Objective To evaluate the outcome of hepatitis B vaccination strategies performed over the past 14 years and different alternatives recommended for future immunization programs from the point of view of economic efficacy.Methods Methods used would include:process of decision analysis including building the tree:populating the model with parameters;estimating expected cost benefit and effectiveness and deterministic and probabilistic sensitivity and threshold analysis.Results In China，over the past 14 vears from 1992 to 2005.around 5.348 billion Chinese Yuan were provided for hepatitis B vaccination but the total benefits were 272.825 billion Yuan,with net benefits as 267.477 billion Yuan.The cost for each infection averted was 81.99 Yuan while the benefit of one Yuan being invested had 51.01 Ynan in return.For the future recommendations,data from the study revealed that the priority of hepatitis B vaccination for new borns and vaccinations plus passive immunization of newborns of HBsAg positive mothers were most effective approaches.If the other population as adolescents was included into the vaccination program,then screening for hepatitis B virus markers before accepting the vaccination appeared to be one of the most cost-saving strategies.Sensitivity and threshold analyses showed that hepatitis B virus marker Was the most important factor,followed by the cost of vaccine,vaccination coverage and vaccine efficacy,in order.Conclusion Routine vaccination of infants in successive birth cohorts to prevent HBV transmission was a cost-effective strategy administrated over the past 14 years in China.In the following years,the immunization of newborns was still the preferential strategy from a societal perspective.However,vaccination provided to other population including adolescents seemed economically less attractive.

Objective: To investigate the current status of antithrombotic strategy for elderly patients with atrial fibrillation (AF) and acute coronary syndrome (ACS) after stent implantation in Beijing area and to study the safety and efficacy of different therapeutic strategy. Methods: A total of 467 relevant patients were enrolled by re-travelling electronic medical records from 12 hospitals in Beijing area. The patients' mean age was (78.70±3.32) years and they were divided into 2 groups by antithrombotic therapy condition: Triple therapy group, n=17 (3.64％), Double therapy group, n=450 (96.36％). The incidence of major adverse cardiac and cerebral events (MACCE) including all-caused death, non-fatal myocardial infarction, stent thrombosis, target vessel revascularization (TVR), stoke and bleeding was compared between Triple therapy group and Double therapy group.Results: The medication in Double therapy group included aspirin+ticagrelor, aspirin+clopidogrel, clopidogrel+warfarin and cilostazol+clopidogrel; in Triple therapy group was aspirin+clopidogrel+warfarin. Patient with HAS-BLED score≥3 was defined as high risk of bleeding and they were all treated by double therapy; HAS-BLED<3 was defined as low risk of bleeding, only 5.03％ patients were treated by triple therapy. 3 patients in Triple therapy group and 33 in Double therapy group suffered from gastrointestinal bleeding, P=0.338; 6 patients in Triple therapy group and 128 in Double therapy group had MACCE, P=0.589; 3 and 80 patients died in Triple therapy group and Double therapy group, P=0.766. Conclusion: Triple therapy was rarely used in elderly AF and ACS patients after stent implantation, double therapy was the main strategy; the incidence of MACCE and mortality were similar between triple and double therapies; patients with triple therapy had the higher incidence of gastrointestinal bleeding.