Introduction of measurement methods of health utility for cancer patients / 中国药房

Cancer is one of the major fatal diseases that seriously threaten human health， and its burden needs to be solved urgently. Health technology assessment （HTA） can provide scientific evidence-based basis for cancer diagnosis， treatment， prevention and related policy formulation. Cost-utility analysis is the gold standard for economic evaluation in HTA， and the accurate measurement of its health utility is one of the key elements to determine the accuracy of its results. This article focuses on systematic introduction of direct measures， multi-attribute health utility scales， and mapping methods in the field of cancer measurement and reviews their applications in cancer patients. Among them， direct measures are complex， costly， and require a high level of subject knowledge； multi-attribute health utility measures are currently the preferred method for measuring health utility in cancer patients； with the continuous development and refinement of disease-specific utility measures in multi-attribute health utility instruments， the mapping method may gradually decrease in future applications. This paper can provide a reference for the selection of health utility measurement tools for HTA in the field of cancer， and provide evidence-based basis for optimizing resource allocation and policy formulation in the field of cancer.

Isolation characteristics and antibiotic resistance analysis of Streptococcus pneumoniae from the hospitalized children in Bao′an district of Shenzhen from 2012 to 2018 / 中华实用儿科临床杂志

Objective:To investigate the isolation characteristics and the antibiotic resistance of Streptococcus pneumoniae in hospitalized children from the Bao′an District of Shenzhen for many consecutive years, and to provide evidence for the assessment as well as clinical prevention and treatment of Streptococcus pneumoniae infection. Methods:The isolation rate and sample source of Streptococcus pneumoniae isolates as well as age composition of hospitalized children in Bao′an Maternal and Child Health Hospital of Shenzhen city from January 2012 to December 2018 were retrospectively analyzed.The susceptibility of the isolates to antibiotics was tested by disk diffusion method and E-test method. Results:(1) From 2012 to 2018, a total of 90 807 specimens were retrospectively summarized, 9 193 strains of Streptococcus pneumoniae were isolated, with an isolation rate of 10.1%, which was the first pathogen; 98.68% (9 072/9 193 cases) from respiratory tract samples and 97.20% from sputum samples.Among 107 strains isolated from aseptic body fluid specimens, 97 strains were blood specimens. Streptococcus pneumoniae was the most common bacteria with positive culture in aseptic body fluids.(2) The isolation rate of Streptococcus pneumoniae was 10.7% in children under 2 years old, 10.2% in children between 2 and 5 years old and 4.1% in children over 5 years old.About 97% of Streptococcus pneumoniae isolates came from children under 5 years old.(3) According to breakpoints of non-meningitis strains, the sensitivity rate of parenteral Penicillin was 93.18%, the mediation rate was 6.79%, the resistance rate was only 0.03%, the lowest drug concentration to inhibit the growth of 50% bacteria(MIC 50) value was 0.50 and the lowest drug concentration to inhibit the growth of 90% bacteria(MIC 90) value was 2.00; the sensitivity rate of Ceftria-xone was 76.55%, the mediation rate was 20.18%, the resistance rate was 3.26%, the MIC 50 value was 1.00 and the MIC 90 value was 2.00; when interpreted by the breakpoint of meningitis strains, the resistance rate of extra-gastrointestinal Penicillin reached 77.22%, and the mediation rate of Ceftriaxone increased to 30.48% and the drug resistance rate reached 18.45%.The drug resistance rates of Erythromycin, Clindamycin, Tetracycline and Compound neomycin were all over 85.00%.The resistance rates against Levofloxacin and Chloramphenicol were 0.16% and 7.85% respectively.No Vancomycin-resistant Streptococcus pneumoniae was found. Conclusions:Streptococcus pneumoniae is the first bacterial pathogen causing respiratory tract and invasive infection in hospitalized children under 5 years old in this area.Penicillin is still the preferred drug for non-meningitis pneumococcal infection, but the drug resistance rate is high in meningitis patients.

