OBJECTIVE: To evaluate the cost-effectiveness of five regimens of antibacterial drug therapy in the treatment of community acquired pneumonia. METHODS: A retrospective study was conducted, in which a total of 128 cases with pneumonia were enrolled and randomly assigned to receive each of the following 5 therapies,cefoperazone sodium/ sulbactam sodium(Group A),levofloxacin(Group B),amoxicillin/ clavulanate potassium(Group C),azithromycin plus ceftazidime(Group D),and cefoxitin(Group E),the therapeutic effects were monitored and the cost-effectiveness analyses were conducted on the five groups. RESULTS: The costs of the five regimens were 2 137.0 yuan, 1 393.0 yuan, 1 152.5yuan, 2 044.2 yuan and 1 827.0 yuan, respectively;The effective rates were 85.2%, 86.6%, 80.6%, 89.6% and 78.5%, respectively;The cost-effectiveness ratios were 25.08 , 16.09, 14.30, 22.82 and 23.27, respectively; As compared with group C, the incremental cost-effectiveness ratios of the other four groups were 214.02,40.08, 99.08 and —321.19, respectively. CONCLUSION: The therapy of amoxicillin/ potassium clavulanate is superior to the other regimes in the treatment of community acquired pneumonia.

Objective To find out easily-processed and longly-preservated nerve allograft transplantation which has not only no-obvious antigenicity,but the integral structure of intermal nerve membrane.Mehtods Acquire the nerve allografts under sterile condition,submerge them into 50 ,70 and 85 percent of glycerol for 3 hours respectively at 37 Centigrade degree,then put them into the containers which contain 85 percent of glycerol. After sealed and preservated at 5 Centigrade degree for 6 weeks,the processed nerves can be used for transplantation.Results 14 nerve allografts processed with glycerol were transplanted in 10 patients with nerve defects varying from 2.5 to 18 cm. After follow-up for 5 to 42 months,the effects were proved to be satisfactory.Conclusion It is obviously effective to transplant nerve allograft processed with glycerol and preservated for 6 weeks for bridging the defects of peripherall nerve through a series of clinical observations.

BACKGROUND: Several different patterns of wavebreak have been described by mapping of the tissue surface during fibrillation. However, it is not clear whether these surface patterns are caused by multiple distinct mechanisms or by a single mechanism. METHODS: To determine the mechanism by which wavebreaks are generated during ventricular fibrillation, we conducted optical mapping studies and single cell transmembrane potential recording in 6 isolated swine right ventricles. RESULTS: Among 763 episodes of wavebreak (0.75 times/sec/cm2), optical maps showed 3 patterns: 80% due to a wavefront encountering the refractory waveback of another wave, 11.5% due to wavefronts passing perpendicularly each other and 8.5% due to a new (target) wave arising just beyond the refractory tail of a previous wave. Computer simulations of scroll waves in 3-D tissue showed that these surface patterns could be attributed to two fundamental mechanisms: head-to-tail interactions and filament break. CONCLUSION: We conclude that during sustained ventricular fibrillation in swine RV, surface patterns of wavebreak are produced by two fundamental mechanisms: head-to-tail interaction between waves and filament break.
Computer Simulation ; Heart Ventricles* ; Membrane Potentials ; Swine* ; Ventricular Fibrillation*

BACKGROUND:In vitro screening and amplification are important links to harvest muscle-derived stem cells that are satisfactory to clinical requirement.OBJECTIVE:To probe into the method of isolation,culture and purification of skeletal muscle-derived stem cells from adult rats in vitro.METHODS:The skeletal muscle was obtained sterilely following adult Sprague Dawley rats were anesthetized.Muscle-derived stem cells were harvested using enzyme digestion with Ⅺ collagenase,Dispese and trypsogen,and then purified by Percoll density gradient centrifugation and differential adhesion method.Growth curves were recorded and MTT colorimetric technique was used to describe the effects of various kinds of inoculum density on cell growth.Cells were identified by immunocytochemistry.RESULTS AND CONCLUSION:Primary muscle-derived stem cells were less in volume,lower adherence and well refraction,appearing as globular or fusiform or spindle and slowly multiplication.Following subculture,complete medium containing 20%serum was added.Cell number was greatest when cell density was 1×109/L,which was the optimal density.Cells at passages 1-4 grew well.Cells showed desmin(+),CD34(+),CD45(-)and Sca-1(+)by immunocytochemistry.Results verified that high-purity muscle-derived stem cells can be obtained in vitro and amplified successfully following primary culture.

