Objective To observe the effect of self-assembling Atractylodes Rhizome Decoction combined with quadruple therapy on Helicobacter pylori (Hp)-positive peptic ulcer and its effect on wound healing, gastric acid secretion and recurrence.MethodsThis study was based on 70 patients with Hp-positive peptic ulcer treated in our hospital from March 2012 to May 2014.The patients were divided into study group and control group according to the order of admission.(BAO), the maximum gastric acid secretion (MAO), the peak gastric acid secretion (P<0.05).The treatment group is divided into two groups according to the treatment group.(PAO), Hp eradication and recurrence were observed and compared.ResultsAfter treatment, the total effective rate of wound healing study group was 80.00% higher than that 57.14% of the control group (χ2=4.242, P<0.05).The levels of BAO, MAO and PAO in the two groups were significantly lower than those before treatment (P<0.05).The eradication rates of Hp in the study group were significantly higher than those in the control group at 6 months and 1 year follow-up.The recurrence rate was significantly lower in the study group than in the control group (P<0.05),There was no significant difference between the two groups.ConclusionThe clinical effect of self-made Baishui Yipi Decoction combined with quadruple therapy on Hp-positive peptic ulcer patients is effective in promoting wound healing and Hp eradication, and inhibiting gastric acid secretion and reducing the recurrence rate.It is a kind of medicine worthy of clinical application Program.

Objective To study the effect of diabetic education on the patients using insulin treatment.Methods 41 cases of diabetes were trained in three different ways:group education,individual education and self education in the hospital for three to four weeks by a team of nurses.Results The results showed that the total average test score was increased by 4.44 after education.The average test scores was 9.37±0.45 after education and higher than before education (4.93±0.59) ( P <0.001).12.4% of the patients got full scores after education,34.1% of the patients got the excellent scores (≥8) before education.82.9% of patients got excellent scores after education.41.5% of the patients got low scores (<3) before education,and it was only 3.1% after education.For diabetic knowledge accumulating,the effects were significant ( P <0.001).The self care skill and knowledge such as self monitor of blood glucose and urine glucose,foot care were improved ( P <0.001).By education,diet control,exercise,oral hypoglycemic durgs and insulin treatment,FBS and PBS of patients were efficiently controled ( P <0.001).Conclusion Education is an important way for the patients to learn diabetic knowledge,improve the ability of self management

Iatrogenic nerve injury is one of the most severe complications of surgical correction for spinal deformity with different etiologies.The intraoperative neurophysiological monitoring (IONM) has been widely used to detect the nerve injury in spinal correction surgery.The commonly used IONM techniques involve somatosensory evoked potential (SEP),motor evoked potentials (MEP) and electromyography (EMG).All the IONM techniques have both advantages and disadvantages,while combing SEP,MEP and EMG in the spinal correction surgery could maximumly improve the accuracy and reliability of the IONM.The different pathophysiology of patients with spinal deformity due to different etiologies might significantly decrease the success rate,sensitivity,and specificity of IONM,which might further decrease the reliability of IONM.However,the IONM still serves as the most important monitoring method for the iatrogenic nerve injury in patients with different spinal deformity due to different etiologies.For those monitoring changes that cannot be distinguished,the wake-up test is still the gold standard.

Objective To evaluate the effects of different levels of neuromuscular blockade(NMB)on transcranial electric motor-evoked potentials(TCeMEPs)during idiopathic scoliosis.Methods Thirty American Society of Anesthesiologists physical status Ⅰ or Ⅱ patients of both sexes,aged 11-23 yr,weighing 31-62 kg,scheduled for elective idiopathic scoliosis under general anesthesia,were enrolled in the study.NMB was monitored with train of four(TOF)-Watch SX.The levels of partial NMB were classified into 5 states according to TOF ratio(TOFR)and TOF counts:1 or 2 TOF counts(TOF1),3 TOF counts and TOFR≤15%(TOF2),TOFR 16%-25%(TOF3),TOFR 26%-50%(TOF4),TOFR 51%-75%(TOF5) and TOFR>75%(no NMB).Each state was maintained for 10 min.Failure and false-positive findings in TCeMEP monitoring,development of unexpected body movement and satisfaction with NMB were recorded.Results Compared with no NMB,the failure and false-positive rates of TCeMEP monitoring were significantly increased,the incidence of unexpected body movement was decreased,and the rate of satisfactory NMB was increased at TOF1,TOF2 and TOF3(P<0.05),no significant change was found in failure or false-positive rates of TCeMEP monitoring at TOF4 and TOF5(P>0.05),and the incidence of unexpected body movement was decreased and the rate of satisfactory NMB was increased at TOF4,the rate of satisfactory NMB was increased at TOF5(P<0.05),and no significant change was found in the incidence of unexpected body movement at TOF5(P>0.05).Compared with those at TOF4,no significant change was found in the failure or false-positive rates of TCeMEP monitoring(P>0.05),the incidence of unexpected body movement was significantly increased,and the rate of satisfactory NMB was decreased at TOF5(P<0.05).Conclusion Maintaining TOFR at 26%-50% the partial NMB during surgery does not affect TCeMEP monitoring during idiopathic scoliosis and meets the intra-operative NMB requirements simultaneously,and it is the optimum NMB for this type of surgery.