PDL1 Ig gene-modified BMSCs induce immune tolerance in rat liver trans-plantation / 中国病理生理杂志

[ ABSTRACT] AIM: To investigate the effects of bone marrow mesenchymal stem cells ( BMSCs) modified by programed death ligand-1 immunoglobulin ( PDL1 Ig) gene on immune rejection of orthotopic liver transplantation in rats. METHODS:Rat BMSCs were cultured and identified.The protein expression of PDL1 Ig in the BMSCs 72 h after infection with pAdEasy-1/PDL1 Ig was detected by Western blot.Mixed lymphocyte reaction was used to detect the inhibitory effect of BMSCs on the viability of T-lymphocytes in peripheral blood.The male Wistar rats were used as donors (n=40), and the male SD rats were used as recipients ( n=40 ) .The rat model of orthotopic liver transplantation was established by im-proved cuff method for observing acute rejection.The rats were randomly divided into control group, BMSCs treatment group, BMSCs/GFP treatment group and BMSCs/PDL1 Ig treatment group with 10 pairs each.Five rats were executed at the 7th day and the remains were used for measuring the survival time.RESULTS:The expression of PDL1 Ig in the BM-SCs was detected after pAdEasy-1/PDL1 Ig infection.The effect of BMSCs/PDL1 Ig on the viability of the lymphocytes was stronger than that of BMSCs/GFP.The level of IL-4 in BMSCs/PDL1 Ig group was significantly higher than that in the other 3 groups, while the levels of IFN-γand IL-2 were significantly decreased.The liver function in BMSCs/PDL1 Ig group was significantly improved and the levels of ALT, AST and TBil were almost recovered to normal at the 7th day after transplan- tation.Severe rejection reaction was observed in control group, and rejection reactions were decreased with different degrees in BMSCs treatment group and BMSCs/GFP treatment group.Much slighter rejection reaction and significantly longer sur-vival time were showed in BMSCs/PDL1 Ig group than those in the other 3 groups.CONCLUSION:PDL1 Ig-modified BM-SCs inhibit the rejection of liver transplantation in rats and induce the immune tolerance, and the effect is better than that of BMSCs alone.

Progress on health economic evaluation of colorectal cancer screening / 实用肿瘤学杂志

Colorectal cancer( CRC) has become one of the major cancer threatening residents′health all around the world, and considerable resources are needed for its prevention and control.Economics evaluation could provide the basis of decision-making for improving the allocation efficiency of health resources in the field of CRC prevention and control.This paper comprehensively reviewed the papers that have been published in the field of colorectal cancer screening,from the points of view of published time,regional economic evaluation re-search,evaluation method,the research angle,input and output measurement,model,recommend strategy.

Accuracy of immunochemical faecal occult blood test for colorectal cancer: meta-analysis / 中华预防医学杂志

<p><b>OBJECTIVE</b>To assess the accuracy of immunological fecal occult blood test (iFOBT) for detection of colorectal cancer (CRC).</p><p><b>METHODS</b>A total of 1 197 studies published before June 2014 were selected from PubMed and Embase and 17 of which were finally included in this meta-analysis. A bivariate mixed-effects models was used for overall value merging and heterogeneity testing. In addition to the overall sensitivity and specificity, the analyses were also performed among certain subgroups, including a "colonoscopy group" (all were referred for colonoscopy diagnosis regardless screening results) and a "follow-up group" (only the screening positive were referred and all were then followed up), a qualitative group and a quantitative group (classified by the way of iFOBT result reading).</p><p><b>RESULTS</b>A total of 161 502 subjects aged from 48 to 63 years were included in the analysis. IFOBT had an overall integrated sensitivity of 0.85 (95% CI: 0.79-0.89) (heterogeneity test: Q = 59.67, P < 0.001) and an overall integrated specificity of 0.93 (95% CI: 0.92-0.94) (heterogeneity test: Q = 1 722.53, P < 0.001) for detection of CRC. In the subgroup analysis, it was found that in the "colonoscopy group" and in the "follow-up group", the sensitivity were 0.81 (95%CI: 0.73-0.87) and 0.88 (95% CI: 0.81-0.92), respectively; the specificity were 0.92 (95% CI: 0.89-0.93) and 0.95 (95% CI: 0.94-0.96), respectively. It was also found that in the qualitative group and the quantitative group, the sensitivity were 0.84 (95% CI: 0.76-0.90) and 0.86 (95% CI: 0.78-0.92), respectively; the specificity were 0.94 (95% CI: 0.91-0.96) and 0.93 (95% CI: 0.91-0.94), respectively.</p><p><b>CONCLUSION</b>IFOBT had high overall sensitivity and specificity for detecting colorectal cancer.</p>

Pathogenic spectrum and bacterial resistance of severe community-acquired pneumonia / 中国小儿急救医学

