OBJECTIVE:To study the identification problems of pharmacokinetic compartment models.METHODS:Problems of the identification of classical compartment models in single administration were systematically discussed by Laplace transformation method.RESULTS:The classical compartment models in single administration don't have the character of u-niqueness and the identification for which is a problem.CONCLUSION:The drug level in plasma and the concentration of drugs that distributed in organs were in a direct ratio under the condition of two kinds of unidentifiable classical compartment models,in that case,it has theoretic bases and significance to predict the concentration of drugs that distributed in organs or target organs by means of determining the drug concentration in plasma;if on the other hand,if two kinds of classical com-partment models are identifiable,the drug level in plasma and the concentration of drugs that distributed in organs or target organs wouldn't be in a proportional relationship,in this case,it is advisable to make sure the relationship between the drug le_ vel in plasma and the concentration of drugs that distributed in organs or target organs before predicting drug concentration that distributed in organs or target organs by means of monitoring the drug concentration in plasma;otherwise,it is baseless and meaningless.

Objective To observe and discuss the effect of using the self-made pressure reduction bilateral nasal oxygen tube to prevent the ear pressure sore for the comatose patients. Methods Totally 86 cases of comatose patients which needed permanent oxygen inhale admitted during Jan 2016 to Dec 2016 were divided into observation group and control group:Each group 43 cases. Observation group used self-made pressure reduction bilateral nasal oxygen tube to inhale the oxygen, control group used the conventional disposable bilateral nasal oxygen tube to inhale the oxygen and the pressure ulcer stage. Results There was no significant difference in Braden score in two groups, the difference was statistically significant (P>0.05) . Observed two groups patients′ nasal oxygen tube ear pressure sore situation, these were only 2 patients happened nasal oxygen tube ear pressure sore in observation group, on the contrary, these were 9 patients happened in control group, occulting probability was higher than observation group significantly. and the extend of the pressure sore is much serious than the observation. Difference was statistically significant (χ2=5.11, P<0.05). Conclusions During the privation of the nasal oxygen tube ear pressure sore for the comatose patients, self-made pressure reduction bilateral nasal oxygen tube can alleviate the ear skin pressure effectively, reduce the pressure sore occur, the effect is obvious, nursing quality is improved, deserve the clinical expansion.

OBJECTIVE:To evaluate the application of cost-utility analysis in health area of China in recent year. METH-ODS:From CNKI,Wanfang and VIP database,settingcost utilityorcost-utilityastitleorkeyword,related literatures were retrieved during Jan. 2011-Dec. 2015,with subject field ofmedical science and technologyin CNKI,medical sciencein Wanfang database,clinical medicineChinese medicinepreclinical medicinepreventive medicine hygieneorpharmacyin VIP. The comprehensive evaluation involved research design,research perspective,cost measurement,utility index and measure-ment method,cost-utility analysis index,discount and sensitivity analysis. RESULTS:A total of 31 literatures meeting inclusion cri-teria were selected,including 12 prospective studies,9 retrospective studies,9 Markov model studies,1 mixed study. Thirteen lit-eratures worked in medical institutions. Seven literatures explicitly mentioned research perspective;most literatures only measured direct cost(19 literatures)and adopted QALY as utility index(27 literatures). Twenty eight literatures described measurement meth-od of utility index(direct measurement,indirect measurement or literature method)in detail. More than half(16 literatures)analyzed cost-utility by using cost-utility ratio(CUR);7 literatures adopted incremental cost-utility ratio(ICUR)and 6 literatures adopted both CUR and ICUR. Five literatures used the threshold of ICUR. Eleven literatures described discount,and the majority was Markov mod-el study. Sensitivity analysis was conducted in 16 literatures,among which 11 literatures adopted single factor analysis. The most com-monly involved influential factor was cost,followed by utility value and discount rate. CONCLUSIONS:Cost-utility analysis has been widely used in China,but the quality and normalization of studies have much room for improvement. Learning more experiences from international researches can help to promote the quality of domestic studies,guide the practice of clinical rational use of drugs and sup-port the government decision-making process and medical insurance payment in the future.

