Fibrosis ; Humans ; Inflammation ; MicroRNAs ; Neoplasms

Kyoto global consensus report on Helicobacter pylori gastritis (Gut, July 2015) is another important international consensus since the European Maastricht Ⅳ consensus was published. Kyoto consensus will improve the etiology-based classification, the diagnostic assessment of gastritis, and the treatment of H. pylori-associated dyspepsia and H. pylori gastritis. However, because of high rate of H. pylori infection and antibiotic resistance as well as limited health resources in China, we need to develop our own strategies of H. pylori infection control with the reference of the Kyoto global consensus.
China ; Consensus ; Dyspepsia ; microbiology ; therapy ; Gastritis ; microbiology ; therapy ; Helicobacter Infections ; therapy ; Helicobacter pylori ; Humans

Objective To explore the effect of dexmedetomidine on phosphoinositide 3-kinase/protein kinase B (PI3K/Akt ) pathway in hippocampus of propofol anesthetized neonatal rats. Methods Eighty Sprague-Dawley male rats,aged 7 days,weighing 10-1 5 g,were randomly divided into 8 groups (n= 10 each):normal saline group (group N),DMSO group (group D),intralipid group (group I),propofol group (group P),dexmedetomidine 25 μg/kg,50 μg/kg and 75 μg/kg +propofol 100 mg/kg groups (groups PD25 ,PD50 and PD7 5 ),LY294002 25 μg + dexmedetomidine 75μg/kg + propofol 100 mg/kg group (group LYPD).The hippocampus of rats in all groups were taken 2 h after the animals fully awake.The ultrastructure of hippocampal neurons was observed by transmission electron microscope.The pAkt-(ser473 )protein and Akt protein in the hippocampus were evaluated by Western blot analysis.Results There was no significant difference in the expression of Akt protein among the eight groups.Compared with group N,the expression of pAkt (ser473)protein was significantly down-regulated in groups P,PD25 ,PD50 ,PD7 5 and LYPD (P <0.05).Compared with group P,the expression of pAkt (ser473)protein was increased significantly in groups PD7 5 and LYPD (P <0.05).Compared with group PD7 5 ,the expression of pAkt (ser473) protein was significantly down-regulated in group LYPD (P <0.05 ).The structure of hippocampal neurons was normal in groups N,I and D.Nuclear nuclei swelling,chromatin decreasing and mito-chondrion vacuolar degeneration were observed in group P while improved gradually with dexmedeto-midine in a dose-dependent manner in groups PD25 ,PD50 and PD7 5 .Neurons karyopyknosis,partial dissolution of nuclear membrane,chromatin condensation,mitochondria vacuolar degeneration were observed in group LYPD.Conclusion Dexmedetomidine pretreatment provides neuroprotection against propofol-induced hippocampal destruction by preserving PI3K/Akt pathway activity in the de-veloping brains.

Objective To summarize the clinical symptoms of patients with non-erosive reflux disease(NERD) and reflux esophagitis(RE),which is helpful to the differential diagnosis.Methods Outpatients who met the criteria of NERD or RE according to the Montreal definition in Gastroenterology Department Wuhan Union Hospital from 2010-2014 were enrolled in our study.Clinical data were comprehensively collected.Incidence of disease,severity,frequency of esophageal and extraesophageal symptoms,and the rates of overlapping with functional dyspepsia (FD) or irritable bowel syndrome (IBS) were all studied.Results Totally 446 subjects were recruited,including 225 patients with NERD and 221patients with RE.The occurrence rates of esophageal symptoms including heartburn [76.0％ (171/225) vs 52.0％ (115/221),P ＜ 0.01] and acid regurgitation [74.7％ (168/225) vs 54.3％ (120/221),P ＜0.05] in NERD group were significantly higher than those in RE patients,with more severe and frequent (P ＜ 0.05).Despite the rates of food regurgitation were similar,NERD patients behaved more severely and frequently (P ＜ 0.05).Extraesophageal symptoms including throat burning and foreign body sensation in NERD group [40.9％ (92/225) vs 27.6％ (61/221),42.2％ (95/225) vs 31.7％ (70/221),all P ＜0.05] were also higher than those in RE group,the degree of which was more severe too (P ＜ 0.05).RE patients claimed a higher proportion of chronic cough.The incidences of overlapping with IBS in two groups were similar.But there were more patients with FD in NERD group [72.0％ (162/225) vs 62.9％ (139/221),P ＜ 0.05] than in RE group.Conclusions The menifestations and degree of esophageal and extraesophageal symptoms in patients with NERD or RE are different,as well as comorbidities such as FD and IBS.These results suggest that NERD and RE are independent diseases.

