OBJECTIVE:To evaluate the cumulative incidence of end-stage renal disease(ESRD)in Chinese hypertensive type2diabetic patients with microalbuminuria(DHM)treated with different regimes,and to provide reference for decision makers.METHODS:A peer-reviewed Markov model that simulated progression from microalbuminuria to nephropathy,dou?bling of serum creatinine,ESRD,and all-cause mortality in patients with DHM was adapted to China.Three strategies were compared:(1)early use of irbesartan(i.e.prompt treatment in subjects with microalbuminuria);(2)late use of irebesartan(i.e.as from overt nephropathy);(3)standard hypertension care(with comparable blood pressure control).Cumulative incidence of ESRD,costs and life expectancy were projected for a hypothetical cohort of1000subjects.Treatment-specific progression and mortality probabilities were derived from published trials:IRMA-2(in microalbuminuria)and IDNT(in overt nephropathy).Medical management and cost data per state were obtained from published local sources.A flexible time horizon up to25years and third party payer perspective were used.Future costs and LE were discounted at3%yearly.RESULTS:When compared with standard blood pressure control,early use of irbesartan was evaluated to reduce the cumulative incidence of ESRD from(mean?standard deviation)8%to22%,save RMB30348(US＄3667),and add0.638life years per treated patient.Late use of irbesartan was dominant over control group but dominated by early irbesartan.Break-even occurred after13years.CON?CLUSION:Treating DHM patients by early use of irbesartan is evaluated to reduce the incidence of ESRD,extend life and reduce costs.Treating patients at a later stage is still beneficial,however to a lower extent.

Maternally expressed gene 3 (MEG3) is a tumor-suppressing gene,and MEG3 RNAs,its products,are a series of long noncoding RNAs.The MEG3 gene is lost in kinds of human tumors,further more,the methylation of related DNA region is directly associated with the deficiency of MEG3 expression.Studies show that MEG3 gene and MEG3 RNAs can inhibit cell proliferation and induce apoptosis,which is associated with the fuction of tumor suppressor gene p53.

Objective To construct a maternally expressed gene 3(MEG3)expression plasmid vec-tor,and to obtain MEG3 over-expressed human pancreatic carcinoma SW1990 cells by transfection,and to ana-lyze the effect of MEG3 overexpression on the proliferation of human pancreatic carcinoma SW1990 cells. Methods A complete gene sequence based on the sequence of MEG3 in the GenBank was designed and inser-ted into the eukaryotic expression vector pcDNA3. 0 to construct recombinant plasmid pcDNA3. 0-MEG3. It was identified by sequencing and transfected into human pancreatic carcinoma SW1990 cells. The expression of MEG3 in SW1990 cells was confirmed by RT-PCR. The effect of MEG3 on proliferation was evaluated by MTT assay. In this study,the SW1990 cells transfected by plasmid pcDNA3. 0 were named negative control group, and the usual SW1990 cells were named blank control group. Results A MEG3 expression plasmid vector-pcDNA3. 0-MEG3 was constructed successfully. And pcDNA3. 0-MEG3 vector was transfected into SW1990 cells successfully. The expression of MEG3 at mRNA in MEG3-SW1990 cells increased significantly,about 895 times(F = 73. 592,P ﹤ 0. 01). The results of MTT assay indicated that over-expressed MEG3 could obviously inhibit SW1990 cells proliferation in vitro. After SW1990 cells transfected with pcDNA3. 0-MEG3 for 72 hours, the absorbance value was 0. 81 ± 0. 06,with a statistically significance(F = 33. 489,P ﹤ 0. 01)compared with negative control group(1. 17 ± 0. 07)and blank control group(1. 08 ± 0. 03). Conclusion A MEG3 expre-ssion plasmid vector-pcDNA3. 0-MEG3 is constructed successfully. It is confirmed that MEG3 and its product have obvious inhibitory effects for the proliferation of human pancreatic carcinoma SW1990 cells.

