Objective To observe the effect and safety of helicobacter pylori eradication by doxycycline, levofloxacin,bismuth potassium citrate combined with omeprazole.Methods 240 patients who infected helicobacter pylori were selected,and were randomly divided into four groups:treatment group(doxycycline,levofloxacin,bismuth potassium citrate,omeprazole),control group A(doxycycline,levofloxacin,omeprazole),control group B(amoxicillin, clarithromycin,bismuth potassium citrate,omeprazole),control group C (amoxicillin,clarithromycin,omeprazole), 60 patients in each group.Helicobacter pylori eradication treatment for 7 days,patients with gastritis stop after the course of the treatment,peptic ulcer patients continue taking omeprazole 5 weeks after 7 days treatment.All patients stopped medicine 2 weeks accepted 14 carbon breath test.And adverse events were investigated.Results In the treatment group and the control group A,B,C,the helicobacter pylori eradication rates were 93.3%,80.0%,91.7%, 75.0%.Compared with group A,the treatment group helicobacter pylori eradication rate increased significantly(χ2 =4.61,P <0.05 ).Compared with group C,the treatment group helicobacter pylori eradication rate increased significantly(χ2 =7.57,P <0.05).But compared with group B,the treatment group helicobacter pylori eradication rate had no significant difference(χ2 =0.12,P >0.05).Compared with the treatment group,group B had high inci-dence of oral odor(χ2 =6.56,P <0.05).Compared with the treatment group,group C had high incidence of oral odor (χ2 =5.46,P <0.05).Conclusion Doxycycline,levofloxacin,bismuth potassium citrate combined with omeprazole can improve the helicobacter pylori eradication rate significantly,and with low price,has little side effect,no need of penicillin skin test,can used for the patients poverty or allergic to penicillin.

Objective To study the association between serum prolactin(PRL)level,prolactin receptor(PRLR)expression on peripheral blood mononuclear cells and the disease activity in the patients with systemic lupus erythematosus(SLE).Methods Serum PRL level was measured by time-resolved fluoroimmunoassay(TrFIA)in113patients of SLE and in28gender-and-age matched control subjects,SLEDAI index was estimated.It was also investigated by logistic multiple regression analysis that the association between clinical manifestations,immunologic parameters,anti-dsDNA antibody titers and hyperprolactinemia in113patients of SLE.The specific binding(SB)rate of peripheral blood lymphocyte PRLR was measured by radioactive binding ligand assay(RLBA)and the mRNA expression of PRLR by reverse transcription polymerase chain reaction(RT-PCR)in24active SLE patients,22inactive SLE patients and15gender-and-age matched control subjects.Results The serum PRL levels of63active patients were much higher than those of50inactive patients and28control subjects.The serum PRL levels ranged9~51.2?g/L in79.3%of active patients.It was also found that PRL level was in positive linear correlation with the titer of anti-dsDNA antibody.The concentration of interleukin2receptors in hyperprolactinemia group was higher than that in normal group.It was shown that proteinuria,low levels of complement3and high titers of anti-dsDNA antibody were associated with hyperprolactinemia by logistic multiple regression analysis.The SB rate of PRL receptor was5.03?2.51%(x?s),the total binding rate(TB)was15.4?6.98%in24active patients with SLE.The SB rate of active patients was much higher than that of22inactive patients(SB4.18?2.26%,TB rate14.03?6.54%)and that of15gender-and-age matched control subjects(SB1.62?1.05%,TB8.19?1.47%).The mRNA expression of PRLR in active patients(x?s,0.85?0.45)was much higher than in inactive patients(0.58?0.43)and that in control subjects(0.20?0.13).Conclusion The slightly increased serum level of PRL,high expression of PRLR and the increased specific binding rate are associated with the disease activity of SLE.

Objective To explore the micresurgical techniques and outcome of tumors in jugular foramen and its around. Methods Eleven patients with jugular foramen tumors were operated through suboccipital-retrosigmoid approach (2 cases), jugular foramen approach (2 cases), temporal fossa approach (4 cases) and mastoid-cervical combined approach (3 cases). Results Nine tumors were totally removed and 2 were subtotally removed. Of those cases, there were 4 neurinoma, 4 paragangliome, I meningioma, 1 mucochondrosarcoma, and 1 low-differentiated carcinoma. Postoperative complications included transient cerebrespinal fluid leak(1 case) and new lower cranial nerve injury (2 cases). All cases were followed up for mere than 8 months. The postoperative hearing was improved in 1 case, stable in 6 cases, deteriorated in 4 cases. Postoperative facial paralysis of grade Ⅱ- Ⅲ occurred in 3 of 9 patients without facial paralysis, which recovered in half a year. Of 2 patients with facial paralysis before surgery, facial function was improved in 1 case and stable in 1 case. Conclusion Proper surgical approaches and micrceurgical techniques, which were adopted according to the types, the location, and the expansion of tumors, the function of facial nerve and lower cranial nerves, and hearing level, are good for reducing complications, exposing and removing jugular foramen tumors.

