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ObjectiveTo investigate the influencing factors of intestinal metaplasia or atypical hyperplasia in chronic atrophic gastritis （CAG） patients and establish a prediction model. MethodThe clinical records and laboratory examination data of 335 CAG patients treated in the department of gastroenterology of the Second Affiliated Hospital of the Anhui University of Chinese Medicine from June 2016 to June 2021 were collected. Single and multiple Logistic regression analyses were used to explore the influencing factors of intestinal metaplasia or atypical hyperplasia in CAG patients by SPSS 26.0. A prediction model was constructed based on the data of the related influencing factors. In addition, 115 CAG patients diagnosed in the First Affiliated Hospital of Anhui Medical University from June 2019 to June 2021 were selected as external validation samples to verify and evaluate the prediction efficiency of the constructed prediction model. ResultMultiple Logistic regression analysis showed that pepsinogen Ⅰ［odds ratio（OR） 0.994，95% confidence interval（CI） （0.990，0.999），P<0.05］，the number of focus［OR 6.765，95% CI（3.831，11.945），P<0.01］， and Helicobacter pylori （Hp） infection［OR 0.546，95% CI（0.335，0.888），P<0.05］ were independent risk factors for intestinal metaplasia or atypical hyperplasia in CAG patients（P<0.05）. The formula of the prediction model is as follows：P=-1.558+0.606×Hp infection-0.006×pepsinogen Ⅰ+1.912×the number of focus. The receiver operating characteristic （ROC） curve showed the specific parameters as below： the area under the ROC curve of 0.76，the Youden index of 0.443，the best cut-off value of 0.52，sensitivity of 0.533，and specificity of 0.910. The prediction model was applied to the data of patients in the validation group for validation，and the predictive efficiency of the model was tested by decision curve analysis （DCA）. The results showed that the model had a good fit and high predictive value. ConclusionPepsinogen Ⅰ，the number of focus， and Hp infection are independent risk factors for intestinal metaplasia or atypical hyperplasia in CAG patients. The prediction model constructed based on these factors has a good fit and high predictive value，which can provide references for the classification of CAG patients and the formulation of individual treatment protocols.
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Viral myocarditis (VMC) is normally caused by myocarditis virus infection. Currently, the Western medicine treatment is mainly about symptomatic supportive treatment, while TCM has remarkable efficacy for this disease. This article started from the 4 common mechanisms of VMC, and elaborated the effects of individual and compound preparation, such as antiviral, regulating immune, anti free redical, antioxidation, improving myocardial metabolism, protecting myocardial cells, with a purpose to provide experimental references for TCM application in clinic.
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The advent of human infections with avian influenza A(H7N9)and the emerging communicable disease has brought us profound thoughts on lemology teaching recently. We analyzed the exiting challenges of lemology teaching, including great changes in communicable diseases com-posing but limited class hours, decreasing of communicable diseases cases, medical students' psycho-logical apprehension, lack of teachers, more and more requirements in the prevention and treatment for communicable diseases from the public, etc. Several suggestions on how to further improve the lemology teaching quality were proposed including adjusting the curriculum arrangement, paing atten-tion to accumulate teaching cases, applying multi-media materials, taking full advantage of the teach-ing cases from specialized hospital, teaching students knowledge about themselves protection, improv-ing the quality of young teachers, emphasizing discipline characteristics and the importance of public health, reforming the teaching method and promoting the effect of teaching in communicable diseases.
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Objective: To explore the relationship between expressions of estrogen (ER) and progesterone (PR) receptors and syndromes of traditional Chinese medicine (TCM) in gastric carcinoma and to establish prognostic indicators for gastric carcinoma. Methods: A total of 72 patients with gastric carcinoma were divided into six groups according to TCM syndrome differentiation. Specimens were collected after operation and ER and PR protein expressions were detected by EnVision immunohistochemical method. Results: The common syndromes in female patients with gastric carcinoma were disharmony between liver and stomach, yin impairment due to stomach heat, and insufficiency of both qi and blood; while in males, interior retention of stagnant toxin, interior retention of phlegm and dampness, and deficiency-cold in spleen and stomach were common. Different TCM syndromes were related with gender (P<0.01), pathology (P<0.01), cell differentiation (P<0.05), infiltration depth (P<0.01), lymphaden metastasis (P<0.05), distant metastasis (P<0.05), and TNM stage (P<0.01). Deficiency and excess syndromes were associated with gender (P<0.05), pathology (P<0.05), tumor location (P<0.01) and TNM stage (P<0.05). The deficiency syndromes were common in female patients. The total positive rates of ER and PR expressions were 8.33% and 37.5% respectively. There was a significant difference in PR expression among different TCM syndromes (P<0.01). PR expression was significantly higher in the syndrome of yin deficiency due to stomach heat than in the other syndromes. The PR expressions in deficiency syndromes were significantly higher than those in excess syndromes (P<0.01). No correlation was found between ER expression and different TCM syndromes. Conclusion: There is a correlation between PR expression and different TCM syndromes in gastric carcinoma.