Objective:To evaluate the cost-effectiveness of duloxetine, escitalopram oxalate and mirtazapine in the treatment of depression. Methods:Totally 120 cases of patients were randomly divided into three group. Group A was given duloxetine 40mg twice a day, group B was with escitalopram oxalate at the initial dose of 10mg per day, and up to 20mg per day in 2 weeks, and group C was treated with mirtazapine 30mg per day. The treatment course was eight weeks. At the 1st, 2nd, 3rd, 4th and 8th weekends after the treatment, Hamilton depression scale ( HAMD) was used to evaluate the total effective rate, and treatment emergent symptom scale ( TESS) was applied to assess the adverse drug reactions. Results:The total effective rate of group A, B and C was 87. 5%,90% and 92. 5% with the cost of 23 822. 22 yuan,33 866. 02 yuan and 19 586. 62 yuan, respectively. The cost-effectiveness ratio respectively was 27 225, 37 629 and 21 175. The incidence of adverse reactions respectively was 30%, 30% and 17. 5%. Conclusion:The cost-effectiveness of mirtazapine is the lowest in the treatment of depression, which can be considered as the best treatment regimen.

The occurrence and development of malignant glioma are closely related to abnormal overexpression and activation of receptor tyrosine kinase (RTK) signal transduction pathways.Targeted therapeutic drugs such as RTK inhibitors,RTK downstream signaling pathway inhibitors and multi-target inhibitors can targeting treat malignant glioma at molecular level,some of which have been investigated in clinical trials and achieved good therapeutic effects.

Objective To investigate the clinical presentation, hormonal profile and metabolic abnormalities in subgroups of women with PCOS and explore a reasonable classification for PCOS. Methods A cross-sectional study of 192 women with PCOS (14-38 years of age) was performed. The patients were divided into 3 groups of A, B and C according to the revised 2003 consensus on diagnostic criteria and also divided into 2 groups according to body mass index(BMI) : group A(n=110), long term anovulation, clinical and biochemical evidence of high androgen level, ovary enlargement with its size larger than 10 ml or number of small follicles of 2-9 mm ≥12 under ultrasound with exclusion of other diseases caused by high androgen;group B(n=46), long term anovulation, clinical and biochemical evidence of high androgen level;group C(n=36), long term anovulation, ovary enlargement with its size larger than 10 ml or number of small follicles of 2-9 mm ≥12 under ultrasound with exclusion of other disease caused by high androgen; obesity PCOS group (OB-PCOS,n=70),BMI≥25(kg/m~2); no obesity PCOS group (NOB-PCOS,n=122), BMI

Objective To establish a flow cytometry-based drug susceptibility test for the rapid de-tection of antifungal susceptibility or resistance of Candida isolates.Methods The gate selection and opti-mal experimental conditions of flow cytometry-based drug susceptibility test were determined by using Candi-da albicans strain ATCC90029 as the test strain and propidium iodide ( PI) as the fluorescent dye .The es-tablished flow cytometry-based drug susceptibility test was used to detect the susceptibility or resistance to fluconazole or voriconazole of 110 isolates belonging to Candida species, and the obtained results were com-pared with those by using typical M 27-A3 constant dilution method .Results The killed and viable Candida albicans ATCC90029 strains were clearly divided into two groups on the figure of SS /log (FL3) by regulating voltages.There was a high correlation between the results of susceptibility test and the proportions of killed and viable fungi in mixture (r=0.999).The flow cytometry-based drug susceptibility test could provide the results within 30 min and its optimal concentration of fungal suspension , time of drug-fungus incubation , dyeing method and time were 1.0×106/ml, 3 h incubation and sodium deoxycholate-pretreated plus PI dye-ing for 5 min, respectively .The total coincident rates between the established test and the constant dilution method were 98.2%and 87.3%in the detection of drug susceptibility of 110 fungal isolates to fluconazole and voriconazole .Conclusion The flow cytometry-based drug susceptibility test shows advantages of rapidi-ty, accuracy and high sensitivity compared with the constant dilution method .It has a great potential for clin-ical application .

