Objective] To explore the effect of Biejiajian oral Liquid (BOL) on the level of angiotensinⅡ(AngⅡ) and angiotensin(1-7) [Ang(1-7)],and ratio of AngⅡ/Ang(1-7) in liver fibrosis rats. [Methods] Randomly divide male Wistar rats into blank group, model group, BOL groups of high dose and low dose, 10 in each. The model rats were injected with inactivated pig serum abdominally, 0.5mL for each, 2 times/w, for successive 8w. Other rats were injected with the same dosage and period of normal saline. After modeling, administer BOL 10g·kg-1 to low-dose groups rats, and 20g·kg-1 to high-dose group rats; give equal distilled water to blank and model groups, for successive 5 weeks of intragastric administration. The liver histopathology was examined by hematoxylin-eosin(HE) and Masson trichrome staining. Liver and spleen index were calculated. Levels of alanine transaminase(ALT) and aspartate aminotransferase(AST) in serum were assayed by automatic biochemistry detection instrument. Contents of hyaluronic acid(HA), laminin(LN), typeⅢprocollagen(PcⅢ) and type IV collagen(Ⅳ.C) in serum were detected by radioimmunoassay. AngⅡand Ang(1-7) levels were determined by enzyme linked immunosorbent assay. [Results] Compared with model group, the histological injury of liver in rats of BOL groups was relieved; serum levels of AST, ALT, HA, LN, PCⅢ and Ⅳ.C, and the content of AngⅡ in liver homogenate were decreased significantly than that of the model group. Ang(1-7) level was further increased, AngⅡ/Ang(1-7) ratio was decreased obviously in BOL groups. [Conclusion] BOL showed the protective function for hepatic fibrosis, the mechanisms of which may be associated with improvement of Ang(1-7) level, decrease of AngⅡlevel and the ratio of AngⅡand Ang(1-7).

Objective To analyze the clinical characteristics and nursing measures of infection in hospital ICU,and to provide the refer-ence for clinical nursing. Methods From January 2010 to June 2013,116 patients with nosocomial infection in surgical ICU were collected as observation group,and 72 patients with nosocomial infection in the surgery were as the control group. The risk factors of nosocomial infec-tion were retrospectively analyzed,and the problems related to nursing were discussed. Results The nosocomial infection rate was 8. 44% in ICU,which was significantly higher than the surgical infection rate(4. 43%) in general ward (P<0. 05). Whether patients in ICU or surgery ward,respiratory and urinary tract infections were the most common site of nosocomial infection. The mortality rate in ICU was 9. 48%,which was higher than that of nosocomial infection in surgical ward (4. 17%),P<0. 05. The nosocomial infections were obviously related to the age of patients,duration of hospitalization,the invasive operation,antibiotic and immunosuppressive agents and disturbance of consciousness in ICU and general wards (P<0. 01). Conclusion The ICU nosocomial infection rate was significantly higher than that in general ward,the main infection sites are respiratory tract and urinary tract,with a variety of factors,the key is to establish the mechanism of prevention and ef-fective nursing strategy.

To investigate whether chemotherapy could prolong the postoperative survival time in patients with early stages pancreatic ductal adenocarcinoma (PDAC). A total of 5280 stage ⅠA -ⅡB PDAC patients diagnosed from 2010 to 2015 were selected from surveillance，epidemiology，and end results (SEER) database. Propensity score matching (PSM) analysis was adopted to reduce the baseline differences between the groups. Univariate survival analysis was conducted with the Kaplan-Meier method. Multivariate survival analysis was performed with the Cox proportional hazards model. Univariate and multivariate survival analyses showed that age, differentiation, stage, chemotherapy were independent risk factors for the survival of PDAC patients. After PSM, it is found that adjuvant chemotherapy could prolong the median overall survival time (mOS) for stage ⅠB, ⅡA and ⅡB patients. However, for stage ⅠA patients, there were no significant differences in 3-year survival rate and mOS between patients with chemotherapy (=283) and without chemotherapy (=229) (57.4% vs 55.6%, vs all >0.05). Further analyses show that among 101 patients with well differentiated PDAC and 294 patients with moderately differentiated PDAC, there were no significant differences in survival rate and mOS between patients with and without chemotherapy (all >0.05). Among 117 patients with low-differentiated + undifferentiated PDAC, 3-year survival rate and mOS in patients with chemotherapy were significantly better than those without chemotherapy (48.5% vs 34.1%, vs all <0.05). Chemotherapy regimen used currently is not beneficial for patients with moderately and well differentiated stage ⅠA PDAC, but it is an independent prognostic factor for low-differentiated + undifferentiated PDAC patients.
Adenocarcinoma/pathology* ; Carcinoma, Pancreatic Ductal/surgery* ; Chemotherapy, Adjuvant ; Humans ; Neoplasm Staging ; Pancreatic Neoplasms/drug therapy* ; Prognosis ; Propensity Score

