Background:With the increasing of antibiotic resistance and decreasing of eradication rate of standard triple therapy, bismuth-containing quadruple regimens were recommended by the update Chinese consensus report for eradication of Helicobacter pylori( Hp ) infection. Aims:To evaluate the eradication rate of the recommended bismuth-containing quadruple regimens for guiding the choice of low cost and high efficiency eradication regimens. Methods:A search of online database( CNKI,Wanfang and VIP)was carried out. Clinical trials published in Chinese from 2011 to 2013 that evaluated the eradication rate of the recommended bismuth-containing quadruple regimens were retrieved. Data were extracted by standardized data forms. According to the categories raised by Dr. Graham,the eradication rates were graded and analyzed. Results:A total of 166 eligible articles including 192 clinical trials for eradication of Hp infection were obtained. Nationwidely,the eradication rates of amoxicillin-containing regimens were acceptable,among which PAFB( PPI+amoxicillin+furazolidone+bismuth)regimen was more prone to achieve excellent eradication rate(≥95%). PACB ( PPI+amoxicillin+clarithromycin+bismuth)regimen was optimal for Hp eradication in East China,and PAFB regimen was optimal in Central South China. A 14-day treatment course was appropriate. Conclusions:In the recommended bismuth-containing quadruple regimens,PAFB regimen might be the first choice nationwidely for eradication of Hp infection in individuals without amoxicillin-hypersensitivity because of its low cost and high efficiency. The recommended treatment course is 14-day.

Objective To evaluate the effects of endoscopic ultrasonography ( EUS) combined with cyst fluid analysis, cytology, histopathology based on endoscopic ultrasound guided fine needle aspiration ( EUS?FNA) on pancreatic cystic lesions ( PCLs) . Methods Clinical data of 45 patients were analyzed ret?rospectively from January 2006 to April 2015 including MRI, EUS?FNA, MRCP. The results of conventional imaging and EUS?FNA were compared based on postoperative pathology. Results There were 8 cases of non tumor pancreatic cystic lesions, 4 cases of serous cystadenoma (SCN), 11 cases of mucinouscystadenoma ( MCN) , 8 cases of intraductal papillary mucinous tumor ( IPMN ) , 5 cases of solid pseudopapillary papilloma ( SPN) , 9 cases of non pancreatic cystic lesions ( nPCLs) . The diagnostic accuracy rate of tradi?tional imaging tests ( B?ultrasound, CT, MRI, MRCP ) and EUS?FNA were 42?2% ( 19/45 ) and 77?8%(35/45) (P<0?05). The diagnostic value of EUS?FNA of PCLs was higher than that of traditional imaging tests, with specificity, sensitivity, positive predictive value ( PPV) and negative predictive value ( NPV) of 58?3% ( 7/12 ) , 97?0% ( 32/33 ) , 86?5%( 32/37 ) , 87?5% ( 7/8 ) and 41?7% ( 5/12 ) , 87?9%(29/33), 80?6% (29/36), 55?6% (5/9),respectively. Conclusion EUS?FNA is more valuable than traditional imaging tests for the diagnosis of PCLs.

Objective To explore the anatomy for transethmoidal-sphenoid optic nerve decompression under endoscopy and its significance in operation. Methods Fifteen cases (30 sides) of formalin-fixed adult optic canal specimens were dissected under the microscope. The anatomic characteristics of the optic canal and its adjacent were observed, and the relative parameters were evaluated according to nasal endoscopic approach. Results ①The relationship between the optic carotid triangle(OCT)with the optic canal, the ophthalmic artery, the cavernous sinus and the internal carotid artery were invariable, its present ratio were in 66.7%. ②The mean distance from the front margin of nasal columella floor to medial wall of the orbital opening, middle portion and the cranial opening in the optic canal were (72.79 ± 5.40)mm, (75.85 ± 5.10)mm and (79.34 ± 4.95)mm, respectively, and the elevation angles were (39.45 ± 3.68)°, (37.30±4.24)°and (35.45 ± 4.16)°, respectively. ③The mean thickness of sheath in the medial wall of the orbital opening,middle portion and the cranial opening were (0.70 ± 0. 18)mm, (0.51 ± 0.15)mm and (0.49-0.22)mm,respectively. The difference in thickness between the orbital opening and middle portion, the cranial opening were very remarkable(P ＜ 0.01 ). ④The lateral deviate distance from medial wall of the orbital opening, middle portion and cranial opening to sagittal median plane of cadaveric were 1/2 (12.69 ± 2.73)mm、1/2( 19.61± 3.47)mm and 1/2 (25.79 ± 3.23)mm, respectively. Conclusion OCT is the most reliable anatomic landmark to locate the optic canal, and the key point is at the orbital opening of the optic nerve in the optic nerve decompression. It is secure and feasible to cut the sheath from the place where the medial wall crosses the superior wall of the optic nerve.

