OBJECTIVE:To analyze the cost-effectiveness of two regimens in the treatment of chronic hepatitis B fibrosis. METHODS:112 cases of chronic hepatitis B fibrosis were divided into Compound biejia ruangan tablet group (group A,n=56) and Anluo huaxian pill group(group B,n=56). Both groups received Entecavir dispersible tablets combined with relevant Chinese patent medicine. The liver fibrosis index and transient elastography of 2 group were detected before and after treatment,TCM symp-tom score and effective rate calculation were conducted to compare the cost-effectiveness of 2 groups. RESULTS:The cost,effec-tive rate and cost-effectiveness ratio of group A were 9 227.10 yuan,74.11% and 12 451;those of group B were 8 202.90 yuan, 69.28%and 11 840;incremental cost-effectiveness ratio was 21 205. Group B showed a better cost-effectiveness. Result of sensitiv-ity test was same to that of cost-effectiveness analysis. CONCLUSIONS:The cost-effectiveness of Anluo huaxian pill combined with Entecavir dispersible tables is better than Compound biejia ruangan tablet combined with Entecavir dispersible tables in the treatment of chronic hepatitis B fibrosis.

OBJECTIVE:To observe clinical efficacy and safety of recombinant human interleukin-11 (rhIL-11) in the treat-ment of chemotherapy-induced thrombocytopenia. METHODS:86 patients with thrombocytopenia induced by chemotherapy were selected and divided into control group and observation group according to random number table,with 43 cases in each group. Con-trol group was given platelet transfusion 10 IU,once every 2-3 d;observation group was given Recombinant human IL-11 for injec-tion 25-50 μg/kg,qd. Both groups received treatment for 14 d. Clinical efficacies of 2 groups were observed as well as platelet count before and after treatment. The duration of platelet decrease and recovery,the occurrence of ADR were compared between 2 groups. RESULTS:The total effective rate of observation group was 81.40%,which was significantly higher than 62.79% of con-trol group,with statistical significance (P<0.05). There was no statistical significance in platelet count between 2 groups before treatment(P>0.05);after treatment,platelet count of 2 groups increased significantly,and the observation group was significant-ly higher than the control group,with statistical significance(P<0.05). The duration of platelet count <50×109 L-1,the time of platelet count recovering to 70×109 L-1 and 100×109 L-1 in observation group were significantly shorter than in control group,with statistical significance(P<0.05). There was no statistical significance in the incidence of ADR between 2 groups(P>0.05). CON-CLUSIONS:rhIL-11 shows good therapeutic efficacy in the treatment of chemotherapy-induced thrombocytopenia,and can signifi-cantly improve platelet count,shorten the duratione of platelet decrease and recovery with good safety.

Cold-heat problem is one core of traditional Chinese medicine theory. This paper summarizes the experimental research related to the biological basis of cold-heat essence in cold-heat syndrome, cold-heat body constitution and cold-heat property of Chinese herbs. In view of the classical physiological and biochemical indices, gene expression, protein expression and metabolic differences, differences in cold-heat syndrome or cold-heat constitution are mainly based on neurotransmitter, thyroid function, sex hormone, cyclic nucleotide system, and energy metabolism relating to the corresponding gene and protein expression. Furthermore, this paper analyses the change of correlation indices that accompany with a dynamic development process of "constitution-syndrome-herbal intervention", implying that the research of biological basis of cold-heat essence has turned from single index to multiple indices, and from dispersion research to system research.

OBJECTIVE: To investigate the correlation of preoperative anxiety and postoperative pain after endoscopic sinus surgery in chronic rhinosinusitis (CRS) with or without nasal polyps (CRSwNP or CRSsNP). METHOD: Subjects were 167 adults scheduled for functional endoscopic sinus surgery(FESS),in our hospital. preoperative issuing State-Trait Anxiety Inventory(STAI), carried anxiety scores. 8 h, 32 h, 56 h after surgery, recorded the pain score of Wong-Banker facial scale method (FPS-R). Analysed the correlation between preoperative anxiety score and the degree of postoperative pain. RESULT: Patients'preoperative S-AI mean score was 42. 45 ± 9. 98, T-AI mean score was 41. 81±8. 47. The mean pain score in patients 8 h after surgery was 6. 33±1. 74,32 h was 4.21±1.51, 56 h was 2.35±1.42. In the 8 h group postoperative pain were 0 cases with no pain, 10 cases of mild pain, moderate pain in 107 cases, 47 cases of severe pain, sharp pain in three cases. After 32 hours 9 cases with no pain, 97 cases of mild pain, moderate pain in 32 cases, 29 cases of severe pain, no sharp pain patients. 56 hours after surgery, there were 108 cases with no pain, mild pain in 44 cases, 15 cases of moderate pain. Preoperative S-AI and T-AI score and 8 h, 32 h, 56 h after surgery pain score had no significant correlation. CONCLUSION The pain of patients within 8 h after FESS is most evident,with the passage of time, the degree of pain gradually reduced. Preoperative anxiety and postoperative pain have no significant correlation.
Adult ; Anxiety ; Chronic Disease ; Endoscopy ; psychology ; Humans ; Nasal Polyps ; Pain, Postoperative ; Paranasal Sinuses ; surgery ; Sinusitis ; surgery

