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.

0.999 5), RSD were no more than 3.0%. The recovery rates were 98.0%-102.0%. There was no significant difference between the results of this method and EDTA-Na2 titration. Conclusion The method is rapid, accurate, simple, little disturbance and is acceptable in determination of total hardness in drinking water.

90% with better sparing of the surrounded normal tissue.However,the metastasis rate is still 20%-25%,which limits the improvement of overall survival(OS).To consolidate the local control rate and reduce the metastasis rate,it is necessary to combine chemotherapy with radiotherapy.According to clinical randomized studies and meta-analysis,chemotherapy can improve the OS of loco-regionally advanced nasopharyngeal carcinoma by more than 6% with radiotherapy alone as baseline.Concurrent chemo-radiotherapy is the most promising strategy to cope with the disease.This review has summarized the progress in the area of combination of chemotherapy and radiotherapy for the treatment of loco-regionally advanced nasopharyngeal carcinoma.

OBJECTIVE:To observe the clinical effect of tiotropium bromide combined with salmeterol xinafoate and fluticasone propionate in the treatment of medium and severe COPD. METHODS:119 patients with medium and severe COPD were divided into control group(54 cases)and observation group(65 cases)according to admission order. Control group was treated with Salmeterol xi-nafoate and fluticasone propionate powder for inhalation 50 μg,bid;observation group was additionally given Tiotropium bromide powder for inhalation 18μg,qn. Both groups received 1 month of treatment. Lung function indexes as FEV1,FVC and IC,blood gas indexes as SaO2,PaCO2 and PaO2 and inflammatory factors as IL-8 and TNF-α,COPD assessment test(CAT)score were observed in 2 groups,and the occurrence of ADR was also observed. RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups(P>0.05). After treatment,FEV1,EVC,IC of observation group were increased significantly,SaO2 and PaO2 of observation group were increased significantly,while PaCO2,IL-8 and TNF-αlevels was decreased significantly;those index-es of observation group were significantly better than those of control group,with statistical significance(P<0.05). CAT score of 2 groups were decreased significantly compared to before treatment,and the observation group was significantly lower than control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Tiotropium bromide com-bined with salmeterol xinafoate and fluticasone propionate shows good clinical efficacy and safety in the treatment of medium and se-vere COPD.

Intrahepatic cholangiocarcinomas (ICCA) are primary intrahepatic malignancies originating from biliary epithelia.While both hepatocellular cancer and ICCA can present as mass lesions within the liver,these cancers are distinct in their morphology,etiology,pathology,natural history and response to therapy.There is a need for accurate and sensitive molecular markers for the diagnosis of ICCA.Recent advances in elucidating molecular and genetic characteristics of ICCA offer the potential of molecular-based diagnosis of ICCA.Specific genetic mutations of IDH1/2,BAP1,p53,and KRAS,FGFR gene fusions and alterations in microRNA have all been described in ICCA.Although there are no accurate serum or biliary biomarkers currently available for diagnosis of ICCA,several potential candidates have been identified.Knowledge of specific genetic or molecular abnormalities offers potential for individualized approaches for the treatment of patients with ICCA in the future.

Acid-related disorders are commonly seen diseases of upper digestive tract which are closely related to acid attack.Antacids and acid inhibitors are the main drugs in the therapy of acid-related disorders.There are complex interrelationships between antacids and acid inhibitors and other drugs.This article reviewed the application and evaluation of antacids and acid inhibitors in acid-related disorders.

AIM: To study the discrepancy and it's significance of ATP binding cassette transporter(ABC1) and CD36 mRNA expression while activate nuclear receptor RRAR?,LXR?,RXR? in THP-1 cells. METHODS: Cultured THP-1 cells were induced to become macrophage by PMA at concentration of 40 ?g/L for 48 hours. Troglitazone, 22(R)-hydrocholesterol and 9-cis-retinoid acid(9-CRA),activators for PPAR?,LXR? and RXR? respectively, were incubated with the macrophage for 24 hours. Total RNA of these cells were abstracted and reverse transcriptional polymerase chain reaction were performed to inspect the expression of ABC1 and CD36 mRNA in the cells. RESULTS: Expression of ABC1 mRNA increased in the presence of troglitazone, 22(R)-HC and 9-CRA. CD36 mRNA also increased while PPAR? activated. Activation of LXR? showed almost no effect on CD36 mRNA expression, and expression of CD36 mRNA was decreased by 9-CRA.CONCLUSION: The discrepancies existing in ABC1 and CD36 mRNA expression while activate nuclear receptors PPAR?,LXR?,RXR? in THP-1 cells implyed that LXR?,RXR? were better targets to deal with to improve cholesterol reverse transportation.

Objective To investigate Caspase 3 activity in the ischemia reperfusion injury in rats and the protective effect of ischemic preconditioning and its possible mechanism.Methods 30 rats were randomly assigned to ischemia reperfusion (IR) group, ischemic preconditioning(IP) group,sham-operation(S)group.The serum aspartate transaminase (AST),alanine transaminase(ALT),liver caspase 3 activity,and apoptosis index(AI) of hepatocytes were examined in the three groups at 3 hours after repersusion.Results The serum AST,ALT,liver caspase 3 activity and apoptotic hepatocytes were significantly higher in both IP and IR groups than those in S group(P

Objective To investigate the relationship between plasma cell mastitis and prolactin. Methods The relationship between the lesion area , degree of inverted nipple and prolactin level of 228 plasma cell mastitis patients were observed , as well as their prolactin level before and after treatment , to explore the factors that influence relapse. Results There was no significant statistical relationship between prolactin level and lesions area and degree of inverted nipple. Prolactin level before and after treatment were statistically different (t =2.347,P = 0.02). Menstrual status, nipple status, comorbidities, lesion area and prolactin level were considered, only prolactin level was related with disease recurrence (P = 0.038). Conclusion prolactin level could significantly reduced as the disease cured , but elevated prolactin may lead to relapse of the disease.