Objective To investigate the effect of omega-3 polyunsaturated fatty acids(ω-3 PUFA)on chronic atrophic gastritis of rats.Methods A rat model of chronic atrophic gastritis was established by synthetic method.The rats successfully modeled were randomly divided into model group,experimental-L group,experimental-M group,experimental-H group,positive control group.Normal rats were selected as the normal group.There were 9 rats in each group.Experimental-L,-M,-H groups were given 3,6 and 12 mL·kg-1ω-3 PUFA daily,respectively.The positive control group was given 0.24 g·kg-1 vitacoenzyme suspension daily.Normal group and model group were given the same amount of 0.9％NaCl.Each group was given the drug for 12 weeks.Enzyme-linked immunosorbent assay(ELISA)was used to detect serum interleukin-1 β(IL-1β)level.In situ end labeling staining(TUNEL)was used to detecte the apoptosis of gastric mucosa.Relevant kits were used to detect the level of superoxide dismutase(SOD)and malonaldehyde(MDA).Results IL-1 β levels in normal group,model group,experimental-L,-M,-H groups and positive control group were(58.96±8.23),(140.02±19.65),(109.81±14.35),(98.72±12.64),(85.31±11.42)and(77.64±10.23)pg·mL-1,respectively;apoptotic indices were(7.89±1.36)％,(77.12±10.05)％,(42.33±6.87)％,(31.05±5.29)％,(22.76±4.16)％and(16.89±3.05)％,respectively;SOD levels were(398.71±58.24),(170.25±29.81),(249.81±34.26),(268.04±34.11),(322.15±46.36)and(276.42±29.81)U·mg-1,respectively;MDA levels were(3.55±0.87),(11.02±2.15),(8.02±1.50),(6.92±1.23),(5.98±1.27)and(6.67±1.32)U·mg-1,respectively.Compared with normal group,the above indexes were significantly different in model group(all P＜0.01);compared with model group,the above indexes were significantly different in experimental-L,experimental-M,experimental-H groups and positive control group(all P＜0.01).Conclusionω-3 PUFA can ameliorate chronic atrophic gastritis of rats,and the mechanism may be related to the anti-inflammatory,anti-apoptosis and anti-oxidative stress effects of to-3 PUFA.

Objective: To investigate the clinical, cardiac imaging characteristics and prognosis of patients with primary cardiac angiosarcoma. Methods: The clinical data of 14 patients hospitalized with primary cardiac angiosarcoma from January 2001 to December 2017 in Peking Union Medical College Hospital were collected and analyzed. Metastatic cardiac angiosarcoma was not included in this study. Patients were followed up post discharge per telephone call or clinical visit. Results: Of the 14 patients, 8 were males and 6 were females, average age was 48 years. The main clinical symptoms were shortness of breath (8/14), hemoptysis (6/14), fever (5/14), chest pain (4/14) and cough (3/14). Imaging examinations showed that the tumors of 8 patients were located in the right heart and 6 in the pericardial cavity. Tumors in the right heart often infiltrate the atrial wall and cause pericardial effusion (7/8). Tumors in the pericardium were characterized by recurrent bloody pericardial effusion (6/6), prone to progressive constrictive pericarditis (3/6), pericardial fluid cytology was often negative (6/6). MRI showed heterogeneous high signal intensity (cauliflower aspect) on T2-weighted image and heterogeneous enhancement with a"sunray" aspect at the perfusion study. At the time of diagnosis, 8 patients developed lung or adrenal metastasis (8/14). The median survival was only 305 days. Conclusions: Primary cardiac angiosarcoma is a rare disease with non-specific clinical manifestation and poor prognosis. Imaging examinations may help diagnosis. The high invasiveness and the easy-to-metastasis feature of the tumor contribute to the poor prognosis of cardiac angiosarcoma.
Aftercare ; Female ; Heart Neoplasms/diagnostic imaging* ; Hemangiosarcoma/diagnostic imaging* ; Humans ; Male ; Middle Aged ; Patient Discharge ; Pericardial Effusion