Objective To study the effects of Weibimei and its Chinese medicine portions(cortex frangulae, fennel powder, acorus tatarinowii, glycyrrhizae and asparagus) on cell cycle regulation in gastric cancer cells and growth inhibition in gastric cancer Xenografts.Methods Gastric cancer SGC-7901 cells were normally cultured and treated with Weibimei, extractum glycyrrhizae, cortex frangulae, fennel powder, acorus tatarinowii and asparagus.Then, the proliferation of SGC-7901 cells were detected by MTT assay, their effect on SGC-7901 cell cycle were measured by flow cytometry, and the expression of cell cycle related proteins were examined by Western blot.Animal models of SGC-7901 cells xenografts in nude mice were constructed to evaluate the growth inhibition effects of Weibimei and its Chinese medicine portions, and the expression of STAT3,p-STAT3, Cyclin D1, Bcl-2 and Survivin in gastric tumors were detected by immunohistochemical assays.Results Weibimei and its three kinds of Chinese medicine portions, cortex frangulae, fennel and acorus tatarinowii could obviously inhibit the proliferation of SGC-7901 cells, compared to control group, with a statistical significant difference (P<0.05).The cell cycle of SGC-7901 was arrested at G1 phase with cortex frangulae, fennel and acorus tatarinowii treatment, the expression of Cyclin A, B, D, E were decreased significantly (P<0.05).However, no significant effects was found in glycyrrhizae or asparagus group.Xenografts tumor sizes in Weibimei, cortex frangulae, fennel or acorus tatarinowi groups were much smaller than that in saline group or Triple Therapy group (three-kinds-drugs-combination for the treatment of gastric ulcer) (P<0.05).Xenografts experiments showed that the tumor growth in nude mice in Weibimei, cortex frangulae, fennel or acorus tatarinowi groups were significantly smaller than that in control group or in Triple Therapy Group (P<0.05), and phosphorylated STAT3, and STAT3 signaling targeted genes, including Bcl-2, Cyclin D1 and Survivin were all significantly down-regulated by immunostaining.Conclusion Weibimei and its Chinese medicine portions including cortex frangulae, fennel and acorus tatarinowii can could significantly inhibit the growth of SGC-7901 cells proliferation and arrested the cell cycle of G1 phase in vitro, and inhibit gastric cancer xenografts in nude mice in vivo.

Objective To explore students nurses′acceptance of case-based group assessment. Method A total of 100 student nurses participated in the survey by a self-designed questionnaire to evaluate the perception and acceptance of the student nurses. Results The score on the acceptance of case-based group assessment was (2.44 ± 0.46). The items with higher acceptance included teamwork spirit, clinical reasoning and decision-making ability, and the items with lower acceptance were improving of nurse-patient communication and the nursing skills. Conclusions The student nurses have a good acceptance of the case-based group assessment and think this assessment method can contribute to development of teamwork spirit and competency of clinical reasoning and decision-making. On the other hand, they suggest we should strengthen the ability in nurse-patient communication and optimize the links in ability assessment.

Objectives:To study efficiency characteristics and changes of county hospitals based on data envel-opment analysis model from 2008 to 2012 . Methods:A three-stage DEA model which can exclude the external envi-ronment variable on its efficiency is also added along with the C2 R and BC2-DEA traditional model. Results: From 2008 to 2012, the technical efficiency value was ranging between 0. 723 and 0. 681 in county hospitals, the pure technical efficiency was 0 . 785~0 . 771 and the scale efficiency value scaled between 0 . 908 and 0 . 897 . These values showed a low efficiency, but had annually improved. This reflects that the new health care reform policies have played an important role in improving county hospitals efficiency. Development of medical service ability is behind the development of hospital scale. How to improve the service and management capabilities has gradually become a major direction to improve the county hospital efficiency.

Objective:To investigate the mechanisms of paeoniflorin on T cells in Bovine Collagen-induced arthritis ( CIA) model.Methods:CIA were established with Bovine Type Ⅱ collagen in DBA/1J mice.From day 21,after divided into two groups at random,mice were treated with PBS or paeoniflorin and recorded arthritis scores every day;the inflammation of CIA was evaluated with HE staining of the joints;the proliferations of splenocytes and CD4+T cells stimulated either by CD3 antibody and CD28 antibody or CII were examined by 3 H-TdR incorporation assay;the ratio of Th1 and Th17 subsets in CD4+T cells were examined by flow cytometry;the concentration of IFN-γand IL-17 in the culture supernatants of splenocytes were detected by ELISA.Results: The administration of paeoniflorin alleviated the symptoms( P<0.05) and inhibited the inflammation response of CIA;paeoniflorin not only inhibited the pro-liferation of CD3/28 antibodies-stimulated splenocytes and CD4+T cells(P<0.05),but also inhibited the proliferation of CII-specific splenocytes and CII-specific CD4+T cells(P<0.01);paeoniflorin modulated the ratio of Th1 and Th17 subsets(P<0.01);paeoniflorin reduced the levels of IFN-γand IL-17 in the culture supernatant of splenocytes ( P<0.05 ).Conclusion: Paeoniflorin may alleviates clinical symptoms of CIA via inhibiting pathogenic T cell proliferation, balancing inflammatory T cell subsets and reducing pro-inflammatory cytokines.

