Construction of competitive endogenous RNA network mediated by lung ischemia-reperfusion core genes / 器官移植

Objective To analyze the core genes of lung ischemia-reperfusion injury and construct a competitive endogenous RNA (ceRNA) network. Methods Original data of GSE145989 were downloaded from the Gene Expression Omnibus (GEO) database as the training set, and the GSE172222 and GSE9634 datasets were used as the validation sets, and the differentially-expressed genes (DEG) were identified. Gene ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed. Protein-protein interaction (PPI) network was constructed, and the core genes were screened, and the diagnostic values of these core genes and the immune infiltration levels of immune cells were evaluated. The ceRNA network was constructed and validated. The targeted drugs based on ceRNA network were assessed. Results A total of 179 DEG were identified, including 61 down-regulated and 118 up-regulated genes. GO analysis showed that DEGs were associated with multiple biological processes, such as cell migration, differentiation and regulation, etc. They were correlated with cell components, such as vesicle membrane, serosa and membrane raft, etc. They were also associated with multiple molecular functions, such as chemokine receptor, G protein-coupled receptor, immune receptor activity and antigen binding, etc. KEGG pathway enrichment analysis revealed that DEG were involved in tumor necrosis factor (TNF), Wnt, interleukin (IL)-17 and nuclear factor (NF)-κB signaling pathways, etc. PPI network suggested that CD8A, IL2RG, STAT1, CD3G and SYK were the core genes of lung ischemia-reperfusion injury. The ceRNA network prompted that miR-146a-3p, miR-28-5p and miR-593-3p were related to the expression level of CD3G. The miR-149-3p, miR-342-5p, miR-873-5p and miR-491-5p were correlated with the expression level of IL-2RG. The miR-194-3p, miR-512-3p, miR-377-3p and miR-590-3p were associated with the expression level of SYK. The miR-590-3p and miR-875-3p were related to the expression level of CD8A. The miR-143-5p, miR-1231, miR-590-3p and miR-875-3p were associated with the expression level of STAT1. There were 13 targeted drugs for CD3G, 4 targeted drugs for IL-2RG, 28 targeted drugs for SYK and 3 targeted drugs for lncRNA MUC2. No targeted drugs were identified for CD8A, STAT1 and other ceRNA network genes. Conclusions CD8A, IL2RG, STAT1, CD3G and SYK are the core genes of lung ischemia-reperfusion injury. The research and analysis of these core genes probably contribute to the diagnosis of lung ischemia-reperfusion injury and providing novel research ideas and therapeutic targets.

Bibliometric analysis based on bowel preparation of elderly colonoscopy subjects in China / 中国实用护理杂志

Objective:To analyze and interpret the literature on intestinal preparation during colonoscopy in the elderly in China, and explore the research hotspots and development frontiers in this field, so as to provide theoretical reference for relevant institutions and researchers.Methods:Bibliometrics CiteSpace Ⅴ software was used to search CNKI, Wanfang Database, VIP, Chinese biomedical journal database, Chinese biomedical literature database from January 1, 2000 to April 30, 2022, and then statistical analysis was made on the number of published papers, distribution of institutions and regions, authors, journals, funding, and the maps of high-frequency keywords, clustering, and cooperation of authors, institutions and burst words were drawn.Results:A total of 281 literatures were included, and the characteristics of intestinal preparation, the effect of intestinal preparation for colonoscopy and nursing intervention of intestinal preparation for colonoscopy in the elderly were extracted as the research focus.Conclusions:The visualization analysis showed the research hotspots and trend of intestinal preparation during colonoscopy in the elderly. Intestinal preparation and comprehensive nursing intervention are still the focus of future research, and the cooperation among researchers and quality of published literature should be improved based on the research hotspots in the future.

