OBJECTIVE:To compare the effects and costs between metformin and acarbose when combined with insulin in treating type2diabetes mellitus.METHODS:Cost-minimization analysis in medical economy was applied to analyze the therapeutic effects,costs and cost related factors with the respect for the patients.RESULTS:There was no statistically sig?nificant difference in effects of the2therapeutic regimens.Total cost and drug cost per head in metformin group were1941.46yuan and138.86yuan respectively as compared with2308.37yuan and229.82yuan respectively in acarbose group.The analysis on cost related factors showed no statistical significance.CONCLUSION:Metformin combined with insulin is a preferable therapeutic regimen.

Objective To investigate the effect of modified Taohe Chengqi Decoction(TCD)and its separated prescriptions on tissue plasminogen activator(tPA)and plasminogen activator inhibitor-1(PAI-1)content in human umbilical vein endothelial cells(HUVEC)with diabetic damage.Methods Purified HUVEC were divided into 10 groups: normal group,model group,rosiglitazone group,high-,middle-and low-dose modified TCD groups,blood-activating prescription group,heat-clearing and purgation prescription group,Qi-strengthening and yin-nourishing group,and TCD group.The serum containing herbal medicine was prepared through seropharmacological method,and was used for co-culture of HUVEC with high glucose and high insulin in vitro.The tPA and PAI contents in the HUVEC culture of different groups were detected.Results The content of tPA was increased in blood-activating prescription group and rosiglitazone group(P0.05).The PAI-1 content in the model group was higher than that in the normal group(P0.05).Conclusion The effect of modified TCD on improving the function of endothelial cells is probably related to the regulatory effect of blood-activating,heat-clearing and purgation herbs on PAI-1.

OBJECTIVE:To compare the curative effect of domestic cefoperazone/sulbactam and imported one for lower respiratory infection. METHODS:The curative effects of domestice vs. imported cefoperazone/sulbactam in 201 vs. 198 patients with lower respiratory infection in recent two years in our hospital were analyzed retrospectively. RESULTS:The effective rate was 61.6% for imported product and 51.7% for domestic product. Significant difference was noted between 2 groups statistically(P

Objective To compare the differences between measured resting energy expenditure calculated by the indirect calorimetry with the resting energy expenditure calculated by the Harris-Benedict formula and weight formula in the mechanically ventilated surgical critically ill patients in SICU.Methods Patients mechanically ventilated in SICU of Xuanwu Hospital,from April 2014 to April 2015 were measured resting energy expenditure by the indirect calorimetry with the resting energy expenditure calculated by the Harris-Benedict formula and weight formula in the 1st,the 3rd and the 5th day.There were twenty-nine patients enrolled,thirteen males and sixteen females,measured the resting energy expenditure 188 times.The distribution of metabolism level was studied,and the resting energy expenditure measured by three methods were calculated and evaluated by paired sample t test.Results There were 177 times(62.24％)of low metabolism level,59 times(31.38％)of normal metabolism level,and 12 times(6.38％)of high metabolism level.Eighteen patients used these three methods to calculate the energy expenditure on 1st,3rd and 5th day:indirect calorimetry (1 627.11 ± 323.63) kcal,(1 614.67± 308.93) kcal,(1 576.11 ± 263.96) kcal;Weight formula (1 479.44 ± 200.24) kcal,(1 488.40 ± 227.72) kcal,(1434.14 ± 216.56) kcal;Harris-Benedict formula (1 777.43 ± 253.00) kcal,(1 730.08 ± 265.18) kcal,(1 689.33 ± 236.69) kcal.The results calculated from Harris-Benedict formula and the weight formula were significantly different fiom calculated from indirect calorimetry (P ＜ 0.05).Resting energy expenditure by Harris-Benedict formula was significantly higher than calculated from indirect calorimetry (All P ＜ 0.05).Resting energy expenditure by weight formula was significantly lower than calculated from indirect calorimetry(All P ＜ 0.05).Conclusions Although Harris-Benedict formula and weight formula is convenient in clinical use,while the results calculated by them is significant different from the results calculated by indirect calorimetry.So clinical nutrition support should rely on indirect calorimetry as far as possible.