BACKGROUND:During the outbreak of severe acute respiratory syndrome(SARS),certain people had been isolated by various reasons and appeared a series of psychological, physical and behavioral reactions. OBJECTIVE:To understand the different defensive features in people with different level of mental health in the isolated population, and explore the relationship between defensive style and mental health. DESIGN:An in investigative study taking the isolated population during outbreak of SARS as the subjects. SETTING:A psychiatric department of a military hospital. PARTICIPANTS:Totally 187 people of different sex,age and education, who were isolated during April and May 2003 due to SARS outbreak in a city of northwest China,were selected as the subjects. INTERVENTIONS:The 187 subjects,who were isolated due to SARS outbreak,were evaluated by using the symptom checklist(SCL 90) and defense style questionnaire(DSQ). RESULTS:About 36.4% people of this population had distinct mental or physical health problems that were characterized by anxiety,horror,depression,hostility and compulsion.There was difference in defensive styles between the high symptom group and low symptom group,among which the score of DSQ factors in the immature type of high and low symptom groups were 5.72± 1.56 and 4.35± 0.96 respectively while the scores in the intermediate type defense were 4.98± 1.44 and 3.72± 0.89 respectively(P< 0.01).Mental health problem was positively correlated with the application of immature defensive style,but had negative correlation with application of mature defensive means. CONCLUSION:There is difference in the defensive styles among the isolated people with different mental health status,and their defensive strategies are closely related to the mental health.

Apoptosis refers to the programmed death process of cells modulated by genes. It plays an important role in promoting the evolution of organisms, regulating the development of multiple systems, and maintaining the stability of internal environment. The major apoptosis pathways include mitochondrial pathways, death receptor pathways, and endoplasmic reticulum pathways. With the rapid development of the scientific research on acupuncture, it’s revealed that cell apoptosis should be closely related to the action of acupuncture. So far, the major apoptosis factors involved in relevant researches are P53, Bcl-2 family, Cyt-C, Caspase, Fas/Fasl, TNFR1/TNF-?, and FADD-Caspase8, and PERK, etc. Via influencing these apoptosis factors or genes, acupuncture can produce various effects in improving tissue ischemia, protecting neural cells, reducing inflammation, and correcting endocrine disorders. This article summarized and reviewed the apoptosis pathways and key factors related to the action of acupuncture, to provide some beneficial references for future studies.

ObjectiveTo explore the correlations of simple bladder capacity measurement and urodynamic examination used for assessing the bladder function of patients with spinal cord injury.Methods From December 2011 to September 2013,a total of 37 patients with spinal cord injury were recruited.Their bladder functions were examined by both simple bladder capacity measurement and urodynamics in the first week after admission.The type of neurogenic bladder,residue urine,bladder capacity and the changes of bladder pressure were documented and compared.Results The simple bladder capacity measurement and urodynamics showed no significant differences in the parameters including residual urine,and bladder pressures when inputting 50mL,100mL,300mL and 400mL water(P>0.05). But there were significant differences in the results of bladder capacity and bladder pressure when inputting 200mL water(P<0.05). The intra-class coefficients between the results by the two methods were 0.606~0.919(P<0.01).The Kappa coefficient of the health professionals’judgments according to the two methods was 0.825(P<0.001).Conclusions The results of simple bladder capacity measurement are reliable.It can be used as the supplement for urodynamics to monitor the bladder function of patients with spinal cord injury.

Objective To understand non stomatology undergraduates'strategies for learning stomatology and to study the reform on this course.Methods The learning strategies of 560 undergraduates majoring in clinical medicine from grade 2007 were investigated s and ten related factors like learning attitudes were investigated by learning strategies scale.Correlation analysis and linear regression analysis were applied to deal with research data.Results Most undergraduates were lack of strategies in learning stomatology.Related coefficient between 10 factors and academic scores ranged from 0.197 to 0.401,existing positive correlation(P＜0.05).Determination coefficients(R2)of attitude,motivation,time management and learning auxiliary means were 0.146,0.167,0.223and 0.122 respectively,which can be used to predict the scores of examination.Condusions Non stomatology undergraduates'strategies for learning stomatology is a vital factor influencing their academic scores.It's necessary for teachers to improve their teaching methods considering students'professional characteristics and learning strategies.

