The nonlinear wavelet method is used to detect ECG signal. The ECG signal disrupted by high-frequency noise is decomposed with a dyadic Daubechies wavelet according to Mallat algorithm. The principle of the nonlinear wavelet detection method is discussed. Along with the Lipschitz criterion, it is applied to denoising the disrupted ECG signal. The ECG signal is effectively recovered while denoised.

Small bowel endoscopy (enteroscopy) is an important technique for diagnosis and treatment of small intestinal diseases. This review summarizes the updated points of the 2018 edition of the Chinese Guideline for Clinical Application of Enteroscopy. It expounds the contents of the guideline from four aspects: indications and contraindications of enteroscopy, the role of enteroscopy in the diagnosis process of small intestinal diseases, the operation skills of enteroscopy, and the expansion of the therapy field of enteroscopy. The current guideline also included many native clinical evidences, which is of great significance in guiding the clinical practice of enteroscopy in China.

Acute pancreatitis (AP) is the most common severe disease of digestive system, with high morbidity and mortality. In 2019, the latest version of guidelines for the management of acute pancreatitis (Shenyang, 2019) was launched. Starting from the etiology and classification of AP, the guidelines proposed 30 statements on the diagnosis and treatment of AP. The guideline fully reflected the level of evidence and consensus level of experts and provided suggestions for the clinical management of AP in the future. This review summarizes the key points of updating the guidelines, focusing on the classification principle of AP, the change of etiology, the unification of diagnostic name, the strategy of fluid resuscitation and antibiotic use to strenthen the understanding of the guidelines for better clinical practice.

Objective To explore the potential correlation between fluoride levels of urine and influencing factors in water-high-fluoride areas.Methods In 2010,based on plain area,mountainous area and mixed area (altitudes were 898,2 200,1 460 m,respectively),3 villages of water-high-fluoride areas were selected by purpose sampling;pupils' family members were selected as survey population by cluster sampling.Questionnaire was conducted to collect general information;fluoride contents in urine and drinking water were measured using ionselective electrode.A linear multiple regression was used to examine which factors affected urinary fluoride.Results Totally there were 968 people distributed in plain area (444),mixed area (368) and mountainous area (156),medians of urinary fluoride level were 0.71,1.59 and 1.67 mg/L,respectively,the difference was significant (F =203.90,P ＜0.01);medians of water fluoride level in the three different habitats were 0.50,1.00 and 3.50 mg/L,respectively,the difference was significant (F =331.98,P ＜ 0.01).Age,gender,fluoride contents in drinking waters and habitat explained 33.1％ of urinary fluoride variation.Male had higher urine fluoride than female,older age and higher level fluoride in drinking water contributed to higher fluoride level in urine,higher altitude contributed to higher urinary fluoride.Conclusion Once fluoride content in urine is used to estimate fluoride exposure level among people in high fluoride area,gender and age must be taken in consideration.

China is a country with high incidence of gastrointestinal (GI) cancer. Gastric cancer, esophageal cancer and colon cancer seriously threaten the health of people, and leads to heavy medical burdens. This review discusses the current screening protocol of GI cancer and pancreatic cancer. It also interprets the relevant policies issued by the state in recent years, and evaluates the effects of new technologies such as serum pepsinogen combined with gastrin in detecting gastric cancer, fecal and blood gene detection for colon cancer, and "serum liquid biopsy" of pancreatic cancer for early cancer screening. We also point out the difficulties and challenges in cancer screening at early stage, and the significance of promoting early cancer screening to reduce the mortality of GI cancer in China.

