OBJECTIVE:To evaluate the pharmacoeconomics of cefathiamidine, ceftriaxone sodium, cefuroxime sodium, amoxicillin sodium/clavulanate potassium and cefoperazone sodium/sulbactam sodium in the treatment of pediatric bronchopneumo-nia,and to provide reference for rational drug use in the clinic. METHODS:By retrospective study,338 children with broncho-pneumonia were divided into groups A,B,C,D and E according to different therapy regimens. There were 75,65,76,66 and 56 cases in groups A,B,C,D and E,and they were given cefathiamidine,ceftriaxone sodium,cefuroxime sodium,amoxicillin sodium/clavulanate potassium and cefoperazone sodium/sulbactam sodium intravenously. The pharmacoeconomics of therapy regi-mens in group A,B,C,D and E were evaluated by cost-effectiveness analysis and decision tree analysis model. RESULTS:The effective rates of groups A,B,C,D and E were 93.33%,90.77%,96.05%,87.88% and 87.50%,respectively. The treatment cost of those groups were 1 929.09,2 173.73,1 611.91,1 661.42,1 801.32 yuan,respectively. The cost/effectiveness(C/E)ratio of those groups were 20.67,23.95,16.78,18.91,20.59,respectively. The treatment cost of group C was the smallest,so was the C/E. Results of cost-effectiveness analysis were supported by sensitivity analysis. CONCLUSIONS:Cefuroxime sodium is the best treatment for pediatric bronchopneumonia among 5 antibiotics in respect of cost-effectiveness.

Objective To compare the killing effect of cytotoxic T lymphocytes(CTLs) induced by dendritic cells transduced recombinant adenovirus associated virus (rAAV ) with different hepatitis B virus gene fragment (rAAV‐HBV‐S ,C ,E ,X ) . Methods Peripheral blood mononuclear cells(PBMCs) from chronic hepatitis B patients were isolated and transduced recombinant adeno‐associated virus with different hepatitis B virus (HBV) antigen gene fragment (rAAV‐HBV‐S ,C ,E ,X) ,then GM‐CSF ,IL‐4 and TNFαwere added to cultivate for 7 days to generate mature dendritic cells (DCs) .The state of DCs were observed and differen‐tiation antigen molecules (CD)were detected by flow cytometry(FACS)to evaluate their maturation and function .Cytotoxic T lym‐phocytes (CTLs) were induced by the mixed cuture of DCs with prepared T lymphocytes .HepaG2 .2 .15 and HepaG2 were targed cells and the killing effect of CTLs wered compared using MTS assay .Results The expression of phenotype CD14 ,CD80 ,CD83 , CD86 from DCs transduced with rAAV‐HBV‐S ,C ,E ,X were compared ,respectively .Of which ,CD80 ,CD86 were significantly dif‐ferent(P<0 .05) .CD80 in group rAAV‐HBV‐X was the highest ,and CD83 in group rAAV‐HBV‐S was the highest .Cytotoxic effect of CTL induced by DC transduced with HBV antigen gene fragment of rAAV (S ,C ,E ,X) to target cells with HBV (HepG2 . 2 .15 cells) were significantly higher than that of without HBV target cells (HepG2 cells) (P<0 .01) ,but the four groups were no significant difference ,respectively(P>0 .05) .Conclusion HBV‐S ,C ,E ,X genes all induce M HC‐I dependently cytotoxic T‐lym‐phocytes specific response based adeno‐associated virus (AAV) vector delivery into dendritic cells .

Objective To investigate the effects of emotional care on the quality of life of breast cancer patients undergoing radical operation.Methods Emotional nursing intervention was conduced to 70 breast cancer patients undergoing radical operation. The modified life quality scale was used before and after the radical operations for the investigation of their quality of life.Result The score on the quality of life after emotional care was significantly higher than that after the emotional care(t=-2.07,P<0.05).Conclusion Emotional care may raise breast cancer patients’quality of life after the radical mastectomy.