Objective To evaluate diagnostic value of the novel virtual touch tissue imaging quantification (VTIQ) technique of acoustic radiation force impulse (ARFI) shear wave elastography in the differential diagnosis between benign and malignant thyroid lesions. Methods From June to July 2014, the imaging data of 82 thyroid lesions in 75 patients proven by fine needle aspiration cytology (FNAC) biopsy on conventional ultrasound and VTIQ were retrospectively analyzed. The thyroid nodules were examined by conventional ultrasound firstly and then the lesions were classified by thyroid imaging report and data system (TI-RADS). The maximum, minimum, median and average of shear wave velocity (SWV) values were obtained from multiple SWV measurement under the VTIQ speed mode. The region of interest (ROI) was determined according to the VTIQ quality mode after the patients holding the breath. According to the FNAC cytology results, ROC curve were plotted to determine the most accurate SWV value and the cut-off value for differential diagnosis. Results According to the FNAC results, grading≥5 level was set as the positive results and FNAC<5 level as the negative results. There were 28 positive nodules and 54 negative nodules in 82 thyroid nodules. The positive rates of TI-RADS classification were consistent with the theoretical results. The SWVmax, SWVmin, SWVmedian, and SWVmean on VTIQ of negative and positive thyroid nodules were (3.2±0.6), (2.2±0.4), (2.7±0.4), (2.6±0.4) m/s, and (4.6±1.7), (3.1±0.8), (3.5±1.0), (3.6±1.1) m/s. There were significant differences between positive and negative thyroid nodules in SWVmax, SWVmin, SWVmedian, and SWVmean on VTIQ (t=3.53, 3.68, 3.32, 3.81, all P<0.01). Based on the area under curve of ROC, the SWVmean value in the nodule was the best value in comparison with other SWV values. The cut-off value of VTIQ mean was 2.9 m/s. According to ROC curve analysis, the sensitivity, specificity and Youden index for VTIQ were 70.6%, 88.5%, 0.59, respectively. Conclusion The study proved that VTIQ elastography technique plays an important role in differential diagnosis of thyroid nodules and the VTIQ SWVmean is the best parameter for differential diagnosis.

To analyze the clinical characteristics of juvenile gout,101 gout patients in Affiliasted First Hospital of Wanan Medical College from 2016 January to Decemder were divided into juvenile group (≤ 20 years,n=41) and adult group (＞20 years,n=60),the clinical data and related biochemical tests were collected.The body mass index (BMI),fasting blood glucose (FBG),TC,TG,uric acid,urea nitrogen,creatinine,cystatin C,glomerular filtration rate (GFR) and C-reactive protein (CRP),the first gout position,the duration of disease,the family history,the number of involved joints and the tophi were compared between two groups.Compared with the adult group,the juvenile group had significantly higher BMI [(25.6± 1.3) vs.(22.8± 1.0),t=-12.51)],TC [(5.55±0.51) vs.(5.07±0.54),t=-4.44),TG [(2.04±0.32) vs.(1.83±0.39),t=-2.92),uric acid[606.0 (541.0,641.0) vs.502.5 (447.5,542.2),Z=-5.65land C-reactive protein[68.0(57.0,83.5) vs.46.0 (36.0,59.8),Z=-4.64],while lower FBG [(4.83±0.68) vs.(5.74± 1.23),t=4.31)] and the number of involved joints[1(1,1) vs.2(1,4),Z=5.45].The GFR was higher in the juvenile group [(140.4± 31.0) vs.(77.7±22.5),t=-ll.81,P＜0.001)],while the urea nitrogen [6.3 (5.8,6.9) vs.7.6 (6.8,8.4),Z=5.89],creatinine [65.1 (56.2,75.1) vs.87.4 (78.5,98.4),Z=7.18] and cystatin C[1.0(0.9,1.1) vs.1.9(1.5,2.0),Z=7.66]were lower than those in adult group(all P＜0.01).The incidence of the first metatarsophalangeal joint involvement and the ankle joint involvement had no statistical difference between two groups (x2=3.434,P＞0.05).The proportion of family history of gout was higher in juvenile group (x2=6.174,P＜0.05)but the proportion of tophi was lower (x2=16.564,P＜0.01) than those in adult group.The characteristics of juvenile gout are significantly different with those of adult gout patients,so the juvenile patients should be managed differently from the adult patients.