OBJECTIVE:To measure and analysis the related costs of drug-induced liver injury (D1LI) from different decision makers,and to provide reference for reducing related costs of DILI,improving medical insurance system and realizing effective health resource distribution.METHODS:In retrospective study,60 cured or recovered DILI inpatieuts were randomly selected as subjects from medical record management system of 4 hospitals in Henan province during Jun.2014-Jun.2015.Demographic character istic,clinical characteristic and related cost of DILI were analyzed retrospectively and the cost structure was also analyzed from different decison makers (patient,society,medical insurance payer).RESULTS:The total direct medical cost of 60 cases was 584 113.05 yuan,and total direct non-medical cost was 31 093.15 yuan and total indirect cost was 169 379.95 yuan.The total cost of DILI of fered by patients was 616 296.38 yuan;the total cost of DILI offered by society was 784 586.15 yuan;the total cost of DILI offered by medical insurance was 168 289.77 yuan.CONCLUSIONS:DILI results in serious economic damage for patients and society,deserving attracting extensive attention worldwide.The study provide reference for reducing patient's medical burden and improving medical insurance system,and contribute to optimize medical resource distribution.

Objective To investigate the effect of laparoscopic varicocele high ligation on the semen parameters of patients with unilateral varicocele associated infertility.Methods A total of 56 cases of unilateral varicocele with infertility treated in our hospital from March 2014 to March 2016 were recruited into this study,who were all recepted laparoscopic high ligation.The content of lactic dehydrogenase isoenzyme X(LDH-X),semen fragmentation rate(DFI) and other seminal plasma were observed and compared before surgery and 3 months after surgery.Results The ratio of LDH-X in seminal plasma and whole sperm,DFI and LDH-X of seminal plasma before laparoscopic varicocele high ligation were significant higher than those after surgery,LDH-X of whole sperm was lower than that after surgery,the differences were significant(P<0.05).Sperm concentration,sperm motility,survivability of sperm,and sperm forward progression percentage before laparoscopic varicocele high ligation were significant lower than those after surgery.Conclusion The quality of semen,the content of LDH-X and sperm DNA integrity of unilateral varicocele with infertility could be improved by laparoscopic high ligation of the internal cord vein.

Objective To observe the effects of mesenchymal stem cells (BMSCs) on the expression of Bcl2 and Bax in atrophied muscles.Methods Immature rats (80～ 100 g) were anesthetized to collect marrow from their femurs and tibias.BMSCs were isolated from the marrow,cultured and purified using the whole bone marrow adherence method.Their right hindlimbs were immobilized fiom the thigh to the paw with the knee in extension and the ankle in plantar flexion.After the modeling,24 of the male rats were divided into a sham-operation group,a BMSC group and a phosphate buffer solution (PBS) group,each of 8.The BMSC and PBS groups were injected with either approximately 106 BMSCs or an equal volume of PBS into the belly of the soleus muscle after they had been immobilized for 48 hours,while the control group did not undergo any treatment except for the injection of PBS.All of the rats were sacrificed for analysis after 14 days.Results The BMSCs were mainly spindle cells,showing radial colony arrangement.They grew vigorously and could passage in a continuous and stable manner over 10 passages.At the 4th passage the BMSCs were positive for CD44 (95.84％) and CD90 (96.00％),but negative for CD34 and CD45.Western blotting assay demonstrated that the expression of Bax protein as measured in grey-scale value (0.41±0.08)in the BMSC group was significantly lower than in the PBS group (0.63±0.10),but significantly higher than in the control group (0.14±0.11) on average.The expression of Bcl-2 (0.47±0.14) was also significantly higher in the BMSC group than in the PBS group (0.22-± 0.13),but significantly lower than in the control group (0.81 ± 0.06).Conclusion Bone marrow mesenchymal stem cells can upregulate the expression of anti-apoptotic Bcl-2 protein and downregulate that of the apoptotic Bax protein when injected early into the belly of a muscle in an immobilized limb.

