OBJECTIVE:To evaluate the cost-effectiveness of5kinds of drug treatment regimes in the treatment of ac_ ute pancreatitis.METHODS:The cost-effectiveness method in pharmacoeconomics was adopted in the retrospective analysis of the following5treatment schemes:octreotide in group A,ulinastatin in group B,fluorouracil in group C,nifedipine in group D and rhei decoction in group E.RESULTS:The costs for the5treatment schemes were2678.24,3071.68,1101.70,1089.04,and1098.04yuan respectively;The effective rates of the5schemes were96.88%,93.55%,92.86%,92.00%and96.55%respectively;The cost effectiveness ratio of schemes E was the minimum,which was11.53yuan;On the basis of group D,the superaddition costs for gaining one effectiveness unit for scheme A,B,C and E were324.33,1321.76,14.07,1.96yuan respectively.CONCLUSIONS:Among the5schemes,scheme E was the best one.

OBJECTIVE:To evaluate the economic effectiveness of different drugs for the same disease.METHODS:Using pharmacoeconomic cost-effect analysis,the short-term effects of three therapeutic schemes on duodenal bulbar ulcer,including A,B and C schemes,were compared.RESULTS:A was the best scheme.CONCLUSION:The results show that pharmacoeconomic cost-effect analysis plays an important role in optimizing therapeutic scheme,guiding rational drug use and increasing economic effectiveness.

Objective:To investigate the alveolar bone defects of anterior alveolar bone in patients with bimaxillary protrusion by using cone-beam computed tomography ( CBCT ) . Methods: The samples consisted of 50 patients with bimaxillary protrusion, who were assigned to the teenage group[20 cases, (13. 1 ± 1. 0) years] and adult group[30 cases, (22. 9 ± 4. 2) years] . The adult group included 9 hy-po-divergent, 11 normo-divergent and 10 hyper-divergent patients. The images were obtained by using NewTom VG CBCT and the alveolar defects were evaluated. Results:The ratio of the patients had alveo-lar bone defects was 94. 00%. Meanwhile, the defects were associated with 38. 60% of all the teeth. Most defects occurred on labial alveolar bone ( 98 . 66%); fenestration was found more in the maxillary alveolar region and dehiscence occurred more in the mandible. The dehiscences (3. 06%) and defects prevalence (30. 13%) of the teenage group were significant lower than those of the adult group (11. 73% vs. 42. 46%), P<0. 05; while there was no significance of the fenestrations prevalence between the two group (P>0. 05). The hypo-divergent group had lower fenestrations prevalence (22. 22%) than the normo-divergent (33. 84%) and hyper-divergent groups (37. 50%), P<0. 05. The upper central incisor had the lowest alveolar bone defect prevalence. Conclusion: Alveolar bone defects are common findings in patients with bimaxillary protrusion before orthodontic treatment. The prevalence of defects is affected by age and vertical-growth type.

Objective To explore the therapy efficacy for children with primary nocturnal enuresis by meta-analysis on the efficiency of alarm treatment versus desmopressin.Methods PubMed, Central, Elesvier, CNKI and some other databases were browsed to obtain all randomized controlled trails(RCT) and to compare the therapy between alarm treatment and desmopressin.Data extraction and quality evaluation were done by methods recommended by Cochrane center.The results of short-term and long-term efficacy and compliance were analyzed by Review Manager 5.0.Results Fifty-four RCT were retrieved and 11 RCT were included in the study.There was no statistical difference between alarm treatment and desmopressin when analyzing by no wetting episode,wetting no more than 1 night per month,wetting nights' decrease over 90％ or wetting nights decrease over 50％.By 3-month follow-up after treatment stopped,alarm treatment significantly reduced the wetting nights to over 50％ or less than 1 night per month than desmopressin.By 6-month follow-ups after treatment stopped, there was no difference between alarm treatment and desmopressin when analyzed by wetting no more than 1 night.The relapse rate of desmopressin was higher than that of alarm treatment (P =0.007).However, the withdrawal and abandonment rate of alarm treatment was higher than that of desmopressin(P ＜0.000 01).Severe adverse effects were not found in both of the treatment groups.Conclusions There is no statistical difference between alarm and desmopressin therapy in short-term treatment.The efficiency of alarm device is better than that of desmopressin in long-term treatment.The follow-up of alarm treatment lost more than that of desmopressin.Desmopressin is better than the alarm treatment in compliance but has higher recurrence rate.

