Objective To investigate the relationship between the detection of serological antibodies of Helicobacter pylori(HP) infection and the pathological features of gastric ulcer.Methods 228 cases of patients with gastric ulcer diagnosed by endoscopic biopsy(180 cases of benign ulcer and 48 cases of malignant ulcer) were enrolled in this study from January 2015 to October 2016.All subjects were given 14C-urea breath test.The positive rates of cytotoxin associated gene A(CagA),urease A(UreA),urease B(UreB),vacuolating toxin A(VacA) and flagellin antibodies in serum were determined by immunoblotting.The relationship between serum antibody level of Hp infection and pathologic features of gastric ulcer patients were analyzed.Results HP positive rate and type Ⅰ HP positive rate in malignant gastric ulcer group were significantly higher than those in benign gastric ulcer group(P<0.05).The positive rates of CagA,UreA,UreB,VacA and flagellin antibodies were significantly higher in patients with malignant gastric ulcer than those in benign gastric ulcer group(P<0.05).The positive rates of UreA,UreB,VacA and flagellin antibodies in patients with gastric ulcer area>2.0 cm2,severe mucosal inflammatory reaction and severe inflammatory reaction activity were higher(P<0.05).Conclusion The occurrence of gastric ulcer and progression of the disease could be related to the interaction of HP virulence factors.HP serological antibodies detection could help to classify patients with HP-positive gastric ulcer and formulate targeted prevention and treatment plan.

Objective To explore the effect of parenting style and behavior on children with allergic asthma.Methods From July to December in 2016,a total of 60 children with allergic asthma,who were from Jiangsu Province Hospital of Traditional Chinese Medicine and Jiangsu Research Institute of Traditional Chinese Medicine,were selected as the asthma group.Another 60 normal children from kindergarten and primary school were selected as the healthy group.Achenbach child behavior checklist (CBCL) and parenting style questionnaire were used to evaluate the behavior and parenting style of the two groups.The Fractional exhaled nitric oxide (FeNO) of the two groups were also collected.Results (1) The scores of dotage,autocracy,inconsistence of parenting style in asthma group ((14.95±4.95),(22.23±4.69),(13.43±3.80))were higher than those in healthy group((11.68±3.69),(16.47±4.16),(11.07±3.32))and the differences were significant (all P＜0.05).The scores of democracy,indulgence in asthma group ((38.92 ± 5.37),(18.12± 4.54)) were lower than those in healthy group((41.35±3.62),(19.88±3.41)),and the differences were statistically significant(all P＜0.05).(2) The scores of attention,socialization,aggression and withdrawal of child behavior in asthma group ((7.35±3.55),(3.85±2.17),(11.57±5.30),(3.40±2.65))were higher than those in healthy group((3.38±2.81),(2.52± 1.52),(6.98±4.77),(2.02± 1.63)),the differences were statistically significant(all P＜0.01).There was no significant difference between the two groups in the dimension of discipline(P＞0.05).(3) The FeNO index of asthma group((32.27± 14.27) × 10-9 mol/L) was higher than that of healthy group ((11.10± 1.88) × 10-9 mol/L) and the differences were statistically significant (P＜0.01).(4)Logistic regression analysis showed that the attention(B=0.38,OR=1.47,95％ CI =1.27-1.70,P＜0.01),dotage(B=0.19,OR=1.20,95％ CI =1.06-1.37,P＜0.01) and autocracy(B=0.24,OR=1.27,95％ CI =1.14-1.42,P＜0.01)had significant effects on allergic asthma.Conclusion Attention,dotage and autocracy are the risk factors to influence the control level of allergic asthma.This should arouse the attention of clinicians and parents.

Objective To detect the tissue stiffness of liver lesions by using acoustic radiation force impulse imaging (ARFI) and to evaluate the clinical value on the characteristics of liver lesions.Methods ARFI was perforrned in 91 patients with 103 liver lesions (56 benign,48 malignant).Tbe elastographic images of virtual touch tissue imaging (VTI) and the values of virtual touch tissue quantification (VTQ) were analyzed.The area under the curve and cutoff value for VTQ value were used to assess diagnostic performance.Results On the elastographic images of VTI,79.17 ％ (31/55) malignant liver lesions and 56.36 ％ (38/48) benign liver lesions appeared stiffer compared with the surrounding liver parenchyma.There was statistical difference between malignant and benign liver lesions (x2 =0.627,P ＜ 0.01).The VTQ values of malignant and benign liver lesions were (2.64±0.65) m/s and (1.72±0.39) m/s,respectively,and there was statistical difference between them (t =8.638,P ＜ 0.01).With a cutoff value of 2.10 m/s for VTQ value,the sensitivity and specificity of diagnosis for liver malignancy were 83.3 ％ and 81.8 ％,respectively.Conclusion ARFI can provide information of the tissue stiffuess in live lesions,which is helpful in the differentiation between benign and malignant liver lesions and might become the imaging modality in the future.

