OBJECTIVE:To compare the pharmacoeconomic efficacies of 5 drug therapeutic regimens for children pneumonia.METHODS:Using retrospective study and cost-effectiveness analysis to compare the pharmacoeconomic efficacies among the following 5 regimens in treating children pneumonia:amoxicillin sodium/clavulanate potassium(Group A),cefotaxime sodium(Group B),cefoperazone sodium/sulbactam sodium(Group C),cefuroxime sodium(Group D),and azithromycin(Group E).RESULTS:The effective rates of the 5 groups(A,B,C,D and E) were 80.43%,76.09%,65.12%,77.27%,and 91.30%,respectively,and the cost-effectiveness ratios were 1 595.06,1 225.38,1 669.69,1 284.83,and 697.84,respectively.CONCLU-SION:The regimen of azithromycin(group E) is the optimal one among the 5 groups for children pnemonia.

Objective To investigate the levels of small and dense low-density lipoprotein-cholesterol (sdLDL-C) and the influence of insulin therapy on lipid metabolism in type 2 diabetic patients.Methods The subjects were composed of a normal group (n =400,195 males and 205 females),and a type 2 diabetic patients group (n =193,108 males and 85 females) which was further divided into normal lipid (n =33),hypercholesterolemia (n =21,TC ≥ 5.18 mmol/L),hypertriglyceridemic (n =53,TG ≥ 1.7 mmol/L),combined hyperlipidemia (n =75),and low high-density lipoprotein-cholesterol(n=11,HDL-C＜ 1.04 mmol/L) subgroups.The pre-and post-treatment levels of sdLDL-C and the influence of insulin therapy on lipid metabolism in type 2 diabetic patients (n =122,70 males and 52 females) were compared.Serum concentrations of sdLDL-C (sdLDL-EX SEIKENreagent),triglyceride (TG),total cholesterol (TC),and fasting plasma glucose (FPG) were measured by automatic biochemical analyzer,fasting insulin and C-peptide were determined by chemiluminesence immunoassay,TG/HDL-C,sdLDL-C/ LDL-C,LDL-C/HDL-C,apoB/apoA Ⅰ,and other parameters were calculated.Results Compared with diabetic normal lipid group,the levels of sdLDL-C in hypercholesterolemia,hypertriglyceridemic,and combined hyperlipidemia subgroups were significantly higher(P＜0.05),the levels in combined hyperlipidemia subgroup were the highest.The levels of sdLDL-C in low high density lipoprotein cholesterol group showed no significantly difference (P＞0.05).While compared with normal group,the levels of sdLDL-C,TG,TC,LDL-C,ApoB,sdLDL-C/LDL-C,TC/HDL-C,TG/HDL-C,LDL-C/HDL-C,apoB/apoA Ⅰ,CRP,and HOMA-IR in type 2 diabetic patients were significantly higher(P＜0.05).Compared with pre-treatment group,the levels ofTG,TC,LDL-C,sdLDL-C,sdLDL-C/LDL,TC/HDL-C,TG/HDL-C,LDL-C/HDL-C,and apoB/apoA Ⅰ in post-treatment group were significantly lower(P ＜ 0.05).Conclusions sdLDL-C is the important indicator of lipid metabolism in type 2 diabetes,particularly in evaluating the changes in LDL particles.Insulin therapy is effective both in blood glucose control and improvement of dyslipidemia.Important information of clinical risk of dyslipidoses in type 2 diabetic patients provided by TG/HDL-C,LDL-C/HDL-C,sdLDL-C/LDL-C,and apoB/apoA Ⅰ ratios should be recognized and implemented in future clinical guidelines.

Objective To establish reference intervals of nine laboratory projects for hepatorenal function and verify its reliability by indirect method . Methods ALL test results were extracted from physical examinations that were stored in the laboratory information system of Zhongshan Hospital during 2012 to 2014.Using Skewness-Kurtosis test to detect the normality of data , if not the original data were transformed through BOX-COX transformation to obtain an approximatenormal distribution .Outliers were identified and omitted by Turkey method .The indirect reference intervals were taken by applying Hoffmann method.The reference change value ( RCV) was selected to inspect the statistical significance between the calculated and published reference intervals .Results Among those nine laboratory projects ,thedifferences betweenthereference intervalsfor ALT , AST, AKP, GGT, TP, BUNwerelessthan their RCV ( <60.12%, 38.12%, 19.9%, 41.53%, 8.53%, 37.5%) , there were no significant differences between the direct method.There were slight differences between the calculated reference intervals and published reference intervals for the lower limit of the LDH and the upper limit of the ALB (>26.65%,9.92%) ,and there was a significant difference between the calculated reference intervals and the current reference interval in the laboratory for the lower limit of the UA of male (>26.65%).Conclusion This research further proved the reliability of indirect reference intervals and this technique deserved to be promoted and applied by other clinical laboratories.

