幽门螺杆菌感染与慢性萎缩性胃炎病理改变的相关性

目的探讨幽门螺杆菌（Hp）感染与慢性萎缩性胃炎胃黏膜固有腺体萎缩、肠上皮化生、异型增生的相关性。方法230例患者均经胃镜和病理检查确诊为慢性萎缩性胃炎,采用快速尿素酶试验和黏膜组织Giemsa染色法进行Hp检测。根据Hp感染情况分组,比较胃黏膜固有腺体萎缩、肠上皮化生及异型增生在Hp阳性组与Hp阴性组之间的差异。结果Hp阳性组129例慢性萎缩性胃炎中黏膜腺体轻度萎缩84例（65.1%）,中重度45例（34.9%）;轻度肠上皮化生48例（37.2%）,中重度23例（17.8%）;轻度异型增生31例（24.0%）,重度6例（4.6%）。与Hp阴性组比较,Hp阳性组胃黏膜中重度腺体萎缩、肠上皮化生及重度异型增生的发生率均显著升高（P〈0.01）。结论幽门螺杆菌感染与慢性萎缩性胃炎黏膜腺体中重度萎缩、肠上皮化生及重度异型增生等癌前病变的关系较为密切。     

胃黏膜病变与幽门螺杆菌感染的临床分析

目的:探讨幽门螺杆菌感染和胃黏膜病变之间的内在联系。方法:通过胃镜活检方法对58例正常胃黏膜组织,86例慢性浅表性胃炎组织,77例肠化生组织,65例慢性萎缩性胃炎组织,53例异型增生组织,61例胃癌组织进行检测。结果:幽门螺杆菌感染的阳性率在正常胃黏膜,慢性浅表性胃炎,萎缩性胃炎,肠化生,异型增生和胃癌活检组织中分别为13.8%,70.9%,46.2%,45.5%,28.3%和21.3%,其中在慢性浅表性胃炎中感染率最高。结论:幽门螺杆菌的感染可能参与胃黏膜早期病变过程,可能通过一定的机制参与胃黏膜的癌变发生。     

幽门螺杆菌感染与慢性胃炎相关性

目的探讨幽门螺杆菌(Hp)感染与慢性胃炎发生及发展相关性。方法对行胃镜检查2 789例慢性胃炎病人的胃镜及病理检查结果进行回顾性分析,研究慢性胃炎与Hp感染关系。结果中老年组(40～87岁)Hp感染发生率明显高于青年组(18～39岁),差异有显著性(χ2=46.60、29.08,P<0.01);不同性别组间Hp感染的发生率差异无显著性(P>0.05)。活动性胃炎组Hp感染率为99.0%,中重度感染占51.5%,均明显高于非活动性胃炎组(χ2=179.93,P<0.01)。慢性浅表性胃炎的Hp感染率为83.6%,慢性萎缩性胃炎为95.4%,二者比较差异有显著性(χ2=28.88,P<0.01)。Hp感染阳性组重度胃炎、肠上皮化生及异型增生的发生率均较Hp阴性组高,差异有显著性(uc=-30.19～-13.17,P<0.01)。结论慢性胃炎的发生和发展与Hp感染密切相关。     

慢性萎缩性胃炎患者幽门螺杆菌感染与胃镜及胃黏膜病理结果的相关性

目的探讨慢性萎缩性胃炎患者幽门螺杆菌(Hp)感染与胃镜及胃黏膜病理结果的相关性。方法选取2016年7月至2018年9月商丘市长征人民医院收治的89例慢性萎缩性胃炎患者,均接受胃镜及胃黏膜病理、Hp检测,统计所有患者的Hp阳性率,分析Hp感染与病理特征的相关性。结果 Hp阳性率为70.89%(63/89)。Hp阳性者胃黏膜萎缩程度、肠化分级、活动性、炎症程度分别与Hp阴性者比较,差异有统计学意义(均P<0.05)。萎缩程度、肠化分级、活动性和炎症程度与Hp感染呈正相关(r=0.265、0.267、0.210、0.472,均P<0.05)。结论慢性萎缩性胃炎患者Hp感染与萎缩程度、肠化分级、活动性及炎症程度密切相关。     

