OBJECTIVE:To evaluate the cost-effectiveness of Acarbose in the treatment of type 2 diabetes. METHODS:The CORE diabetes model was employed to evaluate the long-term cost-effectiveness of Acarbose in the treatment of type 2 diabetes. RESULTS:Acarbose treatment prolonged patients' life expectancy by 0.27 years and quality-adjusted life expectancy by 0.26 years,but its cost was 17 081 yuan higher than in the control group. The incremental cost-effectiveness ratio was 62 717 yuan per life expectancy gained and 66 633 yuan per quality-adjusted life expectancy gained. An acceptability curve of cost-effectiveness showed that 76% of the patients would regard that Acarbose is cost-effectiveness when a willingness to pay was 100 000 yuan. CONCLUSION:Acarbose has long-term cost-effectiveness in the treatment of type 2 diabetes.

Objective: To investigate the trend in incidence of stroke in Yongkang City, Zhejiang Province from 2015 to 2022, so as to provide the evidence for improving stroke prevention and treatment strategies. Methods: The incidence of stroke in Yongkang City from 2015 to 2022 was collected through the Zhejiang Chronic Disease Monitoring Information System, and standardized by the data of the Chinese National Population Census in 2010. The incidence of stroke in gender-, age- and subtype-specific was analyzed, and the incidence trend of stroke was analyzed by average annual percentage change (AAPC). Results: A total of 22 408 stroke cases were reported in Yongkang City from 2015 to 2022, with crude incidence of 457.97/105 and standardized incidence of 379.55/105. The crude incidence of stroke appeared a tendency towards a rise (AAPC=6.447%, P<0.05). The crude incidence of stroke was higher among males than females (495.97/105 vs. 417.58/105, P<0.05), and the standardized incidence of stroke was higher among males than females (425.29/105 vs. 332.49/105, P<0.05). The average age of stroke cases was (70.74±12.64) years. The crude incidence of stroke appeared a tendency towards a rise with age (P<0.05), and which in residents aged 30 to 44 years showed an increasing trend (AAPC=6.142%,P<0.05). There were 18 040 cases of ischemic stroke (80.51%), 4 121 cases of hemorrhagic stroke (18.39%) and 247 cases of unclassified stroke (1.10%) reported from 2015 to 2022. The crude incidence of ischemic stroke was higher than which of hemorrhagic stroke (368.70/105 vs. 84.22/105, P<0.05). The crude incidence of ischemic stroke appeared a tendency towards a rise (AAPC=7.851%, P<0.05). Conclusions The crude incidence of stroke appeared a tendency towards a rise in Yongkang City from 2015 to 2022, with ischemic stroke as the predominant subtype. Male and the elderly should be given a high priority for stroke control.

Objective To investigate the protective effects of vasoactive intestinal peptide(VIP) on gut barrier in rats with severe acute pancrititis(SAP)and its mechanisms.Methods Fifty-four SD rats were randomly divided into sham operated(So)group,SAP group and VIP group.The model of SAP was induced by retrograde injection of 4%sodium taurocholate into the bili-pancreatic duct.The rats in VIP group were intraperitoneal injected with VIP of 5×10-9 nmol 5 minutes after model established.The endotoxin in plasma was measured at 1,6 and 1 2 hour.The expression of Toll-like receptor(TLR)4 in gut mucosa was examined using RT-PCR and immunohistochemistry and mucosa tissue were detected using electroscopic examination.Results The concentration of endotoxin in plasma and expression of TLR4 were both increased at 1 hour and reached peak at 1 2 hour in SAP group compared with SO group(no expression of TLR4),but were decreased in VIP group.A correlation was found between endot6xin and expression of TLR4.The electroscopic examination showed that the pathological injury in intestine was severe in SAP group than that in VIP group.Conclusion The protective effect of VIP in gut barrier function may contribute tO down-regulation of TLR4 expression in gut mucosa.

Human immunodeficiency virus type 1 (HIV-1) is the causative agent of acquired immunodeficiency disease syndrome (AIDS). After over 26 years of efforts, there is still not a therapeutic cure or an effective vaccine against HIV/AIDS. The clinical management of HIV-1 infected people largely relies on antiretroviral therapy (ART). Although highly active antiretroviral therapy (HAART) has provided an effective way to treat AIDS patients, the huge burden of ART in developing countries, together with the increasing incidence of drug resistant viruses among treated people, calls for continuous efforts for the development of anti-HIV-1 drugs. Currently, four classes of over 30 licensed antiretrovirals (ARVs) and combination regimens of these ARVs are in use clinically including: reverse transcriptase inhibitors (RTIs) (e.g. nucleoside reverse transcriptase inhibitors, NRTIs; and non-nucleoside reverse transcriptase inhibitors, NNRTIs), protease inhibitors (PIs), integrase inhibitors and entry inhibitors (e.g. fusion inhibitors and CCR5 antagonists). Here, we intend to provide updated information of currently available antiretroviral drugs for ART to promote the development of novel anti-HIV-1 drugs.

