In recent years, the eradication rate of standard triple therapy for Helicobacter pylori (Hp) infection has been reduced to less than 80% because of many factors, such as strain variation, drug resistance and cross infection of different strains.As more and more cases with failure of initial eradication therapy, the focus of clinical practice is to explore new alternative rescue therapies.Aims: To assess the efficacy and safety of Saccharomyces boulardii combined with moxifloxacin-based triple regimen for rescue therapy of Hp infection.Methods: A total of 400 patients with chronic gastritis who had failed initial bismuth quadruple therapy were enrolled and randomly assigned into two groups: 200 cases of control group and 200 cases of test group.Patients in control group received a rescue triple therapy (esomeprazole, amoxicillin and moxifloxacin) for 14 days and those in test group with the further addition of Saccharomyces boulardii sachets.Hp eradication was assessed by 13C/14C-urea breath test four weeks after treatment, and the adverse events during treatment course were observed.Results: The Hp eradication rates in control group and test group were 80.1% (121/151) and 90.4% (142/157) by per-protocol (PP) analysis, respectively, and 60.5% (121/200) and 71.0% (142/200) by intention-to-treat (ITT) analysis, respectively.The eradication rate in test group was significantly higher than that in control group by both PP and ITT analyses (P<0.05).The incidence rate of adverse events was significantly lower in test group than in control group (9.6% vs.17.9%, P<0.05).Conclusions: Saccharomyces boulardii added to moxifloxacin-based rescue triple therapy could increase the eradication rate of Hp infection with less adverse events.

Objective To investigate the effect of Omaha system intervention on social psychology of the elderly,and to provide evidence for effective intervention in elderly with homebound state.Methods 218 cases with homebound conditions were divided into intervention group and control group by random digits table with each group 109 cases.The intervention group accepted intervention including health education,treatment procedures,case management,supervision of the four aspects of 1-3 times a week according to Omaha intervention system for a period of 3 months.The control group was the blank control.And Omaha evaluation form was used to evaluate social psychological and physical effect before and after the intervention.Results 3 months after the intervention,except physiology in the field of neuromusculo-skeletal function of two groups had no significant difference (t=2.03,P＞0.05),scores in the intervention group in the field of physiology (like the circulation) were higher than the control group,the difference was statistically significant [(1 1.20±2.03) vs.(8.72±1.36),P＜0.05].As for psychology (like mental health),scores of intervention group were higher than that of the control group [(12.53±1.42) vs.(8.63±1.33),t=20.12,P＜ 0.05].Conclusions Omaha system can effectively improve the quality of life of elderly with homebound state and maintain their physiological,social and psychological function.

Objective To investigate the technical feasibility and oncological safety of EPMR for early esophageal cancer and precancerous lesions. Methods Clinicopathological data, procedure quality and complications of 70 patients with early esophageal cancer or precancerous lesions were retrospectively ana?lysed. The technical safety and feasibility were assessed, and the complications were investigated through postoperative surveillance. The results were compared with published data from two high?quality meta?analysis studies on ESD. Results In a total of 70 patients who underwent EPMR, 35?7%( 25/70) were diagnosed as having early esophageal cancer and 64?3%( 45/70) atypical hyperplasia. And tumor size greater than 2 cm was 78?6%(55/70). The mean EPMR time was(28?31±9?49) minutes. The R0 resection rate of EPMR was 88?6%(62/70) and no perforation occurred. The bleeding rate was 21?4%(15/70). The esoph?ageal stricture rate was 1?4%( 1/70) . The recurrence rate was 2?9%( 2/70) . Compared with published ESD data from the two studies, EPMR showed shorter procedure time, lower curative rate and lower rates of stric?ture and perforation, but slightly higher rates of bleeding and recurrence. Conclusion Both EPMR and ESD are feasible and effective for early esophageal cancer and precancerous lesions. The curative results of EPMR are similar to ESD, with shorter procedure time, but higher bleeding and recurrence rates.

