OBJECTIVE:To study the identification problems of pharmacokinetic compartment models.METHODS:Problems of the identification of classical compartment models in single administration were systematically discussed by Laplace transformation method.RESULTS:The classical compartment models in single administration don't have the character of u-niqueness and the identification for which is a problem.CONCLUSION:The drug level in plasma and the concentration of drugs that distributed in organs were in a direct ratio under the condition of two kinds of unidentifiable classical compartment models,in that case,it has theoretic bases and significance to predict the concentration of drugs that distributed in organs or target organs by means of determining the drug concentration in plasma;if on the other hand,if two kinds of classical com-partment models are identifiable,the drug level in plasma and the concentration of drugs that distributed in organs or target organs wouldn't be in a proportional relationship,in this case,it is advisable to make sure the relationship between the drug le_ vel in plasma and the concentration of drugs that distributed in organs or target organs before predicting drug concentration that distributed in organs or target organs by means of monitoring the drug concentration in plasma;otherwise,it is baseless and meaningless.

Objective To investigate the potential factors that may be associated with clinical significant endoscopy findings (CSEF) and the characters of the appropriate patients for upper endoscopy.Methods Information of the out-patients was collected from the questionnaires that were performed before undergoing upper endoscopy from 26 September 2011 to 23 December 2011,including demographics characteristics,symptoms,gastroesophageal reflux disease questionnaire (Gerd Q) score,comorbidities,medication and purpose for upper endoscopy.The analyses were performed by Logistic regression to find the potential factors that were associated with CSEF.Results A total of 942 cases were enrolled.There were 471 (50.0％) patients with dyspepsia and reflux symptoms,300(31.8％)patients with dyspepsia and without reflux symptoms,and 86(9.1％)patients with reflux symptoms and without dyspepsia.Sum to 325 (34.5％) patients were diagnosed with CSEF,119(12.6％) with erosive esophagitis,28(3.0％) with Barrett esophagus,102 (10.8％)with peptic ulcers,66 (7.0％) with gastric dysplasia,and 13 (1.4％) with upper malignancy.Multivariate Logistic regression analysis showed that men (OR=1.677,95％CI:1.148 to 2.451),older age (OR=1.032,95％CI:1.021 to 1.044),alcohol intake (OR=1.761,95％CI:1.068 to 2.903),Gerd-Q score increase (OR=1.079,95％ CI:1.003 to 1.160),and presence of acid regurgitation (OR=1.659,95 ％CI:1.143 to 2.408) were significantly associated with increasing risk of diagnosis for CSEF,while taking proton pump inhibitors (OR=0.298,95％CI 0.109 to 0.818)was associated with lower possibility of detection.Conclusions Factors such as male,older age,alcohol intake,Gerd-Q score increase,presence of acid regurgitation and taking proton pump inhibitors,may have a certain significance for screening out patients and further improving the cost efficiency of gastroscopy.

Objective To study the changes in and correlations between the partial pressure of end-tidal carbon dioxide (PETCO2) and the coronary perfusion pressure during cardio-pulmonary resuscitation (CPR) based on the cardiac arrest dog models of ventricular fibrillation by electric shock. Methods 36 healthy dogs were evenly randomized into 3 groups including 4 minutes close-chest CPR(CCCPR) group, 4 minutes open-chest CPR(OCCPR) group, and 8 minutes OCCPR group. There were 12 dogs in each group, half male and half female. In the process of CPR, all parameters about PETCO2 and CPP were recorded. Results In the 4 minutes CCCPR group, the correlation coefficient between the CPP and the PETCO2 was 0.992 (P<0.05), which was in positive linear correlation. In the 4 minutes OCCPR group, the correlation coefficient between the CPP and the PETCO2 was 0.937 (P < 0.05), which also showed positive linear correlation. In the 8 minutes OCCPR group, the correlation coefficient between the CPP and the PETCO2 was 0.952 (P<0.05), and was also in positive linear correlation. The percentage of ROSC was 66.7(8/12) in the 4 minutes CCOPR group, 100%(12/12) in the 4 minutes OCCPR group and 58.3%(7/12) in the 8 minutes OCCPR group. There were statistical differences in CPP, PETCO2 between models with ROSC and without ROSC at 1, 2, 5, 10, 15 and 20 mins of CPR (all P<0.05). Conclusions This research shows that there is a close positive linear relationship between the coronary perfusion pressure and the PETCO2, and PETCO2 could be used to evaluate the prognosis of the CPR.

