Objective To analyze the diagnostic process and clinical characteristics of autoimmune gastritis(AIG)in order to improve the awareness and diagnostic proficiency of this disease.Methods A retrospective cohort study was conducted on 114 patients diagnosed with AIG in Army Medical Center of PLA between January 2021 and June 2024.Comprehensive statistical analysis was performed on clinical data,including demographic characteristics(age,sex),clinical symptoms,comorbidities,diagnostic process,Helicobacter pylori(H.pylori)infection and treatment history,laboratory indicators[results of routine blood test,anemia-related indices,thyroid function,anti-parietal cell antibody(APCA),intrinsic factor antibody(IFA)],and gastrointestinal endoscopic findings(frequency and endoscopic features).Results Among the 114 patients,males accounted for 28.1%(32/114)and females for 71.9%(82/114),and they were at a mean age of 56.3±8.4 years.Predominant symptoms included epigastric/upper abdominal pain(47.4%,54/114)and postprandial fullness(43.0%,49/114),while 24.6%(28/114)reported acid reflux or heartburn.Diagnostic delay occurred in 76.4%(87/114)of patients,with a median delay duration of 11.5 months.Primary diagnostic clues were endoscopic reverse gradient atrophy(significantly more severe mucosal atrophy in the gastric corpus/fundus versus antrum;53.5%,61/114)and repeated H.pylori eradication failure(≥2 attempts;22.8%,26/114).Positivity rate of thyroid peroxidase antibody(TPOAb)and thyroglobulin antibody(TgAb)was 56.9%(33/58)and 36.2%(21/58),respectively.APCA positive rate was 98.8%(81/82),IFA positive rate was 34.1%(28/82),and dual-antibody rate was 32.9%(27/82).Anemia was present in 25.7%(26/101)of the patients.Gastric neuroendocrine tumors(NET)were found in 12.2%(14/114),intraepithelial neoplasia in 5.3%(6/114),and gastric adenocarcinoma in 0.9%(1/114).Among colonoscopy-examined patients,tubular adenomas occurred in 25.0%(13/52)and colorectal malignancies in 3.4%(2/58).There were 18.4%(21/114)patients having gallbladder-related diseases,7.9%(9/114)having diabetes mellitus,and 1.8%(2/114)of subacute combined degeneration of the spinal cord.Conclusion AIG is frequently associated with diagnostic delay.The reverse pattern of atrophy on endoscopy serves as a critical diagnostic clue,necessitating enhanced recognition in endoscopists.Patients with recurrent H.pylori eradication failure(≥2 attempts)should be evaluated for AIG.

Objective:To investigate the relationship between intracerebral high-density foci and progressive stroke (PS) morbidity by using dual-energy CT, which can quantify the intracerebral high-density foci of patients with acute ischemic stroke after endovascular treatment.Methods:Ninety-two patients with acute ischemic stroke who received interventional treatment in Gaozhou People′s Hospital from May 2019 to August 2020, and underwent dual-energy CT scan immediately after intervention, were analyzed. The patients were divided into PS group ( n=35) and non-PS group ( n=57) according to the National Institutes of Health Stroke Scale (NIHSS) score, and the patients whose NIHSS score increased≥4 points within 72 hours of stroke were included in the PS group, while the patients whose NIHSS score increased<4 points were included in the non-PS group. The clinical data, volume of high-density foci and CT values were compared between the 2 groups. Logistic regression analysis was used to adjust for confounding factors and screen for risk factors. The correlations of the admission NIHSS score, presence and volume of high-density lesions, maximum CT (CTmax) value and average CT (CTave) value with the onset of PS were analyzed, and the receiver operating characteristic curve was used to screen predictive indicators of PS. Results:In the PS group, the NIHSS score (18.80±8.50 vs 14.40±9.58, t=2.229, P=0.028), proportion of high-density foci [29/35(82.9%) vs 32/57 (56.1%), χ 2=6.928, P=0.008], high-density focal volume [13.23 (39.33) cm 3vs 0.76 (9.82) cm 3, U=1 440.000, P<0.001], CTmax value [80.00 (92.00) HU vs 65.00 (87.50) HU, U=1 337.000, P=0.005] and CTave value [53.48 (23.79) HU vs 45.94 (55.11) HU, U=1 345.000, P=0.004] were higher than those in the non-PS group. The NIHSS score ( OR=1.054, 95% CI 1.004-1.106, P=0.033; rs=0.255, 95% CI 0.051-0.447, P=0.014), presence of high-density foci ( OR=3.776, 95% CI 1.358-10.503, P=0.011; rs=0.274, 95% CI 0.093-0.460, P=0.008), high-density focal volume ( OR=1.026, 95% CI 1.003-1.049, P=0.027; rs=0.381, 95% CI 0.183-0.560, P<0.001), CTmax value ( OR=1.006, 95% CI 1.001-1.011, P=0.014; rs=0.292, 95% CI 0.088-0.475, P=0.005) and CTave value ( OR=1.021, 95% CI 1.007-1.035, P=0.004; rs=0.299, 95% CI 0.092-0.484, P=0.004) were all risk factors affecting PS morbidity and were positively correlated with PS morbidity. The area under the receiver operating characteristic curve of NIHSS score, high-density lesion volume, CTmax value, and CTave value to predict the onset of PS was 0.652, 0.722, 0.670 and 0.674, respectively. The volume of high-density lesions had moderate predictive value for the onset of PS. Conclusions:For AIS patients, CT examination should be performed immediately after interventional operation. The volume, CTmax value and CTave value of high-density lesions newly appeared in the ischemic area are positively correlated with the onset of PS. Quantifying the volume of high-density lesions can help to predict the onset of PS.

