Proton pump inhibitors in clinical use is increasingly common and the drug-induced disease caused by them has an upward trend.Through the retrospective analysis of the retrieved literature,this article provides a reference for the rational use of proton pump inhibitors and reduces the occurrence of related drug-induced diseases.

Tight junctions are the primary structure of intestional epithelial cells,which maintains the integrity of the epithelial cell layers.Besides claudins,occludins and ZO-1,more than 40 different proteins have been discovered.The tight junctions(TJs) serve not only as the barrier to the passage of ions and molecules through the paracellula pathway and maintenance of epithelial cell polarity,but also to integrate such diverse processes as cell growth and differentiation,tumor suppression,gene transcription.This review is about the recent discovery of TJ proteins and their functions,which will lead to the complement about intestinal barrier function.

Tight junctions(TJ) are the basic structure of intestinal barrier,which serve as the rate-limitting barrier to passive movement across intestinal epithelial cell and the maintenance of epithelial cell polarity.Recently some progress has been achieved in the structure of TJ proteins.This review is about the regulating mechanisms of TJs response to common enteric pathogens and other factors.

Abjective:To investigate the effect of Lactobacillus plantarun Onlly regulating the intestine epithelial permeability and tight junction proteins of enterocyte-like Caco-2 cells in responsing to Enteroinvasive Escherichia coli.Methods:In the model of Caco-2 monolayer cells,The cells were divided into four groups: normal group,infection group,Lactobacillus group and gentamicin group.The TER was measured by Milicell ERS and the transmissivity of mannitol was determined by HPLC.The distribution and structure of tight junction proteins,such as Claudin-1,Occludin,ZO-1,JAM-1 were examined by indirect IHC.Results: The TER and the transmissivity of mannitol increased after infected with EIEC,but the increase was decreased after dealing with Lactobacillus plantarun Onlly(P

Objective To observe the clinical effect of mouse nerve growth factor on protrusion of the lumbar intervertebral disc (LDP) treated with operation. Methods 60 cases with LDP received posterior lamina resection nucleus pulposus decompression excise pedicle screws fixation, in which 30 cases (the treatment group) accepted mouse nerve growth factor for 30 d. Their symptoms and signs, visual analogue score (VAS) for pain, and the electromyogram were recorded before and after treatment. Results The VAS in the treatment group improved more than in control group (P<0.05). the incidence of cure and improvement (76.7%) was higher than in the control group (50.0%)(P<0.05). The nerve conduction velocity and action potential of main muscle group also improved more in the treatment group (P<0.05).Conclusion Mouse nerve growth factor can improve the recovery of pain as well as the neural function in patients after operation for LDP.

Objective To investigate the clinical effectiveness of procedure for prolapse and hemorrhoids(PPH)in the treatment of outlet obstructive constipation caused by moderate and severe recto-cele. Methods A total of 48 patients with moderate or severe rectocele were treated with PPH. Patients were followed up for 4 ~ 6 months. The preoperative and postoperative parameters from rectoanal manome-try were compared and analyzed. Results After the surgery,patients had loose stool for 1 ~ 2 times a day. Sense of defecation obstruction in all patients was obviously improved. After the surgery,there were no significant changes in rectum resting pressure,anal resting pressure and various rectal sensitivity( P >0. 05). However,the decrease of inside rectal pressure and residual anal pressure were significantly re-duced(P < 0. 05). Conclusion The subjective defecation feeling of postoperative patients with PPH is unblock. Objective results of rectoanal manometry is clearly improved and the function of the rectum and anal canal is obviously restored.

Background and purpose:Venous thromboembolism (VTE) is the second common cause of death in cancer patients. The clinical data from VTE patients in Fudan University Shanghai Cancer Center were collected and analyzed during the last 5 years in this study to increase awareness for diagnosis and prevention of VTE in cancer patients and to improve their prognosis.Methods:The clinical data from 196 VTE patients among the 207 514 cancer patients were analyzed during the period from Jul. 2009 to Jun. 2014, and the clinical characteristics of cancer patients with VTE were investigated to understand the inlfuence of risk factors and symptoms in VTE patients.Results:The incidence of VTE in cancer patients was 0.94‰. Adenocarcinoma was the most common type of gynecological cancer (56.5%), gastrointestinal tract cancer (91.7%), lung cancer (71.4) and pancreatic cancer (80%). Logistic regression analysis showed adenocarcinoma was the high risk factor in cancer patients with pulmonary embolism (PE, OR=0.36, 95%CI: 0.146-0.885,P=0.026). Compared with patients who received 2 cycles of chemotherapy, patients who received 3 cycles of chemotherapy had higher incidence of VTE (χ2=10.976,P=0.001). The incidence of VTE in operative group was higher than that in non-operative group. The patients bearing gynecological cancer with ascites (>2 000 mL) had higher VTE incidence compared with the patients with less ascites. Besides, 78%-88% of the VTE patients were diagnosed because of the deep vein thrombosis (DVT) symptom during postoperative recovery and chemoradiotherapy.However, 59.1% of the preoperative VTE patients were diagnosed by the compression venous ultrasonography (CUS) in lower extremity. Physical therapy was adopted to prevent thrombus in 15 postoperative patients.Conclusion:The incidence of cancer-associated VTE in Fudan University Shanghai Cancer Center is lower compared with those reported in other epidemiologic investigations. The VTE incidence in postoperative patients is higher than that in preoperative patients. The patients with adenocarcinoma were inclined to be accompanied by PE. The examination should be taken in asymptomatic cancer patients and gynecological cancer patients with massive ascites. The physical measurement should be adopted actively to prevent thrombus in our hospital.

