Objective: This multi-group case control study was performed to determine whether Helicobacter pylori infection was associated with gastric cancer and stomach diseases. Methods: Gastric cancer and stomach disease patients that were diagnosed pathologically between 1994 and 1996 years were divided into several case groups and control group, all histological specimens collected in gastric cancer high risk region of Shandong Province were used to measure exposure history. Results: After variables concerning age, sex and education were adjusted, odds ratios of chronic superficial gastritis in antrum, peptic ulcer disease and active degree of inflammation associated with H. pylori infection remained significant (OR was 2.072, 2.980, 2.086 respectively). Correlation analyses showed negative relationship between degree of stomach diseases and H. pylori infection(r=－0.217). Conclusion: The results support the hypothesis of a relationship between H. pylori infection and the development of chronic superficial gastritis in antrum, peptic ulcer disease and active degree of inflammation.

Objective To explore the mechanisms of apoptosis induced by arsenic trioxide and amifostine in human acute promyelocytic leukemia cell lines HL-60 in vitro.Methods HL-60 cells were treated with different concentrations of arsenic trioxide alone and combined with amifostine.The inhibitory ratio of the ceils were measured by MTT assay.and the expression of Survivin Was detected by semiquantitate RT-PCR.Results Proliferation of HL-60 cells exposed to arsenic trioxide dwpped down with increasing dose of the dmg and this effect Was significantly hisher when arsenic trioxide Was used in combination with amifostine.Furthermore.there was a more significant decrease in Survivin expression in HL-60 cells treated with arsenic trioxide in combination with amifostine as compared to the cells treated only with arsenic trioxide.Conclusion Arsenic trioxide induced HL-60 cells to undergo apoptosis by downregulating the expression of Survivin. Amifostine enhanced the sensitivity of HL-60 cells to arsenic trioxide by downregulating the expression of Survivin,thus promoting apoptosis effect.

ObjectiveTo evaluate Fuji intelligent color enhancement (FICE) chromoendoscopy for diagnosis of early gastric cancer. MethodsFrom February 2010 to March 2011 ,a total of 67 patients with suspected gastric mucosal lesions were enrolled in this study. The lesions were observed with magnifying endoscopy, FICE, magnifying chromoendoscopy and indigo-carmine-magnifying-chromoendoscopy.Suspected gastric mucosal pit patterns and microvascular morphology were compared. Targeted biopsy was performed on suspected locations. Sensitivity, specificity and pathological consistency were compared between the 3 procedures. ResultsOut of 67 patients, 17 were diagnosed as having early gastric cancer.There was no difference among magnifying endoscopy, FICE magnifying chromoendoscopy and indigo-carmine-magnifying-chromoendoscopy in pit pattern findings,however, FICE magnifying chromoendoscopy was superior to other 2 procedures in displaying capillary loop. The sensibility, specificity and pathological accordance rate of FICE magnifying chromoendoscopy were 94. 1％ ( 16/17 ), 98. 0％ (49/50) and 97.0％(65/67), which were higher than those of the magnifying endoscopy [58.8％ ( 10/17), 84％ (42/50)and 77.6％ ( 52/67 )] ( P ＜ 0. 05 ), and were not different from those of indigo-carmine-magnifying-chromoendoscopy [88.2％ (15/17), 96％ (48/50) and 94.0％ (63/67)] (P ＞0.05). Conclusion FICE magnifying chromoendoscopy provides rather clear images of gastric mucosa and intrapapillary capillary, thereby improving the accuracy of endoscopic biopsy and then imporving the diagnosis rate of early gastric cancer.

ObjectiveTo evaluate the Fuji intelligent chromo endoscopy (FICE) in the diagnosis of Barrett esophagus (BE).MethodsFrom September 2010 to March 2011,a total of 180 patients with suspected reflux esophagitis were examined successively by FICE,magnifying FICE,acetic dyeing endoscopy and magnifying acetic dyeing endoscopy.The diagnosis was made out under the observation of lesion extensions,superficial mucosa contrast ratio,pit patterns and capillary forms of BE.The endoscopic diagnosis was made and compared with the pathologic diagnosis,and the consistency of the diagnosis was evaluated by Kappa value.ResultsBE was confirmed in 35 patients ( 19.4％ ) pathologically.The consistency rates of diagnosis under FICE and acetic dyeing endoscopy were 81.7％ and 72.8％ ( P ＜ 0.05 ).The consistency rates of diagnosis under magnifying FICE and magnifying acetic dyeing endoscopy were 97.8％ and 85.6％,respectively (P ＜ 0.05).FICE magnifying endoscopy revealed better mucosal structures of capillaries than magnifying acetic dyeing endoscopy did ( P ＜ 0.05 ),but there was no significant difference in revealing of duct openings (P ＞ 0.05).The specificity,sensitivity,positive predictive value,negative predictive value and Kappa value of FICE in diagnosis of BE were 82.1％,80.0％,51.9％,94.4％ and 0.52,respectively,which were 73.2％,71.4％,39.1％,91.4％ and 0.34 of acetic dyeing endoscopy,98.6％,94.3％,94.3％,98.6％ and 0.93 of magnifying FICE,and 88.3％,74.3％,60.5％,93.4％ and 0.58 for magnifying acetic dyeing endoscopy.ConclusionAs a neotypical endoscopic system,magnifying FICE could exhibit clearly the pit patterns and microvascular structures of esophagus mucosa,and it can capture the optimal images of Barrett's epithelium.FICE could improve the diagnosis of BE in vivo.

