Objective: This study aims to evaluate the prevention effect and cost-effectiveness of a prophylactic bivalent human papilloma virus (HPV) vaccine. Methods: A multiple health status dynamic model was developed, including natural history of diseases and prevention strategies. We built 19 prevention strategies including visual inspection with acetic acid/lugol's iodine (VIA/VILI) and/or 3 does prophylactic bivalent HPV vaccine administered to adolescent girls at the age of 15 years old every year under the assumption that vaccine coverage and screening coverage were 70%. The incremental cost-effectiveness ratio (ICER), optimal price of 3 does vaccine and cost-effectiveness frontier of these strategies were analyzed compared with no-intervention. The ICER threshold is 152 087 CNY. Results: Compared with no-intervention, Routine vaccination reduced the incidence of cervical cancer by 69.5%, superior to 5 strategies including VIA/VILI screening only. The range of effect was between 9.0% and 69.2%, and the effect of strategy increased significantly with the increase of screening frequency. Combination vaccination with screening at ages of 35 reduced the incidence of cervical cancer by 72.0%, and the effect increased with the increase of screening frequency. Combination vaccination with screening every 3 years between (35-64) years old reduced the incidence by 89.4%. Compared with no-intervention, the ICER of combination vaccination with screening twice between 35 years and 64 years was 121 292 CNY/life-year, which was cost-effective. The price of vaccine had a significant impact on the ICER of the strategy; when the vaccine price was less than 600 CNY, only routine vaccination or supplementary vaccination between 16-39 years old after routine vaccination was cost-effective; when the vaccine price was less than 1 200 CNY, supplementary vaccination between 16-19 years old plus VIA/VILI was cost-effective. Conclusion Ther prevention strategy was cost-effective, which could effectively reduce the incidence of cervical cancer by implementation of HPV vaccination combined with VIA/VILI in suitable aging females.

To investigate the chemical constituents of the whole plants of Bidens bipinnata, the separation and purification of constituents were performed by chromatography on macroporous resin, silica gel, MCI and Sephadex LH-20. Their structures were elucidated by spectroscopic data as quercetin (1), quercetin-3-0-alpha-L-rhamnoside (2), keampferol-3-O-beta-D-glucopyranoside (3), keampferol-3-O-alpha-L-rhamnoside (4), 3', 5-dyhydroxy-3, 6, 4'-trimethoxyl -7-O-beta-D-glucopyranoside flavonoid (5), 7, 8, 3', 4'-tetraflavanone(6), (2S)- and (2R)-isookanin-7-O-beta-D- glucopyranoside (7a/7b), (2S)- and (2R)-3'-methoxy-isookanin-8-O-beta-D-glucopyranoside (8a/8b), 6, 7, 3', 4'-tetrahydroxyaurone(9), maritimetin (10), esculetin (11), 3-O-caffeoyl-2-methyl-d-erythrono-1, 4-lactone (12), (7S, 8R) balanophonin-4-O-beta-D-glucopyranoside (13), eugenyl-O-beta-apiofuranosyl-( 1"-6') -O-beta-glucopyranoside (14), and (+)-syringaresinol-4'-O-beta-D-glucopyranoside (15). Compounds 8, 13, 14, and 15 were isolated from this genus for the first time. Compounds 1 and 6 were potent inhibitors against HSC-T6 cells in vitro and compounds 1, 2, 6, and 7 were capable of decreasing the inflammatory cytokine production of macrophage cells in vitro.
Bidens ; chemistry ; Drugs, Chinese Herbal ; chemistry ; Molecular Structure ; Spectrometry, Mass, Electrospray Ionization

This article analyzes the particularities of medical products and introduces a design of a medical cart, based on the principles of ergonomics. Its construction embodies convenience, comfort, safety and efficiency of ergonomic factors.
Durable Medical Equipment ; Equipment Design ; Ergonomics

Cervical carcinoma has brought huge burden on patients, especially in developing countries. Preventive vaccines could effectively reduce the incidence of cervical carcinoma. The high prices were one of the most difficult problem in introducing the vaccine in developing countries, so the cost-effectiveness and health financing of the vaccines should be carefully studied before incorporated into the national immunization program. Thus, researchers used mathematical models to predict the effects of HPV vaccines and to study the cost- effectiveness. In order to understand the current situation on the cost-effectiveness of HPV vaccines in the developing countries, a systematic searching of literature from PubMed, Elsevier Science Direct, Medline, ProQuest, CNKI and Wangfang Data was performed, this study aims to conduct a systematic review from aspects of project source, first author, research areas, research perspectives, prevention strategies, vaccine characteristics, cost-effectiveness.
Cost-Benefit Analysis ; Developing Countries ; Female ; Humans ; Immunization Programs ; Incidence ; Models, Theoretical ; Papillomavirus Infections ; economics ; prevention & control ; Papillomavirus Vaccines ; economics ; Uterine Cervical Neoplasms ; economics ; prevention & control

