2002 to December 2008 were included in the study population. The medical records were reviewed; the ERCP procedures and other treatment options and complications were documented. After the follow-up the patients were divided into two groups: single attack group (SAG) and recurrent attack group (RAG). The etiology and the efficacy of endoscopic management were analyzed. Results 804 patients were included, 512 patients(63.68%) had AP attacked once, 292(36.32%) had AP recurrent attack . The SAG had a mean age of 52 years old; the RAG had a mean age of 44 years old, the age difference between the two groups had statistical significance (P<0.01). In 201 patients with severe AP, 104(20.31%) patients had AP attacked once, 97 (33.22%) had AP recurrently attacked , the difference between the two groups was statistically significant (P < 0.01). There were 46 cases in SAG complicated with pancreatic pseudocysts, and 44 cases in RAG complicated with pancreatic pseudocysts, the incidence between the two groups was statistically significant (P < 0.05). Biliary origin, hypertriglyceridemia were risk factors for recurrent AP. 139 patients with recurrent AP underwent ERCP, and 15 patients developed post-ERCP pancreatitis, 1 patient developed post-endoscopic sphincterotormy bleeding. Follow-up of 118 recurrent AP patients showed the overall remission rate of endoscopic treatment was 78.8%. Conclusions The patients in RAG were younger than those in SAG. The incidence of severe AP and pancreatic pseudocyst was higher in RAG. Cholelithiasis and hypertriglyceridemia were high risk factors of recurrent AP. Endoscopic management was an effective treatment for recurrent AP.

With the advance of modern neonatal management, the increase of survival of infants born with ELBW has resulted in collateral increase in incidence of infants with serious chronic lung disease, typically brnchopulmonary dysplasia (BPD). Long-term sensory, motor and cognitive impairments are common outcomes in survivals with moderate and severe BPD and may persist during school years and adolescence. Increasing evidence suggest that BPD exerts a significant effect on brain growth and development and may be associated with chronic sublethal hypoxia which compond the risk of extended brain injury and NS complications such as cerebral palsy. Animal studies have demonstrated progressive gliosis and cerebral ventriculomegaly, injured subcortical white matter and corpus callosum, dysynchrony synaptic development and disrupted neurotransmitssion in the hypoxia newborn brain. In this literature we built upon the review of neurogical and congnitive outcome in preterm infants with BPD and structural, functional and neurochemical alterations in ainimals following clinical and experimental hypoxia respectively, which may underlie the primary or potential mle for chronic sublethal hypoxia on premature brain development.

OBJECTIVE:To find out an effective way to control the unreasonable increase of drug expenses.METHODS:To analyse and evaluate the role of pharmacoeconomic research in suppression of unreasonable increase of drug expenses.RESULTS:The best therapeutic scheme could be found out by pharmacoeconomic research through the way of determination of the cost and efficacy of pharmacotherapy,and the unreasonable increase of drug expenses could also be cut down in5aspects.CONCLUSION:Pharmacoeconomic research is a practical and feasible way to control unreasonable increase of medical expenses.

Objective To investigate the nursing cooperation in clinical application of RetCamⅢ wide-field digital pediatric retinal imaging system.Methods 119 patients were given pointed nursing guidance while they underwent RetCamⅢ wide-field digital pediatric retinal imaging system examination.Results All patients accomplished the examination.29 cases had adverse reactions after using mydriatic.27 cases felt discomfort during the examination.22 cases appeared adverse reactions after examination,but relieved after nursing cooperation and guidance.Conclusions RetCamⅢ wide-field digital pediatric retinal imaging system is a rapid,safe and effective method for pediatric fundus examination.Favorable nursing cooperation and guidance is the guarantee of accurate and effective examination and harmonious relationship between doctor-nurse-patient.