Objective To observe the impact of the five-emotion restrictive therapy on coronary heart disease. Methods109 hospitalized patients with coronary heart disease were randomly divided into a experimental of 56 patients and a control group of 53 patients according to length of stay. The control group was treated with the conventional therapy; the experimental group was imposed five-emotion restrictive psychological intervention on the basis of conventional therapy. The investigation was done using self-rating anxiety scale(SAS) and self-rating depression scale(SDS) on 1 day after admission and ld before discharge respectively. SAS and SDS scores were surveyed. At the same time Holter monitoring and normal ECG test were compared. Results Compared with control group, the experimental group 1 d before discharge of the SAS and SDS scores were (41.9±7.4) and (38.6±8.4), and the difference was statistically significant (P＜0.01) . The total effective rate of Holter monitoring and normal ECG was 64.15％ and 92.85％ in the control and experimental group, and the difference was significant (P＜0.01) . ConclusionThe pathological seven emotions have a certain affection on the incidence of coronary heart disease, treatment and prognosis of the course. Five-emotion restrictive psychological intervention can adjust timely psychological state of patients, eliminate negative emotions, and significantly help the incidence, treatment and prognosis of the disease.

Objective To evaluate the correlation of inflammatory severity between appendiceal ori-fice inflammation(AOI)and ulcerative colitis(UC). Methods A retrospective analysis of the patients who were diagnosed as UC was conducted to investigate the correlation of the severity of inflammation between AOI and UC by linear trend test. Results The detective rate of UC during the above period was 2. 3%(991/ 42 928),with the patient number of 991.Appendiceal orifice observation did not perform in 45 cases due to patients reasons. In 946 patients,260 cases were diagnosed as having AOI,which accounted for 27. 5%of the total cases examined.AOI positive rates were significantly different between groups based on endoscopic severity standard(χ2 = 27. 39,P<0. 05),which was similar in moderate and severe group[30. 2%(109/ 361) VS 29. 8%(147/ 493),P>0. 0125],both significantly higher than that in mild group[4. 3%(4/ 92),P<0. 0125]. In linear regression analysis,regression coefficient was 0. 32,χ2return = 29. 48(P<0. 05)and χ 2partial =31. 66(P<0. 05),which proved a positive correlation between the two drawn existed but not a simple linear relationship. Conclusion AOI is a sign in some active UC patients. Its severity of inflammation can reflect the degree of inflammation in UC,which may offer a terminal point when treating a slice of UC individuals and giving a signal of its relapse.

BACKGROUND: Endothelial progenitor calls are the cells that can form new blood vessels in the way of angiogenesis in the body,which updates the conventional theory of angiogenesis, vascular damage and repair after birth and provides new ideas for research and treatment of ischemic diseases.OBJECTIVE: To investigate the effects of dog umbilical cord blood endothelial progenitor call (UCB-EPC) transplantation on angiogenesis after myocardial infarction.DESIGN, TIME AND SETTING: An in vivo cytological experiment was performed at the Laboratory Center of Xinhua Hospital between May 2006 and March 2007.MATERIALS: One full-term pregnant hybrid dog was included for preparation of UCB-EPCs. Thirty-six adult dogs were randomly divided into a cell transplantation group (n = 18) and a model control group (n = 18).METHODS: Acute myocardial infarction model was established in each group by ligation of antedor descending coronary artery.In the cell transplantation group, 2 mL physiological saline containing 5×10<'6> BrdU-labeled EPCs was injected into the coronary artery, while in the model control group, simple physiological saline of the same amount was given. At 1,4, and 8 weeks after transplantation, dogs were sacrificed for harvesting myocardial tissue.MAIN OUTCOME MEASURES: Myocardial infarction was confirmed by hematoxylin-eosin staining. Myocardial angiogenesis was observed by BrdU immunohistochemical staining. The number of infarcted myocardial vessels was calculated by yon Willebrand (vW) factor staining.RESULTS: There was plenty of scar tissue, flbroblasts, and small vessels in the myocardial infarction region. In the cell transplantation group, brown yellow particles (BrdU-positive expression) appeared in some nuclei in small vessels from infarcted myocardium. Newly formed vessels were not found in the model control group. In the cell transplantation group, brown yellow particles (vW factor-positive expression) appeared in the cytoplasm of the vascular endothelial cells in the myocardial ischemia and infarction regions, vW factors were not expressed in the model control group. At 1, 4, and 8 weeks after myocardial infarction,there was no significant difference in vessel counts no matter in myocardial ischemia region or in myocardial infarction region between the call transplantation and model control groups.CONCLUSION: EPCs derived from UCB of pregnant dog can participate in the formation of blood vessels but can not promote angiogenesis after acute myocardial infarction.