Alpha 5 subunit-containing γ-aminobutyric acid type A receptors (α5GABAARs), mainly distributed in the hippocampus, are an inhibitory synaptic receptor of the central nervous system.α5GABAARs inhibit the hippocampal neurons by mediating a chloride leak current. A number of studies have demonstrated that alterations in the level of excitability of α5GABAARs impair cognitive function and learning-memory, thus resulting in a series of diseases and symptoms including postoperative cognitive dysfunction, pain, depression, schizophrenia and Down syndrome. Accordingly, allosteric modulators for α5GABAARs show therapeutic or improving effects on the above clinical diseases. This review mainly discusses the physiology of α5GABAARs, impact on cognition and key effects of these allosteric modulators.

BACKGROUND: Greatly importance has been attached to ceramic-on-ceramic bearing surface due to its excel ent wear resistance. But the risks of squeaking and ceramic fracture also go with it. Up til now, the choice between ceramic-on-ceramic and ceramic-on-polyethylene bearing surfaces in primary total hip arthroplasty remains controversial. OBJECTIVE: To compare the clinical outcomes and safety between ceramic-on-ceramic versus ceramic-on-polyethylene bearing surfaces in total hip arthroplasty based on meta analysis. METHODS: We electronical y searched databases including PubMed/Medline, Embase, Web of Science, Cochrane Col aboration database, Chinese Biomedical Literature Database (CBMdisc) and China National Knowledge Internet for randomized control ed trials on the comparison between ceramic-on-ceramic versus ceramic-on-polyethylene bearing surfaces in total hip arthroplasty from inception to January 2015. References of the included studies were also retrieved. Investigators severely selected the studies, extracted data and assessed the quality according to the inclusion and exclusion criteria. Then, meta-analysis was performed using RevMan 5.2 software. RESULTS AND CONCLUSION: Nine randomized control ed trials were included, involving 1 231 hips with ceramic-on-ceramic prosthesis and 932 hips with ceramic-on-polyethylene prosthesis. Meta analysis showed that both bearing surfaces achieved satisfied function recovery. But ceramic-on-ceramic had significantly increased risks of squeaking and ceramic fracture, meanwhile ceramic-on-polyethylene showed significantly higher wear rate. There were no significant differences in intra- or post-operative dislocation, osteolysis and other complications and prosthesis failure with any reason between two bearing surfaces. These results suggest that during the short- to mid-term fol ow-up period, no sufficient evidence can tel that ceramic-on-ceramic was obviously super than ceramic-on-polyethylene. Long-term fol ow-up is required for further evaluation.

Objective To investigate the efficacy and safety of standard access assisted minimally access percutaneous nephrolithotomy (MPCNL) combined with EMS lithotripsy system in treatment of staghorn caculi accompanied with pyonephrosis. Methods From October 2015 to May 2017, we retrospectively analyzed the clinical data of 53 patients of staghorn calculi accompanied with pyonephrosis (55 sides, 2 patients with bilateral) were treated with using the special urology ultrasound, kidney dome puncture path method method to do standard channel assisted MPCNL combined with EMS. To summarize the operation time, stone clearance rate, postoperative hospital stay, postoperative blood transfusion rate and complications. Results 53 patients had a total of 55 kidneys had been established first-staged F24 channels,and successfully gravel stone. The operation time was (82.3 ± 22.5) min; 72.7% of the renal had been established first-staged F24 channels assisted F16/18 dual channel;18.2% for the first phase F24 and secondary phase F16/18 of the dual or multi-channel; 9.1% PCNL combined with retrograde flexible ureteroscope; 4 cases of extracorporeal shock wave lithotripsy. The initial stone-free rate was 70.9% (39/55), total stone-free rate was 89.1% (49/55). 2 patients with postoperative blood transfusion, 1 case of super-selective renal artery embolization to stop bleeding, 3 patients had postoperative fever, 1 case of septic shock, 2 cases of conservative treatment of a small amount of liquid chest, 1 case of apparent low back pain due to urine extravasation, given pain medication.no other serious complications. Conclusions By special urology ultrasound probe guide, use the kidney dome puncture path method to do standard channel assisted MPCNL combined with EMS for the treatment of staghorn calculi accompanied with pyonephrosis, its benefits in high stone-free rate, low renal pelvis pressure, high security rate, low complication rate and so on. Therefore, it is worthy of clinical application.