Objective To assess the relationship between acute exposure to gaseous air pollutants (SO2, NO2) and daily mortality in Shanghai. Methods Semi-parametric generalized additive model was used to analyze the relationship between SO2/NO2 concentrations and daily death numbers from January 1, 2001 to December 31, 2004 in the urban area of Shanghai after adjustment for the long-term trend of death, weather conditions, and "days of the week" effect. Results An increase of 10 ?g/m3 of SO2 could increase the total mortality, cardiovascular disease mortality and respiratory disease mortality by 1.25%(95%CI: 0.85%-1.65%), 1.45%(95%CI: 0.86%-2.04%) and 1.71%(95%CI: 0.72%-2.71%) respectively; as for an increase of 10 ?g/m3 of NO2, the mortalities could be increased by 1.04%(95%CI: 0.72%-1.35%), 1.05%(95%CI: 0.59%-1.51%) and 1.43%(95%CI: 0.65%-2.21%) respectively. Conclusion The air SO2, NO2 of present levels in Shanghai have an adverse effect on the daily mortality of residents.

Objective To evaluate the sensitivity and specificity of DNA micro-array in early detection of infectious pathogens on burn wounds,including 9 species of potential infectious pathogens namely Staphylococcus aureus,Escherichia coli and Pseudomonas aeruginosa,etc.Methods Serial dilutions of each targeted bacteria in saline were examined with VITEK automated microbial test systems(routine methods) as well as by DNA micro-array to compare the sensitivity between these two methods.Sixty-two strains of infectious pathogens collected from burn wounds,were identified by routine methods,and they were also subjected to DNA micro-array examination to determine coincidence.One hundred and three examinations of smear specimens collected from fresh burn wounds were performed with both methods synchronously.The difference in positive result of identification of bacteria between routine method and micro-array technology in sensitivity and specificity was compared.Results The identification of bacteria by micro-array was more convenient and rapid than that by routine method.A 10 to 100 fold higher sensitivity was found in bacterial identification by DNA micro-array than by routine methods.The positive and negative coincidence of bacterial identification was 100% between these two methods.All the strains found by the routine methods were successfully identified by DNA micro-array.In a few instances,more strains of bacteria were detected with micro-anay method than rowtine method.Conclusion The extremely high coincidence and sensitivity of micro-array method with the routine method was confirmed.The detection of bacteria from burn wounds and other contaminated or infected wounds using micro-array method has a bright prospect though some improvements are still necessary.

Objective:To analyze the monitoring results of high resolution esophageal manometry (HRM) and 24-Hour impedance-pH for the patients with functional heartburn (FH)and non-erosive reflux disease(NERD), and explore the effect of Gastroesophageal junction morphology, transient lower esophageal sphincter relaxation and regurgitation of gastric acid in FH and NERD.Methods: 86 patients with continuous heartburn who were negative under endoscope were divided into FH group(38cases) and NERD group(48cases), and gastrointestinal symptom rating scales (GSRS), the results of HRM and 24h pH/impedance monitoring of the two groups were compared and analyzed.Results: The GSRS of sour regurgitation, abdominal distension, diarrhea and constipation of FH group were significantly higher than that of NERD group, respectively(t=-4.45,t=3.83,t=3.07,t=4.58,P<0.05). The ratio of esophagogastric junction-III(EGJ-III)of FH group was significantly lower than that of NERD group (Z=-3.27,P<0.05). And the ratio of esophageal hiatus hernia of FH group was significantly lower than that of NERD group(x2=16.01,P<0.05). In HRM parameters, the differences of lower esophageal sphincter pressure (LESP), upper esophageal sphincter pressure(UESP), distal contractile integral(DCI)and esophagogastric junction- contractile integral (EGJ-CI) between FH group and NERD group were statistically significant(t=6.99,t=-4.51,t=-2.91,t=-3.72;P<0.05), respectively. On the other hand, the times of sour regurgitation in erect position, the ratio of fluid regurgitation, exposed time of erect position and clinostatism, and DeMeester integral of NERD group was statistically significant higher than that of FH group(t=-9.48,t=-13.00,t=-13.56,t=-18.31;P<0.05).Conclusion:There are esophageal dysfunction in a certain degree and obvious regurgitation in both of two groups, and the detections of HRM and 24h-impedance pH contribute to differential diagnosis for NERG. Besides, the symptom of patients with FH may be relative with regurgitation of non-acidic material, especially may be relative with regurgitation of air.