Objective To investigate the release pattern of insulin after the load of glucose in patients with polycystic ovary syndrome ( PCOS ) and normal oral glucose tolerance.Methods Sixty-three patients with PCOS were undertaken oral glucose tolerance test (OGTT) and insulin release test,while 34 women with normal menstrual cycle served as control.Results Among 63 patients with PCOS,33 cases were obese with body mass index over 25 kg/m2,including 5 with abnormal OGTT.All 30 non-obese patients with PCOS had normal OGTT.The prevalences of insulin resistance were 78.8％,16.7％,and 9.0％ in obese PCOS,non-obese PCOS,and control groups,respectively.Abnormal insulin release curve were found in 84.5％,70.0％,and 14.7％ of subjects in these 3 groups,respectively.In 58 PCOS patients with normal OGTT,the prevalence of insulin resistance was 44.8％,and 75.9％with abnormal insulin release curve. Among them,body mass index of 32 patients,whose homeostasis model assessment for insulin resistance (HOMA-IR) and fasting insulin remained in normal range,was similar to those of control group [ ( 20.52 ± 2.86 vs 20.01 ± 2.54 ) kg/m2,P＞0.05].Conclusion These findings indicate that insulin release test is useful in detecting insulin resistance.Insulin release is elevated in PCOS patients even with normal OGTT.

Objective:To investigate sinomenine (Sinomenine,SIN) effect on RAW264.7 cells polarization to M1 or M2 phenotype induced by lipopolysaccharide (LPS) or interleukin-4 (IL-4) .Methods:RAW264.7 cells were induced to polarize to M1 by LPS ,and to M2 by IL-4.Sinomenine effects on LPS or IL-4 induced macrophages:TNF-αand IL-10 secretion induced by different condition were detected by Enzyme linked immunosorbent assay (ELISA);The expression level of mRNA of Arginase1(Arg-1),Nitric oxide synthase(iNOS),suppressor of cytokine signaling protein-2(SOCS2) and suppressor of cytokine signaling protein-3(SOCS3) of M1/M2 phenotypes were detected by real time PCR respectively.Results:Sinomenine inhibited the increase of TNF-αsecretion,iNOS and SOCS3 mRNA expression level induced by LPS.Sinomenine inhibited the increase of IL-10 secretion and Arg-1 mRNA expression level induced by IL-4,but SOCS2 mRNA expression level was not affected by Sinomenine.Conclusion: Sinomenine can inhibite the macrophage polarization to M1 and M2 induced by LPS and IL-4.Sinomenine plays a regulatory role on imbalance of M1/M2,and is conducive to maintain the dynamic balance.

Objective To investigate the effect of berberine on the polarization of mice RAW264.7 macrophages induced separately by lipopolysaccharide (LPS) and interleukin-4 (IL-4). Methods Mice RAW 264.7 macrophages cultured in vitro were divided into model group, medication group, and blank control group. Both model group and medication group were given either LPS (in final dose of 100 ng/mL) or IL-4 (in final dose of 10 ng/mL). Additionally, the medication group was treated with berberine in final dose of 20 μmol/L. The blank control group was given the same volume of phosphate buffered saline ( PBS). Real-time fluorescence quantitative polymerase chain reaction (PCR) was used to detect the mRNA expression of arginase-1 (Arg-1), inducible nitric oxide synthase ( iNOS) , suppressor of cytokine signaling2 ( SOCS2) and SOCS3. Enzyme-linked immunosorbent assay (ELISA) was used to determine the contents of tumor necrosis factor alpha (TNF-α) and IL-10. Results The content of TNF-αand the mRNA expression levels of iNOS and SOCS3 in macrophages induced by LPS were increased, and then were down-regulated by berberine (P<0.05 or P<0.01) . The content of IL-10 and the mRNA expression level of Arg-1 in macrophages induced by IL-4 were increased, and then were down-regulated by berberine ( P<0.05), but berberine had no effect on the mRNA expression level of SOCS2 ( P>0.05). Conclusion Berberine has an effect on inhibiting the M1 and M2 polarization of macrophages in vitro, suggesting that berberine may play a regulatory role in the dynamic balance of M1/M2.

