Objective To investigate the infection status of Helicobacter pylori (Hp) in a Lhasa hospital.Methods A retrospective survey of Hp infection from 2009 to 2013 was conducted in Lhasa People's Hospital.The data of 14C-urea breath test and gastroscopy were analyzed.Results A total of 2 908 patients were enrolled,1 518 (52.20％) were Hp positive,including 1 061 males (1 061/1 939,54.72％) and 457 females (457/969,47.16％).The Hp infection rate in males was higher than that in females (x2 =14.788,P =0.000).The Hp infection rate by years from 2009 to 2013 was 55.97％ (267/477),49.79％ (239/480),54.66％ (375/686),52.06％ (291/559) and 49.15％ (347/706),respectively.The infection rate in 2013 was significantly lower than that in 2009 and 2011 (P =0.021,0.040).There were no significant differences in Hp infection rates among Tibetan,Han and Hui ethnic groups.In 2020 cases who underwent endoscopic examination,1 098 had Hp positive (54.36％).The Hp infection rate in chronic superficial gastritis group(39.91％) was significantly lower than that in erosive gastritis (x2 =30.143,P =0.000),gastric ulcer (x2 =22.434,P =0.000),gastric polyps (x2 =9.627,P=0.002),gastric cancer (x2 =9.506,P =0.002),duodenal ulcer (x2 =54.158,P =0.000),duodenitis (x2 =14.966,P =0.000) and compound ulcer groups (x2 =8.582,P =0.003).The Hp infection rate in duodenal ulcer group (68.42％) was significantly higher than that in chronic superficial gastritis (x2 =54.158,P =0.000),erosive gastritis (x2 =6.733,P =0.009),atrophic gastritis (x2 =21.496,P =0.000) and gastric ulcer groups (x2 =8.940,P =0.003).Conclusion Hp infection rate appears a decreasing trend in Lhasa area in last 5 years; among various gastro-duodenal diseases patients with duodenal ulcer have a highest Hp infection rate.

Objective To analyze clinical characteristics of acute mesenteric venous thrombosis (AMVT) and its diagnositic methods. Methods Medical records of 16 patients diagnosed as SMVT in Friendship Hospital of Beijing during October 1985 to October 2002 were collected and analyzed, and its clinical characteristics and diagnostic methods were summarized.Results Median age of the 16 patients was 45.9 years, ranged from 19 to 64 years. Their main symptoms at admission were abdominal pain (100%), abdominal distension (100%), acute abdomen (100%), vomiting (75%, 12/16) and fever (75%, 12/16), with an underdiagnosis rate of 75% (12/16) and case-fatality ratio of 44% (7/16).Conclusions AMVT had several specific manifestations. Early clinical diagnosis for AMVT could be established on the basis of abdominal color doppler ultrasonography, diagnostic abdominocentesis, CT and selective superior mesenteric arteriography, and its case-fatality could be lowered with early surgical operation.

Objective To evaluate the efficacy and safety of endoscopic mucosal resection (EMR) for rectal carcinoid tumors. Methods From January 2006 to January 2009, EMR was performed in 28 patients with rectal carcinoids, who were followed up to evaluate the therapeutic effect and safety. Results Tumor diameters varied from 0.4 cm to 1. 2 cm (mean 0.7± 0. 2 cm). Negative resection margin was a-chieved in 26 cases (92. 9% ), tumor margin within 0. 1 cm of resection margin in 1 (7. 1% ) , and two margins coincided in 1 patient (7. 1% ). Hemostasis was performed with metal clips in 14 patients (50% ) and argon plasma coagulation (APC) in 9 (32. 1% ). Except for rectal bleeding in 1 patient (3. 6% ) , no other complications were observed. There was no recurrence in any patients during a follow-up of 6-36 months. Conclusion EMR is a useful and safe method for treatment of small rectal carcinoid tumor which does not cross submucosal layer.

OBJECTIVETo establish human heart valve interstitial cells calcification culture model in vitro, and observe the effect of bone morphogenetic protein-2 (BMP-2) on calcification of human heart valve interstitial cells.

METHODSHuman heart valve interstitial cells were cultured in vitro, and divided into control group: cells were cultured in conventional media plus recombinant human BMP-2 treatment and experimental group: besides above treaments, calcification inducers ( recombinant human BMP-2, β-glycerophosphate, L-ascorbic acid, dexamethasone) were added to the culture media. The two group of cells were cultured for 14 days and were stained by Von Kossa, then the cell calcification was observed in this valvular interstitial cells calcification culture model in vitro. Protein expression of intercellular adhesion molecule 1 (ICAM-1), interleukin 8, BMP-2 and BMP-4 was determined by Western blot and BMP-2 secretion was measured by ELISA.

RESULTSIn the control group, the structure of human heart valve interstitial cells was clear, and the spindle and radial growth shaped cellular morphology was visible, and Von Kossa staining was negative. In the experimental group, the nuclei become darker in color, and granular sediment distribution was seen surrounding cells, and Von Kossa staining was positive, the cells were forming nodules of calcification. The protein expression of ICAM-1, interleukin 8, BMP-2 and BMP-4 in the experimental was significantly higher than that of the control group (all P < 0.05). The expression of BMP-2 in the experimental group was also significantly higher than that in control group ((92.5 ± 4.9) pg/ml vs. (22.2 ± 1.9) pg/ml, P < 0.05).

CONCLUSIONHuman BMP-2, β-glycerophosphate, L-ascorbic acid, and dexamethasone can induce human heart valve interstitial cells calcification and enhance inflammation in vitro by stimulating the secretion of BMP-2.