OBJECTIVE:To provide reference for standardized management of skin test of cephalosporin injection in our hos-pital. METHODS:In retrospective analysis,skin test of 8 kinds of cephalosporin [cefotaxime(1.0 g),cefotaxime(0.5 g),cefoti-am (1.0 g),cefotiam (0.5 g),ceftazidime (0.5 g),cefminox (0.5 g),cefminox (1.0 g),ceftriaxone (1.0 g)] and the cost of skin test, related cost of allergic reaction induced by cephalosporin injection were analyzed statistically during Sept. 1st, 2015-Aug. 31th,2016. The cost of skin test of cephalosporin injection was compared with allergic reaction cost reduced by skin test. RESULTS:The positive rate of 100330 patients who used above 8 kinds of cephalosporin injections was 6.27%;the rate of skin test was 82.49%;the direct cost of skin test was 3434411.72 yuan;the indirect cost was 141985.12 yuan;the cost of pa-tient was 3162901.44 yuan;the cost of medical insurance was 259096.28 yuan;the cost of the whole society was 3576396.84 yuan. From the perspective of the whole society,the cost of skin test of cephalosporin injections was(447049.61±247395.07)yuan, and allergic reaction cost reduced by skin test was (316075.48 ± 260600.49)yuan. The cost of skin test was significantly higher than allergic reaction cost reduced by skin test,with statistical significance(P<0.05). CONCLUSIONS:Skin test of cephalosporin injection is low in positive rate,has high expense. The government standardizes the management of skin test of cephalosporin injec-tion and reduces the economic burden of patients under the premise of ensuring the safety of drug use.

Objective To observe the effects and safety of adrenocorticotropic hormone (ACTH) combined with Huaiqihuang on frequent relapse nephrotic syndrome (FRNS) in children. Methods Fifty-five child patients with FRNS were divided into control group, which was given glucocorticoid (GC) to maintain the treatment (group A, n=10), Huaiqihuang group (group B, n=17), ACTH group (group C, n=14) and ACTH combined with Huaiqihuang group (combined treatment group, group D, n=14). Continuous treatment was for 12 months. The GC treatment doses, the levels of basal secretion of adrenal cortex and adrenal cortex reserve were recorded at 6-month and 12-month respectively. And the recurrence rate and adverse reactions were observed in four groups. Results After 6-month treatment, the doses of GC were significantly lower in group C and group D than those in group A and group B (P<0.05). The levels of basal secretion of adrenal cortex were increased in turn in group A~D (P<0.05). After 12-month treatment, the doses of GC were significantly decreased in group C and group D than those in group A and group B, while the level of basal secretion of adrenal cortex and adrenal cortex reserve were increased (P<0.05). There were no significant differences in the doses of GC between group C and group D (P>0.05). After treatment for 6 months and 12 months, the recurrence rates of nephrotic syndrome were significantly lower in group C and group D than those of group A and group B (P<0.05). Conclusion The simple application of ACTH and the combination of Huaiqihuang can relieve the inhibition of long-term using GC on hypothalamic pituitary adrenal axis in FRNS patients.

Objective To evaluate the clinical effect and influential factors of intrauterine device (IUD) after insertion under B-type ultrasound guidance. Methods A total of 434 healthy women of childbearing potential, aged for 18 to 40 years were enrolled. After IUD insertion under ultrasound guidance, the uterine profile was observed during the procedure and the patients’ biological characteristic was recorded and gynecologic examiation was performed at month 1, 3, 6, 12, 18 during following up. All data were analyzed with SPSS software. Results There was no accident in operation.In 18 months after IUD insertion, the pregnancy rate with IUD was 1.94%,the expulsion rate was 4.59% and the removal rate was 5.54%. The risk factors of expulsion were the history with cesarean delivery and artificial abortion plus IUD insertion (P

