15 October 2019, Volume 42 Issue 5

    

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  Effect of different blood purification modes on serum visfatin of patients with maintenance hemodialysis

  LIU Yitao, LIU Yunqi

  滨州医学院学报. 2019, 42(5): 321-322. https://doi.org/10.19739/j.cnki.issn1001-9510.2019.05.001

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  Objective To investigate the effect of different blood purification modes on serum visfatin of patients with maintenance hemodialysis (MHD). Methods Sixty cases of patients with regular hemodialysis were selected, and 60 cases of healthy were selected as control group. The expression level of visfatin in serum and its relationship with microinflammation were observed. Then 60 cases were randomly divided into hemodialysis group (HD), hemoperfusion+hemodialysis group (HD+HP) and hemodialysis filtration group (HDF). The level of visceral adiponectin expression and clearance rate after 4 hours of single therapy, 3 months of continuous treatment and before treatment in the treatment mode were observed. Results The visfatin level of MHD was significantly higher than that in healthy control group. The visfatin expression level was positively correlated with IL-6 and Hs-crp. There was no significant change in serum visfatin before and after treatment in HD group. The visfatin levels in HDF and (HD+HP) groups decreased significantly 4 hours before and 3 months after treatment, and the difference was statistically significant. The clearance rate of (HD+HP) group was higher than that of HDF group. Conclusion Serum visceral visfatin of MHD is significantly increased, which is significantly correlated with microinflammation. Both hemodiafiltration and hemoperfusion can remove visceral visfatin. The effect of hemoperfusion is better than that of hemodiafiltration, and hemodialysis can not remove visceral visfatin.
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  Effect of lung recruitment maneuver and protective ventilation on postoperative acute respiratory distress syndrome

  KONG Lingchen, SUN Yunbo, XU Jianhua, PENG Wenhong, LU Shijun, NING Chao, LI Haiyan

  滨州医学院学报. 2019, 42(5): 323-327. https://doi.org/10.19739/j.cnki.issn1001-9510.2019.05.002

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  Objective To investigate the clinical effect of early lung recruitment maneuver combined with protective mechanical ventilation on patients with acute respiratory distress syndrome (ARDS) after operation. Methods A prospective randomized controlled study was designed to select the patients with severe ARDS in early stage. The patients with early severe ARDS were divided into the standard treatment group and the lung recruitment therapy group. The patients were transferred to ICU, and given the treatment of primary disease, protective ventilation strategy and airway humidification therapy. The standard treatment group was treated with protective mechanical ventilation (PCV), the tidal volume (VT) was less than 6 mL/kg, the inhalation oxygen concentration (FiO₂) and the positive end expiratory pressure (PEEP) were adjusted, and the airway plateau pressure (Pplat) was less than 30 cmH₂O. The lung recruitment therapy group was combined with intermittent lung recruitment on the basis of protective mechanical ventilation, the lungs were recruited once every 6 hours until 24 hours after recruitment or the ventilator was withdrawn. The changes of respiratory and hemodynamic indexes were compared between the two groups before and after treatment, and the prognosis and complications were recorded. Results 67 patients were included in the analysis, including 35 in the standard treatment group and 32 in the lung recruitment therapy group. After being randomized into the group, compared with the standard treatment group, PaO₂/FiO₂ of the lung recruitment therapy group increased after 0.5 h of treatment, and the respiratory system compliance showed an improvement trend, but there was no statistical difference. The levels of FiO₂ and PEEP in the two groups were significantly different. After 6.5 h, PaO₂/FiO₂ of the lung recruitment therapy group was significantly increased, respiratory compliance was improved, and FiO₂ was significantly decreased.Compared with the standard treatment group, ICU hospitalization time, mechanical ventilation time and artificial airway extraction timeof the lung recruitment therapy group were significantly shortened. Conclusion Compared with the standard treatment, lung recruitment combined with protective ventilation given to the patients with moderate to severe ARDS can improve the lung compliance and correct hypoxemia, shortening the mechanical ventilation time and the time of hospitalization of ICU, promoting the recovery of the patients.
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  Clinical effect and risk of early recurrence of high dose levofloxacin on the treatment of acute exacerbation of chronic obstructive pulmonary disease

