Objective To investigate the optimal cutoff values of Kyoto gastritis score based on gastroscopy,pepsinogen(PG)combined with gastrin-17(G-17)for predicting Helicobacter pylori positive atrophic gastritis in middle-aged and elderly patients.Methods The subjects of this study were 120 middle-aged and elderly patients admitted,diagnosed with atrophic gastritis through gastroscopy examination and pathological biopsy and proved to be Hp positive via 14C urea breath test from August 2022 to June 2023.All patients were divided into atrophic gastritis group(AG group)with 68 cases and non atrophic gastritis group(non-AG group)with 52 cases according to atrophic gastritis results.The AG group was further divided per Kimura-Takemoto classification into mild AG group(n=12),moderate AG group(n=32)and severe AG group(n=24).Kyoto gastritis score based on gastroscopy was performed in all patients.And test their serum pepsinogen Ⅰ(PGⅠ),pepsinogen Ⅱ(PGⅡ),G-17 levels via chemiluminescence and calculate the PGR=PGⅠ/PGⅡ.Receiver operator characteristic curve(ROC curve)was adopted to assess the value of Kyoto gastritis score and serum PG and G-17 for predicting Hp positive atrophic gastritis in middle-aged and elderly patients.Results There were statistically significant differences in Kyoto gastritis score,serum PGⅠ,PGR and G-17 levels between AG group and non-AG group(t=13.38,P=0.000;t=50.84,P=0.000;t=26.44,P=0.000;t=9.44,P=0.000).The Kyoto score of gastritis in AG group was higher than that in non-AG group(P<0.05).The levels of serum PGⅠ,PGR and G-17 in AG group were lower than those in non-AG group(P<0.05).There was no significant difference in serum PGⅡ level between AG group and non-AG group(t=1.24,P=0.219).There were statistically significant differences in Kyoto gastritis score,serum PGⅠ,PGR and G-17 levels among mild AG group,moderate AG group and severe AG group(F=33.95,P=0.000;F=81.99,P=0.000;F=67.36,P=0.001;F=33.50,P=0.004).The mild AG group had a significantly lower Kyoto gastritis score than the moderate AG group and severe AG group(P<0.05),and the moderate AG group had a significantly lower Kyoto gastritis score than the severe AG group(P<0.05).The mild AG group and moderate AG group had significantly higher serum PGⅠ and PGR levels than the severe AG group(P<0.05),and the mild AG group was higher than moderate AG group(P<0.05).The mild AG group had a significantly lower serum G-17 level than the moderate AG group and severe AG group(P<0.05),and there was no significant difference between the moderate AG group and severe AG group(P>0.05).There was no significant difference in serum PGⅡ levels among mild AG group,moderate AG group and severe AG group(F=1.03,P=0.364).The optimal cutoff values of Kyoto gastritis score and serum PGⅠ,PGR and G-17 for predicting atrophic gastritis in middle-aged and elderly patients with Hp positive were 2.78,38.26 μg/L,1.92 and 9.54 pmol/L,respectively.The AUC of Kyoto gastritis score for predicting Hp positive atrophic gastritis in middle-aged and elderly patients was 0.780,the sensitivity was 71.42%,and the specificity was 78.62%.The AUC of PGⅠ for predicting Hp positive atrophic gastritis in middle-aged and elderly patients was 0.757,the sensitivity was 66.27%,and the specificity was 83.25%.The AUC of PGR for predicting Hp positive atrophic gastritis in middle-aged and elderly patients was 0.792,the sensitivity was 76.23%,and the specificity was 87.35%.The AUC of G-17 for predicting Hp positive atrophic gastritis in middle-aged and elderly patients was 0.672,the sensitivity was 60.24%,and the specificity was 74.28%.The AUC of the combination of the four markers for predicting Hp positive atrophic gastritis in middle-aged and elderly patients was 0.871,the sensitivity was 81.28%,and the specificity was 87.36%.Conclusion The Kyoto gastritis score based on gastroscopy,serum PGⅠ,PGR combined with G-17 have good predictive value for Hp positive atrophic gastritis in middle-aged and elderly patients,and the optimal cutoff values for the four markers are 2.78 points,38.26 μg/L,1.92 and 9.54 pmol/L in turn.