Objective To study the distribution of pathogenic spectrum in children with severe community-acquired pneumonia(CAP) and bacteria antibiotic resistance.Methods One hundred and ninety-three children with severe CAP were enrolled from Mar 2011 to Feb 2012.Sputum specimens were collected for bacterial culture and drug sensitive test.Meanwhile mycoplasma pneumonia and chlamydia trachomatis were detected by fluorescent quantitative polymerase enzyme technology.Antigen of virus were detected by immunofluorescence assay.Results A total of 96 cases (49.7％) were bacteria positive in 193 children with severe CAP.The top four bacteria strains were klebsiella pneumoniae,staphylococcus aureus,escherichia coli and streptococcus pneumoniae.Most of gram-negative bacteria were resistant to ampicillin,cefazolin,ceftriaxone,ceftazidime,and compound sulfamethoxazole,but were sensitive to piperacillin/tazobactam,imipenem,ciprofloxacin,levofloxacin,amikacin.Gram-positive bacteria were resistant to penicillin and erythromycin,but sensitive to vancomycin.Fifty-three cases (27.5 ％,53/193) were virus Positive,81.1％ of which were less than 1 year old.Respiratory syncytial virus accounted for the most prevalent pathogen,followed by adenovirus,influenza virus A.Mycoplasma pneumoniae were positive in 4 patients (2.1％,4/193),chlamydia trachomatis were positive in 3 patients (1.6％,3/193).Mixed infection was found in 23 cases (11.9％,23/193).There were 14 cases (7.2％,14/193) with undetected pathogens.Conclusion Bacterium is the major pathogen in children with severe CAP and the virus is the second.The initial antibiotics administration of piperacillin/tazobactam or carbapenem and vancomycin should be chosen for severe bacteria pneumonia.

Deferoxamine suppresses microglia activation and protects against secondary neural injury after intracerebral hemorrhage in rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the effect of the iron chelator deferoxamine (DFA) in suppressing microglia activation and protecting against secondary neural injury in a rat model of intracerebral hemorrhage (ICH).</p><p><b>METHODS</b>SD rats were randomly divided into sham-operated group, ICH group and DFA treatment group. ICH model was established by infusion of type IV collagenase into the right basal ganglia, and starting from 1 h after the operation, the rats received intraperitoneal DFA injections every 12 h for 7 days. The iron content in the perihematoma brain tissue was determined at different time points after DFA administration, and OX42 immunohistochemistry was used to observe the changes in the microglia. The contents of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in the brain tissue were detected by ELISA. The neural death and neurological deficiency were measured using Nissl staining and neurological scores, respectively.</p><p><b>RESULTS</b>The iron content in the brain tissues around the hematoma was significantly increased 3 days after ICH and maintained a high level till 28 days, accompanied by a marked increase of microglial cells as compared to the sham-operated group. DFA injection caused significantly decreased iron content in the brain tissue, reduced number of microglial cells, and lowered levels of IL-1β and TNF-α. Neuronal loss around the hematoma was obviously reversed after DFA injections, which resulted in improved neurological deficiency.</p><p><b>CONCLUSION</b>DFA can suppress microglia activation by removing iron overload from the perihematoma brain tissue, thus reducing secondary neuronal death and neurological deficiency in rats with ICH.</p>

The expressions of neutrophil and lymphocyte CD11b in children with severe pneumonia / 中国小儿急救医学

Objective To investigate the significance of expressions of neutrophil and lymphocyte CD11b in children with severe pneumonia.Methods Expressions of neutrophils and lymphocytes CD11b were measured by flow cytometry in 36 children with severe pneumonia( severe pneumonia group),compared with 35 children with mild pneumonia ( mild pneumonia group) and 30 healthy children ( control group).Results In acute stage,expressions of neutrophil CD11b in severe pneumonia group and mild pneumonia group were (90.67 ± 7.03 ) ％ and ( 84.03 ± 5.08 ) ％,respectively,both of which were higher than that in control group [ ( 69.32 ± 5.72 ) ％ ] ( P ＜ 0.05 ).Furthermore,in acute stage,expression of neutrophils CD11b in severe pneumonia group was higher than that in mild pneumonia group (P ＜ 0.05 ).In recovery stage,expressions of neutrophil CD11b in children with severe pneumonia and mild pneumonia were(72.68 ±2.07 ) ％ and (71.45 ± 3.21 ) ％,respectively,which were both lower than those in acute stage ( P ＜ 0.05 ).In acute stage,expression of lymphocyte CD11b of children with severe pneumonia was ( 13.35 ± 6.52 )％,which was lower than that of mild pneumonia group [ ( 19.19 ± 6.47 ) ％ ] ( P ＜ 0.05 ),however,no significant difference was found between severe pneumonia group and control group [ ( 12.42 ± 6.43 ) ％ ] ( P ＞0.05).In recovery period,there was no significant difference in the expression of lymphocytes CD11b between severe pneumonia group [ ( 13.37 ± 4.88 ) ％ ] and mild pneumonia group [ ( 13.78 ± 4.53 ) ％ ] ( P ＞0.05).Conclusion Expressions of neutrophil and lymphocyte CD11 b participate in the pathogenesis of severe pneumonia.Detection of CD11b expression is helpful to diagnose severe pneumonia and predict the prognosis.

