OBJECTIVE:To evaluate the cost-effectiveness of 4 different therapeutic regimens for cervicitis of chlamydia trachomatis.METHODS:4therapeutic regimens including regimen A(azithromycin by oral administration),regimen B(azithromycin by intravenous injection),regimen C(minocycline by oral administration),regimen D(levofloxacin and de?oxycycline by oral administration)were analyzed using cost-effectiveness analysis.RESULTS:The total costs of A,B,C,D4regimens were(645.20?109.56)yuan,(933.10?249.90)yuan,(413.14?38.04)yuan,and(489.00?83.60)yuan respective?ly;The effective rate were96.2%,98.6%,93.4%and94.1%respectively;The ratios of cost to effectiveness were6.71,9.46,4.42,and5.19respectively;As compared with regimen C,the incremental cost effectiveness ratios for regimen A,B and D were82.88,99.99,and108.37respectively.CONCLUSION:Regimen C is the preferable one.

Objective To study the effect of simvastatin on high glucose induced vascular endothelial cells injury and explore its action mechanism .Methods Endothelial cells were devided into four group:control group(A) ,high glucose(33 .3 mmol/L)group (B) ,high glucose(33 .3 mmol/L)+simvastatin(1 .0 μmol/L)group(C) ,and high glucose(33 .3 mmol/L)+simvastatin(10 .0 μmol/L)group(D) .The inhibition of cells was detected by CCK-8 assay .The apoptosis was determined by TUNEL assay .The protein ex-pression was detected by Western blot analysis .Results The cells survival rates were (42 .5 ± 6 .4% ) ,(58 .6 ± 7 .8% ) ,and (71 .3 ± 11 .7% ) in B ,C ,and D group respectively .There was significant difference among the three groups(P<0 .05) .The per-cents of apoptosis were (1 .8 ± 0 .6% ) ,(45 .8 ± 8 .9% ) ,(22 .7 ± 6 .4% ) and (12 .6 ± 4 .2% ) in A ,B ,C and D group ,respectively . There was significant difference among the four groups(P<0 .05) .The protein expression of Bcl-2 was lower in B group(0 .13 ± 0 . 03)than that in A group(1 .02 ± 0 .16) .The Bcl-2 expression was higher in C group(0 .28 ± 0 .04)than that in B group ,and in D group(0 .68 ± 0 .11)than that in C group(P<0 .05 ,P<0 .01) .The gene expression of bax was higher in B group than that in A group .The bax expression was lower in C group than that in B group ,and the bax expression was lower in D group than that in C groups(P<0 .05 ,P<0 .01) .Conclusion Simvastatin can inhibit high glucose induced vascular endothelial cells apoptosis .Upregu-lation of Bcl-2 and downregulation of bax may be its action mechanism .

Objective To evaluate the efficacy and safety of hydroxychloroquine sulfate (HCQ) on pregnancy outcomes in patients with systemic lupus erythematosus (SLE). Methods One hundred and sixty-six pregnant patients with SLE from Janurary 2010 to December 2015 were studied retrospectively . Fifty-two patients were excluded due to new-onset during pregnancy, active disease or termination of pregnancy as a result of continuous intaking of immunosuppressant. The remaining 114 SLE patients in stable condition before pregnancy were divided into the following two groups: prednisone combined with HCQ and prednisone alone. The effects of HCQ on disease activity and pregnancy outcome were analyzed. Differences between groups were analyzed by chi-square test. Results A total of 90 patients (78.9%) had successful pregnancy. Among 71 patients treated with prednisone combined with HCQ, 60 patients (84.5%) had no disease flare and 62 cases (87.3%) had successful pregnancy. Among 43 patients treated with prednisone alone, 28 patients (65.1%) had no disease flare and 28 cases (65.1%) had successful pregnancy. No abnormality of neither visual field nor fundus was observed among patients treated with HCQ. No congenital abnormalities were found among new born infants. Conclusion HCQ intake during pregnancy in SLE patients can reduce disease flare and improve the pregnancy outcome, indicating that HCQ is safe for SLE patients during pregnancy.

