PURPOSE: This analysis was conducted to evaluate the cost-effectiveness of gemcitabine-cisplatin chemotherapy for non small-cell lung cancer patients in an outpatient setting compared with the traditional inpatient setting. METHODS: A cost-effective analysis was conducted from a societal perspective. The effects of treatment, which was measured as an adverse event rate, were abstracted from a published literature search and empirical data from one university hospital. The costs included both direct and indirect costs. Direct costs included hospitalizations, outpatient visits, and lab tests. Pharmaceutical costs were excluded in analysis because they were same for both options. Indirect costs included productivity loss of patients as well as care-givers. In order to determine the robustness of the results, sensitivity analysis on treatment protocol was conducted. RESULTS: Literature search showed no difference in adverse effect rates between inpatient treatment protocol and outpatient treatment protocol. Therefore, this analysis is a cost-minimization analysis. Cost-savings in the outpatient setting was 555,936 won for one treatment cycle. Our sensitivity analysis indicated that the outpatient chemotherapy still showed cost-savings, regardless of changes in treatment protocol. CONCLUSION: The outpatient gemcitabine-cisplatin chemotherapy for non small-cell lung cancer resulted in cost savings compared to inpatient chemotherapy. More importantly, outpatient chemotherapy could improve the utilization of health service resources in terms of available beds.
Antineoplastic Combined Chemotherapy Protocols/*economics/therapeutic use ; Carcinoma, Non-Small-Cell Lung/*drug therapy/*economics ; Cisplatin/*economics/therapeutic use ; Cost Allocation ; Cost-Benefit Analysis ; Deoxycytidine/*analogs & derivatives/economics/therapeutic use ; Humans ; Lung Neoplasms/*drug therapy/*economics ; Outpatients

No abstract available.
Eczema, Dyshidrotic* ; Guillain-Barre Syndrome* ; Immunization, Passive* ; Immunoglobulins*

Morphological changes of hepatic microcirculation, especially in the peribiliary plexus, in cirrhotic livers of rats induced by repeated intraperitoneal injections of N-diethyinitrosamine (DEN) (100mg/kg/week) were studied by scanning electron microscopy. Control rats were treated with saline. The livers were perfused with saline and injected with methyl-methacrylated resin (Mercox CL-2B) through the thoracic aorta. Diffuse nodular changes mimicking human cirrhosis were seen in the livers six weeks after injections of DEN. The cirrhotic livers showed an increase of vascular channels composed mainly of venous branches around the regenerating nodules and increased arterioloportal anastonloses. Peribiliary plexi of the cirrhotic livers had more vessels than those of the controls. Many dilated veins and ramificating portal vein branches were also Present. Direct connections between peribiliary plexi and sinusoids or between peribiliary plexi and portal veins were increased in the cirrhotic liver. These results suggest that the peribiliary plexi in experimentally induced cirrhotic liver might play a role in a collateral circulation under a state of portal hypertension.
Humans ; Rats ; Animals

Objective To study the expression of intermediate-conductance-Ca~(2+)-activated K~+ (IKCa1)channels in endometrial cancer and its role in regulating proliferation of endometrial cancer cells. Methods Western blot and RT-PCR were used to examine the expression of IKCa1 channels in 13 normal endometrial specimens and 25 endometrial cancer specimens;and RNA interference(RNAi),[ ~3H ] thymidine incorporation,and inhibitor of IKCa1 channel were used to explore the role of IKCa1 channels in regulation of proliferation of endometrial cancer cells HEC-1A.Results The expression rate and level of IKCa1 mRNA in endometrial carcinoma(84%,0.89?0.52)were higher than in normal endometria(8%, 0.14?0.12;P

Objective:To explore the association between CYP2D6 gene polymorphism of cytochrome and clinical response to atomoxetinein children with attention-deficit/hyperactivity disorder.Methods:Totally 111 Han Chinese boys meeting criteria for ADHD in the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edi-tion (DSM-IV)were recruited.Atomoxetine treatment was given in titrated doses in order to achieve optimal re-sponse.Behavior changes were measured with the ADHD Rating Scale (ADHD-RS)at baseline and after optimal doses were reached.The decrease of ADHD-RS scores were primary measures of the treatment effect,the scores of the items in the ADHD-RS was less than or equal to 1 for the remission criteria.The three SNPs of CYP2D6 genes(rs1080985,rs1065852,rs16947)were genotyped by polymerase chain reaction (PCR).Results:There was no asso-ciation between single polymorphisms andatomoxetine after adjusting for baseline rating scores (P >0.05).In con-trast,haplotype analysis revealed that some patients with GAC haplotype achieved significant remission [remission vs.non-remission haplotype frequency (rate):5 /56 (8.9%)vs.3 /164(1.8%),P <0.05 ].After multiple testing correction still existed significant trend(P =0.082)and also found correlation trends after correlation analysis be-tween GAC haplotype and clinical response to atomoxetine (P =0.078),8 patients with GAC haplotype carriers were all effective response to treatment,non-responders without this haplotype.Conclusion:These results suggest association between polymorphisms of CYP2D6 gene and ADHD better clinical improvement with atomoxetine treatment,it is worth further exploration in a large sample.