Objective To explore MSCT appearances of lung lacerating injury.Methods The MSCT findings of lung lacerating injury in 31 patients were analyzed retrospective.Results The lung lacerating injury of the 31 cases with 67 lesions in total was found,18 of whom were located on the back side of lung near the pleura,11 of whom had solitary lesion and 20 of whom had multiple ones. The MSCT findings included lung cavity in 9 eases,liquid airbag cavity in 1 7 and lung hematoma in 5 .The pulmonary contusion with different degrees was found in all 3 1 cases.Dynamic observation showed the cavities and hematoma could be transformed into each other.Conclusion MSCT is the best method for diagnosis and observation of lung lacerating injury and helpful for the guide of clinical treatment.

Objective : To analyze the survival of patients with malignant mesothelioma, so as to provide insights into the management of malignant mesothelioma. Methods : Totally 36 patients with malignant mesothelioma admitted to Cixi Third People’s Hospital from October 2012 to January 2021 were enrolled, and the demographic features, exposure to asbestos, and diagnosis and treatment were retrospectively reviewed. The survival rate and median survival time were calculated with the life-table method, and the factors affecting the survival rate of malignant mesothelioma were identified using the Kaplan-Meier estimate and log-rank test. Results : The 36 patients with malignant mesothelioma included 6 men ( 16.67% ) and 30 women ( 83.33% ), and had a median age of 61 ( interquartile range, 14 ) years. There were 30 cases with pleural malignant mesothelioma ( 83.33% ) and 6 cases with peritoneal malignant mesothelioma ( 16.67% ), 32 cases ( 88.89% ) with a history of occupational exposure to asbestos, and 26 cases ( 72.22% ) receiving palliative treatment. The 1-, 2- and 3-year cumulative survival rates were 30%, 15% and 3%, respectively, and the median survival time was 0.71 years. In addition, there were no significant differences in the survival period among patients with malignant mesothelioma in terms of gender, age, route of asbestos exposure, duration of asbestos exposure, pathogenic site and treatment regimens ( P>0.05 ). Conclusion The 36 patients with malignant mesothelioma had a median survival period of 0.71 years, and no association was found between the survival period and asbestos exposure or pathogenic site.

Objective : To examine the diagnostic and prognostic value of long non-coding RNA (lncRNA) JPX in mesothelioma, so as to provide insights into diagnosis and prognosis of mesothelioma. Methods: Patients with clinically definitive diagnosis of mesothelioma from 2015 to 2019 that were sampled from asbestos processing plants in Zhejiang Province from 2015 to 2019 were recruited in the mesothelioma group, while healthy residents without asbestos exposure or asbestos-related diseases in the same area served as controls. Participants' demographics, pathologic diagnosis and imaging features were collected, and the expression of blood lncRNA JPX was detected using lncRNA microarrays. The diagnostic value of lncRNA JPX for mesothelioma was evaluated using the receiver operating characteristic (ROC) curve, and the correlation between lncRNA JPX expression and prognosis was examined among mesothelioma patients using survival analysis. Results: There were 17 subjects in the mesothelioma group, with a mean age of (65.71±8.36) years, and 34 subjects in the controls, with a mean age of (64.24±8.70) years. LncRNA microarray detected significantly high lncRNA JPX expression in mesothelioma patients, and higher blood lncRNA JPX expression was detected in the mesothelioma group than in the control group [median (interquartile range), 1.10 (1.31) vs. 0.89 (0.54); t'=-2.300, P=0.034]. The area under the ROC curve was 0.673 (95%CI: 0.507-0.839, P=0.046), and if the cutoff was 1.759, the sensitivity and specificity were 35.3% and 100.0%, respectively. Survival analysis showed no significant difference in the survival rate of mesothelioma patients between the high lncRNA JPX expression group and the low expression group (χ2=0.212, P=0.645). Conclusions LncRNA JPX overexpression is detected in the blood of patients with mesothelioma, and lncRNA JPX expression presents a diagnostic value for mesothelioma; however, it shows little prognostic value for mesothelioma.