  ZHANG Xueping, WANG Meng, HOU Xinfeng, HE Dandan, LI Xin, ZHAI Yunqing

  滨州医学院学报. 2019, 42(5): 328-331. https://doi.org/10.19739/j.cnki.issn1001-9510.2019.05.003

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  Objective To study the clinical effect and risk of early recurrence risk of high dose levofloxacin on the treatment of acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods 92 patients with acute exacerbation of COPD were randomly divided into observation group and control group. The observation group was given levofloxacin 750 mg qd 5 days, while the control group was given levofloxacin 500 mg qd 10 days. Clinical effects between the two groups after treatment and 8 weeks after treatment were compared. Results There was no significant difference of the initial clinical success rate between the observation group and the control group. The use of antimicrobial agents and the duration of hospitalization of the observation group were shorter than those of the control group. The pathogen clearance rate of the observation group was higher than that of the control group. The rate of re-acute exacerbation of the observation group was lower than that of the control group within 8 weeks after treatment. There was no significant difference of pulmonary function at 8 weeks after treatment, and the CAT score of the observation group was better than that of the control group. No serious drug-related adverse reactions were found in the study. Conclusion Compared with routine therapy, the high dose levofloxacin has good initial clinical success rate, higher pathogen clearance rate, lower risk of early acute exacerbation and better improvement of clinical symptoms.
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  A randomized controlledtrial about the treatment of first-episode depression by agomelatine and escitalopram

  LI Huijing, CUI MinghuZHANG Lanlan, SUN Guizhi, WU Xiaorui, GE Xiangli

  滨州医学院学报. 2019, 42(5): 332-334. https://doi.org/10.19739/j.cnki.issn1001-9510.2019.05.004

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  Objective To explore the clinical efficacy and safety of agomelatine and escitalopram used for the treatment of first-episode depression. Methods Sixty patients with first-episode depression were randomly divided into the research group and control group, and each group had 30 patients. The control group was treated with escitalopram, and the research group was treated with agomelatine for 8 weeks. The Hamilton depression rating scale-17 (HAMD-17) and side effect scale (TESS) were used to evaluate the clinical efficacy and adverse reactions. The difference of clinical efficacy was compared according to HAMD-17 scores of two groups and the difference of adverse reactions was compared according to TESS scores of two groups. Results There was no statistically significant difference between the HAMD-17 scores of control group after treatment of 1 week and that before the treatment. The differences among the HAMD-17 scores of control group after treatment of 2, 4, 8 weeks and that before the treatment were significant. The differences were significant among the HAMD-17 scores of research group after treatment and that before the treatment. Conclusion The effect of escitalopram was better than that of agomelatine after treatment of 4 weeks. With the extension of time, the effect between escitalopram and agomelatine was similar after treatment of 8 weeks, but agomelatine had a rapid onset of effect, around 1 week, and escitalopram needs 2 weeks. Both drugs had fewer adverse reactions and higher safety.
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  Effects of psychodrama on emotion self-efficacy, suicidal ideation and psychological distress of patients with depression

  KONG Baojuan

  滨州医学院学报. 2019, 42(5): 335-338. https://doi.org/10.19739/j.cnki.issn1001-9510.2019.05.005

