OBJECTIVE:To measure and analysis the related costs of drug-induced liver injury (D1LI) from different decision makers,and to provide reference for reducing related costs of DILI,improving medical insurance system and realizing effective health resource distribution.METHODS:In retrospective study,60 cured or recovered DILI inpatieuts were randomly selected as subjects from medical record management system of 4 hospitals in Henan province during Jun.2014-Jun.2015.Demographic character istic,clinical characteristic and related cost of DILI were analyzed retrospectively and the cost structure was also analyzed from different decison makers (patient,society,medical insurance payer).RESULTS:The total direct medical cost of 60 cases was 584 113.05 yuan,and total direct non-medical cost was 31 093.15 yuan and total indirect cost was 169 379.95 yuan.The total cost of DILI of fered by patients was 616 296.38 yuan;the total cost of DILI offered by society was 784 586.15 yuan;the total cost of DILI offered by medical insurance was 168 289.77 yuan.CONCLUSIONS:DILI results in serious economic damage for patients and society,deserving attracting extensive attention worldwide.The study provide reference for reducing patient's medical burden and improving medical insurance system,and contribute to optimize medical resource distribution.

Objective: To explore the application value of real-time adenosine stress 3-dimensional echocardiography (3D-ASE) for diagnosing the patients with of coronary artery disease (CAD).
Methods: A total of 46 suspicious CAD patients were studied by 3D-ASE analysis. There were 26 male and 20 female patients from (38-73) years of age at the mean of (63.3 ± 7.2) years. Adenosine stress echocardiography was performed by infusing the agent at 140 ug/(kg?min) in 6 minutes. The changes of segmental ventricular wall motion, electrocardiogram (ECG), clinical symptoms, blood pressure and heart rate were recorded. Positive 3D-ASE result was deifned by the time of left ventricular segment minimum contraction volume gradually extending. Coronary angiograph (CAG) was conducted at 2 weeks after 3D-ASE, positive CAG ifnding was conifrmed by at least one of three main branches with the stenosis≥50%.
Results: There were 29/46 patients with positive CAG findings, 26 with positive 3D-ASE presentations and 8 with positive adenosines tress ECG. CAG showed that 48 coronary branches were positive and 90 were negative;3D-ASE indicated that 40 coronary branches were positive and 98 were negative. For 3D-ASE diagnosed coronary lesions, the overall sensitivity was 89.6%(26/29), speciifcity 76.5%(13/17), accuracy 84.8%(39/46). There were 36 branch lesions conifrmed by both CAG and 3D-ASE. For 3D-ASE determined coronary lesions, the sensitivity was 75%(36/48), speciifcity 95.6%(86/90), accuracy 88.4%(122/138). For 3D-ASE found single, double and three vessels diseases, the sensitivities were 60%(9/15), 88.9%(8/9) and 100%(5/5) respectively. The e occurrence rate of 3D-ASE side effect was 52.2%, there were usually slight symptoms without severe adverse reaction.
Conclusion: 3D-ASE has the high sensitivity and speciifcity in CAD diagnosis, it is an non-invasive examination with slight side effect, and therefore, has an important application value in clinical practice.

This article was aimed to study the action of antigout effects of compoundWeifu. Through the acute gouty arthritis models of rabbits and rats induced by micro-crystal sodium urate (MSU). The histopathological changes of synovial tissues among rabbits were observed. And the contents of TNF-α, IL-1β, IL-6 in rabbit serum were determined. The swelling degree of the rats’ feet and the content of prostaglandin E2 (PGE2) from the inflammatory exudate foot induced by MSU were also determined. The antigout effects of compoundWeifu were observed. The results showed that the grade of the vascular congestion, swelling and inflammatory cell infiltration in synovial tissues in the high-dose and medium-dose CompoundWeifu group had significantly improved (P <0.05). And the levels of TNF-α, IL-1β, IL-6 in serum were significantly decreased (P< 0.05, orP < 0.01). It can obviously reduce the swelling degree induced by MSU, and the level of PGE2 in the inflammatory exudate foot (P< 0.05, orP < 0.01). It was concluded that CompoundWeifu had obvious antigout effects in the study.