OBJECTIVE:To provide scientific basis for the research quality of pharmacoeconomic on the domestic digestive system diseases.METHODS:The pharmacoeconomic research literatures published on professional academic magazines before2003were collected either by computer or by manual research,and which were then systematically evaluated.RESULTS:Some problems were found in the88pharmacoeconomic research literatures obtained,including the study perspective,design,result analysis and discussion of study.CONCLUSION:It is suggested a guideline for pharmacoeconomic research be made and the pharmacoeconomic research be further standardized,the academic exchanges and evaluation feedbacks be increased;meanwhile,personnel training should be emphasized for a better formulation of the related policies and the rational medication in the clinic.

objective To quantify the expression of kallikrein gene 6 (KLK6) in malignant and benign breast tissues and to statistically analyze the relationship between KLK6 expression levels and the clinico-pathological variables in patients with breast cancer. Method Paired breast tissue samples of cancerous and corresponding non-cancerous tissues were obtained from 48 patients with breast cancer who underwent surgical resection. Quantitative analysis of KLK6 mRNA expression was done using real-time quantitative reverse transcription-PCR (RT-PCR). The relationship between KLK6 expression intensity and various clinico-pathological variables was analyzed. In addition, the technique of small interfering RNA-mediated gene silencing was used to suppress the KLK6 expression in MCF-7, and to investigate the effects of KLK6 on cell proliferation rate and cell cycle. Results KLK6 mRNA over expression was found in cancerous tissues in 35 out of 48 patients (73%) as compared with normal breast tissue. The mean expression level of KLK6 mRNA in cancerous tissues was significantly higher than that in non-cancerous tissues (P

Objective:To investigate whether the overexpression of Oct4B1 gene induces epithelial mesenchymal transition in human colorectal cancer SW480 cells and its possible mechanism.Methods: Experimental group(SW480-Oct4B1):Transfection of SW480 cell lines in colorectal cancer with Oct4B1 overexpression plasmid;Control group(SW480-Oct4B1):negative control plasmid with G418 resistance.Stably transfected cell lines were obtained by G418 culture medium.The two groups were compared with:①Detection of Oct4B1 gene expression in stably transfected cell lines by RT-qPCR;②Scratches and Transwell assays were used to estimate migration and invasion;③Detection of EMT related markers E-cadherin,N-cadherin and Vimentin protein expression by Western blot assay;④Detection of Twist gene and protein expression by RT-PCR and Western blot assays.Results: The transient transfection was confirmed by RT-qPCR and the stable transfected cell lines were obtained from two groups of cells transfected with G418 culture medium.Compared with the control group:①RT-qPCR revealed increased expression of Oct4B1 gene in the experimental group(P<0.01);②Cell migration and invasion were significantly increased(P<0.01);③Epithelial marker:the expression of E-cadherin protein was significantly decreased (P<0.01),interstitial marker:the expression of N-cadherin and Vimentin protein was significantly increased (P<0.01);④Twist mRNA and protein expression were significantly increased(P<0.01).Conclusion: Overexpression of Oct4B1 gene can induce epithelial mesenchymal transition in human colorectal cancer SW480 cells,its molecular mechanism may be related to the promotion of Twist expression.

Objectives To analyze comparatively the adverse reactions of Nedaplatin(NDP)and Cisplatin(DDP)in concurrent chemoradiotherapy for locally advanced nasopharyngeal carcinoma and summarize the nursing points as well.Methods From March 2012 to March 2013,112 patients with locally advanced nasopharyngeal carcinoma were randomly divided into NDP group and DDP group.Besides intensity modulated radiotherapy for both groups,NDP group were treated with intravenous drop infusion of NDP by 100 mg/m2 and the control group with intravenous drop infusion of DDP by 100 mg/m2 both for three courses of once every three weeks (e.g.day one,day 22 and day 43 during the course).The two groups were compared in terms of therapeutic effects and incidences of adverse reactions.Results The complete remission rates of the NDP group and DDP group were 87.5%and 85.7%,respectively (P>0.05).The incidences of adverse reactions like gastrointestinal reactions and radioactive mucositis in the NDP group were significantly lower than those in the DDP group(P<0.05)and the index of platelet decrease was significantly higher(P<0.05).There were no significant differences between the two groups in terms of liver and kidney dysfunction and white blood cells decrease(P>0.05). Conclusions Chemotherapy with NDP combined with radiotherapy for locally advanced nasopharyngeal carcinoma has fewer adverse effects and is easy to be accepted by patients so that their quality of life can be improved.In the application of the two kinds of chemotherapy,we should pay attention to the adverse reactions on patients in order to give pertinent care.