Peripheral nerve injury of a limb usually causes functional reorganization of the contralateral somatosensory cortex.However, the patients with an operation of the contralateral seventh cervical nerve (C7) transfer to an injured arm with brachial plexusroot avulsions usually have the sole tactile sensibility of the healthy hand when the injured hand is touched at the early stage after theoperation. Then, at later stage they gradually get normal sense from the injured and the normal hands independently. Mimicked theprocess in a rat model based on the above operation, representations of the injured forepaw and the healthy forepaw in thesomatosensory cortex were studied by means of somatosensory evoked potential (SEP) recording. Somatosensory function shown inSEP response amplitude and peak latency of the injured forepaw gradually recovered with time after the operation due to thecontralateral C7 regeneration toward the injured limb, accompanied with the recovery process of limb movement. The somatosensoryrepresentation of the injured forepaw was observed exclusively in the ipsilateral somatosensory cortex since the 5th month after theoperation. Accordingly, the overlapped representation of the injured and healthy forepaws emerged in the ipsilateral somatosensorycortex of 13 rats studied except one with separated representation though the SEP latency and response amplitude were different inresponding to stimuli on the two forepaws. It is concluded that the contralateral peripheral nerve transfer to the injured arm can causedynamically functional reorganization in the ipsilateral somatosensory cortex suggesting a remarkable plasticity of the brain functioninduced by an alteration of sensory input between two sides of the body in adult rats.

OBJECTIVE:To introduce a self-cure method for the cough caused by cold.METHODS:By placing control group and trial group,30 cases(control group)were assigned to receive Dextromethorphan Hydrobromide oral liquid and 32 cases(trial group)to employ self-cure method for cough caused by cold.And a self-cure method for the cough caused by cold was induced.RESULTS & CONCLUSION:The practice of self-cure method can speed up the self-cure of cough caused by cold and this method deserves to be popularized.

Objective To study the role of down regulation of bcl 2 expression of human cholangiocarcinoma cells with bcl 2 mRNA cleaving ribozyme (RZ). Methods Synthetic gene of bcl 2 mRNA cleaving RZ was recombined with the expression vector of eukaryotic cells. The recombined vector was used to transfect human cholangiocarcinoma cells. The expression of bcl 2 in human cholangiocarcinoma cells was observed by immunocytochemistry and flow cytometry. Results The expression of bcl 2 in human cholangiocarcinoma cells transfected with RZ gene was lower than that of control group. Spontaneous apoptosis was observed in a few of the cells. Conclusion bcl 2 mRNA cleaving RZ can down regulate the expression of bcl 2 of cholangiocarcinoma cells notably and can also induce spontaneous apoptosis.

Objective: To investigate the clinical efficacy of nalmefene hydrochloride in the treatment of patients with traumatic shock. Methods:Totally 62 cases of patients with traumatic shock were randomly divided into nalmefene treatment group (n=31) and the control group ( n =31 ) according to the random number table. The control group was given the conventional treatment, while nalmefene treatment group was treated with nalmefene hydrochloride additionally. The changes of hemodynamics, plasma TNF-αand vas-cular endothelial function index were compared between the groups. Results:The mean arterial pressure in 24h after the treatment signifi-cantly decreased when compared with that in 12h after the treatment of nalmefene treatment group, and the difference was statistically sig-nificant (P<0. 05);the heart rate in 12h and 24h after the treatment in nalmefene treatment group significantly decreased when com-pared with that before the treatment, and the differences were statistically significant (P<0. 05);the plasma TNF-αlevels in 24h after the treatment in nalmefene treatment group significantly decreased when compared with that in 12h after the treatment, and the difference was statistically significant (P<0. 05), and there was no significant difference in plasma TNF-α levels before the treatment and in 12h after the treatment (P<0. 05);the plasma NO and ET in 24h after the treatment in nalmefene treatment group significantly decreased when compared with that in 12h after the treatment, and the difference were statistically significant (P<0. 05);and there was no signifi-cant difference in plasma NO and ET before the treatment and in 24h after the treatment (P<0. 05);abnormality in electrocardiogram, routine blood tests, routine urine and liver and renal function examinations were not found, and no obvious adverse drug reactions were shown during the treatment course. Conclusion:Nalmefene hydrochloride combined with the conventional treatment in the patients with traumatic shock shows striking efficiency with notable effects on hemodynamics ( heart rate and mean arterial pressure) , which can reduce plasma TNF-α, NO and ET levels and shows significant research significance.

