OBJECTIVE:To evaluate the cost-effectiveness of Acarbose in the treatment of type 2 diabetes. METHODS:The CORE diabetes model was employed to evaluate the long-term cost-effectiveness of Acarbose in the treatment of type 2 diabetes. RESULTS:Acarbose treatment prolonged patients' life expectancy by 0.27 years and quality-adjusted life expectancy by 0.26 years,but its cost was 17 081 yuan higher than in the control group. The incremental cost-effectiveness ratio was 62 717 yuan per life expectancy gained and 66 633 yuan per quality-adjusted life expectancy gained. An acceptability curve of cost-effectiveness showed that 76% of the patients would regard that Acarbose is cost-effectiveness when a willingness to pay was 100 000 yuan. CONCLUSION:Acarbose has long-term cost-effectiveness in the treatment of type 2 diabetes.

Objective: To investigate the trend in incidence of stroke in Yongkang City, Zhejiang Province from 2015 to 2022, so as to provide the evidence for improving stroke prevention and treatment strategies. Methods: The incidence of stroke in Yongkang City from 2015 to 2022 was collected through the Zhejiang Chronic Disease Monitoring Information System, and standardized by the data of the Chinese National Population Census in 2010. The incidence of stroke in gender-, age- and subtype-specific was analyzed, and the incidence trend of stroke was analyzed by average annual percentage change (AAPC). Results: A total of 22 408 stroke cases were reported in Yongkang City from 2015 to 2022, with crude incidence of 457.97/105 and standardized incidence of 379.55/105. The crude incidence of stroke appeared a tendency towards a rise (AAPC=6.447%, P<0.05). The crude incidence of stroke was higher among males than females (495.97/105 vs. 417.58/105, P<0.05), and the standardized incidence of stroke was higher among males than females (425.29/105 vs. 332.49/105, P<0.05). The average age of stroke cases was (70.74±12.64) years. The crude incidence of stroke appeared a tendency towards a rise with age (P<0.05), and which in residents aged 30 to 44 years showed an increasing trend (AAPC=6.142%,P<0.05). There were 18 040 cases of ischemic stroke (80.51%), 4 121 cases of hemorrhagic stroke (18.39%) and 247 cases of unclassified stroke (1.10%) reported from 2015 to 2022. The crude incidence of ischemic stroke was higher than which of hemorrhagic stroke (368.70/105 vs. 84.22/105, P<0.05). The crude incidence of ischemic stroke appeared a tendency towards a rise (AAPC=7.851%, P<0.05). Conclusions The crude incidence of stroke appeared a tendency towards a rise in Yongkang City from 2015 to 2022, with ischemic stroke as the predominant subtype. Male and the elderly should be given a high priority for stroke control.

Objective To investigate the protective effects of vasoactive intestinal peptide(VIP) on gut barrier in rats with severe acute pancrititis(SAP)and its mechanisms.Methods Fifty-four SD rats were randomly divided into sham operated(So)group,SAP group and VIP group.The model of SAP was induced by retrograde injection of 4%sodium taurocholate into the bili-pancreatic duct.The rats in VIP group were intraperitoneal injected with VIP of 5×10-9 nmol 5 minutes after model established.The endotoxin in plasma was measured at 1,6 and 1 2 hour.The expression of Toll-like receptor(TLR)4 in gut mucosa was examined using RT-PCR and immunohistochemistry and mucosa tissue were detected using electroscopic examination.Results The concentration of endotoxin in plasma and expression of TLR4 were both increased at 1 hour and reached peak at 1 2 hour in SAP group compared with SO group(no expression of TLR4),but were decreased in VIP group.A correlation was found between endot6xin and expression of TLR4.The electroscopic examination showed that the pathological injury in intestine was severe in SAP group than that in VIP group.Conclusion The protective effect of VIP in gut barrier function may contribute tO down-regulation of TLR4 expression in gut mucosa.

Human immunodeficiency virus type 1 (HIV-1) is the causative agent of acquired immunodeficiency disease syndrome (AIDS). After over 26 years of efforts, there is still not a therapeutic cure or an effective vaccine against HIV/AIDS. The clinical management of HIV-1 infected people largely relies on antiretroviral therapy (ART). Although highly active antiretroviral therapy (HAART) has provided an effective way to treat AIDS patients, the huge burden of ART in developing countries, together with the increasing incidence of drug resistant viruses among treated people, calls for continuous efforts for the development of anti-HIV-1 drugs. Currently, four classes of over 30 licensed antiretrovirals (ARVs) and combination regimens of these ARVs are in use clinically including: reverse transcriptase inhibitors (RTIs) (e.g. nucleoside reverse transcriptase inhibitors, NRTIs; and non-nucleoside reverse transcriptase inhibitors, NNRTIs), protease inhibitors (PIs), integrase inhibitors and entry inhibitors (e.g. fusion inhibitors and CCR5 antagonists). Here, we intend to provide updated information of currently available antiretroviral drugs for ART to promote the development of novel anti-HIV-1 drugs.

