Objective To explore the mucosal healing quality of hydrotalcite combined with esomeprazole in gastric ulcer.Methods Forty-two patients visiting from June 2014 to December 2015 and diagnosed with gastric ulcer were selected and divided into combination therapy group and single therapy group with 21 patients in each group.The patients of combination therapy group received esomeprazole combined with hydrotalcite,and the patients of single therapy group received esomeprazole alone.The total therapeutic course was eight weeks.At the same period,21 health check-up participants were enrolled as normal control group.The healing of gastric ulcer was observed under white light endoscopy.The morphological changes of gastric pits and microvessel of mucosal at peripheral mucosa around ulcer and normal gastric mucosal were observed under narrow band imaging magnifying endoscopy.The gastric mucosa tissues of the two groups before and after treatment,and normal gastric mucosa of healthy control group were taken.The amount of deposition and composition of collagen fibers,the expression level of factor Ⅷ,the level of transforming growth factor (TGF)-beta1 and the content of hydroxyproline were analyzed by Masson,immunofluorescent and immunohistochemistry staining as well as enzyme linked immunosorbent assay.Chi square test,one-way analysis of variance (ANOVA),least significant difference (LSD) method,Dunnett's T3 and Kruskal-Wallis test and other method were used for comparison.Results After treatment,18 patients of combination therapy group (21 patients) had regular microvessel nets (85.7％),which was significantly more than those of single therapy group (12 cases,57.1％) and healthy control group (10 cases,47.6 ％),and the differences were statistically significant (x2 =4.200,P=0.040).In the comparison of maturity of regenerative mucosa between combination therapy group and single therapy group after treatment,the ration between collagen type Ⅰ and Ⅱ,deposition of collagen fibers,the number of factor Ⅷ positive cells,the level of TGF-beta1 and the content of hydroxyproline were 36.05 and 23.14;269 375.63.± 171 608.63 and 137 693.14±98 330.93;34.91±8.40 and 28.24±6.93;104 498.71±40 487.96 and 70 757.11±19 323.95;(1 897.80±879.35) and (1 230.57±536.05) μg/L,respectively;while in healthy control group,the above parameters were 36.81,245 696.90 ± 224 687.00,23.10 ± 8.40,94 048.04 ±41 306.55 and 1 681.20 ± 423.61 μg/L,and the differences were statitically significant among these three groups (H=7.375,F=3.465,11.680,5.190,5.160;all P＜0.05).Those parameters of combination therapy group were significantly higher than those of single therapy group (H=2.416,LSD method;all P＜0.05).Conclusion Hydrotalcite combined with esomeprazole in the treatment of gastric ulcer could significantly improve microvessel morphology,maturity degree of regenerative mucosal structure and function,and the mucosal healing quality was also superior to single esomeprazole group.

Objective To systematically evaluate the effect of case management model in patients with breast cancer in China. Methods The internet-based retrieval was done through SinoMed, CNKI, WANFANG data, VIP, Pubmed and Web of Science (WOS) with case management model of breast cancer patients in the randomized controlled trails. Data extraction and quality evaluation were conducted from the acquired literature. Results Eight studies were included. The case management was showed to improve the treatment compliance of patients with breast cancer and the satisfaction of patients effectively. It also reduced hospitalization time and hospitalization costs of the patients, improve the quality of life and social psychological adaptability. Conclusion The application of case management model is effective, but the case management model is still in the initial stage in China, needing to be strengthened.

OBJECTIVE:To investigate the effects of plasma exchange (PE) combined with intensive insulin glycemic control on related indexes of patients with HLP.METHODS:A total of 120 HLP patients were randomly divided into control group (60 cases) and observation group (60 cases).Based on routine treatment,2 groups were given PE treatment for 3 times+Low molecular weight heparin calcium for injection 5 000 U subcutaneously+Methylprednisolone sodium succinate for injection 40 mg intravenously+Calcium gluconate injection 2 g intravenously.Based on it,Insulin injection was pumped to random blood glucose ＜12 mmol/L with a micro-infusion pump in control group when random blood glucose concentration was equal to or more than 12 mmol/ L.When random blood glucose of patients in observation group were higher than 8.3 mmol/L,Insulin injection was pumped with a micro-infusion pump for a week and random blood glucose concentration was maintained at 6.1-8.3 mmol/L.Plasma levels of triglyceride,PCT,WBC count,APACHE Ⅱ score,Balthazar CT score,length of hospitalization stay in ICU and the occurrence of ADR were observed in 2 groups before and after treatment.RESULTS:After treatment,plasma levels of triglyceride,amylase and PCT,WBC count,APACHE Ⅱ score and Balthazar CT score in 2 groups were significantly lower than before treatment,and the observation group was significantly lower than the control group,with statistical significance(P＜0.05).Length of hospitalization stay in ICU observation group was significantly shorter than control group,with statistical significance(P＜0.05).There was no statistical significance in the incidence of ADR between 2 groups(P＞0.05).CONCLUSIONS:PE combined with intensive insulin glycemic control can effectively reduce the level of plasma triglyceride,relieve inflammatory reaction and improve prognosis without increasing the occurrence of ADR.

