OBJECTIVE:To evaluate the pharmacoeconomic effectiveness of three therapeutic schemes for lower respiratory tract infections.METHODS:The cost-effectiveness analysis of three therapeutic schemes for lower respiratory tract infections was carried out.RESULTS:The cost-effectiveness ratio of penicillin-piperacillin schemes(L1)was minimum in respect to the effective rate.However,the cost-effectiveness ratios had no significant difference between cefotaxime scheme(L3)and L1 scheme in regard to cure rate(P>0.05),the cost-effectiveness ratio of ciprofloxacin-clinadmacin scheme(L2) was higher significantly than those of L1 and L3 schemes(P<0.05,both schemes).CONCLUSION： L1 is the best therapeutic scheme.Although L3 scheme had higher cost,it had higher cure rate and lower ADRs occurrence.L3 scheme is benefitial to improvement of patient's life quality.

Objective To investigate experience in adult inguinal hernia treated with the open preperitoneal herniorrhaphy.Methods Eight hundred and twenty-six cases were retrospectively analyzed from February 2004 to December 2011 in our hospital.The effect of operative methods and treatment were observed simultaneously.Results All the patients were cured completely without special complications; Followed up for 12 months,some negative factors such as incision infection,recurrence,special discomfort,and chronic pain have not been appeared.Conclusions The open preperitoneal herniorrhaphy under local anesthesia for adult inguinal hernia is safe,reliable and effective.

Objective: To evaluate the effect of Shenfu Injection in treating vertigo of mild vertebrobasilar stenosis. Methods: From January 2005 to July 2008, 66 patients with the primary symptom of vertigo undergoing digital subtraction angiography (DSA) examination were diagnosed as mild vertebrobasilar stenosis (MVS) according to the North American symptomatic carotid endarterectomy trial (NASCET) criteria, and then randomly divided into Shenfu (SF) group (34 cases) and Danshen (DS) group (32 cases), the DS group acting as the control. Degrees of vertigo of the patients were evaluated by the screening version of the dizziness handicap inventory (DHI-S) and scoring system for the dizziness assessment rating scale (DARS) on the admitted day, the third and sixth day after treatment and discharged day respectively. The mean of blood ? ow velocity (Vm), resistance index (RI) of right and left vertebral arterys and basilar artery, hematocrit (Hmc) and fi brinogen (Fbg) level in serum were all examined on both the admitted and discharged days. Results: There was no signifi cant difference on the score of vertigo, the parameter of TCD and the index in serum between SF and DS groups at the admitted time. On the sixth day of treatment and the discharged day, the score of DHI-S and DARS in SF group were lower than those in DS group (P

OBJECTIVE: To establish a HPLC method for content determination of gatifloxacin in human plasma.METHODS: The Analytical column was C18,the mobile phase consisted of acetonitrile-30mmol/L ammonium acetate-triethylamine-orthophosphoric acid (20∶80∶1.0∶0.7) with a flow rate of 1.0ml/min,the detection was performed at UV 294nm.RESULTS: The calibration curve was linear in the concentrations ranging from 0.1 to10.0?g /ml (r=0.9 992).The detection limit was 0.05?g/ml.The intraday RSD was less than 8% and interday RSD was less than 10%.The average recovery was (101.67?3.06)%.CONCLUSION: The method is simple, sensitive, accurate and suitable for determination of gatifloxacin in human plasma and pharmacokinetic study.

