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 To explore the correlation of empowerment with illness perception among inpatients with type 2 diabetes mellitus. Method The convenience sampling method was used to investigate the status of empowerment and illness perception among 102 patients with type 2 diabetes mellitus from October 2014 to July 2015, followed by analyzing the association between the two variables. Results The total score of empowerment was (4.00 ± 0.65), and the total score of illness perception was (38.00 ± 2 . 33 ) . The empowerment was positively correlated with illness perception ( P < 0 . 001 ) . The empowerment was positively correlated with the timeline, personal control, treatment control, illness concern and illness comprehensibility, respectively (all P<0.001). Conclusions The empowerment of patients with type 2 diabetes mellitus is at a high level, and positively correlated with illness perception, more pronounced chronic nature, the better personal control and treatment control, a higher degree of concern about the disease and better personal understanding of the illness contributed to a higher degree of empowerment. Medical staff should evaluate the illness perception of the patients with type 2 diabetes mellitus regularly in the daily work so as to improve the illness perception , improve their empowerment and promote the patients′quality of life eventually.

Objective To investigate the treatment of intractable bile duct stones. Methods Of the total 149 cases of biliary stones, some are multiple bile duct stones,large stones,stones obstructed in the duodenal ampulla or residuary stones after T-tube surgery, others are associated with small papilla or papilla with neighoring diverticulum. All the stones were extracted with several endoscopic methods, such as choledochoscopy during or after operation, mechanical lithotripsy after EST(endoscopic sphincterotomy), biliary mother-baby endoscopy, ENBD(endoscopic nasobiliary drainage) or biliary-duodenum internal drainage. Results In general, extrahepatic bile duct stones were effectively removed in 94. 6% cases. In 19 out of 20 cases, stones were completely removed with choledochoscopy during operation; In 35 out of 40 cases stones were fully extracted through T-tube endoscopy, and in 72 of 76 cases stones were thoroughly removed with mechanical lithotripsy after EST. Conclusion The intractable bile duct stones can be effectively managed with combined endoscopic therapy, which is attributed to the high success rate in removing biliary stones and should be popularized in this field.

Objective To validate the accuracy of real-time three-dimensional echocardiography(RT3DE) in measuring spatial geometric parameters of mitral annulus.Methods Hearts in vivo of nine healthy hybrid canines were examined by RT 3DE.Three-dimensional full-volume images of mitral annuli were acquired.The annuli were annotated and measured by TomTec 4D MV-assessment software and MATLAB.The distance between anterolateral and posteromedial commissure (commissure-commissure, CC),septolateral distance (septal-lateral, SL) and height (H) of mitral annulus were measured.Parameters correlation coefficients of CC,SL and H derived by two methods were 0.83( P＜0.01),0.78( P＜0.05)well consistent with anatomic measurements, the mean differences of CC, SL and H between two methods were 0.22 cm,0.12 cm and-0.08 cm respectively.Conclusions RT-3DE is feasible in measuring mitral annulus, which provided a convenient, accurate and reliable new method for quantitative assessing annulus geometry configuration.

Objective To study the effect of auricular point sticking on the cerebrovascular reactivity in hypertension patients of different stages by using Transcranial Doppler (TCD) technology.Method Three hundred hypertension patients were randomized into a treatment group (auricular point sticking) of 180 cases and a control group (medication) of 120 cases. The cerebral arterial hemodynamic indexes were observed and analyzed by TCD before and after intervention.Result In comparing the improvements of cerebral arterial hemodynamic indexes in stage 1-2 hypertension patients, the treatment group was significantly superior to the control group (P＜0.05,P＜0.01); in stage 3 hypertension patients, the improvements of cerebrovascular hemodynamics of the treatment group were significantly better than those in the control group (P＜0.05,P＜0.01).Conclusion Auricular point sticking can improve the cerebrovascular hemodynamics and effectively improve the cerebrovascular reactivity of hypertension patients. TCD can help observe and estimate the cerebral arterial function of hypertension patients, and prevent and intervene in cerebrovascular diseases.