Background:There is no comparison of the current status of Helicobacter pylori(Hp)infection in different ethnic groups in terms of families and their individuals.Aims:To investigated for the first time the status of Hp infection in Tibetan and Han Chinese families at the household level.Methods:A questionnaire was used to investigate factors associated with Hp in 50 Tibetan families in Ya'an,Sichuan Province,and 50 Han Chinese families in Chongqing Municipality.13C-urea breath test was used to detect Hp infection.Results:The individual and household Hp positivity rates of the Tibetan population in southwest China were 47.10%and 80%,which were significantly higher than those of the Han Chinese,which were 27.81%and 58%(P<0.05).However,the difference between Han and Tibetan in individual and household infection rates was not statistically significant.There are differences between Han Chinese and Tibetans in terms of infection status,geography,economic conditions,living habits and levels of hygiene.Infection was concentrated in certain family groups rather than being evenly distributed in the population.Conclusions:The current detection rate of Hp infection in individuals and families of Tibetan residents is significantly higher than that of Han Chinese,while the proportion of infected individuals is not statistically different.Transmission of Hp is characterized by family aggregation.There are differences in infection status,geographical environment,economic conditions,living habits and hygiene levels between Chinese and Tibetan families.

By analyzing the main problems existing in the current management of medical devices for clinical trials, this study proposes a feasible management model and specific requirements for acceptance, distribution, storage and recovery combining with the characteristics of medical consumable equipment and diagnostic reagent, which provides a favorable guarantee for the authenticity and reliability of clinical trials.
Clinical Trials as Topic ; Equipment and Supplies/standards* ; Indicators and Reagents/standards* ; Reproducibility of Results ; Research Design/standards*

Objective To explore, the levels of serum highsensitive C-reactive protein (hs-CRP) in different subtypes of acute ischemic stroke (AIS) and its significance. Methods According to TOAST criteria, 124 cases of AIS were divided into four groups: large-artery atherosclerosis (LAA,47 cases), small-artery occlusion (SVO,37 cases), cardiogenic cerebral embolism (CE,21 cases), acute stroke of other determined etiology and stroke of other undetermined etiology (ODE and UE, 19 cases). The serum concentration of hs-CRP was measured with the immunoturbidimetry in every patient of each group at 72 hours, 7 and 14 days after admitted to hospital. Meanwhile 81 healthy persons were involved in control group. Results The serum concentrations of hs-CRP at 72 hours, 7 and 14 days after onset were (10.77 ± 4.27),(16.41±5.61), (7.63±3.59) mg/L in LAA group;(3.99± 1.56), (6.45±3.25), (4.22±3.21) mg/L in SVO group; (11.60±4.85), (25.14±7.12), (9.24±4.61) mg/L in CE group; (6.09±2.43), (9.65 ±4.65), (5.89 ± 2.68) mg/L in ODE and UE group. The serum concentrations of hs-CRP in LAA group, CE group, ODE and UE group were significantly higher than those in control group [(4.26 ± 1.34) mg/L] (P <0.05) except for that in SVO group, the level of serum hs-CRP in the three groups showed significant difference among the different time (P< 0.05). Conclusions The level of serum hs-CRP in AIS patients is increased and positively correlated with the disease severity. The changes of hs-CRP level are performed in various subtypes of TOAST, and show time-dependent effects. Inflammatory response may play an important role in the pathological mechanism of AIS.