ABSTRACT
Objective:To explore the efficacy and safety of intermittent infusion of ilaprazole sodium and high-dose continuous infusion of esomeprazole sodium in preventing rebleeding in patients with peptic ulcer bleeding after successful endoscopic hemostasis.Methods:This is a multi-center, interval randomized, double-blind, double-dummy, parallel controlled study. From March 3rd to June 15th, 2021, 151 patients with high risk of peptic ulcer bleeding and successfully underwent endoscopic hemostasis from 33 hospitals including the First Affiliated Hospital of Zhejiang University School of Medicine were enrolled. Patients were interval randomly divided into the trial group (74 cases) and the control group (77 cases). Patients in the trial group received intermittent intravenous infusion of ilaprazole sodium once daily (20 mg administered as a 60 min intravenous infusion on day 1, and 10 mg administered as a 30 min intravenous infusion on day 2 and 3); patients in the control group received continuous intravenous infusion of esomeprazole sodium for 72 h (esomeprazole sodium 80 mg at first dose in half an hour, and 8 mg per hour continuous intravenous infusion for 71.5 h). After intravenous infusion treatment, patients of both groups were given oral ilaprazole enteric-coated tablets, 10 mg each time, once a day for 4 d. The rebleeding rate after 72 h and within 7 d after treatment and the proportion of patients who received endoscopic retreatment or surgery due to rebleeding within 72 h after treatment were analysised based on the full analysis set (72 cases in the trial group and 75 cases in the control group); and the incidence rate of adverse reactions was observed in the two groups based on the safety analysis set (74 cases in the trial group and 76 cases in the control group). Chi-square test or Fisher exact probability test was used for statistical analysis.Results:There was no rebleeding case in the trial group within 72 h and 1 case of rebleeding within 7 d (1.39%, 1/72). In the control group, there was 1 case of rebleeding (1.33%, 1/75) within 72 h and 4 cases of rebleeding (5.33%, 4/75) within 7 d. There was no significant difference in rebleeding rate either after 72 h or within 7 d after treatment between the two groups (both P>0.05). Within 72 h of treatment, no patients in both groups needed endoscopic or surgical retreatment due to rebleeding. Adverse reactions occurred in 5 cases (6.8%, 5/74) and 6 cases (7.9%, 6/76) in the trial group and control group, respectively, which recovered spontaneously without treatment. No serious adverse reactions occurred in both groups. Conclusion:In patients with high-risk peptic ulcer bleeding with successful endoscopic hemostasis, intermittent intravenous infusion of ilaprazole sodium has similar efficacy and safety as continuous high-dose intravenous infusion of esomeprazole sodium, but the dosage of intermitten regimen is less, the administration is more convenient, and it is worthy of clinical promotion.
ABSTRACT
Objective To analyze the etiological changes of atrial fibrillation(AF) in Zhanjiang. Methods The etiology of 592 AF cases during 1990～1997 were analyzed, and 610 cases during 2000～2007 were analyzed as comparison. Results Rheumatic heart disease(36.8%) was main etiology of AF during 1990～1997. But coronary artery disease(33.1%) has surpassed rheumatic heart disease recently, and the hyperthyroidism and undetermined-e-tiology of atrial fibrillation were decreasing. The etiology of atrial fibrillation in different age groups was significantly different(P <0.05 or P <0.01). Conclusion The etiology of atrial fibrillation changes every year,and age is a pre-dictable factor to the etiology of atrial fibrillation.
ABSTRACT
Objective To evaluate the value of IHb map in colorectal lesions. Methods IHb map images was observed in 267 patients with colorectal lesions using colonoscopy. Biopsies were taken and microvessel density (MVD) were examined by immunohistochemical staining. Results Colorectal polyps were found in 133 patient,IHb values were higher in inflammatory and adenomatous polyps,and IHb values of hyperplastic polyps were significantly lower than that of inflammatory polyps(P < 0.01). IHb values were higher in the specimens of more inflammatory cell infiltration than normal mucosa (P < 0.05). IHb values seemed to be related to tumor differentiation. An increased IHb values was more frequently observed in differentiated carcinoma than in undifferentiated carcinoma(P < 0.05). The higher of IHb values, the higher of MVD (P < 0.01). Conclusion To oporate IHb map is simple, measurement of IHb map is useful in detecting minimal lesion in colorectal lesions,distingnishing the benign from the malignant,de-termining the extent of the lesion and do endoscopic treatment timely.