幽门螺杆菌根除后慢性萎缩性胃炎胃粘膜的改变

目的探讨幽门螺杆菌(Hp)根除后胃腺体萎缩、肠化、不典型增生改变的可能性. 方法155例患者均经胃镜诊断为慢性萎缩性胃炎(CAG)或伴肠化、不典型增生;Hp感染由13C尿素呼气试验、快速尿素酶试验、组织学检查证实.患者分为两组:治疗组94例,对照组61例.治疗组采用OAC方案,2次/d,共服药10d.治疗结束后4～8周,检测Hp根除情况.对照组不用任何对Hp有影响的药物,且与治疗组在同一时间作Hp检测、胃镜等检查.结果治疗组4例失访.90例患者中Hp根除率为87.8%,萎缩程度均未减轻,炎症消失69.6%,减轻25.3%;32例肠化患者中,消失21.9%,减轻37.5%;40例不典型增生中消失27.5%,减轻40.0%.对照组61例病情无明显变化. 结论Hp根除后,粘膜炎症、肠化及不典型增生能够减轻或消失,对于预防胃粘膜恶变是有益的.     

慢性萎缩性胃炎胃镜下不同病理改变与幽门螺杆菌感染相关性探讨

目的 探讨慢性萎缩性胃炎胃镜下不同病理改变与幽门螺杆菌感染的相关性。方法 回顾性分析2018年1月～2019年5月在我院治疗的130例慢性萎缩性胃炎患者临床资料,按照胃镜诊断结果分为单纯性萎缩性胃炎(A组,67例)和萎缩性胃炎伴增生(B组,63例),均行胃镜检查,观察病理改变同幽门螺杆菌感染的相关性。结果B组萎缩性胃炎符合率(87.30%)高于A组(74.63%),B组肠上皮化生检出率(19.05%)高于A组(7.46%),B组不典型增生检出率(23.81%)高于A组(8.96%),差异均有统计学意义(P0.05);B组幽门螺杆菌感染率(74.60%)高于A组(58.21%),差异有统计学意义(P0.05)。Spearman相关性分析确认萎缩性胃炎伴增生与幽门螺杆菌感染呈正相关(r=0.754,P=0.041)。结论 胃镜检查萎缩性胃炎伴增生诊断率显著高于单纯萎缩性胃炎,萎缩性胃炎合并肠上皮化生和不典型增生的幽门螺杆菌感染率高,在临床诊断和治疗中应给予足够重视。     

儿童慢性萎缩性胃炎与幽门螺杆菌感染关系分析

目的探讨幽门螺杆菌与儿童慢性萎缩性胃炎的关系。方法回顾性分析经胃镜活检组织病理诊断为慢性萎缩性胃炎55例患儿的临床资料,其中Hp阳性组16例,Hp阴性组39例;按年龄分为0～8岁组（10例）及9～14岁（45例）组。分别观察胃腺体萎缩、肠化情况。结果 55例患儿,年龄0～14岁,平均（9.6±2.8）岁;男25例,女30例;胃镜下表现为单纯慢性浅表性胃炎、胃窦炎45例（81.8%）,胆汁反流8例（20%）;伴消化性溃疡13例（23.6%）;萎缩性胃炎2例（3.6%）。组织病理提示腺体萎缩：轻度42例（76.4%）,中度13例（23.6%）;活动期9例（16.4%）,伴肠上皮化生8例（14.5%）。0～8岁和9～14岁患儿萎缩性胃炎发生率、萎缩程度差异均无统计学意义（均P〉0.05）,伴肠上皮化生发生率及处于活动期发生率差异均有统计学意义（均P〈0.05）。基础治疗及抗幽门螺杆菌（Hp）治疗后,临床症状均消失,胃纳好转。16例抗Hp治疗的患儿停质子泵抑制剂后4周门诊行胃镜检查及病理、Hp检测,发现正规抗Hp治疗后,仍有4例Hp未转阴,但Hp数量较前减少,Hp检出率下降为25%。病理提示轻度萎缩4例,未见中度萎缩,余均提示浅表性胃炎。结论 Hp感染与儿童慢性萎缩性胃炎有一定的关系,根除Hp对预后有益。     

萎缩性与非萎缩性胃炎患者之间幽门螺杆菌根除率的差异性研究

目的 探究萎缩性与非萎缩性胃炎患者中幽门螺杆菌(Hp)根除率的差异以及胃窦黏膜萎缩、肠化生和Hp密度分级是否影响Hp根除结果。方法 纳入2021年1—12月在上海市第五人民医院消化内科门诊接受阿莫西林联合克拉霉素治疗的505例Hp阳性初治患者,根据内镜下的组织病理学结果分为萎缩性胃炎和非萎缩性胃炎2组。采用倾向性评分匹配(PSM)平衡组间人口学变量后比较组间Hp根除失败率,并进行logistic回归分析。结果 PSM后萎缩性胃炎组患者的Hp根除失败率显著高于非萎缩性胃炎组(16.3%vs. 7.8%,P=0.023),这种差异在男性中显著(21.2%vs. 7.1%,P=0.008),在女性中不显著(P>0.05)。通过logistic回归分析发现,Hp根除失败与胃窦黏膜轻度(病理分级+)萎缩/肠化生呈正相关性(OR=2.614,95%CI:1.227～5.571,P=0.013;OR=2.882,95%CI:1.310～6.338,P=0.009),而与中重度(病理分级++～+++)萎缩/肠化生无关(均P>0.05)。此外,Hp根除失败与胃窦黏膜Hp密度分级无关(P>...     

