OBJECTIVE: To explore a research path and statistical analytical method for cost-utility analysis suitable for gallstone surgery patients.METHODS: A decision-making model for the treatment of cholelithiasis surgery was established;the costs(C) and utility values at each nodal point(? U) were collected,with the results subjected to sensitivity analysis and threshold analysis.RESULTS: The cost-utility ratios(CUR) of laparoscopic operation and open surgery were 4 605.6(? 30%) yuan/QALY and 5 979.7(? 30%) yuan/QALY,respectively.One dimension sensitivity analysis of each( every) parameter reveals that the former CUR value is greater than the latter one.C1 and ? U1 showed the biggest impact on the CUR of laparoscopic operation,while C5 and ? U5 did on the CUR of open surgery.When C1=10 205.6 yuan,or ? U1=1.303 or C5=10 979.8 yuan or ? U5=3.095,CUR of laparoscopic operation was equal to CUR of open surgery,which means that the conversion of threshold was achieved.CONCLUSION: The designed research path and statistic analytic methods are suitable for the cost-utility analysis of cholelithiasis surgery patients.

OBJECTIVETo investigate the protective effect of mailuoning (MLN) on nerve cells after cerebral infarction induced by photochemistry.

METHODSEighty SD rats were divided into three groups, the control group (n = 20), the model group (n = 30) and the MLN group (n = 30). Focal cerebro-ischemia induced by photothrombosis in adult rat was used as a model. Changes of C-Fos protein expression before and after MLN treatment were observed using immunohistochemistry, computerized imaging technique and transmission electron microscopy (TEM).

RESULTSC-Fos positive cells located in the transitional zone between the necrotic core and normal cortex. C-Fos protein expression began to show 3 hrs after cerebral infarction, peaked at 6 hrs. As compared with the model group, C-Fos expression was significantly reduced in the MLN group (P<0.01).

CONCLUSIONMLN could markedly reduce the injury of nerve cell in the transitional zone, the protection may be related with its inhibition on C-Fos protein expression.

Animals ; Cerebral Infarction ; etiology ; genetics ; metabolism ; Drugs, Chinese Herbal ; pharmacology ; Male ; Neuroprotective Agents ; pharmacology ; Photochemistry ; Proto-Oncogene Proteins c-fos ; biosynthesis ; genetics ; Rats ; Rats, Sprague-Dawley

Objective·To establish a nomogram for the differential diagnosis of early systemic lupus erythematosus(SLE)and other autoimmune diseases based on laboratory indications,and to evaluate its efficacy.Methods·A total of 535 SLE patients admitted to the First Hospital of Lanzhou University from January 2017 to December 2021 were selected as SLE group,and 535 patients with other autoimmune diseases during the same period were selected as control group.Basic information and laboratory test indicators of the SLE group and control group were collected and compared.The SLE group and control group were randomly assigned to the training set and the validation set at a ratio of 7∶3,respectively.LASSO regression method and multivariate Logistic regression were used to select the main risk factors of SLE.The nomogram for differential diagnosis of early SLE(SLE nomogram)was established according to the selected main risk factors.Bootstrap method was used to conduct internal repeated sampling for 1 000 times to calibrate the nomogram.The receiver operator characteristic curve(ROC curve)and decision curve analysis(DCA)were performed to evaluate the differential diagnosis ability and the value in clinical application of SLE nomogram,respectively.The"DynNom"package of R language was used to convert the nomogram into an electronic calculator,and its consistency with SLE nomogram was verified by data from 3 groups of patients.Results·LASSO regression and multivariate Logistic regression identified six major risk factors for SLE,including antinuclear antibody(ANA),anti-double-stranded DNA(anti-dsDNA)antibody,anti-ribonucleoprotein antibody/anti-Simth antibody(anti-nRNP/Sm),anti-ribosomal P protein(anti-P)antibody,anti-nucleosome antibody(ANuA)and urinary protein(PRO),which were used to construct the SLE nomogram.The calibration curve of the SLE nomogram had standard errors of 0.009 and 0.015 in the training set and validation set,respectively,and its area under the curve(AUC)was 0.889 and 0.869,respectively.The results of DCA showed that when the risk threshold of SLE nomogram was 0.15?0.95,the model achieved more net benefit.The prediction results of the electronic calculator showed that when ANA(titer 1∶100)was positive in SLE patient No.1,the prevalence was 0.166;when both ANA(titer 1∶100)and ANuA(titer 1∶100)were positive in patient No.2,the prevalence was 0.676;when all of PRO,ANA(titer 1∶100),ANuA(titer 1∶100)and anti-P antibody(titer 1∶100)were positive in patient No.3,the prevalence was 0.990,which was consistent with the differential diagnosis results of the SLE nomogram.Conclusion·The established SLE nomogram based on ANA,anti-dsDNA antibody,anti-nRNP/Sm,anti-P antibody,ANuA and PRO and its conversion into an electronic calculator can effectively distinguish early SLE from other autoimmune diseases,and have important clinical application value.

The pathomechanisms of glomerulosclerosis in diabetic nephropathy (DN) are considered to be related with glycometabolism disorder, podocyte injury, intra-renal hemodynamics abnormality, fibrogenic cytokines over-expression, oxidative stress and inflammatory reaction. Chinese herbal medicine could delay the progression of glomerulosclerosis in DN by ameliorating the harmful factors of these pathological changes. Therefore, it is possible to postpone the progress of DN to end-stage renal disease through the treatment with Chinese herbal medicine.
Animals ; Diabetic Nephropathies ; drug therapy ; immunology ; metabolism ; prevention & control ; Drugs, Chinese Herbal ; therapeutic use ; Glomerulonephritis ; drug therapy ; immunology ; metabolism ; prevention & control ; Humans ; Oxidative Stress ; drug effects