OBJECTIVE： To evaluate the economic effectiveness of different pharmacotherapeutic schemes for the same disease.METHODS： Using pharmacoeconomical cost-effectiveness analysis， six schemes for upper urinary tract infections were compared.RESULTS： The total effective rate and cost were both the lowest in group B(70.00％ ).The cost-effectiveness ratios of A， B， C， D， E， F were 28.60、 19.13、 43.27、 29.99、 43.02、 29.14， respectively.They became 23.65、 18.01、 34.00、 24.87、 33.91、 24.20 by sensitivity.CONCLUSION： The A and F were both the most inexpensive and effective schemes.

Objective To describe the status of nurses′professional identity and the self-concept and to explore the relationship between nurses′professional identity and the self-concept. This will be the base for intervening nurses′professional identity. Methods A convenience sample of 250 nurses from one major hospital in Beijing was recruited. The Macleod Clark Professional Identity Scale and the Professional Self-Concept Instrument were introduced. A standard translation procedure was carried out. Results A total of 250 questionnaires were sent out, 241 questionnaires were withdrawed with an effective rate of 96.4%. The mean score of nurses′professional identity was 42.54±8.70, which was at moderate level. The mean score of nurses′professional self-concept was 86.28 ±22.86, also at moderate level, among which,knowledgescores highest (25.91±6.00), leadership scored 20.84±8.02, inter-personal relationship scored (20.28±4.18), caring scored the lowest (19.25±4.67). There was significant difference among the professional identity in the different departments (P<0.05) , while the same results were not seen in professional self-concept. Nurses′professional identity was positively correlated with professional self-concept′s four dimensions (P<0.05). Conclusions The nurse managers should pay attention to the cultivation of professional self-concept in the training of nurses in order to improve the professional identity of nurses and the whole nurses′development.

Objective To investigate the application value of extracorporeal extended field radiotherapy in locally advanced cervical cancer. Methods A total of one hundred and twenty patients with stage IIB?IVA cervical cancer in the First Affiliated Hospital of Hebei North University from June 2012 to June 2014 were randomly divided into two groups:the control group and the observation group,each with 60 cases. The routine concurrent chemoradiotherapy was adopted in the control group. The observation group was treated with extracorporeal extended field radiotherapy combined with concurrent chemotherapy. The patients have been followed up for three years. The total efficacy rate,toxicity reaction,local progression free survival time ( PFS) and survival rate of the two groups were compared. Results The total efficacy rate in the observation group was significantly higher than that of the control group ( 88. 3%( 53/60 ) vs. 73. 3%( 44/60 ) , χ2 = 4. 357, P=0. 037),while the incidences of toxicity reaction in the two groups were 18. 3%(11/60) and 16. 7%(10/60), the difference was not statistically significant (χ2=0. 058,P=0. 810) ,the percentages of I and II degree in the two groups were 3. 4%( 2/60 ) and 3. 4%( 2/60 ) , the difference between the two groups was not statistically significant (Z=0. 000,P=1. 000). The PFS value in the observation group was significantly longer than that of the control group ( 25. 6 months vs. 13. 8 months,χ2 = 25. 624, P= 0. 000 ) , and the survival rate in the observation group improved significantly ( 53. 3%( 32/60 ) vs. 33. 3%( 20/60 ) , the difference was statistically significant (χ2 = 4. 887, P= 0. 027 ) . Conclusion Extracorporeal extended field radiotherapy is safe and effective in the treatment of locally advanced cervical cancer.

ObjectiveTo study the effects of placental transfusion of umbilical cord milking on very low birth weight (VLBW) infants. Methods Fifty-seven VLBW infants born from September 2011 to May 2014 who had umbilical cord milking at birth were selected as experimental group. Sixty-one VLBW infants born from January 2008 to August 2011 who had normal cord clamping at birth were selected as control group. The complications of VLBW infants, blood transfusion, frequency of using pulmonary surfactant (PS), the duration of mechanical ventilation, the duration of oxygen and mortality were compared between two groups.Results The incidence of severe asphyxia, IVH and anemia was signiifcantly lower in experimental group than in control group (P< 0.05). The blood transfusion and transfusion volume, duration of mechanical ventilation, and duration of oxy-gen were signiifcantly lower in experimental group than in control group (P< 0.05).Conclusions Umbilical cord milking can reduce the incidence of severe asphyxia, IVH and anemia. It also can reduce the blood transfusion, the duration of mechanical ventilation, and the duration of oxygen in VLBW infants.