Effect of nuclear factor E2-related factor 2 on renal ischemia-reperfusion injury / 器官移植

Renal ischemia-reperfusion injury (RIRI) is the main cause of acute kidney injury (AKI), which commonly occurs in surgery, severe trauma, shock and drug-induced kidney injury. At present, effective treatment for RIRI is still lacking. Oxidative stress is the major pathological injury mechanism of RIRI. Nuclear factor E2-related factor 2 (Nrf2) is the key transcription factor of anti-oxidative stress response, which may activate various cytoprotective genes related to redox and detoxification. Recent studies have shown that Nrf2 may play a protective role in the protection and treatment of RIRI by regulating oxidative stress, inflammation, cell apoptosis and autophagy, etc. Consequently, the structure and biological function of Nrf2, related signaling pathways, its role in the incidence and development of RIRI and potential mechanism were reviewed in this article, aiming to provide novel ideas for the prevention and treatment of RIRI.

Clinical Predominance Disease of Traditional Chinese Medicine： Gastroesophageal Reflux Disease / 中国实验方剂学杂志

Gastroesophageal reflux disease （GERD） is a frequently and commonly occurring disease in clinic. In recent decades， with the development in pathophysiology and drug researches， modern medicine has achieved remarkable progress and results in diagnosis and treatment. However， the treatments for non-erosive reflux disease， refractory gastroesophageal reflux disease， proton pump inhibitor resistance， overlap of disease symptoms， and extraesophageal symptoms are limited and ineffective. Traditional Chinese medicine （TCM） was widely used in clinical practice， which has been proved effective in relieving symptoms and improving the quality of life. Sponsored by China Association of Chinese Medicine （CACM） and undertaken by the Spleen and Stomach Disease Branch of CACM， "the 12th Youth Salon of Clinical Predominance Disease Series （GERD）" invited 18 authoritative digestive experts of TCM and western medicine to discuss "the difficulties of clinical diagnosis and treatment of GERD and TCM advantages". The focus issues such as modern medical diagnosis and treatment achievements and contributions， improvement and maintenance of symptoms， response to overlapping disease symptoms， reduction and withdrawal of acid suppressors， and treatment of extra-esophageal symptoms were discussed in depth. TCM and western medicine exchanged and complemented each other's strengths， combing the difficulties of modern medical diagnosis and treatment， which clarified the positioning and advantages of TCM and provided guidance for clinical and scientific research.

Anti-neutrophil cytoplasmic antibody-associated vasculitis with gastrointestinal bleeding as the main symptom: a case report and literature review / 中华危重病急救医学

Anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) has a wide range of symptoms, and it is difficult for clinicians to make a quick and correct diagnosis. On November 11, 2021, a 36-year-old male patient with AAV was admitted to the emergency and critical care department of Yichang Central People's Hospital. He was admitted to the emergency intensive care unit (EICU) with gastrointestinal symptoms (abdominal pain, black stool) as the main physical signs, and was initially diagnosed as AAV with gastrointestinal hemorrhage (GIH). No bleeding point was found after repeated gastroscopy and colonoscopy. Abdominal emission CT (ECT) showed diffuse hemorrhage in the ileum, ascending colon and transverse colon. Multi-disciplinary consultation in the whole hospital considered the diffuse hemorrhage caused by small vascular lesions in the digestive tract caused by AAV. Pulse therapy with methylprednisolone 1 000 mg/d and immunosuppressive therapy with cyclophosphamide (CTX) 0.2 g/d were administered. The patient's symptoms quickly relieved and transferred out of the EICU. After 17 days of treatment, the patient finally died of massive gastrointestinal bleeding. A systematic review of relevant literatures combined with the case diagnosis and treatment process found that only a minority of AAV patients present with gastrointestinal symptoms as their first symptoms, and patients with GIH were very rare. Such patients had a poor prognosis. This patient delayed the use of induced remission and immunosuppressive agents due to the treatment of gastrointestinal bleeding, which may be the main cause of life-threatening GIH secondary to AAV. Gastrointestinal bleeding is a rare and fatal complication of vasculitis. Timely and effective induction and remission treatment is the key to survival. Whether patients should receive maintenance therapy, the duration of maintenance therapy, and the search for markers of disease diagnosis and treatment response are directions and challenges for further research.

