OBJECTIVE:To evaluate the pharmacoeconomics characteristic of olmesartan medoxomil in ARB anti-hypertension drugs,and to provide reference for clinical drug use. METHODS:The literatures on the pharmacoeconomics study of olmesartan medoxomil published from Jan. 2002 to Dec. 2013 were searched with assigned search strategy from domestic and international data-bases like CNKI,PubMed,etc.,and comprehensive comparison and consistency analysis were conducted. RESULTS:4 literatures about pharmacoeconomics study of olmesartan medoxomil in different countries were screened,with essential hypertension patients as target population cost-minimization analysis or cost-effectiveness analysis as method,and 9 months-5 years as study course. The results consistency was well and showed the treatment cost of olmesartan medoxomil was usually less or better cost-effectiveness. CONCLUSIONS:Olmesartan medoxomil shows pharmacoeconomics advantage among ARBs drugs based on existed literature re-view.

Based on the requirement of biology education development,the article analyzes the approach to improve the teaching quality of medical biology from quality education,subjiect intercrossing or 'regression' and 'outspread',and offers new ideas for education reform and innovation of the medical biology.

Objective To evaluate the value of echo‐contrast RT‐3DE for assessment of left ventricular volume and function in patients with left ventricular non‐compaction(LVNC) .Methods Twenty‐one patients of LVNC were involved and underwent non‐enhanced and contrast‐enhanced RT‐3DE to evaluate left ventricular end‐diastolic volume (LVEDV) ,left ventricular end‐systolic volume (LVESV) ,left ventricular ejection fraction (LVEF) .The endocardial border definition of LV was graded for each of the 16 LV segments as follows :0 = border invisible ,1 = border visualized only partially ,and 2 = complete visualization of the border .Three image‐quality groups (good ,fair ,and uninterpretable) were identified . Results ①Duringcontrast‐enhancedRT‐3DE,ascomparedwithnon‐enhancedRT‐3DE,thenumberof segments with complete visualization of the endocardial border increased significantly (55% vs 82% ,P <0.01) ,and the number of patients with a good‐quality echocardiogram increased significantly (33% vs 81% , P <0.01) .②Contrast‐enhanced RT‐3DE provided significantly larger values of LVEDV ( P < 0 0.1) and LVESV ( P < 0 0.1) as compared with non‐enhanced RT‐3DE ,the values of LVEF were not statistically different between the two techniques ( P =0.07) .③Intra‐and inter‐observer agreement for assessment of LV volumes and systolic function improved during contrast‐enhanced RT‐3DE ,as compared with non‐enhanced RT‐3DE .Conclusions Contrast‐enhanced RT‐3DE can increase the prevalence of good‐quality echocardiograms and significantly improve the reproducibility of LV volumes and function measurements .

Objective To evaluate the structural and elastic changes of the arteries of chronic kidney disease (CKD) patients before dialysis by echo-tracking technique.Methods Thirty-nine CKD patients were enrolled in the study before dialysis and subdivided into CKD stage 2-3 group (n =19) and CKD stage 4-5 group (n =20).Forty age matched healthy subjects were selected as the control group.The parameters of arterial structural and stiffness such as intima-media thickness (IMT),stiffness parameter (β),pressure strain elastic modulus(Ep),arterial compliance(AC),augmentation index(AI),carotid pulse wave velocity (PWVβ),carotid-femoral pulse-wave velocity (PWVcf),carotid diameter (D) were measured by echotracking technique and compared among groups.Stepwise multiple linear regression analysis was performed to identify the associated factors of arterial stiffness.Results Compared with healthy group,PWVcf and Dwere significantly increased in CKD stage 2-3 group (P ＜0.05,P ＜0.001),PWVβ significantly increased in CKD stage 4-5 group(P ＜0.05) ;when compared CKD4-5 group with CKD2-3 group,PWVcf and D were significantly increase in CKD stage 4-5 group(P ＜0.05,P ＜ 0.001).The results of stepwise multiple regression analysis demonstrated that the age and estimated glomerular filtration rate (eGFR) were independent impact factors of PWVcf.Conclusions Echo-tracking technique can assess the structural and stiffness changes of arteries in patients with CKD in the early stage and provide valuable information for clinical management.