Objective To assess the feasibility and efficacy of renal pelvis drainage and ureteral stent of laparoscopic pyeloplasty in treatment of ureteropelvic junction obstruction.Methods Eighteen patients(14 boys and 4girls) with ureteropelvic junction obstruction,the average patient age was 66 months (range 3-182 months),who underwent transabdominal laparoscopic Anderson-Hynes pyeloplasty in Capital Institute of Pediatrics from Aug.2011 to Oct.2012 were selected.The ureteral stent and renal pelvis drainage were installed during the performance of surgery.They were removed in 7 days and 9 days after operation respectively.Results Eighteen cases successfully underwent laparoscopic pyeloplasty,without conversion to open surgery.The mean operating time was 102.8 minutes (ranging between 90 and 150 minutes).Two cases had complications on postoperative day 3,one patients ureteral stent was inadver-tentely pulled out,another was removed because of blood clots.No patient had postoperative urinary leakage or anastomotic stenosis.Postoperative follow-up time was 6 months.The hydronephrosis vanished in 13 patients,reduced obvious ly in 5 patients as revealed by ultrasound examination.Conclusions Intraoperatively,renal pelvis drainage and ureteral stent for postoperative drainage is effective,and it is worthy of application in a large scale.Patients can avoid further anesthesia for removing stents and the complications of long-term indwelling stent tubes,and have an improved quality of life.

Objective To assess apoptosis mediated by the cell death receptor Fas in peripheral T lymphocytes of patients with abdominal aortic aneurysm. Methods The apoptotic pathway was triggered by anti-Fas monoclonal antibody in cultured and activated peripheral T-cells from 20 AAA patients. Control groups consisted of 15 patients with aortic atherosclerotic occlusive disease(AOD)and 25 healthy individuals. Cell survival and death rate were assessed. Results Cross-linkage of Fas receptor exerted a strong apoptotic response on T cells from AOD patients and healthy controls, while the effect on T cells was very limited from that of AAA patients. The evaluation of cell Survival rate showed a significantly higher percentage in AAA group(98.9%±10.3%)than in the AOD subjects(58.9%±15.2%)or the healthy group(59.4%±12.9%;P＜0.001＝.Apoptosis assessment by annexin V and propidium iodide staining and flow cytometry showed similar results. The defect in AAA group was not due to decreased fas expressed at normal levels. Moreover,it specifically involved the Fas system because cell death was induced in the normal way by methylprednisolone. Conclusions Fas-induced apoptosis in activated T cell from AAA patients is impaired. This may disturb the normal down-regulation of the immune response and thus provide a new insight into possible mechanisms and routes in the pathogenesis of AAA.

Objective: To explore the antagonistic effect of quercetin on fine particulate matter (PM2.5)-induced embryonic developmental toxicity in vitro.Methods: PM2.5 was collected on glass fiber filters by PM2.5 samplers during the heating period of Dec.2015 to Mar.2016 in an area of Haidian District, Beijing City.The sampled filters were cut into 1 cm×3 cm pieces followed by sonication.The PM2.5 suspension was filtered into a 10 cm glass dish through 8 layers of sterile carbasus and stored at-80 ℃ until freeze drying.Frozen PM2.5 suspension was dried by vacuum freeze-drying.In vitro post-implantation whole embryo culture was used in this study.Pregnant rats with 9.5 gestation days (GD) were killed by cervical dislocation and the uteri were removed into sterile Hank's solution.The embryos with intact yolk sacs and ecto placental cones were induced by PM2.5, and then subjected to intervention of quercetin at the doses of 0.1 μmol/L, 0.5 μmol/L, 1.0 μmol/L and 5.0 μmol/L, respectively.At the end of the 48 h culture period, the cultures were terminated, and all embryos were removed from the culture bottles and placed in prewarmed Hank's solution for evaluation.Morphological evaluation of the embryos was conducted under a stereomicroscope using the morphologic scoring system by Brown and Fabro.The mitochondrial reactive oxygen species (ROS) level was detected by FACSCalibur flow cyto-metry using MitoSOXTM Red staining.Results: An obvious antagonistic effect was achieved through querce-tin at the dose of 1.0 μmol/L, which could result in an increase of visceral yolk sac (VYS) diameter, crown-rump length and head length, somite number, and the differentiation of visceral yolk sac vascular vessels.The scores of allantois, flexion, heart, hind brain, midbrain, forebrain, auditory system, visual system, olfactory system, branchialarch, maxillary process, forelimb bud and hindlimb bud also revealed a significant increase and the relative mitochondrial ROS level of embryonic cells was significantly decreased when compared with PM2.5 group.Although quercetin at the doses of 0.1 μmol/L, 0.5 μmol/L, 5.0 μmol/L also exhibited protective effects against PM2.5-induced embryonic developmental toxicity, the protective effect was weaker when compared with the dose of 1.0 μmol/L.Conclusion: Quercetin at proper dose may be of great benefit for the development of embryos exposed to PM2.5 in the uterus of the rats.Quercetin provides an effective strategy for the prevention of PM2.5-induced embryonic developmental toxicity.Clearance of mitochondrial ROS may be one of its mechanisms.

