OBJECTIVE:To observe clinical efficacy and safety of Bifidobacterium triple viable capsules in the adjunctive treatment of Helicobacter pylori(Hp)positive chronic atrophic gastritis(CAG)complicated with anxiety-depression. METHODS:A total of 100 Hp positive CAG patients with anxiety-depression were divided into control group and observation group according to random number table,with 50 cases in each group. Control group was given standard triple therapy (rabeprazole+amoxicillin and clavulanate+levofloxacin). Observation group was additionally given Bifidobacterium triple viable capsules 0.42 g,tid. The treatment lasted for 14 d in both groups. Clinical efficacies,Hp eradication rates as well as HAMA and HAMD scores before and after treatment were all observed in 2 group. The occurrence of ADR was compared. RESULTS:Total response rate of observation group was 94.0%,and Hp eradication rate was 92.0%,which were significantly higher than 76.0% and 78.0% of control group, with statistical significance (P<0.05). Before treatment,there was no statistical significance in HAMA and HAMD scores in 2 groups(P>0.05). After treatment,HAMA and HAMD scores of 2 groups were decreased significantly,the observation group was significantly lower than the control group,with statistical significance (P<0.05). The incidence of ADR in observation group (4.0%)was significantly lower than control group(20.0%),with statistical significance(P<0.05). CONCLUSIONS:Adjunctive use of Bifidobacterium triple viable capsules can significantly improve Hp eradication rate,clinical symptom,anxiety and depres-sion,while reduce the incidence of ADR.

Objective To explore mechanisms of sustained and transient effects in encoding processes of emotional memory by examining activation of amygdala via functional MRI and to provide evidence for understanding the underlying neural mechanism related to emotional memory disorders further. Methods Twenty two subjects (aged from 20 to 24 years old) participated in the study and mixed blocked/event-related design was adopted. Sixty negatively emotional pictures and sixty neutral scene pictures were used. Functional MRI scanning was performed while subjects were doing encoding tasks. Behavioral data were acquired during retrieval. Correlation analyses of functional MRI data and simples paired t -test of behavioral performance were performed with SPM2 and SPSS13.0 statistical software,respectively. Results Significant differences of behavioral performance ( t= 2.791,P= 0.01 ) was found between emotional (3.15 ± 0.14) and neutral (2.25 ± 0.08 ) pictures. A whole-brain voxelwise correlation analysis between functional MRI and emotional enhancement effect indicated that the transient effect of emotional enhancement of memory involved the left amygdala, left hippocampus and left lateral orbitofrontal cortex, while the sustained effect involved the right amygdala, right hippocampus, right inferior frontal gyrus, right medial and lateral orbitofrontal cortex. Region of interest analysis demonstrated that the sustained effect was related to the right amygdala (r= 0.50, P = 0.019 ), which was different from transient effect ( Z = 1.655, P = 0.049 ),while the transient effect was correlated with the left amygdala (r=0.65, P=0.001 ) ,which was different from sustained effect( Z= 2.512, P=0.006). Conclusion Different neural mechanisms are involved in sustained and transient effects of emotional memory encoding. The right amygdala is responsible for sustained effect and the left amygdala is responsible for transient effect ,respectively. The results confirm and extend the model of the left-transient/right-sustained effect.

Breast cancer is called "Ruyan" in literature of traditional Chinese medicine. We synthesized the ancient and contemporary discussions and raised the theory that "Duxie" (poisonous pathogenic factor) is the etiological factor and pathologic product through the whole course of breast cancer. "Liuyin Fudu" (latent poison of six exogenous pathogenic factors) and "Qiqing Yudu" (stagnant poison of seven emotions) are the main etiological factors affecting the breast cancer occurrence. "Aidu Neisheng" (internal product of cancer poison) is the essential change in breast cancer occurrence. "Tandu Yujie" (stagnation of phlegm, poison and blood stasis) is the essential pathogenesis of the breast cancer's development. "Yudu Weiqing" (vestigial poison) is the main pathogenesis of breast cancer after operation. "Yudu Pangcuan" (vestigial poison invasion elsewhere) is the key pathogenesis of recurrence and metastasis after operation. "Sanjie Jiedu" (dispersing accumulation and detoxification) is an important therapeutic principle in breast cancer's treatment after operation. The "Tandu Yujie" pathogenesis theory and "Sanjie Jiedu" therapeutic principle developed the theory about breast cancer in traditional Chinese medicine, and have some clinical application value.