Relationship between smoking abstinence self-efficacy， smoking rationalization belief and willingness to quit smoking—a questionnaire survey of 336 male smokers in Shanghai / 上海预防医学

ObjectiveTo explore the influencing factors of willingness to quit smoking in smokers， and to provide reference for further smoking cessation intervention. MethodsThrough purposive sampling， smokers were recruited from 4 residential communities and 3 companies in Shanghai for an online questionnaire survey. The survey included general demographic characteristics， willingness to quit smoking， smoking condition， tobacco addiction， awareness of influence of smoking， smoking abstinence self-efficacy， and smoking rationalization belief. T-test， χ2 test and multiple logistic regression were used to analyze the data. ResultsA total of 336 valid questionnaires were collected. The average age of the smokers was （37.1±10.2） years， and most of their education level was college or above （58.3%）. The daily number of cigarette use was （11.46±7.22） and most of smokers were classified as low nicotine dependence （58.3%）. Today 248 smokers planned to quit smoking in the next six months. Compared with smokers with low smoking abstinence self-efficacy， smokers with high self-efficacy were more likely to quit smoking （OR=2.406，95%CI： 1.357‒4.267）； Smokers with low smoking rationalization belief were more likely to quit smoking than those with high rationalization belief （OR=2.112， 95%CI： 1.167‒3.821）. ConclusionSmoking abstinence self-efficacy has a positive impact on willingness to quit smoking， while smoking rationalization belief has a negative impact on the willingness to quit smoking. Efforts to improve smoking abstinence self-efficacy and dispel smoking rationalization beliefs of smokers should be made to promote the intention to quit among smokers.

Warning effects of tobacco packaging on teenagers / 上海预防医学

ObjectiveTo evaluate the warning effect of different tobacco packaging on teenagers and provide an objective evidence for improving tobacco packaging in China. MethodsA multi-stage cluster sampling method was used to investigate students from two middle schools and two high schools in Huangpu District， Shanghai with a self-filled questionnaire survey， and a total of 1 238 valid questionnaires were collected. Epidata 3.1 was used to input data and SPSS 20.0 was used for data analysis. ResultsAbout 69% of the respondents supported printing pictures of diseases on tobacco packages in China， and 81.58% thought graphic warnings should cover more than 70% of the tobacco package. The effect of graphic health warning labels was better than that of text-only warning labels （P<0.05）， and the effect of real photos was better than abstract pictures. In addition， labels with real graphic warnings had the highest scores in terms of preventing youth smoking and the degree of support， which was significantly different from abstract graphic warning labels and text-only warning labels （P<0.05）. ConclusionCigarette packs with graphic health warnings have a stronger effect on teenagers than plain text health warnings. Teenagers support the use of graphic warnings. It is recommended to apply graphic health warnings with real photos of diseases on the cigarette packages to maximize the effect of the health warnings.

The changes and clinical significance of plasma lipoprotein-associated phospholipase A2,C-reactive protein and cardiac troponin Ⅰ in patients with acute coronary syndrome / 中国基层医药