Objective To study the clinical application of Fuji intelligent color enhancement ( FICE) on the diagnosis of vocal leukoplakia and esophageal diseases. Methods A total of 50 patients suspected with vocal leukoplakia by electronic laryngoscopy were enrolled for undergoing meticulous examination of vocal cords and esophagus using FICE from January 2014 to January 2016. The diagnostic value of FICE for vocal leukoplakia were analyzed. Results Among the 50 patients, 50 lesions were found using laryngoscopy and 52 lesions were found using FICE. There were significant differences between FICE mode and white light mode on the capillary pattern score and lesion boundary resolution score ( all P<0. 05) . The diagnostic coincidence rate of FICE mode with pathology was higher than that of white light mode [ 89. 4％ ( 42/47 ) VS 68. 1％ ( 32/47 ) , P = 0. 01 ] . Among the 50 patients suspected with vocal leukoplakia, 31 combined with gastroesophageal reflux disease, and were given proton-pump inhibitor treatment. In the follow-up after three months, lesions of 16 cases alleviated, 13 cases disappeared, and 2 cases had no significant changes. Conclusion FICE has a higher clinical value than conventional laryngoscopy and white light endoscopy on the diagnosis of vocal leukoplakia.

Objective To explore the clinical characteristics and correlation of adult primary nephrotic syndrome (PNS) with thyroid dysfunction,and early identify high-risk adult PNS patients with abnormal thyroid function by clinical data.Methods The clinical data of 101 adult PNS patients in Heji Hospital Affiliated to Changzhi Medical College from March 2015 to December 2017 were retrospectively analyzed.According to the thyroid function,the patients were divided into 2 groups:normal thyroid function group (67 cases) and thyroid dysfunction group (34 cases),including 9 cases with low triiodothyronine (T3) syndrome and 25 cases with subclinical hypothyroidism.The clinical data were compared,and the correlation between thyroid-stimulating hormone (TSH) and 24 h urinary protein,blood albumin and systolic blood pressure were analyzed.Results The incidence of thyroid dysfunction in adult PNS patients was 33.66％ (34/101),including 21 cases of membranous nephropathy,8 cases of minimal change disease,4 cases of IgA nephropathy and 1 case of membranoproliferative nephritis.The 24 h urinary protein in thyroid dysfunction group was significantly higher than that in normal thyroid function group:(8.76 ± 3.62) g vs.(6.96 ± 3.43) g,the albumin was significantly lower than that in normal thyroid function group:(21.82 ± 4.89) g/L vs.(24.49 ± 4.14) g/L,and there were statistical differences (P＜0.05 or ＜0.01);there was no significant difference in gender composition,age,course of disease,systolic blood pressure,diastolic blood pressure,body mass index,hemoglobin,platelet,creatinine,cystatin C,fasting blood glucose,total cholesterol,triacylglycerol,low-density lipoprotein cholesterol (LDL-C),fibrinogen,complement C3,IgG,IgM,IgA,PNS types and comorbidities between 2 groups (P＞0.05).The results of subgroup analysis results showed that the systolic blood pressure in subclinical hypothyroidism patients of thyroid dysfunction group was significantly higher than that in normal thyroid function group and the low T3 syndrome patients of thyroid dysfunction group:(148.16 ± 18.09) mmHg (1 mmHg =0.133 kPa) vs.(139.55 ± 18.77) and (127.78 ± 16.81) mmHg,the 24 h urinary protein was significantly higher than that in normal thyroid function group:(9.00 ± 3.64) g vs.(6.96 ± 3.43) g,the albumin was significantly lower than that in normal thyroid function group:(21.71 ± 5.26) g/L vs.(24.49 ± 4.14) g/L,and there were statistical differences (P＜0.05).Pearson correlation analysis result showed that TSH had no correlation with 24 h urinary protein and systolic blood pressure (r =0.193 and 0.072,P =0.053 and 0.472);however TSH was negatively correlated with albumin (r =-0.340,P =0.001).Conelusions In adult PNS patients with thyroid dysfunction,membranous nephropathy is the most common,followed by minimal change disease.The systolic blood pressure in PNS patients with subclinical hypothyroidism is significantly higher than that in patients with normal thyroid function and low T3 syndrome.In adult PNS patients,the lower the blood albumin is,the more likely they have thyroid dysfunction.