ObjectiveTo investigate the relationship between gastrc schistosomiasis and gastrc cancer.MethodsThe data of 11 cases of gastrc schistosomiasis were retrospective analyzed.Results 54.5％ (6/11) of gastrc schistosomiasis cases complicated with gastrc cancer,and 83.3％ (5/6) was well-differentiated and moderately differentiated.Seen around the parasite eggs were obvious intestinal metaplasia,glandhyperplasia,abnormalepitheliallesionsandother seriousatypicalhyperplasia.ConclusionsGastric schistosomiasis significantly increases the risk of gastrc cancer.Gnstrc schistosomiasis does not have specific symptoms,and it is clinically sumilar to chronic gastrtis.Therefore,patients with chronic gastrtis-likesymptoms in the schistosomiasis endemic areas should be subjected to an intensive test for gastrc schistosomiasis in the biopsy specimens collected from pyloric antrum and gastric lesser curvature.Patients infected by gastric schistosomiasis are strongly suggested to go regularly for gastric cancer check with gastroscopy.

Objective To observe the therapeutic effect of the Valpar system combined with computer-aided technology in treating early vascular cognitive impairment (VCI).Methods Forty patients in the early stage of VCI were randomly divided into a treatment group and a control group,each of 20.Regular and computer-aided cognition training were applied in both groups,while training using the Valpar system was additionally used in the treatment group.Patients in both groups were assessed using the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and the modified Barthel Index (MBI) before,and after 4 and 8 weeks of treatment.Results Before the treatment,there were no significant differences between the 2 groups in LOTCA and MBI scores (P＞0.05).After 4 and 8 weeks of treatment,the average total LOTCA score in the observation group was significantly better than before the treatment,as were the average scores on the various dimensions,and the average MBI score (P＜0.05).After 4 weeks of treatment the control group showed significant improvement in the patients' orientation (3.50±0.89),visual perception (13.50± 1.43),spatial perception (2.40±0.50),visuomotor construction (24.00± 1.17) and attention (2.30±0.87).However,after both 4 and 8 weeks of treatment,all the measurements of the observation group were significantly better than those of the control group at the same time point (P＜0.05).Conclusion The Valpar system can significantly improve the recovery of cognitive function and ability in the activities of daily living of patients in the early stage of VCI.It is worth applying in clinical practice.

OBJECTIVETo prospective examine the relationship between smoking, quitting and mortality in older Chinese men by in Xi'an, China.

METHODSThe design was a cohort analytic study. One thousand two hundred and sixty-eight retired male military veterans aged 60 or older were examined in 1987. At baseline, there were 388 never-smokers, 461 former smokers and 419 current smokers. Main outcome measure was all-cause and tobacco-associated mortality.

RESULTSThrough 1999, 299 had died, 943 were alive and 26 lost. The mean follow-up time was 11 years and total person-year of follow-up was 14 163. After adjusting for age, blood pressure, body mass index, total cholesterol, triglycerides, alcohol intake, exercise and existing diseases, using Cox proportional hazard regression model, the relative risks (95% confidence intervals) for ever-smoking, deaths resulting from all causes, chronic obstructive pulmonary disease (COPD), lung cancer and coronary heart disease (CHD) were 1.34 (1.02 - 1.76), 3.23 (0.95 - 10.91), 2.31 (0.95 - 5.61) and 1.60 (0.81 - 3.19) respectively. The risks increased significantly with increasing amount and duration of smoking. Compared with current smokers, former smokers had lower risks of total mortality (excess risk reduction of 56%) and from CHD death (93%), but had higher risks for COPD death (excess risk increased 174%).

CONCLUSIONSSmoking is a major cause of death in older Chinese men and quitting can save lives. These results showing that higher risks of COPD death in former smokers with or without existing diagnosed COPD at baseline than those in current smokers could be explained by either the "healthy smoker effect" or the "ill quitter effect" or both. Early recognition of the significance of COPD symptoms followed by prompt quitting should be emphasized as strategies in the control of the growing tobacco epidemic.