Objective To study the expression of Nuclear factor E2 related factor 2 (Nrf2) ,Superoxide Dis‐mutas 1 (SOD1) ,and Heme Oxygenase- 1( HO -1) factors related to Nrf2 signaling pathway in noise-induced cochlear injury of rats .Methods A total of 30 SD rats were randomly and equally assigned into the following 2 groups :noise group and normal control group .The rats in noise group were exposed to an 115 dB SPL continuous steady white noise for 12 hours ,then 1 day ,3 days ,and 7 days later ,the rats receveid the ABR and DPOAE testing after noise exposure .Both RT -PCR and Peggy Sue trace protein detection techniques were used to detect gene ex‐pression in Nrf2 /Keapl-ARE signaling pathway and the protein levels by cochlear tissue sampling after noise ex‐posure 7 days later .Results The ABR thresholds in the noise group was higher than those of in normal control group after noise exposure 1 ,3 ,and 7 days later (P<0 .05) .The DPOAE values of noise group were significantly lower than those of normal control group (P<0 .05) .The up -regulation of expression of Nrf2 ,SOD1 ,HO -1 mRNA(1 .11 ± 0 .05 ,1 .45 ± 0 .12 ,1 .15 ± 0 .03) in noise group were higher than those of in the normal control group after noise exposure 7 days later (1 .00 ± 0 .02 ,1 .10 ± 0 .12 ,0 .92 ± 0 .08) ,and the differences were statistically sig‐nificant (P<0 .05) .And in Peggy Sue trace detection system ,we also found SOD1 ,HO -1 protein levels in noise group were higher than those of in normal control group .Conclusion After the noise -induced cochlear injury in rat ,Nrf2 expression in the cochlea increased and up-regulatd expression of downstream gene and protein content such as antioxidant enzymes SOD1 and HO-1gene by regulating Nrf2 /Keapl-ARE signaling pathway ,which may be involved in protection against oxidative stress injury in noise-induced cochlear injury of rat .

Batch and continuous fermentation were adopted to investigate the effect of specific growth rate and amino acid components on RNA accumulation in Candida tropicalis ATCC 20408 in fermentation medium ( FM), yeast peptone dextrose medium (YPD), molasses fermentation medium ( MFM) and FM without corn steep liquor. The data showed that obvious differences in intracellular RNA accumulation were observed at different cell growth phases in bath fermentation prosess, and RNA level reached 11. 8% (g-RNA /g-DCW) during exponential phase, and only 6.9% during stationary phases. It was also found that intracellular RNA accumulation increased with the increase of specific growth rate in continue fermentation prosess, and the highest RNA level reached 15. 6% with the glucose conversion rate of 42. 8% at the dilution rate of 0. 5 h-1. Furthermore, the data showed that RNA lever was notably increased in batch fermentation process when amino acids or peptone was added into the fermentation medium containing no corn steep liquor. Taken together, it was reported for the first time that specific growth rate and amino acid components plays a leading role on the intracellular RNA accumulation in C. tropica lis, and specific growth rate is more important.