Objective:To investigate the willingness of medical students to work in primary health care institutions.Methods:A cross-section survey was conducted to investigate the willingness and the reasons, involving 597 undergraduate medical students and 2088 junior college students.Results:The employment willingness of undergraduate medical students was relatively low (14.9%), while the employment willingness of junior college students was high (56.02%). The top three factors of low employment willingness were: less opportunities for personal development, poor working environments and welfare. Moreover, the most effective method to cultivate medical students was developing a free training project for rural-oriented medical students, and the best method to attract medical students was formulating a more beneficial comprehensive policy.Conclusion:The willingness of clinical medical students to be employed in primary health care institutions is low for the time being. It is suggested to improve their willingness by improving welfare benefits, providing personal development opportunities, and strengthening social security.

To evaluate the effects of non-pharmacological interventions on cognitive function and activities of daily living in patients with post-stroke cognitive impairment (PSCI).Methods:Based on Cochrane Library, PubMed, Web of Science, Embase, CNKI, WanFang, and VIP databases, randomized controlled studies on rehabilitation therapy for PSCI patients were retrieved. And the retrieval date was from the establishment of the databases to 31 December 2021. Literature screening, data extraction, quality evaluation and data analysis were carried out.Results:A total of 26 studies were included, involving 12 interventions and 2007 patients with PSCI. The results of network Meta-analysis showed that compared with routine rehabilitation and/or routine rehabilitation care, cognitive therapy ( SMD=-1.30, 95% CI -2.09 - -0.52)、repetitive transcranial magnetic stimulation ( SMD=-1.67, 95% CI -2.54 - -0.81; SMD=-2.34, 95% CI -3.71 - -0.97), repetitive transcranial magnetic stimulation combined with cognitive therapy ( SMD=-1.56, 95% CI -2.76 - -0.36; SMD=-2.23, 95% CI -3.39 - -1.07), acupuncture combined with cognitive therapy ( SMD=-2.31, 95% CI -3.51 - -1.12; SMD=-2.98, 95% CI -4.13 - -1.84), virtual reality ( SMD=-1.01, 95% CI -1.98 - -0.04; SMD=-1.68, 95% CI -2.98 - -0.38), computer-assisted cognitive training combined with cognitive therapy ( SMD=-2.50, 95% CI -4.35 - -0.65; SMD=-3.17, 95% CI -4.99 - -1.35), music therapy ( SMD=-1.47, 95% CI -2.61 - -0.33), music therapy combined with cognitive therapy ( SMD=-2.35, 95% CI -4.04 - -0.67), recreational therapy ( SMD=-2.11, 95% CI -3.93 - -0.30), guided imagination therapy ( SMD=-2.48, 95% CI -4.00 - -0.96) had statistical significance in improving the cognitive function of PSCI patients ( P<0.05); recreational therapy ( SMD=-3.57, 95% CI -6.09 - -1.04; SMD=-3.70, 95% CI -7.22 - -0.18) had statistical significance in improving the ability of daily living activities of PSCI patients ( P<0.05). According to the area ranking results under the cumulative ranking probability graph, acupuncture combined with cognitive therapy (89.2%) and recreational therapy (85.1%) ranked first in improving cognitive function and activities of daily living, respectively. Conclusions:Acupuncture combined with cognitive therapy and recreational therapy have the best effect on improving cognitive function and activities of daily living in PSCI patients, respectively. However, considering the poor quality of the original literature included, more large samples and high-quality RCTs are needed for further verification.

OBJECTIVETo investigate the epidemiological characteristics of human infections with avian influenza A (H7N9) in China and to provide scientific evidence for the adjustment of preventive strategy and control measures.

METHODSDemographic and epidemiologic information on human cases were collected from both reported data of field epidemiological investigation and the reporting system for infectious diseases.

RESULTSA total of 433 cases including 163 deaths were reported in mainland China before June 4, 2014. Two obvious epidemic peaks were noticed, in March to April, 2013 and January to February, 2014. Confirmed cases emerged in 14 areas of China. Five provinces, including Zhejiang, Guangdong, Jiangsu, Shanghai, and Hunan, reported about 85% of the total cases. Median age of the confirmed cases was 58 years (range, 1-91), with 70% as males. Of the 418 cases with available data, 87% had ever exposed to live poultry or contaminated environments. 14 clusters were identified but human to human transmission could not be ruled out in 9 clusters.

CONCLUSIONHuman infections with avian influenza A (H7N9) virus showed the characteristics of obvious seasonal distribution, with certain regional clusters. The majority of confirmed cases were among the elderly, with more males seen than the females. Data showed that main source of infection was live poultry and the live poultry market had played a significant role in the transmission of the virus.

Adaptation, Psychological ; Aged ; Animals ; China ; epidemiology ; Demography ; Environmental Pollution ; Female ; Humans ; Influenza A Virus, H7N9 Subtype ; Influenza, Human ; epidemiology ; prevention & control ; transmission ; Male ; Meat ; Poultry ; Research Design