Objective To investigate the potential factors that may be associated with clinical significant endoscopy findings (CSEF) and the characters of the appropriate patients for upper endoscopy.Methods Information of the out-patients was collected from the questionnaires that were performed before undergoing upper endoscopy from 26 September 2011 to 23 December 2011,including demographics characteristics,symptoms,gastroesophageal reflux disease questionnaire (Gerd Q) score,comorbidities,medication and purpose for upper endoscopy.The analyses were performed by Logistic regression to find the potential factors that were associated with CSEF.Results A total of 942 cases were enrolled.There were 471 (50.0％) patients with dyspepsia and reflux symptoms,300(31.8％)patients with dyspepsia and without reflux symptoms,and 86(9.1％)patients with reflux symptoms and without dyspepsia.Sum to 325 (34.5％) patients were diagnosed with CSEF,119(12.6％) with erosive esophagitis,28(3.0％) with Barrett esophagus,102 (10.8％)with peptic ulcers,66 (7.0％) with gastric dysplasia,and 13 (1.4％) with upper malignancy.Multivariate Logistic regression analysis showed that men (OR=1.677,95％CI:1.148 to 2.451),older age (OR=1.032,95％CI:1.021 to 1.044),alcohol intake (OR=1.761,95％CI:1.068 to 2.903),Gerd-Q score increase (OR=1.079,95％ CI:1.003 to 1.160),and presence of acid regurgitation (OR=1.659,95 ％CI:1.143 to 2.408) were significantly associated with increasing risk of diagnosis for CSEF,while taking proton pump inhibitors (OR=0.298,95％CI 0.109 to 0.818)was associated with lower possibility of detection.Conclusions Factors such as male,older age,alcohol intake,Gerd-Q score increase,presence of acid regurgitation and taking proton pump inhibitors,may have a certain significance for screening out patients and further improving the cost efficiency of gastroscopy.

Radiotherapy plays a significant role in the treatment of lung malignant tumor.However,as the most main complication of radiotherapy used to treat lung malignant tumor,radiation-induced lung injury is an important influencing factor in impeding further and higher dose radiotherapy.Previous studies show that mesenchymal stem cells (MSCs) have the characteristics of self-replication,multiple differentiation,immunoregulation and directional migration. MSCs can help to repair many kinds of acute and chronic lung injury,meanwhile stem cell transplantation stimulates production of many cytokines to attenuate acute lung injury.So stem cell therapy provides a new kind of thinking in the prevention and treatment of radiation-induced lung injury.

Abodominal giant incisional hernia is the common complication of abdominal operations,and surgery is the only efficient treatment for it.It is important to treat the local complications,to use antibiotics and to assess the tolerance of increased intra-abdominal pressure before operation.Component separation technique is feasible to close the abdominal wall defect,which is one of the main difficuhies in giant heruia repair.After that,mesh repair with biological materials is recommended to enhance the abdominal wall.Although mesh repair techniques diversified,sandwich hernionhaphy seems superior.This paper will analyse the present treatment progress of abdominal giant incisional hernia.

Objective: To investigate the effects of hepatitis B virus (HBV) X protein (HBx) on the expression of tumor necrosis factor-α (TNF-α) in glomerular mesangial cells (GMCs) and the underlying intracellular signal pathways. Methods: The plasmid pCI-neo-X that carries the X gene of hepatitis B virus was transfected into cultured GMCs. HBx expression in the transfected GMCs was assessed by Western-blot. TNF-α protein and mRNA were assessed by ELISA and semi-quantitative RT-PCR, respectively. Three kinase inhibitors-U0126, an inhibitor of extracellular signal-regulated kinases (ERKs);lactacystin, an inhibitor of nuclear factor-κB (NF-κB);and SB203580, a selective inhibitor of p38 MAP kinase (p38 MAPK) were used to determine which intracellular signal pathways may underlie the action of HBx on TNF-αexpression in transfected GMCs. Results:A significant increase in HBx expression in pCI-neo-X transfected GMCs was detected at 36 h and 48 h, which was not affected by any of those kinase inhibitors mentioned above. A similar increase in the expression of both TNF-αprotein and mRNA was also observed at 36 h and 48 h, which was significantly decreased in the presence of U0126 or lactacytin, but not SB203580. Conclusions:HBx upregulates TNF-αexpression in cultured GMCs, possibly through ERKs and NF-κB pathway, but not p38 MAPK pathway.