Objective To explore the effects of erythropoietin (EPO) on the neural function recovery and the expressions of nuclear factor-κB (NF-κB) in rabbit spinal cord after ischemia-reperfusion injury. Methods 24 rabbits were randomized into 3 groups: EPO treatment group, ischemia-reperfusion (I/R) group and sham group with 8 rabbits in each group. The rabbit model of spinal cord ischemia-reperfusion injury was established with Tetik's method. The changes of neural functional recovery of rabbits of 3 groups were observed through Tarlov's scale at different time points post-operation. The expressions of NF-κB were tested with immunohistochemistry. Results The grade of nerve function improved distinctly in EPO treatment group (P<0.01).The expression of NF-κB in EPO group was lower than that of I/R group (P<0.01).Conclusion EPO can significantly improve the motor function of hind limbs in rabbits after spinal cord ischemia-reperfusion injury, which might be related with inhibition of the expressions of NF-κB.

We observed the effect of vibration parameters on lumbar spine under different vibration conditions using finite element analysis method in our laboratory. In this study, the CT-images of L1-L5 segments were obtained. All images were used to develop 3D geometrical model using the Mimics10. 01 (Materialise, Belgium). Then it was modified using Geomagic Studio12. 0 (Raindrop Geomagic Inc. USA). Finite element (FE) mesh model was generated by Hypermesh11. 0 (Altair Engineering, Inc. USA) and Abaqus. Abaqus was used to calculate the stress distribution of L1-L5 under different vibration conditions. It was found that in a vibration cycle, tensile stress was occurred on lumbar vertebra mainly. Stress distributed evenly and stress concentration occurred on the left rear side of the upper endplate. The stress had no obvious changes under different frequencies, but the stress was higher when amplitude was greater. In conclusion, frequency and amplitude parameters have little effect on the stress distribution in vertebra. The stress magnitude is positively correlated with the amplitude.
Biomechanical Phenomena ; Finite Element Analysis ; Humans ; Lumbar Vertebrae ; physiology ; Vibration

lusions Cardiac MSCT can accurately assess the RV size and function in comparison to MRI. Patients with severe COPD have RV dysfunction.

This study was aimed to estimate the effect of different ProDisc-C arthroplasty designs after it was implanted to C5-C6 cervicalspine. Finite element (FE) model of intact C5-C6 segments including the vertebrae and disc was developed and validated. Ball-and-socket artificial disc prosthesis model (ProDisc-C, Synthes) was implanted into the validated FE model and the curvature of the ProDisc-C prosthesis was varied. All models were loaded with compressed force 74 N and the pure moment of 1.8 Nm along flexion-extension and bilateral bending and axial torsion separately. The results indicated that the variation in the curvature of ball and socket configuration would influence the range of motion in flexion/extension, while there were not apparently differences under other conditions of loads. The method increasing the curvature will solve the stress concentration of the polyethylene, but it will also bring adverse outcomes, such as facet joint force increasing and ligament tension increasing. Therefore, the design of artificial discs should be considered comprehensively to reserve the range of motion as well as to avoid the adverse problems, so as not to affect the long-term clinical results.
Arthroplasty ; Biomechanical Phenomena ; Finite Element Analysis ; Humans ; Intervertebral Disc ; Pressure ; Prostheses and Implants ; Range of Motion, Articular ; Spine ; Zygapophyseal Joint

OBJECTIVE:To provide reference for standardized management of skin test of cephalosporin injection in our hos-pital. METHODS:In retrospective analysis,skin test of 8 kinds of cephalosporin [cefotaxime(1.0 g),cefotaxime(0.5 g),cefoti-am (1.0 g),cefotiam (0.5 g),ceftazidime (0.5 g),cefminox (0.5 g),cefminox (1.0 g),ceftriaxone (1.0 g)] and the cost of skin test, related cost of allergic reaction induced by cephalosporin injection were analyzed statistically during Sept. 1st, 2015-Aug. 31th,2016. The cost of skin test of cephalosporin injection was compared with allergic reaction cost reduced by skin test. RESULTS:The positive rate of 100330 patients who used above 8 kinds of cephalosporin injections was 6.27%;the rate of skin test was 82.49%;the direct cost of skin test was 3434411.72 yuan;the indirect cost was 141985.12 yuan;the cost of pa-tient was 3162901.44 yuan;the cost of medical insurance was 259096.28 yuan;the cost of the whole society was 3576396.84 yuan. From the perspective of the whole society,the cost of skin test of cephalosporin injections was(447049.61±247395.07)yuan, and allergic reaction cost reduced by skin test was (316075.48 ± 260600.49)yuan. The cost of skin test was significantly higher than allergic reaction cost reduced by skin test,with statistical significance(P<0.05). CONCLUSIONS:Skin test of cephalosporin injection is low in positive rate,has high expense. The government standardizes the management of skin test of cephalosporin injec-tion and reduces the economic burden of patients under the premise of ensuring the safety of drug use.