Objective:To evaluate the effectiveness of virtual case teaching integrating standardized patients (SP) and objective structured clinical examination (OSCE) in enhancing students' clinical thinking and practical skills in experimental exercise therapy course.Methods:In April 2023, 52 students from the 2021 cohort and 54 students from the 2022 cohort of the Rehabilitation Therapy undergraduate program at Xinjiang Medical University were selected and divided into the experimental group and control group according to their classes. In the shoulder joint mobilization experimental class of the exercise therapy course, virtual SP teaching was performed in the experimental group of both cohorts. For the control group, student-led SP teaching was performed in the 2021 cohort, while the traditional "lecture + demonstration" method was used in the 2022 cohort. Upon completion of teaching, theoretical exams, case analysis, practical exams, and a teaching satisfaction survey were conducted on the students. Data were analyzed using the t-test and chi-square test in SPSS 25.0. Results:In both cohorts, the experimental group had similar theoretical exam scores ( P=0.207 and P=0.097, respectively) to the control group, but had higher practical exam scores ( P=0.013 and P=0.002, respectively) than the control group. In the case analysis exam, the experimental group scored higher than the control group in the 2022 cohort ( t=2.84, P=0.006) but similarly to the control group in the 2021 cohort ( t=1.53, P=0.132). All students believed that virtual SP teaching was most engaging. In terms of understanding complex concepts, increasing active participation, and fostering clinical thinking, the 2022 cohort was more satisfied with virtual SP teaching, whereas the 2021 cohort experienced no significant difference between virtual SP teaching and student-led SP teaching. In addition, the 2021 cohort found that student-led SP teaching was more helpful for improving doctor-patient communication skills. Conclusions:The application of virtual SP teaching in the experimental exercise therapy course effectively enhances students' practical skills and case analysis capabilities, contributing greatly to their overall clinical management thinking.

Objective:To evaluate the effectiveness of virtual case teaching integrating standardized patients (SP) and objective structured clinical examination (OSCE) in enhancing students' clinical thinking and practical skills in experimental exercise therapy course.Methods:In April 2023, 52 students from the 2021 cohort and 54 students from the 2022 cohort of the Rehabilitation Therapy undergraduate program at Xinjiang Medical University were selected and divided into the experimental group and control group according to their classes. In the shoulder joint mobilization experimental class of the exercise therapy course, virtual SP teaching was performed in the experimental group of both cohorts. For the control group, student-led SP teaching was performed in the 2021 cohort, while the traditional "lecture + demonstration" method was used in the 2022 cohort. Upon completion of teaching, theoretical exams, case analysis, practical exams, and a teaching satisfaction survey were conducted on the students. Data were analyzed using the t-test and chi-square test in SPSS 25.0. Results:In both cohorts, the experimental group had similar theoretical exam scores ( P=0.207 and P=0.097, respectively) to the control group, but had higher practical exam scores ( P=0.013 and P=0.002, respectively) than the control group. In the case analysis exam, the experimental group scored higher than the control group in the 2022 cohort ( t=2.84, P=0.006) but similarly to the control group in the 2021 cohort ( t=1.53, P=0.132). All students believed that virtual SP teaching was most engaging. In terms of understanding complex concepts, increasing active participation, and fostering clinical thinking, the 2022 cohort was more satisfied with virtual SP teaching, whereas the 2021 cohort experienced no significant difference between virtual SP teaching and student-led SP teaching. In addition, the 2021 cohort found that student-led SP teaching was more helpful for improving doctor-patient communication skills. Conclusions:The application of virtual SP teaching in the experimental exercise therapy course effectively enhances students' practical skills and case analysis capabilities, contributing greatly to their overall clinical management thinking.

