Objective To investigate the significance of H.pylori infection on upper gastrointestinal rebleeding in patients with long-term (≥ three months) aspirin and clopidogrel combination therapy.Methods From September 2007 to September 2011,at Yijishan Hospital of Wannan Medical College 78 patients with upper gastrointestinal bleeding and receiving long-term (≥ three months) aspirin and clopidogrel combined therapy were selected and treated with esomeprazole.The results of rapid urease test and gastric mucosal biopsy Giemsa staining of selected patients indicated 55 patients were H.pylori positive (positive group) and the other 23 cases were in negative group.The patients of positive group were randomly divided into intervention group (28 cases) and control group (22 cases) by the random allocation table method.The patients of intervention group received H.pylori eradiation treatment and the situation of H.pylori eradication was checked by 14C breath test.After treatment all patients were followed up for six months and clinical symptoms and the situation of rebleeding were observed.Categorical variables were expressed as percentage,intentional analysis and in accordance with protocol analysis were performed separately and analyzed by chi-square test.Results One patient in negative group with gastric cancer withdraw from the study.Two patients in intervention group lost.And one patient in control group lost.H.pylori of intervention group was all eradiated.In accordance with protocol analysis,the rebleeding rates of intervention group and control group were 7.69％ (2/26) and 34.62％ (9/26),respectively,and the difference was statistically significant (x2 =5.650,P=0.017).There was no significant difference between negative group (18.18％,4/22) and intervention group and no significant difference between negative group and control group (both P ＞ 0.05).In intentional analysis,the rebleeding rates of intervention group and control group were 7.14％ (2/28) and 33.33％ (9/27),respectively,and the difference was statistically significant (x2 =5.893,P =0.015).There was no significant difference between negative group (17.39 ％,4/23) and intervention group and no significant difference between negative group and control group (both P ＞ 0.05).Conclusion Eradication of H.pylori can reduce the rate of upper gastrointestinal rebleeding in patients with long-term aspirin and clopidogrel combination therapy.

Objective:To investigate the effects of alpha-lipoic acid on urinary albumin excretion in the patients with early diabetic nephropathy (DN). Methods:Totally 103 patients with early DN were randomly divided into the control group (n=59) and the treat-ment group ( n=44 ) . The two groups were both treated with dietary control and hypoglycemic drugs. The patients in the treatment group were given alpha-lipoic acid 450 mg·d-1 by intravenous infusion for 10 days on the basis of the initial therapy. The levels of HbA1c, BP, lipids, urinary 8-OHdG, urinary MCP-1 and urinary albumin were determined. Results:Compared with those in the con-trol group, urinary 8-OHdG, MCP-1 and urinary albumin were decreased significantly after alpha-lipoic acid treatment. The changes in HbA1c, BP and lipids were not significant. Conclusion:Aalpha-lipoic acid can decrease urinary albumin and 8-OHdG by lowering the expression of ROS and MCP-1.

Moxibustion dose, closely related to moxibustion methods and sensations, directly influences the efficacy. Moxibustion dose is affected by quantity factors and patients' sensations. Quantity factors are volume and number of moxa cones, and moxibustion time and frequency, etc. The relationship between moxibustion dose and efficacy is discussed from quantity factors and sensations in the paper.
Humans ; Moxibustion ; methods ; standards ; Sensation ; Time Factors

OBJECTIVE To know the present status of endoscopes′ cleaning and disinfection in hospitals in Wuxi,(to find) the problem of existence in endoscopes disinfection management,and puts forward the suggestion.(METHODS) According to Technical Operation Standard for Endoscopes Cleaning and Disinfection(2004)′s(requirement),a survey and sampling of disinfected endoscopes were carried out. RESULTS Every hospital all had the rules and regulations of endoscopes management,personnel training rate was 50.00%,personnel protection fitting rate was 64.71%,the rate of the room special for disinfection was 35.29%,cleaning and disinfection(installation) reaching the designated position rate was 41.18%,the standard rate of cleaning and disinfection order was(11.76%,) the fitting rate of endoscopes to preserve inside condition was 23.53%,the eligible rate of(endoscopes) disinfectants in the use was 100.00%,the disinfecting eligible rate of body surface such as attraction bottle,cleaning slot,enzyme slot and washing slot was 100.00%,and the eligible rate of disinfected endoscopes in use and in preserve were 50.00% and 36.36%,respectively.CONCLUSIONS Our hospital is developing endoscope standard including the use of disinfectants as well as the object surface disinfectiong,but all exist the problems in personnel training,personnel protection,speciaized disinfection room,basic cleaning and disinfection(installation),the process of cleaning and disinfection,preservation and disinfection effect of endoscopes,and the work(remains) further standardize.