TongJi University School of Medicine has performed teaching reforms in the early stage of medical students through curriculum integration of life science,the introduction of PBL,and designing of comprehensive experiments to achieve comprehensive professional competence of medical students.The results showed that the training system is beneficial to the cultivation of students' clinical thinking and early medical professional competence.It has been recognized by both students and faculty.Preliminary practice has proved to be successful.

Objective: To investigate clinical characteristics of urodynamics in elderly male patients with indwelling urinary catheterization. Methods: Clinical urodynamics of 497 male patients with indwelling urinary catheterization aged 60 years and over from December 2010 to April 2019 in our center were retrospectively analyzed and divided into 3 groups: 60-69-year-old group(n=114), 70-79-year-old group(n=220), and 80-111-year-old group(n=163). According to the catheter indwelling time, the patients were divided into 3 groups: 1-2 weeks group(n=262), 2-4 weeks group(n=47)and over 4 weeks group(n=188). The cause of indwelling urinary catheterization, bladder outlet obstruction, acontractile detrusor and other indicators were observed. Results: The main cause of indwelling urinary catheterization in elderly men was acute urinary retention(55.1%, 274 cases), in that the most common diagnosis was benign prostatic hyperplasia(90.3%, 449 cases). No statistically significant difference in the different catheter indwelling time-related urodynamics between the different age groups was found(χ²=1.606, 0.199 and 2.477, all P>0.05). There were statistically significant differences both in the incidences of bladder outlet obstruction between the 1-2 weeks vs.2-4 weeks vs.over 4 weeks groups[56.9%(149/262)vs.55.3%(26/47) vs.42.6%(80/188), χ²=9.315, P<0.05)], and in the incidences of acontractile detrusor between the 1-2 weeks vs.2-4 weeks vs.over 4 weeks groups[15.6%(41/262)vs.12.8%(6/47)vs.29.8%(56/188), χ²=15.319, all P<0.05)]. There was no statistically significant difference in catheter indwelling time-related urodynamics between two groups with normal detrusor muscle function and weak detrusor muscle function(P>0.05). Clinical urodynamics had no statistically significant in different age groups(P>0.05). Conclusions Bladder outlet obstruction is the main cause of indwelling urinary catheterization in elderly men.Urodynamic examination can be performed 1-2 weeks after indwelling urinary catheterization.Age has no significant effect on the catheter indwelling time-related urodynamics.The duration of indwelling urinary catheterization has little effect on the urodynamic diagnosis in patients with normal or weak detrusor muscle contractile strength.The elderly patients may have acontractile detrusor if the duration of indwelling urinary catheterization is more than 4 weeks.

Objective To investigate the status and associated factors of demand satisfaction (DS) of services for older adults with visual disability (OAVD).Methods Based on the 2nd National Sample Survey on Disability in 2006,a total number of 24 017 OAVD cases were included.Associated relationships among demographic,health-related,social,economic factors and services of DS,including health demand (Type Ⅰ),basic livelihood demand (Type Ⅱ),and environmental support demand (Type Ⅲ) were analyzed.Results The proportions of DS of Type Ⅰ,Ⅱ,Ⅲservices for OAVD were 35.1％,9.3％ and 4.3％ respectively.Eight factors as:having pension insurance (OR =1.64),living in urban areas (OR =1.54),per capita household income at ≥ 5 000 or over Yuan (OR=1.46) were favorable ones on OAVD DS while at age ≥ 80 or above (OR =0.90),being male (OR=0.93) were adverse factors of Type Ⅰ.Four factors as:being male (OR=1.43),living in urban areas (OR=1.15),subjects defined as grade Ⅱ (OR=1.36) and grade Ⅰ (OR=1.70)etc.,were favorable factors on OAVD DS.Five factors as:range of age groups at 15-59(OR=0.57)or at ≥60 (OR=0.45),per capita household income at 1 000-1 999 Yuan(OR=0.77),2 000-4 999 Yuan (OR =0.58) and ≥ 5 000 Yuan (OR =0.39) were adverse factors of Type Ⅱ.Factors as:living in urban areas (OR =1.23),defined as grade Ⅱ (OR =1.38) and grade Ⅰ (OR =1.34),having pension insurance (OR=1.62) and per capita household income at ≥5 000 Yuan (OR=1.42) etc.,were favorable factors of Type Ⅲ.Conclusion The DS degree of older adults with visual disability was generally very low while factors as:per capita household income,situation on social insurance,age,degree of disability,age when disability was identified,areas of residence,gender,grade of disability,marriage status,levels of education etc.,were significantly associated with the service on DS.

