Eighty six patients with chronic superficial gastritis, atrophic gastritis and peptic ulcer without autoimmune diseases underwent gastroscopy and biopsy in the gastric antrum and body. Hp was identified by histopathological analysis (Warthin Starry silver stains) and rapid urease test (RUT). Lymphoid tissue was observed by HE stain and immunohistochemistry method. Results showed that Hp infection was found in 68 6% of the patients.Lymphoid follicles were present in 35 6% of the Hp positive patients ,and no lymphoid follicles were found in the Hp negative patients.In six Hp positive patients,Lymphoepithelial lesions were found.Hp infection was closely associated with gastric mucosal lymphoid infiltration,lymphoid follicles and active inflammation( P

Objective To investigate clinical features, diagnosis, treatment and prognosis of multiple primary colorectal carcinoma (MPCC). Methods A retrospective analysis was made on 37 patients with MPCC admitted from 1974 to 1998. ResultsThe incidence of MPCC was 2 74%(37/1 348) with 15 cases being synchronous carcinoma (SC) and 22 cases diagnosed as metachronous carcinomas (MC). Most tumors were located in right colon and rectum. Twelve out of twenty-two (55%) of MC were diagnosed within 3 years from the primary operation and 41% (9/22) of MC occurred after 8 years. JP2Radical resections were performed in all patients except for 1 case. The 5 year survival rate of SC was 5/9 and that of MC after the first cancer or second cancer were 15/21 and 7/18, respectively. Conclusions The results indicated the importance of complete preoperative examination, careful intraoperative exploration and periodic postoperative surveillance. Early diagnosis and active radical resection can increase survival rate of MPCC.

Objective To investigate the risk factors for hemorrhagic transformation (HT) and poor outcomes in patients with acute ischemic stroke after mechanical thrombectomy.Methods The patients with acute ischemic stroke received mechanical thrombectomy were enrolled retrospectively.The demography,vascular risk factors and other clinical data of the patents were collected.The modified Rankin scale (mRS) was used to evaluate the clinical outcomes at day 90.Good outcome was defined as mRS score 0-2.The patients were divided into either a HT group or a non-HT group according to their HT conditions.Multivariate logistic regression analysis was used to identify the independent risk factors for HT and poor outcomes.Results A total of 48 patients with acute ischemic stroke received mechanical thrombectomy were enrolled,including 25 males (52.1％).Their mean age was 64.77± 9.14 years.The mean National Institutes of Health Stroke Scale (NIHSS) score was 17.70 ± 3.77.Twenty-two patients (45.8％) occured HT,of which 9 were symptomatic HT;24 (50.0％) had good outcomes.The proportion of males in the HT group was significantly lower than that in the non-HT goup (30.4％vs.72.0％;x2 =8.293,P =0.004),while the proportions in patients with diabetes (65.2％ vs.36.0％;x2 =4.090,P =0.043) and atrial fibrillation (78.3％ vs.44.0％;x2 =5.880,P =0.015),as well as the baseline fasting blood glucose level (8.514 ± 4.400 mmol/L vs.6.354 ± 1.472 mmol/L;t =2.319,P =0.025) were significantly higher than those in the non-HT group.Multivariate logistic regression analysis showed that the atrial fibrillation (odds ratio [OR] 6.136,95％ confidence interval [CI] 1.617-23.291;P =0.042) was a risk factor for the occurrence of HT after mechanical thrombectomy.The proportion of diabetic patients (29.2％ vs.70.8％;x2 =8.333,P=0.04) and baseline NIHSS score (16.050±4.865 vs.19.210±4.423);t=2.310,P=0.026) of the good outcome group were significantly lower than those of the poor outcome group,while the proportions of patients in atrial fibrillation (75.0％ vs.45.8％;x2 =4.269,P =0.039),anterior circulation stroke (87.5％ vs.62.5％;x2 =4.000,P =0.046) middle cerebral artery (75.0％ vs.29.2％;x2 =10.113,P =0.006),vertebral basilar artery (37.5％ vs.12.5％;x2 =10.113,P =0.006) occlusion and parenchymal hematoma (33.3％ vs.4.1％;P=0.011) were significantly higher than the poor outcome group.Multivariate logistic regression analysis showed that diabetes (OR 5.898,95％ CI 1.699-20.479;P=0.005),baseline NIHSS score (OR 1.167,95％ CI 1.011-1.347;P =0.035),and parenchymal hematoma (OR 1.295,95％ CI 1.099-1.875;P=0.028) were the independent risk factors for poor outcomes.Conclusions Atrial fibrillation is an independent predictor of HT risk in patients with acute ischemic stroke after mechanical thrombectomy.Diabetes mellitus,higher baseline NIHSS score,and concurrent brain parenchymal hematoma are the independent predictors of poor outcomes.Therefore,the risk of HT and adverse outcomes should be fully assessed before mechanical thrombectomy in patients with acute ischemic stroke.

