Objective From the point of view of pharmaceutical economics,to analyze and compare the clinical efficacy,safety,compliance and economic effect of three kinds of scheme:1.moxifloxacin,2.moxifioxacin combined with ambroxol,3.azithromycin combined with levofloxacin in the treatment of acute exacerbation of chronic bronchitis (AECB).Methods Retrieval Chinese joumal full-text database,Wanfang medical database and Chinese science and technology periodical full-text database,included three options for the treatment of AECB randomized controlled trial (RCT) literature,through the analysis of the data to make drug economics evaluation.Results The total effective rates of three programs were 94.92％,95.08％,94.90％,the difference was not statistically significant (P ＞ 0.05).The cost-effectiveness ratios were 213.34,536.40,61.22.Conclusion The efficacy of three treatment options is similar,azithromycin combined with levofloxacin has economic advantages.

0. 05), the mean effective discharge time was 3. 4+ 3. 2 (P0. 05), the mean effective discharge time was 2. 6+1. 7 (P

Objective To evaluate the effects of irregular hepatectomy combined with chemotherapy by placing pump inside hepatic artery on the postoperative recurrence rate and the postoperative survival rate. Methods The clinical data of 66 cases of hepatic cancer treated in the last 15 years were reviewed. 48 cases out of 66 cases were treated with simple hepatectomy and 18 cases with hepatectomy combined with chemotherapy by placing pump inside hepatic artery. Results There was a significant diference in the 1 year or 3 years or 5 years recurrence rate which were 66.7% to 38.9%, 85.4% to 55.6%, 93.8% to 72.2%, respectively in simple hepatectomy group and operation-chemotherapy group ( P

Objective:To investigate the change in myogenin expression at different time in long-term denervated human posterior cricoarytenoid muscles(PCAMs),so as to provide a theoretical basis for timing of reinnervation.Methods: Thisty-eight specimens of denervated human PCAMs were divided into 4 groups according to the period of denervation: 6-12 months denervation group(n=12),1-2 years denervation group(n=10),2-3 years denervation group(n=8),and over 3 years denervation group(n=8).Another 12 specimens of normal PCAMs served as control.The patients in all groups were age-and sex-matched.The expression of myogenin protein and mRNA was studied using immunofluorescence staining and real-time PCR analysis,respectively.Results: Immunofluorescence staining showed that the positive myogenin expression was mainly!found in the myonuclei of PCAMs with a denervation period less than 3 years;no positive staining was found in the myonuclei of control group.The expression of myogenin in myonuclei and the ratio of positive cells were up-regulated in the 6-12 month denervation group compared with those in the control group;the expression and the ratio peaked in 1-2 years denervation group and decreased again in the 2-3 years denervation group,but was still significantly higher than those of the control group(all P

Objective:To study the morphological changes of posterior cricoarytenoid muscles(PCM) in patients with long-term denervation of recurrent laryngeal nerve(RLN),so as to provide theoretical evidence for repair of recurrent laryngeal nerve at advanced clinical stage.Methods: Thirty-eight patients with damaged RLN were divided into 4 groups according to the duration of their RLN damage: 6-12 months group(n=12),1-2 years group(n=10),2-3 years group(n=8),and over 3 years group(n=8).Twelve subjects with normal PCM served as control.Trichrome Masson staining and imaging analyzing system were used to quantitatively analyze the transverse section areas of myofibers,collagen fiber and connective tissues.SDH and AchE staining and cell counting method were used to analyze changes of two kinds of myofibers and motor end plate numbers at different times after denervation of recurrent laryngeal nerve.Results: The transverse areas of myofibers gradually decreased and those of collagen fibers gradually increased with the prolongation of denervation;the difference was significant between different groups(P