Objective To investigate the optimal cutoff values of Kyoto gastritis score based on gastroscopy,pepsinogen(PG)combined with gastrin-17(G-17)for predicting Helicobacter pylori positive atrophic gastritis in middle-aged and elderly patients.Methods The subjects of this study were 120 middle-aged and elderly patients admitted,diagnosed with atrophic gastritis through gastroscopy examination and pathological biopsy and proved to be Hp positive via 14C urea breath test from August 2022 to June 2023.All patients were divided into atrophic gastritis group(AG group)with 68 cases and non atrophic gastritis group(non-AG group)with 52 cases according to atrophic gastritis results.The AG group was further divided per Kimura-Takemoto classification into mild AG group(n=12),moderate AG group(n=32)and severe AG group(n=24).Kyoto gastritis score based on gastroscopy was performed in all patients.And test their serum pepsinogen Ⅰ(PGⅠ),pepsinogen Ⅱ(PGⅡ),G-17 levels via chemiluminescence and calculate the PGR=PGⅠ/PGⅡ.Receiver operator characteristic curve(ROC curve)was adopted to assess the value of Kyoto gastritis score and serum PG and G-17 for predicting Hp positive atrophic gastritis in middle-aged and elderly patients.Results There were statistically significant differences in Kyoto gastritis score,serum PGⅠ,PGR and G-17 levels between AG group and non-AG group(t=13.38,P=0.000;t=50.84,P=0.000;t=26.44,P=0.000;t=9.44,P=0.000).The Kyoto score of gastritis in AG group was higher than that in non-AG group(P<0.05).The levels of serum PGⅠ,PGR and G-17 in AG group were lower than those in non-AG group(P<0.05).There was no significant difference in serum PGⅡ level between AG group and non-AG group(t=1.24,P=0.219).There were statistically significant differences in Kyoto gastritis score,serum PGⅠ,PGR and G-17 levels among mild AG group,moderate AG group and severe AG group(F=33.95,P=0.000;F=81.99,P=0.000;F=67.36,P=0.001;F=33.50,P=0.004).The mild AG group had a significantly lower Kyoto gastritis score than the moderate AG group and severe AG group(P<0.05),and the moderate AG group had a significantly lower Kyoto gastritis score than the severe AG group(P<0.05).The mild AG group and moderate AG group had significantly higher serum PGⅠ and PGR levels than the severe AG group(P<0.05),and the mild AG group was higher than moderate AG group(P<0.05).The mild AG group had a significantly lower serum G-17 level than the moderate AG group and severe AG group(P<0.05),and there was no significant difference between the moderate AG group and severe AG group(P>0.05).There was no significant difference in serum PGⅡ levels among mild AG group,moderate AG group and severe AG group(F=1.03,P=0.364).The optimal cutoff values of Kyoto gastritis score and serum PGⅠ,PGR and G-17 for predicting atrophic gastritis in middle-aged and elderly patients with Hp positive were 2.78,38.26 μg/L,1.92 and 9.54 pmol/L,respectively.The AUC of Kyoto gastritis score for predicting Hp positive atrophic gastritis in middle-aged and elderly patients was 0.780,the sensitivity was 71.42%,and the specificity was 78.62%.The AUC of PGⅠ for predicting Hp positive atrophic gastritis in middle-aged and elderly patients was 0.757,the sensitivity was 66.27%,and the specificity was 83.25%.The AUC of PGR for predicting Hp positive atrophic gastritis in middle-aged and elderly patients was 0.792,the sensitivity was 76.23%,and the specificity was 87.35%.The AUC of G-17 for predicting Hp positive atrophic gastritis in middle-aged and elderly patients was 0.672,the sensitivity was 60.24%,and the specificity was 74.28%.The AUC of the combination of the four markers for predicting Hp positive atrophic gastritis in middle-aged and elderly patients was 0.871,the sensitivity was 81.28%,and the specificity was 87.36%.Conclusion The Kyoto gastritis score based on gastroscopy,serum PGⅠ,PGR combined with G-17 have good predictive value for Hp positive atrophic gastritis in middle-aged and elderly patients,and the optimal cutoff values for the four markers are 2.78 points,38.26 μg/L,1.92 and 9.54 pmol/L in turn.

Introduction: Derangement in calcium homeostasis is common in nephrotic syndrome (NS). It is postulated that low serum total calcium and vitamin D levels are due to loss of protein-bound calcium and vitamin D. It is unclear if free calcium and free vitamin D levels are truly low. The guideline is lacking with regards to calcium and vitamin D supplementation in NS. This study aims to examine calcium and vitamin D homeostasis and bone turnover in NS to guide practice in calcium and vitamin D levels supplementation. Methodology: This is a prospective pilot study of ten patients diagnosed with NS, and eight healthy controls. Calcium, vitamin D, and bone turnover-related analytes were assessed at baseline, partial and complete remission in NS patients and in healthy controls. Results: NS patients had low free and total serum calcium, low total 25(OH)D, normal total 1,25(OH)D levels and lack of parathyroid hormone response. With remission of disease, serum calcium and vitamin D metabolites improved. However, nephrotic patients who do not attain complete disease remission continue to have low 25(OH)D level. Conclusion In this study, the vitamin D and calcium derangement observed at nephrotic syndrome presentation trended towards normalisation in remission. This suggested calcium and vitamin D replacement may not be indicated in early-phase nephrotic syndrome but may be considered in prolonged nephrotic syndrome.
Vitamin D Deficiency

