OBJECTIVE:To evaluate the cost-effectiveness of Acarbose in the treatment of type 2 diabetes. METHODS:The CORE diabetes model was employed to evaluate the long-term cost-effectiveness of Acarbose in the treatment of type 2 diabetes. RESULTS:Acarbose treatment prolonged patients' life expectancy by 0.27 years and quality-adjusted life expectancy by 0.26 years,but its cost was 17 081 yuan higher than in the control group. The incremental cost-effectiveness ratio was 62 717 yuan per life expectancy gained and 66 633 yuan per quality-adjusted life expectancy gained. An acceptability curve of cost-effectiveness showed that 76% of the patients would regard that Acarbose is cost-effectiveness when a willingness to pay was 100 000 yuan. CONCLUSION:Acarbose has long-term cost-effectiveness in the treatment of type 2 diabetes.

Objective: To investigate the trend in incidence of stroke in Yongkang City, Zhejiang Province from 2015 to 2022, so as to provide the evidence for improving stroke prevention and treatment strategies. Methods: The incidence of stroke in Yongkang City from 2015 to 2022 was collected through the Zhejiang Chronic Disease Monitoring Information System, and standardized by the data of the Chinese National Population Census in 2010. The incidence of stroke in gender-, age- and subtype-specific was analyzed, and the incidence trend of stroke was analyzed by average annual percentage change (AAPC). Results: A total of 22 408 stroke cases were reported in Yongkang City from 2015 to 2022, with crude incidence of 457.97/105 and standardized incidence of 379.55/105. The crude incidence of stroke appeared a tendency towards a rise (AAPC=6.447%, P<0.05). The crude incidence of stroke was higher among males than females (495.97/105 vs. 417.58/105, P<0.05), and the standardized incidence of stroke was higher among males than females (425.29/105 vs. 332.49/105, P<0.05). The average age of stroke cases was (70.74±12.64) years. The crude incidence of stroke appeared a tendency towards a rise with age (P<0.05), and which in residents aged 30 to 44 years showed an increasing trend (AAPC=6.142%,P<0.05). There were 18 040 cases of ischemic stroke (80.51%), 4 121 cases of hemorrhagic stroke (18.39%) and 247 cases of unclassified stroke (1.10%) reported from 2015 to 2022. The crude incidence of ischemic stroke was higher than which of hemorrhagic stroke (368.70/105 vs. 84.22/105, P<0.05). The crude incidence of ischemic stroke appeared a tendency towards a rise (AAPC=7.851%, P<0.05). Conclusions The crude incidence of stroke appeared a tendency towards a rise in Yongkang City from 2015 to 2022, with ischemic stroke as the predominant subtype. Male and the elderly should be given a high priority for stroke control.

Objective To observe the application of alkaline cleaning agent in disinfection and supply room cleaning of medical devices, to evaluate the cleaning quality. Methods The 800 contaminated medical instruments collected from February 2016 to February 2017 in municipal maternal and child health hospital were divided into control group (February 2016 to August 2016) and study group (September 2016 to March 2017 ) according to different time periods,with 400 pieces in each group.In the reference group, the instrument was washed with multienzyme detergent, and the study group was cleaned with alkaline detergent. The cleaning of 2 groups of instruments was observed and compared. Results The total excellent and good rate of instrument cleaning in the study group was 97.25％ (389/400), in the reference group was 89.50％(358/400), the difference between the two groups was statistically significant (P<0.05); the cleaning safety, practicality, economy, comprehensive score difference of the study group was significantly better than the reference group (P<0.05). Conclusion The effect of alkaline cleaning agent used in disinfection supply room cleaning medical instruments is remarkable, and the equipment residue and microorganism can be effectively eliminated, and the utility model has the advantages of high safety and low economic cost, and has the important practical value.