Objective To investigate the efficacy of interferon α(IFNα)and adefovir dipivoxil (ADV)combination therapy in HBeAg positive chronic hepatitis B(CHB)patients and to explore the optimized strategy for individualized treatment.Methods A total of 156 HBeAg positive CHB patients were enrolled in the study from January 2005 to June 2009 in the Third Affiliated Hospital of Hebei Medical University.Fifty-six CHB patients with hepatitis B virus(HBV)DNA≥1 X 107copy/mLand/or liver fibrosis stage≥S3,or previous monotherapy failure(relapse)were treated with initial IFNα and ADV combination therapy.Fifty-two patients who didn't meet any of the above baseline characteristics received initial IFNα monotherapy.The remaining 48 patients treated with IFNα monotherapy for full treatment duration were considered as control.At week 24 of treatment,the treatment regimens were adjusted according to quantitative changes of HBV DNA,HBeAg and HBsAg:16 patients who achieved early response in group of initial IFNα and ADV combination therapy subsequently received IFNα monotherapy,the other patients in group of initial combination therapy together with patients who did not achieved early response in group of initial IFNα monotherapy subsequently received IFNα and ADV combination treatment.The HBV DNA levels,HBeAg and HBsAg titers were detected at the end of 48 weeks of treatment to determine the treatment duration.The treatment efficacy,safety,drug resistance and relapse rates were finally evaluated at week 72.All data were analyzed using chi square test.Results At week 24,the early response rate in group of initial combination therapy was 28.6%,and the HBV DNA negative rate and alanine aminotransferase(ALT)normalization rate were significantly higher than those in groups of initial IFNα monotherapy and control(53.6%vs 32.7%vs 27.1%and 62.5%vs 40.4%vs 37.5%,respectively,P<0.05);in addition,HBeAg loss rate was higher than control group(39.3%vs 18.8%,x2=7.48;P<0.05).At week 48,five of 16 patients who achieved early response developed HBeAg reversion and three cases accompanied with virological breakthrough in group of initial combination therapy after switching to IFNα monotherapy,while the rates of HBV DNA negative,HBeAg seroconversion and HBsAg clearance were 73.2%,41.1%and 12.5%,respectively.The HBV DNA negative rate,HBeAg seroconversion rate and HBsAg clearance rate in 96 patients Who had received different combination treatment regimens were 65.6%,33.3%and 8.3%,respectively.At week 72,the relapse rate in individualized treatment group was comparable to those in control group,while HBsAg clearance rate increased 2.7%in individualized treatment group.Conclusions IFNα and ADV combination treatment could improve early biochemical and virological responses.Individualized treatment strategy based on baseline characteristics and treatment responses may be helpful for optimizing antiviral treatment in CHB patients.

Objective To evaluate the factors contributing to medial compartment knee osteoarthritis and the possible correlations between them.Methods Radiographic images were collected for analysis of 840 patients who had sought medical attention from January to July 2017 for 1,422 sides of knees varus at Department of Orthopedic Surgery,The Third Hospital of Hebei Medical University.They were aged from 17 to 87 years(average,61.0 years),involving 323 knees in males and 1,099 knees in females.The alignments and parameters of lower extremity were measured,including hip-knee-ankle angle (HKA),mechanical medial distal femoral angle (mMDFA),medial proximal tibial angle (MPTA) and joint line convergence angle (JLCA).The measurements were compared between HKA values and genders for correlation analysis.Results HKA,mMDFA,MPTA and JLCA were respectively 172.85° ± 4.27°,90.99° ± 2.59°,84.78° ± 2.82° and 2.83° ±2.33 ° for males,and 172.13 ° ± 4.63°,91.11 ° ± 2.74°,84.58 ° ± 3.30° and 3.48 ° ± 2.58 ° for females.The females had significantly smaller HKA and significantly larger JLCA than males (P ＜ 0.05),but there was no significant difference in mMDFA or MPTA between genders(P ＞ 0.05).Pearson correlation test showed that there were significant correlations between HKA and mMDFA,MPTA and JLCA (rmale1 =0.526,rmale2 =0.545,rmale3 =-0.562;rfemale1=0.547,rmale2=0.610,rmale3=-0.485;P ＜0.01).mMDFA (βmale=0.491,βfemale=0.464,P ＜0.01) and MPTA (βmale=0.487,βfemale=0.560,P ＜0.01) had significantly positive influences on HKA;the influence of JLCA was negative (βmale =-0.463,βfemale =-0.450,P ＜0.01).Conclusions Femoral mechanical axis varus,increased JLCA and collapse of medial tibial plateau all significantly contribute to the varus gonarthrosis.The effects of mMDFA,MPTA and JLCA on HKA may be almost the same.