Since the establishment of eight-year clinical medicine specialty, in line with the princi-ple of "eight-year consistency and fusion of the bachelor and doctor degree", the training mode of "strength-ening the foundation, focusing on quality, overall optimization, facing the clinical" has been implemented. In order to reach the standard of professional doctorate, a series of courses of professional doctorate need to be fused in limited time and designed carefully by medical schools. However, grasping proper teaching time and opportunity is particularly important for students' learning and development. By collecting the courses information of 11 medical colleges and universities offering eight-year clinical medicine specialty, we have analyzed the teaching time, methods and course categories of scientific research training courses and graduate degree courses, aiming to find the appropriate teaching program.

Objective:To explore the clinical features of chronic atrophic gastritis (CAG) without Helicobacter pylori ( H. pylori) infection and its correlation with metabolic syndrome. Methods:From June 1, 2022 to March 31, 2023, a total of 966 patients diagnosed with CAG at Army Medical Center of PLA (Chongqing Daping Hospital) were enrolled. All the patients underwent 14C-urea breath test and gastroscopy. The patients were divided into infected group (461 patients with H. pylori-positive CAG) and uninfected group (505 patients with H. pylori-negative CAG). Relevant data including age, body mass index, degree of gastric atrophy (Kimura-Takemoto classification), metabolic syndrome, diabetes mellitus, and hyperlipidemia were collected and compared between the 2 groups. Independent sample t-test and chi-square test were used for statistical analysis. Multiple linear regression analysis was performed to investigate the correlation between relevant indicators and the degree of gastric atrophy in the uninfected group patients. Results:The proportion of patients aged 71 to 80 years old in the uninfected group was higher than that in the infected group (17.0%, 86/505 vs.10.4%, 48/461), and the difference was statistically significant ( χ2=9.62, P=0.002). The degree of gastric atrophy was compared between the 2 groups, the proportions of C1 and C2 patients in the uninfected group were higher than those in the infected group (53.5%, 270/505 vs. 46.4%, 214/461; 34.1%, 172/505 vs. 26.24%, 121/461), and the differences were statistically significant ( χ2=4.78 and 6.96, both P<0.05). The proportions of patients with metabolic syndrome, diabetes mellitus, hyperlipidemia and obesity in the uninfected group were higher than those in the infected group (31.2%, 20/64 vs.14.8%, 9/61; 33.5%, 62/185 vs. 21.5%, 34/158; 31.3%, 67/214 vs. 7.8%, 36/461; 36.7%, 22/60 vs.19.7%, 12/61), and the differences were statistically significant ( χ2=4.77, 6.08, 4.95, and 4.32, all P<0.05). The results of multiple linear regression analysis showed that high density lipoprotein-cholesterol, blood glucose, and body mass index were all correlated with the degree of gastric atrophy ( r=-0.15, 0.20, and 0.31, all P<0.05). Conclusion:CAG without H. pylori infection may be related to physiological aging, and the degree of gastric atrophy is C1 and C2, which is related to metabolic syndrome.

Objective:To explore the clinical characteristics and management of childhood acute lymphoblastic leukemia (ALL) complicated with cerebral venous thrombosis (CVT).Methods:The clinical data of 14 ALL children complicated with CVT who were admitted to Department of Pediatrics of Sun Yat-sen Memorial Hospital and underwent chemotherapy from January 2011 to October 2019 were collected retrospectively. The clinical manifestations, coagulation function, imaging findings, treatment plan and prognosis of patients were analyzed.Results:CVT was diagnosed in 14 (2.8%, 14/505) cases, with a median age of 10 (3-14) years at onset, 11 cases occurred in the stage of induction remission, and the acute onsets were mainly characterized by convulsions (9 cases), consciousness disorders (6 cases) and headache (4 cases). Coagulation function test showed that, before the CVT, antithrombin Ⅲ activity was lower than 60% in 8 cases, D-dimer elevated on the day of onset in 8 cases. Arteriovenous angiography showed filling defects in single (9 cases) or multiple (5 cases) venous sinuses. The most common site of venous sinus enlargement was superior sagittal sinus (10 cases). Secondary cerebral hemorrhage was found in 5 cases. Anticoagulation therapy included combination of low-molecular-weight heparin (LMWH) and warfarin in 9 cases, sequential application of LMWH and warfarin in 2 cases, and LMWH alone in 3 cases. Patients accepted further asparaginase and no CVT recurrence or progression was found.Conclusions:The secondary coagulation dysfunction during induction remission chemotherapy is the major risk factor for CVT in ALL, which needs active monitoring and early prevention. Arteriovenous angiography can diagnose accurately, and the prognosis of anticoagulant therapy with LMWH and warfarin is optimistic.