Objective:To construct a novel biomimetic calcium phosphate (BioCaP) scaffold loaded with bone morphogenetic protein-2 (BMP-2),and to investigate its role in the osteogenesis of human adipose-derived stem cells (hASCs) in vitro and in vivo.Methods:The BioCaP scaffold coprecipitated with BMP-2 (BMP-2-BioCaP) was constructed in this study.Field emission scanning electron microscopy (SEM) was used to analyze the morphology of the surfaces.The release kinetics was measured to evaluate the slow-release characteristics in vitro.BMP-2-BioCaP was immersed in proliferation medium (PM) or osteogenic medium (OM),respectively.The supernatants were collected and used to culture hASCs in vitro.Cell numbers were determined using the cell-counting kit-8 (CCK-8) to assess the cell proliferation.After 7 and 14 days,alkaline phosphatase (ALP) staining and quantification were performed to test the activity of ALP.After 14 and 21 days,the calcification deposition was determined by alizarin red S (ARS) staining and quantification.The expressions of the osteoblast-related genes were tested on day 4 and day 14.In the in vivo study,6 nude mice were used and implanted subcutaneously into the back of the nude mice for 4 groups:(1) BioCaP scaffold only,(2) BioCaP scaffold + hASCs,(3) BMP-2-BioCaP scaffold,(4) BMP-2-BioCaP scaffold + hASCs (test group).After 4 weeks of implantation,hematoxylin-eosin (HE) staining was performed to evaluate the in vivo osteogenesis of hASCs.Results:SEM observations showed that BioCaP and BMP-2-BioCaP scaffold were entirely composed of straight,plate-like and sharp-edged crystal units,and the length of the crystal units varied between 5 and 10 μm.Release kinetics analysis demonstrated that BMP-2 incorporated with BioCaP could be released at certain concentration and last for more than 21 days,and the accumulative protein release could reach 20％.CCK-8 assays showed that cell proliferation was not significantly affected by BMP-2BioCaP.ALP activity was higher by the induction of OM + BMP-2-BioCaP than of the other groups (P ＜0.01).More mineralization deposition and more expressions of osteoblast-related genes such as Runt-related transcription factor 2 (RUNX2),ALP,osteopontin (OPN) and osteocalcin (OC) were determined in the OM + BMP-2-BioCaP group at different time points (P ＜0.01).HE staining showed that,in the test group and BMP-2-BioCaP scaffold group,the extracellular matrix (ECM) with eosinophilic staining were observed around hASCs,and newly-formed bone-like tissues could be found in ECM around the scaffold materials.Moreover,compared with the BMP-2-BioCaP scaffold group,more bone-like tissues could be observed in ECM with typical structure of bone tissue in the test groups.No obvious positive results were found in the other groups.Conclusion:BMP-2-BioCaP scaffold could achieve slow-release of BMP-2 and promote the osteogenic differentiation of hASCs in vitro and in vivo.The novel tissue-engineered bone composed of hASCs and BMP-2-BioCaPis promising for the repair of bone defect.

Objective To investigate the emotional state and its influencing factors in children with nocturnal enuresis,so as to improve clinical attention and give appropriate intervention.Methods Totally 166 nocturnal enuresis patients aged 9 -15 years old were admitted to Beijing Children′s Hospital Affiliated to Capital Medical University from August 2011 to August 2014.Specifically,Screen for Child Anxiety Related Emotional Disorders (SCARED)and Depres-sive Self -Rating Scale for Childhood (DSRSC)were utilized to test the patients′emotional state.The comparison be-tween the general norm data of the healthy children and the psychological test of enuresis children were performed,the lat-ter emotional state and its influence factors were evaluated.Analysis of variance and t -test were performed.Frequency comparison was done by using χ2 test.Influence factors analysis was made by Logistic or multiple regression analysis. Results The incidence of children′s anxiety with enuresis was 39.2%(65 /166 cases).Anxiety overall scores of children with enuresis amounted to 21 .16 ±11 .88 which were significantly higher than the norm(14.40 ±9.41 )(P <0.05).The diagnosis rate of depression in the NE patients was 9.0%.No significant difference was found in the depression total scores(P >0.05).The emotional disorders mainly appeared in patients with primary enuresis,without family history,poor grade and poor relationships with family members and peers.The school performance was an important factor for enuresis patients with anxiety disorders(P <0.05).Conclusions Children with nocturnal enuresis are more likely to have anxiety disorders than normal children.Their emotional states is related to the enuresis type,family history,school performance, family and peer relationship.Therefore,attention should be paid to the emotional state of children with nocturnal enuresis. According to the adverse factors for nocturnal enuresis patients,effective treatment and appropriate psychological interven-tion should be given at the same time.

