OBJECTIVE:To discuss the economical effects of different medications on the treatment of same illness.METH_ODS:148 cases of functional colonic diseases were collected from literature and were randomly divided into three groups;colloidal bismuth artrate was given to the first group,bifidobacterium to the second and cisapride to the last.Data was evaluated using the pharmacoeconomic cost-effectiveness analysis.RESULTS:Colloidal bismuth artrate was the best medicine to treat functional colonic diseases.CONCLUSION:The pharmacoeconomics play an important role in guiding the physician to choose the best therapeutic regimen in making clinical decision,so as to gain the maximal benefit with the minimal cost.

Coronary Artery Disease ; diagnosis ; etiology ; Graft Occlusion, Vascular ; diagnosis ; etiology ; Heart Transplantation ; adverse effects ; Humans

Objective To assess the efficiency and safety of alendronate for the prevention and treatment of glucocorticoid-induced osteoporosis (GIOP).Methods The electronic databases of PubMed,EMBASE,Cochrane Library,Web of Science,Chinese BioMedical Literature Database (CBM) and Wanfang Data were searched for all randomized controlled trials (RCT) of alendronate vs.placebo.Two reviewers independently selected trials for inclusion,assessed trial quality using Jadad's scale and extracted the data.RevMan 5.1 software was used for data synthesis and Meta-analysis.Results Seven studies with 1111 patients were included.Compared with placebo,alendronate significantly increased bone mineral density (BMD) at the lumbar spine[MD ＝3.35,95％CI (2.67-4.02),P =0.000] and the femoral neck[MD =1.90,95％ CI (0.89-2.92),P =0.000] after 12 months of therapy.After 24 months of therapy,alendronate significantly increascd BMD at the lumbar spine [MD =3.91,95％ CI (2.37-5.45),P =0.000],but not at the femoral neck [MD =1.91,95％ CI (-1.15-5.02),P =0.22].Compared with placebo,no significant reduction was found by the use of alendronate in the incidence of vertebral fractures [RR =1.00,95％ CI (0.49-2.07),P =0.99] or nonvertebral fractures[RR ＝ 1.02,95％ CI (0.49-2.14),P =0.95].No difference was shown with the adverse event between the two groups[RR =0.97,95％ CI (0.90-1.05),P =0.47].Conclusions Alendronate is effective for the prevention and treatment of glucocorticoid-induced bone loss at the lumbar spine and the femoral neck with relatively good safety profile.Yet,there is no significant difference between the two groups in reducing the incidence of vertebral fractures and non-vertebral fractures.Large-scale RCT designed to observe whether different lengths of alendronate therapy will influence the efficiency should be conducted in the future and to further explore whether it can reduce the incidence of fractures.

Objective To access the left internal thoracic artery (LITA) graft late postoperative patency after coronary artery bypass grafting (CABG) by peripheral blood vessel ultrasound combined with color Doppler coronary flow imaging (CDCFI).In contrast with angiography,try to find available flow parameter to access graft patency.MethodsForty-six patients with CABG more than 1 year postoperatively followed-by angiography were detected by ultrasound.The LITA graft and left anterior descending artery were examined.Systolic and diastolic peak velocity(Smax,Dmax),velocity time integral(VTIs,VTId)of each segment were measured separately.The ratio of diastolic and systolic peak velocity (D/S),and diastolic velocity time integral fraction(DVTIF) were calculated.All patients were divided into groups according to angiography results.ResultsThirty -one LITA grafts were patent,11 were dysfunctional,4 were occlusive.According to the angiography results,the flow parameters of the proximal segment of LITA graft were significant.The D/S and DVTIF of patent group was higher than that of dysfunctional group.The diastolic peak velocity of distal segment of LAD of patent group was higher than that of dysfunctional group.ConclusionsPeripheral blood vessel ultrasound combined with CDCFI could provide the evidence to access the patency of the graft.It was an effective method for the clinical follow-up.

Objective To investigate the expressions of CXC chemokine 10(CXCL10) in chronic non-atrophy gastritis(CNAG) , precancerous lesions(PL)and gastric cancer(GC) ,primitively understanding of CXCL10 expression levels in three gastric types ,ex-ploring their clinical significances .Methods The expressions of CXCL10 in 20 cases of CNAG ,60 cases of PL ,60 cases of GC tis-sues were examined with immunohistochemistry method ,the expression level of CXCL10 was analyzed by computer-assisted image analysis system ,and then analyzed statistically .Results CXCL10 expression were positive in parts of CNAG ,PL and GC the posi-tive rates were 10 .00% ,26 .67% ,71 .67% respectively) .Expression levels of CXCL10 in the GC tissue specimens were significant-ly higher than in CNAG and PL(P<0 .01) .Expression levels of CXCL10 in the PL and CNAG tissue specimens have no significant difference(P>0 .05) .Expression levels of CXCL10 in CAG with IM ,CAG with Dys had no significant difference(P>0 .05) ,and in CAG with Severe Dys and Light-Moderate Dys had no significant difference(P>0 .05) .The expression levels of CXCL10 were rele-vant to the differentiation degree of GC (P>0 .05) .Conclusion The expression levels of CXCL10 were gradually rose from CNAG , PL to GC ,and had significant correlation with each other in CNAG ,PL and GC ,indicating that CXCL10 have a key role in the pro-duce and development of GC .

