OBJECTIVE:To observe the efficacy and safety of rebamipide triple therapy in the treatment of gastric ulcer with bleeding. METHODS:130 patients with gastric ulcer with bleeding were randomly divided into control group(65 cases)and obser-vation group(65 cases). Control group received Omeprazole enteric-coated capsule 20 mg,orally,twice a day+Aluminum magne-sium carbonate tablet 500 mg,orally,once a day;observation group was additionally received Rebamipide tablet 0.1 g,orally,3 times a day. They were treated for 12 weeks. Clinical efficacy,remission time of belching,abdominal pain,bloating,hematemesis/hematochezia,clinical symptom score before and after treatment,rebleeding and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,remission time of symptoms and signs were significantly shorter than control group,the incidence of rebleeding was significantly lower than con-trol group,with statistical significances (P<0.05). Before treatment,there was no significant difference in the clinical symptom score (P>0.05). After treatment,the clinical symptom scores in 2 groups were significantly lower than before,and observation group was lower than control group,with statistical significances (P<0.05). And there was no significant difference in the inci-dence of adverse reactions (P>0.05). CONCLUSIONS:Rebamipide triple therapy shows obvious short-term efficacy in the treat-ment of gastric ulcer with bleeding,which can effectively improve patients'gastrointestinal symptoms,reduce rebleeding risk,and does not increase the incidence of adverse reactions.

Background and purpose:The impact of the two factors of von Willnbrang factor(vWF) and integrin?3 on tumor metastasis has not been recognized. This study was done to investigate the expression of vWF and integrin?3 in human lung cancer cell line H460,the association between the two factors and tumor metastasis effect of vWF and integrin?3 on adhesion of human lung cancer cell line H460. Methods:The expression of vWF and integrin ?3 protein was examined by immunohistochemical staining. The impact of vWF and integrin?3 on adherent effect of tumor cells was evaluated by adhesion experiment, antibody inhibiting experiment and MTT.Results:Positive expression of vWF and integrin?3 was detected in H460 human lung cancer cells. H460 human lung cancer cells were able to adhere to vWF. Using anti-integrin?3, we observed that the ability of cell adhesion to vWF was inhibited,and A Value decreased from 1.59?0.06 to 0.55?0.03(P=0.01619). Using anti-vWF, we observed cell adhesion to vWF was inhibited too and A Value decreased from 1.60?0.06 to 0.54?0.03(P=0.01598),which had the same effect when using anti-integrin?3.Conclusions:H460 human lung cancer cells are capable of producing vWF, and vWF expression contributes to metastasis by adhering to cancer cells, integrin?3 is the vWF receptor on H460 human lung cancer cells.

Objective In order to further improve the noninvasive measurement precision of human blood glucose and achieve clinical requirements,experiments were conducted to measure human blood glucose by a novel measurement method our group proposed.Methods The blood flow of the tested parts was stopped by pressure,and dynamic distribution of transmission spectra was measured by time-correlated single-photon counting (TCSPC) technology under the dual wavelength light incident.Oral glucose tolerance test (OGTT) was conducted on three human subjects,and the early arriving photons were selected by Laplace transform.Meanwhile,the human blood glucose concentration was measured using the Roche glucose meter.Results The best curve fitting was got when the Laplace parameter was 1Gs-1 (determining parameter R2=0.0922).Conclusions The experimental results showed that better measurement accuracy can be obtained by selecting appropriate Laplace parameter,and noninvasive measurement of human blood glucose under flow control of time gate was feasible.

Objective To analyze the negative experience from medical practice of medical students by Balint group case study,and to explore new approach for training doctor-patient communication skills.Methods 10 times of Balint group activities were held in Zhongshan Hospital of Fudan University,with one case each time.Grounded theory approach were applied for analyzing discussion record.Results The cases were occurred in doctor-patient interaction,teamwork,conflict between one's personal life and vocational development planning.Trigger events involved doctor-patient conflict,conflict of values,decision making problem while conffronted with incurable patients,role ambiguity,unfair treatment.Topics of discussion included emotional experience with patients,career development orientation,medical teamwork,clinical education of medical student.Conclusion Through practice of Balint group,medical students in teaching hospital can improve their awareness of complicating psycho-social problem of patients and themselves,as well as handling it.And it can improve the professional identity,professional growth and professional self-identity.