Objective:To evaluate the effect of Bushen-Tianjing-Huayu Decoction combined with conventional western medicine in the treatment of type 2 diabetes mellitus with osteoporosis. Methods:A total of 83 patients with type 2 diabetes mellitus and osteoporosis who met the inclusion criteria in the Community Health Service Center of Malu Town from January 2018 to December 2018 were recruited and divided into control group (41 cases) and study group (42 cases), according to the random number table method. The control group was treated with conventional western medicine, and the study group was treated with Bushen- Tianjing-Huayu Decoction based on the control group. Both groups were treated for 3 months. The fasting blood glucose and 2 hPG were detected by Accu-Chek Performa roche glucometer, HbAlc was detected by ion exchange chromatography, IL-6 and NO were detected by ELISA, the bone density of femoral neck, L 2-4 and Wards triangle were measured by dual energy X-ray bone mineral density detector. Results:The total effective rate was 90.5% (38/42) in the study group and 70.7% (29/41) in the control group, and the difference between the two groups was statistically significant ( χ2=5.198, P=0.023). After the treatment, the fasting blood glucose, 2 hPG and HbAlc levels in the study group were significantly lower than those of the control group ( t values were 6.822, 6.133 and 5.768, respectively, all Ps<0.001). After the treatment, the bone density levels of femoral neck (0.92 ± 0.10 g/cm 2vs. 0.78 ± 0.09 g/cm 2, t=6.700), L 2-4 (0.98 ± 0.12 g/cm 2vs. 0.87±0.10 g/cm 2, t=4.531) and Wards triangle (0.69 ± 0.08 g/cm 2vs. 0.61 ± 0.06 g/cm 2, t=5.144) in the study group were significantly higher than those of the control group ( P<0.01). The levels of serum IL-6 and NO were significantly lower than those of the control group ( t values were 23.244 and 13.541, all Ps<0.001). Conclusions:The Bushen-Tianjing-Huayu Decoction combined with conventional western medicine can control the blood glucose level, improve bone density, reduce serum IL-6 and NO levels, and improve clinical efficacy for the patients with type 2 diabetes mellitus and osteoporosis.

OBJECTIVESTo investigate the risk factors for cervical cancer in the areas of high incidence, and provide evidence for current intervention of cervical cancer.

METHODSIn the areas of Xiangyuan County, Shanxi Provicne with high incidence of cervical cancer, 1 997 women were interviewed using a questionnaire, including baseline information, menstrual, marital and pregnancy histories, sexual behavior, health habits, contraception, medical history and family history of cancer, etc., after its screening with six kinds of methods. All subjects, including 84 cases with pathological diagnosis of greater than cINI, and 1 784 cases with pathological diagnosis of normal, were tested for high-risk HPV.

RESULTSThe overall rates of HPV infection were 20.8% (415/1 997) in high-risk subjects, 97.7% and 14.2% in the cases and control groups, respectively. Univariate analysis showed that risk factors with statistical significance included high-risk HPV infection, age at first sexual intercourse, history of pregnancy and abortion, the number of sexual partners and family history of cancer. Analysis with non-conditional logistic regression model revealed high-risk HPV infection, multiple sexual partners and family history of cancer associated obviously with occurrence of cervical cancer. In addition, there was significantly positive relationship between HPV infection, which increased with the number of sexual partners, and extramarital sexual activity both in males or females.

CONCLUSIONSThe main risk factor for cervical cancer in this region was high-risk HPV infection, which related to sexual behavior, hygienic habits during menstruation and puerperium. It was particularly important to detect and treat precancerous lesions and to implement behavior modification. In addition, further research on genetic susceptibility was suggested.

