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.

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 observe the clinical effect of tiotropium bromide combined with salmeterol xinafoate and fluticasone propionate in the treatment of medium and severe COPD. METHODS:119 patients with medium and severe COPD were divided into control group(54 cases)and observation group(65 cases)according to admission order. Control group was treated with Salmeterol xi-nafoate and fluticasone propionate powder for inhalation 50 μg,bid;observation group was additionally given Tiotropium bromide powder for inhalation 18μg,qn. Both groups received 1 month of treatment. Lung function indexes as FEV1,FVC and IC,blood gas indexes as SaO2,PaCO2 and PaO2 and inflammatory factors as IL-8 and TNF-α,COPD assessment test(CAT)score were observed in 2 groups,and the occurrence of ADR was also observed. RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups(P>0.05). After treatment,FEV1,EVC,IC of observation group were increased significantly,SaO2 and PaO2 of observation group were increased significantly,while PaCO2,IL-8 and TNF-αlevels was decreased significantly;those index-es of observation group were significantly better than those of control group,with statistical significance(P<0.05). CAT score of 2 groups were decreased significantly compared to before treatment,and the observation group was significantly lower than control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Tiotropium bromide com-bined with salmeterol xinafoate and fluticasone propionate shows good clinical efficacy and safety in the treatment of medium and se-vere COPD.

Intrahepatic cholangiocarcinomas (ICCA) are primary intrahepatic malignancies originating from biliary epithelia.While both hepatocellular cancer and ICCA can present as mass lesions within the liver,these cancers are distinct in their morphology,etiology,pathology,natural history and response to therapy.There is a need for accurate and sensitive molecular markers for the diagnosis of ICCA.Recent advances in elucidating molecular and genetic characteristics of ICCA offer the potential of molecular-based diagnosis of ICCA.Specific genetic mutations of IDH1/2,BAP1,p53,and KRAS,FGFR gene fusions and alterations in microRNA have all been described in ICCA.Although there are no accurate serum or biliary biomarkers currently available for diagnosis of ICCA,several potential candidates have been identified.Knowledge of specific genetic or molecular abnormalities offers potential for individualized approaches for the treatment of patients with ICCA in the future.

Objective To observe the correlation between infrared radiation temperature of specific points of the bladder (Zhongji, Pangguangshu, Weizhong and Shenshu) and OAB symptom severity in patients with overactive bladder (OAB) before and after electroacupuncture.Method Eighty-six patients were treated with electroacupuncture. The infrared radiation temperatures of the points were measured using an infrared thermograph in the patients before and after electroacupuncture. The patients’ symptoms were scored using the OAB Symptom Score (OABSS). The correlation between the infrared radiation temperature and the symptom score was analyzed according to the changes in the two.Result In the patients, the OAB symptom score (OABSS) was 8.00 (7.00, 9.00) before treatment and 2.00 (4.00, 6.00) after. There was a statistically significant difference between the two (P<0.05). There were statistically significant pre-/post-treatment difference in the infrared radiation temperatures of the points (Zhongji, Pangguangshu, Weizhong and Shenshu) (P<0.05). The OAB symptom score (OABSS) and Zhongji infrared radiation temperature had a rank and positive correlation.Conclusion Zhongji infrared radiation temperature has important reference value for the assessment of OAB symptom severity.

This article reviewed information related to the apoptosis of breast cancer cells. Breast cancer is a common malignant tumor in women. Apoptosis is related to the response and resistance to treatment in breast cancer. Here we summarized and integrated the data on apoptosis and its role in the development, prognosis, and treatment of breast cancer. Further study on apoptosis in breast cancer can help find more candidates for predictors and indices of response. Such study will also develop treatment regimens that are tailored to individual tumors and thereby maximize survival.

Objective To examine the effect of mycophenolic acid(MPA)on mesangial cell(MC)proliferation and on expressions of transforming growth factor-?(TGF-?)and connective tissue growth factor(CTGF)induced by high glucose.Methods The proliferation activity of mesangial cells incubated for 24h,48h and 72h in different concentrations of MPA was observed by MTT assay.The expressions of TGF-? and CTGF were measured by Western blot.Results MPA inhibited the MC proliferation and expressions of TGF-? and CTGF induced by high glucose.Conclusions MPA decreases the release of extracellular matrix by inhibiting the MC proliferation and expressions of TGF-? and CTGF,and subsequently slows the development of glomerulosclerosis in diabetic nephropathy.

Objective To observe the application of alkaline cleaning agent in disinfection and supply room cleaning of medical devices, to evaluate the cleaning quality. Methods The 800 contaminated medical instruments collected from February 2016 to February 2017 in municipal maternal and child health hospital were divided into control group (February 2016 to August 2016) and study group (September 2016 to March 2017 ) according to different time periods,with 400 pieces in each group.In the reference group, the instrument was washed with multienzyme detergent, and the study group was cleaned with alkaline detergent. The cleaning of 2 groups of instruments was observed and compared. Results The total excellent and good rate of instrument cleaning in the study group was 97.25％ (389/400), in the reference group was 89.50％(358/400), the difference between the two groups was statistically significant (P<0.05); the cleaning safety, practicality, economy, comprehensive score difference of the study group was significantly better than the reference group (P<0.05). Conclusion The effect of alkaline cleaning agent used in disinfection supply room cleaning medical instruments is remarkable, and the equipment residue and microorganism can be effectively eliminated, and the utility model has the advantages of high safety and low economic cost, and has the important practical value.