Objective To investigate the clinical efficacy of transumbilical single-incision retrograde laparoscopic cholecystectomy.Me,otis The clinical data of 979 patients with gallbladder diseases who were admitted to the Shengjing Hospital of China Medical University from May 2009 to December 2012 were retrospectively analyzed.The numbers of patients who were admitted in the year of 2009,2010,2011 and 2012 were 51,265,374,289,respectively.The preoperative preparation of transumbilical single-incision retrograde laparoscopic cholecystectomy was similar to that of traditional multi-portal laparoscopic surgery.During the operation,the umbilical incision was selected.After the body and bottom of the gallbladder was dissociated,the cystic duct of gallbladder was dissociated and straightened,which was vertical to the common bile duct.After clipping the proximal part of the cystic duct of gallbladder with 2 hem-o-lock clips,the cystic duct was cut off with the ultrasonic knife,and then the gallbladder was removed.Postoperative nursing was also similar to that of traditional laparoscopic cholecystectomy.Patients were followed up via phone call or out-patient examination till March 2013.The wound infection,incisional hernia,incisional pain,cosmetic benefits were observed.Results No patient was converted to open surgery.Twenty patients were converted to multi-portal laparoscopic cholecystectomy because of severe inflammation (3 patients in 2009,5 in 2010,5 in 2011 and 7 in 2012).The mean operation time and volume of blood loss of the 959 patients were 48.5 minutes and (27 ± 25) mL.The operation time in 2009,2010,2011 and 2012 were 51.8 minutes,49.2 minutes,48.9 minutes and 46.7 minutes.The volumes of blood loss in 2009,2010,2011 and 2012 were 35.0 mL,32.1 mL,33.8 mL and 22.9 mL,respectively.The postoperative pain was slight.Forty-seven patients were administered antalgesics (5 in 2009,12 in 2010,18 in 2011 and 12 in 2012).In the 959 patients,umbilical swelling occurred in 4 patients,and was cured by disinfection treatment.Bile duct injury occurred in 3 patients from 2010 to 2011,timely repair wad done in 2 patients,and 1 was cured by drainage.The mean time of postoperative exhuast time and duration of hospital stay were 2.2 days and 4.2 days.A total of 924 patients were followed up for 1-3 months.The scar was hidden in the navel,and no incisional hernia occurred.Conclusion Transumbilical single-incision retrograde laparoscopic cholecystectomy is safe and effective with cosmetic benefits.

Objective To investigate the clinical value of hand-sewn ileal pouch anal anastomosis (HIPAA) for the treatment of ulcerative colitis.Methods The clinical data of 191 patients with ulcerative colitis who were admitted to the General Hospital of Tianjin Medical University from January 1989 to December 2013 were retrospectively analyzed.All the patients received proctocolectomy and open or laparoscopic HIPAA.Patients were followed up by questionnaire at postoperative month 3 and 12.The function of pouch was evaluated according to the defecation frequency per 24 hours and per night,Bristol scale stool form and Kirwan classification.The quality of life was assessed according to the Cleveland global quality of life (CGQL).Patients were followed up till April 2014.The independent samples were compared by t test,and data from multiple groups were compared by analysis of variance,pairwise comparison was done by LSD-t test,and the count data were analyzed using the chi-square test.Results Of the 191 patients,180 received open surgery and 11 received laparoscopic surgery.Nine patients were treated by one-stage surgery,175 by two-stage surgery and 7 by three-stage surgery.The pouches of 181 patients were J shape,9 were H shape and 1 was W shape.No patient died perioperatively.Eight patients had abdominal infection and 7 had incisional infection at early period after the operation,and they were cured by antibiotics.Four patients had pouch anastomotic bleeding and 4 had anastomotic leakage at postoperative week 1-2,and they were cured by local hemostasis or titanium clipping.Six patients had high intestinal obstruction,and they were alleviated by symptomatic treatment.Eight patients had inflammation of pouch,and they were alleviated by diet adjustment or antibiotics treatment.Two patients had sexual dysfunction.All the patients were followed up for 1-25 years.The function of the pouch was improved gradually.At postoperative month 12,the defecation frequencies were (3.7 ± 1.4)/24 hours and (1.3 ±0.5)/night,and the number of patients with type Ⅳ (Bristol classification),type Ⅴ,type Ⅵ and in grade Ⅰ (Kirwan classification),grade Ⅱ,grade Ⅲ were 107,76,8 and 177,8,6,respectively,which were significantly improved when compared with (6.5 ±2.8)/24 hours,(2.9 ± 1.5)/night,86,89,16 and 160,19,12 at postoperative month 3 (t =12.36,3.98,x2=7.76,29.27,P＜ 0.05).The CGQL indexes before operation and at postoperative month 3 and 12 were 0.37 ±0.19,0.67 ±0.16 and 0.82 ±0.13,respectively,with significant differences (F =6.011,P ＜0.05).There were significant differences between the CGQL indexes before operation and at postoperative 12 and 3 months (t =16.69,10.06,P ＜ 0.05).A significant difference was also observed between the CGQL indexes before operation and at postoperative 12 months (t =27.01,P ＜ 0.05).Conclusions HIPAA is suitable for the surgical treatment of ulcerative colitis.The function of the pouch is good and the quality of life is improved.

