Background:Nonvariceal vascular upper gastrointestinal bleeding is a special type of nonvariceal upper gastrointestinal bleeding (NVUGIB) with serious disease course and high mortality rate, which should be paid more attention by clinicians.Aims:To explore the etiological factors and therapeutic strategies of vascular NVUGIB for improving the diagnosis and treatment of the disease.Methods:Clinical data of 111 cases of vascular NVUGIB admitted from Jan.2012 to Dec.2016 at Daping Hospital, the Third Military Medical University were retrospectively analyzed.All cases were diagnosed by gastroscopy, abdominal CT or angiography.Results:One hundred and five patients underwent a gastroscopy within 24 hours of hospital admission.The major causes of bleeding were peptic ulcer involving blood vessels (62.2%) and vascular malformation (22.5%);other causes included Dieulafoy disease, gastrointestinal stromal tumor, malignant tumor, intra-abdominal infection, trauma and gastric angiotelectasis.Seventy-eight patients (70.3%) received endoscopic hemostasis, 19 received conservative medical therapy only, 13 were treated by interventional embolization and 5 underwent surgical operation.Hemostasis was achieved in 96.4% of the patients (107 cases);in four deceased, 3 were failures of endoscopic and interventional therapies.Conclusions:Peptic ulcer and vascular malformation are the major causes of vascular NVUGIB.Endoscopic therapy has generally been recommended as the first-line treatment, however, interventional embolization or surgical operation should be used directly if necessary.

OBJECTIVE: To explore the effects of different analgesia methods after UPPP. METHOD: Ninety cases of patients uvulopalatopharyngoplasty were divided into 3 groups randomly, and 30 cases in each group. The group A was the blank control group without any analgesia measures. The cases in group B were treated with intramuscular injection of parecoxib sodium 40 mg after surgery immediately, and continued injecting 40 mg after 12 hours, 24 hours and 36 hours respectively. 100 mg tramadol replaced 40 mg parecoxib sodium in group C. The VAS scoring was performed after surgery 12, 24, 36, 48, 72, 96 hours in 3 groups, and we observed adverse reaction such as lethargy, nausea, vomiting, dizziness, skin rash and so on. RESULT: The group B and C reduced the pain significantly compared with blank control group. The pain scores in group B were significantly decreased than that in group C (P<. 05). CONCLUSION The analgesic effect of parecoxib sodium after UPPP is significant and better than tramadol. It is worthy to use widely in clinical due to its better effect and less side effect.
Analgesia ; methods ; Analgesics ; therapeutic use ; Humans ; Injections, Intramuscular ; Isoxazoles ; therapeutic use ; Pain Measurement ; Pain, Postoperative ; Palate ; surgery ; Pharynx ; surgery ; Tramadol ; therapeutic use ; Uvula ; surgery

Objective To establish rabbit model of remnant carcinoma after RFA therapy, and to observe pathomorphological changes of remnant carcinoma in different time. Methods Forty-eight New Zealand white rabbits underwent ultrasound-guided percutaneous inoculation with VX2 carcinoma, then RFA therapy was performed to made models of remnant carcinoma. These models were averagely divided into 6 groups randomly (each n=8). Rabbits in each group was killed and pathologically observed before RFA and 1 d, 3 d, 1 week, 2 and 3 weeks after operation, respectively. Results The expression of MVD,VEGF and PCNA in remnant VX2 carcinomas tissues decreased significantly, but increased 2-3 weeks after RFA. The remnant VX2 carcinomas tissues were in inhibitory state 2 weeks after RFA. Conclusion The growth of remnant carcinoma could be inhibited in short term after RFA. Further therapy is necessary.

OBJECTIVE: To observe the effect of acupuncture at "Baihui" (GV 20), "Zhongwan" (CV 12) and "Zusanli" (ST 36) on intestinal flora in rats with stress gastric ulcer (SGU) , and to explore the mechanism of acupuncture promoting SGU recovery. METHODS: Thirty-one SPF SD rats were randomly divided into a control group (7 rats), a model control group (8 rats), an acupuncture group (8 rats) and a medication group (8 rats). The rats in the model group, acupuncture group and medication group were selected to applied the improved restraint water-immersion stress method to establish the SGU model. After modeling, the rats in the control group and model group were fixed and restrained for 20 min every day for a total of 5 days; the rats in the acupuncture group were intervented with acupuncture at "Baihui" (GV 20), "Zhongwan" (CV 12) and "Zusanli" (ST 36), once a day, 20 min each time, and twisting needle for 30 s every 5 min for a total of 5 days; the rats in the medication group were gavaged by solution of omeprazole enteric-coated tablet (200 mg/mL), 2 mL for each rat, once a day. Guth method was used to calculate the gastric mucosal damage index (GMDI), HE staining was used to observe the pathological changes of gastric mucosa, and 16SrDNA identification was used to detect the structural abundance of intestinal flora. RESULTS: Compared with the control group, the GMDI of rats in the model group was increased (<0.01), the gastric mucosal pathological changes were significant, and the intestinal flora richness index Chao1, Observed species and diversity index Shannon were all decreased (<0.05), the diversity index Simpson was increased (<0.05). Compared with the model group, the GMDI of rats in the acupuncture group and medication group was reduced (<0.01, <0.05), the gastric mucosal damage degree was reduced, and the intestinal flora richness index Chao1, Observed species and diversity index Shannon were all increased (<0.05) and the diversity index Simpson decreased (<0.05). Compared with the medication group, the GMDI of rats in the acupuncture group was reduced (<0.01), the recovery of gastric mucosal injury was better than that of the medication group. CONCLUSION Acupuncture can effectively improve gastric mucosal injury of SGU, and the mechanism may be related to increasing the diversity of intestinal flora and promoting the correction of the disordered intestinal flora.
Acupuncture Points ; Acupuncture Therapy ; Animals ; Gastrointestinal Microbiome ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Stomach Ulcer ; microbiology ; therapy