Objective To investigate the clinical value of glypican-3 (GPC3) in the diaganosis of hepatocellular carcinoma (HCC),the contents of GPC3 in the serum and tissues of HCC patients were detected.Methods ELISA and immunohistochemical staining were applied to detect GPC3 expressing level in the serum and tissues in 79 cases with HCC,35 cases with post-hepatitis cirrhosis and 30 normal liver specimens and the resuits were compared.The influential factor of GPC3 content in the patients with HCC was analyzed by logistic regression model.Results The serum level of GPC3 in patients with HCC was (143.02±40.26) μg/L which was signifcantly higher than that in patients with post-hepatitis cirrhosis [(6.15±4.31) μg/L] and healthy controls [(4.47±3.22) μg/L] (all P ＜ 0.01).The expression levels of GPC3 was signifeantly higher in post-hepatitis cirrhosis tumor-adjacent tissue and tumor-distant tissue.The expression levels of GPC3 was significantly positively correlated with tumor presence of distant mestasis (x2 =13.182,P ＜ 0.0) and clinical stage (x2 =4.250,P ＜ 0.05),and not correlated with sex,age,tumor size and the level of AFP inserum (P ＜ 0.01).Conclusion GPC3 is specific the diagnosis of HCC.The joint diagnosis of GPC3 and AFP will improve the sensitivity of HCC.Therefore,GPC3 could as a biomarker for evaluating HCC condition and prognsis.

As the second most common cause of death in the world, cancer has become a persistent public health challenge. The incidence and mortality in different countries and regions or of multiple cancer types are significantly different, which is closely related to economic development level, lifestyle and environmental factors. A large number of epidemiological studies have focused on cancer burden, epidemic pattern, etiology and prevention, which is very important for the government to formulate cancer prevention policies based on medical evidence and protect population health. Therefore, based on the latest epidemiological publications, this paper reviews the incidence and mortality of cancer as well as the time trend in major countries and areas.

Objective To analyze the risk factors of deep venous thrombosis in elderly people after hip joint replacement and nursing countermeasures.Methods A total of 56 elderly patients with DVT after artificial joint replacement in our hospital were selected.And 60 patients without DVT were selected at the same time.Single factor analysis was used to analyze the independent influencing factors of deep vein thrombosis after TRK.At the same time, nursing experience of elderly patients was explored.Results Age, body mass index, blood coagulation function, blood coagulation function, blood loss, smoking history, history of diabetes, and anticoagulation care or not between the DVT group and no DVT group showed significant difference(P<0.05).Conclusion Age, body mass index, blood coagulation function, total hip replacement, blood loss, smoking history, diabetes history, and the prevention and nursing of the patients with DVT were the high risk factors of the patients.The patients need to strengthen preoperative, intraoperative and postoperative monitoring and actively carry out preventive anticoagulation in order to effectively prevent the emergence of DVT after TRK in elderly patients.

Objective To analyze the risk factors of deep venous thrombosis in elderly people after hip joint replacement and nursing countermeasures.Methods A total of 56 elderly patients with DVT after artificial joint replacement in our hospital were selected.And 60 patients without DVT were selected at the same time.Single factor analysis was used to analyze the independent influencing factors of deep vein thrombosis after TRK.At the same time, nursing experience of elderly patients was explored.Results Age, body mass index, blood coagulation function, blood coagulation function, blood loss, smoking history, history of diabetes, and anticoagulation care or not between the DVT group and no DVT group showed significant difference(P<0.05).Conclusion Age, body mass index, blood coagulation function, total hip replacement, blood loss, smoking history, diabetes history, and the prevention and nursing of the patients with DVT were the high risk factors of the patients.The patients need to strengthen preoperative, intraoperative and postoperative monitoring and actively carry out preventive anticoagulation in order to effectively prevent the emergence of DVT after TRK in elderly patients.

Objective To investigate the role of fibromodulin (FMOD) in the xidative stress induced activation of pancreatic stellate cells (PSCs).Methods Lentivirus containing ShRNA targeting FMOD (sh-FMOD) was transfected into PSCs,and then the prooxidant menadione (MND) was used to treat PSCs for 24 h (MND + sh-FMOD group).Lentivirus transfected PSCs cells treated by a equal volume of DMSO served as shFMOD group,parent cells as control group and PSCs treated by MND as MND group.RT-PCR were used to detect the mRNA expression of the markers of activated PSCs including α-SMA,Col3α1,Col1α1,TIMP1 and α1-integrin.Chronic pancreatitis (CP) rat model was induced by DBTC infusion into the tail vein.Immunohistochemical (IHC) staining was used to detect the protein expression of FMOD,FN,α-SMA,SOD and MDA in normal pancreatic tissue and CP tissue.Results FMOD mRNA expression of the PSCs in FMOD group was obviously lowerer than that in control group (0.16 ±0.03 vs 1),and the difference was statistically significant (P ＜ 0.01),indicating that FMOD was successfully silenced.The mRNA expression of FMOD,α-SMA,Col3α1,Col1α1,TIMP1 and α1-Integrin of PSCs in MND group was obviously higher than those in control group,which in MND + sh-FMOD group was lower than those in MND group,and the difference was statistically significant (P ＜0.05 or ＜0.01).Compared with those in normal pancreatic tissue,the protein expression of FMOD,α-SMA,SOD and MDA in CP tissue was up-regulated,and the difference was statistically significant (all P ＜ 0.05).Conclusions Oxidative stress can facilitate the activation of PSCs through the induction of fibromodulin expression.