Objective To explore the short-term prognosis of tirofiban hydrochloride on the patients with acute ST-segment elevation myocardial infarction and the influence of tirofiban hydrochloride on myocardial biomarkers. Methods 334 patients with acute ST-segment elevation myocardial infarction were choosen. They were divided into two groups, 167 cases in each group. Tirofiban hydrochloride was used in the experimental group, and conventional therapy was carried out for control group. Compared the biochemical indexes, myocardial biomarkers and cardiac function of the two groups. Results The effective rate of experimental group was 165 cases (98.80%), which was higher than 150 cases (89.82%) in the control group (χ2=12.556,P<0.05). After treatment, the cardiac troponin I (cTnI) in experimental group was lower than control group (P<0.05). The levels of left ventricular end diastolic volume (LVEDV) and left ventricular endsystolic volume (LVESV) significantly decreased and the level of left ventricular ejection fraction (LVEF) increased in experimental group compared with those in control group(P<0.05).The global registry of acute coronary events (GRACE) after treatment in experimental group was lower than that in control group (P<0.05). The hyporrhea of thrombolysis in myocardial infarction (TIMI) in experimental group were 5 cases (2.99%), which was lower than 19 cases (11.38%) in control group (χ2=8.799,P<0.05). After 12 months, the attack frequency of angina in experimental group was (1.78±0.78)times, which was lower than (2.56±1.04) times in control group (P<0.05). Conclusion Patients with acute ST-segment elevation myocardial infarction should be diagnosed as soon as possible and take treatment strategies according to individual situation to chose suitable dosage of tirofiban hydrochloride for good therapeutic effect.

Objective To explore the methods and mesures for the pre-analytical quality control of test specimen and to improve the accuracy and reliability of test results.Methods According to the relevant requirements of IS015189,various measures for the specimen circulation process and collection technology two aspects were taken to control the full links of clinical specimen collection and transport,and the incidence of unqualified specimen before and after the improvements were analyzed.Results After the imple-mentation of the improvement measures,the incidence of unqualified specimens was decreased significantly.Conclusion Implemen-tation of the whole aspect of pre-analytical quality control can effectively improve the quality of specimen in order to improve the test quality.

Objective To study the clinical value of the platelet count (PC),fibrinogen (Fib) and D-dimer detection in patients with cervical cancer.Methods Eighty-seven patients with cervical cancer (cervical cancer group) and 66 patients with cervical benign lesion (control group) were selected,the levels of PC,Fib and D-dimer were respectively determined to analyze the clinical significance of three factors.Results The PC,Fib and D-dimer in cervical cancer group were significantly higher than those in control group [(274.22 ± 82.32) × 109/L vs.(238.82 ±74.97) × 109/L,(3.03 ±0.59) g/L vs.(2.67 ±0.45) g/L,(182.77 ± 167.07) ng/L vs.(113.74 ± 64.84) ng/L,P ＜ 0.05].Patients with stage Ⅱ and tumor volume ＞ 4 cm were obviously higher than patients with stage Ⅰ and tumor volume ≤ 4 cm in the PC,Fib and D-dimer [(296.66 ±94.30) × 109/L vs.(251.26 ±60.86) × 109/L,(3.22 ±0.67) g/L vs.(2.84 ±0.42) g/L,(238.61 ± 213.29) ng/L vs.(125.63 ± 62.96) ng/L,(299.14 ± 81.33) × 109/L vs.(257.44 ± 79.39) ×109/L,(3.20±0.67) g/Lvs.(2.91 ±0.50) g/L,(281.29 ±223.33) ng/L vs.(116.46 ±51.69) ng/L,P＜0.05].But there was no significant difference between lymph node metastasis positive patients and lymph node metastasis negative patients (P ＞ 0.05).Conclusion The PC,Fib and D-dimer of patients with cervical cancer are helpful to clinical cervical cancer diagnosis,treatment and prognosis improvement.