0.05).The total treatment costs were(1084.43?247.38)yuan for the treatment group and(1211.23?275.95)yuan for the controlled group,which had significant difference(P0.05).The total costs were(1270.45?218.12)yuan for the treatment group and(1407.51?51.01)yuan for the controlled group(P

OBJECTIVE:To evaluate the cost-effectiveness of 3 therapeutic regimes in the treatment of functional dyspepsia. METHODS:125 cases were randomly divided into 3 groups,group A was treated with domperidone,group B was treated with domperidone plus doxepin hydrochloride,and group C was treated with domperidone plus famotidine,the curative effects of the 3 group were observed after oral administration and the cost-effectiveness analysis was conducted as well. RESULTS:The costs for group A,B and C were 792.56 yuan,800.12 yuan and 803.76 yuan,respectively;The effective rates were 51.17%,82.50%and 71.43%,respectively;The cost-effectiveness ratio were 15.49,9.70 and 11.25,respectively;The incremental cost-effectiveness ratios of group B and C vs. group A were 0.24 and 0.55,respectively. CONCLUSION:Regime B was superior among the other two therapeutic regimes.

Objective To investigate the effect of hydroxyethyl starch (HES) 130/0.4 on intraabdominal hypertension (IAH) and inflammatory cytokines in early stage of severe acute pancreatitis (SAP).Methods Clinical data of 55 case of SAP with IAH from Nov 2007 to Oct 2013 in Pancreas Surgery Department of Wuhan Union Hospital were analyzed retrospectively.All patients received conventional treatment without operation.According to the method of fluid resuscitation,patients were divided into treatment group (n =24) and control group (n =31).In treatment group,patients received ringer solution plus 6％ HES 130/0.4 for fluid resuscitation,and patients in control group received only ringer solution for fluid resuscitation.The IAP level,APACHE Ⅱ score and serum inflammatory cytokine from day 1 to 8 were measured.Results The baseline data between the two groups were comparable.The IAP level was significantly lower in treatment group than that in control group from day 5 to day 8 [(10.2 ±2.9),(8.8 ±2.9),(7.9 ± 2.5),(6.9±2.6)mmHg vs (11.9±2.7),(10.5±2.7),(9.5±2.4),(8.6±2.5)mmHg,1 mmHg=0.133 kPa,respectively],and the difference between the two groups was statistically significant (P ＜0.05).There was no significant difference in APACHE Ⅱ score between the two groups,but the decline of APACHE Ⅱ score from baseline (△APACHE Ⅱ score) was more significant in treatment group (P ＜0.05).The serum IL-1 and IL-8 level in treatment group at day 8 was lower than that in control group [(15.1 ± 13.7) μg/L vs (23.6 ± 13.5) μg/L,(11.2 ± 12.8) μg/L vs (23.8 ± 27.9) μg/L,respectively],and the difference between the two groups was statistically significant (P ＜ 0.05).And the serum TNF-α level in treatment group at day 4 and day 8 was lower than that in control group [(31.9 ± 12.1) μg/L vs (43.4 ± 22.4) μg/L,(24.2 ± 12.8) μg/L vs (35.1 ± 15.3) μg/L],and the difference between the two groups was statistically significant (P ＜ 0.05).Conclusions Early fluid resuscitation with HES 130/0.4 and ringer solution relieves IAH,reduces APACHE Ⅱ score and down-regulates IL-1,IL-8 and TNF-α level.

Abstract: Objective To clarify the long-term evolution of hepatitis B virus (HBV) quasi-species in HBsAg asymptomatic carriers in Long'an county, Guangxi. Methods ELISA was used to detect serological markers of HBV. Viral loads were measured by real time PCR. HBV DNA was extracted from serum by kits. The whole HBV genome was amplified using nested PCR and amplicons were sequenced by next-generation sequencing (NGS). These sequences from NGS were analyzed by the software like Mega. Results Serum samples were collected from 9 HBsAg asymptomatic carriers in Longan County，Guangxi at 4 different time points in 2004, 2007, 2013, 2019 or 2020. A total of 23 serum samples and 309 full-length gene quasi-species sequences were obtained, with an average amount of (0.18±0.07) G sequencing data for each sample. Genotype of 55.54%(5/9) the studied subjects underwent genotype conversion during the long-term evolution process of HBV quasi-species, and the genotyping results of the phylogenetic tree in the PreS/S region are in perfect agreement with the results of the whole genome analysis; recombinant B/C, I/C were found; the Sn ranged from 0 to 0.37 and the genetic diversity ranged from 0 to 0.11, respectively. A total of 21 special single nucleotide/amino acid mutations (7 in the S region, 2 in the X region, 3 in the PreC region and 9 in the BCP region) and 6 deletion mutations were detected, multiple mutations were found and no drug resistant mutations were found; 77.8%(7/9) of the HBV strains carried by the subjects in 2004 had double mutations at nt1 762(A→T) and 1 764(G→A) and a stop mutation at nt1 896(G→A); HBV mutations can be restored from the mutant type to the wild type and (or) vice versa without antiviral drug pressure, and The evolution rate of HBV genome was 2.03×10-5~3.50×10-3.Conclusion HBV genotype, recombinants, genetic complexity and diversity of HBV quasi-species can change over time during in natural infection. The transformation between HBV mutation type and wild type reduces the value of predicting clinical outcomes by genetic types and related mutations to some extent. The HBV genome evolution rate of asymptomatic carriers of HBsAg in Long'an County is very high.