Objective: To study the effect of helicobacter pylori on gastric mucosal cell proliferation in gastritis. Methods: Fifty-six gastritis patients with or without Helicobacter pylori infection (Hp+ 27; Hp- 29) were selected. The expression of proliferation cell nuclear antigen (PCNA), epidermal growth factor receptor (EGFR), transforming growth factor beta receptor type Ⅰand typeⅡ(TGF?RⅠ, TGF?RⅡ) in gastric mucosa were examined by immunohistochemical method. Results: The PCNA and EGFR were significantly higher in Hp positive chronic gastritis patients than in Hp negative ones(P

Objective To assess the latency and amplitude changes in P300 in senile patients with depression.Methods 13 domestic published study literatures meeting our criteria were searched from CBM,CNKI,and a meta-analysis on P300 latency and amplitude was performed with RenMan 4.1 soft ware.Results 1.The P300 latency in senile patients with depression was significant longer than that in senile normal controls in N1,P2,N2,P300 (N1:WMD=3.07,95 ％ CI:0.7～5.42,Z=2.55,P=0.010;P2:WMD=18.41,95％CI:15.11～21.71,Z=10.93,P＜ 0.01;N2:WMD=25.41,95％CI:12.80～29.02,Z=13.80,P＜0.01;P3:WMD=32.14,95％CI:24.14～34.88,Z=23.04,P＜0.01).2.The amplitude in senile patients with depression was significant lower than that in senile normal controls in N2,P2,P3 (P2:WMD=-0.83,95％CI:-1.07～-0.59,Z-6.78,P＜0.01; N2:WMD＝-0.34,95％CI:-0.59～-0.08,Z=2.57,P=0.01;P3:WMD=-2.54,95％CI:-2.75～-2.33,Z=23.99,P＜0.010).Conclusions P300 longer latency and lower amplitude are the statistically characterized features for senile depressive patients.

Objective: To investigate the clinical efficacy of acupuncture combined with tuina in treating patients with cervical vertigo. ＜br> Methods: According to the principle of randomization, 258 cases with cervical vertigo who met the inclusion criteria for the study were randomly divided into an observation group and a control group, with 129 cases in each. The patients in the observation group received acupuncture combined with tuina therapy, while those in the control group were just treated by the same acupuncture therapy as in the observation group. After 10-day continuous treatments, the clinical efficacies of the two groups were analyzed and compared. ＜br> Results: The total effective rate of the observation group was 100%, versus 86.0% of the control group, and the difference was significant (P＜0.05). After treatment, cervical range of motion (ROM) scores in both groups were statistically significantly different from those before treatment (allP＜0.05); in addition, there was a statistically significant difference in inter-group comparison of ROM score (P＜0.05). ＜br> Conclusion: Compared with simple acupuncture treatment, acupuncture combined with tuina therapy has a better effect in improving the ROM of cervical vertigo patients, with higher clinical efficacy.

Purpose To investigate the clinicopathologic characteristics, differential diagnosis, treatment and prognosis of differentia-ted-type vulvar intraepithelial neoplasia ( dVIN) . Methods Clinicopathologic findings and immunophenotypes of 6 cases diagnosed as“dVIN” were retrospectively analyzed, and the relevant literatures were also reviewed. Results 6 patients were all female ranged 53~80 years old with mean age of 62 years old. Clinical aspects included leukoplakia vulvar, pruitis, irritation, pain, ulcer and so on. The histopathological features were hyperplasia of basal and parabasal layer with elongation and anastomosing reteridges. Cells were marked atypia with obvious nucleoli, atypical mitosis, and dyskeratosis. In the middle and surface layer, cells were well differentiated with pronounced intercellular bridges, and eosinophilic cytoplasm, hyperkeratosis and parakeratosis. Oedema and band of infiltration of chronic inflammatory cells of subepidermal could been seen. Immuohistochemistry showed the expression rates of p53 and p16 in totally 6 cases were 83. 3% (5/6), 0 (0/6), respectively. The Ki-67 index was more than 90% in basal and parabasal cells. Four patients were followed up ( mean follow-up 17 months, range 6~36 months) , one patient died at 9 months later after surgery, another patient recurred at 6 months later after surgery, both of the 2 cases were all with invasive lesions after resection, and the rest two cases had no recur in 18 months and 36 months after surgery, respectively. Conclusion dVIN is a high grade squamous intraepithelial lesions of vulvar with low incidence rate, but had more risk of progression. p53, p16 and Ki-67 stain were useful in the diagnosis of dVIN.