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  Objective To analyze the effects of psychodrama on emotion self-efficacy, suicidal ideation and psychological distress of patients with depression. Methods A total of 90 patients with depression were divided into observation group and control group by random number table method, 45 cases in each group. The control group was given routine western medicine and health education for 2 months. On this basis, the observation group was given psychodrama for 2 months. The emotion status, emotion self-efficacy, suicidal ideation and psychological distress were compared between the two groups. Results After 2 months of treatment, Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) scores of the observation group were significantly lower than those of the control group. After treatment, scores in Regulatory Emotional Self-Efficacy (RESE) such as expressing positive emotion efficacy, regulating anger/irritability efficacy and regulating depression/pain efficacy of the observation group were higher than those of the control group. After treatment, scores of despair and optimistic factors, total scores and masking factors score in suicidal ideation of the observation group were lower than those of the control group. After treatment, degree of psychological distress was milder than that of the control group. Conclusion Psychodrama in treatment of depression can effectively alleviate anxiety and depression of patients with depression, improve their emotion self-efficacy, reduce suicidal ideation and psychological distress.
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  Effect of platelet-rich fibrin on proliferation and differentiation of osteoblasts

  HAN Xiaoqian, DONG Zhiheng, LYU Lixia, ZHANG Yuntao

  滨州医学院学报. 2019, 42(5): 339-341. https://doi.org/10.19739/j.cnki.issn1001-9510.2019.05.006

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  Objective To observe the effect of platelet-rich fibrin (PRF) on the proliferation and differentiation of osteoblasts. Methods MC3T3-E1 osteoblasts were cultured in a PRF environment, and a blank control group was established. Cell adhesion was observed by scanning electron microscopy. Cell proliferation and alkaline phosphatase activity were observed by CCK-8 cell proliferation assay on 1d, 4d and 7d. The expression of osteogenic related gene OPG was observed. Results CCK-8 cell proliferation assay showed that the proliferation of cells in the experimental group was significantly higher than that in the control group at 4 and 7 days. The difference was statistically significant. The ALP activity assay showed that the culture was 4d, 7d. Afterwards, the experimental group had a significant promoting effect compared with the control group, and the difference was statistically significant. PRF promoted OPG mRNA expression. Conclusion PRF promotes the proliferation and differentiation of MC3T3-E1 cells and the expression level of osteogenic gene OPG mRNA.
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  Logistic regression analysis about the diagnostic value of multisliecs helieal CT on thyroid benign and malignant nodules

  GUO Lantian, MA Zhenzhen, FENG Yan, ZOU Xuexue

  滨州医学院学报. 2019, 42(5): 342-345. https://doi.org/10.19739/j.cnki.issn1001-9510.2019.05.007

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  Objective To evaluate and screen out the characters of multisliecs helieal CT (MSCT) on thyroid benign and malignant nodules. Methods 143 thyroid nodules of the 105 patients were reviewed retrospectively with MSCT. By using the Logistic model, the radiological features by dependent MSCT were screened out. Results There were significant differences in the number, morphology, border, calcification, cysts, enhancement characteristics, marginal discontinuation and lymph node enlargement of thyroid benign and malignant nodules on MSCT. No significant difference in the maximum diameter and nodule position, Logistic regression analysis showed statistically significant differences in boundary, calcification and enhancement. Conclusion Boundary, calcification and enhancement of the thyroid nodules were characteristic predictors for the differential diagnosis of benign and malignant thyroid nodules.
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  Ultra-early diagnosis of Hyun-speed dual-source CT perfusion imaging in acute ischemic cerebral infarction in dogs

  WANG Shanshan, JIANG Xingyue, LIU Xinjiang, GUO Lantian, MAO Xijin, SU Qian

  滨州医学院学报. 2019, 42(5): 346-348. https://doi.org/10.19739/j.cnki.issn1001-9510.2019.05.008