Aged ; China ; Cohort Studies ; Coronary Disease ; etiology ; mortality ; Humans ; Lung Neoplasms ; etiology ; mortality ; Male ; Middle Aged ; Prospective Studies ; Pulmonary Disease, Chronic Obstructive ; etiology ; mortality ; Risk Factors ; Smoking ; adverse effects ; mortality ; Smoking Cessation ; Survival Rate ; Veterans

Objective: To discuss the application of three dimentional(3D)visualization technologies in treatment plan of hepatic malignant tumor. Methods: The clinical data of 300 patients with liver malignant tumor who received treatment from January 2016 to January 2017 in the Third Department of Hepatic Surgery of Eastern Hepatobiliary Surgery Hospital was retrospectively analyzed in this study, including 221 male and 79 female patients aged from 7 to 76 years with median age of 54 years. The median height was 168 cm (115-183 cm), the median weight was 65 kg (20-105 kg) and the median tumor volume was 142 ml (23-2 493 ml). Three-dimensional visualization technology was used in all patients to reconstruct liver three-dimensional graphics. Also, two and three-dimensional methods were taken respectively to evaluate patients and develop treatment strategy. The change of treatment strategy caused by 3D evaluation, actual surgical plan, operation time, time of hepatic vascular occlusion, intraoperative blood loss, volumes of blood transfusion and postoperative complications was observed. Results: After three-dimensional visualization technology was applied, 75(25%) of 300 patients′ treatment strategies had been changed. The range of hepatectomy was extended in 25 patients. And 7 of them were due to hepatic venous variation, which resulted in increasing drainage area. In other 4 patients, liver resections were extended due to lack of perfusion of the liver parenchyma after the removal of portal vein. And hepatectomy was expanded in 14 patients in order to increase the surgical margin. The range of hepatectomy was reduced in 8 patients, 4 of which were due to hepatic venous variation, such as hepatic vein of segment 4 or lower right posterior hepatic vein. The remaining 4 cases were because of insufficient residual liver volume.The surgical resection was performed in 278 cases, 257 of which received operation directly. Left hepatectomy was performed in 24 patients and right hepatectomy was performed in 33 patients. Left trisectionectomy was carried out in 12 patients and right trisectionectomy was carried out in 11 patients. Caudate lobectomy was applied in 10 patients. There were 18 cases of left lateral sectionectomy, 7 cases of right anterior sectionectomy, 25 cases of right posterior sectionectomy and 18 cases of mesohepatectomy. Single or multi segment resection was performed in 99 patients. The treatment strategy of thirty-six patients was converted to staged hepatectomy (ALPPS 11 cases and portal vein embolization 25 cases). The median operation time was 130 minutes (90-360 minutes) and the median inflow blood occlusion time was 20 minutes (0-75 minutes). Median blood loss volume was 200 ml (20-1 600 ml). Thirty-seven of 278 patients received transfusions, and the average red blood transfusion volume was (4.4±1.7)units (0-8 units). Median hepatic resection volume was 530 ml(30-2 600 ml). There were 117 cases of pleural effusion after operation, including 3 patients needing invasive therapy. Ascites occurred in 23 patients, 6 of whom needed invasive therapy. Biliary leakage was observed in 30 patients. Eight patients occurred hepatic cutting surface hemorrhage, 6 of whom received blood transfusion, and 4 of whom underwent laparotomy to stop bleeding. Three patients had pulmonary infection after surgery and 3 patients appeared biliary obstruction. Deep vein thrombosis took place in 2 patients and portal vein thrombosis was observed in 4 patients. No postoperative liver failure and death ever happened in our study group. Conclusion Three-dimensional visualization technique can optimize the treatment strategy of patients with liver malignant tumor, improve surgical safety.

