Acute non-variceal upper gastrointestinal bleeding (ANVUGIB)is one of the most common medical emergencies in China and worldwide. In 2009,we have issued the Guidelines for the diagnosis and treatment of acute non-variceal upper gastrointestinal bleedingin China;however,numerous studies on the diagnosis and treatment of ANVUGIB have been conducted in the past years,and the management of ANVUGIB needs to be updated. Finally,the 2015 version of Guidelines for the diagnosis and treatment of acute non-variceal upper gastrointestinal bleedingwas issued. We hope to provide information and help for understanding the new guidelines by clinicians.

Arthritis, Juvenile ; diagnosis ; therapy ; Humans ; Practice Guidelines as Topic

Objective To investigate the effect of intranasal instillation of insulin with different doses on cognitive function in patients with Alzheimer disease (AD).Methods Sixty-three AD patients were collectcd.According to the order of doctor's office visiting,they were divided into insulin 1 group (21 cases,intranasal instillation of insulin 20 U,2 times per day),insulin 2 group (21 cases,intranasal instillation of insulin 40 U,2 times per day) and placebo group (21 cases,intranasal instillation of physiological saline,2 times per day).Mini-mental state examination scale (MMSE) and Rivermead behavioural memory test second edition (RBMT Ⅱ) were used to evaluate the improvement of cognitive function after 3 months and 6 months.Results Before treatment,the scores of MMSE and RBMT Ⅱ in insulin 1 group were (20.2 ± 2.3) and (17.2 ± 1.9) scores,in insulin 2 group were (20.7 ± 2.8) and (16.5 ± 1.9) scores.After treatment for 3 months,the scores of MMSE and RBMT Ⅱ in insulin 1 group were (21.8 ± 3.2) and (19.2 ± 2.0) scores,in insulin 2 group were (21.6 ± 3.5) and (18.1 ± 2.0) scores.The scores of MMSE and RBMT Ⅱ in insulin 1 group and insulin 2 group significantly improved compared with those before treatment (P ＜ 0.05 or ＜ 0.01).But the scores of MMSE and RBMT Ⅱ in placebo group were significantly aggravated,(18.9 ± 3.8) scores vs.(20.9 ± 2.5) scores,(15.2 ± 2.1) scores vs.(16.1 ± 2.0) scores,P ＜ 0.05.After treatment for 6 months,the scores of MMSE and RBMT Ⅱ in insulin 1 group were (22.5 ± 3.3) and (20.5 ± 2.0) scores,in insulin 2 group were (22.7 ± 3.1) and(19.8 ± 1.9) scores,and in placebo group were (17.9 ± 4.5) and(14.7 ± 2.0) scores.The scores of MMSE and RBMT Ⅱ in insulin 1 group and insulin 2 group were significantly better than those in placebo group (P ＜ 0.01).Conclusion Intranasal instillation of insulin can improve cognitive disorders in patients with AD.

The centrosome plays a crucial role in the maintaining of cell conformation,mitosis and chromosome seg-regation.It responds to the DNA damage and keeps the genome stability via cross-talking with the intranuclear DNA damage repair system.The apoptosis of tumor cells can be induced through inhibition of the duplication of centro-some.So the inhibitors of centrosomal proteins will be a potential anti-tumor therapy.

Objective To study the clinical effect of minimally invasive treatment of 24 patients with hemor-rhagic moyamoya disease.Methods The clinical features of onset,bleeding location of the lesions and the type,ther-apeutic results of minimally invasive treatment were studied retrospectively.Results 24 patients with hemorrhagic moyamoya disease spontaneous intracerebral hematoma who need to acutely remove the hematoma were examined by CT angiography ( CTA) .Emergency minimal invasive puncture was performed according to the result of CTA,and the role of CTA in operation was analyzed.In all 24 patients,most of them were cerebral hemorrhage breaking into ventri-cles,5 cases with intracranial aneurysm.In all the hemisphere of hemorrhage,dilatation and abnormal branching of the AchA and P-CoM were observed in 9 patients,superficial temporal artery.Conclusion Minimally invasive treat-ment of hemorrhagic moyamoya disease scheme is simple,practical and effective,the maneuverability is strong.

