OBJECTIVE:To evaluate the economic burden of chronic hepatitis B(CHB)and its complications,and to e-valuate the benefits of treatment with interferon-?.METHODS:The components of the economic burden of disease included direct medical costs and non-medical costs as well as indirect economic loss per patient-year in patients with chronic hepatitis B virus infections,including chronic hepatitis B,compensated and decompensated cirrhosis,and hepatocellular carcinoma.Net cost savings due to treatment of CHB with interferon-?were estimated using clinical data from2therapeutic schemes used in hospital.RESULTS:For the patients at different stages of hepatopathy,the direct medical cost and economic burden per year were different:9000yuan,11362yuan(CHB);13865yuan,19412yuan(compensated cirehosis);25678yuan,36979yuan(decompensated cirrhosis);26501yuan,40264yuan(liver cancer),Compared with conrentional therapy against CHB,the direct medical cost and total cost were reduced following4months treatment of interferon-?after5-year follow-up.The reduced amounts were831yuan,2038yuan per person,respectively.The surrival rate rised by2.8%.CONCLUSION:CHB infections create a heavy economic burden on the society,as well as patients and their families.We have seen the potential cost-savings due to treatment with interferon-?.

Objective To explore the efficacy of endoscopic electric cutters in the treatment of adenoidal hypertrophy .Methods 36 patients who underwent adenoidectomy treatment of adenoid hypertrophy were divided into the observation group and control group according to the random number table .The observation group was taken endo-scopic electric cutters treatment , the control group was taken traditional adenoid removal treatment .The therapeutic effect of the two groups was compared .Results In the observation group,the total time required for removal of the adenoids was (10.65 ±2.38)min,blood loss was (28.82 ±0.98)mL,compared with the control group,there were significant differences(t=25.93,31.79,χ2 =3.92,all P<0.05).In the observation group,there was 1 case had severe pain,but in the control group,there were 9 cases,the difference was significant (χ2 =8.86,P<0.05).In the observation group,the total effective rate was 94.45%,which was significantly higher than 55.55% in the control group(χ2 =7.26,P<0.05).Conclusion Compared to the traditional treatment of adenoid surgery ,electric cutters endoscopic treatment can significantly reduce adenoidal hypertrophy blood loss and the incidence rate of complication , improve patients'pain and clinical outcomes ,it is worth clinically further promotion .

OBJECTIVE: To investigate the postoperative application of nasopharyngeal airway (NPA) in rhinogenous obstructive sleep apnea hypopnea syndrome (OSAHS) patients, so that to observe the parameters including vital signs of the patients and evaluatethe value of clinical application and reliability of NPA. METHOD: A total of 216 patients diagnosed as rhinogenous OSAHS were randomly assigned to experimental group (setting NPA, 112 cases) and control group (not setting NPA, 104 cases) according to whether NPA was placed in the nasal cavity postoperatively. ECG, oxygen saturation and hemodynamics were monitored for 24 h postoperatively. The pharyngeal pain and discomfort, low oxygen saturation and hemodynamics were compared between these two groups. The subjective assessment and clinical symptoms were compared between the two groups using visual analogue scale (VAS). RESULT: The experimental group showed better relief of nasal obstruction, nasal pain, headache, dry pharynx, insomnia and pain while taking out nasal packing compared with control group, where the differences were statistically significant (P < 0.01). In the experimental group, the level of LSa2O2 (P < 0.05), HR (P < 0.01), SBP (P < 0.05), DBP (P < 0.01), MAP (P < 0.01) and RPP (P < 0.01) was significantly lower than in the control group. CONCLUSION The postoperative application of nasopharyngeal airway in rhinogenous OSAHS patients could help to keep nasal patency and avoid the upper airway obstruction, which exhibited good safety and compliance. The nasopharyngeal airway can reduce patients' discomfort and improve hyoxemia, ensuring hemodynamic stability.
Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Nasopharynx ; Postoperative Care ; Respiration, Artificial ; methods ; Sleep Apnea, Obstructive ; therapy ; Young Adult

Purpose Median arcuate ligament (MAL) compression is the most common reason for celiac artery stenosis or occlusion, celiac artery compression of asymptomatic MAL is often misdiagnosed. This study aims to evaluate the multi-slice spiral CT manifestations of the celiac artery compression of median arcuate ligament. Materials and Methods CT features of 26 patients with celiac artery compression of median arcuate ligament were retrospectively studied. Eleven cases were symptomatic and fifteen cases were asymptomatic. Results In 14 cases (53.8%), the location of compression was at the level of superior 1/3 of the L1 vertebral body. There was statistic difference in location of the origin of compression between the celiac artery narrowing group and the non-narrowing group (P<0.05). CT manifestations included: narrowing of the celiac artery were observed in 26 patients on sagittal reformatted images with hollow on the anterior wall; a characteristic hooked appearance was observed. Narrowed celiac artery on the transverse images was seen in 21 patients, and a soft-tissue band extending across the anterior aspect of artery in 12 of them. Poststenotic dilatation was revealed in 20 patients. Collateral circulation was seen in 8 patients. Conclusion Multi-slice spiral CT can be helpful in demonstrating the location of celiac artery compression of median arcuate ligament and tell the characteristic imaging features.