Objective To investigate the relationship between lipoprotein associated phospholipase A2 (Lp－PLA2)and atherosclerotic plaque instability in patients with acute coronary syndrome (ACS),and to provide theoretical basis for diagnosis and treatment of ACS.Methods From September 2015 to February 2016,80 patients with ACS in Shidao People's Hospital of Rongcheng were selected as the study group,including 38 cases in unstable angina group(UAP group),24 cases in non ST segment elevation myocardial infarction group (NSTEMI group), 18 cases in ST segment elevation myocardial infarction group(STEMI group).Forty patients with stable angina pectoris (SAP group)and 40 healthy subjects(healthy group)were selected as control group.Each group was collected 8 hours fasting morning blood sample,the levels of Lp－PLA2,C reactive protein(CRP),troponin Ⅰ,and low density lipoprotein were detected,in order to compare the differences among the groups and the correlation between Lp－PLA2 and ACS plaque instability was analyzed.Results The levels of Lp－PLA2,CRP,troponin Ⅰ and low density lipopro-tein in the ACS group were (312.63 ±11.14)ng/mL,(21.98 ±7.83)mg/L,(0.720 ±0.490)μg/L,(174.76 ± 30.82)mg/dL,respectively,which were significantly higher than those of the healthy group [(141.14 ±12.30)ng/mL, (2.38 ±1.68 )mg/L,(0.010 ±0.003 )μg/L,(79.24 ±17.80 )mg/Ml],and stable angina pectoris group [(176.42 ±12.44)ng/mL,(4.22 ±3.68)mg/L,(0.010 ±0.004)μg/L,(96.54 ±19.41)mg/mL].There were statistically significant differences among all groups(F＝3.07,1.99,2.43,3.25,all P＜0.01).The levels of CRP, Lp－PLA2 and cTnI in ACS patients with different types of the STEMI group,NSTEMI group,UAP group had statisti-cally significant differences,which of the STEMI group were higher than those of the NSTEMI group,which of the NSTEMI group were higher than those of the UAP group(F＝5.15,3.47,2.43,all P＜0.05).Correlation analysis showed that the level of Lp－PLA2 was positively correlated with low density lipoprotein(r＝0.625,P＜0.01)and lipoprotein a(r＝0.532,P＜0.01).logistic regression analysis showed that Lp －PLA2 and CRP were significant independent risk factors of ACS,Lp－PLA2(OR＝1.613,95%CI:1.292 －1.992,P＜0.01),CRP(OR＝1.452, 95%CI:1.210-1.782,P＜0.01).Conclusion Lp－PLA2 is independent risk factor of ACS.Lp－PLA2 is involved in the inflammatory reaction of ACS,and is strongly associated with the stability of atherosclerotic plaque.

Anti-tumor therapy of thalidomide / 国际肿瘤学杂志

Studies have found that thalidomide has anti-tumor activity due to its inhibitory effect on angiogenesis and immunomodulation,which has been effectively used in targeted therapy resistant non-small cell lung cancer,castration-resistant prostate cancer,colorectal cancer,advanced hepatocarcinoma and advanced gastric cancer.Many clinical studies have also found that it has certain practical value in the aspects of improvement of cancer cachexia and chemotherapy-induced nausea and vomiting.

Efficacy analysis of zoledronic acid combined with radiotherapy and combined with chemotherapy for bone metastasis of non-small cell lung cancer / 肿瘤研究与临床

Objective To observe and compare the curative effects of zoledronic acid (ZA) combined with radiotherapy and ZA combined with chemotherapy in the treatment of bone metastasis of non-small cell lung cancer (NSCLC). Methods Seventy-eight patients with NSCLC bone metastasis treated by radiotherapy or chemotherapy were taken in our hospital from January 2010 to June 2014, including 39 cases of ZA combined conventional fractionation radiotherapy (radiotherapy combined group), and 39 cases of ZA combined with chemotherapy (paclitaxel liposome + cisplatin) (chemotherapy combined group). Each group had 39 cases. WHO objective evaluation standard, efficacy evalulation of solid tumor metastasis and curative effect standard grading of pain, anticancer agent toxicity classification standard, Karnofsky standard were used for evaluating and analyzing the patients with primary lung tumor, bone metastasis, degree of pain, adverse reactions and functional status (once before and after the treatment). Results The efficiency rate of primary lung tumor, the efficiency rate of bone metastasis, the total effective rate of pain relief and the improvement rate of functional status (Karnofsky score increased by 10 points or more)in the radiotherapy combined group and chemotherapy combined group were 82.05 % (32/39) vs. 79.49 % (31/39), 48.72 % (19/39) vs. 51.28 %(20/39), 82.05 % (32/39) vs. 84.62 % (33/39), 66.67 % (26/39) vs. 71.79 % (28/39) respectively, and the differences were not statistically significant (the values of x2 were 0.224, 0.237, 0.195, 0.259 respectively, all P> 0.05); Although the two groups showed low-grade fever, bone marrow suppression, esophagitis, liver and kidney damage, gastrointestinal reactions and other adverse reactions, the adverse reactions of two groups were close to [28.21 % (11/39) vs. 30.77 % (12/39)] (x2 = 0.314, P> 0.05). Fortunately, these reactions were controlled well after symptomatic treatment. Conclusion ZA combined with radiotherapy or chemotherapy is a safe and effective way for bone metastasis of NSCLC, which should be taken based on the individual condition of the patients.