Objective:To examine the expression of nitric oxide synthase(NOS),the content of nitric oxide and blood flow in nasal mucosa of allergic rhinitis guinea pigs,so as to further investigate the mechanism of allergic rhinitis.Methods:One hundred and twenty guinea pigs were randomly divided into control group(injected with normal saline)and allergic group(nasal challenge with egg albumin).The guinea pigs were executed before and immediately,24,48,72 h after the last nasal challenge;the expression of endothelial nitric oxide synthase(eNOS)and inducible nitric oxide synthase(iNOS)and the content of nitric oxide were examined in mucosa tissues.The blood flow in the nasal mucosa was determined in animals before execution.Linear regression correlation was used to analyze the relationship between the nitric oxide content and blood flow in nasal mucosa.Results:The immunostaining for iNOS in surface epithelium of allergic rhinitis guinea pigs was markedly stronger than that of normal guinea pigs at all time points(P

Objective: To explore the role of cytosine-phosphate-guanine oligodeoxynucleotide(CpG ODN)in enhan- cing the radiosensitivity to X-ray in mouse with Lewis lung cancer.Methods: The tumor-bearing mouse model was in- duced by injevting Lewis lung cancer cells into the right infra-axillary dermis.Thirty-two C57BL/6J mice were evenly ran- domized into 4 groups.Group A: the control group;Group B: the X-Ray radiation group;Group C: the CpG group; Group D: the CpG plus X-Ray radiation group.Group B was treated with X-Ray radiation only(3 Gy/F,on day 1,3,5, 8,10,and 12;the total dose was 18 Gy);group C was administered with CpG ODN 0.05 mg on day 1,3,5,8,10, and 12;group D was administered with CpG ODN 6h before X-ray radiation.The tumor growth and tumor growth delay (TGD)were observed in all groups.Meanwhile,the pathological change of the tumor tissue was observed with H-E staining method and the apoptosis of tumor cells were examined with the method of TUNEL.Results: The Lewis hmg cancer-bearing model was successfolly established in mice.The tumor volumes of the treatment groups were smaller than that in lhe control group(P

Psychiatric professional talents is specially needed in China.Our university was ratified by ministry of education of people's republic of China in 2011 to cultivate professional master degree postgraduates majoring in mental health and psychiatry.According to the social needs and requirements of ministry of education,we carried out comprehensive reform and exploration in cultivation direction and objective,time management and course offering,cultivating model,examination and evaluation system.Cultivation direction included clinical psychiatry,forensic psychiatry,community psychiatry,behavioral medicine and clinical psychology,which were closely related with social needs.The objective was to cultivate high-grade psychiatric special talents with higher political diathesis,competent clinical skills,certain teaching and research abilities and grasping one foreign language.The total time for cultivating clinical skills should no less than two years and a half.Course offering included degree course and non - degree course,clinical skills,academic activities,teaching practice,medical record arrangement or case analysis essay writing.We developed the cultivating model combining ‘ medicine,study and research' and developed multilevel and comprehensive examination and evaluation system.

PURPOSE: To investigate the effect of a maternal role adjustment program on first-time mothers. METHODS: The research was quasi-experimental with a non-equivalent control group non-synchronized design. Participants were first-time mothers admitted to two postpartum clinics at women's hospitals. The experimental group had 38 mothers and the control group had 35 mothers. A maternal role adjustment program was applied individually to the experimental group between the 1st and 2nd weeks after childbirth. Assessing Adaptation to Motherhood, Semantic Differential Scale-Myself as Mother, and Edinburgh Postnatal Depression Scale were used to measure effects of the program. A pre-test was conducted in the 1st week after childbirth while post-tests were conducted in the 4th and 6th weeks. Data were analyzed with χ2 test, Fisher's exact test, t-test, and repeated measures ANOVA using SPSS 24.0. RESULTS: Maternal role adjustment (F=6.17, p=.015) and maternal identity (F=6.63, p=.012) were significantly increased in the experimental group compared to those in the control group. However, the difference in postpartum depression (F=1.11, p=.335) was not statistically significant between the two groups. CONCLUSION: The maternal role adjustment program can be utilized as an effective nursing intervention program to enhance maternal role adjustment and maternal identity for first-time mothers.
Adaptation, Psychological ; Depression, Postpartum ; Female ; Humans ; Maternal Behavior ; Mother-Child Relations ; Mothers* ; Nursing ; Parturition ; Postpartum Period ; Semantic Differential