AIM:Sodium butyrate has antitumor effects on colon cancer cells such as inhibiting cell growth and promoting differentiation and apoptosis.The aim of this study is to investigate whether sodium butyrate induces apoptosis in human colon cancer cell line HT-29 and to examine the intracellular mechanisms involved,especially the role of caspase activation in the process.METHODS:HT-29 cells were cultured to logarithmic phase before treatment with sodium butyrate at concentration of 5.0 mmol/L and caspase inhibitors at the concentration of 20 ?mol/L.The latter were added in the medium ahead of sodium butyrate for 1 h.Then,the staining of Annexin V-FITC and PI were used to analyze HT-29 apoptosis and the dye JC-1 was applied to detect mitochondrial membrane potential by flow cytometry.Caspase activity within the cells was measured respectively using a specific caspase activity assay kit and a microplate reader.RESULTS:Preincubation of HT-29 cells with sodium butyrate significantly increased apoptosis [(35.40?0.70)%] and decreased mitochondrial membrane potential(5.53?0.91).This effect was blocked when pretreatments were enforced with z-VAD-fmk,z-DEVD-fmk and z-LEHD-fmk.The apoptosis percentages were(1.33?0.59)%,(1.40?0.53)% and(1.27?0.91)%,respectively and mitochondrial membrane potentials were 9.80?1.15,10.23?0.50 and 10.33?1.02,respectively.However,the role of reduction by z-IETD-fmk,which presented the apoptosis percentage of(32.10?2.33)% and mitochondrial membrane potential of 5.93?1.31,was not observed.An enhancement of caspase-3 and-9 activities(2-3-fold)but no change of caspase-8 activity was confirmed.CONCLUSION:Apoptosis of HT-29 colon carcinoma cells induced by sodium butyrate is tightly linked to caspase activation via mitochondrial pathway other than tumor necrosis factor-alpha and has the potential to inhibit proliferation and thereby may contribute to the progression of colon cancer.

Purpose:To investigate the variant expression of human belomerase reverse transcriptase (hTERT) and NF ?B p65 protein and their relationships in gastric carcinogenesis.Methods:A total of 41 primary gastric cancers, 15 cases dysplasia, 23 cases intestinal metaplasia and 10 cases normal gastric mucosa were taken into this study. Expression of hTERTmRNT, hTERT protein and p65 protein were determined by in situ hybridization and immunohistochemistry. Results:①Among normal mucosa intestinal metaplasia dysplasia carcinoma,p65 expression were 0?34.18%(8/23)?53.33%(8/15)?60.98%(25/41),hTERTmRNA 10.00%(1/10)?39.13%(9.23)?66.67%(10/15)?85.37%(35/41) and hTERT protein 0?30.43%(7/23)?60.00%(9/15)?78 05%(32/41),respectively. All the three parameters were significantly increased in dysplasia and carcinoma, compared to normal mucosa, while the expression level were also significantly higher in carcinoma than in intestinal metaplasia ( P

Objective To evaluate out-patient individual health education prescription by diabetes nurse specialist on related knowledge of type-2 diabetes mellitus and blood glucose.Then combined with patient satisfaction surveys to explore the intervention value of out-patient individual health education prescription.Methods 100 out-patients with type-2 diabetes mellitus were chosen,and gave them individual health education prescription by evaluate individual condition and existing problems with previous treatment protocol unchanged,the prescription content included individual condition,diet,exercise,medication instructions and disease condition monitoring.The grasp of related knowledge of type-2 diabetes mellitus and satisfaction degree with diabetes nurse specialist were investigated by questionnaires.Results 3 months after individual health education,The grasp of related knowledge of type-2 diabetes mellitus,blood glucose and 2 hours' postprandial blood glucose greatly alleviated.Total satisfaction degree of patients reached 94%.Conclusions Paying attention to individualized instruction and out-patient individual health prescription in prevention and treatment of type-2 diabetes mellitus accords with humanization of nursing service,and is a powerful measure to improve health education quality.

