OBJECTIVE To evaluate the cost-effectiveness of using Bacillus Calmette-Guérin （BCG） versus epirubicin for intravesical perfusion after transurethral resection of bladder tumor （TUR-BT） in patients with intermediate- to high-risk non-muscle- invasive bladder cancer （NMIBC）. METHODS From the perspective of China’s health system， a Markov cohort model was constructed based on the ChiCTR-IIR-16008357 study. Quality-adjusted life years （QALYs） were used as the health outcome measure， with the willingness-to-pay（WTP） threshold set at one time the per capita gross domestic product of China in 2023 （89 358 yuan/QALY）. A cost-utility analysis was used to compare the incremental cost-effectiveness ratio （ICER） of the BCG regimen relative to the epirubicin regimen for intravesical perfusion after TUR-BT in patients with intermediate- to high-risk NMIBC in China. In addition， sensitivity analysis was performed. RESULTS The incremental cost of the BCG regimen compared to the epirubicin regimen was 34 309.51 yuan， with an incremental utility of 0.800 QALYs， resulting in an ICER of 42 871.33 yuan/QALY， which is below the WTP threshold. When the WTP threshold was 89 358 yuan/QALY， the probability that the BCG regimen would be acceptable was 77.70% in the probabilistic sensitivity analysis， higher than that of the epirubicin regimen， and the acceptability of the BCG regimen increased with increasing in the WTP threshold. CONCLUSIONS When the WTP threshold was set at one time the per capita gross domestic product of China in 2023， compared to epirubicin， BCG used for intravesical perfusion after TUR-BT in patients with intermediate- to high-risk NMIBC demonstrated better cost-effectiveness.

OBJECTIVE To study the impr ovement effects of Dianxianqing granule on blood-brain barrier （BBB）injury in Alzheimer’s disease （AD）model mice by regulating NLR family pyrin domain containing 3（NLRP3）inflammasome signaling pathway. METHODS Totally 125 mice were randomly divided into sham operation group （n＝25）and modeling group （n＝100） by body weight. AD model was induced by intracerebroventricular injection of β-amyloid 25-35 in model group. Sham operation group was given normal saline with same method. The 100 model mice were randomly divided into model group ，Donepezil hydrochloride tablets group （positive control 1，1.3 mg/kg，i.g.），MCC950 group [positive control 2（selective NLRP 3 inhibitor），10 mg/kg，i.p.] and Dianxianqing granule group （12.48 g/kg by crude drug ，i.g.）by body weight ，with 25 mice in each group. Second day after modeling ，administration groups were given relevant medicine ，once a day ，for consecutive 21 d. Sham operation group and model group were given intragastric administration of water and intraperitoneal injection of normal saline. At last administration，the learning and memory ability was determined by Y maze test ，and blood-brain barrier permeability was measured by Evans blue leakage assay. The expressions of NLRP 3，anti-ionized calcium-binding adapter molecule 1（IBA-1），nuclear factor kappa B （NF-κB）p65，p53 upregulated modulator of apoptosis （PUMA），occludin（ocln），zonula occluden- 1（ZO-1）and claudin-5 （cldn5） in cerebral tissue were determined. RESULTS Compared with model group ， spontaneous alternate response rate ，protein expressions of ocln ，cldn5 lnzyxyqy2003@163.com and ZO- 1 in cerebral tissue were increased significantly in administration groups （P＜0.05 or P＜0.01）；Evans blue E-mail：jiadg2003@126.com content and protein expressions of NLRP 3，IBA-1，PUMA and NF-κB p65 in cerebral tissue were decreased significantly （P＜0.05 or P＜0.01）. CONCLUSIONS Dianxianqing granule can improve BBB injury of AD model m ice by inhibiting NLRP 3 inflammasome signaling pathway.

Objective To explore the relationship between childhood asthma and pregnant and neonatal risk factors, thus provide evidence for early prevention of childhood asthma. Methods 162 children diagnosed asthma and 213 healthy children in pediatric outpatient and the inpatient services of our hospital who was born and living in Baotou city were retrospectively analyzed. The pregnancy related factors (parity, fever during pregnancy, pregnancy-induced hypertension syndrome, gestational diabetes mellitus, history of overdose in early-pregnancy) and the neonatal period related factors (surface defects, asphyxia, rough placenta, birth weight, number of fetus during this pregnancy, gestational age, premature birth, cesarean section) were investigated. The sex and age showed no signiifcance between childhood asthma and control group. Results Eight pregnant and neonatal factors (fever during pregnancy, pregnancy-induced hypertension syndrome, history of overdose in early-pregnancy, surface defects, asphyxia, rough placenta, birth weight, premature birth, cesarean section) showed signiifcant difference between the two groups (P<0.05). Multifactor regression analysis found fever during pregnancy (OR=9.43, 95%CI:3.08~28.82), rough placenta (OR=2.15, 95%CI:1.29~3.59), premature birth (OR=5.16, 95%CI:1.53~17.39) and cesarean section (OR=4.05, 95%CI:2.40~6.86)are independent risk factors for childhood asthma. Conclusions Fever during pregnancy, abnormal placenta;premature birth and cesarean section are likely risk factors of childhood asthma.

Objective To investigate the expression levels and the roles of IL-17 and IL-23 in children with Mycoplasma pneumoniae (MP) pneumonia. Methods One hundred and three children with pneumonia admitted to pediatric department from February to May in 2012 were divided into MP pneumonia group and non-MP pneumonia group according to the results of MP antibody tests. Meanwhile, 42 healthy children were chosen as normal controls. Serum levels of IL-17, IL-23 and MP antibodies were measured in all children. Immunoglobulin, C reactive protein, total white blood cell count and granulocyte count were detected in children with pneumonia. Results The serum levels of IL-17 and IL-23 were signiifcantly different among three groups (P<0.05). The children in MP pneumonia group had higher levels of IL-17 and IL-23 than those in non-MP pneumonia group (P<0.05). Compared with the control group, levels of IL-17 and IL-23 were higher in two pneumonia groups (P<0.05). There was no signiifcant difference in levels of IL-17 and IL-23 between pneumonia patients with normal and with abnormal levels of immunoglobulin (P>0.05), while IL-17 and IL-23 levels were both positively correlated with granulocyte count (P<0.05).Conclusion IL-17 and IL-23 may be involved in the immune response of MP pneumonia and may contribute to the clearance of pathogens.

In the educational process of medicine,not only medical knowledge and skills,but also the medical ethics of being a good doctor should be taught to medical students.In her teaching course of traditional Chinese medical doctrine of ShangHanLun,besides the curricular content proposed by the Ministry of Education of China,the author also arouses her students the enthusiasm and devotion to traditional Chinese medicine,builds up the spirit of hard working and probity as well.By introducing ZHANG Zhong-jing's respectable medical ethics,she also enlightens uhem with the gracious medical ethics.