Objective To evaluate the prognostic significance of lymph node ratio (LNR) in axillary lymph node positive breast cancer.Methods Eight hundred and three cases axillary lymph node positive breast cancer patients without distant metastasis were systematically treated in the Obstetrics and Gynecology Hospital of Fudan University from 2006 to 2014,at least 10 lymph node removed in each case.Clinicopathological data including 5-year disease-free survival rate (5y-DFSR) and 5-year overall survival rate (5y-OSR) were described.Factors related with prognosis were analyzed by univariate analysis.Prognostic difference was compared among different LNR stage in each axillary lymph node pathological stage(pN).Prognostic significance of pN and LNR was compared by multivariate analysis.Results Mean lymph nodes removed were 15.47±4.70 lymph,and median positive lymph nodes were 4 lymph in 803 cases axillary lymph node positive breast cancer patients.Altogether 159 cases of local recurrence and distant metastasis and 99 cases of breast cancer-related death occurred during median follow-up of 61 months.Five-year DFSR was 77％ and 5y-OSR was 83％.Log-rank univariate analysis showen that pT,pN,LNR,lymphovascular invasion and ER status were related to DFS and OS.Five-year DFSR and OSR for pN1,pN2,pN3 were 89％,68％,59％ and 93％,78％,63％,respectively,whereas 5y-DFSR and 5y-OSR for LNR1,LNR2,LNR3 were 90％,69％,56％ and 94％,80％,57％,respectively.There was statistically significant difference among different LNR in pN1 and pN2 (pN1:DFS:P=0.005,0S:P=0.024;pN2:DFS:P=0.017,0S:P=0.000),but not in pN3,inspite of difference tendency (DFS:P =0.165,OS:P =0.075).In multivariate analysis,when pN or LNR were entered into the Cox regression mode respectively,both were the independent prognostic factors of DFS(P＜0.001) and OS(P＜0.001).When pN and LNR were entered into the Cox hazard regression model at the same time,LNR remained as the independent prognostic factor of DFS and OS (P ＜ 0.001),but pN lost significance (DFS:P =0.461,OS:P=0.162).Conclusion LNR is independent prognostic factor for positive axillary lymph node breast cancer.

Objective To evaluate the clinicopathological characteristics of mucinous breast carcinoma (MBC) and its prognosis.Methods 112 cases of MBC treated in Obstetrics and Gynecology Hospital of Fudan University between Jan 2005 and Dec 2014 were enrolled retrospectively together with 1 157cases of invasive ductal carcinoma (IDC) for comparison.There were 71 cases of pure MBC (PMBC) and 41cases of mixed MBC (MMBC).PMBC and MMBC were compared with each other,and were also compared with IDC respectively.Results PMBC had smaller tumor mass,higher expression rate of hormone receptors (all P＜0.05),lower rate of lymph node metastasis (7.0％ vs.40.6％,x2 =32.663,P ＜0.001) when compared with IDC.The 5 year disease free survival (DFS) and overall survival (OS) of PMBC were both better than those of IDC (DFS:94.6％ ±3.0％ vs.81.3％ ± 1.1％,x2 =7.265,P =0.007;OS:92.4％ ±5.3％ vs.88.5％ ± 1.0％,x2 =4.059,P =0.044).MMBC had relatively larger tumor mass,higher expression rate of hormone receptor,but had no difference in the rate of lymph node metastasis (48.8％ vs.40.6％,x2 =3.417,P =0.332) when compared with IDC.There was no statistically significant difference in 5 yearDFSandOSbetweenMMBCandIDC (DFS:79.1％ ±7.1％ vs.81.3％±1.1％,x2 =0.167,P=0.683;OS:84.5％ ±7.2％ vs.88.5％ ± 1.0％,x2 =0.123,P =0.726).PMBC had relatively smaller tumor mass,lower rate of lymph node metastasis,but had no difference in the expression rate of hormone receptors.The 5 year DFS and OS of MMBC were both better than those of MMBC (DFS:94.6％ ± 3.0％ vs.79.1％±7.1％,x2 =6.772,P =0.009;OS:92.4％ ±5.3％ vs.84.5％ ±7.2％,x2 =6.401,P=0.036).Lymph node status was the only statistically significant prognostic factor of MBC by COX multivariate analysis.Conclusions PMBC has better prognosis than MMBC and IDC owing to its lower rate of lymph node metastasis.MMBC has higher rate of node metastasis than PMBC,hence similar prognosis with IDC.