Objective:To observe the role of lamividine and silymarin preventing and curing liver fibrosisrelevant factors induced by alcohol drinking in hepatitis B virus (HBV) transgenic mice (Tg mice).Methods:Forty HBV-Tg BALB/C mice with 1.3 copy were randomly divided into 4 groups:a control group,a model group,a lamivudine group and a silymarin group.Tg mice in control group were treated with normal saline via intragastric administration;Tg-mice in the model group were treated with 50％ alcohol (5 mL/kg) once a day via intragastric administration;while Tg-mice in lamivudine group and silymarin group were treated with alcohol (5 mL/kg) plus laminvudine (100 mg/kg) and silymarin (200 mg/kg) once a day via intragastric administration respectively.All groups were raised for 10 weeks.The levels of HBV-DNA copy number,ALT,AST in serum,the degree of inflammation,the degree of fibrosis,the mRNA expression levels of TGF-β 1,Smad3,Smad7 and connective tissue growth factor (CTGF),and the protein expression levels of TGF-β1,CTGF and α-SMA in liver tissue were detected.All the images were scanned with electronic computer and the data were analyzed with SPSS13.0 software.Results:Compared with the control group,liver injury were significantly aggravated,while HBVDNA copies,mRNA levels ofTGF-β1,Smad3,Smad7 and CTGF as well as the protein levels of TGF-β1,CTGF and α-SMA were significantly increased (P＜0.05).Compared with the model group,liver injury were significantly attenuated in silymarine group and lamivudine group,while mRNA levels of TGF-β 1,Smad3 and CTGF as well as the protein levels of TGF-β1,CTGF and α-SMA were significantly decreased;mRNA level of Smad7 was further increased (P＜0.05);the levels of ALT and AST in serum were decreased in the silymarine group (P＜0.05).Conclusion:Lamivudine and silymarin relieve the histological damage in the liver of alcohol-fed Tg mice.The mechanisms for the beneficial effects of lamivudine or silymarin might be related to inhibiting the expression of TGF-β 1,Smad3 and CTGF,modulating the expression of Smads and suppressing the activation of HSC.

Four patients with coexistence of sarcoidosis and primary Sj(o)gren syndrome (pSS) were retrospectively analyzed.All patients were female,who were referred to our department mainly because of respiratory symptoms.Positive antinuclear antibody (ANA) was detected in 2 patients and anti-Sj(o)grens syndrome A (SSA) antibody positive in 1 patient.All patients presented specific histologic patterns of both sarcoidosis and pSS.Publications related to coexistence of these two diseases were reviewed.Forty-one patients were finally included in the analysis,among whom 37 confirmed patients were from literature search.There were 37 women and 4 men.The main clinical features presentation were xerophthalmia in 40,xerostomia in 38,hilaradenopathies in 28,interstitial lung disease in 15,respiratory symptoms in 13.The main immunologic data were positive ANA in 23,SSA antibody in 19,anti-Sj(o)grens syndrome B antibody in 10 and rheumatoid factor in 12.All patients presented specific histologic patterns of both diseases.Patients with both sarcoidosis and pSS of ten represent multisystemic involvement and positive immunologic parameters,as well as the dual expression of specific histologic characteristics.

Objective To evaluate the causes of local masses found after periocular fat grafting,and the way of treatment in order to avoid the medical dispute.Methods In 37 patients with local mass being repaired,15 patients with superficial bulges were treated through surgical removal and as piration;10 patients with focal masses were treated with aspiration;12 patients with bulges close to eyelid margin and failure after the first two treatment methods were treated through incision.Results Histopathologic findings showed the characteristic features of lipogranuloma.Chronic inflammatory cells were infiltrated.Numerous,variable-sized lipid vacuoles were surrounded by histiocytes and for eign body-type giant cells.There were areas of fibrosis and fat necrosis.35 cases were followed-up for 3 months to 1 years.Both doctors and patients were satisfied with results in 27 cases,basically satisfied in 6 cases,but not satisfied in 2 cases.Two patients were lost to follow up.Conclusions The special complication of masses in the periocular fat grafting operation can be greatly improved with the personalized therapy.