Objective:To analysis the risk factors and safety of administration of norepinephrine (NE) via peripheral vein line (PVL) in patients with septic shock.Methods:A single-center retrospective study was conducted. According to the Lanzhou University Second Hospital information system (HIS) and nursing adverse events report cards, patients with septic shock administrated with NE via PVL to correct the hypotension from January 1st 2015 to December 31st, 2019 were enrolled. The patients' general information, placement location of peripheral venous catheter and venousneedle type, characteristics of NE usage and patient general condition when extravasation occurred were collected. The univariate analysis and Logistic regression were used to analyze risk factors associated with extravasation. Also, the receiver operator characteristic curve (ROC curve) was drawn, and the predictive value of risk factors for extravasation was analyzed.Results:A total of 1 022 cases with NE were enrolled. After a preliminary screening, a total of 910 cases with NE were used to correct low blood pressure, including 116 cases of peripheral venous infusion. The average age was (52.91±18.69) years old, with majority of female (77 cases, 66.4%). Basic diseases were mainly chronic obstructive pulmonary disease (COPD, 100 cases, 86.2%), followed by hypertension(91 cases, 78.4%), coronary heart disease (87 cases, 75.0%), type 2 diabetes (74 cases, 63.8%) respectively, the primary disease was septic shock in 109 cases (94.0%). A total of 147 peripheral venous catheters were inserted, and the most common site of puncture was the forearm [78.9% (116/147)], followed by the hand [12.2% (18/147)] and the median cubital vein [8.8% (13/147)]. 89.9% of the needles were 20 G in diameter, and 75 cases (64.7%) were converted to central venous catheters (CVC) during subsequent treatment due to continuous infusion of NE. Six patients (5.2%) had extravasation, the median time of extravasation was 29 (23-39) hours, and the median time of NE was 23 (11-53) hours, including 2 patients with an infusion concentration of 60 mg/L and 4 patients with an infusion concentration of 120 mg/L.The infusion speed was 0.5-1.0 μg·kg -1·min -1, and the average speed of infusion was (0.75±0.04) μg·kg -1·min -1 when extravasation. Univariate and binary Logistic regression analysis showed that the risk factors related to the occurrence of extravasation included: ① patient factors: the presence of basic diseases, hypertension [odds ratio ( OR) = 3.11, 95% confidence interval (95% CI) was 3.09-3.12, P = 0.001] and edema ( OR = 1.79, 95% CI was 1.32-2.99, P = 0.032). ② Factors of infusion fluid itself: long-term (> 24 hours) infusion ( OR = 2.91, 95% CI was 1.04-5.96, P = 0.040), infusion concentration > 60 mg/L ( OR = 1.88, 95% CI was 1.32-3.99, P = 0.024), infusion speed > 0.3 μg·kg -1·min -1 ( OR = 2.43, 95% CI was 2.38-2.51, P = 0.029) and diameter of needles < 20 G ( OR = 3.11, 95% CI was 3.09-3.22, P = 0.033).③ Medical personnel factors: lack of observation and assessment ( OR = 1.09, 95% CI was 1.03-6.77, P = 0.043). The ROC curve analysis showed that: edema, long-term infusion (> 24 hours), infusion rate > 0.3 μg·kg -1·min -1and diameter of needles < 20 G had a certain predictive value for extravasation of NE through peripheral venous infusion in patients with septic shock, the area under ROC curve (AUC) was 0.610, 0.762, 0.672, 0.629, 95% CI was 0.508-0.713, 0.675-0.849, 0.571-0.772, 0.525-0.732, and P values were 0.044, 0.000, 0.002, 0.019, respectively. Conclusions:Hypertension, edema, long-term infusion (> 24 hours), infusion concentration > 60 mg/L, infusion speed > 0.3 μg·kg -1·min -1, diameter of needle < 20 G, and lack of observation and evaluation by medical staff regularly were risk factors affecting the safety of peripheral intravenous NE in patients with septic shock. Peripheral NE should be avoided in the presence of the above risk factors.