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  Objective To investigate the value of Hyun speed dual-source CT perfusion imaging in the early diagnosis of acute cerebral infarction and to observe the effect of ischemia-reperfusion on neuronal apoptosis. Methods Twelve healthy hybrid dogs were established by interventional Methods to establish a model of canine acute ischemic cerebral infarction. CT scan and Hyun speed dual-source CT perfusion imaging were performed before embolization and 1, 2, 3, 4, 5, and 6 h after embolization. To measure the cerebral blood flow, cerebral blood flow volume, and time to peak of the infarction area and the contralateral normal control area, and obtain the corresponding cerebral perfusion CT imaging.In 24 h after the CT examination, the animals were sacrificed and the brain tissues were taken for pathological examination. Results The cerebral infarction model was successfully established in 12 dogs. The CTP examination showed that the CBF and CBV of the 11 infarct areas were decreased compared with the contralateral side. The TTP and MTT were longer than the contralateral side, and there was no significant change in the infarction area. The ΔCBF and ΔCBV decreased significantly in the 1h group and the 2h group, P < 0.05, statistically significant, 2h group was more obvious than 1h group. The ΔTTP values in the 1-6h group were all P<0.05, which was statistically significant.. After 24 hours, the experimental animals did not die. After the pathological examination, the infarcts of the dog brain tissue were found to be about 2.3mm~8.3mm in diameter. Conclusion CT perfusion imaging can quickly and accurately reflect the location and extent of ischemic penumbra in dogs with acute ischemic stroke. It can accurately determine the location of embolized blood vessels. It has an early diagnosis of ischemic stroke and grasping the timing of arterial thrombolysis.
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  Correlation analysis among parameters of IVIM-DWI model, prognostic factors and molecular subtypes of breast cancer

  MA Dejing, LU Feng, ZHANG Hu, DONG Jingmin, MA Mimi

  滨州医学院学报. 2019, 42(5): 349-352. https://doi.org/10.19739/j.cnki.issn1001-9510.2019.05.009

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  Objective To explore the correlation analysis among the parameters of IVIM-DWI model and the prognostic factors and molecular subtypes of breast cancer. Methods The DCE-MRI and IVIM-DWI data of 152 patients with breast cancer were retrospective analyzed, the parameters of IVIM-DWI (f value, D value and D^* value) and the expression of prognostic factors (ER, PR, HER-2, Ki-67) were used to analyze the correlation among IVIM-DWI parameters and prognostic factors. The molecular subtypes of the lesions were determined by the immunohistochemical Results and then the correlations between the IVIM-DWI parameters and molecular subtypes were analyzed. Results There was no significant difference of D value, D^*value and f value between the ER positive and negative groups. The D value was negatively correlated with the expression of PR, HER-2 receptors and Ki-67. The D^* value was positive correlated with the expression of HER-2. The D value of the Luminal A type group was significantly higher than that of the other groups; The D value of the triple negative breast cancer was the lowest among of them, there was significant difference of Luminal A type and HER overexpression, however, there was no significant difference between the triple negative breast cancer and the Luminal B type. D^* value and f value had no significant difference among the molecular subtypes. Conclusion The D value had some correlation with PR, HER-2 receptors and Ki-67 expression. And the D value might have a potential value in distinguishing different molecular subtypes of breast cancer.
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  Evaluation of the clinical value of transvaginal real-time three-dimensional ultrasound in the conservative treatment of ectopic pregnancy

  TANG Liwei, SUN Fang, LIU Xiaona, GAO Yanbing, DONG Jingyun, YANG Zhi, LIU Can

  滨州医学院学报. 2019, 42(5): 353-356. https://doi.org/10.19739/j.cnki.issn1001-9510.2019.05.010