Objective To understand the clinical characteristics, treatment effect and prognosis of children with methylmalonic acidemia (MMA) combined with renal damage, and to provide experiences about how to improve the level of diagnosis and treatment.Methods The medical records of children with MMA were collected from January of 2007 to December of 2013 in Beijing Children's Hospital Affiliated to Capital University of Medical Sciences,while the clinical manifestations,laboratory findings, imaging material, inspection results were analyzed, and the renal pathological gene analysis, treatment effect, and prognosis of MMA children with renal damage were studied, and follow-up was carried out for 3 months up to 7 years.Results Among the two hundred and ninety-six cases of MMA,28 cases (9.5％) with renal damage,including 19 boys and 9 girls, 18 patients with hyperhomocysteinemia.Their ages varied from 2 days to 13 years old when confirmed.The first symptoms of 16 cases were proteinuria, hematuria, and edema, 9 cases were complicated with acute renal failure,5 cases were diagnosed as hemolytic uremic syndrome,6 patients were diagnosed as nephrotic syndrome, receiving enough glucocorticoids treatment without improvement.The routine examination of the urine showed that proteinuria (241-3 060 mg/d), methylmalonic acid levels and urinary protein were positively correlated (r =0.982, P =0.003), as urinary β2-microglobulin [(360.386 ± 231.496) μg/L], retinol binding protein [(338.537 ± 243.293) μg/L] increased.Extrarenal clinical manifestations were the spiritual, mental and physical development retardations, seizures, anemia etc.Two cases had a positive family history.Renal pathology showed mesangial cells and mesangial matrix proliferation broadening, no electron dense deposits in mesangial area, renal tubular epithelial cell swelling degeneration, and immunofluorescence was negative.Gene analysis of 3 cases showed exon1:c.80A ＞ G,p.Q27R and exon1 :c.365A ＞ T,p.H122L/c.609 G ＞ A,p.W203X.Children with MMA were treated with vitamin B12 treatment.Two cases of multiple organ failure died during hospitalization, and 2 cases died after leaving hospital.After treatment, the level of urinary methylmalonic acid was significantly decreased, while nervous system symptoms improved significantly, and the mental state and the renal function were improved.Conclusions MMA may be associated with kidney damage,usually with severe renal tubular and glomerular impairment.Early diagnosis is the key,and timely treatment can effectively control the disease, improve the prognosis.

ObjectiveTo observe the clinical efficacy of Chinese medicine combined with indirect moxibustion plaster on corona virus disease 2019 （COVID-19） patients during recovery period. MethodNinety patients of COVID-19 during the recovery period were randomly divided into a Chinese medicine group， an indirect moxibustion plaster group， and a combination group，with 30 cases in each group. According to the 10th edition of COVID-19 Diagnosis and Treatment Protocol，patients in the Chinese medicine group received oral Chinese medicine based on syndrome differentiation，one dose per day， twice a day. Patients in the indirect moxibustion plaster group were treated with indirect moxibustion plaster at Zusanli （ST 36）， Pishu （BL 20）， Dazhui （GV 14）， Feishu （BL 13）， Kongzui （LU 6）， and Tiantu （CV 22），once a day，40 min each time. Patients in the combination group were treated with Chinese medicine combined with indirect moxibustion plaster. Treatment lasted two weeks. Before and after treatment，the traditional Chinese medicine （TCM） symptom score，pulmonary computed tomography （CT） score，St. George's Respiratory Questionnaire （SGRQ） score，blood routine indexes ［white blood cell count （WBC），neutrophil count （NEUT），and lymphocyte count （LYM）］， and inflammatory indexes ［C-reactive protein （CRP），serum ferritin， and interleukin-6 （IL-6）］ were observed in the three groups. The clinical efficacy was evaluated. ResultAfter treatment，the scores of TCM symptoms，pulmonary CT， and SGRQ，CRP，IL-6，and ferritin in the three groups decreased（P<0.05），while WBC and LYM increased（P<0.05）， but there was no significant difference in NEUT. The above indexes in the combination group were better than those in the other two groups（P<0.05）. After treatment， the cured and markedly effective rate was 76.7% （23/30） in the combination group， 50.0% （15/30） in the Chinese medicine group， and 46.7% （14/30） in the indirect moxibustion plaster group. The cured and markedly effective rate of the combination group was significantly higher than that of the Chinese medicine group （χ²=4.593， P<0.05） and the indirect moxibustion plaster group （χ²=5.711， P<0.05）. The total effective rate was 96.7 % （29/30） in the combination group， 93.3% （28/30） in the Chinese medicine group， and 86.7% （26/30） in the indirect moxibustion plaster group. The total effective rate of the combination group was higher than that of the Chinese medicine group and the indirect moxibustion plaster group， but the differences were not statistically significant. ConclusionChinese medicine combined with indirect moxibustion plaster can effectively improve the clinical symptoms，promote pulmonary inflammation，blood routine indexes， and inflammatory indexes， and improve the quality of life of COVID-19 patients during the recovery period，which is more advantageous than Chinese medicine alone or indirect moxibustion plaster.