Objective To observe the effect of SSRI combined with TCM on the treatment of depression of different TCM types. Methods 70 depressive patients of stagnation of liver qi (SLQ) were randomly recruited into a study (34 cases) and a control group (36 cases); 60 depressive patients of spleen deficiency and liver qi stagnation (SDLQS) were randomly recruited into a study (30 cases) and a control group (30 cases); and SO depressive patients of deficiency of both heart and liver (DBHL) were randomly recruited into a study (24 cases) and a control group (26 cases). Patients in the study group were treated with SSRI and TCM; with the control group was only treated with SSRI. All patients were assessed with HAMD, HAMA and CGI before treatment and after treatment at 1st weekend, 2nd weekend, 4th weekend and 6th weekend. Differences of effective rate and full remission rate were contrasted. Results ①Scores of depression scale decreased in both the study group and the control group of patients with SLQ and SDLQS at the 4th [SLQ study group: (9.01±3.45), control group (13.02±4.54); SDLQS study group (10.22±3.23)、 control group (14.12±3.87)] and 6th [SLQ study group (6.02±2.20), control group (10.22±2.10); SDLQS study group (7.25±2.20) control group (10.68 ± 3.45)] weekend, showing statistical differences; anxiety state has been improved since the 1st weekend; no obvious changes of HAMD and HAMA showed in both the study group and the control group of patients with DBHL; ②Therapeutic effects in the study group were higher than the control group of both patients with SLQ and SDLQS, showing statistical significance; while no difference can be seen between the two group of patients with DBHL; ③ No differences of full remission rate between the study group and the control group of 3 TCM types were found(SLQ:41.1%v30.6%,χ2=0.859,P>0.05; SDLQS:40.0%v33.3, χ2=0.287,P>0.05; DBHL: 33.3%v26.9%,χ2=0.244,P>0.05). ④Significant differences of HAMD and HMDA between the study and the control group of 3 TCM types were found before and after treatment Conclusion SSRI integrated with TCM may promote effective rate and decrease anxiety in patients with SLQ and SDLQS.

Objective To investigate the relationship between waist circumference and new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus. Methods A total of 1 950 patients with diabetes mellitus, who determined fasting plasma glucose(FPG)≥7.0 mmol/L or who were using hypoglycemic drugs and FPG<7.0 mmol/L,and body mass index (BMI)< 25 kg/m2, was selected in this study using prospective cohort method. Patients were divided into five groups according to the baseline data of waist circumference, including waist circumference<78 cm (A group, n=387), 78 cm90 cm (E group, n=421). Multiple Logistic regression model was used to analyze influential factors of new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus. Re?sults The average duration of follow-up was(47.24±5.13) months. The incidence rate was 11.85%(231/1 950) in patients with non-alcoholic fatty liver disease. The incidence rates were 6.98%, 9.28%, 12.38%, 14.19%and 15.68%in A, B, C, D and E groups, and which were increased with the increased waist circumference (P<0.05). Results of multiple Logistic re?gression model analysis showed that compared with A group,OR values were 1.97 and 2.19 in D and E groups respectively (P<0.05). Conclusion Waist circumference≥85 cm was the risk factors of new-onset non-alcoholic fatty liver disease in non-obese patients with diabetes mellitus.