Objective:To investigate the effect of oxycodone hydrochloride on patients with analgesic effect and immune function of intestinal tumor after operation.Methods:50 patients with intestinal tumor from June 2014 to December 2016 who were treated in our hospital were selected randomly to divide into oxycodone group and fentanyl group with 25 cases in each group.Patients in oxycodone group were given oxycodone hydrochloride intravenous injection of 5mg 15 minutes before the end of surgery;and patients in fentany group were given fentany intravenous injection of 50ug 15 minutes before the end of surgery.Visual analogue scale (VAS),ramsey sedation score were observed at 3 h (T0),6 h (T1),12 h (T2),24 h (T3) 48 h (T4) after operation,Levels of serum tumor necrosis factor-α (TNF-α),interleukin-6 (IL-6) and IL-10 CD4+,CD8+,CD4+/CD8+ and NK cells measured before anesthesia,and at T2,T3,T4 respectively.Results:At time point of T1,T2,Ramsey scores of oxycodone group were significantly lower than that of fentany group (P＜0.05),At time point ofT0,T3,T4,Ramsey scores of the two groups showed no significant difference (P＞0.05).At time point of T2,T3,T4,levels of serum TNF-α,IL-6 and IL-10 of two groups of patients were significantly higher than those of anesthesia before (P＜0.05),TNF-α,IL-6 and IL-10 ofoxycodone group was significantly lower than those of fentany group (P＜0.05).At time point ofT2,T3,T4,CD4+/at CD4+ of the two groups were significantly decreased,and CD8+ was significantly increased(P＜0.05).Levels of CD4+,CD4+/CD8+ of oxycodone group was significantly higher than that of fentany group (P＜0.05),and level ofCD8+ was significantly higher than that of fentany group.At time point of T2,T3,NK cells of two groups were significantly decreased,NK cells of oxycodone group were significantly higher than that of oxycodone group (P＜0.05).Differences among postoperative nausea,vomiting,respiratory depression,dizziness,skin itching incidence of two groups of patients were not statistically significant (P＞0.05).Conclusion:Oxycodone hydrochloride has little effect on the immune function of patients with intestinal tumor,and it is suitable for Postoperative analgesia of patients with intestinal tumor.

[ ABSTRACT] AIM: To determine the aberrant methylation status in the gene promoter regions of CDH13, RASSF1A, DLEC1, SEPT9 and RUNX3 by detecting the plasma specimens and the value of their combined detection for di-agnosis of lung cancers.METHODS:Nest methylation specific PCR ( nMSP) was used to detect the promoter methylation status of the 5 genes in the plasma from 106 normal controls, lung cancer tissues, lung benign tissues and the plasma from 106 patients with lung cancers.Multiple displacement amplification ( MDA) was used to amplify modified genomic DNA to solve the problem of insufficient of plasma DNA template.RESULTS: The positive rates of promoter methylation of CDH13, RASSF1A, DLEC1, SEPT9 and RUNX3 in the lung cancer tissues were 51.9%, 44.3%, 54.7%, 36.8%, 24.5%, respectively, and those in the plasma were 46.2%, 41.5%, 50.9%, 31.1%, 19.8%, respectively.The re-sults of the Kappa consistency check showed that the lung cancer tissues and the plasma had obviously coherence in the methylation status of the 5 gene promoter regions.Combination of DLEC1, CDH13, RASSF1A, and SEPT9 had a higher di-agnostic efficiency than the others, as their ACC value was 0.8208 and youden index was 0.6415 ( with the sensitivity of 81.13% and the specificity of 83.02%) .CONCLUSION:Combination detection of promoter methylation of lung cancer-related genes in the plasma is expected to apply to the early diagnosis of lung cancer.

