Objective To assess the cost-utility and medical economics of surgjcal treatment for SAP.Methods A retrospective study of SAP patients admitted from January to December 2003 to Ruijin Hospital was carried out.The cost of treatment was obtained from financial department and patients questionnaire;health-related quality of life was assessed by using the SF-36 brief questionnaire and the results were compared with normal population and were converted into rQALY,then utility scores were obtained so as to conduct CUA (cost-utility analysis)and related factors were analyzed.Results 98 patients with SAP were discharged,85 were discharged healthy;of them,59 patients had complete records were followed up,2 died during follow up,with a mortality of 3.4%,one patients could not finish the questionnaire and 6 did not respond,finally 50 finished the questionnaire;the total cost in hospital was 9899095 yuan,per capita 101011 yuan;the corrected post-discharge cost was 681737 yuan;the total cost was 10580832 yuan.The cost of medication was the highest,which accounted for 56%of all the cost.The means and deviations for each of eight scales(PF,RP,RE,BP,VT,MH,SF,GH)scores of SF-36 in SAP patients were 83.00±14.64,61.5.0±42.32,68.67±36.52,79.98±14.90,68.80±18.94,72.40±14.75,75.00±17.53,64.70±18.28.compared with normal population,gained 1929.05 QALYs;the cost-utility analysis was 5485 yuan per QALY.The patient's age,length of stay,chronic co-morbidity was associated with the cost of treatment.Conclusions SAP treatment in surgery department was justified in medical economics.Medication contributed to the most part of total costs.The related factors of cost included age,length of stay and chronic co-morbidity.

Objective To investigate the change of intestinal barrier function and the protection of pentoxifylline (PTX) to intestinal barrier. Methods Fifty-four SD male rats were randomly divided into 3groups, including sham operation group, ANP group, PTX group. ANP rat model were induced by retrograde injection of 5% sodium taurocholate into pancreatic and bile duct. Rats in sham operation group underwent operation without injection of taurocholate. After ANP induction, the rats in PTX group received PTX at a dose of 25 mg/kg weight via penis vein. The rats were sacrificed 3, 6, 24 h after operation, the serum levels of amylase, D-lactic acid, TNF-α were determined. The pancreas tissue and terminal ileum were harvested for pathological examination; ZO-1 levels of ileum epithelial tight junction were analyzed by immunohistochemistry. Results Six hours after induction, the serum levels of amylase, TNF-α, D-lactic acid in ANP group were(9141±672)U/L, (347.96±79.47) pg/ml and (10.21±1.08 ) rmg/L, which were significantly higher than those in sham operation group [(1723 ± 57 )U/L, (134.09 ± 31.36 )pg/ml and (4.33 ±0.49)mg/L, P ＜0.01]. The serum levels of amylase, TNF-α, D-lactic acid in PTX group were (7965 ± 318 ) U/L, (238.48 ± 44.35 ) pg/ml and ( 8.75 ± 1.28 ) mg/L, which were significantly lower than those in ANP group, but they were significantly higher than those in sham group ( P＜0.05 or ＜0.01). The positive rate of ZO-1 was (3.29±0.36)% in sham operation group, and it was (1.91 ± 0. 32)% in ANP group,which was significantly lower than that in sham operation group (P ＜ 0.05 ); and the value was (2.53±0.43)%in PTX group, which was lower than that in sham group, but it was higher than that in ANP group(P＜0.05).Conclusions PTX may attenuate intestinal barrier function injury by decreasing the breakdown of intestinal ZO-1.

Objective To investigate the variation of procalcitonin(PCT) in blood and tissue level of acute pancreatitis rats and probe its significant. Methods One hundred and two male Wistar rats were randomly divided into control group ( n = 6 ), lipopolysaccharide group ( LPS, n = 24 ), acute edematous pancreatitis (AEP) group ( n = 24), acute necrotizing pancreatitis (ANP) group ( n = 24), AN P + LPS group ( n = 24). Subcutaneous injection of cerulein was used for AEP induction, while ANP model was induced by retrograde injection of sodium taurocholate into the biliary and pancreatic duct. The rats were sacrificed at 3,6, 18 and 24 hours after model induction. Pancreatic tissue was harvested and the pathological scores were assessed. Levels of PCT in serum, liver, lung, spleen, pancreas, small intestine, large intestine tissue was harvested and tissue levels of PCT were determined. Results AEP and ANP models were established successfully. At 6 h, the serum levels of PCT in control group, LPS group, AEP group, ANP group and ANP +LPS group were (0.0144 ±0.0082) ng/ml, (0. 1722 ±0.0449) ng/ml,(0.4751 ±0.0572) ng/ml, (0.7070 ±0. 1040) ng/ml and ( 1. 1960 ±0.8644) ng/ml, respectively; and the difference was statistically significant (P < 0.05 ). PCT could be detected in liver, lung, spleen, pancreas, small intestine and large intestine tissue of normal rats. PCT levels in liver and pancreas of ANP group were not statistically different, but the PCT levels in lung, spleen, and large intestine tissue significantly decreased, and the corresponding values were (5.63 ±0.62) ng/ml vs. (6.85 ±0.46) mg/ml, (4.73 ±1.27) mg/ml vs. (6.88 ±0.37) ng/ml, (1.08 ±0.52) ng/ml vs. (4.12 ± 1.02) ng/ml (P <0.01 ). However, the PCT levels in small intestine significantly increased, which were (2.51 ±0.90) ng/ml vs (0.98 ±0. 12) ng/ml (P<0. 01). Conclusions Serum PCT level was associated with the severity of AP and infection; the changes of PCT levels in different tissues may be related with the changes of organ's function.

As a first-line classical drug, glucocorticoids are used in most combination treatment regimens of keloid. However, there are issues such as poor treatment efficacy and recurrence of keloid after keloid was treated with glucocorticoids, which seriously affect the therapeutic effect. In recent years, many studies have explored the factors influencing the efficacy of glucocorticoids in treating keloid and the action mechanism of glucocorticoids from different perspectives. Based on this, this paper reviews the mechanism and the factors influencing the efficacy of glucocorticoids in treating keloid, and explores ways to improve the treatment efficacy of glucocorticoids, aiming to provide thoughts for improving glucocorticoid-related diagnostic and therapeutic strategies.