Objective To explore the relationship between blood glucose and lipid levels and cognitive function in elderly patients with comorbidity of depression and type 2 diabetes mellitus (T2DM). Methods The clinical data from elderly participants (60 to 79 years old) receiving physical examination between Nov. 1 and Dec. 30, 2017 were collected. According to inclusion and exclusion criteria, 59 cases with comorbidity of depression and T2DM were assigned to comorbid group, 106 depression cases were in depression group, 84 T2DM cases were in diabetes group and 248 were in control group (with no diabetes or depression). The general physiological indicators (height, body mass, waist circumference, hip circumference and blood pressure) were collected, the body mass index (BMI) and waist-to-hip ratio (WHR) were calculated, and blood glucose and lipid levels were determined. The Montreal Cognitive Assessment (MoCA) scale was used to assess the cognitive function of the elderly in each group. The differences in BMI, WHR, blood pressure, blood glucose level and blood lipid level among the groups were compared, and the relationships between these indicators and the adjusted total score and scores in each cognitive domain of MoCA scale were analyzed. Results (1) There were no significant differences in height, body mass, BMI, WHR or diastolic blood pressure (DBP) among four groups (all P>0.05), while the differences in systolic blood pressure (SBP) and pulse pressure (PP) were significant (both P<0.01), with the increase in the diabetes group being most obvious. (2) Compared with the control group, the fasting blood glucose (FBG) level, oral glucose tolerance test (OGTT) 2 h and glycosylated hemoglobin (HbA1c) level were significantly higher in the comorbid group and the diabetes group (all P<0.01); while there was no significant difference between the control and the depression groups (P>0.05). The triglyceride (TG) level in the comorbid group was significantly higher than that in the control group (P<0.05), and the high-density lipoprotein (HDL) levels in the comorbidity and the diabetes groups were lower than that in the control group (P<0.05, P<0.01). (3) There was no significant difference in the adjusted total score of MoCA scale among the four groups (P>0.05). Compared with the control group, the attention scores of the other three groups were significantly lower (all P<0.01). The elderly in the comorbid group had significantly lower fluency and orientation scores compared with the elderly in the control group (P<0.05, P<0.01), and had significantly lower orientation score compared with the elderly in the diabetes group (P<0.05). (4) Simple linear regression analysis showed that the adjusted total score of MoCA scale was negatively correlated with FBG and HbA1c levels (b=-0.339, P=0.006; b=-0.482, P=0.023), and the attention score was negatively correlated with FBG, OGTT 2h and HbA1c levels (b=-0.119, P<0.001; b=-0.040, P=0.002; b=-0.161, P=0.006). (5) Multiple linear regression analysis revealed that FBG level was negatively correlated with the adjusted total score of MoCA scale (B=-0.349, P=0.004). Conclusion Hyperglycemia may be a risk factor of cognitive dysfunction of elderly patients with comorbid of depression and T2DM.

Severe acute pancreatitis is a common critical emergency in the digestive system. It is difficult to treat in clinic and has high mortality. According to the new Atlanta classification standard proposed in 2012, the treatment of acute pancreatitis mainly focused on early indentification, maintenance of organ function, anti-inflammatory response, intestinal function maintenance and other measures, so as to improve the success rate of the treatment. As more patients with severe acute pancreatitis have successfully crossed the acute phase, the prevention and treatment of subsequent complications of acute pancreatitis have been increasingly valued. To focus on the “secondary attack” of acute pancreatitis, it is necessary to carry out clinical research on the subsequent complications such as the accumulation of peripancreatic fluid, infectious necrosis, and vascular complications, and to reduce the mortality. This is a change in the focus of acute pancreatitis treatment and a further extension of the concept of multidisciplinary collaboration in acute pancreatitis.

Gastric cancer has become the world's fourth most common malignant tumor, and the second leading cause of cancer death worldwide. Helicobacter pylori(H.pylori) infection is a major risk factor of occurrence and development of gastric cancer. In the multistage pathogenesis of gastric cancer, H.pylori infection induces chronic active gastritis slowly, which develops into gastric cancer in the end through precancerous stage of atrophic gastritis, intestinal metaplasia and hyperplasia. Related researches prove that eradication of H.pylori, particularly in the early stage, can effectively prevent the occurrence of gastric cancer. In some cases, the eradication of H.pylori can prevent the development of gastric precancerous lesions and reverse them. This paper will elaborate on the role of H.pylori eradication in the prevention of gastric cancer.

Gastric cancer is a serious threat to human health. A large number of studies have found that Helicobacter pylori(Hp)infection is closely related to gastric cancer. Japan has reduced the incidence of gastric cancer by eradicating Hp, which is worth learning.This review shows the evidence that Hp infection increases the risk of gastric cancer, and draws on Japan's strategy of radically treating Hp to prevent gastric cancer. Based on China's national conditions, this review proposes the method to eradicate Hp and prevent gastric cancer in China.

Since the National Institute of the United States proposed the first Helicobacter pylori(Hp)eradication indication, peptic ulcer,in 1994, the indications of Hp eradication has been modified and expanded continuously.In 2015, Kyoto global consensus report on Helicobacter pylori gastritis proposed that “H. pylori-infected individuals should be offered eradication therapy, unless there are competing considerations”, which means that Hp eradication indications are no longer needed. This article aims to elaborate the evolution process of Hp eradication indications in China based on the five Chinese consensus reports of Hp infection treatment, and provide an outlook of the indications in the future.