OBJECTIVE:To study the pharmacokinetics of recombinant staphylokinase(r-SAK)in a thrombosis model of femoral artery in rabbits.METHODS:Large glass plates were used for modified agar-well diffusion assay to measure r-SAK concentration in plasma of rabbits which had been administered different doses drug by different means respective?ly.RERULTS:The pharmacokinetics of r-SAK infusion in thrombosis model of the femoral artery in rabbits fits two-com?partment model,the plasma levels and the diameter of lytic circles showed a good linear correlation under the scope of20～2500IU/ml(r=0.9960),and the averaged recovery rate was(96.05?9.20)%.The peak concentrations of low,medial and high dose drop group and single iv group are(2.28?1.06),(3.54?0.32),(6.12?1.61)and(5.16?1.02)?g/ml.CONCLUSION:The biological assays is a simple,reliable method to determine the plasma level.

Objective To understand the elementary information and pharmacotherapy for benign prostatic hyperplasia (BPH) in outpatients in geriatrics department of three hospitals. Methods The outpatients diagnosed as BPH were investigated by daily BPH diagnosis report form, BPH medical-care requirement questionnaire, international prostate symptom score (IPSS) questionnaire and BPH quality of life scale (BPHQLS) in odd months. Results There were 657 outpatients in the three hospitals, including 456 males and 201 females. 289 patients were diagnosed as BPH, accounting for 44% of all outpatients and 63.4% of male patients. The average age of BPH patients was (77.2±5.7)years, the mean volume of prostate was (41.44 ± 21.00)ml, the median value of prostate specific antigen (PSA) was 2.24 μg/L, the mean maximum flow rate was (12. 65± 5.74)ml/s, and the average of IPSS and BPHQLS were 14.8±8. 11, 2. 56±1.36, respectively. The percentage of pharmacotherapy was 66.21% (96/145), and the rates of a-receptor blocker monotherapy and 5α-reduetase inhibitor monotherapy were 6.90% and 8. 97%, respectively. The percentage of drug combination was 26.90%. Conclusions BPH outpatients in geriatrics department of the three hospitals are at high risk, and most of them receive drug therapy. The drug choice is reasonable.

Objective To explore the standard clinical pathway and stratified cost insurance in patients with senile cataract operation. Methods Patients treatment by senile cataract phacoemulsification combined with IOL implantation were selected as research subjects by cluster sample from two hospitals from 2013 to 2014 . Patients were divided into different groups according to the year, chronic diseases, preoperative waiting time. The difference of hospitalization expenses and hospitalization time were compared. Different levels of hospital costs were established by CHAID decision tree used hospitalization cost as target variable. Results The waiting time for operation was 2 days, the total hospitalized time was 5 days and these can be used as reference time in clinical pathway. Patients uninsured or with long waiting time for operation had longer hospitalized time. Chronic disease, terms of payment and waiting time before operation were point factors that effect the hierarchical of decision tree. Conclusion The new standard of clinical path need to adjust constantly. Distinguish different patients condition and pay different clinical path costs.

ObjectiveTo investigate the efficiency of autologous transplantation of peripheral blood stem cells for treatment of patients with diabetic lower limb ischemia.MethodsEighteen patients of type 2 diabetes with diabetic lower limb ischemia (30 legs) were treated by autologous transplantation of peripheral blood stem cells.ResultsThe limb pain, cool feeling and numbness feeling improved significantly after PBSC transplantation,the improvement rate were 96.7％, 100.0％ and 95.8％ respectively.Intermittent claudication was also relieved significantly, total remission rate was 76.9％.The ABI and TcPO2 of patients increased significantly at 3 months after transplantation.After the transplantation ABI raised from 0.60 ± 0.11 to 0.71 ±0.12(t =-6.882, P ＜ 0.01) .93.3％ of patients' TcPO2 raised in different degrees.The foot infections were well controlled.Ulcer or toes gangrene got better or healed.No obvious complications or adverse reaction were observed after the transplantation.ConclusionAutologous transplantation of peripheral blood stem cells shows to be a simple, safe and effective method in treating patients with diabetic lower limb ischemia.