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OBJECTIVE：To provid e reference for safe ，effective and economical medication scheme for type 2 diabetes mellitus（T2DM）. METHODS ：Markov model was established for rosiglitazone sodium and metformin in the treatment of T 2DM. According to the development characteristics of T 2DM，the development of T 2DM was simulated by the dynamic changes of event-free，complications and deaths of T 2DM. The long-term cost and effect of rosiglitazone sodium and metformin in the treatment of T 2DM were obtained by regression analysis and queue simulation analysis. QALYs was used as a health output indicator，and t he superiority and inferiority of different schemes were judged by the ICER value ，and in our study ICER value was WTP（12 000 yuan per year ）of diabetics. The sensitivity of cost ，utility and discount was analyzed to check the stability of the analysis results. RESULTS ：Cost-effectiveness analysis of Markov model showed that the cumulative cost and health effectiveness of rosiglitazone sodium therapy were 25 164.00 yuan and 7.50 QALYs，while 17 773.36 yuan and 7.36 QALYs for metformin ； ICER of rosiglitazone sodium relative to metformin was 50 983.08 yuan/QALYs，which was greater than WTP ，so the metformin treatment was an advantageous scheme. Sensitivity analysis showed that health utility value and discount rate of diabetes mellitus greatly influenced analysis results of the model ，but advantage plan had not changed within the sensiitivity analysis range seted in this study. CONCLUSIONS ：For T 2DM，metformin is more cost-effective than rosiglitazone sodium.
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OBJECTIVE： To provide reference for improving the economics evaluation studies for pediatric therapeutic regime in China. METHODS： By searching the literature published in domestic journals from Jan. 1st， 2009 to Dec. 31th， 2018， the current situation of the measurement of cost （including time range， cost calculation） and health output （including outcome indicators and measurement scales） were explored. Combined with relevant literature at home and abroad， the deficiencies of economics evaluation for pediatric therapeutic regime in terms of cost measurement and health outcome measurement were summarized in China， and the corresponding research prospects were put forward. RESULTS & CONCLUSIONS： Totally 140 related literatures were finally included. In terms of cost measurement， short-term （≤1 year） research accounted for the highest proportion （109 literatures， 77.86％）. Cost calculation mostly had no clear research perspective （125 literatures， 89.29％）. It did not involve the cost of child productivity. The main shortcomings were unclear time range， incomplete cost calculation （lack of productivity， hidden cost） and so on. In terms of health output measurement， 103 （73.57％） used cost-effectiveness analysis， 23 （16.43％） used cost-benefit analysis， and only 4 （2.86％） related to the use of measurement scales. Main shortcomings included that the difficulty in obtaining outcome indicators， lack of child health output measurement scale and so on. Based on this， it is suggested that related demands should be complied before conducting economics evaluation research， we should clarify the research angle， formulate unified and standardized cost measurement methods， rationally select technical analysis methods and health outflow indicators according to research purposes and disease characteristics， and develop appropriate measurement scales according to the physiological and psychological characteristics of children in different age groups. At the same time， future studies can report on the status of family members when reporting on children's related conditions， and conduct an economic evaluation of therapeutic regimen in the family unit.
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Objective To investigate the treatment results for different regions of posterior cruciate ligament ganglion cyst by surgery.Methods From January 2011 to September 2016,17 patients with posterior cruciate ligament ganglion cysts of the knee were involved in this study.5 cases were located on the femoral side of the ligament (upper 1/3),8 cases were in the middle,and 4 cases were located in the tibia side (lower 1/3),15 cases were operated and 2 were not.A total of 13 cases in the upper 2/3 of the ligament were resected by the anterior two approaches through arthroscopy.two of which were resected by the posterior capsule.2 cases of the tibial lateral cysts were resected by posterior approach.Lysholm scoring system was used to evaluate the knee function before and after operation,and Glasgow curative effect system was used to evaluate the final follow-up results.Results A follow-up 6-24 months in an average of (12.6 ± 3.2) months shows no sign of recurrence at the last follow-up,all patients had no complications such as infection,ligament relaxation,et al.Lysholm score was improved from 57.5 ± 5.2 preoperatively to 92.5 ± 3.6 postoperatively,and the statistical difference is very significant (P ＜ 0.05).And curative effect was evaluated well by Glasgow system.Conclusions Arthroscopic surgery is an effective measure in the treatment of postior cruciate ligament (PCL) ganglion cysts.The upper part of the ligament can be resolved through the anterior approach,and the lower part should be followed by the posterior approach,and if necessary,open the way to handle the external part of the joint.
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Objective To explore the effect of dexmedetomidine on upper limb surgery during brachial plexus block anesthesia and its influence on cognitive function.MethodsFrom May 2015 to May 2016, 60 cases of elbow joint operation patients were studied.The patients were randomly divided into control group (local anesthesia combined with physiological saline) and observation group (using local anesthesia drugs with dexmedetomidine).The mean arterial pressure and heart rate before and after anesthesia in two groups were compared.The changes of anesthesia and cognitive function, and the incidence of adverse reactions were compared between the two groups.ResultsCompared with before anesthesia, the mean arterial pressure and heart rate were significantly lower in the two groups (P<0.05).The mean arterial pressure and heart rate in the observation group were significantly lower than those in the control group (P<0.05).There was no significant difference between the two groups in the onset time of motor block sensory block, while the observation group was significantly longer than the control group (P<0.05).The control group patients with Ramsay score below 3 points, a total of 4 cases, accounting for the observation group of patients with Ramsay score of less than 3 points, a total of 24 cases, accounting for 80%, the observation group was significantly better than the control group (P<0.05) sedative effect.Compared with before anesthesia, two groups of patients with postoperative 20min MMSE score were lower, but the observation group MMSE score was significantly higher than that of the control group (P<0.05).There was no significant difference in adverse reactions between the two groups.ConclusionIn the following surgery, the use of local anesthesia combined with dexmedetomidine anesthesia can prolong the time of nerve tissue, and can obtain better sedation and pain, and has little effect on the cognitive function of patients.
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Objective To explore the composition principles of prescriptions for simple obesity based on the analysis of medical literature issued in recently 30 years about Chinese medicine for simple obesity. Methods We collected literature of Chinese medicine in treating simple obesity from VIP, CNKI, Wanfang, CBM and CMCC/CMCI databases, and screened out the formulas for simple obesity to establish a formula database. And then the medication rules were figured out with the Traditional Chinese medicine Inheritance Support System version 2.5 (TCMISS 2.5) software. Results A total of 57 formulas were screened out. And the top 10 herbs with highest occurrence frequency in the prescriptions were Poria, Rhizoma Atractylodis Macrocephalae, Rhizoma Alismatis, Radix et Rhizoma Rhei, Fructus Crataegi, Radix Astragali, Radix Glycyrrhizae, Folium Nelumbinis, Pericarpium Citri Reticulatae and Semen Cassiae. After data mining, we got 13 high-frequency herb-pair combinations and 31 core combinations, and 8 new prescriptions were extracted. Conclusion The research has achieved the quantitative description of the relationship between the Chinese medicines, the extraction of the core combinations and the discovery of new Chinese medicine prescriptions for simple obesity. The results will provide references for the development of new Chinese medicines for the treatment of simple obesity .