OBJECTIVE: To investigate the clinical and pathological characteristics of sinonasal neoplasms. METHOD: A cohort of 333 patients with sinonasal neoplasm, which were confirmed by surgical pathology, were enrolled in this study. The clinicopathological characteristics, in terms of age, sex, location, and disease constituent ratio were retrospectively reviewed. RESULT: (1) In this series of patients, there were 200 males and 133 females, aged from 2 to 84 years, with a median of 54 years. The benign to malignant ratio was 1.1:1. As for their origination, 144 tumors arose from the nasal cavity, while, 191 tumors derived from sinus, including 90 from maxillary sinus, 31 from frontal sinus, 46 from ethmoid sinus, and 24 from sphenoidal sinus. (2) Disease constituent ratio decreased in order of epithelial tissue, soft tissue, lymphohematopoietic tissue, bone and cartilaginous tissue, ectopic intracranial tumors. The five most frequent malignant tumors were squamous carcinoma, lymphoma, adenoid cystic carcinoma, malignant melanoma and esthesioneuroblastoma, while, benign tumors ranked in the top five were papilloma, fibroma, osteoma, angioma and ectopic intracranial tumors,respectively. (3) Of 200 cases arising from epithelium, 118 were benign, 82 were malignant, and the benign to malignant ratio was 1.4:1. Of 68 cases from soft tissue, 37 were benign and 31 were malignant tumors (ratio, 1.2:1). Among the 22 cases from bone and cartilaginous tissue, 17 were benign and 5 were malignant (ratio, 3.4:1). With respect to the 29 cases from lymphohematopoietic tissue, the majority of tumors were malignant (28 cases), with only one benign case. In addition, ectopic intracranial tumors were also observed. Besides the above all, 12 cases of other types were found in this work. CONCLUSION Neoplasms from different parts of nasal cavity and paranasal sinus have specific clinical characteristics. The pathological types of these tumors may be highly diverged. The diagnosis and differential diagnosis depend mainly on pathological examination. Comprehensive treatment, which employs surgery in combination with other modalities, is the main strategy for these tumors.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Carcinoma, Squamous Cell ; diagnosis ; pathology ; surgery ; Child ; Child, Preschool ; Female ; Humans ; Male ; Middle Aged ; Nose Neoplasms ; diagnosis ; pathology ; surgery ; Papilloma, Inverted ; diagnosis ; pathology ; surgery ; Paranasal Sinus Neoplasms ; diagnosis ; pathology ; surgery ; Retrospective Studies ; Young Adult

Objective To investigate the effect of optimizing rescue time for patients with acute st-elevation myocardial infarction (STEMI) in the hospital. Methods A retrospective analysis of the clinical data of 133 patients with ST-elevation myocardial infarction who were hospitalized in the first affiliated hospital of university of science and technology of china during July,2016 to June,2017 was performed. Timeline in the rescue, the result of coronary reperfusion and satisfaction degree of patients were analyzed. Results The rapid evaluation time (F=2.609, P=0.046),emergency handling time(F=7.581, P=0.032), login and logout time (F=5.667, P=0.017)and visit-ballon time (F=8.942, P=0.007) were shortened quarter by quarter . The average time of each project in the four quarters showed a statistically significant difference. The difference of TIMI classification of coronary flow reperfusion among the four quarters was statistically significant (H=8.402, P=0.038). The satisfaction degree of each quarter showed a statistically significant difference (the third quarter of 2016:94.68±2.38, the fourth quarter of 2016:96.72± 5.10, the first quarter of 2017:97.23 ± 7.64,the second quarter of 2017:98.36 ± 4.86;F=7.891,P=0.048). Conclusions Enhancing timeliness of emergency care can remarkably shorten rescue time, improve satisfaction degree of patients and help to improve the success rate of emergency treatment for patients with STEMI.