Analysis on the prognosis effect after health management intervention of chronic prostatitis / 中华健康管理学杂志

Objective To investigation the relationship between health management and prognosis of chronic prostatitis. Methods Three hundied and forty-six cases of chronic prostatitis were divided into two groups. The control group treatment was local washing and medicine for three months. The experiment group treatment was local washing, medicine, and health management for three months. NIH-CPSI was used for the results. Results There was no significant different between the experimental group(165 cases)and the control group(154 cases)before treatment in NIH-CPSI. The effective rate of the the experimental group was 88.5%, and that of the control group was 64.9% after treatment. It is effective for cure and the prognosis of the experiment was better than the control (P<0.05). Conclusion It is suggested that it is more effective for the prognosis of chronic prostatitis after the intervention of health management.

Nosocomial Infections in Difference Hospital Divisions:Their Characteristic and Nursing Measure / 中华医院感染学杂志

OBJECTIVE To study the disposition,hospital divisions and risk factors that induce nosocomial infections,and approach utility measure for prevention.METHODS To investigate and analyze the nosocomial infections in the patients who hospitalized from 2004 to 2006,through the way combined with retrospective investigation and the cases report by doctors.RESULTS In our hospital,the nosocomial lower respiratory tract infection was the highest(33.7%).The second was the upper respiratory tract infection(23.0%),and the gastrointestinal tract infection(18.7%).The incidence of nosocomial infection in medical and paediatrics department was higher than other departments,the main infection site in internal medicine department was lower respiratory tract(49.1%),but in pediatrics it was skin soft tissue infection(41.6%).There was significance difference of risk factors in nosocomial infection.CONCLUSIONS To grasp the causes of nosocomial infection,emphasize the monitoring for the high risk factors in departments,strengthen the prevention for nosocomal infection among the staff,standardize the various kinds of nursing operation and reasonably apply antibiotics,all are the effective measures for the prevention of nosocomial infection.

Recommendation of a new prostatic massage--an aside-bending and up-standing vs parallel and semi-squatting method to massage the prostate via the rectum / 中华男科学杂志

<p><b>OBJECTIVE</b>To recommend an improved method of prostate massage, which is safe, effective, simple and tolerable, and may increase the expressed prostatic secretin (EPS) success rate and promote the efficiency of the prostate massage.</p><p><b>METHODS</b>Two methods are described in this paper, one being the aside-bending and up-standing vs parallel and semi-squatting method to massage the prostate via the rectum, and the other being the traditional massage method. A total of 261 chronic prostatitis (CP) patients were randomly divided into two groups, and treated separately with the new method and the traditional method. Then, the two methods were compared by EPS quantity and the patients' tolerability.</p><p><b>RESULTS</b>The new method made it possible to collect larger quantity of EPS. The results of comparison showed that the new method was better received by the patients.</p><p><b>CONCLUSION</b>The aside-bending and up-standing vs parallel and semi-squatting method to massage the prostate via the rectum may increase the EPS success rate of prostatic massage and hence help the clinical diagnosis and treatment of chronic prostatitis. This method is well worth recommending.</p>