Objective To investigate the clinical characteristics and surgical management of adult presacral tumors.Methods The clinical data of 24 patients with adult presacral tumors from 2007 to 2012 were retrospectively analysed.All patients were diagnosed by digital rectal examination and imaging examination before operation.Seventeen patients with via sacrococcygeal approach,4 patients with via abdominal approach,and 3 patients with via combined abdominal and sacrococcygeal approach.Results The incision of 22 patients primary healing.There were 2 patients with postoperative incision infections,after dressing change cure.No patients died during perioperative period.Twenty patients were followed up for 3-17 months,1 patient with via abdominal approach recurrenced,and was healed after a second surgical resection.Conclusions Digital rectal examination and imaging examination are the main methods for diagnosis of adult presacral tumors.Most adult presacral tumors can be resected through sacrococcygeal route.

Objective To evaluate the comparability of the test results of two immunoassay systems based on the electrochemical luminescence and the fluorescence lateral flow immunoassay for serum procalcitonin (PCT).Methods Roche cobas system was used as the reference system,and fluorescence lateral flow immunoassay system of Shanghai Upper biotech company was used as evaluated system.A total of 141 clinical samples during November,2015 were detected by the two systems to obtain the correlation coefficient and the Kappa values at the two cutoff values(0.5,2.0 ng/ml).Results The two systems showed high correlation (Y=1.008X-0.032,r=0.995,P＜0.001) and low deviation (t=-0.230,P=0.819＞0.05) without statistic significance between two methods.Kappa values were 0.944,0.943 respectively at the two cutoff values (0.5,2.0 ng/ml).Conclusion The test results showed no significant difference between the two immunoassay systems,suggesting a consistency between them for clinical detection of PCT.All the observed indicators reached the clinical diagnostic requirements and the method of quantitative detection of PCT by fluorescence lateral flow immunoassya can be applied for the quick detection of clinical human PCT.

Objective To observe the autophagy induced by heavy ion and X-ray radiations in SW480 cells and its effect in radiation responses.Methods The cellular ultrastructure was observed with a transmission electron microscope (TEM).The autophagy vesicles were labeled by monodansylcadaverin (MDC) fluorescence.The levels of LC3 which were induced by radiation and rapamycin were measured by Western blot assay.Cell proliferation was detected by MTT assay.The invasion of SW480 colon cells was measured with a Transwell.Cell wound healing assay was used to observe the migration of SW480 colon cells.Results Heavy ion and X-ray radiation could induce autophagy in SW480 cells in a dose dependent manner i.e., the autophagy level increased along with irradiation dose (F =458.526, P ＜ 0.05) , but this induction of autophagy was inhibited by chloroquine.Rapamycin could also induce autophagy in SW480 cells and it had a synergistic effect with irradiation (F =189.393, P ＜ 0.05).The abilities of invasion, migration and proliferation of SW480 cells were reduced by irradiation and the combination treatment of irradiation and rapamycin (F =194.692, 629.917, 302.903, P ＜ 0.05) , but they were enhanced by chloroquine (F =194.692, 629.917, 302.903, P ＜ 0.05).Conclusions Ionization radiation causes cell death by inducing autophagy.