OBJECTIVE: To observe the effect of Ruyiping, a traditional Chinese compound herbal medicine composed of 5 Chinese herbs for removing toxic materials and dissipating nodules from Runing II, another traditional Chinese compound herbal medicine for treating breast cancer, in preventing recidivation and metastasis in breast cancer patients after operation. METHODS: Eighty patients with breast cancer after operation were randomly divided into Ruyiping group and Runing II group, and prescribed Ruyiping and Runing II on the basis of chemotherapy, radiotherapy and endocrine therapy respectively for two years. RESULTS: There were two patients with metastasis and three patients lost to follow-up in Ruyiping group and three and two in Runing II group. The recidivation and metastasis rates were 5.41% and 7.89% respectively. The difference between the two groups was not statistically significant (P>0.05). The difference of disease-free survival time between the two groups was also not statistically significant. CONCLUSIONS: The effect of Ruyiping in preventing recidivation and metastasis is similar to that of Runing II. Ruyiping is the essential component of Runing II for preventing recidivation and metastasis. The result provides some clinical evidences for the theory that "Yudu Pangcuan" (vestigial poison invasion elsewhere) is the essential pathogenesis of breast cancer's recidivation and metastasis and the utilization of "Sanjie Jiedu" (dispersing accumulation and detoxification) is the therapeutic principle in preventing recidivation and metastasis after operation.

Objective To evaluate the curative methods of periampullary diverticula(PAD) complicated with biliopancreatic disease.Methods The clinical data of 32 cases of PAD complicated with biliopancreatic disease treated by surgical or endoscopic measures were retrospectively analyzed.Results Of the 32 cases,16 cases were treated with gastroectomy and Roux-en-Y gastrojejunostomy,and 8 with gastroectomy and Billroth Ⅱ gastrojejunostomy,8 with endoscopic sphincterotomy (EST).Postoperative complication occured in 4 cases,but no operative death.Twenty-seven cases were followed up for 5 months-8 years, and the results were excellent in 20 cases, good in 7 cases.Conclusions Gastroectomy and Roux-en-Y gastrojejunostomy is a better surgical method for PAD complicated with biliopancreatic disease.EST has become a new effective measure to deal with the diseases;It will be safe to use the first method for patients with intradiverticular papilla if it treated by EST.

Objective To analysis of risk factors for left atrial thrombosis in patients with rheumatic mitral stenosis.Methods From January 2001 to December 2008, 2277 patients with rheumatic mitral stenosis underwent operations in our hospital. There were 737 males and 1540 female, the age ranged from 19 to 84 years [average (50.9 ±10.2) years]. Left atrial thrombosis group (554 cases) and no thrombosis group (1723 cases) were divided, retrospectively collected data were analyzed with univariate and multivariate Logistic regression. Results 12 bvariables, including age, mitral valve orifice area, left atrial diameter, left ventricular diastole diameter, CRP, gender , degree of mitral stenosis, or regurgitation, degree of bicuspid regurgitation, degree of pulmonary hypertension, atrial fibrillation and heart function had statistic difference between two groups. With multivariate Logistic regression for these 12 factors, age, mitral valve orifice area, left atrial diameter, degree of mitral regurgitation and atrial fibrillation were found to be the affecting factors for left atrial thrombosis in patients with rheumatic mitral stenosis. Conclusion For patients with rheumatic mitral stenosis, age, mitral valve orifice area, left atrial diameter and atrial fibrillation are the risk factors for left atrial thrombosis. Mitral regurgitation is a protective factor for left atrial thrombosis.