Early changes of endothelin, nitric oxide and arginine-vasopressin in patients with acute cerebral injury / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the early changes and clinical significance of plasma endothelin (ET), nitric oxide (NO) and arginine-vasopressin (AVP) in patients with acute moderate or severe cerebral injury.</p><p><b>METHODS</b>The early (at 24 hours after injury) plasma concentrations of ET, NO and AVP were measured with radioimmunoassay and Green technique in 48 cases of acute moderate (GCS<or=8 in 27 cases ) or severe (GCS>8 in 21 cases) cerebral injury (Group A), in 42 cases of non-cerebral injury (Group B) and in 38 normal individuals (Group C), respectively.</p><p><b>RESULTS</b>The early plasma concentrations of ET (109.73 ng/L+/-12.61 ng/L), NO (92.82 micromol/L+/-18.21 micromol/L ) and AVP (49.78 ng/L+/-14.29 ng/L) in Group A were higher than those in Group B (67.90 ng/L+/-11.33 ng/L, 52.66 micromol/L+/-12.82 micromol/L and 29.93 ng/L+/-12.11 ng/L, respectively, P<0.01) and Group C (50.65 ng/L+/-17.12 ng/L, 36.12 micromol/L+/-2.16 micromol/L and 5.18 ng/L+/-4.18 ng/L, respectively, P<0.001 ). The amounts of ET, NO and AVP in patients with severe cerebral injury were 116.18 ng/L+/-18.12 ng/L, 108.19 micromol/L+/-13.28 micromol/L and 58.13 ng/L+/-16.78 ng/L, respectively, which were significantly higher than that of the patients with moderate cerebral injury (92.33 ng/L+/-16.32 ng/L, 76.38 micromol/L+/-12.71 micromol/L and 36.18 ng/L+/-12.13 ng/L respectively, P<0.01 ). The early levels of ET, NO and AVP in Group A were negatively related to the GCS scales. The amounts of ET, NO and AVP were 126.23 ng/L+/-15.23 ng/L, 118.18 micromol/L+/-10.12 micromol/L and 63.49 ng/L+/-14.36 ng/L respectively in patients with subdural hematoma, which were significantly higher than those in patients with epidural hematoma (81.13 ng/L+/-12.37 ng/L, 68.02 micromol/L+/-13.18 micromol/L and 45.63 ng/L+/-12.41 ng/L respectively, P<0.01). The plasma concentrations of ET, NO and AVP in stable duration (at 336 hours after injury) in Group A and Group B were similar to those in Group C.</p><p><b>CONCLUSIONS</b>ET, NO and AVP were related to the pathophysiological process that occurs in the early stage of acute cerebral injury and the values of ET, NO and AVP correlate positively with the clinical manifestations. The changes of plasma ET, NO and AVP can be regarded as important indices to assess the severity of acute cerebral injury.</p>

Early changes of endothelin and nitric oxide in patients with acute brain injury / 中华创伤杂志

Objective　To investigate the early changes and clinical significance of plasma endothelin(ET) and nitric oxide(NO) in patients with acute brain injury.　Methods　The plasma ET and NO concentration at 1 day after injury were checked with radioimmunoassay and Green method in 48 cases of acute brain injury, in 42 cases of non-brain injury and in 38 healthy volunteers. 　Results　 The early plasma concentrations of ET and NO were (109.73±12.61) ng/Lf and (92.82±18.21) μmol/L, respectively, in 48 cases of acute cerebral injury, which were higher than those in the non-brain injury group［(67.90±11.33) ng/L and (52.66±12.82) μmol/L, respectively, P<0.01］ and in the normal control group ［(50.65±17.12)ng/L and (36.12±12.16) μmol/L, respectively, P<0.001］. The amounts of ET and NO in the patients with severe brain injury were (116.18±18.12) ng/L and (108.19±13.28) μmol/L, respectively, which were significantly higher than that of the moderate brain injury group［(92.33±16.32) ng/L and (76.38±12.71) μmol/L, respectively, P<0.01］.The early levels of ET and NO were negatively related to the GCS scores of the patients with acute brain injury. The amounts of ET and NO were (126.23±15.23)ng/l and (118.18±10.12) μmol/L, respectively, in the patients with subdural hematomas, which were significantly higher than those in the patients with epidural hematomas ［(81.13±12.37) ng/L and(68.02±13.18) μmol/L, respectively, P<0.01］. The stable plasma concentrations of ET and NO at 14 days after injury in the patients with acute brain injury and with non-brain injury were similar to that in the normal controls. 　Conclusions　 ET and NO are related to the pathophysiological process in the early period of acute brain injury, and the values of ET and NO correlate positively with the clinical manifestations. The changes of plasma ET and NO can be regarded as important indexes to diagnose the severity of acute brain injury.