Objective To evaluate the iodine nutritional status and thyroid function of pregnant women in different periods of pregnancy,analyze the relationship between iodine nutritional status and thyroid function and provide a basis for scientific supplementation of iodine to pregnant women.Methods In 2013 and 2014,using stratified random sampling method,six counties were selected in the city;around 30 early,middle and late pregnant women each in every county were selected;a total of 545 (173 early,203 middle and 169 late) pregnant women were investigated in the 6 counties;instant random urine samples of 25 ml were collected and urinary iodine was tested.A total of 151 (52 early,55 middle and 44 late) pregnant women were selected to collect 3 ml venous blood samples for determination of thyroid hormone and thyroid autoantibodies.Results Median urinary iodine levels of early,middle and late pregnant women were 132.2,128.9 and 113.5 μg/L,respectively,under the condition of iodine deficiency.Prevalence rates of low frce thyroxine FT4,subclinical hypothyroidism,hypothyroidism and hyperthyroidism in pregnant women were 0.66％ (1/151),15.23％ (23/151),0.66％ (1/151) and 0.66％ (1/151),respectively.The positive rate of TgAb and TPOAb was 15.23％ (23/151) and 11.92％ (18/151),respectively.There were significant differences in the levels of free three iodine thyroid (FT3) in different periods of pregnancy (F =7.723,P ＜ 0.05);FT3 in late pregnancy was lower than that in early and middle pregnancy (P ＜ 0.05).There were significant differences in the levels of FT4 in different periods of pregnancy (F =3.762,P ＜ 0.05);FT4 in late pregnancy was lower than that in early and middle pregnancy (P ＜ 0.05).There were significant differences in the levels of thyroid stimulating hormone (TSH) in different periods of pregnancy (F =13.199,P ＜ 0.05);TSH in early pregnancy was higher than that in middle and late pregnancy (P ＜ 0.05).Subclinical hypothyroidism prevalence rate in late pregnancy was higher than that in middle pregnancy (x2 =3.912,P ＜ 0.05).The positive rate of TgAb in early and middle pregnancy was higher than that in late pregnancy (x2 =9.883,3.906,all P ＜ 0.05).Urinary iodine ≥250 μg/L was a risk factor for subclinical hypothyroidism in pregnant woman [odds ratio (OR) =5.076,P ＜ 0.05].Conclusions The iodine nutrition of pregnant women in Tianjin is insufficient.Excessive urinary iodine is an increased risk of subclinical hypothyroidism.We should monitor the urinary iodine and thyroid function in pregnant women.

Objective To establish a real-time fluorescence quantitative PCR method for detection of the different expression level of FPGS in methotrexate enantiomer-resistant A549 cell lines,and observe FPGS mRNA expression in patients with leukemia.Methods A real-time fluorescence quantitative PCR method for detection FPGS mRNA was established using SYBR Green Ⅰ as fluorescence and β-actin as reference.The method was evaluated by Ct,correlation coefficient,slope,repeatability curve,melting curve and amplification efficiency curve.The expression levels of FPGS gene in methotrexate enantiomer-resistant A549 cell lines and methotrexate resistant leukemia cells in bone marrow were detected by the method.Results The standard curves had a high linear relationship between cycle threshold and template concentration.The correlation coefficients of FPGS and β-actin were 0.996 8 and 0.998 7,and the slopes were -3.595 and -3.740,respectively.The inter-coefficient of variation was from 1.27% to 2.95%.The intra-coefficient of variation was 3.82%.The method was characterized with specific melting curve and similar amplification efficiency(slope was 0.021 7).The relative contents of FPGS mRNA were(3.51 ±0.66),(0.16 ±0.01) and(1.00 ±0.31) in L-(+)-MTX/A549 cells(L),D-(-)-MTX/A549 cells(D)and A549 parent cells,and there was statistically difference among the three groups(F = 64.45 ,P＜ 0.01)Statistical difference was observed between L and D(q =9.29,P＜0.01).After treated with MTX,the expression level of FPGS mRNA was(0.35 ± 0.04) in methotrexate resistant leukemia patients,compared with(1.00 ± 0.44) before treatment.Statistical difference was observed(t = 8.83 ,P＜ 0.01).Conclusions The real-time fluorescence quantitative PCR is suitable for the quantification of FPGS.The expression levels of FPGS in methotrexate resistant leukemia cells in bone marrow and drug resistant cells are different.Two enantiomer forms of methotrexate may play different roles in drug resistance mechanisms.

Objective:To study the role of indocyanine green(ICG)fluorescence imaging in laparoscopic partial splenectomy (LPS).Methods:The data of 4 patients who underwent ICG fluorescence imaging technology for LPS at Beijing Luhe Hospital Affiliated to Capital Medical University from May 2017 to May 2020 were retrospectively analyzed. There were 3 females and 1 male, aged 46, 41, 27 and 12 years respectively. The extents of spleen preservation were compared between ICG fluorescence imaging with ordinary white light during operation. The residual splenic remnants were tested with fluorescence imaging after splenectomy, which showed fluorescence fading indicating good vascular perfusion.Results:ICG fluorescence imaging was performed on 4 patients. The operation time ranged from 180.0 to 250.0 min, and the intraoperative blood loss ranged from 40.0 to 200.0 ml. The postoperative hospital stay ranged from 4 to 14 days. There were no serious complications. Postoperative histopathology showed: splenic cyst ( n=1), splenic hemangioma ( n=2), and splenic laceration ( n=1). Conclusions:ICG fluorescence imaging technology had a significant role to play in partial splenectomy. This study showed this technique to improve safety of laparoscopic partial splenectomy.