Objective We conduct this research in order to understand the satisfaction rate of vaccination outpatient service and awareness rate of vaccination knowledge among parents ,and to provide scientific basis for strengthening immune programming . Methods We used unified and structured questionnaire suggested by Regulations for Management of Vaccination Units in Sichuan Province .A total number of 116 vaccination outpatient sections were included in our research and in each outpatient section ,30 par-ents were investigated .Results In children′s parents ,the overall satisfaction rate of vaccination outpatient service was 98 .07% , with the highest satisfaction rate(96 .41% ) in technical skills of vaccination staffs ,and lowest satisfaction rate(94 .34% ) in the en-vironment of vaccination outpatient section .The overall awareness rate of vaccination knowledge was 88 .02% ,with the highest awareness rate(100 .00% ) in the question “If it is necessary to take vaccines after child′s birth” ,and lowest awareness rate (67 .93% ) in the question“Which are the three kinds of national immunization vaccines” .Conclusion In Chengdu ,the satisfaction rate of vaccination service is quite high among parents and most of the parents understand the necessity of taking vaccines ,but the awareness rates of questions related to vaccines are low .Therefore ,it is necessary to continue pushing standardized construction of vaccination outpatient service and strengthen health education about immune programming .

ObjectiveTo investigate the gastroscopic manifestations of gastric mucosa in portal hypertensive gastropathy (PHG) and the association of PHG with gastroesophageal varices, ulcers, and liver cirrhosis complications. MethodsA retrospective analysis was performed for the clinical data of 867 patients with liver cirrhosis who were treated in Daping Hospital of Army Medical University from August 2012 to June 2018, and the incidence rates of gastroesophageal varices, PHG, and ulcers were recorded. Meanwhile, the data of spontaneous bacterial peritonitis (SBP), hepatic encephalopathy (HE), and hepatocellular carcinoma (HCC) were collected. The chi-square test was used for comparison of categorical data between groups, and a Spearman correlation analysis was also performed. ResultsThe incidence rate of PHG in the patients with liver cirrhosis reached 66.2% (574/867), and gastric mucosa abnormalities in mild PHG were mainly red-spot lesions (68.6%) and snakeskin (56.8%), while diffuse erythema (76.5%) was the main gastric mucosa abnormality in severe PHG. There was a significant difference in the incidence rate of PHG between the patients with different severities of esophageal varices (χ2=304712, P＜0.05), and the severity of PHG increased with the aggravation of esophageal varices (r=0.515, P＜0.05). There was a significant difference in the incidence rate of PHG between the patients with different severities of gastric varices (χ2=81.004, P＜0.05), and the severity of PHG was positively correlated with that of gastric varices (r=0.292, P＜0.05). There was a significant difference in the incidence rate of PHG between the patients with varices at different locations (χ2=41.361, P＜0.05); the patients with gastric varices alone had the lowest incidence rate of PHG (34.8%) and only had mild PHG, and those with gastroesophageal varices had the highest incidence rate of PHG (85.6%). Among the patients without PHG, 71 (24.2%) were hospitalized due to hematemesis and/or tarry stool, and among the 574 patients with PHG, 316 (55.1%) were hospitalized, and there was a significant difference between the two groups (χ2=74562, P＜0.05). ConclusionPatients with different severities of PHG have different features of gastric mucosa abnormalities. The development and severity of PHG are closely associated with the severity of gastroesophageal varices and are important causes of gastrointestinal bleeding in liver cirrhosis. PHG should be treated and prevented to reduce the risk and complications of gastrointestinal bleeding.

Objective:To investigate the awareness of digestive system injury caused by coronavirus disease 2019 (COVID-19) in gastroenterologists.Methods:From February 21 to 23 in 2020, the electronic questionnaire was used to learn about the condition of the basic knowledge of COVID-19 and awareness of digestive system injury caused by COVID-19 among the gastroenterologists across the country. Chi-square test was used for statistical analysis.Results:A total of 2 216 gastroenterologists from 31 provinces, autonomous regions and municipalities nationwide completed the survey. 99.7% (2 209/2 216) of gastroenterologists stated that they had read the COVID-19 diagnosis and treatment guidelines. The percentages of physicians who knew clearly about the diagnostic criteria of suspected and confirmed cases of COVID-19 was 34.9% (774/2 216) and 39.4% (874/2 216), respectively. The percentages of physician who gave the right answers of COVID-19 detectable methods and pulmonary imaging was 68.4% (1 516/2 216) and 71.6% (1 586/2 216), respectively. The percentages of correct answers of digestive system injury caused by COVID-19 were physicians and chief physicians was 30.9% (134/433) in residents, 33.9% (234/691) attending physicians, 32.4% (213/657) associated chief physicians and 34.9% (152/435) chief physicians, respectively, however there were no statistically significant differences among physicians with different professional titles ( χ2=6.60, P> 0.05). 95.6% (2 119/2 216) of gastroenterologists believed that probiotics could effectively improve bowel function, and 94.0% (2 082/2 216) of gastroenterologists considered that enteral nutrition support could improve patients’ prognosis. Conclusions:The knowledge and dynamic progress of the digestive system injury caused by COVID-19 are still insufficiently grasped by gastroenterologists in China. So it is necessary to carry out systematic and pertinent training programmes for them.