Objective To observe the effects of treadmill training at different intensities on the expression of p-AKT in rats' gastrocnemius muscles after focal cerebral ischemia,and to investigate whether intensive training is beneficial for the recovery of motor function.Methods Left middle cerebral artery occlusion (MCAO) was induced in 120 male Wistar rats using the intraluminal thread method,and they were divided into an MCAO group (no training),a normal training group (treadmill training once a day for 30 min) and an intensive training group (treadmill training twice a day for 60 min),each of 30 rats.There was also a sham control group with 30 members not given MCAO or training.The four groups were further divided into 3 day,7 day and 14 day subgroups.Five rats randomly selected from each subgroup were sacrificed for hematoxylin-eosin staining after 4％ paraformaldehyde treatment.Neurological function was evaluated using Zausinger scores,and the expression of p-Akt was detected by western blotting.Results No significant differences in Zausinger scores were observed between the intensive training group and the normal training group after 1,3 or 7 days of training.However the average Zausinger score in the intensive training group was significantly higher than in the normal training group after 14 d of treadmill training.After 7 d and 14 d of treadmill training the average cross-sectional area of the gastrocnemius muscles in the sham group was significantly higher than in the other three groups.The average area of the intensive training group was significantly larger than that of the normal training group.The expression of p-Akt in the gastrocnemius was significantly increased in the intensive training group compared with the normal training group in the 7 day and 14 day subgroups.Conclusion Treadmill training can improve the expression of p-Akt in atrophied gastrocnemius muscles caused by MCAO.Intensive training is more effective for the recovery of muscle function.

Objective To explore the imaging characteristics of the ovarian thecoma-fibroma.Methods The clinical imaging characteristics of 25 patients with thecoma-fibroma were retrospectively analyzed. Results A total of 27 lesions were seen in 25 patients, and the maximum diameter of the tumors was 1.2 - 15.0 cm, with an average diameter of 6.9 cm. The tumors whose maximum diameter larger than 6 cm were mainly as cysticsolid. Twenty-six lesions were well-defined margin, and 14 lesions were round and oval masses, 9 lesions were lobulated masses, 3 lesions were irregular masses, and 1 lesion presented with unclear boundary. A total of 10 lesions in 9 cases were performed with CT scan, and the density was similar to uterine muscle density. In MRI scan of a total of 17 lesions of 16 cases, all lesions showed hypointensity on T1WI. On T2WI, 8 lesions showed slightly hyperintensity, 7 lesions appeared slight hypointensity, and 2 lesions appeared significantly hypointense. Eight lesions showed slit hyperintensity. Enhancement scanning was performed in seven cases. Five cases showed mild to moderate enhancement, 1 case was enhanced obviously, and 1 case was not strengthened. Conclusions The imaging findings of the ovarian thecoma-fibroma have somewhat features and can indirectly reflect pathology of tumor. Combined with the clinical data, imaging characteristics are is helpful to the diagnosis and differential diagnosis of the disease.

OBJECTIVETo study the effect of dracorhodin perchlorate on high glucose-induced connective tissue growth factor (CTGF) expression in human mesangial cells (HMC), and its mechanism of prevention and treatment on renal fibrosis in diabetic nephropathy (DN).

METHODThe HMC were divided into low glucose group (LG group, 5.5 mmol x L(-1) D-glucose), high glucose group (HG Group 25 mmol x L(-1) D-glucose), each group was located with dracorhodin perchlorate (7. 5 micromol x L(-1)) as comparison, and was examined at 24, 48 h. The expression of CTGF mRNA was assessed by semi quantatiue RT-PCR, and the expression of CTGF protein was assessed by Western blot.

RESULTCompared to HG group, the expression of CTGF mRNA and protein were reduced in LG group after stimulating 24, 48 hours (P < 0.01). Compared to HG group, the expression of CTGF mRNA and protein were reduced in HG group by added with dracorhodin perchlorate after stimulating 24, 48 hours (P < 0.01).

CONCLUSIONDracorhodin perchlorate can inhibit high glucose-induced connective tissue growth factor expression in human mesangial cells, and this may be its mechanism of prevention and treatment on renal fibrosis in diabetic nephropathy (DN).

Benzopyrans ; pharmacology ; Connective Tissue Growth Factor ; genetics ; metabolism ; Dose-Response Relationship, Drug ; Gene Expression Regulation ; drug effects ; Glucose ; pharmacology ; Humans ; Mesangial Cells ; drug effects ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Time Factors

Increasing evidence indicates that brain-derived neurotrophic factor(BDNF), especially its BDNFVal66Met gene polymorphism, plays an important role in cognitive function of Alzheimer's disease(AD), with its effects on cognition function confirmed by a large number of studies.Therefore, this article reviews the clinical application of BDNF and BDNFVal66Met for Alzheimer's disease(AD), aiming to examine their practical value and effects on AD.