Child ; Diarrhea ; diagnosis ; therapy ; Humans

BACKGROUND: The recovery of activity of daily living (ADL) in hemiplegic patient is related to the recovery of motor function to certain extent. But the correlation between two aspects has not been determined yet over the past study.OBJECTIVE: To probe into the correlation between the motor function of upper and lower limbs and ADL of hemiplegic patients after cerebral apoplexy.DESIGN: Case analysis.SETTING: Department of Rehabilitation of First Affiliated Hospital of Nanjing Medical University.PARTICIPANTS: Thirty cases of hemiplegia of cerebral apoplexy were selected from inpatients of Department of Rehabilitation of Jiangsu People's Hospital from August 2002 to June 2003, of which, 20 cases were male and 10 cases were female, aged varied from 39 to 76 years.METHODS: Simplified Fugl-Meyer assessment of motor recovery (FMA)was used to evaluate the motor function of patient. Modified Barthel index assessment was used to evaluate ADL.MAIN OUTCOME MEASURES:① Simplified Fugl-Meyer assessment and modified Barthel index assessment.② Correlation between the motor function and ADL of hemiplegic patients after cerebral apoplexy.RESULTS: All of 30 cases entered result analysis.①The average result of general FMA was 40.96±32.04.The average result of motor function of upper limb was 21.78±22.87 and of low limb was 18.43±10.29.The average result of modified Barthel index assessment was 39.46±25.94. ② The correlative coefficient of general FMA and modified Barthel index assessment was 0.65, in which, the correlative coefficient of upper limb assessment and modified Barthel index assessment was 0.62 and that of lower limb assessment was 0.61.CONCLUSION: A certain correlation presents between motor function and ADL in hemiplegic patient and the influences of upper and lower limb motor functions are almost same to daily life activity.

ObjectiveTo investigate the clinical value of routine para - aortic lymphadenectomy in patients with stage Ⅰ B1 and Ⅱ A2 cervical cancers treated by surgical intent.Methods240 patients with stage Ⅰ B1 and Ⅱ A2 squamous cervical cancer were randomly divided into tow groups( group A and B).120 patients (group A) underwent radical hysterectomy with systematic pelvic lymphadenectomy and paraaortic lymphadenectomy.Other 120 patients (group B) underwent radical hysterectomy with systematic pelvic lymphadenectomy,additional para-aortic lymphadenectomy were carried out when para-aortic lymph nodes were identified as suspicious by visualization and palpation.The operation time,amount of surgical bleeding,length of stay,complications,and metastasis rates of pelvic lymph node,metastasis rates of common iliac lymph node and metastasis rates of para-aortic lymph node were analyzed between two groups.ResultsThe clinical characteristics of the patients had no statistically significant difference between the two groups.The length of stay and the complications of group A were significantly higher than group B ( P ＜0.05 ).During the 240 patients,the metastasis rates of pelvic lymph node,common iliac lymph node and para-aortic lymph node were 27.9％,10.8％ and 5.4％.The metastasis rate of para-aortic lymph node in group A was statistically higher than that in group B( 8.3％ vs 2.5％,P ＜0.05),whereas there had no significant difference of the metastasis rates of pelvic lymph node and common iliac lymph node between the two groups.ConclusionsRoutine para-aortic lymphadenectomy can be helpful to accurately predict the status of the para-aortic lymph node in patients with stage Ⅰ B1 and Ⅱ A2 cervical cancer,but the length of stay and the complications of operation will increase.

Objective To examine the effect of mycophenolic acid(MPA)on mesangial cell(MC)proliferation and on expressions of transforming growth factor-β(TGF-β)and connective tissue growth factor(CTGF)induced by high glucose.Methods The proliferation activity of mesangial cells incubated for 24h,48h and 72h in different concentrations of MPA was observed by MTT assay.The expressions of TGF-β and CTGF were measured by Western blot.Results MPA inhibited the MC proliferation and expressions of TGF-β and CTGF induced by high glucose.Conclusions MPA decreases the release of extracellular matrix by inhibiting the MC proliferation and expressions of TGF-β and CTGF,and subsequently slows the development of glomerulosclerosis in diabetic nephropathy.

Our clinical teaching quality evaluation system is based on the information from experts,students,departments deans,and fellows.Emphasis on dynamic state evaluation,random evaluation,and comprehensive evaluation are characteristics of this system.Through one year practice,our clinical teaching quality evaluation system has good effects on improving teaching quality.

Laboratory animal science is a preceding subject,which contains particular theory system and characteristics.In order to meet the developmental need of higher medical education and train more medical talents with high quality,the traditional teaching model must be reformed.A series of teaching reforms have been performed and analyzed in this paper.