Objective To evaluate the model of end-stage liver disease (MELD) and Child-Tur-cotte-Pugh (CTP) in prognosis for cirrhotic patients with massive hemorrhage from esophageal varieosis, who underwent emergency endoscopic sclerotherapy (EIS). Methods The clinical and follow-up data of a co-hort of 65 liver cirrhotic patients with massive hemorrhage from esophageal varicosis treated by EIS were ana-lyzed retrospectively. Correlation between MELD values and CTP score and classification was analyzed. The area under the receiver operating characteristic (ROC) curve was used to compare MELD with CTP score and classification in predicting mortality risk. The optimal threshold of MELD to determine the prognostic death risk was calculated by ROC curves. Results MELD, CTP score and classification correlated signifi-cantly with each other. Seven patients died within six months and 9 died within the first year of follow-up.There was no significant difference in gender, age and serum bilirubin between the survival and death groups, while the serum creatinine, international normalized ratio (INR), CTP score, and MELD score were significantly different. The areas under the ROC curve of MELD were both greater than 0.8 to predict 6-month and 1 -year survival, and also were greater than those of CTP score and classification. Areas under the ROC curve of MELD is superior to, but not significantly different though, CTP score or classification. The optimal threshold values of MELD and CTP score both showed satisfactory predicting accuracy of mortality risk. Conclusion MELD is an accurate predictive system for 6 months and 1 year in liver cirrhotic patients with massive hemorrhage from esophageal varicosis treated by EIS. The MELD value is very important in the selection of patients for E1S. But it is not more efficient than CTP score and classification.

Objective Helicobacter pylori ( Hp ) infection is an important risk factor of the gastrointestinal disease, including chronic gastritis, peptic ulcer and gastric cancer. However, many recent experimental and clinical studies have shown that its addition to causing gastrointestinal diseases, but also associated with many diseases, and closely related with the occurrence of liver diseases. Summarized recent advances in the study of the relevant studies,including the relationship between hepatitis and cirrhosis,and the occurrence and development of liver cancer.

Objective To evaluate the relationship between hippocampal monocyte chemotactic protein-1 (MCP-1) and its receptor C-C chemokine receptor 2 (CCR2) and postoperative cognitive dysfunction (POCD) in aged rats.Methods Forty-eight male Sprague-Dawley rats,aged 20-22 months,weighing 480-550 g,were randomly divided into 2 groups (n =24 each) using a random number table:control group (group C) and POCD group.POCD group inhaled 2.0％ isoflurane and underwent splenectomy.Before surgery and at 1,3 and 7 days after surgery,Morris water maze test was performed to evaluate the spatial learning and memory ability.The escape latency and swimming distance were recorded.Eight rats were sacrificed after the end of Morris water maze test performed at 1,3 and 7 days after surgery.Then the brains were removed,and the hippocampi were isolated for detection of the expression of MCP-1 and CCR2 by Western blot.Results Compared with group C,the escape latency and swimming distance were significantly prolonged,and the expression of MCP-1 and CCR2 in hippocampi was up-regulated at 1,3 and 7 days after surgery in POCD group.Conclusion Up-regulation of hippocampal MCP-1 and CCR2 expression may be involved in the mechanism of POCD in aged rats.

Objective: To identify the risk factors for postoperative fatigue syndrome (POFS) in outpatients with painless gastroscopy. Methods: The outpatients received painless gastroscopy from October 2016 to February 2017 in our hospital were included in this study.The possible factors related to POFS were summarized by reviewing the relevant literature.The questionnaires were completed by the methods such as preoperative interview, intraoperative recording, and telephone follow-up.POFS occurrence, score and outcomes were evaluated.The patients were divided into POFS group (groupⅠ) and non-POFS group (groupⅡ) according to whether POFS occurred.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify the risk factors. Results: Two hundred and forty-six patients completed this study.Sixty-nine cases developed POFS, and the incidence was 28.0%, the initial fatigue score was (5.2±2.4), and the duration of POFS was 3(9) h. The mean consumption of propofol (according to anesthesia time, mg/min) was an independent risk factor for POFS. Conclusion The mean consumption of propofol is an independent risk factor for POFS in outpatients with painless gastroscopy.