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  Objective To evaluate the clinical value of transvaginal four-dimensional ultrasonography in the evaluation of ectopic pregnancy after drug treatment and conservative surgery for tubal patency. Methods 120 cases of patients with ectopic pregnancy were divided into conservative treatment (drug group), laparotomy conservative surgery (laparotomy group) and laparoscopic conservative surgery (laparoscopic group), each group of 40 cases, effect of transvaginal four-dimensional ultrasound fallopian tube imaging evaluation of ectopic pregnancy treatment of fallopian tube patency. Results The operative time of laparoscopic group was significantly lower than the laparotomy group operation time, the laparoscopic group of intraoperative bleeding was significantly lower than the laparotomy group operation time. The exhaust time and hospital stay in laparoscopic group were lower than that in control group, and there was no significant difference between the two groups. After treatment, there was a significant difference in the number of days between the laparoscopic group, the open group and the drug group, the initial blood beta -HCG level, and the number of HCG decreased to normal. Tubal patency rate of laparoscopic group was 92.5%, which was better than that of open group and 70% of tubal patency rate, and 65%. Conclusion Compared with conservative treatment and conservative surgery, laparoscopic conservative surgery in the treatment of tubal pregnancy tubal function recovery is faster. The evaluation of fallopian tube patency by transvaginal four-dimensional fallopian tube ultrasound has the advantages of simple operation and no invasive, which is worth popularizing.
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  Analysis of the requirements of family doctor contract service in a city community

  HE Xiaomin, JIA Zhihui, ZHAO Yongjun, LIU Jingyu, DU Qing

  滨州医学院学报. 2019, 42(5): 357-359. https://doi.org/10.19739/j.cnki.issn1001-9510.2019.05.011

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  Objective To investigate and analyze the demand of the community residents for the contracted services of family doctors in a certain city, and provide theoretical and practical basis for the further development of the contracted services of family doctors in the area. Methods Based on the previous literature study, a questionnaire was designed, and 500 out-patients from five community health service centers in the city were investigated by means of convenient sampling. Results The rate of awareness of contracting services by family doctors was low, with 24.39 percent of the respondents being fully familiar with and aware of the contents of contracting services by family doctors; 70.73 % of the respondents had a need for services contracted by family doctors, but there were significant differences in gender, age, family income, and health status. In the family doctor contract service content and formation at the same time has the centralization and the difference. Conclusion The promotion of contract services for family doctors needs to be further strengthened. It is one of the ways to effectively improve the service utilization of contracted residents to provide personalized contracting service in multi-level, multi-type and multi-service way with local residents 'needs as the orientation.
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  Researchabout the nursing needs of the rural elderly in Binzhou

  FENG Dexiang, WEI Xiuhong, LUAN Shunlian, KONG Dehai

  滨州医学院学报. 2019, 42(5): 360-362. https://doi.org/10.19739/j.cnki.issn1001-9510.2019.05.012

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  Objective To understand the nursing needs of the rural elderly at home in binzhou city, and explore the relevant factors affecting the nursing needs of the elderly, to provide theoretical basis for the relevant government departments to formulate the nursing policies for the rural elderly at home. Methods The nursing needs of 465 rural elderly at home in binzhou city were investigated by stratified cluster sampling. Results The self-care ability of the rural elderly in binzhou city was good, and the difference of self-care ability of the elderly in different age groups was statistically significant. The main nursing needs are blood pressure measurement, health lectures and counseling, intravenous injection. Different age, gender, marital status, living style, income level, medical insurance type, self-care ability and social support have different nursing needs. Conclusion The proportion of home-based elderly people in rural areas in binzhou city who need nursing services is relatively high and their income is relatively low. Therefore, the government should establish an appropriate nursing service mode according to the nursing needs of home-based elderly people, so as to meet the basic nursing needs of the elderly.
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  Practical study of elaborate nursing based on iceberg theory in perioperative period of intracranial aneurysms

  CAI Wenyu

  滨州医学院学报. 2019, 42(5): 363-366. https://doi.org/10.19739/j.cnki.issn1001-9510.2019.05.013