Objective Post-operative cognitive dysfunction (POCD) and post-operative delirium (POD) are two common post-operative cerebral complications. The current meta-analysis was to systematically review the effects of penehyclidine hydrochloride (PHC) on POCD and POD in surgical patients.Methods Electronic databases were searched to identify all randomized controlled trials comparing PHC with atropine/scopolamine/placebo on POCD and POD in surgical patients. Primary outcomes of interest included the incidences of POCD and POD; the secondary outcomes of interest included peri-operative mini-mental state examination (MMSE) scores. Two authors independently extracted peri-operative data, including patients' baseline characteristics, surgical variables, and outcome data. For dichotomous data (POCD and POD occurrence), treatment effects were calculated as odds ratio () and 95% confidential interval (). Each outcome was tested for heterogeneity, and randomized-effects or fixed-effects model was used in the presence or absence of significant heterogeneity. For continuous variables (MMSE scores), treatment effects were calculated as weighted mean difference (WMD) and 95% . Statistical significance was defined as <0.05.Results Our search yielded 33 studies including 4017 patients. Meta-analysis showed that, the incidence of POCD in PHC group was comparable to that in saline group (=0.97; 95% : 0.58-1.64; =0.92), scopolamine group (=0.78; 95% : 0.48-1.27; =0.32) and atropine group (=1.20; 95% : 0.86-1.67; =0.29). The incidence of POD in PHC group was comparable to that in saline group (=1.53; 95% : 0.81-2.90; =0.19) and scopolamine group (=0.53; 95% : 0.06-4.56; =0.56), but higher than that in atropine group (=4.49; 95% : 1.34-15.01; =0.01).Conclusions PHC premedication was not associated with increased incidences of POCD or POD as compared to either scopolamine or placebo.

Objective To observe the clinical efficacy and safety of re-bamipide combined with rabeprazole sodium enteric -coated tablets in the treatment of chronic atrophic gastritis .Methods A total of 94 pa-tients with chronic atrophic gastritis were randomly divided into control and treatment groups with 47 cases per group.Control group was given riberazole 20 mg per time, qd, orally.Treatment group received rabe-prazole 0.1 g per time, tid, orally, on the basis of control group.Two groups were treated for 8 weeks. The clinical efficacy, pepsinogen (PG), endothelin (ET) and adverse drug reactions were compared be-tween two groups.Results After treatment, total effective rates of treat-ment and control groups were 93.62%( 44 cases/47 cases ) and 70.21%(33 cases/47 cases) with significant difference ( P<0.05 ) . After treatment, the main indexes of treatment and control groups were compared: PGⅠ were ( 127.38 ±13.96 ) and ( 103.84 ±13.58 ) μg· L-1, ET were (65.49 ±5.99 ) and ( 74.20 ±9.79 ) ng· L-1, there were statistically significant differences (all P<0.05).The adverse drug reactions of treatment group were liver dysfunction and skin rash , which in control group were diarrhea , rash and nausea and vomiting .The total incidence of adverse drug reactions were 6.38%and 14.89%without significant difference (P>0.05).Conclusion Rebamipide combined with rabeprazole sodium enteric-coated tablets has a definitive clinical efficacy in the treatment of chronic atrophic gastritis , which can effectively regulate the levels of PG and inhibit the expression of ET , without increasing the incidence of adverse drug reactions.

Objective To evaluate the necessity of bedside echocardiography ( ECG) in patients with dif-ferent clinical conditions and to investigate its values in diagnosis and treatment .Methods We analyzed the clinical conditions of all the patients who applied for and received bedside ECG in Peking Union Medical College Hospital from July 1 to 30, 2013.The necessity of this examination and its values in the diagnosis and treatment were evaluated.Results Fifty-eight patients were included (33 males, 56.9%), aged (56.4 ±19.9 ) years. Thirty-seven (63.8%) patients were from emergency department , 16 (27.6%) were from intensive care units , and 5 (8.6%) from other departments.In 36 (62.1%) patients, the purpose of applications for bedside ECG was in compliance with the consensus of the American Society of Echocardiography ( ASE) and American College of Emergency Physicians (ACEP).The purposes of bedside ECG were accomplished in 53 (91.4%) applica-tions.The bedside ECG confirmed or altered the initial diagnosis in 13 (22.4%) cases, supported the initial diagnosis in 40 (69.0%), but offered no diagnostic information in 5 (8.6%).Based on the ECG results, the treatment was adjusted in 16 patients (27.6%).After the examination, 23 (39.7%) applications for bedside ECG were considered necessary by cardiologists , the other 35 ( 60.3%) were unnecessary .Compared with the applications not conforming to the consensus of ASE and ACEP , those conforming to the consensus were signifi-cantly more likely to provide valuable diagnostic information ( P =0.01 ) , to result in treatment adjustment ( P=0.06 ) , and to be necessary ( P<0.01 ) .Conclusions The indications of bedside ECG should be strictly observed .To make full use of the limited medical resources , bedside ECG should be applied in accordance with the consensus of ASE and ACEP to ensure its values in diagnosis and treatment .

BACKGROUNDCD44v6 plays an important role in invasion and metastasis of tumor, Livin has anti-apoptotic effects. The present study aimed to explore the expression and clinical significance of CD44v6 and Livin in gastric cancer tissue.

METHODSStreptavidin-peroxidase linked immunohistochemical method was used to determine the expression of CD44v6 and Livin in gastric cancer tissue and adjacent normal gastric tissues from 59 patients with histopathologically confirmed gastric cancer, and in gastric tissue specimens of 15 patients with gastric polyps, and 15 patients with chronic non-atrophic gastritis. The chi-square test was used for comparison of the relevant factors, Spearman's rank correlation test was applied for relationship among positive expression of the proteins.