Objective To explore the effect of psychological nursing on anxiety and depression and quality of life of patients with multi drug resistant pulmonary tuberculosis.Methods 58 patients with multi -drug resistant pulmonary tuberculosis were randomly divided into observation group and control group,29 cases in each group.The control group received routine nursing care,the observation group received psychological nursing on the basis of the control group.Before and after psychological nursing intervention,the self rating anxiety scale(SAS)and depression self rating scale(SDS),health survey(SF -36)score were observed,and the clinical curative effect and compliance of the two groups were observed.Results After psychological nursing intervention,the SAS and SDS scores of the observation group[(36.83 ±7.61)points and (40.07 ±5.49)points]were significantly lower than the control group [(44.07 ±9.16)points and (43.90 ±7.91)points],the differences were statistically significant(t =3.27,2.14,all P <0.05).The SF -36 scores showed that after psychological nursing intervention,the physiological function(PF), physiological functions(RP),general health(GH),vitality(VT),social function(SF),role emotional(RE),mental health(MH),the seven dimensions scores of the observation group were significantly higher than those in the control group,the differences were statistically significant(t =7.18,10.22,8.85,12.71,12.04,9.68,4.79,all P <0.05). The compliance of the observation group was 93.10%,which of the control group was 72.41%,the difference was significant(χ2 =4.35,P <0.05).The total effective rate of the observation group was 86.21%,which of the control group was 62.07%,the difference was statistically significant(χ2 =4.41,P <0.05).Conclusion The psychological nursing intervention can improve the anxiety and depression of patients with multi -drug resistant tuberculosis, improve the quality of life of patients,improve the treatment compliance of patients,and improve the clinical efficacy.

Aims Toevaluatethepharmacodynamic efficacy of different types of antiangiogenic agents as HM-3 on a non-small cell lung cancer xenografts tumor model .To explore the interaction between the antian-giogenic agents and the tumor microenvironment,and to offer suggestions for clinical therapy.Methods Thenon-smallcelllungcarcinomaxenograftmodelwas established in Balb/c nude mice.The model mice were treated with Docetaxel(10 mg·kg-1 )as the positive control.The mice were parallelly treated with,HM-3 at the doses of 3 mg · kg-1 and 48 mg · kg-1 and, Avastin(5 mg·kg-1 ).The parameters include tumor volume,tumor weight and immunohistochemical analy-sis.Result Animalexperimentsshowedthatdocetaxel had good anti-tumor activity.Tumor growth inhibition by tumor weight of G2 docetaxel(10 mg·kg-1 )group was 60. 80%.Tumor growth inhibition by tumor weight of G3 HM-3(3 mg·kg-1 )group,G4 HM-3(48 mg· kg-1 )group ,G4 Avastin(5 mg·kg-1 )group,were 43. 60%,-34. 80%,44. 40%,respectively.Con-clusion Theantigiogeniceffectisaffectedbytumor growth stage,tumor microenvironment and their work-ing mechanisms.Angiogenesis inhibitors HM-3 has a certain effect of inhibiting tumor growth,but to little a-vail.HM-3 shows on inhibitory effect in a dose-de-pendent manner at the doses of 0~6 mg·kg-1 .HM-3 at a high dose of 48 mg · kg-1 has no inhibitory but promoting effects on human non-small cell lung carci-noma A549 xenografts in nude mice .Special dose-effect relationship indicates that dosage should be paid attention to in the clinical use of blood vessel inhibi-tors.

OBJECTIVETo determine the economic effects on the prevention of dental fear (DF) by pre-operation-education or local anesthesia method during the process of tooth filling.

METHODSOne hundred and fifty school children of age 7 to 12, participating in this study, suffered from occlusal caries on their mandibular first molars. They were divided into 3 groups, with 25 boys and 25 girls each. Group A (pre-operation-education) was showed video tape on caries to, familiarized with clinic environment, including dental chairs and instruments; Group B (local anesthesia) received injection of 1.8 ml of 2% lidocaine for local anesthesia about 15 minutes before treatment; Group C (blank) received no intervention for DF. Thereafter, all subjects received same filling treatment. During that process, each DF case was evaluated blindly based on Venham's clinical ratings of anxiety and cooperation. Cost-minimization analysis was then studied.

RESULTSSignificant difference was found between groups, but not between group A and B in DF rate (5/50, 9/50 and 21/50, chi(2) = 15.503 1, P = 0.000 4). The costs of each case in 3 groups were 83.99 Yuan, 87.09 Yuan and 87.76 Yuan respectively.