Objective:To observe the clinical effects of aspirin combined with low-molecular-weight heparin in the prevention of preeclampsia in patients with hypertension during pregnancy.Methods:From October 2017 to December 2018, 120 patients with hypertension during pregnancy who were treated in the Maternal and Child Health Hospital of Cixi were selected.The patients were divided into control group and observation group according to the wishes of pregnant women and informed consent, with 60 patients in each group.Control group received single oral aspirin 100 mg daily from 11-13 + 6 weeks of pregnancy to 36 weeks of pregnancy or 5-10 days before termination of pregnancy.The observation group received 3075 IU of low-molecular-weight heparin subcutaneous injections daily from 11-13 + 6 weeks of pregnancy for 2 weeks, and was orally given aspirin 100 mg daily for 36 weeks or until 5-10 days before termination of pregnancy.The incidence of preeclampoia, adverse pvegnany outcome and complication of the two groups were observed and compared. Results:The incidences of preeclampsia, preterm birth, cesarean section, fetal distress, placental abruption and neonatal asphyxia in the observation group were 15.00%, 20.00%, 36.67%, 11.67%, 6.67% and 1.67%, respectively, which were significantly lower than those in the control group (31.57%, 35.00%, 55.00%, 30.00%, 23.33% and 15.00%, χ 2=4.658, 4.104, 4.061, 6.113, 6.535, 6.981, all P<0.05). The gestational age at delivery[(37.88±3.72)weeks] and the weight of the newborn [(2.63±0.24)kg] in the observation group were significantly larger than those in the control group[(36.11±3.59)weeks, (2.13±0.20)kg]( t=2.652, 12.397, all P<0.05). The incidences of postpartum blood loss, thrombocytopenia, oligohydramnios and pleural and ascites in the observation group were 5.00%, 1.67%, 5.00% and 16.67%, respectively, which were significantly lower than those in the control group (25.00%, 16.67%, 23.33% and 15.00%, χ 2=9.411, 8.106, 8.292, 6.981, all P<0.05). Conclusion:Low-dose aspirin and low-molecular-weight heparin for patients with hypertension during pregnancy can reduce the incidence of preeclampsia and improve adverse pregnancy outcomes, which is worthy of promotion and application.

ObjectiveTo investigate the effects of acupuncture combined with Du-Moxibustion (ADM) on peripheral blood cell count and levels of immune factors in patients with occupational chronic benzene poisoning. Methods A total of 70 patients with occupational chronic benzene poisoning (leukopenia and neutropenia) were selected as the research subjects by judgement sampling method. They were randomly divided into a control group and an ADM group using a random number table method, with 35 cases in each group. Patients in the control group were treated with conventional Western medicine such as leukocyte boosting and symptomatic treatment. While patients in the ADM group were treated with ADM treatment in addition to treatments of the control group, once per week for five consecutive weeks. Peripheral blood samples of patients were collected before and after treatment from both groups, to detect cell counts and serum levels of immune factors. Results The white blood cell count, red blood cell count, absolute lymphocyte count, absolute neutrophil count, platelet count, and levels of hemoglobin, immunoglobulins (Ig) A, IgM, IgG, complement C3 and complement C4 of patients in both groups improved after treatment compared with those before treatment (all P<0.05). The white blood cell count, levels of IgA, IgM, IgG, complement C3 and complement C4 of patients in the ADM group were higher than those in the control group after treatment (all P<0.05). Conclusion ADM treatment can increase peripheral blood white blood cells and serum levels of immune factor in patients with occupational chronic benzene poisoning (leukopenia, neutropenia), which helps improve patient recovery and can be promoted clinically.

Objective The bispectral index (BIS) was introduced into the sedation strategy of critical patients in intensive care unit (ICU) and replaced the Richmond agitation sedation scale (RASS).The ventilation time,ICU length of stay,and 90-day mortality were compared between the two groups of patients who performed early goal-directed sedation (EGDS) or standard traditional directed sedation (STDS) strategies.Methods A prospective controlled study of severe patients with mechanical ventilation ≥48 h in ICU (20 cases from April 2016 to May 2017,46 cases from June 2017 to April 2018) were randomly divided into EGDS or STDS group.There were no significant differences in age,gender,and acute physiology and chronic health evaluation score Ⅱ (APACHE Ⅱ) score between the two groups in the two periods.The correlation between RASS and BIS was analyzed in the first period.The BIS of the patients in a RASS range of (-2-1) was 73.65 ± 7.87 in the EGDS group,and that of RASS range of (-3--1) was 64.14 ± 7.25 in the STDS group.The above BIS was applied to the two sedation strategies in the second period respectively.The ventilation time,ICU length of stay,and 90-day mortality were recorded.Results There was no significant difference in the ventilation time between the two groups [(164.12 ± 137.96) h and (155.33 ±64.86)h,P =0.08].ICU length of stay of the EGDS group was longer than that of the STDS group.The 90-day mortality of the EGDS group was higher than that of the STDS group.Conclusions Correlations between RASS and BIS were found in this study,and BIS can be used for sedation assessment in ICU patients.Large sample study is still needed to compare EGDS and STDS with BIS.