Objective To develop a real-time quantitative PCR method for detection of human breast cancer related novel gene-kallikrein gene 6 (klk6) expression and investigate klk6 expression levels in breast cancer tissue.Methods Using Sybr Green I, with GAPDH as reference, a real-time quantitative PCR method was established. klk6 expression levels of 32 normal and breast cancer tissues were detected and analyzed by the method and REST software.Results The amplification efficiencies for GAPDH and klk6 of the real-time quantitative PCR method were 0.90 And 0.95, respectively; inter-coefficient of variation were 1.0%~2.1% and 0.8%~1.2%,respectively; intra-coefficient of variation were 3.2% and 3.9%, respectively. The relative expression levels of klk6 in normal breast and breast cancer tissues were 0.017?0.009 and 0.040?0.017 with GAPDH as reference. Analysis results with REST indicated klk6 expression was up- regulated in breast cancer.Conclusion The real-time quantitative PCR method with Sybr Green I for klk6 mRNA quantification was simple, specific, reproductive and reliable, and could be used to study relationship betweeen klk6 expression and tumor.

Objective To investigate the role of chemokine ligand 21 (CCL21) in the spinal cord in tibia bone cancer pain (BCP) in rats.Methods Forty adult female SD rats weighing 160-180 g were randomly divided into 5 groups (n=8 each):sham operation group (group Ⅰ ); sham operation + CCL21 neutralizing antibody group (groupⅡ); BCP group (group [); BCP + PBS group (group Ⅳ); BCP + control IgG group (groupⅤ)and BCP + CCL21 neutralizing antibody group (group Ⅵ).BCP was induced by inoculating Walker-256 mammary gland carcinoma cells into the rat tibia medullary cavity in groups Ⅲ-Ⅵ.PBS 15 μl,IgG 10 μg and CCL21 neutralizing antibody 10 μg were injected intrathecally (IT) at 14 days after intra-tibial injection of Walker-256 mammary gland cancer cells in groups Ⅳ- Ⅵ respectively.Mechanical withdrawal threshold to yon Frey filament stimulation (MWT) was measured at 1 day before (To,baseline) ; 7 and 14 d after Walker-256 cell injection (T1,T2)and at 0.5,1,2,4,8,12,24 and 48 h after intrathecal injection (T3-10 ).Results Intra-tibial injection of Walker-256 mammary gland cancer cells significantly decreased MWT as compared with the baseline values in administration of CCL21 neutralizing antibody at T5-8 as compared with MWT before intrathecal administration at T2 in group Ⅵ.MWT was significantly lower in groups Ⅲ- Ⅳ than in groups Ⅰ and Ⅱ.MWT was significantly higher at T5-8 in group Ⅵ than in groups Ⅲ - Ⅴ.Conclu]sion CCL21 in the spinal cord is involved in the maintenance of tibia BCP in rats.

This paper presented both the theoretical basis and the technical route of the study for health system reform in Shanghai via system monitoring and evaluation.By way of two rounds of expert consultation and joint liaison meetings,the study initially established framework indicators of such based on the following four aspects,including inputs and activities,outputs,outcomes and impact.Also,the study identified 13 grade-2 indicators and 133 grade-3 indicators.Based on the main results of the baseline survey,the paper preliminary analysed the problems and challenges that may be faced in the field of Shanghai health system reform,and proposed suggestions for carrying out monitoring and evaluation of the health system reform respectively on both a research and practical level.