The effect of calorie restriction on the proliferation of satellite cells in elderly rats' skeletal muscles / 中华物理医学与康复杂志

Objective To explore any effect of calorie restriction on the proliferation of satellite cells in the skeletal muscles of elderly rats.Methods Twelve male C57BL rats aged 12 or 13 months were randomly divided in to an experimental group and a control group,each of 6.The control group was fed 75.09 kJ/d as normal,while the experimental group was provided with 45.05 kJ/d (60％ of normal).The intervention lasted for 15 weeks and each rat's weight was measured every week.After the intervention,limb muscle satellite cells were sorted by fluorescenceactivated cell sorting after digestion,and the cell cycle was analyzed.Western blotting was used to assess the expression of cyclin A,D1 and E.Results There was no significant difference in the average weight of the two groups before the experiment.After the 15 weeks the average weight of the experimental group had decreased significantly (to 19.5±0.4 g),and it was significantly lighter than that of the control group (31.9±0.5 g).The average percentage of the satellite cells in the G0/G1 phase had decreased significantly in the experimental group,but the percentage in the S phase had increased significantly.The expression of cyclin A and E was significantly greater in the experimental group compared with the control group,but the expression of cyclin D1 had decreased significantly.Conclusion Caloric restriction can delay the proliferation of satellite cells in the skeletal muscles of elderly mice.

Significance of leukocyte subtypes and thyroid function tests in differential diagnosis of thyrotoxicosis / 吉林大学学报(医学版)

Objective:To explore the differences of leukocyte subtypes and thyroid function of the patients with different thyrotoxicosis diseases,and to clarify the practical significance of leukocyte subtypes and thyroid function tests in the differential diagnosis of Graves disease thyrotoxicosis and destructive thyrotoxicosis.Methods:A total of 33 patients with Graves disease thyrotoxicosis and 30 patients with destructive thyrotoxicosis confirmed by clinical and laboratory examination were selected; the levels of neutrophils (Ne),lymphocyte (Ly),basophils (Ba), eosinophil (Eo)and mononuclear cells (Mo),serum free thyroxine (FT4),three free iodine thyroid former glycine (FT3),and thyroid stimulating hormone (TSH)of the patients in two groups were analyzed and the receiver operator characteristic curve (ROC)was used to evaluate the values of the indicators with statastical significance in the differential diagnosis of Graves disease thyrotoxicosis and destructive thyrotoxicosis.Results:The levels of serum Eo,FT4 and FT3,and the modified data Eo/Mo,Eo × FT3 / Mo of the patients in Graves disease thyrotoxicosis group were significantly higher than those in destructive thyrotoxicosis group (P <0.05);the levels of TSH and Mo of the patients were lower than those in destructive thyrotoxicosis group (P < 0.05).The ROC curve analysis results showed that the sensitivities and specificities of Eo,Eo/Mo,Eo×FT3/Mo in the differential diagnosis of two diseases were good, and the best diagnostic boundaries were 1.54, 0.34, and 3.94. Conclusion:Eo,Mo,TSH,FT3,FT4,Eo/Mo,and EoxFT3/Mo could be regarded as the basis in the differential diagnosis of Graves disease thyrotoxicosis and destructive thyrotoxicosis ,and the practical significances of Eo,Eo/Mo,and Eo×FT3 /Mo in the differential diagnosis of Graves disease thyrotoxicosis and destructive thyotoxicosis are bigger.

