OBJECTIVE:To Study the cost-effectiveness among3therapeutical schemes in the treatment of Graves ophthalmopathy.METHODS:A total of94cases with Graves ophthalmopathy were randomized into3groups,Group A was assigned to receive medrat,Group B to receive dexamethasone and Group C to receive prednisone,the outcomes were evaluated in terms of the cost-effectiveness analysis.RESULTS:The costs for Group A,B and C were2956.76yuan,2059.42yuan and31.09yuan,respectively.The total effective rates were93.94%,93.75%and51.72%,respectively.The cost-effec-tiveness ratios were31.47yuan,21.97yuan and0.60yuan,respectively.The incremental cost-effectiveness ratios of Group A and B were69.30yuan and48.26yuan,respectively as against Group C.CONCLUSION:In terms of pharmacoeconomics,Group B is comparatively the best option in treating Graves ophthalmopathy.

Dexamethasone ; administration & dosage ; Humans ; Infant, Newborn ; Infant, Premature ; Respiration, Artificial

Objective To conduct prospective randomized controlled clinical observation on patients with nasopharyngeal carcinoma under chemotherapy and radiotherapy using inhaling therapy with recombinant human interleukin 11,and the preventing and curing effect of recombinant human interleukin 11 on radiation-induced pharyngitis is evaluated.Methods 161 cases of newly diagnosed patients with head and neck cancer were selected under the principle of informed consent and these 161 cases were divided into the observation group (87 cases) and the control group (74 cases) based on randomization principle.In the observation group,when the dose reached 20Gy,then recombinant human interleukin-11 inhaling therapy was applied `ll the end of radiotherapy,for the control group,conventional treatment was applied in the event of radioactive throat.RTOG criteria were used during the observation in patients with the occurrence and treatment of radioactive pharyngitis.Results When compared with the control group,the average time for radioactivity to appear was prolonged,the severity decreased and the healing time was shortened in the observation group,those data were statistically significant.Conclusions Recombinant human interleukin-11 inhaling therapy can prevent and cure inhalation of radioactive pharyngitis and this therapy is better than conventional treatment.It's worthy of further study and clinical application.

Intracerebral delivery of drugs for the treatment of central nervous system disorders is usually limited by the blood-brain barrier (BBB). Transdermal drug delivery systems (TDDS) have the advantage of improving patient compliance and avoiding first-pass effects compared to intravenous, oral and intranasal drug delivery, and are an emerging non-invasive drug delivery route that facilitates long-term drug delivery to patients. The discovery of direct subcutaneous targeting of lymphatic pathways to brain tissue has made TDDS a new brain-targeted drug delivery strategy. At the same time, the development of nano-delivery technology has further facilitated the application of TDDS for targeted drug delivery to the brain. This review summarizes the mechanism of transdermal drug delivery into the brain and the application of TDDS in the treatment of brain diseases, providing new ideas and methods for the treatment of central nervous system diseases.

Objective To study effects of raloxifene (RLX) with different doses of conjugated equine estrogen(CEE) on prothrombotic profiles in the ovariectomized rats model.Methods Total of 32healthy female SD rats at age of 9 to 10 months were equally divided into every 8 rats at 4 groups randomly.One week after ovariectomized,they were treated by drugs,including control group with placebo(0.9％ Nacl intragastric administration),RLX group with RLX 6 mg/(kg · d),RLX and low CEE group with RLX 6 mg/(kg · d) + CEE 0.07 mg/(kg · d)and RLX and high CEE group with RLX 6 mg/(kg · d) + CEE 0.5mg/(kg· d)for 10 weeks before death.Thrombin turbidimetry method was used to evaluate the plasma fibrinogen(FIB),transmitting substrate method for antithrombin Ⅲ (AT Ⅲ) activity,double-antibody sandwich ELISA for plasminogen activator inhibitor 1 (PAI-1),D-dimer (D-D) and yon Willebrand factor (vWF) and nitrate reductase method for nitric oxide(NO).Results (1) Coagulation and anticoagulation indicators:it was observed (1.62 ± 0.22) g/L FIB at control group,(2.02 0.54) g/L at RLX group,(1.97 ±0.16) g/L at RLX and low CEE group,(2.00 0.18) g/L at RLX and high CEE group.There was a statistically significant difference between control group and any one of treatment groups(P ＜ 0.05) and no statistical significance among those three treatment groups (P ＞ 0.05).No significant change was observed in plasma AT Ⅲ activity among groups (P ＞ 0.05).(2) Fibrinolytic and anti-fibrinolytic indicators:it was observed (14.1 2.8) μg/L PAI-1 at control group,(20.0 ±3.3) μg/L at RLX group,(41.5 ±5.5) μg/L at RLX and low CEE group,(38.9 ± 6.0) μg/L at RLX and high CEE group.A remarkable increase was observed between control group and any one of treatment groups(P ＜0.05).But there was no significant difference of D-D among groups (P ＞ 0.05).(3) Endothelial function:it was (43 ± 7) ％ vWF at control group,(49±5)％ at RLX group,(46±6)％ at RLX and low CEE group,(36±5)％ at RLX and high CEE group.The vWF of RLX and high CEE group was the lowest among all groups (P ＜0.05).There was no difference of NO among groups (P ＞ 0.05).Conclusions In the different links of thrombosis,RLX gives different fuction and may increase the risk.CEE plays a synergism role in the matter of fibrinolysis and anti-fibrinolysis with RLX,further giving rise to thrombosis effect of RLX.And it also has a protective role in the function of vascular endothelium to some extent.But this only works with high dose.