Abortion, Induced ; Adult ; Analysis of Variance ; China ; epidemiology ; Female ; Humans ; Interviews as Topic ; Multivariate Analysis ; Papillomaviridae ; Papillomavirus Infections ; epidemiology ; Risk Factors ; Sexual Behavior ; Sexual Partners ; Surveys and Questionnaires ; Tumor Virus Infections ; epidemiology ; Uterine Cervical Neoplasms ; epidemiology ; virology

Objective:To monitor nucleic acid contamination and evaluate the biosecurity risk in a temporary 2019-nCoV nucleic acid testing laboratory situated within designated infectious disease care facilities.Methods:Quantitative real-time PCR technology was used to detect nucleic acid contamination in samples collected from high-risk experimental activity areas and the surface of the laboratory staff′s personal protective equipment. Sampling was conducted every Monday from March 14 to May 16, 2022, both during and after disinfection procedures.Results:A total of 760 samples were collected from 40 sampling sites. A total of 27 out of 100 samples (27%) collected from 8 sampling sites in the sample processing area were positive. Among them, the contaminated area of biological safety cabinet, the outer surface of the sample transport box, and the sample rack were found to have the highest positive detection rates, with rates of 5/10, 4/10, and 6/10, respectively. Ten out of 140 samples (7.1%) obtained from 7 sampling sites in the nucleic acid detection area showed positive results. The inner wall of sample transfer window and the door handle of the nucleic acid detection area had the highest positive detection rates, both at 4/20. The Ct values for the target genes from the positive samples in the sample processing area were significantly higher than those from the nucleic acid detection area. The detection rate for nucleic acid contamination on the surface of the personal protective equipment of the laboratory staff was 20% (16/80), and the positive detection rate of the outer gloves from operator during the experiment reached 9/10. After disinfection, the nucleic acid residues on the surfaces of the various areas of the 2019-nCoV nucleic acid laboratory and the surfaces of the personal protective equipment of the laboratory staff were observed to be effectively removed.Conclusions:During experimental operation, the positive detection rate and nucleic acid contamination intensity of 2019-nCoV are higher in the sample processing area compared to those in the nucleic acid detection area. The laboratory staff are exposed to high biosecurity risk during the experiment. Implementing a scientific disinfection process can significantly reduce the risk of 2019-nCoV residues from the laboratory environment and the surface of the personal protective equipment of the laboratory staff, ensuring the accuracy of inspections and the safety of the laboratory staff.

BACKGROUND: We have recently developed a new Coronary Artery Tree description and Lesion EvaluaTion (CatLet) angiographic scoring system. Our preliminary studies have demonstrated its superiority over the the Synergy between percutaneous coronary intervention (PCI) with Taxus and Cardiac Surgery (SYNTAX) score with respect to outcome predictions for acute myocardial infarction (AMI) patients. The current study hypothesized that the residual CatLet (rCatLet) score predicts clinical outcomes for AMI patients and that a combination with the three clinical variables (CVs)-age, creatinine, and ejection fraction, will enhance its predicting values. METHODS: The rCatLet score was calculated retrospectively in 308 consecutively enrolled patients with AMI. Primary endpoint, major adverse cardiac or cerebrovascular events (MACCE) including all-cause mortality, non-fatal AMI, transient ischemic attack/stroke, and ischemia-driven repeat revascularization, was stratified according to rCatLet score tertiles: rCatLet_low ≤3, rCatLet_mid 4-11, and rCatLet_top ≥12, respectively. Cross-validation confirmed a reasonably good agreement between the observed and predicted risks. RESULTS: Of 308 patients analyzed, the rates of MACCE, all-cause death, and cardiac death were 20.8%, 18.2%, and 15.3%, respectively. Kaplan-Meier curves for all endpoints showed increasing outcome events with the increasing tertiles of the rCatLet score, with P values <0.001 on trend test. For MACCE, all-cause death, and cardiac death, the area under the curves (AUCs) of the rCatLet score were 0.70 (95% confidence intervals [CI]: 0.63-0.78), 0.69 (95% CI: 0.61-0.77), and 0.71 (95% CI: 0.63-0.79), respectively; the AUCs of the CVs-adjusted rCatLet score models were 0.83 (95% CI: 0.78-0.89), 0.87 (95% CI: 0.82-0.92), and 0.89 (95% CI: 0.84-0.94), respectively. The performance of CVs-adjusted rCatLet score was significantly better than the stand-alone rCatLet score in terms of outcome predictions. CONCLUSION: The rCatLet score has a predicting value for clinical outcomes for AMI patients and the incorporation of the three CVs into the rCatLet score will enhance its predicting ability. TRIAL REGISTRATION http://www.chictr.org.cn , ChiCTR-POC-17013536.
Humans ; Coronary Artery Disease/complications* ; Death ; Myocardial Infarction/etiology* ; Percutaneous Coronary Intervention ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Treatment Outcome