Clinical Study of Ursodeoxycholic Acid Combined with Adenosylmethionine in the Treatment of Intrahepatic Cholestasis of Pregnancy / 医学研究杂志

Objective To study the clinical efficacy of ursodeoxycholic acid combined with adenosylmethionine in the treatment of intrahepatic cholestasis of pregnancy (ICP) and its effect on pregnancy outcomes.Methods One hundred and four patients with ICP were divided into study group (52 cases) and control group (52 cases) according to the random number table.The patients in the control group were treated with ursodeoxycholic acid on the basis of routine treatment.While ursodeoxycholic acid combined with adenosylmethionine in the study group.The levels of serum IL-17 and TGF-β were measured before and after treatment,and the serum levels of IL-17 and TGF-β were measured before and after the treatment in both groups.The clinical efficacy,pregnancy outcome and also the levels of serum IL-17 and TGF-β were measured and compared before and after treatment in both groups.Results The treatment efficiency (88.46％) of the study group was significantly higher than that of the control group (71.15％),the difference was statistically significant (P ＜ 0.05).The clinical efficacy of mild ICP patients in the control group was better than that the severe ICP patients (P ＜ 0.05),but the clinical efficacy of the study group was not significantly related to the severity of ICP.The score of pruritus in the ICP group was significantly higher than that in the mild ICP group (P ＜ 0.05),and the score of itching in the study group was significantly lower than that in the control group (P ＜ 0.05).The pregnancy outcome of the study group was significantly better than that of the control group (P ＜0.05).The pregnancy outcome of severe ICP patients was significantly better than that of the mild ICP patients (P ＜ 0.05).The improvement of liver function in study group was better than that in control group,and the improvement of liver function in severe ICP patients was less than that in mild ICP group (P ＜ 0.05).The improvement of IL-17 and TGF-β levels in the study group was better than that in the control group,and the levels of IL-17 and TGF-β in patients with severe ICP were lower than those in patients with mild ICP (P ＜ 0.05).Conclusion Ursodeoxycholic acid combined with adenosylmethionine can significantly improve the outcome of pregnancy and the liver function in patients with intrahepatic cholestasis of pregnancy.The mechanism of which may be to improve the patient's Th1T/Treg imbalance,the efficacy is related to the severity of ICP.

Study on glycemic control of the gestational diabetes mellitus to the neonatal immunity / 中国基层医药

Objective To investigate the influence of the glycemic control level of gestational diabetes melli-tus (GDM)to neonatal immunity system function.Methods 41 newborns whose mothers suffered from GDM and treated,were selected as the observation group.Inside the observation group,based on the glycemic control level,they were divided into 25 cases in higher satisfaction group and 16 cases in lower satisfaction group.20 cases from normal full -term and single -birth pregnancy were selected as the control group.The levels of serum immunoglobulin and the complement were observed in three different groups.Results The level of serum immunoglobulin(IgG)in lower satisfaction group was (5.2 ±1.4)g/L,which was significantly lower than higher satisfaction group (10.4 ±2.2)g/L and control group (10.3 ±1.9)g/L(t =8.957,8.470,P <0.01).The C3 and C4 levels in the higher satisfaction group [C3 (59.3 ±12.9)g/L,C4(39.4 ±11.2)g/L]and control group[C3 (59.9 ±13.8)g/L,C4 (39.8 ± 10.6)g/L]were significantly higher than the lower satisfaction group [C3(40.6 ±10.5)g/L,C4 (21.9 ±6.3)g/L] (t =4.612,4.854,5.956,5.685,all P <0.01 ).Conclusion Higher level of glycemic control on GDM mothers benefits neonatal serum immunoglobulin and the complement,and has positive impact on the immunity system and liver function.

The influence of labor delivery ball exercise and free position on labor and birth outcome / 中国基层医药