Objective To observe the effects of blood pressure by intravenous infusion of different doses ofoxytocin in cesarean section.Methods Sixty full-term pregnant women undergoing cesarean section with continuous epidural anesthesia were divided into three groups by random digits table method with 20 cases each:group A,B and C.Three groups were injected 10 U oxytocin in uterine muscle after infant delivery.Group A,B and C received 5,10 and 20 U oxytocin (sodium lactate ringer,500 ml) continuous intravenous infusion at the speed of 10 ml/min.If happened uterine contractions bad,they were sublingual administering 0.2 mg misoprostol.If happened severe hypotension,they were intravenous injected 5 mg ephedrine.The change of mean arterial pressure (MAP) and heat rate before anesthesia (T0),after fetal childbirth (T1),5 m in (T2),10 min (T3),30 min (T4) after infusion of oxytocin and the dosage of ephedrine and misoprostol were recorded.Results There were no significant differences in MAP and heart rate at every time point between group A and B (P＞ 0.05).MAP decreased and heart rate increased in group C at T2,T3 compared with those in group A and B,and there were significant differences (P＜ 0.05).The number of cases of sublingual misoprostol were increased in group A (7 cases) compared with that in group B (2 cases) and group C(1 case).The 8 patients injected ephedrine in group C were more than group A(1 case) and group B (3 cases).Conclusion Cesarean section after the delivery of the fetus in the uterus muscle injection of oxytocin 10 U,after 10 U of oxytocin added 500 ml sodium lactate ringer injection at the speed of 10 ml/min intravenous infusion has little effect on the blood pressure and heart rate,and has good uterine contractions.

Objective To study the pro-invasive effect of irradiation on human glioblastoma cell line U87 and its possible mechanism.Methods Cultured U87 cells received different doses of irradiation (0,2,and 4 Gy).The change in cellular invasiveness was measured using the real-time cell analyzer system.The activities of matrix metalloproteinase-2 (MMP2) and matrix metalloproteinase-9 (MMP9) in U87 ceils were measured by gelatin zymography before and after irradiation.The content and distribution of intracellular β-catenin after irradiation were determined by immunohistochemistry.The mRNA levels of Wnt/β-catenin target genes were measured by real-time quantitative PCR.Results After irradiation,the invasiveness of U87 cells increased significantly (P ＜ 0.01),which was dose-dependent within a certain dose range; the activities of MMP2 and MMP9 in U87 cells increased significantly (P =0.031 for MMP2 ; P =0.004 for MMP9) ;the content of β-catenin in U87 cells increased significantly (P ＜ 0.01),with translocation from the cell membrane and adherens junctions to the nucleus; the mRNA levels of Wnt/β-catenin-related genes (FZD7 and TCF1) increased significantly (P ＜ 0.01),and the transcription of Wnt/β-catenin target genes,especially those related to migration and invasion such as MMP2,MMP7,MMP9,and CD44,was significantly enhanced (P ＜ 0.05).Conclusions Irradiation can promote the invasion of glioblastoma U87 cells,possibly by activating the Wnt/β-catenin pathway and enhancing the transcription of migration-and invasion-related genes.

OBJECTIVE:To establish the purity determination of bisacodyl by differential scanning calorimetry(DSC)and the valuation of uncertainty. METHODS:DSC was conducted to detect the purity of bisacodyl and determine the optimal testing condi-tions. According to related standards,indium enthalpy change values,measurement repeatability,weighing process,instrument tem-perature deviation and system software deviation were systematically analyzed. The results were verified by HPLC. RESULTS:When the fiducial probability P was 0.95,the standard value and uncertainty of content of bisacodyl was (99.88 ± 0.06)% mea-sured by DSC. Weighing process,instrument temperature deviation and system software deviation had great effects on the total un-certainty. The result of HPLC and DSC were the same. CONCLUSIONS:The established DSC can quickly and accurately determine the chemical purity of bisacodyl. The uncertainty evaluation is reliable. Regularly calibrated and verificated equipment and strict con-trol of the weighing process will help to improve the accuracy measured by DSC;and it provides a new analysis method for the de-termination of purity of bisacodyl.