In order to clarify the chemical constituents of Si-Wu Decoction rapidly and holistically, we analyzed the ethanol extract of Si-Wu Decoction by UPLC/Q-TOF-MSE and UNIFI which based on traditional Chinese medicine database, the probable structures of 113 compounds were identified. The results show that this method can rapidly and effectively characterize the chemical compounds of Si-Wu Decoction and provide a new solution for identification of components from complex TCM extract.
Chromatography, High Pressure Liquid ; Databases, Pharmaceutical ; Drugs, Chinese Herbal ; chemistry ; Medicine, Chinese Traditional

OBJECTIVETo prospectively investigate the effectiveness of suction drainage for correction of maxillofacial deformities caused by cystic lesions of the mandible.

METHODSSuction drainage was performed in 21 cases with large cystic lesions of the mandible which had expanded facial contour. Clinical and radiological examinations of these patients were carried out regularly. The volume of the cavity was measured during treatment. The expansion indexes on axial CT image and area of the cyst on a panoramic radiograph were measured preoperatively and postoperatively. The curettage via intraoral incision was completed until the extent of disease significantly shrunk.

RESULTSAfter a mean duration of suction drainage of 5.1 months, the volume and the size on the panoramic radiographic of the cystic lesions were reduced by an average of 84% and 63% respectively. The expansion indexes were reduced notably during treatment. Computerized tomography of the mandible showed that the contour of expanded mandible was restored greatly and notable new bone was formed in the area of cortex perforation.

CONCLUSIONSSuction drainage is a useful treatment modality for the primary management of giant cystic lesion of the mandible, and can fast correct maxillofacial deformities caused by bony expansion and perforation in the area of cystic lesions.

Adolescent ; Adult ; Female ; Humans ; Male ; Mandibular Diseases ; complications ; therapy ; Maxillofacial Abnormalities ; etiology ; therapy ; Middle Aged ; Prospective Studies ; Suction ; Young Adult

OBJECTIVETo investigate the effects of electromagnetic radiation on the physiological indices and immune function of operators.

METHODSThe general conditions and electromagnetic radiation awareness rate of 205 operators under electromagnetic radiation were evaluated using a self-designed questionnaire. Physical examination, electrocardiography, and routine urine test were performed in these operators. Peripheral blood was collected from the operators under electromagnetic radiation for blood cell counting and biochemical testing, and their peripheral blood lymphocytes were cultured for determination of chromosomal aberrant frequency and micronucleus frequency. The data from these operators (exposure group) were compared with those of 95 ordinary individuals (control group).

RESULTSThe chief complaint of giddiness, tiredness, dizziness, and amnesia showed significant differences between the exposure group and control group (P < 0.01), and the difference in headache became larger with an increase in working years. The awareness rate of electromagnetic radiation damage was significantly higher in the exposure group than in the control group. The difference in bradycardia was significant between the two groups (P <0.01), and the incidence was higher with longer working years. Significant differences between the two groups were also found in the numbers of individuals with elevated alanine aminotransferase, total bilirubin, and direct bilirubin (P < 0.01), populations with increased lymphocyte ratio and decreased neutrophil ratio (P < 0.01), populations with positive occult blood, urobilinogen, and bilirubin tests, and the number of individuals with increased micronucleus frequency of cultured peripheral blood lymphocytes (P < 0.01). In addition, the exposure group had significantly increased complement C3 and C4 (P < 0.01), significantly increased IgG (P < 0.05), and significantly decreased IgM (P < 0.01), as compared with the control group.

CONCLUSIONElectromagnetic radiation may lead to the changes in physiological indices, genetic effects, and immune function and affect the health and immune function in operators. The adverse effects are increased as the working years increase. So it is important to strengthen occupational protection of operators under electromagnetic radiation.

Adult ; Chromosome Aberrations ; radiation effects ; Electromagnetic Radiation ; Female ; Humans ; Lymphocytes ; radiation effects ; Male ; Middle Aged ; Occupational Exposure ; adverse effects ; Young Adult