OBJECTIVE:To evaluate the effect of psychological intervention based on pharmaceutical care on the communi-ty patients with essential hypertension. METHODS:172 patients with essential hypertension in a community health service certer in Nanjing Gulou area in 2013 were divided into control group(n=87)and intervention group(n=85)by simple random meth-od. Control group received conventional antihypertensive drugs and management,intervention group additionally received pharma-ceutical care and psychological intervention,it lasted 6 months. Blood pressure controlling,drug compliance,mastery of drug knowledge and health status in 2 groups before and after treatment were compared. RESULTS:Before treatment,there were no significant differences in the systolic blood pressure(SBP)and diastolic blood pressure(DBP)between 2 groups(P>0.05);af-ter treatment, SBP and DBP in 2 groups were lower than before,SBP and DBP in intervention group were lower than control group,the decrease degree of SBP and DBP was bigger than control group,the differences were statistically significant (P<0.01). 1 month after the beginning of intervention,there was no significant difference in the proportion of drug compliance be-tween 2 groups (P>0.05);1 month after the end of the intervention,the proportion of drug compliance in intervention group was higher than 1 month after the beginning of intervention and control group,the differences were statistically significant(P<0.05). Before treatment,there was no significant difference in mastery of drug knowledge between 2 groups (P>0.05);after treatment,the proportion of patients showed good and excellent mastery of drug knowledge was higher than before and control group,the differences were statistically significant (P<0.05). Before treatment,there were no significant differences in scores of physical,mental,social health subscale and SRHMS between 2 groups(P>0.05);after treatment,scores of physical health subscale and SRHMS in control group,each subscale and to-tal scale scores in intervention group were higher than be-fore, and scores of mental, social health subscale and SRHMS in intervention group were higher than control group, the differences were statistically significant (P<0.05). CONCLUSIONS: The psychological intervention based on pharmaceutical care can effectively promote the con-trol of blood pressure,improve drug compliance,mastery of drug knowledge,health status and mental situation,which is worth of popularizing and applying in community health services.

Objective To observe the role of dual-source CT (DSCT) in the diagnosis of coronary artery fistula. Methods Nine patients with coronary artery fistula were examined with dual-source CT coronary artery angiography. Then the source images were post processed using volume rendering (VR), multiple planar reformation (MPR), maximum intensity projection (MIP) and curved planar reformation (CPR), and sequential segmental analysis of the intracardiac and extracardiac anomalies was performed. Results Coronary artery fistula in all the 9 patients were accurately displayed with DSCT, including 2 with left main trunk to right ventricle fistula, 7 with left main trunk and (or) left anterior descending artery to main pulmonary trunk fistula, 5 with complex coronary-pulmonary artery fistula. Conclusion Dual-source CT coronary artery angiography is convenient, fast, non-invasive, and may be the preferable method for diagnosis of coronary artery fistula.

Objective To investigate the apoptotic effect of microRNA-1 (miR-1) on hypoxemic cardiomyocytes. Methods The cultured H9C2 cells were divided into 5 groups:normal control group, negative control group, H2O2 group, miR-1 group and H2O2+miR-1 group. After verified the success of transfection by real time PCR, MTT and flow cytometry methods were used to test the cell vitality and apoptotic rate, while the mRNA and protein expression level of Bcl-2 were de-tected by real time PCR and Western blot methods. Results Compared with normal control group, there were no significant differences in all indexes in negative control group. The application of H2O2 and miR-1 respectively or together significantly increased the miR-1 level and apoptotic rate, and reduced the cell vitality and Bcl-2 expression level. Conclusion mi-croRNA-1 can induce cardiomyocyte apoptosis by downregulating anti-apoptosis factor Bcl-2.