Objective To investigate the clinical effect of combined treatment of upper gastrointestinal bleeding in emergency internal medicine. Methods A total of 102 patients with upper gastrointestinal bleeding were enrolled in the Department of Emergency Gastroenterology, Peking Binhai University Hospital from June 2014 to October 2016. The patients were randomly divided into observation group and control group, 51 cases in each group.The control group were only given omeprazole sodium, tranexamic acid injection,the observation group were given Agkistrodon hemocoagulase for injection on patients on the basis of the control group.After treatment, the clinical curative effect of two groups of patients were evaluated, the hospitalization days, the average hemostasis time, blood transfusion, bowel recovery time, abdominal pain relief time, the adverse reactions occurred of the two groups were observed.Results The total effective rate of the observation group was significantly higher than that of the control group (P< 0.05). The hemostasis time,the time of hospitalization and the average blood transfusion in the observation group were significantly lower than those in the control group (P<0.05). The recovery time of bowel and the time of pain relief in the observation group were significantly lower than in the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the observation group and the control group.Conclusion Comprehensive treatment of upper gastrointestinal bleeding with emergency internal medicine can significantly improve the clinical efficacy, shorten the time of hemostasis and recovery, and is worthy of clinical application.

Objective:To study the size difference of bilateral axillary vein in adults, and to provide basis for the design of interventional surgical treatment.Methods:From December 2017 to December 2018, 145 inpatients (117 cases of hypertension, 28 cases of heart failure) and 87 healthy volunteers were selected from the Second People's Hospital of Lianyungang as study objects.The size of bilateral axillary vein of each study object was measured and the difference was statistically analyzed.Results:Among the 232 subjects, the dominant hand was the right hand, accounting for 95.7% (222/232). There were no statistically significant differences in the size of left and right axillary veins (all P>0.05). There were no statistically significant differences in the other indicators except age between the two groups (all P>0.05). The diameter of axillary vein was (0.67±0.15)cm in male and (0.53±0.13)cm in female, the difference is statistically significant( P=0.000). In the healthy control group, the dominant, non-dominant and large cross-sectional areas were (0.54±0.17)mm 2, (0.54±0.15)mm 2, (0.60±0.16)mm 2, respectively, which in the hypertension group were (0.55±0.14)mm 2, (0.54±0.14)mm 2, (0.59±0.14)mm 2, respectively, which in the heart failure group were (0.54±0.16)mm 2, (0.56±0.19)mm 2, (0.59±0.1)mm 2, respectively, there were no statistically significant differences among the three groups (all P>0.05). Conclusion:The difference is not obvious in the size of bilateral axillary vein, and there is no correlation between the size of bilateral axillary vein and dominant hand.The size of axillary vein in adults of different genders is different, and the size of axillary vein can be estimated by the gender of subjects, but not by the dominant hand or other data.