The pathogenesis of drug-induced Iiver injury( DILI)remains uncIear. AccumuIating evidences in recent years showed that immunoIogicaI factors pIay important roIe in the pathogenesis of DILI. In this articIe,we summarized recent studies on immunoIogicaI factors invoIved in pathogenesis of DILI and compared the immunity mediated DILI with drug induced autoimmune hepatitis. The advances in study on immunoIogicaI factors in DILI wiII have significant impact on prevention and treatment of DILI and autoimmune hepatitis.

Objective To study changes and meaning of serum IL -4,IL -10,IFN -gamma,TGF -beta 1 level in patients with delayed encephalopathy after carbon monoxide poisoning.Methods From January 2011 and June 2014 in our hospital,40 cases of DEACMP patients were selected as group A;the 40 patients with DEACMP was divided into 12 cases of mild cognitive dysfunction,mild cognitive dysfunction in 20 cases,8 cases of severe cognitive dysfunction.40 cases with acute carbon monoxide poisoning (ACMP)patients were selected as group B;40 cases of healthy subjects were selected as healthy controls.Serum interleukin 4 and interleukin 10(IL -4)(IL -10),interfer-on gamma (IFN -gamma),conversion,growth factor beta 1 (TGF -beta 1)content were tested.Results In Group A and group B serum IL -4 levels were lower than that of healthy controls (P <0.01),and serum levels of IL -10 in group B were higher than that in group A and healthy controls (P <0.01),serum level of IFN -gamma in group A and group B was higher than the healthy controls (P <0.01),and in group A IFN -gamma levels were higher than group B (P <0.01),while in group A serum TGF -beta 1 level was lower than B group and the control group (P <0.01),and in group B TGF -beta 1 level was higher than the control group (P <0.01);With cognitive impairment aggravating of DEACMP patients,IL -4,IL -10,TGF -beta 1 levels were on the decline,and IFN -gamma level was increasing (P <0.01).Conclusion DEACMP patients serum and cerebrospinal fluid of IL -4,IL -10,IFN -gam-ma,TGF -beta measures such as abnormal expression,showed that the onset of DEACMP may be related to neural immune injury.Serum IL -4,IL -10,IFN -gamma and TGF -beta of DEACMP patients exists abnormal expression Serum IL -4,IL -10,IFN -gamma and TGF -beta levels are also related to the degree of cognitive impairment of DEACMP patients.The onset and progress of DEACMP may be associated with neural immune injury.

Objective To observe the effect of intermittent and continuous blue light therapy for pathological neonatal jaundice,and to evaluate the prognosis of newborns.Methods 214 patients with pathologic neonatal jaundice who treated with blue light irradiation were slected,they were randomly divided into two groups according to the admission number combined with single and double numbers,107 patients in each group.Group A received continuous blue light irradiation treatment.Group B received intermittent blue light irradiation.The clinical efficacy and prognosis of children,blue light exposure time,serum total bilirubin (TBiL) recovery time,the hospitalization time and the adverse reactions during the treatment were observed.The levels of serum TBiLwere measured before and after light exposure 3,5 days.Results The total effective rate of group B was 97.18％ (104/107),which was higher than that of group A [90.65 ％ (97/107)],the difference was statistically significant (x2 =10.30,P ＜ 0.05).The time of blue light irradiation and hospital stay time of group B were (71.59 ± 7.05) d and (11.51 ± 1.23) d,respectively,which were significantly shorter than those of group A [(79.54 ± 6.82) d and (13.64 ± 1.18) d],the differences were statistically significant (u =11.42,9.87,all P ＜ 0.05).The level of TBiL of group B was (96.28 ± 10.25) μmol/L,which was significantly lower than (104.52 ± 10.31) μmol/L of group A (u =8.94,P ＜ 0.05).The incidence rate of adverse reactions in group B was 2.55％ (4/157),which was lower than that in group A [7.01％ (11/157)],the difference was statistically significant (x2 =9.66,P ＜ 0.05).The prognosis of neonatal in the two groups was good.Conclusion The intermittent and continuous blue light in the treatment of pathological neonatal jaundice has good clinical effect and the neonatal prognosis is good.The clinical efficacy of intermittent blue light irradiation is better,which can significantly shorten the treatment time and has higher safety.

