Objective To investigate the effect of hyperbaric oxygen therapy on awareness,sports,activities of daily living in the rehabilitation of patients with early traumatic brain injury,and to observe the curative effect. Methods 80 patients with severe traumatic brain injury whose disease course within 1 months were randomly divided into observation group and control group,40 cases in each group.The control group received conventional drug therapy in neurosurgery and rehabilitation training.The observation group received hyperbaric oxygen therapy on the basis of the control group.Before treatment and one month after treatment,consciousness (GCS score),motor function (FMA score),activities of daily living (MBI score),and the clinical efficacy were compared between two groups.Results The scores of FMA,MBI and GCS in the control group were (7.81 ±2.27),(26.05 ±22.58),(15.25 ±12.14), which in the observation group were (7.78 ±2.32),(27.01 ±23.60),(14.37 ±12.54),and the differences were not significant (P >0.05).After 1 month of treatment,the scores of the control group were (9.44 ±2.76),(43.10 ± 31.54),(42.75 ±16.58),which of the observation group were (10.67 ±2.48),(56.98 ±29.68),(52.76 ± 17.23).The scores in the two groups were improved,the observation group increased more and the clinical efficacy was more obvious,there were significant differences between the two groups (P =0.039,0.046,0.009).Conclusion Hyperbaric oxygen plays an active role in early rehabilitation of patients with traumatic brain injury,it can improve consciousness,motor function and activities of daily living,and can improve the prognosis.

Lack of sufficient technical supports for sharing and management of current curriculum resource, which leads to inefficiency in searching curriculum information, has become a common issue in current higher medical education. The key to best use of increasing digital medical teaching resource lies in coping with the problems of sharing and integration. A cloud based storage platform is built to manage the teaching resource of obstetrics, which enables the efficiently sharing and integration of obstetrics related courses. The achievements gained from the platform have demonstrated to improve the work efficacy of teachers and provide students with the opportunity of systematically learning, both of which ultimately con-tribute to the improvement of the quality of theoretical and clinic teaching on obstetrics and gynecology.

Objective To describe the distribution of medication costs of rheumatoid arthritis patients, and to analyze the factors that may affect the costs. Methods Data were obtained from a 12-month retrospective investigation of patients with rheumatoid arthritis (RA) across China. Department of Rheuma-tology of 18 hospitals were randomly selected. The data about their social conditions, clinical conditions, medications associated with RA such as disease-modifying antirheumatic drugs (DMARDs), non -steroidal anti -inflammtory drugs (NSAIDs), steroids, biologic agents were collected, and the costs of drugs were calculated. A non-parameter test and multivariate logistic regression analysis were performed. Results Six hundred and forty six patients were enrolled into the study, 435 completed data were chosen for analysis. The results demonstrated that the average costs per patient for medications in the past year was 8018 . The total medication costs were further subdivided into the following parts: DMARDs, (represented 20% of the total costs), biologic drugs (49%), NSAIDs (4%), herbal drugs (22%), steroids (1%). Data analysis showed that patients with higher education and higher incomes, with medical insurance,better health function status and outpatients paid more on DMARDs. Extra-articular manifestations increased the odds of the high-cost group (OR: 2.180, 95%CI: 1.335～3.558, P=0.002), while poor health function status increased the probability of paying high costs (OR: 1.373, 95%CI: 1.012～1.863, P=0.041). Conclusion High medication costs in RA do exist in RA patients. The costs of medication is associated with health function status and the presence of extra-articular manifestations.

【Objective】 To evaluate the predictive value of isoform [-2] proprostate-specific antigen, p2 PSA (p2PSA) and its derived indexes for prostate cancer in a Chinese cohort with PSA 4-20 ng/mL. 【Methods】 A total of 139 males scheduled for biopsy were enrolled in the prospective study from Nov.2021 to Jun.2022. The total PSA (tPSA), free PSA (fPSA), fPSA/tPSA (f/t) and p2PSA were collected, and the percentage of p2PSA(%p2PSA) and prostate health index(PHI) were calculated. The predictive value of p2PSA and its derived indexes were compared with traditional indexes with receiver operating characteristic (ROC) curve and Logistic analysis. 【Results】 Prostate cancer was found in 54 cases (38.8%). There were significant statistical differences in tPSA(10.68 vs.8.14, P=0.021), f/t(0.13 vs.0.16, P=0.006), p2PSA(30.25 vs.19.81, P<0.001), %p2PSA(21.52 vs.13.15, P<0.001) and PHI(64.3vs.38.2, P<0.001) between prostate cancer patients and non-prostate cancer patients. The area under the ROC curve (AUC) of tPSA, fPSA, %fPSA, p2PSA, %p2PSA and PHI were 0.63, 0.51, 0.63, 0.71, 0.73, and 0.80, respectively. The inclusion of %p2PSA and PHI significantly increased the prediction efficiency of the basic prediction model (AUCbase+PHI=0.81, AUCbase+%p2PSA=0.78, AUCbase=0.67). With 35 as the recommended cut-off value of PHI, the incidence of meaningless puncture was reduced by 25.8%(36/139). 【Conclusion】 The application of p2PSA and its derived indexes have good predictive value for patients with PSA 4-20 ng/mL. The combined detection of %p2PSA and PHI can significantly increase the detection efficiency of prostate cancer and reduce the incidence of meaningless prostate puncture by 25.8%.