Objective To investigate the characteristics of TCM constitution distribution in hepatitis B cirrhosis patients with dysplastic nodules(DN),and to provide a basis for the prevention and treatment of precancerous lesions of liver cancer.Methods This study was conducted among 113 hepatitis B cirrhosis patients with DN,105 hepatitis B cirrhosis patients with regenerative nodules(RN),and 70 hepatitis B cirrhosis patients with small hepatocellular carcinoma(sHCC)who were hospitalized in Guangdong Provincial Hospital of Traditional Chinese Medicine from May 2015 to March 2023.Related data were collected,including age,sex,liver function Child-Pugh class,TCM constitution type,and laboratory markers.A one-way analysis of variance was used for comparison of normally distributed continuous data between multiple groups,and the least significant difference t-test was used for further comparison between two groups;the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups;the chi-square test was used for comparison of categorical data between groups,and the Bonferroni correction method was used for further comparison between two groups.Results The main TCM constitution types of hepatitis B cirrhosis patients with DN were Qi-deficiency constitution(27 patients,23.89%),blood-stasis constitution(26 patients,23.01%),and phlegm-dampness constitution(23 patients,20.35%).There were significant differences between the three groups in the proportion of patients with phlegm-dampness constitution or damp-heat constitution(χ2=6.822 and 6.383,both P<0.05);the hepatitis B cirrhosis patients with RN had the highest proportion of patients with phlegm-dampness constitution(30.48%),followed by those with DN(20.35%)and those with sHCC(14.29%),while the hepatitis B cirrhosis patients with sHCC had the highest proportion of patients with damp-heat constitution(27.14%),followed by those with DN(16.81%)and those with RN(12.38%).There were significant differences between the hepatitis B cirrhosis DN patients with different TCM constitution types in sex,age,Child-Pugh class,prealbumin,albumin(Alb),aspartate aminotransferase,total bilirubin(TBil),total bile acid,and alpha-fetoprotein(all P<0.05).Compared with the male hepatitis B cirrhosis DN patients,female patients showed a significantly higher proportion of patients with Qi-deficiency constitution(χ2=4.895,P=0.027).Among the patients with Qi-deficiency constitution,the patients with Child-Pugh class A liver function accounted for a significantly lower proportion than those with Child-Pugh class B liver function(χ2=6.380,P=0.012),while among the patients with phlegm-dampness constitution,the patients with Child-Pugh class A liver function accounted for a significantly higher proportion than those with Child-Pugh class B liver function(χ2=8.515,P=0.004).The patients with phlegm-dampness constitution had significantly higher levels of prealbumin and Alb than those with the other four constitutions(all P<0.05),as well as significantly lower levels of TBil and total bile acid than those with damp-heat constitution(P<0.05);the patients with Yin-deficiency constitution had a significantly lower level of Alb than those with qi-deficiency constitution,blood-stasis constitution,or phlegm-dampness constitution(all P<0.05);the patients with Yin-deficiency constitution had a significantly lower proportion of patients with abnormal alpha-fetoprotein than those with non-Yin-deficiency constitutions(χ2=4.448,P=0.035).Conclusion Hepatitis B cirrhosis patients with DN mainly have the TCM constitution types of Qi deficiency,blood stasis,and phlegm dampness.The patients with phlegm-dampness constitution seem to have a low probability of carcinogenesis,while those with damp-heat constitution and Yin-deficiency constitution have a relatively high risk of carcinogenesis.

Objective To investigate the value of early trophic feeding on maintenance of the integrity of intestinal mucosa barrier in severe traumatic patients.Methods The seriously traumatic patients were eligible for enrollment to this study from January 1st,2014 to March 31st,2015 in the intensive care unit of Xiangcheng People's Hospital.All patients were randomly divided into early enteral nutrition (EEN)group and the control group.Within 12 to 24 hours after ICU admission,all patients were fed on enteral nutrition.In the EEN group,the nutrient was reached to 25％ of target nutrient amount [104.6 kJ/ (kg · d)],and in the control group,the nutrition was reached to 60％ of the target nutrient amount.Comparisons of feeding intolerance,incidence of newly developed lung infection,the total length of hospital stay,ICU medical costs,and the markers of mucosa barrier function including lactulose/mannitol ratios (L/M),serum lactic acid level,and diamine oxidase (the first day,the third day and the seventh day) between two groups were carried out.Results Of them,56 patients were treated with early enteral nutrition.Early enteral feeding intolerance and ICU associated infection complications were significantly lower in EEN group than those in control group (P =0.012,P =0.046).There were no significant differences in ICU associated infection complications,the length of ICU stay,the length of hospital stay,ICU medical costs,L/M ratios,D-lactic acid level and diamine oxidase concentration between the two groups (P=0.135,P=0.126,P =0.223,P =0.235).Conclusions Under the seriously traumatic stress,the significantly increased intestinal mucosal permeability will be occurred early.In patients with early trophic feeding,the intestinal mucous membrane barrier function can be improved,thus decreasing ICU associated infection complications and incidence of feeding intolerance.