Objective: To investigate awareness of digestive system injury caused by corona virus disease 2019 (COVID-19) in gastroenterologists. Methods: From February 21 to 23 in 2020, the electronic questionnaire was sent out to explore the condition of the basic knowledge of COVID-19 and knowledge of digestive system injury caused by COVID-19 grasped by gastroenterologists. Chi-square test was used for statistical analysis. Results: A total of 2 216 gastroenterologists from 31 provinces, autonomous regions and municipalities nationwide completed the survey. 99.7% (2 209/2 216) of gastroenterologists stated that they had read the COVID-19 diagnosis and treatment guidelines. The percentage of physicians who well knew the diagnostic criteria of suspected and confirmed cases of COVID-19 was 34.9% (774/2 216) and 39.4% (874/2 216), respectively. The percentage of physician who gave the right answer of COVID-19 detectable methods and lung imaging was 68.4% (1 516/2 216) and 71.6% (1 586/2 216), respectively. The percentage of correct answer of digestive system injury caused by COVID-19 in residents, attending physicians, associate chief physicians and chief physicians was 30.9% (134/433), 33.9% (234/691), 32.4% (213/657) and 34.9% (152/435), respectively, however there were no statistically significant differences among physicians of different level (χ²=6.60, P> 0.05). 95.6% (2 119/2 216) of gastroenterologists believed that probiotics could effectively improve bowel function, and 94.0% (2 082/2 216) of gastroenterologists considered that enteral nutrition support could improve patients’ prognosis. Conclusions The knowledge and dynamic progress of the digestive system injury caused of COVID-19 are still insufficiently grasped by gastroenterologists in China. So it is necessary to carry out systematic and pertinent training for them.

Objective:To summarize the clinical features of special portal hypertension-Abernethy malformation reported at home and abroad.Methods:The relevant literature on Abernethy malformation published at home and abroad from January 1989 to August 2021 was collected. Patients'clinical features, imaging and laboratory test results, diagnosis, treatment, and prognosis were analyzed.Results:A total of 380 cases were included from 60 and 202 domestic and foreign literatures. Among them, there were 200 cases of type I, with 86 males and 114 females, and the average age was (17.08±19.42) years, while there were 180 cases of type II, with 106 males and 74 females, and the average was (14.85±19.60) years. The most common reason for the first visit of an Abernethy malformation patient's was gastrointestinal system symptoms such as hematemesis and hematochezia caused by portal hypertension (70.56%). Multiple malformations were present in 45.00% of type Ⅰ and 37.80% of type Ⅱ patients. The most prevalent condition was congenital heart disease (62.22%, and 73.53%). Complications related to Abernethy malformation was occurred in 127 and 105 cases with type I and type II, respectively, with liver lesions in 74.02% (94/127) and 39.05% (42/105) and hepatopulmonary syndrome of 33.07% (42/127) and 39.05% (41/105), respectively. The imaging diagnosis of type I and type II Abernethy malformations were mainly based on abdominal computed tomography (59.00%, and 76.11%). Liver pathology was performed in 27.10% of patients. Blood ammonia increased by 89.06% and 87.50%, and AFP increased by 29.63% and 40.00% in laboratory findings. 9.76% (8/82) and 6.92% (9/130) died, while 84.15% (61/82) and 88.46% (115/130) had improved conditions after medical conservative, or surgical treatment.Conclusion:Abernethy malformation is a rare disease in which congenital portal vein development abnormalities lead to significant portal hypertension and portasystemtic shunt. Patients often seek medical treatment for gastrointestinal bleeding and abdominal pain. Type Ⅰ is more common in women, often associated with multiple malformations, and prone to secondary intrahepatic tumors. Liver transplantation is the main treatment method. Type Ⅱ is more prevalent in males, and shunt vessel occlusion is the first treatment choice. Overall, type Ⅱ has a better therapeutic impact than type Ⅰ.