Medical students will be the clinicians in the future.The medical moral education and the moral character formation will directly influence their medical careers.It is extremely important for the medical students to know basic theory of the medical moral and develop their character by strengthening the medical moral and criterion education,especially in the time of increasing conflicts between doctors and patients.

BACKGROUND:Cytokines secreted from neurons and glial cel s in early stage of spinal cord injury probably are essential factors for inducing secondary immunologic injury.
OBJECTIVE:To investigate the effects of interleukin-1β, interleukin-6 and interleukin-17 on inflammatory reaction after acute spinal cord injury.
METHODS:A total of 75 adult male Sprague-Dawley rats were randomly divided into control group and the spinal cord injury groups:1, 6, 24 and 72 hours. A rat model of incomplete spinal cord injury was established by the modified Al en weight drop method. The control group just underwent laminectomy. Injured spinal cord and spleen tissues were col ected at corresponding time points after model induction. Immunohistochemical staining was used to detect the distribution and expressions of interleukin-6 and interleukin-17 in spinal cord tissue. Western blot assay was utilized to detect the changes in p-STAT3 expression in injured spinal cord. RT-PCR was applied to measure the mRNA expression of interleukin-1β, interleukin-6 and interleukin-17 in the spleen.
RESULTS AND CONCLUSION:The expression levels of p-STAT3, interleukin-1β, interleukin-6, and interleukin-17 were significantly higher in the spinal cord injury groups than those in the control group (P<0.05). The expression of inflammatory cytokines increased immediately after injury. Interleukin-1βand interleukin-6 levels peaked at 6 hours, and then decreased. p-STAT3 and interleukin-17 levels peaked at 24 hours, and then decreased. The expression was stil higher at 72 hours than that in the control group. Results suggested that the expression of p-STAT3-mediated pro-inflammatory cytokines interleukin-1βand interleukin-6 in early stage increased. Inflammatory cascade would enlarge in the injured area, which probably induced secondary spinal cord injury and increased interleukin-17 levels. These possibly played a key role in secondary inflammatory reaction.

The endoscopic findings of 884 cases of colonic polyps with different pathological types were retrospectively analyzed.Among all cases,there were 418 cases of tubular adenoma (47.3％ ),92 cases of fluff tubular adenoma ( 10.4％ ),334 cases of inflammatory polyps ( 37.8％ ) and 40 cases of hyperplastic polyps (4.5％ ).There were significant differences in age,location,polyp surface morphology and Yamada grouping among colonic polyps with different pathological types (P ＜0.05).The average age of fluff tubular adenoma group [ (64 ± 12)y] was the highest among all patients; and the average diameter of polyps was the largest [ ( 1.38 ± 1.09 ) cm ],lobulated and mulbenry,polyps were the most common forms; and the majority of fluff tubular adenoma was Yamada type Ⅲ or Ⅳ.The results indicate that fluff tubular adenoma was associated with higher age,larger polyp size,surface morphology and Yamada grouping (P ＜0.05).

Objective The study was performed to analyze the diagnosis and treatment of blue rubber bleb nevus syndrome of Chinese patients by evaluating the researches in China.Methods Chinese Journal Full-text Database,Wangfang Data and Weipu Chinese Medical Journal Database were searched for the clinical data of the patients with blue rubber bled nevus syndrome.Results Among the 50 patients,31 cases were male,and 19 cases were female.All patients (100％) had the venous malformations of the skin.Thirty-five (70％) cases had melena,13 (26％) cases had bloody stool,and 35(70％) had dizziness and palpitation.Blue rubber bled nevus syndrome were diagnosed with gastroscopy (40/48,83.33 ％),coloscopy (30/41,73.17％) and small intestinal examination (23/25,92％).Fourteen cases received symptomatic treatment.Twelve cases received therapeutic endoscopy,which lesions were located in stomach and colon.Sixteen cases received operation,and 2 cases were treated by laparoscopy and endoscopy.Conclusions Blue rubber bleb nevus syndrome is a rare disease.The skin and gastrointestinal system are involved in all patients with blue rubber bleb nevus syndrome in China.The routine examination for diagnosis of blue rubber bleb nevus syndrome should include examination of the small intestine.It still needs further research about effective treatment of blue rubber bleb nevus syndrome.

Objective To evaluate the quality of the examination paper of the theory of Clinical Diagnostics,to explore and reflect on the teaching methods,so as to improve the quality of teaching.Methods Finals results of Clinical Diagnostics including 40 clinical undergraduates of Capital Medical University were analyzed.SPSS 20.0 was used to make analysis of the frequency,means statistics and normality of the examination paper.Kuder Richardson/Cmnbacha formula,percentage unification methods and so on were used to calculate confidence,validity,difficulty and degrees of distinction.Acquisition of relevant knowledge was assessed according to score distribution,while test paper quality was evaluated based on indicators including confidence,validity,difficulty and degrees of distinction.Results Test scores of 40 students were between 61 to 96 (83.64 ± 8.07).The degree of confidence (γ) for choice questions and subjective questions was 0.65 and 0.59 respectively;The validity (V) was 0.27;The overall difficulty (P) of the examination was 0.84;The degrees of distinction (D) were between 0.16 to 0.30.And the total points losing rate was 16.36％.Conclusion The examination is of medium difficulty and good degree of distinction,but the teaching strategies still need further adjustment in order to improve the students' ability of flexible application of the basic knowledge.