Objective: To evaluate the role of microRNA-125b (miR-125b) on ventilator-induced lung injury (VILI) in mice. Methods: Forty healthy male C57BL/6 male mice, weighing 25-30 g, aged 2-3 months, were divided into 4 groups (n=10 each) using a random number table method: sham operation group (group Sham), group VILI, VILI plus miR-125b negative control group (group VILI+ NC), and VILI plus miR-125b overexpression group (group VILI+ miR-125b agomir). In VILI+ NC and VILI+ miR-125b agomir groups, miR-125b negative control and miR-125b agomir transfection complex 50 μl were intratracheally instilled, respectively, and 48 h later VILI model was established.The animals were mechanically ventilated for 4 h with high tidal volume (40 ml/kg) to induce VILI.Blood samples were obtained from the femoral artery at 4 h of mechanical ventilation for detection of PaO₂, then animals were sacrificed, lungs were removed for determination of wet to dry weight ratio (W/D ratio) and for examination of pathological changes (with a light microscope), and lung injury was scored.In VILI+ NC and VILI+ miR-125b agomir groups, bronchoalveolar lavage fluid (BALF) was collected to measure the concentrations of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) by enzyme-linked immunosorbent assay.The cell apoptosis of lung tissues was measured using TUNEL, apoptosis index was calculated, the caspase-3 expression was detected by Western blot, and the miR-125b expression was detected by real-time polymerase chain reaction. Results: Compared with Sham group, PaO₂ was significantly decreased, and W/D ratio and lung injury score were increased in VILI, VILI+ NC and VILI+ miR-125b agomir groups, and the expression of miR-125b was down-regulated in VILI and VILI+ NC groups (P<0.05). Compared with VILI group, PaO₂ was significantly increased, W/D ratio and lung injury score were decreased, the expression of miR-125b was up-regulated (P<0.05), the pathological changes of lung tissues were significantly attenuated in group VILI+ miR-125b agomir, and no significant change was found in the parameters mentioned above in group VILI+ NC (P<0.05). Compared with group VILI+ NC, the concentrations of TNF-α and IL-6 in BALF and apoptotic index were significantly decreased, and the expression of caspase-3 was down regulated in group VILI+ miR-125b agomir (P<0.05). Conclusion MiR-125b is involved in the endogenous protective mechanism of VILI in mice.

Objective To identify the risk factors for postoperative fatigue syndrome(POFS)in outpatients with painless gastroscopy.Methods The outpatients received painless gastroscopy from October 2016 to February 2017 in our hospital were included in this study.The possible factors related to POFS were summarized by reviewing the relevant literature.The questionnaires were completed by the methods such as preoperative interview,intraoperative recording,and telephone follow-up.POFS occurrence,score and outcomes were evaluated.The patients were divided into POFS group(groupⅠ)and non-POFS group(groupⅡ)according to whether POFS occurred.The risk factors of which P values were less than 0.05 would enter the multivariate logistic regression analysis to stratify the risk factors.Results Two hundred and forty-six patients completed this study.Sixty-nine cases developed POFS,and the incidence was 28.0％,the initial fatigue score was(5.2±2.4),and the duration of POFS was 3(9)h.The mean con-sumption of propofol(according to anesthesia time,mg/min)was an independent risk factor for POFS.Conclusion The mean consumption of propofol is an independent risk factor for POFS in outpatients with painless gastroscopy.