Objective To investigate the diagnostic value of DNA ploidy analysis combined with immunocytochemistry p16/ki-67 double staining in cervical high grade squamous intraepithelial neoplasia(HSIL) and cervical squamous cell carcinoma(SCC).Methods A total of 73 cases of cytological tests were randomly collected.Among them,53 cases were small DNA ploidy abnormal cells and 20 cases were DNA ploidy negative.The p16/Ki-67 results were detected by immunocytochemistry double staining.With the pathological results as the golden standard,the diagnostic values of DNA ploidy analysis and DNA ploidy analysis combined with p16/Ki-67 double staining in HSIL + was contrastively analyzed by pathologic results.Results Among 20 samples of DNA ploidy negative,the p16/Ki-67 double staining results all were negative.The positive predictive value of DNA ploidy analysis for HSIL + was 34.62％.The sensitivity of DNA ploidy analysis combined with p16/Ki-67 double staining for HSIL + was 84.62％,and its specificity was 92.31％,the positive predictive value was 78.57％ and the negative predictive value was 94.74％,which were significantly higher than those of DNA ploidy analysis(P＜0.05).Conclusion p16/Ki-67 double staining can significantly im prove the prediction value of HSIL.The DNA ploidy analysis combined with p16/Ki-67 double staining is an effective method for predicting HSIL +,which is suitable for the implementation in the areas with lack of medical resources.

The interferons(IFNs) are a family of the multifunctional cytokines, which are a kind of highly active and multifunctional glycoproteins.Studies in recent years have shown that IFNs exert a powerful antitumor effect by regulating the proliferation of tumor cells, suppressing tumor metastasis and angiogenesis, and activating antitumor immune response.Combined with other tumor treatment methods, it can inhibit the development of a variety of blood system tumors and solid tumors.In addition, the use of IFNs inducers or IFNs combined with emerging immunotherapy can significantly increase the effectiveness of tumor therapy.This review focuses on our understanding of antitumor mechanism and clinical application of IFNs, and provides some guidance for future research and clinical treatment.

Objective To measure the reconstructed cranial CT images,and to clarify the safety range of unilateral nasal transsphenoidal approach for pituitary surgery.Methods 100 normal pituitary cranial CT images were randomly selected,and the three-dimensional reconstruction was performed by using the CT images of perpendicular and parallel to the edge of the two eyes as base line, and the distance and angle in unilateral nasal transsphenoidal approach for pituitary surgery from the sagittal plane in the middle of the nasal meatus and the plane through the tip of the nose and both ends of dorsum sellae were measured,respectively. The angles and distances were compared when grouped the data by gender and age. Results Angle A1 (the angle between the tip of the nose and the tuberculum sellae and saddle back root line in the sagittal plane)in the sagittal plane of the middle nasal meatus was (11.22±1.35)°,95% confidence interval was 8.92°-13.76°degrees;the distance D1(the distance on the line between tuberculum sellae and saddle back root, and the line was formed by the plate contained the angle A1 and sellar floor)was (16.71 ± 2.07)mm,95% confidence interval was 13.11-19.93 mm.Angle A2 (the angle between the tip of the nose and the saddle back ends)which was in the plane through the tip of the nose and both ends of dorsum sellae was (8.91±1.19)°,95% confidence interval was 7.12°-10.72°;the distance D2(the distance on the line between the saddle back ends,and the line was formed by the plate contained the angle A2 and sellar floor)was (14.23±2.09)mm,95% confidence interval was 10.81-17.92 mm. The four parameter data was normally distributed,and there was no significantly statistic difference between different gender and ages (P>0.05).Conclusion The angle of the movement for unilateral nasal transsphenoidal approach for pituitary surgery operation in the sagittal plane in the middle of the nasal meatus should be less than (11.22 ± 1.35)°,and the distance of the movement should be less than (16.71±2.07)mm. The angle of the movement in the plane through the tip of the nose and both ends of dorsum sellae should be less than (8.9 1 ± 1.1 9 )°, and the distance of the movement should be less than (14.23±2.09)mm.