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

Abstract: Objective　To analyze the prevalence of peripheral arterial disease (PAD) among residents in Shenzhen and explore its relationship with different obesity statuses, to provide data support for understanding the prevalence of PAD in China and a basis for formulating prevention and control policies to prevent PAD. Methods　From April 2021 to December 2021, a multi-stage stratified random sampling method was used to select permanent residents aged 18 years or older from 54 community neighborhood committees in Shenzhen as the study population. Data were collected using questionnaires, physical examinations, and laboratory tests. A generalized additive model was fitted and plotted using the R package, and logistic regression models were used to analyze the association between different obesity status groups and PAD. Results　Among the 6 230 study subjects, the prevalence of PAD in the study population was 6.21%, and the prevalence of PAD increased with age, with the lowest rate of 4.67% in the 18-<25 age group and the highest rate of 33.33% in the ≥85 age group. In addition, the prevalence of PAD increased with increasing body mass index (BMI) or waist circumference. Analysis of multifactorial logistic regression models showed that both overall obesity (OO) classified by BMI and central obesity (CO) classified by waist circumference may increase the risk of PAD (OO statistic value OR=2.63, 95%CI:1.97-3.50; CO statistic value OR=2.32, 95%CI:1.79-2.99). When combining BMI and waist circumference classification, compared to those who were neither OO nor CO, individuals who were both OO and CO had a significantly higher risk of PAD (OR=2.61, 95%CI:1.99-3.44). Conclusions　The prevalence of PAD among adults in Shenzhen is not optimistic, and the elderly need additional attention. Both OO based on BMI and CO based on waist circumference are independent risk factors for PAD. The joint use of BMI and waist circumference grouping helps to better classify and manage people at risk of PAD.

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 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 explore the dose-effect,time-effect and safety of alteplase in the treatment of acute cerebral infarction.Methods One hundred and ten patients with acute cerebral infarction were selected,among whom 50 patients whose time window ≤3.0 h were divided into group A and group B by random digits table method with 25 cases each,and 60 patients whose time window 3.1-4.5 h were divided into group C and group D by random digits table method with 30 cases each.The patients in group A and group C received alteplase 0.6 mg/kg (maximum dose 60 mg) intravenous thrombolysis;the patients in group B and group D received alteplase 0.9 mg/kg (maximum dose 90 mg) intravenous thrombolysis.The national institutes of health stroke scale (NIHSS) scores before treatment and 1 h,24 h,7 d,30 d and 90 d after treatment were observed in the 4 groups.The therapeutic effect,complication incidence and fatality rate were compared.The prognosis was estimated by modified Rankin scale (mRS) score 90 d after treatment.Results The NIHSS scores 1 h,24 h,7 d,30 d and 90 d after treatment were significantly lower than those before treatment in the 4 groups,and there were statistical differences (P ＜ 0.05).The NIHSS score decreased significantly with time.There were no statistical differences in NIHSS score between group A and group B,group C and group D.There were no statistical differences in complication incidence and fatality rate 90 d aftcr treatment in group A and group D compared with group B and group C (P＞ 0.05).The rate of eusemia in group A was 76.00％ (19/25),in group B was 64.00％ (16/25),in group C was 43.33％ (13/30),and in group D was 53.33％ (16/30).And there were no statistical differences between group A and group B (x2 =0.620,P ＞0.05),and between group C and group D (x2 =0.069,P＞ 0.05).Conclusions The low dose alteplase is also effective and safe to acute cerebral infarction patients at time window ≤ 3 h.It is also effective and safe to acute cerebral infarction patients at time window 3.0-4.5 h at standard dose.

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 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.