Objective To study the effect of three different kinds of intervenient measures for TB control on the disease burden of TB patients. Method The estimating method of disability adjusted life years(DALY) as recommended by the WHO was used to assess the disease burden of TB patients. Result The average disease burden of new and retreated TB patients covered by the international TB program(ITP) was the lightest, with the loss of 0.31 DALY and 0.62 DALY respectively; the average disease burden of new and retreated TB patients covered by the national TB program(NTP) was intermediate, with the loss of 0.42 DALY and 0.59 DALY respectively; and the average disease burden of new and retreated TB patients from areas using conventional TB therapy(CTT) was the heaviest, with the loss of 0.61 DALY and 0.91 DALY respectively. From a social perspective, the average yearly loss of DALY per thousand TB patients in the ITP, NTP and CTT areas was respectively 16.42, 33.6 and 37.36, with the loss in the NTP areas being 2.05 times as much as that in the ITP areas and the loss in the CTT areas being 2.28 times as much as that in the NTP areas. Conclusion ITP was far superior to NTP and CTT in reducing the disease burden of TB patients, achieving better results both from the perspective of TB patients and the society.

Objective To study the effect of different intervenient measures for TB control on disease financial burden. Method A survey was conducted of the expenses incurred on 1 700 new and retreated TB patients from areas covered by the World Bank project, the Ministry of Public Health project, and non project areas where intervenient measures were also taken. The method of economic estimation was used to explore the disease financial burden carried by the patients families and society. Result The average family disease financial burden is as follows: 1 735 yuan for a new case and 2 755.99 yuan for a retreated case in the international TB program(ITP); 2 669.27 yuan for a new case and 3 530.17 yuan for a retreated case in the national TB program(NTP); and 6 787.02 yuan for a new case and 7 276.10 yuan for a retreated case in the non project areas using conventional TB therapy(CTT). The average social disease financial burden is as follows: 4 735.55 yuan in ITP; 6 471.91 yuan in NTP; and 10 919.96 yuan in CTT. Conclusion The disease financial burden was the lowest in ITP, highest in CTT, and intermediate in NTP.

Objective To study the cost effectiveness, cost utility and cost benefit of three programs for TB control, viz. the World Bank TB project, the Ministry of Public Health TB project and measures taken by non project areas. Method A survey was conducted in TB prevention and treatment institutions in 17 counties of 6 provinces with regard to the course of disease, expenditure for treatment and financial burden of 1 700 new and retreated TB patients. Result The World Bank project, wherein the strategies of directly observed treatment and short course chemotherapy were adopted, proved to be a low input and high output program with low capitalized cost and significant effectiveness, utility and benefit. Suggestion A new round of TB control projects ought to be started so as to achieve the sustainable development of TB prevention and treatment programs and to achieve the goals of the nation in this aspect.

Objective To explore the value of time-invariant CTA in assessing collateral circulation of patients with acute ischemic stroke and assisting clinicians in predicting clinical outcomes.Methods The score of collateral circulation was compared between single-phase and time-invariant CTA.NIHSS score was calculated at admission and two weeks after admission.A 50% or greater decrease in NIHSS score over two weeks was considered as major neurologic improvement,which showed good clinical outcome;otherwise,it indicated bad outcome.The predictive ability of time-invariant CTA for clinical outcomes was assessed based on ROC curves.Results Compared with single-phase CTA,more collateral vessels could be viewed on time-invariant CTA.The average score of collateral circulation on time-invariant and single-phase CTA was 1.50±0.69 and 1.15±0.49 respectively (P=0.006<0.05 ).Time-invariant CTA had the moderate predictive ability for clinical outcomes in patients with acute ischemic stroke (AUC=0.810;P=0.032<0.05). Conclusion The time-invariant CTA showed potential value in assessing collateral circulation of patients with acute ischemic stroke and assisting clinicians in predicting clinical outcomes.

Objective To investigate treatment of meditation training for elderly patients with cogni-tive disorder recovering from operation for valvular heart disease( VHD) . Method 67 elderly patients who were up to the inclusion criteria were divided into experiment group( n=34)and control group( n=33),by dropping coins according to the admission time.Both of the two groups accepted regular health education and mental nursing.Besides,the experiment group accepted meditation training 5 times a week. Montreal Cogni-tive Assessment (MoCA) was used to evaluate cognitive function before and after the treatment. Results ( 1) Ridit analysis showed the intervention effect of the experimental group was better than that of the control group( R=2.12, t=-2.48, u=0.02),and the difference was statistically significant(P<0,05).The total effec-tive rate of experiment group is 90.32%,while the rate of control group is 62.89%. (2)The score of MoCA for the experiment group(25.79±1.23)was higher than that of the control group(23.85±1.82)after 6 weeks intervention,and the difference was statistically significant( t=5.14,P<0.01).(3) The score of MoCA of the experiment group before the intervention (23.91±2.22)was lower than after 6 weeks intervention(25.79±1. 23),and the difference was statistically significant( t=-4.30,P<0.01).Conclusion Meditation training can effectively improve cognitive function of elderly patients recovering from operation for VHD.