Objective To study the relationship between the expression of breast cancer susceptibility gene (BRCA)1 and the pathological parameters in sporadic breast cancer. Method Immunohistochemistry was used to detect the expression of BRCA1 in 42 cases of breast cancer tissues and 30 cases of breast fibroadenoma tissues and analyzed the correlation of the results with other parameters which included tumor size,tumor type,histological grade and axillary lymph nodes metastases. Results The positive expression rate of BRCA1 was 52.4% (22/42) in breast cancer patients and 85.7% (36/42) in breast fibroadenoma patients. The lower positive expression rate of BRCA1 was found in axillary lymph nodes metastases (P < 0.05). The positive expression rate in stage Ⅲ of breast cancer was lower than that in stage Ⅰ (P < 0.05 ) and was also lower than that in stage Ⅱ (P < 0.05 ), but there was no significant difference between stage Ⅰ and stage Ⅱ (P > 0.05). No significant correlation was observed among expression of BRCA1 and tumor size, tumor type (P > 0.05). Conclusions BRCA1 plays an important role in pathogenesis and development of breast cancer.BRCA1 maybe a adjuvant index for treating breast cancer and estimating prognosis.

Objective To explore whether health examination save medical insurance fund or not. Methods To observe the sparing medical cost which 371 health examination people avoid repeated checking and shorten the length of stay during hospitalization from March 2006 to March 2007. To observe the effect of sparing medical cost because of regular health examination, early discovery diseases, pretreatment promptly and avoidance transforming to advanced diseases. Results Because of avoiding repeated checking and shortening the length of stay,everybody save the medical cost about 570 yuan,371 people can save about 21 ten thousands yuan. To statistics the average hospital cost of different courses of eight common diseases and malignant tumors from January to November at 2007, we discovered that the medical cost is large distinction between the earlier period and advanced stage of disease. For example: the medical cost of one stage of hypertension is 6608 yuan ,the two stage is 8838 yuan ,the three stage is 13 869 yuan, and the stage of hypertensive heart disease is 13 033 yuan. Parts of health examination crowd who stay at my hospital from 1996 were visited for five years ,we conformed many chronic diseases by prompt intervention can relieve and even reverse, avoiding the transformation to incurable disease which will consume a large number of strength and money. Conclusion Health examination resource is a medical treatment resource which isn't restricted by social security fund, the utilization can not only save medical cost but also discover and treat diseases earlier, thus we can save the strength and money before the advanced diseases.

Objective To investigate the protective effect of gynostemma on myocardium and its mechanism in patients with diabetes associated with hyperlipemia.Methods 178 patients with type 2 diabetes mellitus with hyperlipidemia from the department of endocrinology in our hospital were selected and divided into two groups, 89 cases in the control group treated with basic treatment of diabetes+atorvastatin, 89 cases in the experiment group received gynostemma on the basis of the control group, myocardial injury index, blood glucose level, blood lipid level, serum cytokine levels and serum oxidative stress response indexes were detected and compared after the treatment.Results Compared with the control group, serum levels of aspartate aminotransferase(AST), creatine kinase(CK), CK-MB, lactate dehydrogenase(LDH)were lower in the experiment group after treatment, fasting plasma glucose(FPG), 2h postprandial blood glucose(2hPG), HbA1c level were lower after treatment, serum levels of total cholesterol(TC), triglycerides( TG ) , low-density lipoprotein cholesterol ( LDL-C ) were lower, high-density lipoprotein cholesterol ( HDL-C ) level was higher after treatment, serum level of adiponectin(ADPN) was higher, tumor necrosis factor-alpha(TNF-α), interleukin-6(IL-6), interleukin-18(IL-18) levels were lower after treatment, serum levels of malondialdehyde(MDA), reactive oxygen species(ROS) were lower, glutathione peroxidase(GSH-Px), superoxide dismutase(SOD) levels were higher after treatment, with significant difference (P<0.05).Conclusion Gynostemma can significantly reduce the cardiac muscle damage of patients with diabetes associated with hyperlipemia , plays a role in myocardial protection, the mechanism may be to reduce blood glucose and blood lipid levels, inhibit the inflammatory reaction caused by inflammatory cytokines, improve the antioxidant capacity of the body and reduce oxidative stress damage.

