ObjectiveTo investigate the gastric adaptation to aspirin in rats. MethodsMucosal in-jury was induced by repeated doses of acidified aspirin (ASA) in rats. Mucosal lessions and necrosis depth were measured. Mucosal contents of epidermal growth factor (EGF) were tested by radioimmunoassay. To test the possible implication of endogenous nitric oxide in gastric adaptation to aspirin. L-Arg, L-NAME and L-Arg +L-NAME were given intravenously 30 minutes before the exposure to ASA. ResultsThe lession areas of gas-tric mucosa in first exposure to ASA was (50.4 ± 6.2)mm2. After repeated dose of ASA, the mucosal lessions were significantly alleviate, P ＜0.01. The mucosal contents of EGF were significantly increased, P < 0.01.The rat mucosa had adaptation to ASA after pretreated L-Arg、L-NAME and L-Arg + L-NAME. The lession areas of the pretreated L-NAME rats were significantly bigger than that of the pretreated L-Arg rats. Conclu-sionGastric mucosa exhibits the ability to adapt to ulcerogenic action of aspirin. After four days repeated doses of ASA, the full adaptation to ASA was achieved. The mechanism of the adaptation was possibly through increased gastric mucosal EGF. NO played a part of role in the gastric adaptation to ASA.

Objective To evaluate the value of the Bedside Index for Severity in Acute Pancreatitis (BISAP) in diagnosing severe acute pancreatitis. Methods Sixty-eight patients with suspected diagnosis of severe acute pancreatitis were collected and were scored by BISAP, APACHE Ⅱ , Ranson and CTSI scoring systems, respectively. BISAP scoring system included the blood urea nitrogen, impaired mental status,systemic inflammatory response syndrome, age, and pleural effusion. The diagnosis criteria of severe acute pancreatitis was BISAP ≥ 3 points or APACHE IⅡ ≥ 8 points, Ranson ≥ 3 points, CTSI ≥ 3 points. The diagnostic accuracy of SAP of these scoring systems was calculated. Results Among these 68 cases, 63.2％(43/68) were graded ≥ 3 points in BISAP scoring system;60.3％ (41/68) were marked ≥8 points in APACHE Ⅱ scoring system; 60.3％ (41/68) were scored ≥ 3 points in Ranson scoring system; and 67.6％(46/68) were scored ≥3 points in CTSI scoring system. There was no statistical difference between BISAP scoring system and other three scoring systems in diagnosing severe acute pancreatitis. Conclusions As a new and simple scoring system, BISAP scoring system can be widely used in the diagnosis of severe acute pancreatitis.

Objective To explore the relationship between polyp features at first-time colonoscopy and the recurrence, and to analyze the risk factors of recurrence at different time points of follow-up. Methods The data of 614 patients undergoing colorectal polypectomy between May 2008 and May 2016 were retrospectively analyzed. Patients were classified into 3 groups according to the characteristics and polyp features at first-time colonoscopy. The risk factors influencing polyp recurrence at different time points during follow up were analyzed. Results Univariate analysis showed that age ≥70 years, polyp′s diameter ≥0.5 cm,the number of polyps >2 and distribution throughout colon were risk factors for recurrence. In multivariate models,the number of polyps at baseline was the only significant predictor for recurrence(OR=2.36,95%CI:1.06-5.25). All of 614 patients underwent 6-87 months surveillance colonoscopy. The total recurrence rate was 58.6%(360/614). During four different surveillance intervals including 6-24 months,>24-36 months, >36-48 months, and >48-87 months,the cumulative recurrence rate of high-risk group was 60.1%,65.7%,80.7%,and 83.8%,respectively,whereas,that of low-risk group was 22.7%,40.0%, 53.8%,and 65.4%, respectively. There was a significant difference between the two groups(P=0.00). Conclusion The number of initial colorectal polyps is useful for predicting the risk of polyp recurrence,and the rate of polyp recurrence during surveillance increases with the passage of time. The cumulative recurrence rate of high-risk group after polypectomy is significantly higher than that of low-risk group.

Objective:To understand and explore the psychological experience of standardized patients, in order to provide an effective basis for training and applying standardized patients.Methods:The phenomenological methodology in qualitative research was used in the study, and the Colaizzi 7-step data analysis method was used for analysis the interview recording.Results:The psychological experience of standardized patients can be summarized into three themes: understanding of pressure from medical staffs, the desire for balance the effort and harvest, challenge and growth.Conclusions:Medical staffs need to considere the psychological experience of standardized patients in the training and application, pay more attention to their psychological changes and provide corresponding work and emotional support.