ObjectiveThis study aimed to investigate the risk factors affecting the positive detection of Acinetobacter baumannii on the hands in medical staff of hospitals in Shanghai， and provide epidemiological evidence for the prevention and control of nosocomial infections. MethodsThe hands of doctors， nurses and care workers in key departments were sampled every quarter from 2018 to 2020 according toGB 15982‒2012 "Hospital Disinfection and Hygiene Standards". Separation and identification of A. baumannii were followed with sampling shortly. Information about the working years of sampling subjects， the hand sanitizers of which sampling subjects had used and the ingredients and actual using time of the hand sanitizers was collected while sampling. Finally， 709 samples were selected for this research after excluding the unqualified samples. ResultsThe positive detection of the hand samples was 7.05%. The logistic regression model suggested that the department， the time of using hand sanitizer， the hospital grade and occupational category were determinants of A. baumannii positive detection on hands in medical staff. The risk of A. baumannii positive detection in internal medicine department was 2.846 （95%CI：1.402‒5.776） times higher than that in intensive care unit while it was 3.357 （95%CI：1.349‒8.353） times higher in surgery department than that in intensive care unit. Regarding the use of hand sanitizer， the risk of A. baumannii positive detection was 3.076 （95%CI：1.534‒6.168） times higher in the staff used the hand sanitizer over 14 days than in the medical staff used the sanitizer within 14 days. The risk of A. baumannii positive detection in medical worker in secondary hospitals was 2.235（95%CI：1.088‒4.588）times than in tertiary hospitals. The risk of A. baumannii positive detection of care workers was 3.634 （95%CI：1.764‒7.484） times higher than nurses. ConclusionThe positive detection of hand samples was 7.05%. Department， the time of using hand sanitizer， the hospital grade and occupational category were determinants of A. baumannii positive detection on hands in medical staff. It was necessary to improve hand hygiene for medical staff， especially for care worker. Cleaning and disinfection need to be strengthened in internal department and surgery department.

Objective: To describe the clinical manifestations of central nerve system inflammatory demyelinating disease associated with anti-myelin oligodendrocyte glycoprotein antibody (MOG-IDD) in children, and to explore the clinical characteristics of the children. Methods: The clinical and laboratory characteristics of the patients diagnosed in Beijing Children′s Hospital, Capital Medical University, from October 2016 to August 2018 were described, and the clinical data of the patients with unipolar and recurrent diseases were compared. Results: A total of 50 patients were included, among whom the ratio of male to female was 24:26, and the average age of onset was (6.7±3.1) years old (0.4-12.6 years old). There was no significant difference in the age of onset between boys and girls(t=0.712, P=0.480). The main symptoms included fever (31/50 cases), encephalopathy (26/50 cases) and optic neuritis (22/50 cases), etc.In the last follow-up, 26 patients (52.0%) had a monophasic course and 24 patients (48.0%) had a recurrent course.There were age differences in encephalopathy and ataxia in the first episode of [(5.7±2.8) years old vs.(8.1±3.0) years old, (5.0±2.5) years old vs. (7.7±3.0) years old](t=2.746, P=0.009; t=2.837, P=0.007). The average number of recurrence was (2.1±1.4) times (1-7 times), in which 17 cases (70.8%) of recurrence presented within 12 months and 20 cases (83.3%) of recurrence presented within 24 months after onset.Convulsion incidences of recurrent cases were 10 cases and 13 cases respectively in the first episode and recurrent courses, which were significantly higher than those of monophasic cases (4 cases, 4 cases)(χ²=7.912, P=0.005; χ²=8.365, P=0.004). All patients were sensitive to first-line immunotherapy.Seven patients with recu-rrence were treated with mycophenolatemofetil, and 17 patients with repeated first-line therapy.In the last follow-up, all patients were in remission and 2 patients had mild neurological dysfunction. Conclusions MOG-IDD can occur in childhood.Encephalopathy and optic neuritis are the most common symptoms.Encephalopathy and ataxia are more common in young children.Convulsions may indicate the course of recurrence.