Objeetive To investigate the relationship between 24-hour blood pressure rhythm and carotid scleratheroma in elderly patients with hypertension.Methods 193 elderly patients with hypertension were enrolled in the study and divided into study group (91 cases with carotid atherosclerosis) and control group (102 cases).All the patients were given 24h blood pressure rhythm examination.The characteristics of 24hour blood pressure rhythm was compared between the two groups.Results The 24h average systolic blood pressure(24h-SBP),24h average diastolic blood pressure (24h-DBP),24h average pulse pressure (24h-MBP) between the study group and the control group had no significant differences(P ＞ 0.05).The daytime average systolic blood pressure(d-SBP),diurnal mean diastolic blood pressure (d-DBP),diurnal average pulse pressure (d-MBP),nocturnal mean systolic blood pressure (n-SBP),nocturnal mean diastolic blood pressure(n-DBP),nocturnal mean pulse pressure(n-MBP) of the study group were significantly higher than those of the control group (t =16.92,24.68,6.16,12.87,11.59,6.35,all P ＜0.05).In study group,d-SBP,d-DBP,d-MBP were higher than n-SBP,n-DBP,n-MBP,the differences were statistically significant(F =73.61,P ＜ 0.01).The circadian blood pressure variability of the study group was more than 10％,the 24h ambulatory blood pressure curve graph of the study group was non-dipper curve.The circadian blood pressure variability of the control group was less than 5％,the 24h ambulatory blood pressure curve was dipper type curve.Conclusion The MBPS is strongly associated with carotid scleratheroma,and clinical treatment and study could derive from ABPM data analysis.

Choroidal neovascularization (CNV) is the key characteristic of neovascular age-related macular degeneration (nAMD),and the effective therapy is intravitreal injection of anti vascular endothelial growth factor (VEGF) agents based on clinical and basic research.In the meantime the challenge is how to further improve the inhibiting effect for CNV and visual function of anti-VEGF treatment on nAMD.The new strategy and drug delivery devices for anti-VEGF treatment will optimize the clinical scheme.From bench to bedside,the research on targeted treatment of angiogenesis brings the bloom of nAMD medical therapy.

Cancer-related fatigue survivors have been found to have lower morning serum cortisol levels, flattened diurnal cortisol cy-cles, and decreased cortisol responses to psychological stress. The mechanism may be related to the inflammation caused by disorder of hy-pothalamus-pituitary-adrenal axis, and there are also some evidences to support that cortisol can be used to reduce cancer-related fatigue. This study introduced the research progress of the relationship between cancer-related fatigue and hypothalamus-pituitary-adrenal axis.

Objective:To evaluate therapeutic effect and safety of rosuvastatin on patients with hyperlipidemia com‐plicated hyperuricemia .Methods :A total of 88 patients with hyperlipidemia complicated hyperuricemia ,who were hospitalized in our hospital ,were selected ,randomly and equally divided into rosuvastatin group (10 mg/d) and atorvastatin group (20 mg/d) ,both groups were treated for eight weeks .Changes of levels of blood lipids and serum uric acid (SUA) were observed and compared between two groups before and after treatment .Results:Compared with before treatment ,after eight -week treatment ,there were significant reductions in levels of blood lipids (ex‐cept high density lipoprotein cholesterol ) and SUA in both groups , P<0.01 all;compared with atorvastatin group after treatment ,there were significant reductions in levels of total cholesterol [ (4.87 ± 0.47) mmol/L vs .(4.48 ± 0.53) mmol/L] in rosuvastatin group (P=0.04) ,and there was no significant difference in SUA level between two groups , P>0.05. There were all no more serious side effects in both groups .Conclusion:While reducing blood lipid levels ,rosuvastatin can also reduce serum uric acid level in patients with hyperlipidemia ,and it possesses good safety and tolerance .