Objective To evaluate the clinical efficacy of radial head prosthesis replacement in treatment of comminuted fracture of the radial head and discuss relative operative announcements.Methods There were 27 patients with comminuted fracture of the radial head who were treated with radial head prosthesis replacement. Results Of all,26 patients were followed up for averaged 14months.According to Broberg score,the post-operative function was excellent in 9 patients(35%),good in 13(50%)and fair in 4(15%),with no poor results and with excellence rate of 85%. Conclusion Radial head prosthesis replacement can better restore the stability,flexion and extension of the elbow as well as the rotational motion of the forearm and is worthy of clinical application.

[Objective]To evaluate our protocol with the extensile lateral approach to open reduction and internal fixation in the treatment of displaced intra-articular calcaneus fractures.[Method]From 2001 to 2005,35 patients(41 feets)were treated with open reduction and internal fixation using extensile lateral approach,with 25 right feet and 16 left feet and with plate fixation using in 40 cases,single screw fixation using in 1 case.[Result]Evaluated with postoperative plain radiographs,90%(37/41) fracture had anatomic or near anatomic reduction of posterior facet.73%(30/41) Bhler angle above than 20? in 28 cases,32 feets among the patients were followed up at a mean of 14 months(ranged,9 to 24 mouths) and evaluated according to hind foot and ankle score system of AOFAS,average score was 87.The function were satisfactory.It took average 4 month to come back normal action,none of nerves injury,4 patients had wound hematoma.Two cases developed surgical wound edge necrosis and dehiscence among them,who were treated in initial phase in the treat group,the 2 cases were managed with dressing changes and healed in 1 month,whitout skin flaps and grafts.[Conclusion]Open reduction and internal fixation using lateral approach is a better choice to treat intra-articular calcaneal fractures,because it can correct directly the pathology of calcaneal fractures.Anatomical reduction of joint congruity and the shape of the calcaneus are important prognostic factors.

[ ABSTRACT] AIM:To investigate the effect of astragaloside IV on neurological function and the protein expres -sion of neuron-specific enolase (NSE), Notch1 and NF-κB in acute cerebral hemorrhage (ACH) rats.METHODS:ACH model in rats was established via injection of autologous blood , and the rats were divided into 4 groups:sham, ACH, ACH+astragaloside IV (100 mg/kg) and ACH+astragaloside IV (200 mg/kg) groups.The impairment of neurological func-tion in each group was graded , and the brain coefficient and water content were calculated .The serum level of NSE was measured by ELISA.Additionally, the expression of Notch1 and NF-κB was determined by Western blot .RESULTS:As-tragaloside IV improved the neurological function and decreased the brain coefficient and water content in ACH rats .Moreo-ver, the ACH-induced increase in NSE was inhibited after astragaloside IV treatment .Similarly, astragaloside IV also sig-nificantly attenuated the expression of Notch 1 and NF-κB in ACH rats.CONCLUSION: Astragaloside IV attenuates the impairment of neurological function in ACH rats , which may be through decreasing the NSE level and down-regulating the expression of Notch1 and NF-κB.

Objective To probe into the significance and role of double testing of blood for virus markers.Methods The data on the results of routine blood testing at some blood centers in China from July to December,1999 were gathered and analysed.The blood donors with inconsistent results during the double testing were followed up and their blood samples were collected at least half a year later.Nucleic acid amplification testing(NAT) was performed on the samples.Results Only 0.63% of the donors showed inconsistent results during the double testing.Most of the positive results were false positive.Conclusion The double testing currently implemented does not help significantly improve the quality of the blood supply.It is important to enhance blood safety further by improvement of quality of the reagents and introduction of NAT.

Objective To investigate the effect of position ventilation(PPV) on oxygenation,the airway sputum drainage and hemodynamic of acute respiratory distress comprehensive syndrome(ARDS).Methods From June 2015 to April 2016,13 cases with moderate or severe ARDS were researched.The changes of PaO2,PaCO2,SpO2,PaO2/FiO2 and airway sputum drainage were observed as well as HR,MAP,CVP,CO,CI,SVV,etc.Results Totally 56 PPV were taken.Compared with pre-treatment of PPV,the number of PaO2 and PaO2/FiO2 increased from (74.7±13.18) mm Hg and 168.65±22.12 to (92.13±17.82) mm Hg and 208.80±24.04(P<0.05) respectively;SpO2 and airway sputum drainage increased from (95.32±2.76)% and (7.84±1.68)mL to (97.04±1.84)% and (13.25±3.55)mL(P=0.000).However,there were no significant differences in HR,MAP,CVP,CO,CI and SVV(P>0.05).Conclusion PPV can effectively improve oxygenation in patients with ARDS and promote airway sputum drainage,and hemodynamic effects are not obvious.However,nursing intervention still should be strengthened.