Objective:To investigate the value of serum gastrin 17 (G-17), pepsinogen I (PG I), pepsinogen II (PG II), and programmed cell death protein 5 (PDCD5) in the identification of gastric precancerous state and the diagnosis of early gastric cancer.Methods:A total of 86 patients with early gastric cancer who received treatment at the Marine Police Corps Hospital of Chinese People's Armed Police Force from July 2018 to June 2022 were included in the gastric cancer group. Eighty patients with gastric precancerous states who concurrently received treatment in the same hospital were included in the precancerous state group. An additional 80 partiapants who concurrently received physical examination in the same hospital were included in the healthy group.The value of G-17, PG I, PG II, and PDCD5 in the diagnosis of early gastric cancer was analyzed.Results:The levels of G-17 and PG II in the precancerous state group [(10.87 ± 3.23) pmol/L, (15.78 ± 3.33) μg/L] and gastric cancer group [(18.78 ± 4.10) pmol/L, (21.25 ± 4.48) μg/L] were significantly higher compared with the healthy group [(5.56 ± 1.43) pmol/L, (13.52 ± 3.02) μg/L, F = 362.65, 94.12, all P < 0.05]. The levels of PG I and PDCD5 in the precancerous state group [(79.52 ± 16.62) μg/L, (1.35 ± 0.15) μg/L] and gastric cancer group [(50.06 ± 15.58) μg/L, (0.85 ± 0.13) μg/L] were significantly lower than those in the healthy group [(110.12 ± 30.23) μg/L, (1.60 ± 0.12) μg/L, F = 151.07, 650.56, all P < 0.05)].There were significant differences between the precancerous state and the gastric cancer groups in terms of family history of gastric cancer, consumption of high salt fried foods, alcohol consumption history, and Helicobacter pylori (Hp) infection ( χ2 = 10.39, 4.68, 11.47, 36.49, all P < 0.05). Family history of gastric cancer ( OR = 1.42, 95% CI = 1.03-1.96) and Hp infection ( OR = 3.76, 95% CI = 1.30-10.85) were identified as risk factors for gastric cancer ( P < 0.05). The combination of G-17, PG I, PG II, and PDCD5 had the highest predictive efficiency for early gastric cancer ( P < 0.05), with the area under the receiver operating characteristic curve being 0.982, sensitivity and specificity of 98.84% and 90.00%, respectively. Conclusion:Family history of gastric cancer and Hp infection are risk factors for gastric cancer. Patients with precancerous state and early gastric cancer have elevated serum levels of G-17 and PG II and reduced serum levels of PG I and PDCD5 protein. Combined detection of these four indicators has a high diagnostic value for early gastric cancer.