Objective To prospectively assess right ventricular dysfunction and the metergasis before and after therapy of thrombolysis with ECG gated multi-detector spiral computed tomography (MSCT)in patients with acute pulmonary embolism. Methods Triple rule-out ECG gated MSCT examination was performed in 96 consecutive patients suspected of PE. 25 patients with central PE were confirmed. 25 agematched subjects without cardiac and pulmonary disease were recruited as control group. Triple rule-out ECG gated MSCT were performed again to assess cardiac function after therapy of thrombolysis. Dimension ratios for the right ventricle (RV) and left ventricle ( LV), main pulmonary artery and aorta were measured.Furthermore, the RV and LV end-diastolic volumes (EDV), end-systolic volume (ESV) and ejection fraction (EF) were also measured. The mean values were compared with analysis of variance (ANOVA) and Newman-Keuls test before and after thrombolysis. Results The mean values of RVEDV, RVESV, RVEF,RV/LV ESV volume ratio, RV/LV dimension ratio and main pulmonary artery/aorta dimension ratio in control group were (150.5±24.1) ml,(71.5 ±18.5) ml, (53.5 ±4.2)%, 1.08 ±0.04, 1.01 ±0.04 and 0. 99 ±0. 02, respectively. While those in PE group were ( 190. 3 ± 16. 2) ml, ( 128. 1 ± 13.2) ml,(32.7 ± 3.6 ) %, 2.00 ± 0.26, 1.30 ± 0. 09 and 1.34 ± 0. 11, respectively. Those after therapy of thrombolysis were ( 159. 2 ± 21.5 ) ml, ( 80. 7 ± 9.4) ml, (49. 2 ± 5.9) %, 1.22 ± 0.25, 1.02 ± 0.02 and 1.02±0.11,respectively. ESV and EDV of RV were larger (q= 6.28, P<0.01; q=7.59, P<0.01),EF value was lower (q = 4. 82, P < 0.01 ) in PE group than those in control group. RV/LV ESV volume ratio, the RV/LV dimension ratio and main pulmonary artery/aorta dimension ratio were larger ( q = 6. 04,P <0. 01; q =4. 43, P <0. 01; q =4. 36, P <0. 01 ) and EDV of LV was lower in PE group than those in control group. However, ESV and EDV of RV and RV/LV ESV volume ratio were lower (q = 5.03, P <0.01;q=6. 11,P<0.01;q=4.74,P<0.01), EF value was larger (q=6.29, P<0.01) and EDV of LV was larger(q =4.01 ,P <0.01 ) after therapy of thrombolysis than before. Conclusion Retrospective triple rule-out ECG-gated MSCT can show pulmonary embolism, measure the function of RV and LV and evaluate curative effect of thrombolysis.

Objective To investigate the hepatitis B virus (HBV) infection status quo among childbearing age women to provide the theoretical basis for adopting the effective intervention ,treatment and blocking measures in pre-pregnant women .Methods The enzyme-linked immunosorbent assay (ELISA) and the time-resolved fluorometric immunoassay were adopted to detect HbsAg in 68 682 children bearing age women ,including outpatient and hospitalized patients ,in this hospital from February 2012 to September 2013 .The detect results were analyzed according to the age ,place of residence and medical departments .Results Among 68 682 children bearing age women ,3 260 cases were found positive for HbsAg with the HBsAg positive rate of 4 .70% .The statistically significant differences in the HBV infection positive rate existed among different age groups ,the positive rates in the age groups of 16- <20 years ,20 - < 25 years ,25 - < 30 years ,30 - < 35 years ,35 - < 40 years ,40 - < 45 years and 45 - < 50 years were 3 .83% ,4 .89% ,4 .96% ,4 .91% ,4 .18% ,4 .40% and 4 .18% respectively ,the differences among them had statistical significance (χ2 =15 .76 ,P=0 .015) ,in which the age 25- <30 years group had the highest HBV infection rate .At the same time the signifi-cant differences in the geographical distribution and medical departments existed .The HBV infection positive rate in rural area was significantly higher than that in city with statistical difference (χ2 =27 .47 ,P<0 .05) ,and the HBV infection positive rate in the outpatient departments was higher than that in the inpatient departments with statistical difference (χ2 =46 .88 ,P<0 .05) .Conclu-sion Children bearing women at 20-34 years old show the highest HBV infection rate .The HBV screening and the works of pre-vention and treatment during this age period should be strengthened ,which conduces to discover the HBV infection positive patients in time and prevent the mother-to-fetus transmission .