Objective To explore the clinical application value of blood routine examination in judgment of the activity of inflammatory bowel diseases.Methods 102 patients with inflammatory bowel disease were selected as the main research objects,60 healthy persons in the same period were selected as the control group,all of the subjects were received routine testing of blood,C-reactive protein and erythrocyte sedimentation rate,and the relationships between disease and blood routine indexes were compared.Results In UC group,the PLT,WBC RDW index levels of remission were higher than those of the control group,the differences were statistically significant(t =6.75,8.21,5.73,all P ＜0.05).In patients with UC,the HGB,HCTand MPV index levels were lower than those in the remission patients and the control group,the differences were statistically significant(t =8.12,11.03,6.72,9.35,10.23,8.71,all P ＜0.05).But the PLT index was higher than that of patients in remission,the RDW and WBC indexes were higher than those in the control group and the remission period,there were statistically significant differences (t =7.59,8.51,6.03,all P ＜ 0.05).The routine blood indexes of the relief patients of CD group had significant differences compared with the control group(t =6.17,7.29,9.01,10.35,8.27,7.69,8.01,9.91,allP ＜ 0.05),the HCT,MCV,HGB and MPV indexes were lower than those of the control group,the differences were statistically significant (t =9.01,10.35,8.27,9.9i,all P ＜ 0.05),the WBC,PLT,N and RDW indexes were higher than those of the control group,the differences were statistically significant (t =6.17,7.29,7.69,8.01,all P ＜ 0.05).In UC group,the HGB,HCT,MCV and MPV indexes were lower than those in the remission patients and the control group,there were statistically significant differences(t =8.19,6.97,7.53,9.02,all P ＜ 0.05).But the PLT,RDW,WBC and N indexes were higher than those in the remission patients and the control group,the differences were statistically significant (t =9.81,7.94,8.36,7.61,P ＜ 0.05).In the active patients of CD group,the WBC and N indexes were significantly higher than those of UC group,the differences were statistically significant (t =8.15,9.07,all P ＜ 0.05).In the remission patients of CD group,the PLT index was significandy higher than that in the remission patients of UC group,the difference was statistically significant (t =10.35,P ＜ 0.05).Conclusion Indexes of blood routine has obvious significance in activity of inflammatory bowel disease,and it is significant correlation with inflammation index,which can be used as one of the routine clinical method to determine the activity of inflammatory bowel diseases.

Objective:To compare the value of new gastric cancer screening scoring system and serum pepsinogen (PG) combined with gastrin-17 (G-17) (new ABC method) in screening gastric cancer and precancerous lesions.Methods:A total of 576 patients were enrolled after the examination of endoscopy at Endoscopy Center,Department of Gastroenterology,from December 2017 to December 2019. There were 275 males and 301 females with an age of 40-72 (52±10) years. According to the new ABC method and the new gastric cancer screening scoring system, the population was divided into three groups according to age,gender,serum helicobacter pylori antibody test, PG Ⅰ/PG Ⅱ(PGR) and G-17 before endoscopy. The detection rates of gastric cancer and atrophic gastritis by two different methods were analyzed and the value in screening gastric cancer and precancerous lesions were evaluated. Statistical analysis was accomplished by Chi-square test and Gamma coefficient analysis. Results:A total of 576 patients were enrolled. According to the new ABC method, 382 patients were classified into low-risk group, 170 patients into middle-risk group and 24 patients into high-risk group, respectively. In the new ABC method, 1 case of gastric cancer (0.3%) was detected in low-risk group, 8 cases (4.7%) in middle-risk group and 3 cases (12.5%) in high-risk group. As for atrophic gastritis, 89 cases (23.3%) was detected in low-risk group, 94 cases (55.3%) in middle-risk group and 18 cases (75.0%) in high-risk group. According to the new gastric cancer screening scoring system, 336 patients were classified into low-risk group, 205 patients into middle-risk group and 35 patients into high-risk group, respectively. One case of gastric cancer (0.3%) was detected in low-risk group, 6 cases (2.9%) in middle-risk group and 5 cases (14.3%) in high-risk group. As for atrophic gastritis, 41 cases (12.2%) were detected in low-risk group, 134 cases (65.4%) in middle-risk group and 26 cases (74.3%) in high-risk group. In this two methods, the prevalence of gastric cancer increased according to the disease stage ( χ2 =22.509, P<0.01; χ2=24.156, P<0.01); in terms of atrophic gastritis, the detection rate of the new screening scoring system in the low-risk group was significantly lower than that in the new ABC method ( χ2=14.844, P<0.01), but higher in the middle-risk group ( χ2=3.955, P=0.047). Gamma coefficient test showed that there were strong correlations between gastroscopy pathology and classification grade of both methods ( P<0.01). Conclusions:Both methods are suitable for screening gastric cancer and precancerous lesions, and the new scoring system may be more valuable in screening gastric cancer and precancerous lesions.