OBJECTIVE:To evaluate the application of cost-utility analysis in health area of China in recent year. METH-ODS:From CNKI,Wanfang and VIP database,settingcost utilityorcost-utilityastitleorkeyword,related literatures were retrieved during Jan. 2011-Dec. 2015,with subject field ofmedical science and technologyin CNKI,medical sciencein Wanfang database,clinical medicineChinese medicinepreclinical medicinepreventive medicine hygieneorpharmacyin VIP. The comprehensive evaluation involved research design,research perspective,cost measurement,utility index and measure-ment method,cost-utility analysis index,discount and sensitivity analysis. RESULTS:A total of 31 literatures meeting inclusion cri-teria were selected,including 12 prospective studies,9 retrospective studies,9 Markov model studies,1 mixed study. Thirteen lit-eratures worked in medical institutions. Seven literatures explicitly mentioned research perspective;most literatures only measured direct cost(19 literatures)and adopted QALY as utility index(27 literatures). Twenty eight literatures described measurement meth-od of utility index(direct measurement,indirect measurement or literature method)in detail. More than half(16 literatures)analyzed cost-utility by using cost-utility ratio(CUR);7 literatures adopted incremental cost-utility ratio(ICUR)and 6 literatures adopted both CUR and ICUR. Five literatures used the threshold of ICUR. Eleven literatures described discount,and the majority was Markov mod-el study. Sensitivity analysis was conducted in 16 literatures,among which 11 literatures adopted single factor analysis. The most com-monly involved influential factor was cost,followed by utility value and discount rate. CONCLUSIONS:Cost-utility analysis has been widely used in China,but the quality and normalization of studies have much room for improvement. Learning more experiences from international researches can help to promote the quality of domestic studies,guide the practice of clinical rational use of drugs and sup-port the government decision-making process and medical insurance payment in the future.

OBJECTIVE:To fathom American pharmaceutical benefit managers(PBMs).METHODS:The development of PBMs in America was reviewed and the role they played in American pharmaceutical management was analyzed.RESULTS:PBMs,whose strength was increasing,did play a role in curbing the increase of drug expenses though their place was still somewhat controversial.CONCLUSION:PBMs in American sets a good example for other countries including China to follow.

Objective To prepare a 10-hydroxycamptothecin (10-HCPT) loaded folate-receptor targeted phase-change contrast agent (FR-HCPT-PNPCA),and to study the general characteristics including drug loading,phase changing and targeting capability in vitro.Methods Using a method of two-step emulsification,the phase-change nanoparticles loading anticancer drug (10-HCPT) with lipids shell and liquid pefluorocarbon core were prepared.The entrapment efficiency and the drug-loading amounts were studied by high performance liquid chromatography,and the phase transition of the nanoparticles after heating was observed.The targeting ability was evaluated on liver cancer cell line 7721 in vitro.Results The FR-HCPT-PNPCA,with a drug encapsulation rate of about 70.42 ％ and drug loading amounts of about 20.05 ％,was prepared successfully.When being heated to 70℃,obvious phase changing and microbubbles generating could be observed under microscope.In addition,a large amount of FR-HCPT-PNPCA particles could adhere specifically around the 7721 cells.Conclusion The prepared FR-HCPT-PNPCA,which has a stable characteristic and high performance of drug loading and tumor targeting,is expected to become a promising multifunctional molecular ultrasound probe for diagnosis and treatment of tumor.

Objective To evaluate the therapeutic efficacy of acupuncture based on syndrome differentiation for functional dyspepsia (FD), and to explore the plausible action mechanism.Method Seventy-two eligible FD patients were randomized into a treatment group (36 cases) and a control group (36 cases). In the treatment group, the FD patients were divided into four types, liver-qi stagnation, spleen-stomach qi-deficiency, liver-qi affecting stomach, damp-heat accumulated in stomach, to receive acupuncture at the corresponding points based on syndrome differentiation in addition to the basic points including Zhongwan (CV12), Tianshu (ST25), Zusanli (ST36), and Neiguan (PC6); the control group was given Itopride hydrochloride tablets. Before and after intervention, the symptomatic efficacy index and the MOS 36-Item Short-Form Health Survey (SF-36), as well as serum Gastrin (GAS) content were observed in the two groups.Result The total effective rate was 94.1% in the treatment group, significantly higher than 63.9% in the control group (P＜0.01); after intervention, the improvement of symptomatic efficacy index in the treatment group was markedly better than that in the control group (P＜0.01); the improvements of the SF-36 component scores in the treatment group were markedly higher than those in the control group (P＜0.05).Conclusion Acupuncture based on syndrome differentiation can obviously improve the symptoms of FD patients, gastrointestinal function, and the quality of life, which is possibly realized by regulating serum GAS, and thus this treatment protocol is proper to be the optimal protocol in clinic for FD.