OBJECTIVE:To observe the clinical efficacy and safety of Yinzhihuang oral liquid in the adjuvant treatment of neo-natal breast-feeding faundice. METHODS:112 newborns with faundice were randomly divided into control group and observation group. Control group stopped breast-feeding for 3 d and given artificial feeding,as well as keeping warm,nutritional support, maintaining water and electrolyte and acid-base balance,blue light irradiation and severe patients were given liver protection,en-zyme inducers;observation group was additionally given Yinzhihuang oral liquid 10 ml,twice a day. The treatment course was 7 d. Clinical efficacy,and serum total bilirubin(TBIL)level before and after treatment,and incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,the difference was statistically significant(P<0.05). After treatment,TBIL level in 2 groups was significantly lower than before and gradually de-creased with time,and observation group was lower than control group,the differences were statistically significant(P<0.05). The incidence of adverse reactions of 2 groups was no statistically significant(P>0.05). CONCLUSIONS:Based on the conventional treatment,Yinzhihuang oral liquid can be used in the adjuvant treatment of neonatal breast-feeding faundice,with good efficacy and good safety.

The oxidative stress, inflammatory cytokines and apoptosis have been strongly implicated in the pathogenesis of multiple diseases. Recently, more and more research findings have demonstrated that hydrogen-rich saline (HRS) has the anti-oxidant, anti-inflammatory and anti-apoptotic effects in vivo and in vitro, and can be used to treat multiple diseases, such as ischemia/reperfusion injury, stroke, neurodegeneration, sepsis, neuropathic pain and multiple organ dysfunction syn-drome diseases. This article reviews the possible mechanism of HRS for the treatment of diseases.

Objective To explore selection of the procedures in one stage urethroplasty for treatment of the coexistence of urethral strictures in anterior and posterior urethra.Methods Between January 2008 and December 2014, a total of 27 patients with coexist strictures simultaneously in anterior urethra and posterior urethra were treated in our hospital.The mean age was 38 years old (ranging 13-83 years old.Stricture etiology was secondary to lichen sclerosus in 2 patients, iatrogenic in 3 and posttraumatic in 22.The mean length of urethral stricture was 11cm (ranging 6-14cm).Two procedures for treatment of anterior urethral stricture, including augmentation of urethroplasty using penile skin flap was performed in 20 patients and augmentation of urethroplasty using lingual mucosa in 7.Three procedures for treatment of posterior urethral stricture, including non-transecting spongiosum end to end anastomosis of the two urethral ends was performed in 3 patients, end to end anastomosis of the two urethral ends was performed in 17 and substitution urethroplasty using different tissues was performed in reminder 7 patients.Of them, pedicle scrotal skin urethroplasty was performed in 2 patients and lingual mucosal graft urethroplasty in 5 patients.Results The patients were mean followed up 2.6 years (ranging 0.545.0 years) with an overall success rate of 88.9％ (24 of 27 cases).Complications developed in 3 patients (11.1％).Of the 17 patients with end to end anastomosis, urethral stricture developed respectively 4 and 6 months in 2 patients and voiding well after pedicle scrotal skin urethroplasty.Urethral pseudodiverticulum developed 9 months after pedicle penile flap urethroplasty in another patient and voiding well after urethroplasty.Urethrography showed patent urethra with adequate lumen in the remaining patients and mean urinary peak flows was 21.3 ml/s (ranging 14.2-37.9 ml/s).Conclusions Substitution urethroplasty using penile skin or oral mucosa was more good procedure for anterior urethral stricture during the treatment of the coexistence of urethral stricture in the anterior and posterior urethra.The treatment of posterior urethral stricture was based on the length of the stricture, local condition to make a choice between anastomotic urethral reconstruction and substitution urethroplasty using other tissue.