Objective To analyze the influence of labor delivery ball exercise and free position for nursing on labor and birth outcome.Methods 110 cases of primipara were selected as the research subjects in our hospital, they were randomly divided into observation group and control group accorrded to digital method,55 cases in each group.The observation group received labor delivery ball exercise and free position for nursing,the control group received conventional way for nursing.The labor time of 1,2,3 stage,the total time of labor and 2h postpartum blood loss in two groups were compared,the VAS,VRS,PPI,VAS -A and LAS scores,the vaginal natural births rate of two groups were compared.Results The pain score,anxiety score in the observation group were (6.14 ±1.66)points and (3.63 ±1.24)points respectively,which were significantly lower than (8.46 ±1.27)points and (6.32 ± 1.33)points in the control group,and birth control score (171.21 ±19.75)points was also significantly higher than the control group (125.71 ±17.42)points,the differences between the two groups were statistically significant(t =6.115,3.938,5.327,all P <0.05 ).The first labor time and the total labor time in the observation group were (452.44 ±137.75)min and (493.02 ±137.99)min respectively,which were also significantly lower than the control group [(525.51 ±128.19)min,(576.41 ±132.13)min],the differences between two groups were statistically sig-nificant(t =3.097,5.406,all P <0.05).The natural childbirth success rate of observation group was 92.73%,which was obviously higher than 67.27% in the control group,the difference between the two groups was significant (χ2 =16.135,P <0.05).Conclusion Free position midwifery match with ball movement launched applied in natural birth can obtain good results,and has small injury,can improve the pregnant women's sense of control,reduce pain,it is worthy of clinical popularization and application.

Minocycline quadruple versus tailored therapy in retreatment of Helicobacter pylori infection / 中华内科杂志

Objective To compare eradication rates,safety and compliance of minocycline quadruple and tailored therapies in patients retreated for Helicobacter pylori (H.pylori) infection.Methods Between January 2014 and June 2014,135 patients with dyspepsia (18-70 years) and H.pylori infection after at least one previous eradication treatment at a tertiary hospital were randomly assigned to a 10-day treatment with minocycline quadruple therapy versus tailored triple regimen of PPI,amoxicillin and a third antibiotic.In the group of tailored therapy,medications were adjusted based on clarithromycin sensitivity and cytochrome P450 isoenzyme 2C19 genotype.Eradication status was assessed 4-12 weeks after treatment.Results Although H.pylori eradication rates were higher in the minocycline therapy group than that in the tailored therapy group in intention-to-treat [84.1％ (95％ CI 75.0％-93.2％) vs 75.8％ (95％ CI 65.1％-86.5％),P =0.245] and per-protocol [88.3％ (95％ CI 80.3％-96.3％) vs 79.7％ (95％CI 69.7％-89.7％),P =0.197] analyses,the differences between the two groups were not statistically significant.The incidence of adverse effects and compliance between the two groups were also comparable.Conclusions The tailored therapy in this study had a poor eradication efficacy in the retreated patients with H.pylori infection.Minocycline quadruple therapy achieved a relatively satisfactory eradication efficacy and may be an alternative choice for the retreatment of H.pylori infection.Clinical trial registration Chinese Clinical Trial Registry,ChiCTR-TRC-13003975.

Expression of Epstein-Barr virus-latent membrane protein 1 in patients with chronic atrophic gastritis with intestinal metaplasia and its significance / 中国医师进修杂志

Objective To investigate the expression of Epstein-Barr virus(EBV)-latent membrane protein 1 (LMP1) in chronic atrophic gastritis (CAG) with intestinal metaplasia and discuss its effect on gastric cancer.Methods Immunohistochemistry was used to examine the expression of EBV-LMP1 in 45 cases of chronic superficial gastritis(CSG),63 cases of CAG with intestinal metaplasia and 36 cases of gastric cancer.Results There was no expression of EBV-LMP1 in CSG and gastric cancer,while the positive rate of EBV-LMP1 in CAG with intestinal metaplasia was 36.5％ (23/63) and EBV-LMP1 was mainly stained in the cell nucleus.The expression of EBV-LMP1 in CAG with intestinal metaplasia was significantly higher than that in CSG and gastric cancer,and there was significant difference (P =0.000).Conclusions EBV-LMP1 is expressed in CAG with intestinal metaplasia.The expression of EBV-LMP1 is significantly higher than that in CSG and gastric cancer indicating that EBV infection in gastric carcinogenesis may play an important role in the early stages.

The relationship between the expression of bFGF in gastric cancer and precancerous lesions / 中国基层医药

Objective To explore the relationship of bFGF in the pathogenesis of gastric cancer.Methods The expression of bFGF was determined by immunohistochemical method in 130 gastric specimens including 30 cases of chronic superficial gastritis,30 cases of intestinal metaplasia,30 cases of dysplasia and 40 cases of gastric carcinomas.Results In control group with chronic superficial gastritis,precancerous group,and gastric carcinoma group,the expression level of bFGF had a increasing tendency(P ＜ 0.05).Conclusion The expression of bFGF was up-regulated in the carcinogenesis of gastric carcinoma.