Objective To assess the value of carcinoembryonic antigen (CEA) level,liquid based cytology examination and combining 2 methods in predicting advanced pancreatic cystic neoplasms (PCNs).Methods The clinical data of 78 patients pathologically confirmed with PCN who underwent surgical resection after EUS-FNA and cyst fluid analysis in Shanghai Changhai Hospital,from January 2006 to June 2017 were collected and analyzed,including 32 (A-PCNs) patients and 46 non A-PCNs patients.The comparisons on the CEA level in the cyst fluid and liquid based cytology between the two groups were performed.ROC curve for CEA level in cyst fluid was applied and under curve area was calculated.Sensitive,specificity and accuracy were applied to assess the diagnosis value of 2 methods in predicting A-PCNs.Results In 35 patients,the difference on cyst fluid CEA level was statistically significant between 9 A-PCNs and 26 non A PCNs patients) [(1419.9 ± 1416.9) μg/L vs (316.0 ± 475.2) μg/L,P =0.049].Based on ROC curve,CEA ＞ 418.9 ng/ml could help to predicting A-PCNs with the sensitivity of 85.7％,specificity of 73.1％,and accuracy of 75.8％ as the cutoff value,and the area under ROC curve was 0.863.Liquid based cytology were performed in 27 A-PCNs patients and 33 non A PCNs patients,and the positive rate had statistical difference between 2 groups (48.1 vs 9.1％,P =0.001).The sensitivity,specificity and diagnostic accuracy for liquid-based cytology for diagnosing A-PCNs were 48.1％,90.9％,and 55.1％.Cyst fluid CEA combined with liquid based cytology can effectively diagnose A-PCN,and the sensitivity,specificity,and diagnostic accuracy were 100％,64.7％ and 76.0％.Conclusions Liquid-based cytology and cyst fluid CEA level were useful in predicting A-PCNs to a certain degree.Combining 2 methods could improve the sensitivity and accuracy in predicting A-PCNs.

Objective:To investigate the diagnostic efficacy of inflammatory biomarkers [neutrophil/lymphocyte (NLR), monocyte/lymphocyte (MLR), platelet/lymphocyte (PLR)] combined with tumor markers [carbohydrate antigen (CA)125, CA199] in mature cystic teratoma (MCT) patients possess torsion.Methods:The clinical data of patients with MCT diagnosed by surgery and pathology in the third Affiliated Hospital of Sun Yat-Sen University from March 2013 to October 2019 were retrospectively analyzed. A total of 31 MCT patients with torsion were included in observation group , another 101 MCT patients without torsion were assigned to the control group.Clinical characteristics and the levels of NLR, MLR, PLR, CA125, CA199 were assessed and analyzed.Results:The inflammatory biomarkers (NLR, MLR, PLR) and tumor markers (CA125) in the observation group were higher than those in the control group ( P<0.05). Univariate regression analysis was used to screen variables with statistical significance, including NLR, PLR, CA125 and CA199 ( P<0.05), and multivariate logistic regression was used to construct a prediction model for diagnose MCT patients with torsion , which combined NLR and CA199 ( P<0.05). The area under curve (AUC) of NLR, PLR, CA125, CA199 and the combined prediction models of NLR and CA199 were 0.83, 0.72, 0.69, 0.60 and 0.86, respectively. Among them, the joint prediction model of NLR and CA199 had the highest diagnostic efficiency, with a sensitivity of 77.42% and a specificity of 82.18% ( P<0.05). In the observation group, the accuracy of combined prediction model of NLR and CA199 in the diagnosis of MCT pedicle torsion was higher than that of ultrasound (87.10% vs 61.29%), but according to the clinical symptoms and ultrasonic examination, 90.32% of the patients were diagnosed as MCT pedicle torsion. Conclusions:The inflammatory biomarkers and tumor markers have useful clinical significance in the diagnosis of MCT with torsion, especially the combine measurement of NLR and CA199. Associated with the patient's symptoms, signs, examination included doppler ultrasound may assist in improving the diagnostic accuracy .