Objective To analyze the epidemiological characteristics of fatty liver complicating gallbladder diseases among the people undergoing healthy physical examination and to investigate its onset risk factors.Methods A total of 7 364 subjects undergoing abdominal color Doppler ultrasonography in the physical examination center of this hospital from June 2011 to June 2015 were selected as the study subjects and divided into 4 groups according to the examination results,fatty liver complicating gallbladder disease group,simple fatty liver group,simple gallbladder diseases group and non-fatty liver and non-gallbladder disease group.The Logistic regression model was used to analyze the influence of related factors on the patients with fatty liver complicating gallbladder diseases.Results The prevalence rate of gallbladder diseases in the patients with fatty liver ia significantly higher than that in the patients without fatty liver(P＜0.05).The multivariate Logistic regression model statistical analysis results showed that often skip breakfast,greasy food,eating more meat,eating much sweet food,dirking more tea,gender(female),age and LDL-C were the independent risk factors for fatty liver complicating gallbladder diseases(P＜0.05).Conclusion The unhealthy living habits were the independent risk factors for fatty liver complicating gallbladder diseases.

Objective To investigate the relationship between spina bifida occulta in lumbasacral portion and functional defe-cation abnormality among middle-aged and elderly people.Methods The cross-sectional and cluster random sampling survey meth-od was adopted to select the residents aged 45-90 years old in 7 communities of Zhengzhou City as the respondents.All respond-ents underwent the physical examination and lumbosacral digital radiography(DR)examination in the physical examination center of the First Affiliated Hospital of Zhengzhou University,and filled the related questionnaire about defecation abnormality.The rela-tionship between SBO and functional defecation abnormality among middle-aged and elderly people was studied by diagnosing and analyzing the functional constipation(FC)and functional incontinence(FC).Results The effective sample amounts were 1 057 ca-ses,including 497 males and 560 females,167 cases of SBO(86 males and 81 females).The morbidity rate of functional defecation abnormality was 26.02%(275/1 057),23.34%(116/497)in males and 28.39%(159/560)in females.Among 275 cases of functional defecation abnormality,there were 72 cases of complicating SBO.The Logistic regression analysis results showed that age,SOB,physical activity status,diet and living habits,education level and psychological factors were the risk factors for functional defecation abnormality (P<0.05),while there was no relationship between between past-history of stroke and functional defecation abnormality(P>0.05).Con-clusion SBO may be one of risk factors for functional defecation abnormality among middle-aged and elderly people.

Hyperuricemia contributes to renal inflammation. We aimed to investigate the role of Na⁺–K⁺–ATPase (NKA) in hyperuricemia-induced renal tubular injury. Human primary proximal tubular epithelial cells (PTECs) were incubated with uric acid (UA) at increasing doses or for increasing lengths of time. PTECs were then stimulated by pre-incubation with an NKA α1 expression vector or small interfering RNA before UA (100 μg ml⁻¹, 48 h) stimulation. Hyperuricemic rats were induced by gastric oxonic acid and treated with febuxostat (Feb). ATP levels, the activity of NKA and expression of its α1 subunit, Src, NOD-like receptor pyrin domain-containing protein 3 (NLRP3) and interleukin 1β (IL-1β) were measured both in vitro and in vivo. Beginning at concentrations of 100 μg ml−1, UA started to dose-dependently reduce NKA activity. UA at a concentration of 100 μg ml⁻¹ time-dependently affected the NKA activity, with the maximal increased NKA activity at 24 h, but the activity started to decrease after 48 h. This inhibitory effect of UA on NKA activity at 48 h was in addition to a decrease in NKA α1 expression in the cell membrane, but an increase in lysosomes. This process also involved the subsequent activation of Src kinase and NLRP3, promoting IL-1β processing. In hyperuricemic rats, renal cortex NKA activity and its α1 expression were upregulated at the 7th week and both decreased at the 10th week, accompanied with increased renal cortex expression of Src, NLRP3 and IL-1β. The UA levels were reduced and renal tubular injuries in hyperuricemic rats were alleviated in the Feb group. Our data suggested that the impairment of NKA and its consequent regulation of Src, NLRP3 and IL-1β in the renal proximal tubule contributed to hyperuricemia-induced renal tubular injury.