Objective To compare different susceptibility testing methods of tigecycline against Acinetobacter baumannii and Klebsiella pneumoniae.Methods Fifty carbapenem-resietant A.baumannii (CRAB) strains and 49 K.pneumoniae strains were collected from Tianjin Medical University General Hospital during January and March 2012.Minimum inhibitory concentration (MIC) and inhibitory zone diameters for tigecycline were determined by broth microdilution,Vitek-2,MTS and disk diffusion methods.The results of Vitek-2,MTS and disk diffusion methods were compared with those of broth microdilution method.Results According to FDA standards,the susceptibilities of CRAB and K.pneumoniae to tigecycline determined by broth microdilution,Vitek-2 and MTS were 94.0％/91.8％,68.0％/91.8％ and 90.0％/91.8％,respectively.For CRAB isolates,the essential agreement (EA) and categorical agreement (CA) produced by Vitek-2 and MTS were 94.0％/72.0％ and 92.0％/90.0％.MICs determined by Vitek-2 were 1-2 dilutions higher than the reference method in 33 (66.0％) strains,and those determined by MTS were higher in 16 (32.0％) strains and lower in 11 (22.0％) strains.For K.pneumoniae isolates,the EA/CA produced by Vitek-2 and MTS were 95.9％/98.0％ and 83.7％/91.8％,respectively.MICs determined by Vitek-2 were 1-3 dilutions lower than the reference method in 17 (34.7％) strains,and those determined by MTS were 1-3 dilutions lower than the reference method in 39 (79.6％) strains.None of thetwo methods produced very major error (VME) and major error (ME) against two kinds of isolates.The results were determined by disk diffusion method using different breakpoints according different isolates.For CRAB,using ≥14 mm/≤ 10 mm as breakpoint,CA was 94.0％,which was higher than the breakpoint recommended by Jones et al (≥16 mm/≤12 mm,CA was 82.0％) ; and for K.pneumoniae,using the ≥ 14 mm/≤ 10 mm as breakpoint,CA was 93.9％,higher than the FDA Enterobacteriaceae breakpoint (≥ 19 mm/≤ 14 mm,CA was 67.3％).Conclusion For CRAB strains,MTS produces better consistence with broth microdilution,with several higher or lower MIC results.For K.pneumoniae strains,Vitek-2 has better correlation with reference method,with several lower MIC results.The consistence between disk diffusion method and broth microdilution is comparatively lower,and the breakpoint should be adjusted according to different bacteria.

In order to improve the quality of teaching in medical genetics,we adopted a lot of measures in medical genetics teaching program according to the requirements of basic course and the characteristics of lower grade undergraduates.Firstly,cultivating students' awareness of genetic diseases; Secondly,integrating related courses and selecting teaching contents seriously; Thirdly,guiding the class by introducing cases of illness.The results showed that these methods can promote the understanding of medical genetics and improve the quality of study in lower grade undergraduates.

Objective To study the clinical efficacy of intra-arterial thrombolysis with recombinant tissue plasminogen activator (rt-PA) for the treatment of ischemic cerebrovascular disease caused by cerebral thrombosis. Methods A total of 245 patients accepted by our hospital during May 2013 and July 2015 were divided into the observation group (n=148) and the control group (n=97). All patients were given conventional process for controling blood pressure and blood lipids. Patients in observation group received intra-arterial thrombolysis with rt-PA, while patients in control group accepted conventional treatment. At the time of admission, the demographic characteristic, vascular influencing factors, baseline clinical findings, laboratory findings and neurological deficits were collected. The improvement of neurological function was evaluated by the modified Rankin scale 3 months after treatment. The levels of fibrinogen (FIB), D-Dimer, activated partial thromboplastin time (APTT) and thrombin time (PT) were measured before and 24 h after the treatment. Results There were no significant differences in demographic characteristic and general clinical data between the two groups ( P>0.05). The proportion of patients with improved neurological function was significantly higher in observation group than that of the control group (83.11％vs. 53.61％, P<0.05). There were no significant difference in coagulation index and fibrinolysis index before treatment between the two groups (P>0.05). Twenty-four hours after the treatment, the levels of FIB, D-Dimer, APTT and PT were significantly improved in the observation group compared with those before treatment. The level of FIB was significantly decreased, D-Dimer was significantly increased, APTT and PT were significantly prolonged in observation group compared with those of control group (P<0.05). Conclusion The rt-PA can effectively dissolve thrombosis and correct the coagulation system and fibrinolytic system.

Objective:To study the clinicopathologic characteristic of the primary extranodular non-Hodgkin's lymphoma in head and neck.Method:Clinical manifestation and the characteristic of clinicopathology of 216 extranodular non-Hodgkin's lymphoma patients in head and neck were analyzed retrospectively.Result:The age of thirty-one to sixty and seventy-one to eighty years old were more common age range in the group of patients. Nasal cavity was the most commonly primary involved site(95 cases, 44.0% ) , secondly was tonsil ( 47 cases, 21.8%). The most common histologic subtype was NK/T cell lymphoma, which accounted for 49.5%(107 cases)of cases, secondly was diffuse large B cell lymphoma (DLBCL, 58 cases, 26.7%). The most common histologic subtype in different swtach groups respectively is: NK/T cell lymphoma in nasal cavity(74 cases,77.9%), DLBCL in paranasal sinus(6 cases,50.0%), DLBCL in tonsil(27 cases,57.4%),NK/T cell lymphoma in nasopharynx(17 cases,44.7%), and DLBCL in lingual root(5 cases,45.4%).Conclusion:We conclude that primary extranodular non-Hodgkin's lymphoma is common in head and neck patients. There is characteristic in age, primary involved site and histologic subtype, which is helpful to understand these characteristic for pathologic diagnosis.