Immune system is the autologous defense system for people to resist disease. Immunotherapy stimulates the immune system to resist disease, including treatment with immunocyte and vaccine. In recent years, the prognosis and survival quality of tumour patients have been greatly improved through cell immunotherapy by immunoregulation and killing directly on tumor. Immunotherapy becomes the hotspot in research.The study of DN Treg cell on immunotherapy will be of vital significance.

In order to expand the capabilities of hospital's traditional ECG device and enhance medical staff's work efficiency, an ECG monitoring system based on internet of things is introduced. The system can monitor ECG signals in real time and analyze data using ECG sensor, PDA, Web servers, which embeds C language, Android systems, .NET, wireless network and other technologies. After experiments, it can be showed that the system has high reliability and stability and can bring the convenience to medical staffs.
Electrocardiography ; Internet ; Monitoring, Physiologic ; Reproducibility of Results ; Wireless Technology

Objective To discuss the influence of the management of family-doctor responsibility system on drug utilization and compliance of hypertensive patients.Methods 1039 primary hypertension patients in Zhenhai Lianhua Community who were under the management of the residents electronic health files in June 2012,were implemented with the latest family-doctor responsibility system for eight months.The on-site questionnaire survey and electronic health management platform were carried out to analyze the drug utilization and treatment compliance of hypertensive patients.Results The proportion of taking medicine treatment among 1039 patients with essential hypertension reached 85.2％,including 56.3％ patients who took one kind of drug,35.4％ patients who took two kinds of drugs and 8.3％ patients who took at least three kinds of drugs.The most commonly used drugs were Amlodipine Besylate,Felodipine,Irbesartan and Hydrochlorothiazide tablets,Irbesartan,Levamlodipine Besylate tablets,Metoprolol Tartrate tablets and etc.The rate of patient compliance was 65.5％.After comparing the compliance of any two among three kinds of drug groups,the comparison of compliance between patients who took one kind,two or three kinds of drugs showed statistical significance.The comparison of drug types and compliance showed that compliance with compound preparation was statistically different from compliance with ARB,calcium antagonists,sympatholytic agent,diuretics.The educational level was also related to the compliance.Conclusions After the implementation of the family-doctor responsible management,the treatment rate and compliance rate are high,and the patients with hypertension in community still give priority to long-acting drugs.

ObjectiveTo investigate the clinical value of routine para - aortic lymphadenectomy in patients with stage Ⅰ B1 and Ⅱ A2 cervical cancers treated by surgical intent.Methods240 patients with stage Ⅰ B1 and Ⅱ A2 squamous cervical cancer were randomly divided into tow groups( group A and B).120 patients (group A) underwent radical hysterectomy with systematic pelvic lymphadenectomy and paraaortic lymphadenectomy.Other 120 patients (group B) underwent radical hysterectomy with systematic pelvic lymphadenectomy,additional para-aortic lymphadenectomy were carried out when para-aortic lymph nodes were identified as suspicious by visualization and palpation.The operation time,amount of surgical bleeding,length of stay,complications,and metastasis rates of pelvic lymph node,metastasis rates of common iliac lymph node and metastasis rates of para-aortic lymph node were analyzed between two groups.ResultsThe clinical characteristics of the patients had no statistically significant difference between the two groups.The length of stay and the complications of group A were significantly higher than group B ( P ＜0.05 ).During the 240 patients,the metastasis rates of pelvic lymph node,common iliac lymph node and para-aortic lymph node were 27.9％,10.8％ and 5.4％.The metastasis rate of para-aortic lymph node in group A was statistically higher than that in group B( 8.3％ vs 2.5％,P ＜0.05),whereas there had no significant difference of the metastasis rates of pelvic lymph node and common iliac lymph node between the two groups.ConclusionsRoutine para-aortic lymphadenectomy can be helpful to accurately predict the status of the para-aortic lymph node in patients with stage Ⅰ B1 and Ⅱ A2 cervical cancer,but the length of stay and the complications of operation will increase.

Serum tumor biomarkers are significant for the early diagnosis and treatment,preoperative evaluation,prognosis prediction and relapse surveillance of endometrial carcinoma.Recently,serum CA125 and human epididymal secretory protein 4 are widely recognized as closely related with staging,metastasis and prognosis of endometrial cancer.In addition,the serum miRNAs are characterized by their features of high stability and specificity.Omics studies will be helpful for the general assessment of the initiation and progression of endometrial cancer.Insights into these two aspects will facilitate the identifications of new biomarkers with higher sensitivity and specificity for endometrial carcinoma.