Aiming at evidence-based medicine course of graduate students, foreign medical colleges and universities usually took in the teaching philosophy that emphasized stages (focusing on knowledge ac-cumulation) and practicality (focusing on ability training). And they put forward a lot of teaching methods which implemented the conception, such as problem-based learning, journal club, blended learning approach, online learning platform, concept mapping etc. In order to provide a useful reference for the domestic teaching reform and development, this paper introduced the teaching philosophy and related teaching meth-ods mentioned above.

Objective To examine the operation efficiency of hospital clinical departments and explore ways to improve inefficient units from an input-output perspective.Methods We used the data envelopment analysis(DEA) to analyze the panel data in 2013-2017 from 30 clinical departments of a hospital,applying the CCR model and the BCC model.Results The overall operation efficiency of the hospital was as high as 26.32％ of its clinical departments showed the increasing returns to scale.The scale efficiency was found to be high when the bed size in clinical departments ranged from 1 to 20,from 41 to 80,or from 91 to 100.There was an irrationality in fixed assets and staff deployment.Conclusions Size and input of clinical departments should be carefully planned to increase resource utilization efficiency.

OBJECTIVETo determine the expressions of miR-155, miR-34a and miR-30a in diffuse large B-cell lymphoma (DLBCL) and to explore their potential correlation with clinicopathological characteristics.

METHODSThe expression level of miR-155, miR-34a and miR-30a in 46 DLBCL samples were determined with TaqMan real-time polymerase chain reaction. Interphase fluorescence in situ hybridization (I-FISH) was performed to detect MYC and p53 genes' status, and immunohistochemistry (Envision method) was used to evaluate the expression of CD3, CD10, CD20, BCL-6 and MUM-1 in DLBCL. The DLBCLs were classified into germinal center B cell-like (GCB) and non germinal center B cell-like (non-GCB) subtypes according to Hans' criteria.

RESULTSCompared with normal controls, miR-155 expression level was significantly higher in DLBCL. The expression level of miR-155 in non-GCB type was higher than that in GCB type. It was shown that the patients with MYC rearrangement had lower expression level of miR-155 than the negative controls. Compared with p53 normal group, the expression level of miR-34a was significantly lower in p53 deletion group. It was also shown that the patients with BCL-6 protein expression had lower expression of miR-30a compared with the negative group.

CONCLUSIONmiR-155 expression level is different in normal controls, DLBCL and patients with subtype DLBCL. It therefore has a diagnosis value for DLBCL. miR-34a is of great prognostic significance. miR-155, miR-34a and miR-30a may be potential therapy targets for DLBCL.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Gene Expression Regulation, Neoplastic ; Humans ; Lymphoma, Large B-Cell, Diffuse ; genetics ; metabolism ; pathology ; Male ; MicroRNAs ; genetics ; metabolism ; Middle Aged ; Proto-Oncogene Proteins c-myc ; genetics ; metabolism ; Tumor Suppressor Protein p53 ; genetics ; metabolism ; Young Adult

Objective To investigate the application value of multi-slice spiral CT on the congenital malformation of coronary sinus. Methods MSCT finding of 98 patients with coronary sinus malformation confirmed by surgery were retrospectively analyzed,and the cases were divided into four categories based on the Mantini theory and comparison was made between the diagnosis from ultrasound and CT.A 2 × 2 table for Chi-square test was also used for statistics analysis.Results Among 98 patients,there were 72 patients with persistent left superior vena cava reflowed to right atria through coronary sinus,with 48 patients diagnosed by ultrasound and 72 patients by MSCT; there were 13 patients with anomalous pulmonary venous connection to coronary sinus,with 12 patients diagnosed by ultrasound and 13 patients by MSCT diagnosis; there were 10 patients with unroofed coronary sinus syndrome,with 6 patients diagnosed by ultrasound and 8 patients by MSCT,there were 2 patients with coronary sinus atresia,all diagnosed by MSCT; there were 1 patient with coronary sinus anomaly reflow to left arita.The significant difference between 2 modalities (x2 =22.7,P＜0.01) shows that CT is superior to ultrasound.Conclusion MSCT is much more better than ultrasound in the diagnosis of malformation of coronary sinus and it can provide reliable diagnosis prior to surgery or interventional therapy.

