OBJECTIVE:To evaluate the cost-effectiveness of 3 "Cocktail" therapeutic regimens in treating acute cerebral infarction(ACI).METHODS:141 patients with ACI were administered with Sodium Ozagrel + Cinepazide + Edaravone(Group A),Vinpocetine + Propylgallate + Deproteinized calf blood Extractives(Group B)or Sodium Ferulate + Buflomedil + Muscular Amino Acids and Peptides and Nucleosides(Group C)for 14d.Cost-effectiveness analysis in pharmacoeconomics was applied to analyze the therapeutic effects and costs.RESULTS:The total costs of 3 groups(A,B and C)were 5 970.67 yuan,4 865.11 yuan and 3 939.72 yuan,respectively,the efficiency rates were 82.98%,63.04% and 64.58% respectively,and the cost-effectiveness ratio were 7 195.31,7 717.50 and 6 100.53,respectively.CONCLUSION:Group A is preferable for ACI.

OBJECTIVE:To compare the cost-effectiveness of3therapeutic schemes on acute cerebral infarction(ACI).METHODS:A total of123patients with ACI were ascribed to receive sodium ozagrel injection(shemeⅠ),ginkgo leaf extract(GLE)and dipyridamole injection(schemeⅡ)and sodium ozagrel injection plus ginkgo leaf injection(schemeⅢ),the cost-effectiveness analyses of3groups were conducted using pharmacoeconomics method.RESULTS:The costs for the3schemes were9766.51yuan,5562.22yuan and8273.05yuan,respectively;The effective rates were36.84%,32.50%and71.11%,respectively;The cost-effectiveness ratios of3were265.11,171.15and116.34,respectively.CONCLUSION:SchemeⅢis preferable among3schemes.

Objective To investigate the status of vitamin(Vit)B12 deficiency in elderly inpatients in department of neurology.Methods 827 patients admitted to the department of neurology of Shanghai Punan hospital from March 2007 to July 2008,aged 60 and older,with no severe hepatosis and renal disfunction,and without using VitB12 preparation for 3 months,were included in the study.The levels of serum VitB12,folate,homocysteine(Hcy) were tested to screened patients with VitB12 deficiency.The results of symptoms,positive signs of neurological system and the laboratory examination were analysed and compared between patients with or without VitB12 deficiency.Results There were 827 patients,with the mean age of(77.1?7.5)years old,fulfilled the enrolling criteria.VitB12 deficiency was found in 163 patients(19.7%).The prevalence was higher in female(21.9%)than male(17.4%),which had a tendency of increased with age.In the patients with VitB12 deficiency,the rate of complicating gastrointestinal diseases was higher.Compared with patients with normal serum VitB12 level,there were more cases suffered from unstable gait(27.0%),hypopallesthesia(34.4%),and more cases combined with some chronic diseases such as cerebral infarction(62.6%),hypertension(68.7%),coronary heart disease(39.9%).77% cases had neuroelectricphysiological abnormalities,but only 9.82% cases had megaloblastic anemia.Conclusions VitB12 deficiency is common in elderly inpatients in neurology department,whose clinical manifestations are various and atypical,and the neurological symptoms are more common than megaloblastic anemia.

OBJECTIVEThe effect of sandblasting on the bond strength between 3mol% yttrium-stabilized tetragonal zirconium polycrystal (3Y-TZP) zirconia framework and veneering porcelain was evaluated.

METHODSA total of 21 specimens [(25 ± 1) mm x (3 ± 0.1) mmx (0.5 ± 0.05) mm] were prepared according to ISO 9693. The specimens were then randomly divided into 3 groups. Sandblasting was performed on 2 meshes of Al₂O₃ particles: group A with mesh 110 and group B with mesh 80. Group C, which was not sandblasted, was the control group. The surface roughness of the zirconia framework, as well as the bond strength between 3Y-TZP zirconia framework and veneering porcelain, was measured. The interface microstructure was observed by scanning electron microscope (SEM), and elemental distribution was detected by energy dispersive spectroscopy (EDS).

RESULTSSurface roughness values were (1.272 ± 0.149) μm for group A, (0.622 ± 0.113) μm for group B, and (0.221 ± 0.065) μm for group C. Statistical significance were found among groups (P < 0.05). The bond strength values were (28.21 ± 1.52) MPa for group A, (27.71 ± 1.27) MPa for group B, and (24.87 ± 3.84) MPa for group C. Statistical significance was found between group A and group C (P < 0.05), whereas the other groups had no statistical significance (P > 0.05). Interface adhesion failure was the primary performance. SEM images showed the close interface bonding, and EDS showed that the interface had no obvious element penetration.

CONCLUSIONAl₂O₃ sandblasting can slightly enhance the bond strength between zirconia framework and veneering porcelain.

