Background:Nonvariceal vascular upper gastrointestinal bleeding is a special type of nonvariceal upper gastrointestinal bleeding (NVUGIB) with serious disease course and high mortality rate, which should be paid more attention by clinicians.Aims:To explore the etiological factors and therapeutic strategies of vascular NVUGIB for improving the diagnosis and treatment of the disease.Methods:Clinical data of 111 cases of vascular NVUGIB admitted from Jan.2012 to Dec.2016 at Daping Hospital, the Third Military Medical University were retrospectively analyzed.All cases were diagnosed by gastroscopy, abdominal CT or angiography.Results:One hundred and five patients underwent a gastroscopy within 24 hours of hospital admission.The major causes of bleeding were peptic ulcer involving blood vessels (62.2%) and vascular malformation (22.5%);other causes included Dieulafoy disease, gastrointestinal stromal tumor, malignant tumor, intra-abdominal infection, trauma and gastric angiotelectasis.Seventy-eight patients (70.3%) received endoscopic hemostasis, 19 received conservative medical therapy only, 13 were treated by interventional embolization and 5 underwent surgical operation.Hemostasis was achieved in 96.4% of the patients (107 cases);in four deceased, 3 were failures of endoscopic and interventional therapies.Conclusions:Peptic ulcer and vascular malformation are the major causes of vascular NVUGIB.Endoscopic therapy has generally been recommended as the first-line treatment, however, interventional embolization or surgical operation should be used directly if necessary.

Portal vein thrombosis (PVT) refers to thrombosis in the main portal vein and portal vein branches and is an important complication of liver cirrhosis.PVT can aggravate portal hypertension,increase the risk of bleeding,and lead to acute ischemic necrosis of the small intestine in case of shedding or retrograde movement.This article focuses on the new points of view on the mechanisms and treatment of PVT in cirrhotic patients and points out that treatment regimen should be selected based on patients'overall conditions.

Objective To explore the changes of hepatocyte proliferation in rats during the progression of nonalcoholic fatty liver disease (NAFLD). Methods Rat models of NAFLD were established by giving a fat-rich diet. The rats fed with normal diet were taken as normal control at the same stage during the study. These rats were sacrificed at week 4, 8, and 12 respectively and collected the liver tissues. The cell cycle and the changes of the S-phase cell fraction (SPF), proliferation index (PI) was measured by flow cytometry. The expression of proliferating cell nuclear antigen (PCNA) was detected by immunohistochemistry. Results There was no significant difference between NAFLD group and the control group at week 4, 8. But as compared with the control group, SPF and PI of 12-week group were significantly increased and PCNA labeling index were also higher. Conclusion Hepatic hyperplasia occurred after the nonalcoholic steatohepatitis was established in the rat models of NAFLD. Hepatic hyperplasia probably was the reaction of inflammation and necrosis, but whether it was the early incident of hepatocarcinoma should be paid attention.

Natriuretic factors,include cardionatrin(CN)and digoxin-like immunoreac-tive substances(DLIS),were important humoral factors relating to ascites formation inliver cirrhosis.An observation was made on the levels of plasma CN,DLIS,angiotensinⅡ, aldosterone and serum and urine sodium contents berore and after ascites extinction in40 cirrhotic patients.The results showed that the plasma levels of CN and DLIS had dis-tinct changes before and after ascites extinction and their changes were parallel with theactivity of renin-angiotensin-aldosterone system.These facts suggested that CN and DLIShad certain relation with ascites formation in liver cirrhosis.

0.05) , while at the 4th week significantly increased (P

Objective To explore the effects of TNF alpha on the expression of sterol-regulatory element binding protein-1c, SREBP-1c mRNA and the content of triglyceride (TG) in the models of cultured steatosis hepatocytes. Methods Steatosis models of hepatocytes were established by adding oleic acid to the growing L-02 cells, and then cultured in present with TNF alpha or its antibody. The expressions of SREBP-1c and fatty acid synthetase (FAS) mRNA were measured with RT-PCR, lipid droplets in the hepatocytes were observed with oil red staining and the TG contents in hepatocytes were measured with analyzed kit. Results SREBP-1c mRNA was upregulated in the TNF alpha treatment group in comparison with the normal control group(P

Gastrointestinal bleeding is a severe,complicated and commonly seen disease in Department of Digestive Diseases,the frequent etiology is peptic ulcer,acute gastric mucosal lesion,esophageal gastric varices and digestive tract tumors. In recent years,clinicians gradually noticed a kind of disease characterized by acute,recrudescent and life-threatening bleeding,that is the non-variceal vascular originated gastrointestinal hemorrhage. The guidelines and scholars have not paid enough attention to this problem. However,non-variceal vascular originated gastrointestinal hemorrhage is not uncommon,and is difficult and tricky in its management for clinicians. Therefore,clinicians should pay sufficient attention to the characteristics and therapeutic principles of non-variceal vascular originated gastrointestinal hemorrhage.

Gastrointestinal bleeding is a common acute and critical illness that may result in hemorrhagic shock.In conventional concept, sufficient blood transfusion to ensure volume resuscitation was necessary for this emergency condition.With the propose and application of restrictive transfusion strategy in clinical practice, the new concept has been applied in patients with gastrointestinal bleeding.Restrictive transfusion strategy could maintain the perfusion of vital organs with a minimized blood transfusion, and avoiding the coagulopathy and acidosis caused by massive transfusion.This article reviewed the advances in study on gastrointestinal bleeding and restrictive transfusion strategy.

Objective To investigate the expression and significance of activating transcription factor 4 (ATF4) in the hepatocyte steatosis models induced by oleic acid,and to explore the relationship between the expression of ATF4 and nonalcoholic fatty liver disease (NAFLD). Methods L02 cells were treated by 20 mg/ml oleic acid for 0,24,48 and 72 h respectively to induce the hepatocytes steatosis,and then the cells were collected and the total RNA and protein were extracted. Reverse transcriptional polymerase chain reaction (RT-PCR) and Western blot analysis were used to detect the expressions of ATF4 gene at different time points. Results With the development of deterioration of steatosis,the expression levels of ATF4 mRNA were 1.01?0.12,1.87?0.24,2.01?0.13,and 1.79?0.19 respectively correspondingly from 0 h to 72 h. The peak of ATF4 mRNA expression was reached at the 48th hour,and then showed the tendency of down-regulation. At the same time points,the protein expression of ATF4 were 0.31?0.16,0.57?0.14,0.91?0.20,and 0.89?0.17 separately,and the protein expression was maintained at a high level up to the 72nd hour. There were significantly differences compared with the control group(P

为提高我院康复科护士的护理水平，采用康复理论学习、技术操作及其分别考核的方法，对护士进行继续教育。结果经统计学t检验，P＜0．01，有显著性差异。证明对护士进行继续教育和考核有明显的提高作用，应予推广实施。