OBJECTIVE:To evaluate the cost-effectiveness of amiodarone versus sotalol for Atrial fibrillation.METHODS:A total of 102 patients with atrial fibrillation were treated with amiodarone(Group A)or sotalol(Group B).The cost-effectiveness analysis was performed on two groups.RESULTS:The total cost in Group A was 2 714.18 yuan versus 2 176.56 yuan in Group B;the effective rates were 78.43% vs.70.59%(P

0.05),and the costs were 330.27 yuan,540.48 yuan and 790.73 yuan,respectively. CONCLUSION: Regime A was proved to be the optimal scheme.

OBJECTIVE:To study the incidence,the etiological factor and the harm of metoclopramide-induced children poisoning.METHODS:We reviewed 30 reports published in Chinese Pharmaceutical Abstracts(2003～2006)and domestic pediatric journals and gave a comprehensive evaluation on the confirmed 56 metoclopramide-induced children poisoning cases.RESULTS:All of the 56 poisoning cases were induced by oral administration and all had high daily dose.The condition was predominantly characterized by posterior tilt of head,stiffing of root of tongue,ataxia,upward staring or side-glance etc.Metoclopramide has inhibition effect on leucocytes,and it can result in cumulative poisoning,especially for children with hepatorenal inadequacy.CONCLUSION:Great attention should be attached to the dose and course of treatment of metoclopramide to enhance drug efficacy while reducing incidence of adverse drug reactions.

Objective: To investigate the effects of ?-melanocyte-stimulating hormone(?-MSH) on TGF-?_1 secretion of fibroblasts from keloids so as to find a novel evidence to research etiology of keloids.Methods:Fibroblasts isolated from human keloids were cultured in DMEM medium with 15% bovine serum and treated with ?-MSH. The level of TGF-?_1 was measured with ELISA method. Results: ?-MSH at the concentration of 10 -6 mmol/L triggered the TGF-?_1 secretion of fibroblasts. Conclusion:?-MSH possesses the effect of triggering human keloid fibroblasts to secrete TGF-?_1, and its effective concentration is 10 -6mmol/L.

Objective To explore the clinical effect of cholangioscopic Holmium laser lithotripsy for bile duct refractory residual stone and orthomorphia for intrahepatic bile duct membranous stenosis. Methods The final diagnosis was established by T tube retrograde cholangiography and cholangioscopy in 12 patients with refractory bile duct residual stone. Twenty-nine stones distribute in extrahepatic and intrahepatic bile duct and 5 intrahepatic bile duct membraneous stenosis were found in 3 cases. All patients underwent Holmium laser lithotripsy and orthomorphia. Results The stone clearance rate was 100% in 12 patients after cholangioscopic holmium laser lithotripsy. No serious complication occurred in patients after 5 membranous stenosis orthomorphia. Follow-up observation on 11 patients shows no obvious recurrence of symptom and stones. Conclusion Holmium laser lithotripsy and orthomorphia are safe and effective in the treatment of bile duct refractory residual stone and stenosis.

Objective To study the relationship of pit pattern in the progress of colorectal and the expression of PCNA and survivin in pit pattern. Methods Chromoendoscopy observation results were recorded according to the pit pattern classification proposed by Kudo. These results were divided into 6 groups according to the pit pattern and the results of histophathology. Expression of PCNA and surviving mRNA was detected by RT-PCR. Statistical analysis was performed using χ2 test , Fisher's exact test or Spearman rank correlation with SPSS 12.0 software package. Results In 6 groups classified according to the pit patterns, the expression rate of PCNA mRNA in type Ⅰ, Ⅱ, Ⅲ L, Ⅳ, V 1 and VN were 0% (0/13), 12.5% (1/8), 38.9% (7/18), 66.7% (12/18), 75.0% (3/4) and 100.0% (9/9), the expression rate of survivin mRNA in type Ⅰ,Ⅱ, Ⅲ L, Ⅳ, V 1 and V N were 0%, (0/13), 12.5% (1/8), 22.2% (4/18), 44.4% (8/18), 50.0% (2/4) and 77.8% (7/9), respectively. Conclusions The expression of survivin and PCNA mRNA had positive correlation in the coloree-tal lesions classified whether by the pit patterns or histophathology. Study of the two genes simultaneously could complement each other and reflect the biological characteristics of colorectal cancer more accurately.

10.3969/j.issn.2095-4344.2013.25.010

Objective To evaluate the endoscopic precut sphincterotomy for malignant biliary obstruction. Methods Endoscopic precut sphincterotomy was performed in different ways for 46 patients with malignant biliary obstruction and difficult biliary cannulation according to the anatomic structure of the papilla and cannulation. Ways of precut were summarized and complications were analyzed. Results Precut sphincterotomy was performed with bow-like knife in 4 patients, with needle-knife in 24, with trans-pancreatic sphincterotomy in 12 and with combined ways in 6. The procedure succeeded in 35 cases (76. 1%, 35/46). Post-procedure complications included bleeding in 3 patients, pancreatitis in 1, hyper-amylasemia in 2and cholangitis in 1. No perforation was found. Conclusion Endoscopic precut sphincterotomy is not only able to improve the therapeutic endoscopy achievement rate in patients with malignant biliary obstruction, but also to lower the incidence of complications if used adequately.

Pancreatic cancer is one malignancy with high aggressive and extremely poor prognosis,its incidence and mortality rates are increasing gradually in our country.Although surgical techniques and adjuvant drug therapy are improving,survival of patients with pancreatic cancer still has not been significantly improved.Long non-coding RNA are a class of non-coding transcripts longer than 200 nucleotides.Recent studies show long non-coding RNA is closely related to pancreatic cancer cells,apoptosis,metastasis and drug resistance.LncRNA plays an important role in the diagnosis,treatment and prognosis of pancreatic cancer.In this article we reviewed the role of long noncoding RNA and their significance in pancreatic carcinoma.

Objective To understand the basic situation of healthcare-associated infection(HAI)management and prevention and control of multidrug-resistant organism(MDRO)infection in medical institutions in Hubei Province.Methods Questionnaires were used to investigate the basic situation of HAI management and MDRO infection in 47 tertiary and secondary hospitals in Hubei Province.Results 47 hospital were enrolled in this study,HAI management full-time staff was allocated with a median of 0.90/250 beds;in 2015,the isolation rates of methicillin-resistant Staphylococcus aureus,carbapenem-resistant Enterobacteriaceae,carbapenem-resistant Pseudomonas aeruginosa,carbapenem-resistant Acinetobacter baumannii,and vancomycin-resistant Enterococcus were 39.13%,4.13%,19.44%,63.60%,and 2.77%respectively.47 hospitals all carried out surveillance on MDROs,28(59.57%)hospitals were installed HAI monitoring system software,could directly obtain data through collecting with the laboratory system.The diagnosis of MDRO infection was mainly based on the combined diagnosis by HAI full-time personnel and clinicians(26 hospitals,55.32%).44(93.62%)hospitals regularly convened coordination meeting on prevention and control of MDROs,in 2015,hand hygiene compliance rate were 10.0%-89.2%by self-inspection;42(89.36%)hospitals routinely prescribed isolation orders for patients with MDRO infection,33(70.21%)hospitals conducted environmental clean and disinfection twice a day,24(51.06%)hospitals performed personal protection by using complete set of protective equipment.Conclusion This investigation is helpful for understanding the general situation of HAI management in medical institutions,as well as the detection and control of MDROs in this area,and make continual improvement on the problems and weakness found in the investigated project,so as to promote the development of HAI management in this area.