胃复春联合益生菌治疗幽门螺杆菌感染的慢性萎缩性胃炎疗效分析

目的:观察中成药胃复春联合益生菌治疗幽门螺杆菌感染的慢性萎缩性胃炎临床疗效,探讨根除Hp感染有效、且不良反应小的方法。方法:将Hp阳性的慢性萎缩性胃炎患者94例随机分为两组,治疗组52例和对照组42例,共治疗4周,观察两组的临床疗效、Hp根除率。结果:治疗组的总有效率为96.15%,对照组为80.95%(P<0.05);治疗组的Hp根除率为94.23%,对照组为83.33%(P<0.05)。结论:胃复春联合益生菌治疗幽门螺杆菌感染的慢性萎缩性胃炎和根除Hp感染是有效、安全的药物组合。     

互助地区316例胃肠疾病与幽门螺杆菌感染的相关性分析

目的:探讨幽门螺杆菌感染与胃肠疾病黏膜病理诊断的相关性.方法:对全县经胃镜检查的316例胃黏膜活检标本作病理诊断及幽门螺杆菌染色,并进行相关性分析.结果:肠上皮化生、单纯性萎缩性胃炎、消化性溃疡及异性增生组中Hp检出率较高,以上4组之间比较无显著性差别(P>0.05).胃癌组Hp检出率较低,和胃溃疡、单纯性萎缩性胃炎、肠上皮化生及异型增生组之间比较差别有显著性(P<0.05).结论:幽门螺杆菌感染和胃肠疾病的发生有相关性.     

Value of D-Dimers in patients with acute aortic dissection

Objective: To evaluatel the value of D-dimers in patients with acute aortic dissection (AAD). Methods: This study consisted of 16 patients with AAD and 27 non-AAD patients. Serum D-dimets were measured by Sta-Liatest D-DI immunoturbidimetric assay. Results: D-dimer level was higher (P ＜ 0.001) in patients with AAD(7.91 ± 5.52 μg/ml) than that in non- AAD group(1.57±1.24 μg/ml). D-dimer was positive (＞0.4 μg/ml) in all patients with AAD and in 10 control group patients (37%). Among patients with acute AAD, D-dimers tended to be higher in Stanford A than in Stanford B (8.67 ± 4.31 μg/ml vs. 3.24±1.27 μg/ml, P ＜0.01). D-dimer values tended to be higher in more extended disease(3.84 ± 1.65 μg/ml, 8.57 ± 3.58 μg/ml and 11.87 ± 5.69 μg/ml in thoracic aorta, thoracic and abdominal aorta, thoracic and abdominal aorta and iliacal arteries, respectively, P ＜ 0.05 for both 8.57 ± 3.58 and 11.87 ± 5.69 vs. 3.84 ± 1.65 ). Including the control group into the analysis, we found a sensitivity of 100%, a negative predictive value of 100%, and a specificity of 66% and a positive predictive value of 64% for D-dimer in diagnosis of AAD in our patients with suspected AAD. Conclusion: D-dimer was elevated in patients with AAD. A negative D-dimer test result could be useful in excluding AAD.     

Research of combined liver-kidney transplantation model in rats

Objective： To set up a simple and reliable rat model of combined liver-kidney transplantation. Methods： SD rats served as both donors and recipients. 4℃ sodium lactate Ringer＇s was infused from portal veins to donated livers,and from abdominal aorta to donated kidneys, respectively. Anastomosis of the portal vein and the inferior vena cava （IVC） inferior to the right kidney between the graft and the recipient was performed by a double cuff method, then the superior hepatic vena cava with suture. A patch of donated renal artery was anastomosed to the recipient abdominal aorta. The urethra and bile duct were reconstructed with a simple inside bracket. Results： Among 65 cases of combined liver-kidney transplantation, the success rate in the late 40 cases was 77.5%. The function of the grafted liver and kidney remained normal. Conclusion： This rat model of combined liver-kidney transplantation can be established in common laboratory conditions with high success rate and meet the needs of renal transplantation experiment.     

