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.

In order to expand the capabilities of hospital's traditional ECG device and enhance medical staff's work efficiency, an ECG monitoring system based on internet of things is introduced. The system can monitor ECG signals in real time and analyze data using ECG sensor, PDA, Web servers, which embeds C language, Android systems, .NET, wireless network and other technologies. After experiments, it can be showed that the system has high reliability and stability and can bring the convenience to medical staffs.
Electrocardiography ; Internet ; Monitoring, Physiologic ; Reproducibility of Results ; Wireless Technology

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.

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.

BACKGROUND: Resent studies demonstrate that sciatica is caused by inflammatory reaction of nucleus pulposus, and dorsal root ganglion (DRG) is in involved in this process; however, its pathophysiological changes remain poorly understood. OBJECTIVE: To explore pathogenesis of sciatica related to nucleus pulposus protrusion without mechanical compression. METHODS: Totally 24 male SD rats were randomly divided into the experimental group and control group, with 12 rats in each group, The coccygeal intarvartebral discs of rats were opened to obtain 5 coccygeal nucleus pulposus, mixed with 50 μL physiological saline to prepare suspension. Rats in the experimental group were prepared non-compressive models by injecting suspension to the epidural cavum of rats. Meantime, the same volumes of physiological saline were injected into rats in the control group. The rat hind paw mechanical withdrawal thresholds were measured, pain-related behavior and dorsal root ganglion morphology were observed. RESULTS AND CONCLUSION: In the absence of mechanical pressure, disappearance of the nucleolus, degeneration of the nuclear membrane and significant hyperalgesia derived by auto-transplantation of nucleus pulposus to the epidural cavum of rats were observed. Dorsal root ganglion cells often had hyperemia, edema and intracytoplasmic vacuoles, with large and irregular nuclei. Prominent Nissl bodies were not seen. The Inflammatory reaction derived by autograft nucleus pulpcsus is an important factor in DRG injury and sciatica.

Objective To evaluate the use of pediatric clinical illness score(PCIS) and pediatric risk of mortality(PRISM) in severe cases in pediatric intensive care unit(PICU). Methods 580 patients were divid-ed into groups according to PICS results, death and the numbers of organ failure. Severity, mortality were ana-lyzed. PRISM scores were also investigated in these groups respectively. Results The PRISM score of the ex-tremely-severe group was higher than that of the severe group and the non-severe group(P<0.01). The mean value of scores in death group was higher than that in survival group(P<0.01). The PRISM scores was in-creasing along with the growing numbers of organ failure (P<0.05). Conclusion Both PCIS and PRISM scores have good clinical value in assessing the severity and risk of death in patients in PICU.

Objective Satellite cells(SCs) transplant was tried to treat myocardium infarction(MI) in human.Methods 10 patients who affected by coronary artery disease(CAD) and MI were selected.A piece of muscle was taken away from their quadriceps femoris 2 weeks before surgical operation.SCs were extracted,purified,cultured by modified Dorfman method,and then transplanted into the MI area by intramyocardial injection after CABG.EKG,UCG,99cTc-SPECT cardiac blood pool imaging,18F-FDG myocardial perfusion imaging were examined before operation and 3 months after operation.The cell metabolism status in the MI area were observed and LVEF were measured and analyzed by paired-samples t test with SPSS13.0 statistics software.Results After cultured in vitro for3 days,SCs were spindleshaped,and sticked to walls.SCs growth was stasis,fused into each other,and formed myotube when the cells were delayed to divide Petri dish or the concentration of fetus bovine serum(FBS) in the culture medium was reduced.Average 2.7 blood vessel bypass were established in these patients.SCs were transplanted merely in one patient whose coronary arteries were extensively sclerosed.No patients died in hospital.Heart function of these patients were recovered to NYHA I 3 months after operation.Their symptoms of angina pectoris were disap peared and quality of life was improved obviously.The cell metabolism activity was appeared again in the MI area 3 months after operatio(including the patient without CABG).LVEF were increased(9.70±4.17)% than preoperation.There is significant deviation between them(P<0.01).Conclusions Autograft of SCs can be alive in the MI area,and SCs can improve the heart function by participating the heart's systole and diastole activity directly or by altering cardiac compliance and stimulating the blood capillary proliferation.

Objective To investigate the effect of VIP on gut barrier function in rats with acute neerotizing panereatitis (ANP). Methods Fifty four SD rats were randomly divided into three groups: sham operated (SO) group,ANP group and VIP group. Each group was subdivided into 1h, 6h and 12h subgroup after the models were established and each subgroup had 6 rats. The models of ANP were indueed by retrograde injection of 4% sodium taurocholate into the pancreatic duet. VIP group was induced by 5 nmol VIP intraperitoneal injection within 5 minutes after the establishment of ANP model. The serum VIP and intestinal homogenate VIP were detected with ELISA. The serum endotoxin was tested by MB-80 microbes dynamic detecting system. The expression of TNF-α, IL-6, IL-10 mRNA in gut mncosa were determined by RT-PCR.Intestinal samples were harvested for pathological examination. Results The intestinal structure was significantly damaged in ANP group, and the extent of pathological changes were ameliorated in VIP group.The serum and intestinal homogenate VIP levels 6h after the establishment of ANP model were (49. 582 ±3. 735) pg/ml and (87. 731 ±4.601 ) pg/g pro, respectively, which were significantly lower than that of SO group (P ＜ 0.05 ). 12 h after the establishment of SAP model, the serum and intestinal homogenate VIP levels in ANP group were (65. 192 ± 5. 785) pg/ml and ( 110. 978 ± 6. 420) pg/g pro, respectively, which were significantly higher than that of SO group. The serum endotoxin, expression of TNF-α, IL-6, IL-10 mRNA in gut mucosa were(29.570 4-5.127)pg/ml,0.861 ±0.081,1.150 ±0.187 and 0.786±O.102,respectively,which were significantly higher than those of SO group(P＜0.05).The serum endotoxin,expression of TNF-α,IL-6 in gut mucosa in VIP group 6h after establishment of ANP model were(20.486 ±2.81 1)pg/ml,0.707±0.095 and 0.889±0.136,respectively,which were significantly lower than those of ANP group(P＜0.05).The expression of IL-10 mRNA in VIP group was 0.992 ±0.126,which was significantly higher than that of ANP group(P＜0.05).Conclusions VIP had significant protective effects on gut barrier function in rats with ANP.