OBJECTIVE:To explore the basic principles,advantages and application prospects of Bayesian mixed treatment comparison (MTC),and provide theoretic support for making reasonable decisions of pharmacoeconomics. METHODS:The prob-lems existing in model and method that had been used in the study of pharmacoeconomics as starting point,literature research was used to sort out the domestic development and applications of MTC and study its application and development prospect. RESULTS &CONCLUSIONS:The evaluation methods of pharmacoeconomics play an important role in selection of essential medicines,medi-care insurance directory medicines,basic health and basic public health programs,the results directly affect the total effective rate of medical resources’configuration. The current research models cannot effectively solve the problem,for example,decision tree model is difficult to make evaluation of long-term treatment;Markov model and the use of multiple attribute utility theory are restricted by the model parameters;discrete event simulation is limited because it depends on the epidemiological study and clinical trial. MTC, an extension approach of the traditional Meta-analysis,is an effective new method developed recently to analyze and compare the di-rect or indirect evidence of several different clinical treatment factors in order to make a comprehensive evaluation of the various inter-ventions in the absence of evidence support. So the MTC can make up for the limitation of current evaluation methods.

Objective To observe the synapse formation in hippocampal dentate gyrus, and the memory ability after transplanting bone marrow stromal cells (BMSCs) into lateral ventricle of ischemic brain injury rats. Methods BMSCs from femur of a Sprague-Dawley rat were cultured for 3 generations in vitro. 60 newborn Sprague-Dawley rats were divided into sham group (n=20), model group (n=20) and BMSCs group (n=20). The latter 2 groups were ligated the left common carotid artery, and the BMSCs group were injected BMSCs into the lateral ventricle 7 days after ligation. They were tested with Morris's water maze 8 weeks later, and then, the brains were immunohistochemical staining to detect synaptophysin (SY). Results The time of probe trial of acquisition phase (T1) and reveral phase (T2) decreased in the model group compared with the sham group (P<0.05), and increased in the BMSCs group compared with the model group (P<0.05). The integral optical density (IOD) of SY positive cells decreased in the model group compared with the sham group (P<0.05), and increased in the BMSCs group compared with the model group (P<0.05). Conclusion BMSCs implantation through lateral ventricle can improve the learning and memory ability of rats, which may associated with the synapse formation in dentate gyrus.

Objective To investigate the clinical feature,pathologic characteristics and prognosis of non-muscle invasive urothelial bladder tumor in young and old patients.Methods From January 2000 to March 2011,the clinicial data of 48 young patients (age ≤ 40 years) with non-muscle invasive urothelial bladder tumor and 50 patients randomly selected with non-muscle invasive urothelial tumor (age ≥ 60 years) were analyzed and compared retrospectively.There were 38 male and 10 female with a median age of 35.4 years (range,18 to 40).There were 34 male and 16 female with a median age of 68.5 years (range,68.5 to 87).All patients had postoperative intravesical instillation for one year.Young patients presented with gross hematuria mostly,which were similmar with old patients.Solitary tumor were 45 cases and 40 cases,and the multiple tumors were 3 cases and 10 cases in the young and old groups,respectively.Of the young group,40 patients were treated by transurethral resection of bladder tumor,and 8 patients by partial cystectomy.Of the old group,35 patients were treated by transurethral resection of bladder tumor,and 15 patients by partial cystectomy.Results According to 2004 WHO classification of papillary urothelial tumor,lower grade tumor were more frequentto occur in young group than in old group.There was significant difference in incidence of PUNLMP between young group and old group (16/48,33.3％ and 8/50,16.0％,P ＜ 0.05).There was significant difference in incidence of high grade bladder cancer between young group and old group (7/48,14.6％ and 17/50,34.0％,P ＜0.05).The incidence of PTa tumor was 70.8％ and 44.0％ in the young and old groups,respectively (P ＜ 0.05).Median follow up was 34 months (range,6 to 132) in young group and 35 months (range,6 to 130) in old group,respectively.Five-year recurrence rate was 36.7％ and 64.3％ respectively (P ＜ 0.05).Conclusions Non-muscle invasive urothelial bladder tumor in young patients had a better prognosis than those in the old group,with lower grade and stage at diagnosisand lower recurrence rate.

ObjectiveTo assess the values of 320-detector row dynamic volume CT angiography (CTA) and transthoracic echocardiography (TTE) in follow up of coronary artery aneurysm (CAA) caused by Kawasaki disease (KD).Methods320-de-tector row CTA and TTE were applied in long-term follow-up of 8 patients with CAA caused by KD.ResultsIn 8 patients, the mean age at onset was 41.63±22.70 months and the mean follow up time was 43.50±10.99 months. In acute phase, 3 cases of giant coronary artery aneurysms (GCAA) and 5 cases of mid-small CAA were diagnosed by TTE. A total of 16/32 arteries (50%) were involved. At the end of follow-up, 3 cases of GCAA and 2 cases of mid-small CAA were still diagnosed by TTE, and small CAAs were regressed in another 3 cases. A total of 6/32 arteries (18.75%) were involved. Simultaneously at the end of follow-up, a total of 7/32 arteries (21.9%) were involved by 320-detector row CTA. The distribution was consistent with that of TTE. Mean-while, there were one case of left circumlfex artery, one case of GCAA at distal of the right coronary artery, 2 cases of thrombus, 1 case of coronary stenosis and 2 cases of calciifcation.ConclusionsCAA caused by KD may be persistent for a long time. The thrombus, stenosis, and calciifcation of coronary can occurr at late phase in GCAA. TTE is sensitive and reliable to detect proxi-mal and middle segment of coronary lesions, but has limitations in detection of distal segment of coronary arteries. 320-detector row CTA has more comprehensively view of each coronary artery lesions and is especially sensitive and reliable to detect coro-nary thrombosis, calciifcation and narrowing in proximal and distal coronary arteries after acute phase.

