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

OBJECTIVE:To observe the clinical effect of tiotropium bromide combined with salmeterol xinafoate and fluticasone propionate in the treatment of medium and severe COPD. METHODS:119 patients with medium and severe COPD were divided into control group(54 cases)and observation group(65 cases)according to admission order. Control group was treated with Salmeterol xi-nafoate and fluticasone propionate powder for inhalation 50 μg,bid;observation group was additionally given Tiotropium bromide powder for inhalation 18μg,qn. Both groups received 1 month of treatment. Lung function indexes as FEV1,FVC and IC,blood gas indexes as SaO2,PaCO2 and PaO2 and inflammatory factors as IL-8 and TNF-α,COPD assessment test(CAT)score were observed in 2 groups,and the occurrence of ADR was also observed. RESULTS:Before treatment,there was no statistical significance in above indexes between 2 groups(P>0.05). After treatment,FEV1,EVC,IC of observation group were increased significantly,SaO2 and PaO2 of observation group were increased significantly,while PaCO2,IL-8 and TNF-αlevels was decreased significantly;those index-es of observation group were significantly better than those of control group,with statistical significance(P<0.05). CAT score of 2 groups were decreased significantly compared to before treatment,and the observation group was significantly lower than control group,with statistical significance(P<0.05). No obvious ADR was found in 2 groups. CONCLUSIONS:Tiotropium bromide com-bined with salmeterol xinafoate and fluticasone propionate shows good clinical efficacy and safety in the treatment of medium and se-vere COPD.

Intrahepatic cholangiocarcinomas (ICCA) are primary intrahepatic malignancies originating from biliary epithelia.While both hepatocellular cancer and ICCA can present as mass lesions within the liver,these cancers are distinct in their morphology,etiology,pathology,natural history and response to therapy.There is a need for accurate and sensitive molecular markers for the diagnosis of ICCA.Recent advances in elucidating molecular and genetic characteristics of ICCA offer the potential of molecular-based diagnosis of ICCA.Specific genetic mutations of IDH1/2,BAP1,p53,and KRAS,FGFR gene fusions and alterations in microRNA have all been described in ICCA.Although there are no accurate serum or biliary biomarkers currently available for diagnosis of ICCA,several potential candidates have been identified.Knowledge of specific genetic or molecular abnormalities offers potential for individualized approaches for the treatment of patients with ICCA in the future.

Acid-related disorders are commonly seen diseases of upper digestive tract which are closely related to acid attack.Antacids and acid inhibitors are the main drugs in the therapy of acid-related disorders.There are complex interrelationships between antacids and acid inhibitors and other drugs.This article reviewed the application and evaluation of antacids and acid inhibitors in acid-related disorders.

OBJECTIVE: To containment the unhealthy tendency in drug purchase and to promote the healthy and harmonious development of heath service.METHODS: Honest government risk prevention & control pattern was established in our hospital,and the system construction was strengthened,furthermore,a scientific operation flow was formulated,and a system of rewards and disciplinary evaluation was established.RESULTS: With the honest government risk prevention & control pattern,the centralized public bidding was achieved in 100% of the hospital drug purchasing,the clinical drug use tends to be more and more rational and standard,and the drug use structure became more reasonable,the honest government risk in drug purchase and sale has been effectively avoided.CONCLUSION: This honest government risk prevention & control pattern is practical and feasible thus deserving popularized in medical institutions.

Objective To investigate the relationship between plasma cell mastitis and prolactin. Methods The relationship between the lesion area , degree of inverted nipple and prolactin level of 228 plasma cell mastitis patients were observed , as well as their prolactin level before and after treatment , to explore the factors that influence relapse. Results There was no significant statistical relationship between prolactin level and lesions area and degree of inverted nipple. Prolactin level before and after treatment were statistically different (t =2.347,P = 0.02). Menstrual status, nipple status, comorbidities, lesion area and prolactin level were considered, only prolactin level was related with disease recurrence (P = 0.038). Conclusion prolactin level could significantly reduced as the disease cured , but elevated prolactin may lead to relapse of the disease.

The increasing need for ideal body shape makes more and more patients choose to receive different types of breast reconstruction surgery after mastectomy. Right now, it is a key problem for the multidisciplinary treatment to find an optimal sequence of comprehensive treatment from which those patients can receive the maximum benefits and a good balance between ideal body shape and satisfactory antitumor outcomes. This paper reviews the latest research advances in the effect of postoperative radiotherapy on breast shape after breast reconstruction, the sequential relationship between the replacement of the temporary tissue expander with the permanent breast prosthesis and postoperative radiotherapy, breast construction surgery, and radiotherapy techniques. To provide a basis for clinical practice, this paper proposes a flow chart for decision?making in reconstruction surgery and adjuvant treatment based on the current literature and clinical data.

Objective To compare the effects of glutathione and tiopronin in chemo -induced liver injury respectively.Methods 122 patients with gastrointestinal cancer who were diagnosed with chemo -induced liver injure were chosen.According to random number table,they were divided into treatment group(63 cases)and control group(59 cases).The control group were given glutathione 1.8g/d intravenously,while the treatment group were given tiopronin 0.2g/d.Both treatments lasted a week.Liver function indexes before /after the treatment were observed respectively,as well as the symptoms of every patient.The adverse drug reactions of both treatments were also observed.Results The remission ratio of the treatment group and the control group was 90.48% and 81.35%, respectively,the difference of the two groups was statistically significant(χ2 =7.65,P <0.05).The liver function indexes of the two groups before the treatment had no significant differences(t =0.75,1.23,0.97,0.95,all P >0.05);after both treatment the indexes were significantly improved,and ALT,TBIL,AST and ALP between the two groups were significantly different(t =4.67,6.13,4.76,6.90,all P <0.05).The adverse drug reactions of the two groups had no significant difference(χ2 =0.42,P >0.05),and no severe adverse drug reactions were observed in our research.Conclusion Tiopronin is more effective in treating chemo -induced liver injure caused by capetcitabine /5-FU and oxaliplatin,when compared with glutathione.And no severe adverse drug reaction were observed in our research.