ObjectiveTo investigate the changes in positive staining of CD34, CK7, and CK19 and amount of fibrous collagen deposition in patients with chronic hepatitis B (CHB) and the pathological basis affecting FibroTouch measurements. MethodsA retrospective analysis was performed for the clinical data of 72 CHB patients who visited Department of Liver Cirrhosis in Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2015 to December 2017. The amount of positive immunohistochemical staining of CD34, CK7, and CK19 was calculated, as well as the amount of fibrous collagen deposition in Masson trichrome staining and liver stiffness measurement (LSM) by FibroTouch. The t-test was used for comparison of normally distributed continuous data between two groups. The Wilcoxon rank-sum test was used for comparison of non-normally distributed continuous data or continuous data with heterogeneity of variance between two groups. The chi-square test was used for comparison of categorical data between groups, and the Kruskal-Wallis H test was used for comparison of ranked data between multiple groups. The receiver operating characteristic (ROC) curve was used to analyze the value of LSM in the diagnosis of hepatitis B cirrhosis, and the logistic regression model was used for multivariate analysis. ResultsWith the increase in inflammation degree, there was no significant change in the amount of positive staining of CD34 (P＞0.05), while there were significant increases in the amount of positive staining of CK19 and the amount of fibrous collagen deposition (H=9.02 and 14.12, P=0011 and 0.001). With the progression of liver fibrosis, there were significant increases in the amount of positive staining of CD34 and CK7 and the amount of fibrous collagen deposition (H=10.26, 16.29, and 22.97, P=0.016, 0.001, and ＜0.001). The logistic regression analysis showed that the amount of positive staining of CK7 (Wald=4.756, P=0.029) and the amount of fibrous collagen deposition (Wald=4.757, P=0.029) were independent influencing factors for FibroTouch measurements. ConclusionIncreases in the amount of fibrous collagen deposition and the amount of positive staining of CK7 may lead to increased FibroTouch measurements.

Objective: To explore the clinical efficacies of applying aged marginal donor liver. Methods: From January 2015 to June 2018, clinical data were retrospectively analyzed for 199 adult liver transplantation donors and recipients. They were divided into two groups of aged (≥60 years) and appropriate age (<60 years). The prognosis of two groups was compared after a follow-up period of 1 year. And the aged group was further assigned into lower and higher fat infiltration groups according to the degree of fat infiltration in donor liver and compared the prognosis of two groups. Results: No significant differences existed in initial, peak value and recovery time of transaminase (AST/ALT), peak value and recovery time of total bilirubin, glutamyl transpeptidase, alkaline phosphatase, international normalized ratio (INR), peak value of lactate, postoperative hospital stay, graft dysfunction, biliary/vascular complications, acute/chronic rejection or graft survival rate between aged and appropriate age groups post-transplantation. The aged group was further divided into lower and higher fat infiltration groups according to the fat infiltration rate (<20%, ≥20%). And significant inter-group differences existed in peak value and recovery time of AST/ALT, peak value of total bilirubin, glutamyl transpeptidase, lactate, postoperative hospital stay and graft dysfunction. The above parameters were significantly worse in higher fat infiltration group. Also the rejection rate was higher in high group at 1 year post-operation and no significant inter-group difference existed in biliary/vascular complications. In higher group, 4 patients showed graft dysfunctions during perioperative period. Two of them were discharged successfully after secondary transplantation and another 2 patients died. Conclusions On the premise of comprehensive evaluations of donor liver status and reasonable matching of recipients, aged marginal donor liver can be safely applied with excellent clinical outcomes. Severe fatty donor liver should be employed with caution. Hypertensive drugs, high serum sodium and long period of cold ischemia are also important influencing factors for aged donors.

Objective To summarize the screening Methods for human parvovirus (HPV) B19 infection after liver transplantation and analyze the related risk factors. Methods Clinical data of 86 recipients were retrospectively analyzed. According to the Results of next generation sequencing (NGS), all recipients were divided into the HPV B19 infection group and control group. Clinical characteristics, treatment regime and clinical prognosis of patients infected with HPV B19 were analyzed. The risk factors of HPV B19 infection were analyzed using univariate and multivariate Logistic regression model by forward LR step method. Results Nine of the 86 recipients developed fever and progressive anemia with unexplained reasons at approximately 2 weeks after liver transplantation. NGS detection demonstrated that HPV B19 was positive and they were diagnosed with pure red cell aplasia (PRCA) caused by HPV B19 infection. After intravenous immunoglobulins (IVIG) was given and the immunosuppressant therapy was adjusted, the hemoglobin levels in all patients were significantly increased. The Results of multivariate analysis revealed that low serum globulin level in peripheral blood at postoperative 7 d [odds ratio (OR) =0.749, P=0.040] and young age (OR=0.937, P=0.038) were the independent risk factors of HPV B19 infection after liver transplantation. Conclusions HPV B19 infection should be considered in relatively young patients with unexplained hemoglobin decline early after liver transplantation. NGS screening is an effective method for early diagnosis of HPV B19 infection. Low serum globulin level in peripheral blood at postoperative 7 d and young age may be independent risk factors of the incidence of HPV B19 infection.