ObjectiveTo investigate the value of different noninvasive diagnostic models in the diagnosis of esophageal and gastric varices since there is a high risk of esophageal and gastric varices in patients with compensated hepatitis B cirrhosis and significant portal hypertension， and to provide a basis for the early diagnosis of esophageal and gastric varices. MethodsA total of 108 patients with significant portal hypertension due to compensated hepatitis B cirrhosis who attended Guangdong Provincial Hospital of Traditional Chinese Medicine from November 2017 to November 2023 were enrolled， and according to the presence or absence of esophageal and gastric varices under gastroscopy， they were divided into esophageal and gastric varices group （GOV group） and non-esophageal and gastric varices group （NGOV group）. Related data were collected， including age， sex， imaging findings， and laboratory markers. The chi-square test was used for comparison of categorical data between groups； the least significant difference t-test was used for comparison of normally distributed continuous data between groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups. The receiver operating characteristic （ROC） curve was plotted to evaluate the diagnostic value of five scoring models， i.e.， fibrosis-4 （FIB-4）， LOK index， LPRI， aspartate aminotransferase-to-platelet ratio index （APRI）， and aspartate aminotransferase/alanine aminotransferase ratio （AAR）. The binary logistic regression method was used to establish a combined model， and the area under the ROC curve （AUC） was compared between the combined model and each scoring model used alone. The Delong test was used to compare the AUC value between any two noninvasive diagnostic models. ResultsThere were 55 patients in the GOV group and 53 patients in the NGOV group. Compared with the NGOV group， the GOV group had a significantly higher age （52.64±1.44 years vs 47.96±1.68 years， t=0.453， P<0.05） and significantly lower levels of alanine aminotransferase ［42.00 （24.00 — 17.00） U/L vs 82.00 （46.00 — 271.00） U/L， Z=-3.065， P<0.05］， aspartate aminotransferase ［44.00 （32.00 — 96.00） U/L vs 62.00 （42.50 — 154.50） U/L，Z=-2.351， P<0.05］， and platelet count ［100.00 （69.00 — 120.00）×10⁹/L vs 119.00 （108.50 — 140.50）×10⁹/L， Z=-3.667， P<0.05］. The ROC curve analysis showed that FIB-4， LOK index， LPRI， and AAR used alone had an accuracy of 0.667， 0.681， 0.730， and 0.639， respectively， in the diagnosis of esophageal and gastric varices （all P<0.05）， and the positive diagnostic rates of GOV were 69.97%， 65.28%， 67.33%， and 58.86%， respectively， with no significant differences in AUC values （all P>0.05）， while APRI used alone had no diagnostic value （P>0.05）. A combined model （LAF） was established based on the binary logistic regression analysis and had an AUC of 0.805 and a positive diagnostic rate of GOV of 75.80%， with a significantly higher AUC than FIB-4， LOK index， LPRI， and AAR used alone （Z=-2.773，-2.479，-2.206， and-2.672， all P<0.05）. ConclusionFIB-4， LOK index， LPRI， and AAR have a similar diagnostic value for esophageal and gastric varices in patients with compensated hepatitis B cirrhosis and significant portal hypertension， and APRI alone has no diagnostic value. The combined model LAF had the best diagnostic efficacy， which provides a certain reference for clinical promotion and application.