The study investigated the burden of smear-positive pulmonary TB and its infectivity using DALY(disability-adjusted life year) as an indicator. Methods An assumed cohort of 2 000 cases was set up based on the age-specific incidence of 794 newly registered smear-positive cases in Beijing in 1994. Prognostic trees and model diagrams of infectivity under natural history and DOTS(directly observed treatment, short-course) strategy were established according to the epidemiological evidence. Results The results showed that 29.6%of DALYs would be neglected if the burden caused by the infectivity was not considered.Conclusion DOTS strategy may reduce 97.3% of the number of potential cases infected,92.9% of DALYs related to TB-patients themselves. and 99.9% of DALYs caused by TB's infectivity as well.

OBJECTIVEAccuracy of diagnostic methods for detecting Helicobacter pylori (H. pylori) infection among patients with bleeding peptic ulcers has not been thoroughly investigated. The aim of this study was to compare the diagnostic tests and their combined usage in detection of H. pylori infection in patients with bleeding gastric ulcers and without the use of nonsteroidal anti-inflammatory drugs.

METHODSA total of 57 patients who presented with bleeding gastric ulcers by endoscopy were enrolled. The status of H. pylori was identified by performing the rapid urease test (RUT), histology and (13)C-labeled urea breath test (UBT). The criteria for having H. pylori infection was a minimum of two positive tests.

RESULTSThe prevalence of H. pylori infection in our patient group was 80.7%. Among the three tests used: RUT, histology, and UBT, sensitivities were 56.5%, 97.8% and 100%, while specificities were 100%, 45.5% and 81.8%, respectively. The overall accuracies of the tests were 78.3%, 71.6% and 90.9%, respectively. Although UBT obtained significantly higher accuracy than histology (P = 0.02) as opposed to RUT (P = 0.11), UBT had significantly higher sensitivity than RUT (P < 0.001). In terms of combining any two of the three tests, more accuracy (98.9%) was achieved when both UBT and histology were used to confirm the diagnosis of the other. Conversely, failure to use combined tests generated the potential of missing a proper H. pylori diagnosis.

CONCLUSIONSUBT is superior to the other two tests in bleeding gastric ulcers. RUT lacks sensitivity for detection of H. pylori infection. However, the concomitant use of UBT and histology seems to be more accurate when gastric ulcers present with bleeding.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Breath Tests ; Female ; Helicobacter Infections ; diagnosis ; pathology ; Helicobacter pylori ; Humans ; Male ; Middle Aged ; Peptic Ulcer Hemorrhage ; complications ; Sensitivity and Specificity ; Stomach Ulcer ; complications ; Urea

AIMTo establish a suitable condition for extraction of phenylalanine (Phe), 5-hydroxytryptophan (5-OH-Trp) and four diastereomeric salts, (1R,2S)-ephedrine- (2S,3S)-tartaric acid, (1R,2S)-ephedrine-(2R,3R)-tartaric acid, (1S,2S)-pseudoephedrine-(2S,3S)-tartaric acid, (1S,2S)-pseudoephedrine- (2R,3R)-tartaric acid in supercritical fluid extraction and to assess the solubilities of Phe, 5-OH-Trp and the four diastereomeric salts in CO2.

METHODSSingle-pass method and HPCE.

RESULTSThe solubilities of Phe, 5-OH-Trp and the four diastereomeric salts in CO2 were determined over temperature and pressure ranges of 25-50 degrees C and 6.32-34.03 MPa respectively. The experimental results showed that the solubilities of Phe, 5-OH-Trp and the four diastereomeric salts do not increase with density of CO2. There existed a maximum in the critical region of CO2.

CONCLUSIONThe dramatically high solubilities in the pressure of 6.32-7.78 MPa show a critical behavior, which can be explained by critical characteristic through thermodynamics analysis. The results suggest that the separation of Phe, 5-OH-Trp and the four diastereomeric salts is more efficient in critical region of CO2.

5-Hydroxytryptophan ; chemistry ; Ephedrine ; chemistry ; Phenylalanine ; chemistry ; Pressure ; Solubility ; Stereoisomerism ; Tartrates ; chemistry ; Temperature

OBJECTIVETo define TB control priorities using cost-effectiveness and burden of disease.

METHODSAn assumed cohort of 2,000 cases was set up based on age-specific incidence of 794 newly registered smear-positive cases in Beijing in 1994. Prognostic trees and model diagrams of infectivity with natural history and DOTS intervention were constructed based on the epidemiological parameters.

RESULTSDOTS reduced 89.19% of YLL, 78.90% of YLD, and 99.98% of infectivity BOD. One DALY could be saved with 45.70 Yuan by DOTS with 3% discount. Sensitivity analysis showed that discount had effect on CER. Weight of age was insensitive to CER. The higher the DOTS cured rate, the more the cost-effectiveness.

CONCLUSIONSDOTS is a good cost-effectiveness TB control strategy. Cost-effectiveness and burden of disease can be used to define TB control priorities.

Adolescent ; Adult ; Child ; Child, Preschool ; China ; epidemiology ; Cohort Studies ; Cost of Illness ; Cost-Benefit Analysis ; Disabled Persons ; Forecasting ; Humans ; Middle Aged ; Models, Biological ; Quality-Adjusted Life Years ; Tuberculosis ; economics ; epidemiology ; prevention & control

Objective To investigate the effect of laparoscopic totally extraperitoneal (TEP) on sexual function in young and middle-aged patients with inguinal hernia. Methods 147 male with inguinal hernia treated by TEP from January 2014 to Feberary 2016 were included in the observation group, while 133 male with inguinal hernia treated by laparoscopic transabdominal preperitoneal (TAPP) during the same time were included in the control group. The effect of surgery and changes on sexual function between the two groups were retrospective analyzed and compared. Results The operative time, length of hospital stay, time of postoperative pain and in the observation group shorter than in the control group. The differences between the two groups were statistically significant (P < 0.05). The level of seminal alpha glucosidase, fructose contents and acid phosphatase in the observation group were higher than in the control group at 12 months after surgery. The differences between the two groups were statistically significant (P < 0.05). There were a small number of complications in both groups. After symptomatic treatment, all complications were cured. The ratio of complications and recurrences of the two groups have no significantly differences (P > 0.05). Conclusion Compared with laparoscopic TAPP, laparoscopic TEP can shorten the time of postoperative recovery, and will not increase the complications and recurrences. It is good for recovery of semen quality. It is worthy of attention.

Asari Radix et Rhizoma （ARR） is a traditional Chinese medicine for relieving exterior syndrome， and its roots and stems contain rich chemical components， including volatile oils （terpenoids， aromatics and aliphatics）， lignans， flavonoids， etc. Clinically， it has been traditionally used for the treatment of diseases such as phlegm and cough， anemofrigid cold， rheumatic arthralgia due to its ability to spread cold. Modern pharmacological studies have shown that ARR played beneficial roles in analgesic， anti-inflammatory， antitussive， antiasthmatic， antiviral， antibacterial， sedative， antioxidative， and antidepressant responses， antihypertension， as well as tumor suppression. The current studies on the chemical composition of ARR mainly focused on volatile components， and little information is available for the occurrence and pharmacological effects of non-volatile components. In addition， there is a lack of clear classification of chemical components and the distribution of chemical components in medicinal parts and the origin of species. Therefore， in this study， the authors reviewed a large number of literature on the chemical compositions and pharmacological effects of ARR， and hoping to provide a reference for further pharmacological research and the new drug development of ARR.