Objective To discuss which is more efficient between Needle-knife precut and Plough-knife precut in difficult biliary cannulation. Methods The difference in the average time of cannula, percentage of cannula achieve-ment and the complication rate between the two kinds of operation were compared. Results The percentage of can-nula achievement about the Needle-knife precut is higher than Plough-knife precut, while there is no notable differ-ence in average time of cannula and the complication rate between the two precuts. Conclusion Needle-knife precut is more efficient than Plough-knife precut in difficult biliary cannulation, if guide wire can not get into pancreatic duct.

Objective To observe and discuss the effect of using the self-made pressure reduction bilateral nasal oxygen tube to prevent the ear pressure sore for the comatose patients. Methods Totally 86 cases of comatose patients which needed permanent oxygen inhale admitted during Jan 2016 to Dec 2016 were divided into observation group and control group:Each group 43 cases. Observation group used self-made pressure reduction bilateral nasal oxygen tube to inhale the oxygen, control group used the conventional disposable bilateral nasal oxygen tube to inhale the oxygen and the pressure ulcer stage. Results There was no significant difference in Braden score in two groups, the difference was statistically significant (P>0.05) . Observed two groups patients′ nasal oxygen tube ear pressure sore situation, these were only 2 patients happened nasal oxygen tube ear pressure sore in observation group, on the contrary, these were 9 patients happened in control group, occulting probability was higher than observation group significantly. and the extend of the pressure sore is much serious than the observation. Difference was statistically significant (χ2=5.11, P<0.05). Conclusions During the privation of the nasal oxygen tube ear pressure sore for the comatose patients, self-made pressure reduction bilateral nasal oxygen tube can alleviate the ear skin pressure effectively, reduce the pressure sore occur, the effect is obvious, nursing quality is improved, deserve the clinical expansion.

OBJECTIVE:To evaluate the application of cost-utility analysis in health area of China in recent year. METH-ODS:From CNKI,Wanfang and VIP database,settingcost utilityorcost-utilityastitleorkeyword,related literatures were retrieved during Jan. 2011-Dec. 2015,with subject field ofmedical science and technologyin CNKI,medical sciencein Wanfang database,clinical medicineChinese medicinepreclinical medicinepreventive medicine hygieneorpharmacyin VIP. The comprehensive evaluation involved research design,research perspective,cost measurement,utility index and measure-ment method,cost-utility analysis index,discount and sensitivity analysis. RESULTS:A total of 31 literatures meeting inclusion cri-teria were selected,including 12 prospective studies,9 retrospective studies,9 Markov model studies,1 mixed study. Thirteen lit-eratures worked in medical institutions. Seven literatures explicitly mentioned research perspective;most literatures only measured direct cost(19 literatures)and adopted QALY as utility index(27 literatures). Twenty eight literatures described measurement meth-od of utility index(direct measurement,indirect measurement or literature method)in detail. More than half(16 literatures)analyzed cost-utility by using cost-utility ratio(CUR);7 literatures adopted incremental cost-utility ratio(ICUR)and 6 literatures adopted both CUR and ICUR. Five literatures used the threshold of ICUR. Eleven literatures described discount,and the majority was Markov mod-el study. Sensitivity analysis was conducted in 16 literatures,among which 11 literatures adopted single factor analysis. The most com-monly involved influential factor was cost,followed by utility value and discount rate. CONCLUSIONS:Cost-utility analysis has been widely used in China,but the quality and normalization of studies have much room for improvement. Learning more experiences from international researches can help to promote the quality of domestic studies,guide the practice of clinical rational use of drugs and sup-port the government decision-making process and medical insurance payment in the future.

Radiotherapy plays a significant role in the treatment of lung malignant tumor.However,as the most main complication of radiotherapy used to treat lung malignant tumor,radiation-induced lung injury is an important influencing factor in impeding further and higher dose radiotherapy.Previous studies show that mesenchymal stem cells (MSCs) have the characteristics of self-replication,multiple differentiation,immunoregulation and directional migration. MSCs can help to repair many kinds of acute and chronic lung injury,meanwhile stem cell transplantation stimulates production of many cytokines to attenuate acute lung injury.So stem cell therapy provides a new kind of thinking in the prevention and treatment of radiation-induced lung injury.