BLOOD PRESSURE CHANGE WITH AGE IN SALT-SENSITIVE TEENAGERS

Objective To observe blood pressure change with age in salt-sensitive teenagers whose salt sensitivity were determined by repeated testing.Methods Salt sensitivity was determined through intravenous infusion of normal saline combined with volume-depletion by oral diuretic furosemide in 55 teenagers. After five years, salt sensitivity was re-examined and subject blood pressure was followed up. Blood pressure changes in salt-sensitive teenagers were compared to that of non-salt sensitive teenagers over five years.Results After 5 years, the repetition rate of salt sensitivity determined by intravenous saline loading is 92.7%. In teenagers with salt sensitivity on the baseline, both the systolic blood pressure increments and increment rates were much higher than non-salt sensitive teenagers (12.7±12.1 mmHg vs. 2.8±5.2 mmHg, P＜ 0.01; 12.2%± 12.0% vs. 2.5% ±4.4%, P＜ 0.001,respectively). There was a similar trend for diastolic blood pressure (8.4 ± 6.4 mmHg vs. 3.7 ± 6.4 mmHg, P = 0.052; 13.2% ±10.6 % vs. 6.8%± 10.1%, P = 0.053, respectively).Conclusions Salt sensitivity determined by intravenous saline loading showed good reproducibility. Blood pressure increments with age were much higher in salt-sensitive teenagers than non-salt sensitive teenagers, especially in terms of systolic blood pressure.     

安心颗粒对急诊经皮冠状动脉介入术后生活质量影响的研究

目的：评价使用安心颗粒对急诊经皮冠状动脉介入术（PPCI）术后生活质量的影响.方法：将160例接受PPCI的急性ST段抬高型心肌梗死患者随机分为安心颗粒组（术前顿服安心颗粒8.8g,术后安心颗粒4.4 g/次,每日2次）和对照组（仅接受基础药物治疗）.所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀.分别在入院时、出院前1d、出院后180 d时,应用心肌梗死多维度量表（MIDAS）、中文版SF-36评价量表对患者生活质量评分.并观察术后30 d以内的出血并发症、血小板减少症发生情况.结果：入院时和出院前1d,两组患者的心肌梗死MIDAS、SF-36量表评分比较无差异（P＞0.05）;出院后180 d时,与对照组比较,安心颗粒组MIDAS、SF-36评分明显减低（P＜0.05）;组内与入院时比较,两组出院前1d、出院后180 d时,MIDAS、SF-36评分均降低（P＜0.05）.两组患者在随访期间均无大量出血、少量出血、重度和极重度血小板减少症发生,安心颗粒组有4例、对照组有7例发生不明显出血（P＞0.05）.两组发生轻度血小板减少症的患者数比较无差异（P＞0.05）.结论：PPCI使用安心颗粒,能改善急性ST段抬高型心肌梗死患者的生活质量,且不增加出血风险.     

The comparative studies of the influences of Urapidil and Nicardipine on sino-atrial node function, atrio-ventricular node function and hemodynamics

Objective:To investigate the influences of urapidil and nicardipine on rabbit sinus function,atrio-ventricular node function and hemodynamics.Methods:Thirty-two Angora's rabbits were selected and randomly divided into four groups.U1 group:urapidil 0.25 mg/kg;U2 group:urapidil 0.5 mg/kg;N1 group:nicardipine 10 μg/kg;N2 group:nicardipine 20 μg/kg.All these medicine were administrated within 30 seconds.Measurements were taken before and after the administration of urapidil or nicardipine for the following data:mean blood pressure(MAP),heart rate(HR),sino-atrial conduction time(SACT),maximal sinoatrial recovery time(SNRTmax)corrected sinus node recovery time(CSNRT),index of sinus node recovery time(SNRTI),Wenckebach A-V conduction frequency (WB),and P-R interval.Results:Significant MAP and HR changes were identified in all of the four groups before and after administration of both urapidil and nicardipine.No significant changes could be found in the rest of the parameters.Intergroup analysis showed that SACT and CSNRT of N1 and N2 groups were shorter than those of the U2 group(P＜0.01);the MAP decreased(P＜0.01)and the HR increased drastically(P＜0.01).Conclusions:Neither urapidil(0.25 mg/kg,0.5 mg/kg)nor nicardipine(10μg/kg,20μg/kg)has any significant influence on rabbit sinus function or rabbit atrio-ventricular node function.Nicardipine could be a better choice than urapidil for parafunctional sinus node patients.     