Aluminum Oxide ; chemistry ; Dental Bonding ; Dental Porcelain ; chemistry ; Dental Stress Analysis ; Dental Veneers ; Materials Testing ; Microscopy, Electron, Scanning ; Shear Strength ; Surface Properties ; Yttrium ; chemistry ; Zirconium ; chemistry

Objective:To investigate the immunogenicity of pORF5 plasmid protein,and further to screen and identify its im-munodominant domian.Methods: 10 different fragments of pORF5 gene including full length were amplified from the DNA of Chlamydia trachomatis serovar D by PCR and cloned into appropriate site of pGEX-6p vector to construct recombinant vectors after digested with BamHⅠand NotⅠrestriction endonucleases.After identification by PCR and sequencing,the recombinant plasmids were transformed into XL1 Blue E.coli to express the GST fusion proteins.ELISA and Western blot were carried out to identify the immunogenicity and immunoreaction of pORF5 plasmid protein.10 different fragments were reacted with sera from patients urogenitally infected with Chlamydia trachomatis, mouse polyclonal antibodies and mouse monoclonal antibodies of pORF5 plasmid protein with ELISA method.Results: pORF5 plasmid protein displayed strong immunogenicity and could induce a strong antibody response in human.The reactivity of human antibodies almost completely disappeared,when the native structure of pORF5 plasmid protein was de-stroyed.F6 that only lacked the N-terminal 66 amino acids was recognized by antibodies in ELISA as strongly as the whole pORF5 plasmid protein was.However,no other fragments were significantly recognized although there was a minimal reactivity of F2 and F3 with antibodies.Conclusion:pORF5 plasmid protein was an immunodominant antigen containing conformation-dependent epitope,and the C-terminal three quarters of pORF5 amino acid sequence was required for maintaining its immune dominance and conformation.The significance of the above findings lay a foundation for the further study on pORF5 protein function and vaccine development.

Objective To evaluate the feasibility and significance of CT image-based threedimensional (3D) brachytherapy for cervical cancer.Methods Three-dimensional (3D) plan and twodimensional (2D) plan were designed for 55 CT images of brachytherapy from 12 cervical cancer patients who received radical radiotherapy in 2013.Dosimetric comparison was performed between the 3D plan and 2D plan,and paired t-test,Wilcoxon signed rank test,Pearson correlation analysis,and Spearman correlation analysis were performed.Results A point dose,D90,V100,CI,and CI' in 3D plan were higher than those in 2D plan (P=0.015,0.016,0.000,0.000,0.000).Bladder point dose,rectal point dose,and rectal D2 cm3 in 3D plan were slightly higher than those in 2D plan,but hot spot dose was significantly reduced in 3D plan (P =0.140,0.123,0.214).Bladder D2cm3 was significantly higher than bladder point dose (P =0.000).Sigmoid colon D2cm3 was more correlated with the average doses of the three highest rectal points than rectal D2 cm3 (r =0.314,0.630,P =0.000,0.000).V100 showed a linear relationship with high-risk CTV (r =0.981,P =0.000).Bladder D2cm3 was higher than 430 cGy when the bladder volume was more than 80 cm3 ;small intestinal D2 cm3 did not change significantly when the bladder volume was less than 115 cm3,but decreased significantly once the volume exceeded the value.Conclusions Compared with the traditional 2D plan,the 3D plan for CT image-based cervical cancer brachytherapy significantly increases the target coverage and conformity index,but does not significantly increase the doses to organs at risk.Point dose evaluation is confirmed to be inaccurate.The doses to the bladder,rectum,and small intestine can be adjusted by controlling the bladder volume.

Objective To investigate the imaging features of splenic littoral cell angioma (LCA)and correlate with pathological findings.Methods Ten patients of LCA with pathologically confirmed diagnosis were included in this study.A retrospective review of clinical data and imaging findings on CT and MRI was performed,along with review of the literature.Results Splenic littory cell angiomas presented with multiple nodules of varying sizes with a predoninance of small ones.Nine of 10 patients had clinical symptoms of splenomegalia and hypersplenia.MR T2WI and DWI showed masses with high-signalintensity.The CT and MRI enhancing pattern of LCA was similar to splenic hemangioma.There were many mammiliform structures pointing inside in the wall of the vascular channels,a hallmark feature allowing its differentiation from splenic hemangioma pathologically.Conclusion The CT and MRI findings of LCA can show some of its characteristic signs,especially on DWI,which can assist to identify LCA in clinical practice.