OBJECTIVE: To investigate the relationship between the subjective sensation of nasal obstruction and the corresponding objective parameters of acoustic rhinometry. METHOD: Three hundred and sixty-five patients with nasal diseases were divided into two groups: one group included 220 cases with nasal obstruction, and the second group of 145 cases without nasal obstruction. Seventy healthy adults were selected as control. Each one were assessed for nasal minimal cross-sectional area (NMCA), volume of nasal cavity (NV), nasal airway resistance (NAR) and distance of the minimal cross section area from the nostril (DCAN) by using acoustic rhinometry, and the subjective test were performed using the VAS scores. The results were statistically analyzed. RESULT: NV, DCAN and NAR had a significant difference between nasal obstruct group and control group (P < 0.05). The VAS score had linear correlation with NMCA, NV, DCAN and NAR, and the correlation coefficient were R(NAR) = 0.7385, R(NV) = -0.853 2, R(NMCA) = -0.745 4 and R(DCAN) = 0.369 7, respectively. CONCLUSION Since NAR and NV coincide with the subjective perception of patients with nasal obstruction, they can be used as the sensitive parameters to evaluate subjective symptoms of patients.
Adult ; Aged ; Airway Resistance ; Case-Control Studies ; Humans ; Male ; Middle Aged ; Nasal Obstruction ; physiopathology ; Rhinometry, Acoustic ; Young Adult

BACKGROUND:Satellite cells are myogenic stem cells located between the muscle fiber membrane and the basement membrane.However,a comprehensive review of the aging mechanisms of satellite cells and their potential mitigation strategies is still lacking.This gap in knowledge hinders the effective guidance for current strategies aimed at attenuating skeletal muscle aging. OBJECTIVE:To review the mechanisms of satellite cell aging in skeletal muscle and the relevant strategies for mitigating this aging process. METHODS:Major databases were searched up to May 2023,including Web of Science,PubMed,China National Knowledge Infrastructure(CNKI),WanFang Data,and VIP.Chinese and English search terms included"skeletal muscle,satellite cells,aging,mechanism,and solution strategy".After strict inclusion and exclusion criteria were applied,78 articles were finally included. RESULTS AND CONCLUSION:(1)Satellite cells,situated between the muscle fiber membrane and basement membrane,possess proliferative and differentiative potential.They usually remain in a quiescent state but become activated in response to muscle tissue stimuli,participating in processes of repair and restoration of normal tissue structure.Aging leads to a reduction in satellite cell numbers,resulting in symptoms such as muscle weakness and decreased endurance.(2)Mechanisms of satellite cell aging primarily involve diminished regenerative capacity,perturbed niche interactions with changing ecology,age-dependent loss,and heterogeneity changes.Reduced satellite cell numbers and activity due to aging lead to slower muscle regeneration and increased injury recovery time.Errors during differentiation may occur,resulting in decreased muscle quality and function deterioration.(3)Strategies for mitigating satellite cell aging encompass modulation of the receptor environment of intra-body satellite cells,peripheral interventions to promote satellite cell regeneration,construction of human muscle models,and exercise and nutritional interventions to induce satellite cell proliferation.These strategies hold promise in offering novel insights and methods for satellite cell regeneration and treatment of skeletal muscle diseases.(4)Future research should delve into the mechanisms of satellite cell aging,explore the interaction between satellite cells and their niches,investigate the relationship of satellite cells with the immune system and mitochondrial function,and develop human muscle models to enhance research depth and accuracy.