Objective To analyze the clinical characteristics and survival prognosis of patients with AIDS-related malignant tumor. Methods We retrospectively analyzed the data of 354 patients with AIDS-related malignant tumor. Univariate analysis was conducted by Log rank test and multivariate analysis was conducted by Cox proportional risk regression model. Results The average age of the patients was 54.10±12.96 years old. The ratio of male to female patients was 2.1:1. The number of patients with AIDS complicated with lymphoma was the most, accounting for 28.25%. The 1-, 3- and 5-year survival rates were 78.48%, 62.13% and 55.31%, respectively. Univariate analysis showed that there were statistical differences in prognosis of patients with different types of malignant tumor, age, gender, medical insurance type, number of admissions after diagnosis of AIDS, average length of stay, radiotherapy or not, leaving hospital according to medical advice. Multivariate analysis showed that gender, number of admissions after diagnosis of AIDS, average length of stay, proportion of out-of-pocket and leaving hospital according to medical advice were independent risk factors affecting the survival and prognosis of patients. Conclusion AIDS is easily complicated with lymphoma, lung cancer and cervical cancer. The patients received insufficient anti-tumor courses in hospital.

Objective:To investigate the values of two-dimensional and three-dimensional echocardiographic parameters in predicting pulmonary vascular resistance (PVR) in chronic pulmonary thromboembolic pulmonary hypertension (CTEPH).Methods:A total of 141 patients diagnosed with CTEPH in China-Japan Friendship Hospital from November 2015 to December 2022 were included. Two-dimensional echocardiographic indicators reflecting PVR were constructed according to the calculation formula of PVR: echocardiographic estimated systolic pulmonary artery pressure (sPAP Echo)/left ventricular end-diastolic diameter (LVIDd), echocardiographic estimated mean pulmonary artery pressure (mPAP Echo)/LVIDd. sPAP Echo/left ventricular end-diastolic volume (LVEDV), sPAP Echo/left ventricular cardiac output (LVCO) were measured by three-dimensional echocardiography. The correlations between two-dimensional and three-dimensional echocardiographic ratios and invasive PVR were then analyzed using the Spearman correlation method. Using receiver operating characteristic curve analysis, cut-off values for the ratios were generated to identify patients with PVR>1 000 dyn·s -1·cm -5. Pre- and postoperative hemodynamics and echocardiographic data were analyzed, as well as the correlation between the reduction rate of the echocardiographic index and PVR in 54 patients who underwent pulmonary endarterectomy (PEA). Results:sPAP Echo/LVIDd, sPAP Echo/LVEDV and sPAP Echo/LVCO were moderately correlated with PVR( rs=0.62, 0.52, 0.63, both P<0.001). The ratio of sPAP Echo to LVEDV, when greater than or equal to 1.41, had a sensitivity of 0.800 and a specificity of 0.930 for determining PVR >1 000 dyn·s -1·cm -5 (AUC=0.860, P<0.001). Similarly, the ratio of sPAP Echo to LVIDd, when greater than or equal to 2.14, had a sensitivity of 0.647 and a specificity of 0.861 for determining PVR >1000 dyn·s -1·cm -5 (AUC=0.830, P<0.001). The sPAP Echo/LVIDd and mPAP Echo/LVIDd significantly decreased after PEA (both P<0.001). The sPAP Echo/LVIDd and mPAP Echo/LVIDd reduction rate (ΔsPAP Echo/LVIDd and ΔmPAP Echo/LVIDd) were significantly correlated with PVR reduction rate (ΔPVR), respectively ( rs=0.61, 0.63, both P<0.05). Conclusions:Two-dimensional ratio sPAP Echo/LVIDd and three-dimensional ratio sPAP Echo/LVEDV can be used to noninvasively estimate PVR in CTEPH patients. The conventional ratio sPAP Echo/LVIDd is convenient and reproducibly suitable for monitoring the improvement of PVR before and after treatment, and its ratio of 2.14 can predict the significant increase of PVR in CTEPH patients (>1 000 dyn·s -1·cm -5).

Humans ; Hospital Mortality ; Pulmonary Embolism ; Comorbidity ; Registries ; Neoplasms/complications*