Objective The present study investigated the expression of heat shock cognate protein 70 (Hsc70) in the synovial tissues and blood samples of patients with rheumatoid arthritis (RA) to determine the pathological role of this protein in the pathogenesis of the disease.Methods The expression of Hsc70 in synovial membranes was quantitatively analyzed by immunohistochemistry,real-time quantitative PCR and western blotting.The samples from osteoarthritis (OA) and ankylosing spondylitis (AS) were used as controls.The levels of Hsc70 in blood of patients with RA were determined using enzyme linked immunosorbent assay (ELISA) with the samples of the healthy subjects as controls.Statistical analysis was conducted with one-way ANOVA,LSD test and Spearmen's correlation.Results Immunohistochemistry showed that Hsc70 had significantly increased expression in synovial tissues of RA than in the samples of OA and AS.Real-time PCR and western blotting confirmed the above findings.ELISA detected significantly elevated level of Hsc70 in blood of patients with RA as compared with samples from the controls (P＜0.01).Conclusion The study suggests that the up-regulation of Hsc70 may be involved in the pathogenic process of RA.

Objective To study the diagnosis and treatment of malignant renal angiomyolipoma with metastases. Methods Three cases of advanced malignant renal angiomyolipoma with metasta-ses were retrospectively reviewed. Case 1 was a 55-year-old woman presenting with recurrent low-grade fever and aching pain in left flank. Ultrasound showed solid mass in the left kidney. Left radical nephrectomy was then performed. The right pulmonary lobectomy of the inferior lobe and wedge ex-section of superior lobe was performed 7 years later because of multiple pulmonary metastases. Case 2 was a 37-year-old woman. Left nephrectomy was performed because Ultrasound and CT showed left kidney solid mass. Six years later, multi-site metastases were found in liver and retroperitoneum and mestastasis tumors were resected. At 10 years after the primary diagnosis, CT showed multi-metasta-ses in liver and retroperitoneum. The retroperitoneal masses were resected and liver lesions were trea-ted by radiofrequency ablation. Case 3 was a 34-year-old man presenting with swelling pain in right flank. CT scan showed a lesion in the right kidney and right radical nephrectomy was performed. Four months after the surgery, MRI revealed multiple liver and retroperitoneal nodules. All the 3 cases had not been diagnosed with tuberous sclerosis and did not accept chemotherapy. Results The cut sur-face of the lesions was red-brown and yellow and the texture was tender. Under microscopic examina-tion, the tumors of case 1 and case 3 were composed of sheets or nests of large polygonal epithelioid cells. It revealed that occasionally clear cytoplasm with abundant eosinophilic, prominent nucleoli, and multinucleated and markedly pleomorphic form. Necrosis was presented as well. Large areas of case 2 tumor were made up of spindle smooth-muscle cells, adipose tissue, thick-wall blood vessels and some areas merged with a proliferation of epithelioid which was consistent with typical angiomyolipoma. Im-munohistochemical study showed that the epithelioid cells and spindle smooth-muscle cells were posi-tive for VM, HMB45, Melan-A and negative for S100, CK. Case 1 and case 3 were diagnosed with malignant epithelioid angiomyolipoma, while case 2 was diagnosed with malignant classic angiomyoli-poma and epithelioid in part of the tumor. Case 1 was well alive. Case 2 was alive with tumor 12 years after the diagnosis. And case 3 was missed in the follow-up 3 months after metastasis resection. Conclusions Malignant renal angiomyolipoma is a rare disease. The diagnosis depends on histopatho-logic, immunohistochemieal study and clinical follow-up. Radical resection of the primary, recurrent and metastatic tumors is the main therapy. It needs more research to clarify if metastasis has any effect on prognosis.

Objective To study the correlation between 5-serotonin transporter ( 5-HTT) gene pol-ymorphism and the first episode major depressive disorder ( MDD ) and cognitive function in adolescent. Methods 5-HTT genotype and allele were detected by polymerase chain reaction ( PCR) amplification of 76 patients with first episode of MDD and 73 normal controls. Case control method was used to analyze the correlation between different genotypes and the onset, the clinical features, and cognitive function. Result-s There was no significant difference between 5-HTTLPR genotype frequencies for the 41 cases of type S/S (53.9%),27 cases of type L/S(35.5%),8 cases of type L/L(10.5%)of case group and 5-HTTLPR geno-type frequencies for the 38 cases of type S/S(52.1%),18 cases of type L/S(24.7%),17 cases of type L/L (23.3%) of control group(P>0.05).Patients with S/S type,L/S type had significantly higher sleep scores than those of patients with type L/L(P=0.005,P=0.001). Agitation score in patients with S/S type group was significantly higher than that in patients with S/L,L/L(P=0.000,P=0.001);patients with S/S inferior-ity scores were significantly lower than those of patients with S/L,L/L(P=0.002,P=0.006). There was no significant difference in cognitive function among three groups. Conclusions In Chinese Han population, there may be no direct association between 5-HTTLPR gene polymorphism and susceptibility to MDD and its cognitive function in adolescents. S/S and L/S patients may be prone to sleep problems,type S/S patients may be prone to irritability and type L/L patients may be prone to inferiority.