Objective To determine the correlations between breast ultrasonic and mammographic features and molecular classification of breast infiltrating ductal carcinoma in young women.Methods A retrospective review of radiological,clinic-pathology features of breast cancers for women under 40 years at our hospital between January 2011 and May 2016 covering 94 patients.Mammography and ultrasound were available for all 94 patients.Results On sonography,basal like type tumours more often appeared as oval or round masses and microlobulated or indistinct margins luminal type irregular mass and angular or spiculated margins(P =0.000,P =0.000).Basal like type masses were often with abrupt interface,luminal A type with echogenic halo (P =0.000).On mamography,HER-2 enriched type cancers more presented as microcal cification only,basal likc type more masses(P =0.002).Luminal typc masses were more often with spiculated or obscured margins,basal like with indistinct margins(P =0.000).Conclusion The imaging charasteristics of breast infiltrating ductal carcinoma in patients under 40 years appear correlated to breast infiltrating ductal carcinoma.

Objective To explore the characteristics of childhood tuberculosis and recent advances in the diagnosis and treatment of this disease in order to improve its diagnosis and treatment. Methods Key words“child”“tuberculosis”“diagno-sis” and “treatment” were used to retrieve relevant literatures from Pubmed,Web of Science,CNKI and Wanfang databases.The literatures were reviewed and clinical experience summarized. Results Disseminated tuberculosis and extrapulmonary tubercu-losis were common in children with tuberculosis. It was difficult to collect with samples of diagnostic value for detection. There counterparts were no systematic diagnosis and treatment programs available for children with drug-resistant tuberculosis,and phar-maceutical dosage forms tailored for children were lacking. Conclusion Tuberculosis in children is more complex to diagnose and treat than in adult counterpart.Diagnosis of this disease relies on a variety of diagnostic methods.It's still challenging to control childhood tuberculosis.

Objective To investigate the incidence of adult epilepsy patients with attention-deficit hyperactivity disorder (ADHD) and the characteristics of ADHD subtypes, and to explore the correlations between several epilepsy-related factors with ADHD.Methods According to corresponding inclusion criteria and exclusion criteria, 156 adult epilepsy patients who visited to Neurology Clinic of Zhejiang Hospital and the First Affiliated Hospital of Anhui Medical University from March 2014 to October 2014 were enrolled as a study group to enter this test.Eighty-six nomal adults were enrolled as the control group who matched for the age, gender, inteligence quotient with the study group.Using the chi-square test and Logistic regression analysis and the other statistical methods to analyze the phenomenon of ADHD in adults with epilepsy and the factors that may contribute to the phenomenon.Results The detection rate of ADHD in 156 adult patients with epilepsy was 26.9％ (42/156), significantly higher than that in the heathly control group which was 4.7％ (4/86, x2 =17.862, P ＜ 0.05).Symptomatic epilepsy and the electroencephalogram showed multifocal discharge had higher detection rate of comorbid ADHD and the difference was statistically significant (The detection rate of idiophathic epilepsy was 22.1％ (21/95), symptomatic epilepsy was 46.7％ (14/30), cryptogenic epilepsy was 22.6％ (7/31), x2 =7.362, P =0.025.The detection rate of frontal epileptiform discharges was 30.6％ (11/36), temporal area was 25.9％ (14/54), central area was 18.2％ (4/22), multifocal epileptiform discharges was 46.2％ (12/26), the normal was 1/18, x2 =10.187, P =0.037).The results of binary Logistic regression analysis showed that epilepsy age of onset (B =-0.889, P =0.049) was possibly an important factor for epilepsy with ADHD.Conclusions The risk of ADHD occurred in adults with epilepsy is higher than that in the healthy adults and attention-deficit is the common subtype.The etiology, age of onset and electroencephalogram features of adults with epilepsy may be associated with the occurrence of ADHD.