Objective:To investigate the regulatory effects of tenofovir disoproxil fumarate on oxidative stress and peripheral blood Th17/Treg balance in patients with hepatitis B cirrhosis.Methods:A total of 102 patients with hepatitis B cirrhosis who received treatment in the Marine Police Corps Hospital of Chinese People's Armed Police, China from March 2020 to June 2021 were included in this study. They were randomly assigned to undergo treatment with either tenofovir disoproxil fumarate ( n = 51, observation group) or entecavir ( n = 51, control group) for 42 weeks. The levels of malondialdehyde (MDA), superoxide dismutase (SOD), nitric oxide (NO), T helper 17 cells (Th17), regulatory T cells (Treg), Th17/Treg ratio, hyaluronic acid (HA), laminin (LN), type III procollagen (PC III), type IV collagen (IV-C), hepatitis B virus DNA negative rate, HBeAg negative rate, and alanine aminotransferase normalization rate pre- and post-treatment as well as the incidence of adverse reactions were compared between the two groups. Results:Before treatment, there were no significant differences in SOD, MDA, NO, Th17, Treg, Th17/Treg ratio, HA, LN, PC III, IV-C between the two groups (all P > 0.05). After treatment, SOD and Treg in the observation group were (121.52 ± 23.52) U/L and (3.51 ± 0.70)% in the observation group, respectively, which were significantly higher than (113.30 ± 20.05) U/L and (3.14 ± 0.49)%, respectively in the control group ( t = 1.90, -4.14, both P < 0.05). MDA, NO and Th17, Th17/Treg ratio, HA, LN, PC III, and IV-C in the observation group were (7.40 ± 1.35) mmol/L, (22.56 ± 4.25) μmol/L, (1.29 ± 0.46)%, (0.45 ± 0.11), (212.52 ± 16.62) μg/L, (135.52 ± 14.02) μg/L, (132.52 ± 15.62) μg/L,(96.52 ± 10.02) μg/L, respectively, which were significantly lower compared with the control group ( t = -6.81, 4.02, 3.10, -8.46, -13.27, -15.23, -13.67, -17.38, all P < 0.05). Hepatitis B virus DNA negative rate, HBeAg negative rate, and alanine aminotransferase normalization rate in the observation group were 76.47% (39/51), 68.63% (35/51) and 74.51% (38/51), respectively, which were higher than 56.86% (29/51), 41.18% (21/51), 54.90% (28/51) in the control group ( χ2 = 4.41, 7.76, 4.29, all P < 0.05). There was no significant difference in the incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Tenofovir disoproxil fumarate is highly effective on hepatitis B cirrhosis. It can reduce oxidative stress and regulate peripheral blood Th17/Treg balance.

Objective:To propose a novel classification system based on the morphology and relative position of spinal cord in the spinal canal at sagittal T2-MRI, and to investigate the incidence and risk factors of the intraoperative neuromonitoring event (IONME) across these classifications.Methods:From January 2016 to December 2021, a consecutive cohort of 85 patients who underwent surgical correction of congenital kyphosis with pedicle screw/rod constructs were retrospectively reviewed, including 43 males and 42 females, aged 14.6±6.1 years old. According to the morphology and relative location of spinal cord at the apex of the curve on the sagittal-T2 MRI, patients were divided into three groups. Type A (5 cases) is characterized by the spinal cord centrally positioned within the spinal canal, surrounded by discernible cerebrospinal fluid (CSF). Type B (33 cases) depicts the spinal cord abutting the spinal canal's anterior wall, maintaining its intrinsic morphology. In Type C (47 patients), the spinal cord is contorted by the apical vertebral body, devoid of interposing CSF. The global kyphosis (GK) and sagittal deformity ratio (SDAR) of patients were measured before surgery. The incidence of IONME were recorded. All patients included in the study were further divided into the IONME group and the non-IONME group. Potential risk factors were identified using univariate testing. Binary Logistic Regression was used to analyze the independent risk factors for IONM.Results:All of 85 patients were reviewed: 5 (5.9%) Type A; 33 (38.8%) Type B; and 47 (55.3%) Type C spinal cords. Intraoperatively, 27 (31.8%) instances presented with lost trans-cranial motor-evoked potentials (MEPs) and/or somatosensory evoked potentials (SSEPs). Of these, 2 (7.4%) were Type B, and 25 (92.6%) were Type C, reflecting a statistically significant variance in IONME occurrences across types (χ 2=27.15, P<0.001). Notable differences were observed between IONME and non-IONME groups concerning GK, SDAR, and apex location ( t=5.41, P<0.001; t=3.65, P<0.001; χ 2=7.71, P=0.005). Univariate analysis showed that potential risk factors of IONME included Type C spinal cord ( OR=20.46, P<0.001), higher GK ( OR=1.07, P<0.001), SDAR ( OR=1.15, P=0.002) and apical vertebrae located at middle thoracic( OR=4.30, P=0.008). Independent predictors identified on binary Logistics regression modeling included higher GK ( OR=1.05, P=0.015), Type C spinal cord ( OR=6.22, P=0.042) and apex located at middle thoracic ( OR=6.43, P=0.021). Specifically, within Type C, 79% of cases where the apical vertebra was mid-thoracic experienced IONME, contrasting the 42% incidence observed in those with a lower thoracic apex positioning, signifying a notably elevated IONME likelihood for the mid-thoracic region (χ 2=5.16, P=0.023). Conclusion:Risk factors of IONME included Type C spinal cord, higher GK and apex located at middle thoracic during correction of congenital kyphosis. Preoperative MRI spinal cord typing showed great predictive value for IONME.