Objective To explore the clinical features,laboratory test results,diagnosis,treatment and prognosis of patients with anti-N-methyl-D-aspartic acid receptor (NMDAR) encephalitis.Methods A retrospectives analysis of clinical characteristics,laboratory test,treatment and prognosis of 3 patients with NMDRA encephalitis,admitted to our hospital from February 2012 to November 2014,was performed in our study.Results The most predominant symptoms of 3 patients with anti-NMDAR encephalitis included fever,psychiatric behavioral disturbances,seizures,orofacial dyskinesias and movement disorders and autonomic dysfunction.One patient had immature ovarian teratoma and one had mature mediastinal teratoma.Anti-NMDAR antibody was positive in serum and cerebrospinal fluid of two patients with teratoma,and anti-NMDAR antibody was positive in cerebrospinal fluid and negative in serum of one patient without tumour;all three patients showed abnormal electroencephalography,and 2 had increased signal on MR imaging T2 sequences or fluid-attenuated inversion.Patients were responsive to early immunotherapy and tumour resection.Conclusion The patient with NMDAR encephalitis presented with characteristic clinical manifestations;detection of anti-NMDAR antibody in serum and cerebrospinal fluid may be important for early diagnosis;early immunotherapy and tumour resection are effective for patients with NMDAR encephalitis.

Objective To determine whether the apoptosis of PC12 cells induced by MPP+ can be protected when the activity of cyclin-dependent kinase 5(CDK5)/p25 is inhibited specifically by TFP5.Methods The 100 μg/L of beta nerve growth factor (β-NGF) was used to induce PCI2 cells differentiating into dopaminergic neurons in vitro.Different concentrations of MPP+ (0,100,200,300,400,600,800 and 1000 μmol/L) were added to the cells;CCK8 assay was used to determine the cell activities and adequate concentration of MPP+.After induction,four groups were designed:PBS and PBS group,MPP+ and PBS group,MPP+ and TFP5 group,and MPP+ and Roscovitine group.Pretreatment of TFP5 and Roscovitne for 12 h was given to the MPP+ and TFP5 group and MPP+ and Roscovitine group,respectively.Hochest33258 staining and flow cytometry were used to detect the cell apoptosis.Western blotting was used to detect the protein expressions ofp35/25,caspase3,cleaved caspase3.Results CCK8 assay showed that the survival rate of PC12 cells was (64.84±1.58)％ when the MPP+ concentration was 300 μmol/L.Flow cytometry indicated significant differences in the apoptosis rate between different groups,which was the highest in MPP+ and PBS group ([25.61±2.74]％),following by MPP+ and TFP5 group ([13.33±1.24]％),MPP+ and Roscovitine group ([9.94±1.70]％),and PBS and PBS group ([8.68±0.21]％);significant difference was noted between MPP+ and TFP5 group and MPP+ and Roscovitine group (P＜0.05).Hochest33258 staining indicated the most obvious nucleus condensation and fragmentation and more apoptotic bodies in MPP+ and PBS group,While few apoptotic bodies were found in MPP+ and TFP5 group and MPP+ and Roscovitine group.Western blotting showed that as compared with that in the PBS and PBS group,the p25 protein level in the MPP+ and PBS group,MPP+ and TFP5 group,and MPP+ and Roscovitine group was significantly increased (P＜0.05).The cleaved caspase-3 protein expression in the MPP+ and PBS group was significantly higher than that in the PBS and PBS group (P＜0.05);the cleaved caspase-3 protein expression in the MPP+ and PBS group was significantly higher than that in the MPP+ and TFP5 group (P＜0.05).Conclusion TFP5 has protective effect against the apoptosis of PC12 cells induced by MPP+ through inhibiting the CDK5/p25 expression and reducing the cleaved caspase-3 protein production.