Objective To explore the pharmacological function of immune enhancer of gypenosides and discuss the dose-effect relationship.Methods The gypenosides was used as an immune enhancer to cure the immune deficit mouse and observe non-specific immunological function by carbon clear test.All of the mice were administrated with CTX and then were divided into six groups:control group,high dose group,middle dose group,lower dose group.Respectively,the carbon clear test was performed in each group and the variation of non-specific immune function was observed.Results The carbon clear test showed that the index of carbon clear test in control group was markedly decreased while the index of carbon clear testing high and middle group was increased.The effect of gypenosides was dose-dependent on the non-specific immune.Conclusion Gypenosides can markedly increase the non-specific immune function.

CARMA1, BCL10 and MALT1 are lymphocyte-specific signaling molecules of NF-?B pathway.The abnormalities of those molecules such as gene mutation, rearrangement, translocation or amplification often connect with the lymphoma genesis. This article reviewed the physiological function of those molecules and the relationship between genetic abnormalities and lymphoma genesis, also with present target-treatment research and new gene medicine development.

Objective To investigate the safety and accuracy of diagnosing alpha-thalassemia with extraembryonic coelomic cells. Methods Coelocentesis was performed before artificial abortion to collect extraembryonic coelmic fluid in 40 women with singleton pregnancy during 6-10 gestational weeks. The villi was gathered after suction. PCR technique was used to amplify alpha-thalassemia gene in both extraembryonic coelomic cells and villi and concordant rate of two different kinds of samples were compared. Results The genotypes of alpha-thalassemia were successfully amplified in 37 cases of coelomic cells and all were concordant with the results of villi. Conclusion Extraembryonic coelomic cells can be used in early prenatal diagnosis of alpha-thalassemia by PCR technique and is practicable.

Objective To investigate the role and significance of E selectin in the pathogenesis of neonatal acute lung injury (ALI).Method Ninety neonatal Sprague Dawley (SD) rats (6 or 7 days after birth) were randomly assigned to the control group (n =10) and ALI group (n =80).The rats in the ALI group received intraperitoneal injection of lipopolysaccharide (LPS) at dose of 4 mg/kg and they were divided into eight subgroups with 10 rats in each group according to different sacrifice time (0.5 h,1 h,2 h,3 h,4 h,8 h,12 h and 24 h after injection).Rats in the control group were injected intraperitoneally the same volume of normal saline and they were sacrificed at 4 hours after injection.Expression of the E-selectin in lung tissue was detected dynamically by immunohistochemistry and the serum soluble endothelial selectin (sE-selection) was detected by enzyme-linked immunosorbent assay (ELISA).The pathological changes of the lung tissue and the wet/dry lung weight ratio (W/D ratio) were recorded.Result The strong expression of a large number of E-selectin was detected in the vascular endothelial cells of the lung tissue in the ALI group,while only moderate expression of E-selection was observed in the control group.The W/D ratio in the ALI group gradually increased from 0.5 h after intraperitoneal injection of LPS,reached the peak at 8 h,and then began to decline.The ratio was significantly higher in the ALI group than that of the control group from 4 to 12 h after injection (P ＜ 0.05).The mean optical density of E-selectin in lung tissue of ALI group was also higher than that of the control group and the average optical density of ALI group at 2 h,3 h,4 h and 8 h was significantly higher [2 h:(0.36 ±0.09),3 h:(0.38 ±0.01),4 h:(0.44 ± 0.06),8 h:(0.30 ± 0.09),control group:(0.24 ± 0.01),P ＜ 0.05].The level of serum sE-selectin gradually increased after intraperitoneal injection of LPS,reached the peak at 2 h,and then decreased gradually.The level of sE selection was significantly higher than that of the control group at the point of 2 h,3 h,4 h and 8 h (P ＜ 0.05).The level of serum sE-selectin increased along with the expression of E-selectin in lung tissues,and they were positively correlated (r =0.730,P ＜ 0.01).Conclusion The increased expression of E-selectin and the elevation of serum sE-selectin level may reflect the injury of pulmonary vascular endothelial cells induced by systemic inflammatory response.

Objective To observe the therapeutic effect and safety of the umbilical blood stem cell transplantation on patients with end-stage cirrhosis.Methods We chose 80 patients diagnosed with end-stage cirrhosis.All the re-lated contraindications were excluded .Communicated with all the patients, 50 patients chose the umbilical blood stem cell transplantation and conservative treatment , and 30 patients only chose conservative treatment .The 50 pa-tients were defined as observation group and the left were defined as control group .After transplantation, clinical symptoms and laboratory data were recorded at the 1 month, 6 month, and 12 month.Results ① 12 months after transplantation, clinical symptoms were improved in 38 cases(76%) in the observation group and that in 12 cases (40%) in the control group.② The laboratory data, including ALB, TBiL, ALT, AST, PTA were improved after transplantation in observation group (P <0.05).No significant difference was found in the control group after thera -py.③ After transplantation, the improvement of ALB, A/G, TBiL, PTA in observation group was higher than the control group(P <0.05).Conclusion After transplantation of the umbilical blood stem cell transplantation , the liver function and life quality of patients are significantly improved .This method is better than conservative treat -ment.The method is safe and effective in the treatment of patients with end -stage cirrhosis.

30?) and 33 subjects of low angle (MP/FH