Expression of OPGmRNA and ODFmRNA in the patients of hip fracture due to osteoporosis

Objective：To investigate the gene expression of osteoprotegerin（OPG） and osteoclast differentiation factor（ODF） in the bone tissue of patients with hip fracture due to osteoporosis. Methods：OPGmRNA and ODFmRNA in the bone tissue in 50 cases of osteoporosis sufferers（over 50 years old） with hip fracture（Observer Group） and 30 cases of hip facture sufferers with no osteoporosis（Control group） were analyzed with the Semi-Quantitative RT-PCR method. Results：The mRNA expressed of ODF, OPG were both high in the patients with hip fracture. In the control group, the expression of OPG mRNA was observed, while the expression of ODF mRNA was very slight. Conclusion：Aged patients contained all signals including OPG, ODF that are essential for inducing osteoclastogenesis and promoting bone resorption.     

The clinicopathological and immuohistochemical analysis of solid-pseudopapillary tumor of the pancreas： report of 9 cases

Objective：To investigate the clinical features, pathological characteristics and immunophenotype of solid-pseudopapillary tumor of the pancreas（SPTP）. Methods：Nine surgically treated cases of SPTP were retrospectively reviewed. Hematoxylin and Eosin（HE） staining and immunohistochemical staining were used to analyze all cases, and the general clinical data was collected. Results：Six patients were asymptomatic except for a palpable mass. Two patients complained of vague-epigastric pain. One patient appeared jaundice. The tumor was encapsulated and solid tissues alternately with cystic tissues. Histologically, the histological structure of solid portion was pseudopapillary with a fibrovascular core. Tumor cells were uniform and medium-sized which were arranged in sheets ets or nests or pseudopapillary patterns. Immunohistochemical studies demonstrated that SPTP proved positive in vimentin（9/9 cases）, AAT（9/9 cases）, NSE（9/9 cases）, ACT（7/9 cases）, CK20（2/9 cases）, CgA（1/9 cases）, S-100（3/gcases）, PR（4/gcases）, Syn（3/9 cases） and CD56（5/9cases）, negative in CEA and ER. Conclusion：SPTP is a tumor predominantly occurring in young women frequently without special symptoms. This tumor has various characteristical histological patterns with different immunophenotype.     

Dynamic Changes in Serum Estradiol and Progesterone levels in Patients of Premenstrual Syndrome with Adverse Flow of Liver-qi

Objective:To probe into the influence of changes of ovarian hormones on the pathogenesis of the specific sub-type premenstrual syndrome(PMS)and reveal partial microcosmic mechanisms of adverse flow of liver-qi.Methods:Estradiol(E2)and progesterone(P)levels in serum were determined at different phases of menstrual cycle by radioimmunoassay.Results:In the group of PMS with adverse flow of liver-qi.the secretive peak value Of E2 and P at the follicular phase significantly decreased,and the secretive peak value at the luteal phase did not come into being.Conclusions:Low E2 and P secretive peak at the follicular phase and absence of secretive peak at the luteal phase is one of the microcosmic mechanisms of PMS with adverse flow of liver-qi.One of the pathophysiologic mechanisms of specific sub-type PMS is probably the continuous low level of E2and P.     

Real-time Three-dimensional Echocardiography in Assessment of Left Ventricular and Right Ventricular Volumes

Real-time three-dimensional echocardiography (RT3DE)is a new ultrasound technique that enables dynamic threedimensional visualization and quantification of the heart in real time. Investigation of feasibility and methodology of RT3DE in determining left ventricular (LV) and right ventricular (RV) volumes, RT3DE was performed in 35 normal adults using Philips SONOS 7500 system with a 2-4 MHz matrix array transducer. The 60°×60° "pyramid" volume database was obtained and analyzed on a TomTec echo workstation. Both LV and RV volumes were calculated with four 3DE methods (i.e. apical 2, 4, 8, and 16-plane) through manually tracing ventricular endocardial borders in end diastole and end systole. Stroke volumes were then calculated. LV volume was also measured by 2DE Simpson's rule using GE VIVID 7 ultrasound machine.     

SCREENING FOR A 21-CHROMOSOME ABNORMALITY IN PREIMPLANTED EMBRYOS OF ELDERLY WOMEN

Increasing maternal age is the only etiological factor unequivocally linked to Down's syndrome in humans. The occurrence rate of newborns with Down's syndrome is about 1/220 in women over 35 years old. However, the occurrence rate in embryos fertilized in vitro, of the elder woman is unclear. Using FISH we screened the number of chromosome 21 in preimplanted embryos of 5 elderly women (average age, 38.4 years) to study the feasibility and necessity of screening trisomy 21 in embryos in patients over 35 years old at the in vitro fertilization (IVF) center.