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  Objective To explore the effect of elaborate nursing based on iceberg theory in the perioperative period of intracranial aneurysms. Methods The clinical data of 31 patients with intracranial aneurysms were retrospectively analyzed. The patients receiving routine nursing during the perioperative period were divided into routine group. The clinical data of the other 31 patients with intracranial aneurysms were retrospectively analyzed. They given the perioperative elaborate nursing based on iceberg theory was established as the research group. The depression and anxiety of the two groups before and after the intervention were compared, and the compliance behavior and the incidence of adverse events during the intervention were compared. The life quality before and after comparative intervention of the 2 groups were compared. Results There were no significant differences in the scores of SDS and SAS between the two groups before intervention. The average scores of SDS and SAS in the two groups after intervention were lower than those before intervention, and the study group were lower than those in the conventional group. There was significant difference in the grade distribution of compliance behavior between the two groups, and the complete compliance rate of the study group was higher than that of the conventional group. There was no significant difference in the incidence of nausea/vomiting, blockage of drainage tube and adverse events between the two groups, but the total incidence of adverse events in the study group was lower than that in the conventional group. There was no significant difference in the scores of physical, mental, social and environmental adaptability between the two groups before intervention. The scores of quality of life in the two groups after intervention were higher than those before intervention, and the scores in the study group were higher than those in the conventional group. Conclusion The elaborate nursing based on the iceberg theory could improve the depression, anxiety and the compliance behavior during the perioperative period of intracranial aneurysms, and reduce the incidence of adverse events.
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  Preparation and Feasibility Study of Polymeric Nanoparticles Based on N-arginyl-chitooligosaccharide as Drug Carriers

  LUO Tingting, ZHANG Jing

  滨州医学院学报. 2019, 42(5): 367-372. https://doi.org/10.19739/j.cnki.issn1001-9510.2019.05.014

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  Objective To prepare N-arginyl-chitooligosaccharide nanoparticles (ACOS NPs) and study thefeasibility of ACOS NPs as drug carriers. Methods N-arginyl-chitooligosaccharide(ACOS) was synthesized and analyzed by FT-IR and 1HNMR. ACOS NPs were prepared by ionic gelation method and characterized by TEM and ZetasizerNano-ZS. The in vitro cytotoxicity profiles of ACOS NPs againstHeLa cells were performed by MTT assay. The cellular uptake profiles of ACOS NPs byHeLa cells were determined by flow cytometry (FCM) and viewed by confocallaser scanning microscopy (CLSM). Results The FT-IR and 1H NMR Results confirmed the formation of ACOS. ACOS NPs were spherical in shape with a mean particle size of 146.3 nm and zeta potential of 9.76 mV and well-dispersed. ACOS NPs possessed no cytotoxicity to HeLa cells in vitro, indicating their good biocompatibility. ACOS NPs could be internalized rapidly and continuously by HeLa cells with a high uptake rate, and the cellular uptake was time- and concentration-dependent. Conclusion ACOS NPs with good biocompatibility can significantly improve the intracellular delivery efficacy of drugs,therefore are promising to be used as drugcarriers with low cytotoxicity and high efficacy.
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  Pharmacoeconomic evaluation of gefitinib in the treatment of non-small cell lung cancer

  ZHAO Shengwen, SU Jin, DING Yuexia

  滨州医学院学报. 2019, 42(5): 373-376. https://doi.org/10.19739/j.cnki.issn1001-9510.2019.05.015

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  Objective To make a pharmacoeconomic evaluation of gefitinib and carboplatin plus paclitaxel in treating non-small cell lung cancer considering the medical insurance management, and the whole society in Hubei province. Methods IPASS test Results were taken as the treatments utility evidence, corresponding medical expense by the survey in Wuhan five hospitals as the cost. Incremental cost-utility analysis was done by their Epidermal Growth Factor Receptor (EGFR) mutation. Results The incremental cost of the treated by gefitinib was 0.98 times to the per capital GDP by their overall survival (OS), 0.61 times to the per capital GDP by their quality of life adjusted OS in the EGFR positive group. The OS was lower treated by gefitinib than that of control group in the EGFR negative group. Conclusion Gefitinib met the recommended criteria for pharmacoeconomic evaluation to EGFR positive patients. It is suggested that gefitinib be included in medical insurance payments, and the EGFR mutation test was strongly recommended before they be treated with gefitinib.