Clinical observation on patients older than seventy years with AECOPD treated with budesonide in combination with salbutamol sulfate and ambroxol through fog inhalation / 中国综合临床

Objective To assess the clinical efficacy of budesonide in combination with salbutamol sulfate and ambroxol through fog inhalation in the treatment of elderly patients older than 70 years with acute exacerbation chronic obstructive pneumonia disease (AECOPD). Methods A total of 58 elderly patients older than 70 years with AECOPD were randomly assigned to receive medication of budesonide in combination with salbutamol sulfate and ambroxol through fog inhalation in addition to conventional therapy ( n = 58 treatment group). In the control group,56 AECOPD patients received conventional therapy (including oxygen uptaking,anti-infection, medication, relieving asthma, eliminating sputum, nutritional support, et al). Results The overall effective rate in the treatment group was 76.79% (43/56) ,which was significantly lower than that in the control group 89. 66% (52/58) ( χ2 = 6. 46, P = 0. 007 ). Blood gas analysis ( pH, PaCO2, PaO2 ) and lung function ( FEV1/FVC, FEV1 occupy prospect% ) outcome were significantly improved after treatment (Ps ＜ 0.05 ). We found no significant difference in the comparison of the blood gas analysis improvement between the treatment and control ( Ps ＞ 0. 05 ), whereas significant difference was observed in the improvement on lung function between the two groups (P ＜ 0. 05 ). Conclusion Combined budesonide with salbutamol sulfate and ambroxol through fog inhalation in addition to conventional therapy has a significant better effect and less side effects on the treatment of AECOPD patients older than 70 years.

Effects of low-dose ketamine pretreatment on intestinal ischemia-reperfusion injury in rats / 中华麻醉学杂志

Objective To investigate the protective effects of pretreatment with low-dose ketamine on intestinal mueosa against ischemia-reperfasion injury (I/R) and the underlying mechanism. Methods Forty-eight male SD rats weighing 230-270 g were randomly divided into 6 groups (n = 8 each) : group Ⅰ sham operation (S) ;group Ⅱ ketamine + sham operation (KS);group Ⅲ l/R;group Ⅳ ketamine + I/R (K);groupⅤ ketamine + ZnPPⅨ + I/R (KZ) and group Ⅵ ZnPPⅨ + I/R. Ketaminc 10 mg/kg and/or ZnPPⅨ 5 mg/kg were injected intraperitoneally 30 min before I/R in group Ⅳ, Ⅴ and Ⅵ. Intestinal I/R was produced by clamping of superior mesentery artery for 1 h followed by 6 h reperfusion. The animals were then killed and a segment of small intestine of 2 cm in length at about 10 cm from ileocecal valve was removed for determination of MDA content and SOD activity, HO-1 and iNOS expression and histological examination. The degree of intestinal tissue damage was graded using Chiu's scoring system (0 = normal, 5 = severe damage-exfoliation of villi, disruption of proper lamina, bleeding and ulceration). Results Intestinal MDA content was significantly increased, SOD activity was decreased and HO-1 and iNOS expression was significantly up-regulated by I/R (group Ⅲ) as compared with group Ⅰ and Ⅱ . Ketamine pretreatment significantly attenuated I/R-induced increase in MDA content and decrease in SOD activity and the protective effects of ketamine against I/R were counteracted by concomitant asministration of ZnPPⅨ. Microscopic examination showed that the pathological changes induced by I/R were significantly attenuated by ketamine and the protective effects of ketamine pretreatment against I/R were reversed by ZnPPⅨ in group Ⅴ. Conclusion Low-dose ketamine pretreatment can significantly ameliorate intestinal ischemia-reperfusion injury and up-regulation of intestinal HO-1 expression and down-regulation of iNOS are involved in the mechanism.