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.

Programmed death1 (PD-1) is mainly expressed on the surface of activated T cell. The combination between PD-1 and its legends PD-L1/PD-L2 activate downstream signaling pathways and negatively regulate T cell activation. Ab?normal increase expression of PD-L1 on tumor cell surface mediates the tumor immune escape. Inhibition of PD-1 signaling pathway contributes to antitumor effect of T cells. The development of this pathway inhibitors has become a hot spot for tu?mor immunotherapy. This article expounds the progress about antitumor effects mediated by PD-1 pathway inhibition from experiments in vivo or in vitro and clinical development of PD-1 pathway inhibitors, providing a new target for cancer immu?notherapy and theoretical and clinical basis for the clinical application of immunotherapy with traditional therapy methods.

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.

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.

Objective To investigate the method and curative effect of the CT-guided percutaneous catheter drainage in hepatic ab-scess.Methods 36 patients with liver abscess were treated with “one-step”percutaneous 8F pig tail catheter tube under CT guidance. Results 36 patients were performed “one-step”percutaneous catheter drainage,the successful rate was 100%,no severe complica-tions occurred.Symptoms were improved after cathetering in all patients.Of these 36 patients,30 patients had single abscess and 6 patients had multiple abscesses.The mean duration of drainage catheterization was 21.2 days for 36 patients.The diameter of ab-scess was between 4.0-1 9.5 cm,the mean diameter of abscess was 8.3 cm.Conclusion CT-guided percutaneous hepatic abscess catheter drainage is a safe,effective,minimally-invasive treatment.

Reforming the managerial system and the educational system of higher medical education is the requirement of the social development in the twenty-first century. The article expounds the fundamental characteristics of medical education including small scale, longer-duration program, and high expenditure. It emphasizes the significance of following the rule of medical education, and analyzes the important position of medical college and the relation of medical college to affiliated hospitals and other related colleges in the comprehensive university. Based on the requirement of the social development and the trend of higher medical education internationalization, it also analyzes the necessity of the adjustment on the medical educational system and the way of the adjustment.

At present,the satisfaction of free medical care of undergraduate is declining,and the doctor-patient relationship is becoming tense.By investigating and interviewing the three representative universities in Beijing,we conclude three reasons including the supplier of medical service,the receiver and doctor-patient communication.By adhering to the medical treatment concept of"Patient-Oriented",the paper puts forword serveral measures including incresing input and improving system and so on to achieve the harmonious development of doctor-patient relationship of undergraduate.

TLR4 signaling pathway plays an important role in regulation of the innate immune response and the adaptive immune response.Studies have shown that TLR4 signaling pathway is closely associated with the immune inflammatory process in major depressive disorder,but the underlying mechanisms are not clear.The pathophysiological process of depression involves multiple molecule mechanisms and signal pathways.The change of TLR4 signaling pathways exists in the peripheral circulation system or the central nervous system of depressive patients and depression animal models.The activation of TLR4 signaling pathways is associated with stress-inflammation-depression approach and leaky gut hypothesis,however,the relationship of peripheral and central TLR4 signaling pathways is not clear yet.TLR4 signaling pathway may be potential targets for the anti-inflammatory treatment of depression.