OBJECTIVE: To explore a research path and statistical analytical method for cost-utility analysis suitable for gallstone surgery patients.METHODS: A decision-making model for the treatment of cholelithiasis surgery was established;the costs(C) and utility values at each nodal point(? U) were collected,with the results subjected to sensitivity analysis and threshold analysis.RESULTS: The cost-utility ratios(CUR) of laparoscopic operation and open surgery were 4 605.6(? 30%) yuan/QALY and 5 979.7(? 30%) yuan/QALY,respectively.One dimension sensitivity analysis of each( every) parameter reveals that the former CUR value is greater than the latter one.C1 and ? U1 showed the biggest impact on the CUR of laparoscopic operation,while C5 and ? U5 did on the CUR of open surgery.When C1=10 205.6 yuan,or ? U1=1.303 or C5=10 979.8 yuan or ? U5=3.095,CUR of laparoscopic operation was equal to CUR of open surgery,which means that the conversion of threshold was achieved.CONCLUSION: The designed research path and statistic analytic methods are suitable for the cost-utility analysis of cholelithiasis surgery patients.

Objective·To investigate the effects of a novel chitosan-silver nitrate gel (CSNG) dressing on anti-septic in wound healing.Methods·By using the ion membrane,the release rate of the new composite materials of silver ion was tested in vitro.Meanwhile,the anti-septic effects of CSNG on methicillin resistant Staphylococcus aureus (MRSA),Escherichia coli and Candida albicans were tested by colony counting.The rat wound healing model was used to detect the ability of new material to kill MRSA in vivo.Results·Compared with control group,the release of silver ions of CSNG was much slower.Sterilization experiment showed that CSNG killed the MRSA,Escherichia coli and Candida albicans much more efficiently,compared to that in the other treatments.Animal experiments also showed that CSNG promoted the rats of wound healing.Conclusion·Combining chitosan with silver nitrate and supplementary material could develop a novel chitosan-silver nitrate gel material,which not only has the obvious effects on antibacterial,but also on promoting wound healing.

Objective To compare the clinical curative effect of allogeneic bone ring and titanium mesh in repairing adolescent spinal tuberculosis kyphosis.Methods Forty-four cases of kyphosis after adolescent spinal tuberculosis operation in this hospital from January 2012 to January 2015 were selected as the study subjects and divided into the control group and observation group ac-cording to the treatment types,22 cases in each group.The control group was repaired with titanium mesh,while the observation group was given allogeneic bone ring fusion repair.Postoperative follow up lasted for 2 -5 years.The perioperative indexes,repair material and vertebral fusion and neurological score,preoperative and postoperative Cobb angle,ESR,CRP and postoperative com-plications occurrence were compared between the two groups.Results There was no statistically significant difference in periopera-tive indexes between the two groups(P>0.05).The fusion time,occurrence rate of local pain and motion limitation had statistical differences between the two groups(P<0.05).The occurrence rate of material loosening had no statistical difference(P>0.05). No grade A and B spinal injury appeared in both groups.The incidence rate of grade D and E in the observation group was signifi-cantly lower than that in the control group,the difference was statistically significant(P<0.05).The postoperative Cobb angle, ESR and CRP had no statistical difference between the two groups(P>0.05),moreover no significant adverse reactions and post-operative tuberculosis recurrence occurred.Conclusion Allogeneic bone ring and titanium mesh have satisfactory effect for repairing juvenile spinal tuberculosis kyphosis,allogeneic bone ring fusion time is longer,early stability is worse than the titanium mesh,the brace protection is needed in the early time,but the clinical effect of patients is more significant,which is worthy of being promoted and applied in clinical treatment.