OBJECTIVE：To investigate the contents of 5 kinds of heavy metal as copper （Cu），arsenic（As），cadmium （Cd），mercury（Hg）and lead （Pb）in Yougui pills ，and to evaluate its safety risk. METHODS ：Using yttrium （89Y），indium （115In）and bismuth （209bi）as internal standard ，the contents of each element were determined by ICP-MS. ICP-MS condition included that atomization gas flow rate was 0.95 L/min，auxiliary gas flow rate was 1.2 L/min，plasma gas （argon）flow rate was 18 L/min，pump speed was 30 r/min. RF power of inductively coupled plasma was 1 200 W，the voltage in simulation stage was 1 750 V，the voltage in pulse stage was 1 300 V，the voltage of deflection device was －12 V，and the detector was in analog and pulse dual-mode. The determination methods of various elements were investigated ，and 45 batches of marketed Yougui pills were determined. Hazard index （HI）was used to analyze the non-carcinogenic risk of each element and calculate the maximum residual limit（MRL）of each element. RESULTS ：The linear range of Cu ，As，Cd，Hg and Pb ranged from 10-200，1-50，0.4-30，0.2-6 and 2-100 μg/L（all r＞0.999 0），respectively. The limits of quantitation were 0.67，0.23，0.20，0.07，0.27 μg/L. The limits of detection were 0.20，0.07，0.06，0.02，0.08 μg/L. RSDs of precision，stability and reproducibility tests were all lower than 3.5％ （n＝6 or n＝5）. Average recoveries were 92.96％-100.89％（RSD＝2.23％-3.62％，n＝3）. Average contents of Cu ，As，Cd，Hg and Pb in 45 batches of Yougui pills were 2.72，0.28，0.07，0.05，0.62 mg/kg，and superimposed HI of each element was less than 1. The contents of 5 kinds of heavy metals in Yougui pills were lower than the proposed MRL （MRL of Cu ，As，Cd，Hg and Pb were 20，2，1，0.2，5 mg/kg or 111.11，4.44，2.22，1.48，8.89 mg/kg respectively ）. CONCLUSIONS ：Established method can be used for the determination of content of 5 kinds of heavy metal in Yougui pills ；the heavy metal pollution rate of marketed Yougui pills is low and the safety risk is small.

OBJECTIVES: This study aimed to observe the clinical and immune response characteristics of vaccinated persons infected with the delta variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Yangzhou, China. METHODS: We extracted the medical data of 129 patients with delta-variant infection who were admitted to Northern Jiangsu People's Hospital (Yangzhou, China) between August and September, 2021. The patients were grouped according to the number of vaccine doses received into an unvaccinated group: a one-dose group and a two-dose group. The vaccine used was SARS-CoV-2-inactivated vaccine developed by Sinovac. We retrospectively analyzed the patients' epidemiological, clinical, laboratory, and imaging data. RESULTS: Almost all patients with delta-variant infection in Yangzhou were elderly, and patients with severe/critical illness were over 70 years of age. The rates of severe/critical illness (P=0.006), fever (P=0.025), and dyspnea (P=0.045) were lower in the two-dose group than in the unvaccinated group. Compared to the unvaccinated group, the two-dose group showed significantly higher lymphocyte counts and significantly lower levels of C-reactive protein (CRP), interleukin-6 (IL-6), and D-dimer during hospitalization and a significantly higher positive rate of immunoglobulin G (IgG) antibodies at admission (all P<0.05). The cumulative probabilities of hospital discharge and negative virus conversion were also higher in the two-dose group than in the unvaccinated group (P<0.05). CONCLUSIONS Two doses of the SARS-CoV-2-inactivated vaccine were highly effective at limiting symptomatic disease and reducing immune response, while a single dose did not seem to be effective.
Aged ; Aged, 80 and over ; Humans ; COVID-19/prevention & control* ; COVID-19 Vaccines/adverse effects* ; Critical Illness ; Immunity ; Retrospective Studies ; SARS-CoV-2 ; Vaccines, Inactivated/adverse effects* ; Viral Vaccines/adverse effects*