Objective To investigate the correlation between prostatitis and bladder outlet obstruction (BOO) in patients with benign prostatic hyperplasia.Methods From January 2008 to January 2012,Three hundred BPH patients were divided into two group according to whether had prostatitis determined by pathology.One hundred and thirty six patients with simple BPH and 164 patients with BPH combined with prostatitis were included with the median age of 69 years.PSA was (4.9 ± 8.3) μg/L and (7.0 ± 8.5)μg/L,the prostate volume was (41.4±18.1) ml and (48.7±20.7) ml,and IPSS was 21.9±7.0 and 27.5 ± 5.1 in BPH group and prostatitis group,respectively.The urodynamic parameters of bladder outlet obstruction between the two groups were analyzed.Results Qmax was (8.8 ± 4.8) ml/s and (6.3 ± 3.7)ml/s,Pdet.Qmax was (96.7 ± 33.0) cm H2O and (113.3 ± 39.8) cm H2O,AG value was 77.7 ± 31.9 and 93.9 ± 39.6,and Schafer grading value was 3.3 ± 1.5 and 4.4 ± 1.2 in BPH group and BPH combined with prostatitis group,respectively (P ＜ 0.05).Logistic regression analysis showed that prostatitis (OR =2.66,P =0.002),PV (OR =1.37,P =0.000),and Qmax(OR =0.72,P =0.000) were positively correlated with Schafer grading value.Conclusions Prostatitis increased the degree of BOO in patients with BPH.

Objective To analyze the expression of glial fibrillary acidic protein(GFAP) in hippocampal of rats with hypoxic-ischemic brain damage(HIBD) after injection of bone marrow stromal cells(BMSCs) supernatant into the lateral ventricle of the neonate rats,assess the ability of learning and memory,and explore the mechanism.Methods 7-day-old SD rats were randomly divided into sham operation group,model group,cells and supernatant group,with 20 rats in each group.The HIBD model was established via the ligation of left carotid arteries followed by 2-hour hypoxia.One week later,rats in control group were injected with 0.01 mol/L PBS 2 μl via the left ventricle.Meanwhile,the cell and the supernatant groups were injected with BMSCs and supernatant harvested from BMSC culture,respectively,via the same route.In the sham operation group,the left carotid arteries were separated but not ligated,and no hypoxia treatment was imposed on this group.They also received 0.01 mol/L PBS injection 2 μl per weak post surgery.8 weeks later,Morris water maze test was performed to assess the learning and memory,and the expression of GFAP in the dentate gyrus of rats was measured by immunohistochemistry.Results Morris water maze showed that the searching time of the probe trail(T1:(15.40±2.80) s) and reversal probe trail (T2:(16.45± 1.16) s) of the model group was shorter than that of the sham operation group (T1:(19.96±2.57) s,T2:(2:25.32±2.54)s,P＜0.05),while the searching time of the cell group(T1:(17.54± 1.80)s,T2:(18.99± 1.47) s) and supernatant group (T1:(17.40±2.37) s,T2:(17.96± 1.09) s) was prolonged compared with that of the model group (P＜0.05).No significant difference between the cell group and the supernatant group (P＞0.05).The integral optical density (IOD) value of GFAP positive cells was higher in the model group than that in the sham operation group(15.26±1.49 vs 12.82±2.56,P＜0.05),while the IOD of cell group(18.13±1.97) and that of the supernatant group(17.38± 1.64) were higher than that of the model group (P＜0.05).However,there was no significant difference between the cell group and the supernatant group (9＞0.05).Conclusion BMSC supernatant injected through lateral ventricle can improve the HIBD rats' abilities of learning and memory.The mechanism might be that MSCs secrete some cytokines to promote central nervous system repair.

