Objective To investigate the relationship among Helicobacter pylori (Hp) infection, serum gastrin level and colorectal carcinoma. Methods Fasting serum samples from 47 consecutive patients with colorectal carcinoma and 30 demoographically matched colonoscopy-negative controls were detected for serum gastrin levels and IgG antibodies against Hp (Hp IgG) by enzyme linked immunosorbent assay. Some of them accepted 14C urease breath test and/or rapid urease test after undergoing endoscopy. Hp infection was affirmed when at least two of the three tests were positive. Results The Hp infection incidence was significantly higher in patients with eoloreetal carcinoma (61.7%, 29/47) as compared with controls (36.7%, 11/30) (P<0.05). The Hp infection incidence in distal distribution of carcinoma was higher than that in controls, and in female carcinoma was higher than that in female controls(P <0.05). Mean fasting serum gas-trin levels were significantly higher in patients with coloreetal carcinoma[(139.7±53.3 ) ng/L]than those in controls [(89.5±26.1 ) ng/L] (P < 0.01 ). There was a significant association between hypergastrinemia and distal distribution of carcinoma. Conclusion Increasing serum gastrin levels, higher Hp infection incidence has a positive relationship with colorectal carcinoma.

With the reform of the medical and health system entering a critical period,public hospitals have also exposed new risks and challenges in economic operation.As an important means of hospital standardized management,internal control can better prevent and resolve the risk of hospital economic operation and ensure the sustainable operation of the hospital.By interpreting the requirements of current national policies on hospital internal control,it analyzes the functional positioning of financial and accounting supervision in hospital internal control,shares the internal control implementation path of sample hospitals from the perspective of financial and accounting supervision,and puts forward suggestions on strengthening internal control construction of public hospitals in the new era,in order to lay a good foundation for the high-quality development of hospitals.

This paper summarized the clinical experience of using the method of “returning fire to its origin” for treatment of paroxysmal sympathetic hyperactivity （PSH）. According to the causes and clinical characteristics of PSH， the author believes that the deficiency of kidney qi， and the loss of yin and yang are the basis of the pathogenesis of PSH. Fright causes qi to be chaotic as the triggering mechanism of PSH. The key mechanism of PSH is that the deficiency yang with upper manifestation， and the fire does not return to its origin. The treatment should be nourishing yin and astringing yang， by taking modified Yinhuo Decoction （引火汤） internally， and receiving warm moxibustion as the first choice externally with selected acupoints Guanyuan （CV 4）， Mingmen （GV 4）， and bilateral Yongquan （KI 1）； For prevention， attention should be paid to take care of stomach qi， support healthy qi， and cultivate original qi.

ObjectiveTo explore the potential influencing factors and complex pathways affecting rehabilitation effect for children with autism spectrum disorder (ASD) from the perspective of parental efficacy in doctor-patient communication, and to provide evidence for improving the quality of rehabilitation service for children with ASD. MethodsAn anonymous face-to-face questionnaire survey was conducted to collect general demographic information of parents of children with ASD at designated rehabilitation institutions in Gansu province. The data included parental efficacy in doctor-patient communication, parental compliance of treatment and children's rehabilitation outcomes were collected. A structural equation model was used to explore the impact mechanism of parental communication efficacy on the rehabilitation outcomes of children with ASD. ResultsData from 519 parents at 37 rehabilitation institutions across 13 cities/counties in Gansu province were collected. Significant positive correlations were found between parental efficacy in doctor-patient communication, doctor-patient relationships, parental compliance with treatment and rehabilitation outcomes for children with ASD (P < 0.05). Through structural equation model analysis, the standardized direct effect of children with ASD from parents' doctor-patient communication efficacy was 0.151 (P = 0.023). The mediating effect of doctor-patient relationship and parental compliance with treatment were 0.160 (P = 0.001) and 0.111 (P = 0.001), respectively, with a chained mediating effect of 0.035 (P = 0.001). The pathway "parental efficacy in doctor-patient communication → doctor-patient relationship → ASD child's rehabilitation outcome" accounted for the highest proportion of the total mediating effect, at 52.29%. ConclusionParental doctor-patient communication efficacy may positively impact on the rehabilitation outcomes of children with ASD directly, and indirectly through the doctor-patient relationship and parental compliance with treatment. Rehabilitation institutions should focus on fostering parental communication skills and enhancing high-quality and humanized rehabilitation services.