Objective To explore factors associated with incision infection in elderly patients undergoing general surgery and thus provide a basis for its clinical prevention.Methods Retrospective clinical data of 2985 elderly patients who underwent routine surgical operation after admission to the Department of General Surgery from Feb.2009 to Dec.2013 were analyzed.Patients with incision infection following surgery were assigned into the infection group,while patients without incision infection served as the control group.Single factor analysis and multivariate Logistic regression analysis were conducted to identify factors responsible for incision infection.Results There were 91 cases with incision infection,constituting a rate of 3.0％.Compared with the control group,patients in the infection group showed an older average age [(67.3±5.8) years vs.(63.0± 5.6) years,t=1.906,P＜0.05],a longer average operating time [(2.13±0.26) hours vs.(1.87±0.24) hours,t=10.149,P＜0.001],and a longer average incision length [(8.14±2.62) cm vs.(7.59±2.14) cm,t=2.396,P＜0.01].In addition,compared with the control group,more patients in the infection group received prophylactic antibiotics (74.7％ vs.83.3％,x2 =4.819,P=0.032),exhibited malnutrition (20.9％ vs.10.0％,x2 =11.418,P=0.001),and had diabetes mellitus (11.0％ vs.5.1％,x2 =5.968,P=0.015).Therefore,independent risk factors for incision infection included age (OR=1.89),operating time (OR=3.32),nutritional status (OR=2.08) and diabetes mellitus (OR=3.18).Conclusions A few risk factors may contribute to incision infection.Clinicians should take necessary preventive measures accordingly to minimize its occurrence.

Objective To compare the results of manually -tested speech recognition threshold (SRT ) with automatically software -recorded SRT in the trial of Mandarin disyllabic test ,exploring the significance to the clini-cal applying .Methods 128 normal people of different ages without hearing loss and 57 workers exposed to noise in an automobile manufacturing was selected .These two group of volunteers speak mainly Mandarin in their daily life . MADSEN Conera (Danmark) clinical audiometr was applied .A group of double syllable word list with the same dif-ficulty of equivalence was used as test material .The initial presentation level was 20 dB HL higher than PTA .Then compared the results of manually -tested SRT with automatically software -recorded SRT .Results In the normal group ,the automatic value SRT was 7 .84 ± 3 .98 dB HL ,the manual value was 9 .19 ± 4 .47 dB HL ,and the average value of speech frequency threshold was 7 .63 ± 5 .78 dB HL .In the noise group ,the automatic value SRT was 6 .10 ± 8 .40 dB HL ,the manual value was 18 .81 ± 9 .52 dB HL ,and the average value of language frequency threshold was 27 .18 ± 19 .13 dB HL .There was significant difference between the values of SRT tested manually and recorded automatically (P<0 .01) .Conclusion There are differences between SRT valued manually and automatically .The SRT in people with normal hearing can be tested using automatic -recorded method .This method is convenient for screening in people without hearing loss .To exam in people with hearing loss ,the manual test is more appropriate .

Objective:According to the existing hospital static mixing method, the problem of dynamic allocation model for half a year period is put forward, in order to solve emergency equipment safe are deployed in a timely manner. Methods: The hospital can allocate all emergency equipment evaluation, grade and tabulation, according to the score for sorting, system of sorting table provides emergency center allocate use half a year. Results: According to the deployment of table realized in emergency equipment safety in time in case of major events are deployed and able to skillfully use effect. Conclusion: The use of emergency equipment dynamic allocation model can not only improve the social benefit of the hospital, and reduce the pressure of the functions of the hospital departments.