Objective To explore the role of compound nerve conduit, made of nerve growth factors (NGF) encapsuled by biodegradable core-shell nanofibers through coaxial electrospinning, in regeneration of injured sciatic nerves in rats. Methods The compound nerve conduits were developed from the core-shell structured biodegradable nanofibers with P(LLA-CL) as a shell and BSA/NGF or BSA as a core through coaxial electrospinning. Seventy-two Sprague-Dawley rats were randomly divided into 4 even groups. The middle segments (10 mm) of the sciatic nerve were excised and the defects were repaired with sciatic nerve autograft (group A), with P(LLA-CL) conduit (group B), with PLLA-CL conduit and one injection of NGF (group C), and with P(LLA-CL)/NGF controlled-release conduit (group D), respectively. Morphologic and functional evaluations of nerve regeneration were done by gross observation, sciatic function index, neural electrophysiological examination, resumption rates of triceps weight, histological and ultrastructural observa-tion respectively in 1, 2, 3 months after the operation. Results Three months after the operation, although partial biodegradation and small cracks could be observed, conduits remained intact in outline. Based on the functional and histological observations, nerve regeneration, nerve fibers arrangement, myelination and nerve function reconstruction in the P(LLA-CL)/NGF controlled-release conduit (group D) were similar to those in nerve autograft (group A) and significantly superior to those in groups B and C (P<0.05). Conclusion As the P(LLA-CL)/NGF-controlled release conduit has favorable mechanical properties and biocompatibility, it can effectively promote regeneration of the sciatic nerve in rats.

Objective: To analyze and to predict the 1 year re-admission risk in patients of chronic heart failure with reduced left ventricular ejection fraction (HFrEF) by echocardiography.
Methods: A total of 313 HFrEF patients in our hospital community from 2007-01 to 2008-12 were studied. The patients were followed-up for (6-7) years and the end point was 1 year re-admission. All patients received routine echocardiography and the parameters included left ventricular ejection fraction of (LVEF), left ventricular diameter (LVd), pulmonary artery systolic pressure (PASP), mitral regurgitation (MR), tricuspid regurgitation (TR) and pericardial effusion. Based on the above 6 parameters, the risk factors for 1 year re-admission were analyzed.
Results: Univariate analysis indicated that MR (HR=1.437, 95%CI 1.190-1.737, P=0.000), TR (HR=1.288, 95%CI 1.056-1.572, P=0.013) and pericardial effusion (HR=1.560, 95%CI 1.050-2.318, P=0.028) had better predictive value for 1 year re-admission. Multivariate analysis presented that MR (HR=1.404, 95%CI 1.159-1.701, P=0.001) took ifrst place for predicting the 1 year re-admission and pericardial effusion took second place (HR=1.410, 95%CI 1.030-1.928, P=0.032).
Conclusion: MR, TR and pericardial effusion were the independent predictors for 1 year readmission in HFrEF patients;while MR and pericardial effusion were the independent risk factors for 1 year re-admission.

Objective: To assess blood levels of renal function related influencing factors with baseline clinical parameters for predicting the risk of 8-year survival in patients with chronic heart failure (CHF). Methods: A total of 293 CHF patients admitted in our hospital from 2006-07 to 2009-11 were enrolled. The patients were followed-up until 2014-6-30, the end point was death. According to followed-up results, they were divided into 2 groups: Survival group,n=107 and Death group,n=186. All patients received routine renal function and electrolytes examination including blood levels of urea nitrogen, creatinine, uric acid, sodium, potassium, chloride, calcium, anion gap and phosphorus; GFR was calculated by MDRD formula. Baseline clinical parameters as left ventricular end diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF) were measured by echocardiography; blood pressure (BP) and heart rate (HR) were recorded. The risk factors for 8-year survival in CHF patients were analyzed. Results: Compared with Survival group, Death group had increased LVEDD, urea nitrogen, creatinine and uric acid, while decreased LVEF, HR, GFR, blood sodium and calcium, allP<0.05. Univariate analysis indicated that LVEDD, LVEF, GFR, urea nitrogen, creatinine, uric acid, blood sodium, calcium and phosphorus had the better predictive value for the risk of 8-year survival in CHF patients, allP<0.05. Multivariate analysis presented that LVEDD, GFR and blood sodium had the highest predictive value for the risk of 8-year survival, allP<0.001; the next one was blood calcium,P<0.01. Conclusion: LVEDD, GFR, blood sodium and calcium were the independent predictors for the risk of 8-year survival in CHF patients.