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.

AIM: To investigate the influence of matrine on cyclin E and cyclin A in U937 cell strain. METHODS: The inhibitory effect of matrine on proliferation in U937 cell strain was observed by MTT.The distribution of cell cycle was measured by flow cytometry.Immunocytochemical method and Western blot were used to detect the protein expression of cyclin E and cyclin A. RESULTS: After being treated with matrine,the proliferation of U937 cell strain was inhibited significantly,the inhibiting effect conformed to time and dose-dependence,cells were arrested in S-phase.The expression of cyclin E and cyclin A was down-regulated significantly in a dose-dependence manner. CONCLUSION: Matrine could reduce the expression of cyclin E and cyclin A and inhibit the proliferation in U937 cell strain.

Objective To investigate the clinical significance of ambulatory blood pressure monitoring in short-term prognosis of acute inferior myocardial infarction patients .Methods A total of 80 patients with acute inferior myocardial infarction received 24 hours ambulatory blood pressure monitoring after enrolled .According to the results of 24 hours ambulatory blood pressure monito-ring ,eligible patients were divided into dipper model group(n=29) and non-dipper model group(n=51) .Clinical information was collected and all patients were followed-up for major adverse cardiovascular events (MACE) .Results The rate of intravenous thrombolysis in dipper model group was significantly higher than that in non-dipper model group(t=4 .120 ,P=0 .021) .Night mean systolic blood pressure and night mean diastolic blood pressure were all significantly lower in dipper model group than in non-dipper model group(t=2 .032 ,P=0 .040 ;t=3 .175 ,P=0 .002) .The rate of cumulative MACE in non-dipper model group was significant-ly higher than that in dipper model group(t=2 .626 ,P=0 .041) .Multivariate logistic regression analysis showed that ,daytime mean systolic blood pressure(<90 mm Hg) was independent risk factor of MACE(P=0 .018 ,OR=1 .298) ,dipper model blood pressure (P=0 .019 ,OR=0 .769) and intravenous thrombolysis(P=0 .007 ,OR=0 .520) were protective factors for MACE .Conclusion Parameters of ambulatory blood pressure monitoring are closely correlated with prognosis of acute inferior myocardial infarction pa-tients ,and the change of blood pressure model is an important factor for short-term prognosis .

Objective To observe the application of alkaline cleaning agent in disinfection and supply room cleaning of medical devices, to evaluate the cleaning quality. Methods The 800 contaminated medical instruments collected from February 2016 to February 2017 in municipal maternal and child health hospital were divided into control group (February 2016 to August 2016) and study group (September 2016 to March 2017 ) according to different time periods,with 400 pieces in each group.In the reference group, the instrument was washed with multienzyme detergent, and the study group was cleaned with alkaline detergent. The cleaning of 2 groups of instruments was observed and compared. Results The total excellent and good rate of instrument cleaning in the study group was 97.25％ (389/400), in the reference group was 89.50％(358/400), the difference between the two groups was statistically significant (P<0.05); the cleaning safety, practicality, economy, comprehensive score difference of the study group was significantly better than the reference group (P<0.05). Conclusion The effect of alkaline cleaning agent used in disinfection supply room cleaning medical instruments is remarkable, and the equipment residue and microorganism can be effectively eliminated, and the utility model has the advantages of high safety and low economic cost, and has the important practical value.

TLR4 signaling pathway plays an important role in regulation of the innate immune response and the adaptive immune response.Studies have shown that TLR4 signaling pathway is closely associated with the immune inflammatory process in major depressive disorder,but the underlying mechanisms are not clear.The pathophysiological process of depression involves multiple molecule mechanisms and signal pathways.The change of TLR4 signaling pathways exists in the peripheral circulation system or the central nervous system of depressive patients and depression animal models.The activation of TLR4 signaling pathways is associated with stress-inflammation-depression approach and leaky gut hypothesis,however,the relationship of peripheral and central TLR4 signaling pathways is not clear yet.TLR4 signaling pathway may be potential targets for the anti-inflammatory treatment of depression.

0.05).Conclusions Laparoscopic-assisted radical gastrectomy for gastric cancer is safe and effective,and its short-term outcome is similar to open surgery.

Objective To examine the effect of mycophenolic acid(MPA)on mesangial cell(MC)proliferation and on expressions of transforming growth factor-?(TGF-?)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-? and CTGF were measured by Western blot.Results MPA inhibited the MC proliferation and expressions of TGF-? and CTGF induced by high glucose.Conclusions MPA decreases the release of extracellular matrix by inhibiting the MC proliferation and expressions of TGF-? and CTGF,and subsequently slows the development of glomerulosclerosis in diabetic nephropathy.

Objective s To investigate the value of Doppler ultrasound in diagnosing active sacroiliitis of axial spondyloarthropathy (axSpA) patients.Methods The Doppler ultrasound and MRI data of 51 patients with early axSpA was retrospectively analyzed.According to MRI results,axSpA patients were divided into active sacroiliitis (active group) and inactive sacroiliitis (inactive group).The color flow display and blood flow resistance index (RI) were compared.Considering MRI as the diagnostic standard,ROC curve was used to evaluate the diagnostic efficacy of RI in detecting active sacroiliitis.Results There were 32 cases wth 58 joints (6 cases were single active sacroiliitis) in activity group and 19 cases with 38 joints in inactivity group.The flow signals demonstration rate of sacroiliac joint in activity group (51/58,87.93％) was higher than that in inactive group (26/38,68.42％;x2 =5.505,P=0.019).There was no statistical difference of the indegree of blood flow between the two groups (Z=-1.93,P=0.053).RI in active group (0.59±0.08) was lower than that in inactive group (0.71±0.09;t=-6.04;P＜0.001).Taking RI=0.64 for diagnosis of active sacoriliitis in axSpA patients,the sensitivity,specificity and accuracy rate were 80.8％,74.5％ and 78.7％,respectively.Conclusion Through observing abnormal blood flow signals around and internal the sacroiliac joints,ultrasonography can response active sacroiliitis in axSpA patients with higher accuracy.

Abnormal endothelial growth factor receptor transportion was involved in the development of tumor so more and more researches focus it as a target of anti-tumor therapy. Based on the known mechanism in EGFR mis-localization this review summarized the latest research progress in the abnormality in signal of EGFR transportation and its role in tumori?genesis, anti-tumor drug and therapy that target to EGFR. It is aim to provide reference for the development of anti-tumor treatments which target EGFR and for the mechanism in resistance of anti-tumor.