Peripheral nerve injury of a limb usually causes functional reorganization of the contralateral somatosensory cortex.However, the patients with an operation of the contralateral seventh cervical nerve (C7) transfer to an injured arm with brachial plexus root avulsions usually have the sole tactile sensibility of the healthy hand when the injured hand is touched at the early stage after the operation. Then, at later stage they gradually get normal sense from the injured and the normal hands independently. Mimicked the process in a rat model based on the above operation, representations of the injured forepaw and the healthy forepaw in the somatosensory cortex were studied by means of somatosensory evoked potential (SEP) recording. Somatosensory function shown in SEP response amplitude and peak latency of the injured forepaw gradually recovered with time after the operation due to the contralateral C7 regeneration toward the injured limb, accompanied with the recovery process of limb movement. The somatosensory representation of the injured forepaw was observed exclusively in the ipsilateral somatosensory cortex since the 5th month after the operation. Accordingly, the overlapped representation of the injured and healthy forepaws emerged in the ipsilateral somatosensory cortex of 13 rats studied except one with separated representation though the SEP latency and response amplitude were different in responding to stimuli on the two forepaws. It is concluded that the contralateral peripheral nerve transfer to the injured arm can cause dynamically functional reorganization in the ipsilateral somatosensory cortex suggesting a remarkable plasticity of the brain function induced by an alteration of sensory input between two sides of the body in adult rats.

Objective To investigate spiral CT,PET/CT and clinical manifestations in non-HIV infectious penicilliposis marneffei lung disease, to improve diagnostic level of this disease.Methods Imaging manifestations of 6 cases of non-HIV infectious penicilliposis marneffei confirmed by bronchofiberscope lung biopsy and/or pus culture were analyzed retrospectively All cases underwent chest CT,two had brain MRI,and two had PET/CT scan before treatment.Imaging appearances were observed and combined with clinical dates and literatures.Results Unilateral lung lesion was detected in 1 case,bilateral lungs lesions in 5 cases.Multiple patchy consolidation,stripe shadow in bilateral lungs or right lung were found in 3 cases, multiple nodes in 2 cases, mass with nodes in 1 case.Among 6 cases, 2 had septa interlobulare thickness,1 had tracheal fistula,2 had pericardium and pleura involvement,4 had bone destruction,1 had the brainand liver involvement.6 cases showed multiple lymphadenectasis,amalgamation and necrosis in bilateral hilar,mediastinaand the neck.2 had abdominal cavity and or retroperitoneal lymphadenectasis.On PET/CT,2 cases showed high uptake,and the range of SUV value were 1.4-13.9.Initial misdiagnosis by imaging was found in 5 cases.6 patients recovered after anti fungus treatment.Conclusion Imaging appearances of non-HIV infectious penicilliposis marneffei mainly reveals as multiple patchy consolidation,nodes and mass in bilateral lungs, all accompany with lymphadenectasis, many with bone destruction,lack of specificity, which needs lesion biopsy and pus culture to make confirmed diagnosis.

Objective Dexmedetomidine is known to have a neuroprotective effect.The aim of this study was to investigate the effects of dexmedetomidine on ketamine-induced apoptosis of primarily cultured cortical neurons and its action mechanisms. Methods Rat cortical neurons were primarily cultured for 7 days and treated with ketamine (100μmol/L) and different concentrations of dexmedetomi-dine (0.001, 0.01, 0.1, and 1 μmol/L) for 24 hours, followed by measurement of the viability of the neurons by MTT assay.The neurons were divided into four groups:vehicle control, ketamine ( trea-ted with 100 μmol/L ketamine), dexmedetomidine+ketamine (DD+K, treated with 0.1 μmol/L DD and 100 μmol/L ketamine), and LY294002 ( treated with 0.1 μmol/L DD, 100 μmol/L ketamine, and 10 μmol/L LY294002) .After 24 hours of treatment, the apoptosis rate of the neurons was determined by Hoechst33258 staining, and the expressions of pAkt and cleaved-caspase-3 in the neu-rons detected by Western blot. Results The apoptosis rate of neurons was dramatically increased in the LY294002 and ketamine groups in comparison with the vehicle control and DD+K groups ([36.8 ±4.4] and [43.4 ±4.5]%vs [7.5 ±1.1] and [16.4 ± 3.6]%, P<0.01), the pAkt level remarkably decreased (0.26 ±0.02 and 0.15 ±0.01 vs 0.61 ±0.05 and 0.50 ±0.04, P<0.01), and the expression of cleaved caspase-3 significantly upregulated in the former two as compared with the latter two groups (0.40 ±0.02 and 0.65 ±0.03 vs 0.10 ±0.02 and 0.12 ±0.01, P<0.01). Conclusion Dexmedetomidine exerts a neuroprotec-tive effect against ketamine-induced apoptosis of neurons by activating the PI3K-Akt signaling pathway.