Objective To investigate the clinical significance of ambulatory blood pressure monitoring in short-term prognosis of acute inferior myocardial infarction patients .Methods A total of 80 patients with acute inferior myocardial infarction received 24 hours ambulatory blood pressure monitoring after enrolled .According to the results of 24 hours ambulatory blood pressure monito-ring ,eligible patients were divided into dipper model group(n=29) and non-dipper model group(n=51) .Clinical information was collected and all patients were followed-up for major adverse cardiovascular events (MACE) .Results The rate of intravenous thrombolysis in dipper model group was significantly higher than that in non-dipper model group(t=4 .120 ,P=0 .021) .Night mean systolic blood pressure and night mean diastolic blood pressure were all significantly lower in dipper model group than in non-dipper model group(t=2 .032 ,P=0 .040 ;t=3 .175 ,P=0 .002) .The rate of cumulative MACE in non-dipper model group was significant-ly higher than that in dipper model group(t=2 .626 ,P=0 .041) .Multivariate logistic regression analysis showed that ,daytime mean systolic blood pressure(<90 mm Hg) was independent risk factor of MACE(P=0 .018 ,OR=1 .298) ,dipper model blood pressure (P=0 .019 ,OR=0 .769) and intravenous thrombolysis(P=0 .007 ,OR=0 .520) were protective factors for MACE .Conclusion Parameters of ambulatory blood pressure monitoring are closely correlated with prognosis of acute inferior myocardial infarction pa-tients ,and the change of blood pressure model is an important factor for short-term prognosis .

0.05).Conclusions Laparoscopic-assisted radical gastrectomy for gastric cancer is safe and effective,and its short-term outcome is similar to open surgery.

Objective To examine the effect of mycophenolic acid(MPA)on mesangial cell(MC)proliferation and on expressions of transforming growth factor-?(TGF-?)and connective tissue growth factor(CTGF)induced by high glucose.Methods The proliferation activity of mesangial cells incubated for 24h,48h and 72h in different concentrations of MPA was observed by MTT assay.The expressions of TGF-? and CTGF were measured by Western blot.Results MPA inhibited the MC proliferation and expressions of TGF-? and CTGF induced by high glucose.Conclusions MPA decreases the release of extracellular matrix by inhibiting the MC proliferation and expressions of TGF-? and CTGF,and subsequently slows the development of glomerulosclerosis in diabetic nephropathy.

The incidence of severe viral pneumonia increased year on year,cardiac dysfunction is one of the commonest complications in severe pneumonia.But it is still controversial whether or not the severe pneumonia is associated with heart failure.This article focuses on the mechanisms and the treatment of severe pneumonia complicated with cardiac dysfunction.

Objective To study the awareness and behaviors for patients′ privacy protection among undergraduate nurses. Method By using questionnaire, the survey was conducted among 100 undergraduate nurses. Results The score on the awareness and behaviors for patients′privacy protection was (15.84 ± 1.25). There were significant differences in the awareness and behaviors among different internship time, gender and hospitals (all P<0.05). Conclusions Awareness and behaviors for patients′privacy protection among undergraduate nurses are at a medium level. It is a demand to enhance the education on patients′privacy protection , especially to male undergraduate nurses and at the beginning of internship so as to prevent the patient-nurse disputes.

Reforming the managerial system and the educational system of higher medical education is the requirement of the social development in the twenty-first century. The article expounds the fundamental characteristics of medical education including small scale, longer-duration program, and high expenditure. It emphasizes the significance of following the rule of medical education, and analyzes the important position of medical college and the relation of medical college to affiliated hospitals and other related colleges in the comprehensive university. Based on the requirement of the social development and the trend of higher medical education internationalization, it also analyzes the necessity of the adjustment on the medical educational system and the way of the adjustment.

At present,the satisfaction of free medical care of undergraduate is declining,and the doctor-patient relationship is becoming tense.By investigating and interviewing the three representative universities in Beijing,we conclude three reasons including the supplier of medical service,the receiver and doctor-patient communication.By adhering to the medical treatment concept of"Patient-Oriented",the paper puts forword serveral measures including incresing input and improving system and so on to achieve the harmonious development of doctor-patient relationship of undergraduate.