Objective To study the feasibility of helical tomoterapy (HT) at prescription dose escalation for nasopharyngeal carcinoma (NPC).Methods Static-IMRT (sIMRT) and HT plans were designed for 10 nasopharyngeal carcinoma patients which were treated by sIMRT and HT treatment plan.Prescription dose was escalated for each plan until any organs at risk (OARs) reached the quantitative analysis of normal tissue effects within the clinical threshold.Dosimetric factors of target and OARs were analyzed for both sIMRT and HT plans.Results Compared with sIMRT plan, prescribed dose of HT plans increased 42.6％ (t =6.373, P ＜ 0.01), and the homogeneity index was also improved (t =-2.288, P＜0.05);the conformity index decreased (P ＞ 0.05).The limits of HT prescribed dose escalation were spinal cord (2 cases), optic nerve (5 cases) and brainstem (3 cases).The limits of sIMRT prescribed dose escalation were lens (1 case), spinal cord (1 case) and parotid (8 cases).Conclusions HT could improve prescription dose of nasopharyngeal carcinoma while keeping the OARs safe.Compared with sIMRT, HT technology might be used at high dose NPC radiotherapy.

Objective To investigate the role of IL-6 and IL-6R in the pathogenesis of systemic lupus erythematosus (SLE) and its clinical significance. Methods RT-PCR technique was used to semiquantitatively analyze IL-6R mRNA expression in peripheral blood mononuclear cells (PBMC), and double antibody sandwich ELISA was applied to determine the serum level of IL-6 from 89 SLE patients . Results The positive IL-6R mRNA expression was found in each individuals among active SLE group (groupⅠ), inactive SLE group (groupⅡ) and control group (group Ⅲ). The mean levels of IL-6R mRNA expressions in groupⅠ,Ⅱ or Ⅲ were 0.902 ? 0.273, 0.519?0.11 and 0.573?0.24, respectively. Compared with group Ⅱand group Ⅲ, the mean level of IL-6R mRNA expression in groupⅠ was markedly increased (P = 0.00), while there was no statistical difference between group Ⅱ and group Ⅲ(P = 0.289). The mean serum levels of IL-6 in groupⅠ,Ⅱ and Ⅲ were 71.89 ? 20.02,17.96 ? 6.93, and 0.035 ? 0.035, respectively. Compared with group Ⅱand group Ⅲ, the mean level of IL-6 in groupⅠ was significantly higher than those in groupⅡ and groupⅢ (P = 0.00), while that in groupⅡwas higher than group Ⅲ (P = 0.00). There was a positive correlation between IL-6 and IL-6R in active SLE group and inactive SLE group(r = 0.887, and r = 0.615 P

Objective To detect p16 gene DNA methylation in the plasma of patients with systemic lupus erythematosus (SLE) and its significance in the disease activity and clinical manifestations. Methods Forty-five cases of SLE and 20 healthy controls were enrolled. Promoter methylation in p16 gene was measured by methylation specific PCR (MSP) in patients' plasma, and the correlation between the methylation status and clinical manifestations and routine laboratory findings were analyzed. Results Hypermethylation of p16 gene DNA was observed in the plasma of SLE. It was found that the rate of DNA hypermethylation was significantly higher in active SLE patients (20/24, 83.33%) than that in inactive patients (9/21, 42.85%) (x2 = 8.008 b; P

Objective To assess the value of prenatal sonographic diagnosis on fetal agenesis of corpus callosum(ACC). Methods A retrospective study was on prenatal sonographic findings of 10 cases with ACC malformation and their abnormalities in central nervous system (CNS) or extra-CNS.Results The special sonographic findings established the diagnosis of ACC malformation in all 10 cases,with 7cases diagnosed absence agenesis. Among all patients with ACC,6 cases were accompanied with abnormalities in extra-CNS,8 in CNS and 5 in both. Conclusions Prenatal ultrasonography plays a vital role in accurate diagnosis on fetal ACC. Attentions should be paid to the indirect encephalic features and complicated abnormalities so as to make accurate and prompt diagnosis.

After the stratification of the normal glucose tolerance, the changes of insulin resistance and βcell function in the development of type 2 diabetes mellitus were investigated. A retrospective analysis on data of 275 cases with oral glucose insulin releasing tests. The area under the insulin curve (AUCINS ) 108. 43 mU/ L was taken as the critical value of diagnosis. Normal glucose tolerance subjects were divided into the NGT-a group(AUCINS<108. 43 mU/ L) and the NGT-b group(AUCINS≥108. 43 mU/ L). The plasma glucose, insulin, insulin sensitivity, and β cell function were compared among the 4 groups: NGT-a group (n=96), NGT-b group (n=49), prediabetes group (n=71), and type 2 diabetes mellitus group ( n = 59). Among the fasting insulin, 2 h insulin, AUCINS , early-phase insulin secretion index(△I30 / △G30), the ratio of total insulin area under curve, and total glucose area under curve, disposition index, homeostasis model assessment for insulin resistance, and Matsuda insulin sensitivity index, the relationship as follows: NGT-b group>prediabetes group>NGT-a group>type 2 diabetes mellitus group. The NGT-b group was always the highest, prediabetes group was lower, NGT-a group and type 2 diabetes mellitus group were the lowest, there were significant differences (all P<0. 05). Making the NGT-a group as the basic state, in the NGT-b group, β cell function has begun to appear compensation and insulin resistance, and β cell function compensation reached the peak, the β cell function in the prediabetes group was beginning to compensate for the deficiency, the function of β cell in type 2 diabetes mellitus group decreased further. These findings suggest that the development process of type 2 diabetes mellitus could be the following four stages according to the function of β cell: β cell function normal, β cell functional compensation, β cell function loss of compensation, and finally β cell function failure.