CONCLUSIONBetween pre-operation-education and local anesthesia methods, the former was worth promoted for it's better clinical effect in DF prevention with lower cost.

Child ; Dental Anxiety ; economics ; epidemiology ; prevention & control ; Dental Caries ; therapy ; Dental Cavity Preparation ; economics ; methods ; Female ; Humans ; Incidence ; Male

OBJECTIVETo develop a non-pharmacotherapy program for patients with hyperlipidemia and assess its effectiveness.

METHODSA cluster control trial was used. The experimental group was given non-pharmacotherapy for hyperlipidemia once a week for 6 weeks; the content of non-pharmacotherapy included the basic knowledge about hyperlipidemia, a guide of changing unhealthy diet and life-style. Patients were followed for once every two weeks in the department of out-patient. The control group received general care conducted by university clinicians, without the non-pharmacotherapy program. A self-completion questionnaire on hyperlipidemia-related knowledge level, questionnaires on diet and exercise, body weight, body height and the serum TG, TC were measured at entry point and at the end of 6 month.

RESULTSOne hundred and fifty-four patients in experimental group and 150 patients in control group completed the study. The non-pharmacotherapy group showed a significant increase of knowledge on hyperlipidemia in the experimental group comparing with the control group: the mean (sd) score of hyperlipidemia-related knowledge were 22.5 (4.8), 17.4 (4.2) (95% CI: 4.1, 6.1). The diet score and the proportion of regular physical activity had increased 27.20%, 21.78% respectively in experimental group. The mean (sd) of serum TG, TC and body mass index (BMI) for experimental group [2.0 (0.9) mmol/L, 5.4 (0.9) mmol/L, 23.4 (1.9)] lowered significantly comparing to those for control group [2.4 (0.9) mmol/L, 5.9 (1.0) mmol/L, 24.2 (3.0)].

CONCLUSIONNon-pharmacotherapy seemed to be an important intervention for the patients with hyperlipidemia. If same patients with hyperlipidemia failed to respond to non-pharmacotherapy, it is necessary to use pharmacotherapy. However, non-pharmacotherapy should be viewed as basic therapy.

Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Hyperlipidemias ; blood ; therapy ; Life Style ; Lipids ; blood ; Male ; Middle Aged ; Regression Analysis

Objective To investigate the value of high frequency magnetoencephalography signals in the localization of refractory temporal lobe epilepsy. Methods Retrospective analysis was performed in 10 patients with refractory temporal lobe epilepsy admitted to and accepted surgery in our hospital from January 2015 to December 2015. Surgical approaches of these patients were determined according to the results of long-term video EEG monitoring (VEEG), MR imaging, and conventional and high-frequency magnetoencephalography (MEG). MEG positioning analysis was performed after the surgery; followed up for 12 months was performed to evaluate the surgical efficacies. Results The surgery was effective in all the 10 patients; 5 patients achieved Engel grading Ⅰ, 2 patients achieved Engel grading Ⅱ, and 3 patients achieved Engel grading Ⅲ. The results of high-frequency MEG analysis indicated that 8 lesions were consistent with the surgical sites, enjoying good results; while the positioning error of the 2 patients was large. Conclusions The localization analysis of high-frequency neuromagnetic signals has the potential to determine epileptogenic zones preoperatively for epilepsy surgery. High-frequency oscillation is a new biomarker for the diagnosis of epilepsy.

Objective To discuss the experience of surgical treatment for cerebral sparganosis and analyze the factors affecting the removal of live worms.Methods A retrospective analysis was performed on clinical data and treatment experience of 49 patients with cerebral sparganosis,admitted to and accepted surgery in our hospital from January 2001 to December 2017.These patients were divided into two groups according to whether the live worms were removed during the operation,namely live worms removal group and live worms non-removal group;factors affecting the removal of live worms were analyzed.Results A total of 36 live worms were removed from 49 patients,one of them took out two live worms in the same lesion.In 45 patients with seizures before surgery,39 of them had seizure-flee after surgery (Engel grading I).Re-examination MR imaging showed that lesions disappeared and no new lesions were found in the brains of the 39 patients.Another two with original lesion enhancement had shadow disappearance;however,new lesions appeared behind the lesion;one of them was re-operated in the contralateral temporal lobe of the original lesion,and the other one continued follow-up observation.No new hemorrhage lesion,infarction or meningitis after operation was noted in all patients.Statistical analysis showed that there were significant differences in times from lesion discovery to surgery and lesion locations between patients of the live worms removal group and the live worms non-removal group (P＜0.05).Conclusions Surgical treatment of cerebral sparganosis is safe and effective.Surgical treatment should be performed as soon as possible after the lesion is discovered.The times from lesion discovery to operation should be shortened to prevent the displacement of the worms.At the same time,it is necessary to select the specific surgical plan and timing of surgery in combination with lesion location to improve removal rate of live insects and reduce surgical complications.If necessary,surgery can be performed again.