Objective To study the clinical anesthetic effect of butorphanol combined with propofol in painless gastroscopy. Methods 90 patientswith stomachache check were randomly divided into observation group and control group,45 cases each. The observation group was received butorphanol combined with propofol and the control group were treated with fentanyl combined with propofol. The heart rate of pa-tients before anesthesia,during checking and conscious,the change of blood pressure and oxygen saturation,respiratory depression and anes-thetic effect were analyzed. Results The heart rate,blood pressure and oxygen saturation of two groups after treatment were decreased,the difference was not statistically significant(P>0. 05). The total volume of propofol and respiratory depression between the two groups were compared,the differences were statistically significant(P<0. 05). Conclusion Butorphanol combind with propofol in painless gastroscopy with long anesthesia time and low respiratory depression,which was worthy of promotion.

Objective To explore the role of the change of the CD11b expression in hyperleukocytosis and acute promyelocytic leukemia(APL) differentiation syndrome, we observed the effects of all-trans retinoie acid(ATRA) and trioxide arsenic(ATO) alone or the combination together with daunorubicin (DNR) on CD11b expression of human APL cell line NB4 cells. Methods By using the mono-antibody of CD11b FITC-conjugated, we monitored the level of CD11b expression of NB4 cells by flow cytometry. Results With the length of the 1 μmol/L ATRA exposure,the CD11b expression was increased. Exposed to ATRA for 24 h, 48 h, 72 h and 168 h;the CD11b expression of NB4 cell was (33.34±3.15)%, (55.59±5.13)%, (86.08±5.12)% and (90.69±2.69)%, respectively which were higher than control group and the difference was statistically significant (P<0.01). With the length of the 1 μmol/L ATO exposure, the CD11b expression showed no significant difference with control group(P>0.05), but was significantly lower than that in ATRA exposure(P<0.01). Exposed to 1 μmol/L ATRA combined with 1 μmol/L ATO for 72 h and 168 h, the CD11b expression were (18.81±1.40)% and (25.61±4.54)%, which were significantly higher than that in control group (P<0.05, P<0.01), but significantly lower than ATRA exposure (P<0.01). With the exposure to 1 μmol/L ATRA combined with 1 μmol/L ATO and 1 μmol/L DNR, the CD11b expression was also significantly lower than ATRA exposure (P<0.01) and showed no difference with control group (P>0.05). Conclusion By avoiding the increase of CD11b expression of promyelocytic leukemia cells, ATRA combined with ATO or two drugs together with DNR could play a role in eliminating incidence of hyperleukocytosis and retinoic acid syndrome.

ObjectiveTo summarize the effect of staged operations strategy for delayed spontaneous rupture of esophagus with empyema.MethodsThree patients in the department of thoracic surgery of the second affiliated hospital of Guangzhou medical university underwent staged operative treatment for delayed spontaneous rupture of esophagus with empyema.The primary operative procedure consisted of removal of empyema sac,T-tube drainage and jejunostomies.The second operative procedure included alimentary reconstruction with thoracic esophageal resection and exclusion,or with esophageal resection and exclusion later.ResultsAll cases were cured with mean hospitalization of 78.7 days.None of them had any dysphagia at followup of 5-14 months.ConclusionDelayed spontaneous rupture of esophagus with empyema can be managed safely and effectively through staged operations strategy.

Objective To compare the operations for patients with colorectal cancer through laparoscopic or traditional surgery.Methods Sixty-one colorectal cancer patients,who underwent laparoscopic surgery were enrolled into the observation group.Forty patients with colorectal cancer,who underwent traditional surgery were enrolled into the control group.The operation time,intraoperative blood loss and hospitalization time were observed.Results The operation time of the control group was less than that of the observation group(P ＜ 0.01).The intraoperative blood loss and hospitalization time of the observation group were less than those of the control group (P ＜ 0.01).In the lymph node dissection,there was no significant difference between two groups (P ＞ 0.05).Conclusion Laparoscopic surgery for treatment colorectal cancer can effectively remove cancer cells,dissect lymph nodes.