Objective To study the change characteristics of erythrocyte parameters in carriers of deletional alpha-thalassemia gene.Methods 389 patients with deletional alpha-thalassemia gene determined by the gap-PCR technique were classified into three groups based on different genotypes of alpha-thalassemia including silent thalassemia group,alpha-thalassemia trait group (265 ca-ses)and intermediate thalassemia group,and contemporaneous 188 healthy adults were randomly selected as the normal control-group(NC).The erythrocyte parameters including RBC,Hb,MCV,MCH,RDW were retrospectively analyzed and their differences were compared among aboved-mentioned groups by the analysis of variance and the multiple comparison.Results Alpha-thalasse-mia manifested by different degrees of microcyte hypochromia.There were statistically significant differences in the erythrocyte pa-rameters among various genotypes and phenotypes about erythrocyte indices(P <0.05).Moreover,the Hb,MCV and MCH values were lower than those in the control group,and had the decreasing tendency with the increase of deletedα-globin gene numbers;but the RDW value was higher than that in the control group,showing the increasing tendency,the differences had statistical siginifi-cance(P <0.05).Conclusion With the increase of deleted α-globin gene number,the characteristic of small-cell low-hemoglobin is more and more remarkable.RBC has a overall increase,while Hb,MCV and MCH have a decreasing tendency,and the heterogeneity of erythrocyte volume is increased.When MCV and MCH decreasing in high risk region,thalassemia should be highly suspected, but normal MCV and MCH can not exclude silent thalassemia and alpha-thalassemia trait.

Objective To explore the in vitro cytotoxicity of sunitinib in highly metastatic hepatocellular carcinoma cell line MHCC97-H, and the effect of it on the expression level of focal adhesion kinase (FAK). Methods MHCC97-H hepatoma cells were cultured and divided into control group and experimental (sunitinib) group. Experimental groups were added 2.5, 5,10 and 20μmol/L of sunitinib for 24, 48 and 72 hours respectively. The morphological changes were observed before and after sunitinib treatment in MHCC97-H with Giemsa stain. The inhibitory rate of proliferation in MHCC97-H was detected by MTT assay. The expressions of FAK protein before and after sunitinib treatment were detected by Western blot assay. Results Sunitinib showed the inhibitory effect on hepatoma cell line MHCC97-H. Giemsa staining showed that chromatin condensation, nuclear fragmentation, apoptotic bodies and other typical morphological features. The inhibitory rate was the most obvious in 48-h treatment group. The inhibitory rates were (0.433 ± 0.115)%, (32.863 ± 1.471)%, (49.240 ± 2.256)%, (63.797±2.707)%and (58.887±3.409)%for 2.5, 5, 10 and 20μmol/L concentration groups, and there were signifi-cant differences between groups (P<0.05). Results of Western blot assay showed that the expression levels of FAK protein were significantly reduced after different concentrations of sunitinib treatment for 48 h (P<0.05). Conclusion Sunitinib has inhibitory effect on hepatoma cell line MHCC97-H, enhances the apoptosis and decreases the the expression of FAK pro-tein.

Background and purpose:The expression of dickkopf homolog 3 gene(DKK3)is always reduced or absent in tumors,instead part of the tumor vascular endothelial expressed DKK3.vWF is a macromolecular glycoprote synthesized and released by vascular endothelial cells and megakaryocytes.However,vWF was also expressed by tumor.The relationship between these 2 factors and the occurrence of cancer is still unclear.The purpose of this study was to observe the expression of DKK3 and vWF proteins in colorectal carcinoma and determine their clinical significance through finding their association with MVD and correlation with each other.Methods:Immunohistochemistry staining was used to detect the expression of DKK3,vWF proteins and MVD in the colorectal carcinoma tissue microarrays that contained 94 colorectal carcinoma specimens.Results:The expression of DKK3 in colorectal carcinoma was lower than or nonexistent compared to that in normal tissues(P＜0.05).The expression of vWF in colorectal carcinoma was higher than that in normal tissues(P＜0.05).Expression of DKK3 and vWF in colorectal carcinoma were not correlated to the age or gender of the patients,invasive depth,or tumor locus of the colorectal carcinoma (P＞0.05).Correlations with the expression of DKK3 and vWF in colorectal carcinoma were only found with differentiation and iynphnode metastasis (P＜0.05).However,the expression of DKK3 and vWF in colorectal carcinoma was not correlated to MVD(P＞0.05).The expression of DKK3 was not correlated to the expression of vWF in coiorectal carcinoma(r=0.1310,P=0.2090).Conclusion:A lowered expression of DKK3 and higher expression of vWF may be associated with the carcinogenesis,various biological behaviors and metastasis of colorecml carcinoma.These 2 factors can be used as important biological markers for colorectal cancer.