Objective:To explore the effects of different courses of Bifidobacterium combined with bismuth on the eradication rate, ulcer healing rate and adverse reactions in the initial eradication treatment of Helicobacter pylori positive gastric ulcer patients.Methods:From September 2018 to September 2021, 219 patients with gastric ulcer were selected from the outpatient department of gastroenterology department of Kailuan General Hospital Affiliated,all of whom were positive for 13C or 14C-urea breath test and were not treated with Helicobacter pylori eradication. Group A, B and C were randomly divided by Excel, Group A was the control group (73 patients): 14-day bismuth quadruple therapy (Eprazole + colloidal bismuth pectin + amoxicillin + furazolidone); group B (73 patients): 7 days Bifidobacterium tetravaccine tablets (live) was given in the second week of treatment in group A; group C (73 patients): Bifidobacterium tetravaccine tablets (live) was given 14 days on the basis of treatment in group A. 13C or 14C-urea breath test and gastroscope were reexamined after all treatments, to compare the eradication rate, ulcer healing rate and the incidence of adverse reactions.Results:The eradication rates in three groups were 90.8%(59/65), 91.2% (62/68)and 91.0%(61/67) respectively, there was no significant difference among the three groups (χ 2=0.01, P=0.997). The ulcer healing rate in three groups were 93.8%(61/65), 94.1%(64/68) and 95.5%(64/67) respectively, group B and group C were compared with group A, and the difference was not statistically significant(group B: group A P=1.000, group C: group A P=0.716).The incidence of adverse reactions in three groups was 21.4%(15/70), 7.1%(5/70) and 7.0%(5/71) respectively, the difference was statistically significant (χ 2=9.21, P=0.010). The incidence of adverse reactions in group B and C was significantly lower than that in group A (group B: group A χ 2=5.83, P=0.016; group C: groups A χ 2=5.99, P=0.014). Compare means of measurement data among the three groups use analysis of variance. Chi square test, Fisher exact probability method and split chi square test were used to compare the three groups of counting data. Conclusion:14-day Bifidobacterium tetravaccine tablets (live) and the second half of the treatment lasted for 7-day Bifidobacterium Bifidobacterium tetravaccine tablets (live), they are combined separately with bismuth quadruple therapy in the first eradication of Helicobacter pylori positive gastric ulcer patients can significantly reduce adverse reactions, but Bifidobacterium tetravaccine tablets (live) could not significantly improve the eradication rate, and had no promoting effect on the healing of gastric ulcer.

Objective:To explore the effect of the eradication rate and adverse reactions of different courses of Bifidobacterium combined with quadruple therapy containing furazolidone and tetracycline for rescue eradication of Helicobacter pylori.Methods:From December 2016 to May 2019, 348 patients with chronic gastritis who failed to eradicate Hp for the first time were selected from the outpatient department of digestive medicine of Kailuan General Hospital affiliated to North China University of Technology.Group A, B and C were randomly divided by Excel, Group A(116 patients): 14-day quadruple therapy (Eprazole+ colloidal bismuth pectin+ furazolidone + tetracycline); group B(116 patients): Bifidobacterium was given 14 days on the basis of treatment in group A; group C(116 patients): 7 days Bifidobacterium was given in the second week of treatment in group A 4 weeks after the end of eradication treatment, 14 C urea breath test was reexamined, to compare the eradication rate and the incidence of adverse reactions.Results:The eradication rates were 80.2%, 84.5% and 82.3% respectively according to intention treatment.The eradication rates were 88.6%, 90.7% and 89.7%, respectively according to perprotocol.There was no significant difference between the three groups(according to intention to treat analysis: χ 2=0.755, P=0.685; according to the perprotocol analysis: χ 2=0.271, P=0.873). The incidence of adverse reactions in three groups was 16.4%, 6.3% and 7.3% respectively, the difference was statistically significant(χ 2=7.561, P=0.023). Group B was significantly lower than group A(χ 2=5.570, P=0.017), the difference was statistically significant, but there was no statistically significant difference between group C and group A(χ 2=4.362, P=0.037). Conclusion:After 14 days of Bifidobacterium tetrad live tablet assisted with tetrad therapy containing furazolidone and tetracycline, the adverse reactions could be significantly reduced, but Bifidobacterium could not significantly improve the eradication rate.

Objective:To investigate the clinical application value of qualitative and quantitative analysis of Sonazoid contrast-enhanced ultrasound(CEUS)in the 4 category of breast lesions of the Breast Imaging Reporting and Data System(BI-RADS)of diagnosis.Methods:A total of 53 patients with breast lesions(All 53 lesions were BI-RADS 4 category)who underwent biopsy or surgery in Chengdu First People's Hospital from April 2022 to April 2023 were selected.According to the pathological results of breast nodules,they were respectively divided into benign and malignant groups.All patients had underwent Sonazoid CEUS before biopsy or surgery.The differences of the qualitative and quantitative indexes of the breast nodules CEUS between benign and malignant groups were compared.The indexes with statistical significances were fitted into regression equation.And then,the receiver operating characteristic(ROC)curves were drawn for obtaining area under curve(AUC).The differences of enhanced strengths of breast nodules and surrounding normal tissues in CEUS were coded to intuitive color images,and generated dynamic vascular model(DVP)parameter picture by using Sonoliver software.The differences of image colors between benign and malignant breast nodules were analyzed.Results:According to the results of biopsy or surgical pathology,the 53 breast nodules were respectively divided into benign group(34 cases)and malignant group(19 cases).In qualitative indexes of Sonazoid-CEUS for breast nodules,the most appearance of the malignant nodules showed 13 cases were the enlargement of enhancement range(68.4%),and 14 cases were uneven enhancement(73.7%)and 12 cases were peripheral perforating blood flow(63.2%),and the differences of them between benign and malignant group were statistically significant(x2=10.268,9.642,5.717,P＜0.05),respectively.In the quantitative index of Sonazoid-CEUS for breast nodules,the rise time(RT)and mean transition time(mTT)of breast nodules of malignant group were significantly shorter than those of benign group,and the differences were statistically significant(Z=-1.985,-2.272,P＜0.05).After the above indexes were fitted into multiple factors analysis,the regression equations of predicting malignant nodules by using qualitative and quantitative indexes were respectively established.The AUC values of ROC curves of qualitative and quantitative analyses were respectively 0.723 and 0.902.The result of qualitative analysis was significantly better than that of quantitative analysis(Z=-1.965,P＜0.05).In DVP parametric images,the nodules of 23 cases(67.6%)of 32 nodules of benign group appeared lesions,and the most in region of interesting(ROI)appeared monotonous red/yellow filling,and 15 cases(78.9%)of 19 cases of malignant group appeared lesions,and the ROI inside appeared patchy red/yellow filling of disordered,irregular,scattered or clumpy shape.Conclusion:Sonazoid CEUS can discriminate benign and malignant nodules of breast BI-RADS 4 category,and the diagnostic efficacy of qualitative indexes is better than that of quantitative indexes..