Objective The brain volume and behavioral performance of emotional memory were measured by combining voxel-hased morphometry (VBM) and behavior to explore the morphological characters of brain regions related to the emotional enhancement effect of memory.Methods A total of 32 healthy young subjects participated in the study.The experimental processes included MR scan and behavioral performance of emotional memory the latter of which involved two phases-encoding and retrieval.Behavioral performance was recorded and the whole-brain 3D MRI data were acquired via 3.0T MR.3D MRI data were segmented by VBM5,and the wholebrain volumes of gray matter,white matter and CSF were produced.SPM5 and SPSS13.0 were used for statistical analysis of the 3D MRI data and behavioral data,respectively.Results Retrieval accuracy of the emotional pictures was higher than that of the neutral pictures ( t =5.08,P＜0.001 ),the emotional enhancement effect was significant ( Δ Pr =0.12 ± 0.01 ).Brain regions related to emotional enhancement effect included bilateral amygdala,dorsolateral prefrontal cortex,middle frontal gyrus,dorsomedial prefrontal cortex,fusiform gyms,right parahippocampus,left orbitofrontal cortex and middle cingulate gyms.Volume ratio of bilateral amygdala were related to emotion enhancement effect evidently (left:r=0.564,P＜0.01 ; right:r=0.541,P＜0.01 ).Conclusion This study morphologically confirms that brain regions,such as amygdale and prefrontal cortex,are critical structures for the enhancement of emotional memory,and further extends the findings of previous functional imaging studies.

ObjectiveTo compare the effects of preventative intra-aortic balloon pump (IABP) insertion with intra-or post-operative IABP insertion in high-risk patients undergoing coronary artery bypass grafting (CABG).MethodsFrom Jan 2008 to May 2011,one hundred and four patients received CABG or off-pump CABG (OPCABG) and IABP therapy in our hospital.The enrolled criteria of IABP insertion included left ventricular ejection fraction (EF) less than 0.40,unstable angina,AMI,left main stenosis,emergency CABG,refractory ventricular arrhythmia.Group1 included thirty eight patients with preoperative IABP insertion,thirty one for intra-operative IABP insertion ( group 2 ) and thirty four for postoperative IABP insertion ( group 3 ).The indications for IABP insertion for group 2 and 3 were unstable hemodynamics,failure to wean off cardiopulmonary bypass and low output syndrome during or after operation.Clinical data including operative mortality,ventricular fibrillation,chest drainage,hospital stay,ICU stay,ventilator supporting time,IABP supporting time,EF improvement rate,mechanical assist device and Inotropic drugs utilizations were analyzed among three groups.ResultsGroup 1 demonstrated good therapeutic results.There were significant statistic differences in operative mortality ( group 1 2.6％,group 2 12.9％,Group 3 47.1％),hospital stay[group 1 (23.6 ± 9.8) days,group 2 (21.5 ±9.7) days,group 3 (28.9 ±13.3) days],ICU stay[group 1 (2.3 ± 1.1 ) days,group 2 (3.5 ± 1.5 ) days,group 3 (5.2 ± 3.4) days],ventilator supporting time [group 1 (29.5 ± 23.0) hours,group 2 (38.7 ± 20.6) hours,group 3 (84.1 ± 48.0) hours],IABP supporting time [group 1 (77.0 ± 43.7 ) hours,group 2 ( 93.8 ± 44.8 ) hours,group 3 ( 121.5 ± 71.7 ) hours],EF improvement rate [group 1 (7.5 ± 7.2),group 2 ( 8.5 ± 7.5 ),group 3 (2.0 ± 6.7)],inotropic drugs utilization[group 1 ( 3.7 ± 4.9) days,group2 (6.2±4.6) days,group3 (10.8±5.4) days](P＜0.05).ConclusionComparing with intra- or post-operative IABP insertion,high-risk patients undergoing CABG could significantly benefit from preventative IABP insertion.Early IABP insertion was recommended for high-risk patients undergoing coronary artery bypass grafting.