Objective To evaluate the sonographic features of testicular adrenal rests tumors in minor males. Methods The sonographic feature of pathologically or clinically confirmed testicular adrenal rests tumor in 13 minor males was retrospectively analyzed;we analyzed the number, morphology and size of affected testis; the involvement of testicular mediastinum; lesion location; the growth pattern, shape, boundaries, size, internal echo and blood supply of lesions. Results All of the 13 cases were bilateral and there were 26 lesions in all, 5 cases (5/13, 39%) had normal testicular size and morphology, testicular mediastinum were seen in 12 cases (12/13, 92%);26 (26/26, 100%) TARTs were all located near the testicular mediastinum or the testis hilar;21 (21/26, 81%) lesions had irregular shape while 5 (5/26, 19%) lesions were round;26 (26/26, 100%) lesions all had clear boundary but had no echo envelope;the lesion size was (1.5 ± 1.0) cm in average;13 (13/26 , 50%) lesions showed homogeneous hypoecho, 11 (11/26, 42%) lesions showed inhomogeneous hypoecho and 2 (2/26, 8%) lesions showed inhomogeneous isoecho; 19 (19/26,73%) lesions displayed rich blood supply and 7 (7/26, 27%) lesions displayed scarce blood supply. Conclusion The sonographic appearance of TART in minor males was characteristic, ultrasonography has important clinical value.

Objective To investigate the early diagnostic value of cornel confocal microscopy for the screening of small neuropathy in elderly patients with type 2 diabetic mellitus.Methods In the prospective study,96 elderly patients with diabetes as study group and 46 patients with non-diabetes as the control group were continuously collected from our hospital endocrinology and ophthalmology out patients during May 2014 to February 2016.The 96 cases of type 2 diabetes were subdivided into 47 patients with diabetic peripheral neuropathy (DPN)and 47 patients with nowdiabetic peripheral neuropathy(non DPN).Results The diabetes course was shorter in non-DPN group than in DPN group(P=0.000).The levels of glycosylated hemoglobin and urine albumin were lower in the nonDPN than in the DPN(P =0.072,0.007,respectively).The corneal nerve fiber density was lower in the DPN group than in NDPN group (P =0.000).Corneal nerve fiber density was higher in control group than in DPN and NDPN group.The differences in number of corneal nerve fibers showed no statistical significance between DPN and NDPN group (x2 =2.391,P =0.314).But the number of corneal nerve fibers was significant less in DPN and NDPN group than in control group(x2 =16.014,P =0.000).The negative correlation was found between the course of disease and corneal fibrous density by using single factor linear regression analysis.The number of corneal nerve fibers was lower in smoking group than in non-smoking group(P=0.003).The multiple linear regression analysis showed that duration of diabetes was a risk factor for diabetic neuropathy.Conclusions In some elderly diabetic patients with non-neuropathy,corneal nerve fiber density and number have been significantly decreased before nerve conductive velocity is reduced.Therefore,corneal confocal microscopy can be used to detect and diagnose small diabetic neuropathy in elderly patients with diabetes mellitus.

Objective To evaluate the relationship between different Framinghan vascular risk factor and cognitive impairment in the middle-aged and elderly.methods 71 participants from Physical Examination Center,Zhongnan Hospital of Wuhan University were consecutively recruited from March 2016 to May 2016.Framingham Cardiovascular Disease Risk Profile (FCVDRP),Framingham Stroke Risk Profile (FSRP) and Framingham Coronary Heart Disease Risk Profile (FCHDRP) were respectively used to evaluate the vascular burden of the participants.Mini-mental state examination (MMSE) and digital sign conversion test (DST) were used to evaluate the cognitive function of the participants.Partial correlation analysis was used to investigate the correlation between FCVDRP,FSRP and FCHDRP scoring methods and cognitive function.Result s(1)After adjusting for education years,with the increase of vascular burden scores,the scores of MMSE (FCVDRP:low-risk group (28.29±1.38),mid-risk group(27.40±1.73),high-risk group (26.72±1.93);FSRP:low-risk group (28.00±1.60),mid-risk group (26.26±2.46),high-risk group (27.2±2.04);FCHDRP:low-risk group (27.74±1.73),mid-risk group (27.46±2.00),high-risk group (27.18±1.59)) and DST (FCVDRP:low-risk group (29.24±5.54),mid-risk group (27.40±1.73),high-risk group (26.72±6.76);FSRP:low-risk group (30.09±5.61),mid-risk group (25.11±7.55),high-risk group (23.53±5.60);FCHDRP:low-risk group (30.37±6.41),mid-risk group (25.46±6.76),high-risk group (26.82±5.99)) were significantly decreased(all P<0.05).(2)The Result s of partial correlations analysis showed that the scores of FSRP were significantly correlated with MMSE (r=-0.249) and DST (r=-0.291)(both P<0.05).Conclusion Aggregation of vascular risks factors may aggravate cognitive impairment in middle-aged and elderly people.Compared to FCVDRP and FCHDRP,FSRP assessment may be more significantly associated with vascular cognitive impairment.