Objective:To investigate the influencing factors for postoperative venous thromboembolism (VTE) of inguinal hernia.Methods:The retrospective case-control study was conducted. The clinical data of 350 patients undergoing surgical treatment of inguinal hernia who were admitted to Affiliated Hospital of Zunyi Medical University from January to December 2017 were collected. There were 287 males and 63 females, aged from 15 to 89 years, with a median age of 57 years. Observation indicators: (1) surgical and postoperative situations; (2) follow-up; (3) analysis of influencing factors for postoperative VTE of inguinal hernia. Follow-up using outpatient examination and telephone interview was performed to detect recurrence and complications of inguinal hernia after patients being discharged from hospital. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test.Measurement data with skewed distribution were represented as M (range), and comparison between groups was analyzed using the nonparametric rank sum test. Count data were described as absolute numbers or percentages, and comparison between groups was analyzed using the chi-square test or Fisher exact probability. Multivariate analysis was conducted using the binary Logistic regression model. Results:(1) Surgical and postoperative situations: of the 350 patients, 173 underwent open inguinal hernia surgery including 66 cases with plain patch repair, 54 cases with Lichtenstein repair, 30 cases with mesh plug plain patch repair, 23 cases with Bassini repair, and 177 underwent laparoscopic inguinal hernia surgery including 134 cases with laparoscopic transabdominal preperitoneal prothetic repair, 43 cases with laparoscopic totally extraperitoneal prothetic repair. There were 335 of the 350 patients negative for postoperative VTE while 15 patients positive for postoperative VTE. Of the 15 patients who were diagnosed with postoperative VTE, 13 cases underwent open surgery while 2 cases underwent laparoscopic surgery including 1 died; 12 cases were diagnosed with deep vein thrombosis and 3 cases were diagnosed with pulmonary thromboembolism including 1 died. (2) Follow-up: 349 of the 350 patients were followed up for one year after operation. Of the 349 patients, 2 had recurrence of inguinal hernia and 18 had seroma in the operation area within one year. None of the 349 patients had postoperative patch-related infection or incision infection in the operation area. Of the 14 patients who were diagnosed with postoperative VTE, recurrence of inguinal hernia was not observed within one year. (3) Analysis of influencing factors for VTE of inguinal hernia. Results of univariate showed that age, body mass index (BMI), hypertension, type of operation, the compression time of operative area, time to first out-of-bed activities, duration of hospital stay, postoperative Caprini score were influencing factors for postoperative VTE of inguinal hernia ( χ2=13.217, 9.183, 4.388, 8.694, Z=-4.690, -5.265, -4.281, -4.883, P<0.05), and age, cases with chronic bronchitis, the stable stage of chronic obstructive pulmonary disease (COPD) were influencing factors for postoperative VTE of inguinal hernia ( P<0.05). Results of multivariate analysis showed that age≥65 years, BMI≥25.0 kg/m 2, chronic bronchitis, the stable stage of COPD, open surgery, the compression time of operative area≥42 hours, time to first out-of-bed activities≥60 hours, postoperative Caprini score>5 were independent risk factors for postoperative VTE of inguinal hernia ( odds ratio=1.085, 1.320, 0.256, 0.013, 7.874, 1.112, 1.027, 6.909, 95% confidence interval: 1.031-1.141, 1.024-1.702, 0.071-0.929, 0.016-0.800, 1.489-41.630, 1.061-1.165, 1.008-1.047, 3.045-15.678, P<0.05). Conclusions:Age≥65 years, BMI≥25.0 kg/m 2, cases with chronic bronchitis preoperatively, the stable stage of COPD, open surgery, the compression time of operative area≥42 hours, time to first out-of-bed activities≥60 hours, postoperative Caprini score>5 are independent risk factors for postoperative VTE of inguinal hernia.