Objective To investigate the effects of interventticular septal thickness (IST) on postoperative trans-aonic valve pressure after aortic valve replacement (AVR).Methods 273 patients were divided into 3 groups with different mechanical valves and postoperative trans-aortic valve pressure (TAVP).Hemodynamic parameters including left ventricular end diastolic diameter,left ventricular end systolic diameter,ejection fraction and IST were analyzed.Results There was no significant difference in left ventricular diastolic diameter,left ventricular systolic diameter and ejection fraction in three groups with different mechanical valves ( P ＞ 0.05 ).In patients with St.Jude Regent valve,preoperative IST in severe TAVP group was significantly thicker than those of moderate and mild groups ( P ＜ 0.05 ).In patients with On-x valve,preoperative IST in severe and moderate TAVP groups were thicker than that of mild group ( P ＜0.05 ).In patients with other mechanical valve,preoperative IST in severe TAVP group is greater than those of moderate and mild groups ( P ＜ 0.05 ).Conclusion Interventricular septal thickness did have positive influence on postoperative trans-aortic valve pressure after AVR.When IST was more than 13.6mm,the postoperative trans-aortic valve pressure after aortic valve replacement was higher than the IST was less than 13.6mm.When IST was thicker than 15.3mm,partial ventticular septal resection or replacement of stentless valve should be considered.

Objective:To explore the value of the logistic regression model with three-dimensional CT quantitative parameters in combination with qualitative parameters in predicting the invasiveness of pure ground glass nodules (pGGN).Methods:The clinical data and image features of 191 patients (196 lesions) with pGGN on CT confirmed as lung adenocarcinoma by pathology from April 2019 to December 2019 in Anhui Chest Hospital were retrospectively analyzed. Totally, 196 lesions were divided into atypical adenomatous hyperplasia (AAH)+adenocarcinoma in situ (AIS)+minimally invasive adenocarcinoma (MIA) group ( n=128) and invasive adenocarcinoma (IAC) group ( n=68). CT quantitative parameters included the maximum diameter, volume, average CT value and quality of pGGN, and the qualitative parameters included the intrinsic vascular changes, abnormal air-bronchogram, lobulated signs, bubble-like sign, pleura-traction sign, and fuzzy tumor-lung interface sign. The Mann-Whitney U test was used to compare the quantitative parameters and the Pearson χ 2 test was used to compare the qualitative parameters between two groups. The independent predictors of IAC and predictive probability value were screened by univariate analysis in combination with multivariate logistic regression analysis. The ROC curves were drawn to compare the diagnostic probability of logistic regression prediction probability and each single parameter. Results:There were statistically significant differences in maximum diameter [0.92(0.77,1.14) cm vs. 1.41(1.12, 1.93) cm, Z=-7.366, P<0.001], volume[0.31(0.20, 0.53) cm 3 vs. 0.88(0.41, 2.00) cm 3, Z=-6.254, P<0.001], average CT value[-571.5(-637.2, -477.0) HU vs. -418.1(-532.4, -338.5) HU, Z=-5.882, P<0.001], quality[0.14(0.09, 0.25) g vs. 0.42(0.26, 1.21) g, Z=-7.438, P<0.001], intrinsic vascular changes(23 vs. 49, χ2=55.906, P<0.001), abnormal air-bronchogram(13 vs. 30, χ2=29.908, P<0.001) and pleura-traction sign(39 vs. 32, χ2=5.291, P=0.021) between the two groups. The logistic regression analysis showed that the maximum diameter, average CT value, intrinsic vascular changes and abnormal air-bronchogram were the independent risk factors of IAC, and the odds ratio value(95%CI) were 10.624(1.275-88.522), 1.004(1.000-1.008), 3.424(1.458-8.043) and 2.993(1.114-8.043), respectively. The ROC curve demonstrated that the area under the curve, sensitivity and specificity of the logistic regression model were 0.899, 0.912, and 0.711 respectively, which were better than separate analysis results from each single parameter. Conclusion:The logistic regression model with a combination of three-dimensional CT quantitative and qualitative parameters can predict the invasiveness of pGGN better.