OBJECTIVE:To investigate the effects of NOS1AP rs12742393 A/C gene polymorphism on lipid-regulating re-sponse of rosuvastatin calcium. METHODS:Two hundred and tuirty six patients with coronary heart disease(CHD)were selected from cardiology department of our hospital during Jan. 2014-Jun. 2015,and then given rosuvastatin calcium and other symptomatic treatment for 12 weeks. Polymorphism of NOS1AP rs12742393 A/C was detected by PCR-RFLP. The levels of TG,TC,HDL-C and LDL-C were detected by photoelectric colorimetry before treatment and 4,12 weeks after treatment. The serum relationship of genotype with the level of blood lipid was analyzed. RESULTS:Among 236 CHD patients,there were 131 cases of AA genotype (55.5%),98 cases of AC genotype(41.5%) and 7 cases of CC genotype(3.0%);genotype and allele frequencies met the Har-dy-Weinberg balance(P>0.05). There were 132 patients with normal blood lipid and 104 patients with hypercholesterolemia;there was statistical significance in genotype and allele frequencies (P<0.05). Among 104 CHD patients with hypercholesterolemia be-fore treatment,there was no statistical significance in the levels of TG,TC,LDL-C and HDL-C between AA genotype and AC+CC genotype(P>0.05). 4th and 12th week after treatment,the levels of TG,TC and LDL-C in different genotypes were all de-creased significantly;4th week after treatment,the level of LDL-C in AC+CC genotype was significantly lower than AA genotype, and the change compared to before treatment was significantly more than AA genotype,with statistical significance (P<0.05). There was no statistical significance in the level of HDL-C among different genotypes compared to before treatment;there was no statistical significance in the levels of TG,TC and HDL-C 4th,12th week after treatment and their changes compared to before treatment between AA genotype and AC+CC genotype;there was no statistical significance in the level of LDL-C 12th week after treatment and their changes between AA genotype and AC+CC genotype(P>0.05). CONCLUSIONS:NOS1AP rs12742393 A/C gene polymorphism is associated with CHD complicated with hypercholesterolemia;the C allele of NOS1AP rs12742393 may strengthen the response of CHD patients with hy-percholesterolemia to rosuvastatin calcium through influencing the level of LDL-C.

Objective To research and discuss the scientificalness and effectiveness of professional core competence training in the operating theatre so as to seek for a way for the professional growth of operating room nurses.Methods Under the guidance of Guideline on Core Competence Building of Professional Nurses compiled by Department of Health of Guangdong Province in 2009,in accordance with the theory of core competence training and taking into account of different yearly salaries and levels of 21 nurses,we made respective plans and carried them out.Results After implementing professional core competence training,the rate of operating nurses' mastering basic knowledge and techniques reaches 92.50％,the rate of mastering professional knowledge and techniques reaches 86.25％,the ability of clinical thinking increases by 85％,the ability of education and research development increases by 78.50％,the ability of self-training raises by 98.20％,safe management raises by 91.50％,and the emergency ability raises by 93.60％.The analysis and compare are based on seven aspects,therefore are of statistical significance.Conclusion The training of the core competence in the operating theatre is practical,scientific and feasible in-service education which not only improves operating room nurses' abilities of clinical thinking and solving clinical nursing problems,but also provides career progress for operating room nurses.

Objective To evaluate the tissue motion tracking of mitral annular displaeement(TMAD) method in the assessment of short-term effect of cardiac resynchronization therapy (CRT). Methods Twenty six chronic heart failure (CHF) patients with CRT were detected by TMAD. The maximal displacement of the six points of mitral annulus(DS), the standard deviation of the time to regional peak systolie displacement of the six points (Td-sd) and the maximal temporal difference of any two points(Tds-diff) were compared before and one month after CRT. And the correlation between mean displacement and left ventricular ejection fraetion(LVEF),left ventricular end systolic volume(LVESV), fraction area change (FAC) was analyzed. Results Compared with the pre-operatively, the displacement and the mean displaeement of the six points of mitral annulus were significantly increased(P<0.01),Tds diff and Td-sd were decreased(P<0.05) one month after CRT. TMAD correlated with LVEF,LVESV and FAC (r =0.419, r = 0.529, r = 0.567, P <0.05) one month after CRT. Conclusions TMAD is a new technology to evaluate the short-term effect of CRT.