Objective To analyze the expression of synaptophysin (SY) in hippocampal dentate gyrus of rats with hypoxic-ischemic brain damage(HIBD) after the injection of bone marrow stromal cells(BMSCs) and its supernatant into the lateral ventricle and to explore the mechanism of potential effects. Methods Eighty 7-day-old sprague-dawley(SD) rats were randomly divided into sham group, control group, cell group and supernatant group, with 20 rats in each group. The HIBD model was established via the ligation of left carotid arteries followed by 2-hour hypoxia. One week later, control group was injected with 0.01 mol/L PBS via the left ventricle. Meanwhile, cell and supernatant group were injected with BMSCs and supernatant harvested from BMSC culture, respectively, via the same route. For spam group, the left carotid arteries were separated but not ligated, and no hypoxia treatment was imposed on this group. They also received 0.01mol/L PBS injection one week post surgery. After 8 weeks, the expression of SY in the dentate gyrus of rats was measured. Results Compared with sham group, model group showed significantly lower IOD (integral optical density) of SY positive material in the dentate gyrus(P < 0.05). Compared with model group, supernatant group and cell group exhibited significantly increased IOD values (P < 0.05), but there was no significant difference between cell group and supernatant group (P > 0.05). Conclusions BMSCs and supernatant injected via the lateral cerebral ventricle can increase SY expression in the hippocampal dentate gyrus of HIBD rats and promote synapse formation. The mechanism of this effect may be related to cytokine secretion by BMSCs which promotes synapse formation.

ObjectiveTo investigate the finasteride application during the off-cycle of intermittent androgen blockade (IAB) in patients with advanced prostate cancer treated with IAB.MethodsEighty-seven patients with advanced prostate cancer were divided into two groups: forty-nine patients received IAB (group A), and thirty-eight patients underwent IAB and finasteride during the off-cycle of IAB (group B). The time of treatment cycle and the time to disease progression were compared between the two groups. ResultsThe patients in group A completed 89 treatment cycles and the mean cycle length was (12.8±5.4) months [treatment time and non-treatment time were (6.6±3.5) months and (7.1±4.8) months, respectively]. The patients in group B completed 85 cycles and the mean cycle length was (15.3±5.9) months [treatment time and non-treatment time were (6.9±3.2) months and (9.2v±3.9) months, respectively]. There was a significant difference between group A and B in the mean cycle length and the non-treatment time (P=0.0428,P=0.03).The 3-year progression rate was ( 34.8±3.5 )% in group A and ( 28.4±2.7)% in groups B ( P=0.035). ConclusionsThe application of finasteride during the off-cycle of IAB in patients with advanced prostate cancer treated with intermittent androgen blockade (IAB) can delay progression of advanced prostate cancer.

Objective To evaluate the efficacy and safety of the TVT-Secur procedure for female stress urinary incontinence (SUI). Methods Analyze retrospectively the preoperative, intraoperative and postoperative complications and follow-up data of 27 SUI patients from October 2008 to May 2010. 20 cases were simple SUI, and 7 cases were mixed SUI. The average age was 56.1 ± 10.7 years (range, 35-77), the average parity was 2.8-±- 1.4 (range, 1-6), the average body mass index was 25.6±2.5, and the average course of the disease was 6.8±7.2 yeas (range, 1-30). Two cases had past history of pelvic surgery without any anti-incontinence surgery. Mashall-marchett test was positive in all patients, with an average abdominal leak point pressure (ALPP) of 60.9±27.5 cm H2O (range, 27- 120 cm H2O). The mean International Consultation on Incontinence-Short Form (ICIQ-SF) score was 11.2 ± 1.8 (range, 7- 14) before surgery. Results 27 patients underwent TVT-Secur procedure, of which 19 cases underwent "U" procedure, and 8 cases underwent "H" procedure. The mean operation time was 15.3±1.4min (range, 13- 19 min). There were no intraoperative bladder or urethral injury, and no obturator vessel or nerve damage. The blood loss was 10 to 50 ml, and the maximum urinary flow rate was 25. 4±13. 1 ml (range, 4-50 ml). Three eases had mild dysuria(11. 1%), and 3 cases had wound effusion(11. 1%). Followed up for 12. 6 ±6. 7 months (range, 3-21 months). 10 cases complained of bladder overactivity symptoms such as frequency, urgency, and urge incontinence, and no case had vaginal erosion. Therapeutic efficacy: 15 cases were cured (56%), 8 cases were improved (30%), and 4 cases were ineffective (15%). Conclusions TVT-Secur procedure is a simple, safe and minimally invasive surgery, while the cure rate is low. The long-term efficacy needs great amount of clinical data and long-term follow-up to prove.

Objective To study the clinical efficacy and operative skill of multi-endoscopic technique in treatment of post-traumatic urethrostenosis in male patients.Methods A retrospective analysis was done on clinical data of 47 male patients with post-traumatic urethrostenosis treated with direct visional incision urethrotomy combined with transurethral resection of scar tissue and ureteroscopic incision.There were 29 patients with anterior urethral strictures and 18 with posterior urethral strictures.Results Of all,43 patients underwent successful endoscopic surgeries at the first time but one underwent secondary surgery because of unsuccessful endoscopic incision.These patients achieved satisfactory results without urinary incontinence,fistula or reoperation.The left three patients underwent open surgeries because of unsuccessful endoscopic incision,in which one patient could micturate at maximal flow rate of 9-12 ml/s,without therapeutic urethral dilation,one could micturate under regular therapeutic dilation and the other one could not micturate.Conclusions With the advantages of safety,high success rate and good long-term efficiency,multi-endoscopic technique can be used as an initial treatment for male patients with post-traumatic urethrostenosis and is worthy to be popularized.