RESULTSThe expresion of CD44v6 was positive in 64.4% of the gastric cancer patients; 5.1%, 0 and 13.3% in specimens of normal tissues adjacent to the cancer tissues, in gastric tissue specimens of patients with gastric polyps, and patients with chronic non-atrophic gastritis, respectively. The expression of Livin was positive in 52.5% of the gastric cancer tissues, 6.8%, 0 and 6.7% in the adjacent normal gastric tissue, specimens of patients with gastric polyps and chronic non-atrophic gastritis, respectively. The expression of CD44v6 was significantly correlated with the depth of invasion, the degree of differentiation, and lymphnode metastasis of gastric cancer (P < 0.05). The positive expression rate of Livin protein was also significantly correlated with degree of differentiation of gastric cancer cells and metastasis to lymphnodes (P < 0.05), but not correlated with the depth of invasion and pathological types (P > 0.05). The expression of CD44v6 and Livin in the gastric cancer tissue was positively correlated (r(s) = 0.286, P = 0.028).

CONCLUSIONSThe increased expression of CD44v6 and Livin in gastric cancer tissue may be closely related with development and progression of gastric cancer. CD44v6 and Livin may be new biological markers of gastric cancer.

Adaptor Proteins, Signal Transducing ; analysis ; physiology ; Aged ; Female ; Humans ; Hyaluronan Receptors ; analysis ; physiology ; Immunohistochemistry ; Inhibitor of Apoptosis Proteins ; analysis ; physiology ; Male ; Middle Aged ; Neoplasm Proteins ; analysis ; physiology ; Stomach Neoplasms ; chemistry ; metabolism ; pathology

Objective To analyze the clinical characteristics of infective endocarditis in patients with hypertrophic obstructive cardiomyopathy.Methods Clinical characteristics from 5 patients with infective endocarditis and hypertrophic obstructive cardiomyopathy hospitalized from January 2000 to December 2010 in our hospital were analyzed.Results Four patients were diagnosed with left ventricular outflow tract obstructive cardiomyopathy with outflow pressure gradient from 36 to 140 mm Hg( 1 mm Hg =0.133 kPa) and left atrial size 44 - 68 mm. Another patient was diagnosed as ventricular hypertrophic cardiomyopathy with significant right-ventricular outflow tract hypertrophy (30 mm),high pressure gradient ( 164 mm Hg) and enlarged right atrial (56 mm ×53 mm),there was a 17 mm ×8 mm vegetation on right-ventricular outflow tract in this patient. Blood cultures were positive for streptococcus viridans in all five patients,and enterococcus faecium was revealed in one aortic valve vegetation culture. Transthoracic echocardiogram was performed 2 -4 times for each patient,the vegetations of two patients was detected only by transesophageal echocardiography.The mitral valve vegetation was detected in two patients,the aortic and mitral valve vegetations were detected in one patients,mitral and tricuspid vegetations in one patient and right ventricular outflow tract vegetation in one patient. The four hemodynamically stable patients were successfully treated with antibiotic therapy,one patient received urgent surgery (replacement of the aortic and mitral valve as well as septal myectomy).All patients recovered and follow-up (1 -6 years) was available in 4 patients and no complication was observed.Conclusion The risk of infective endocarditis complicating hypertrophic obstructive cardiomyopathy is the highest in patients with both outflow obstruction and marked valve insufficiency,these patients should receive prophylactic antibiotic therapy during procedures that predispose to infective endocarditis.

BACKGROUNDHemodynamic evaluation is crucial for the management of patients with pulmonary hypertention. Clinicians often prefer a rapid and non-invasive method. This study aimed to examine the feasibility of transthoracic echocardiography for the measurements of hemodynamic parameters in patients with pulmonary hypertension.

METHODSA prospective single-center study was conducted among 42 patients with pulmonary hypertension caused by different diseases. Transthoracic echocardiography and right-heart catheterization were performed within 24 hours. Pulmonary artery systolic, diastolic and mean pressure (PASP, PADP and PAMP), cardiac output (CO), and pulmonary capillary wedge pressure (PCWP) were measured by both methods. A linear correlation and a Bland-Altman analysis were performed to compare the two groups of hemodynamic parameters.

RESULTSA good correlation was found between invasive and non-invasive measurements for PASP (r = 0.96), PADP (r = 0.85), PAMP (r = 0.88), CO (r = 0.82), and PCWP (r = 0.81). Further agreement analysis done by the Bland-Altman method showed that bias and a 95% confidence interval for PASP, PADP, and CO were clinically acceptable while great discrepancies existed for PAMP and PCWP.

CONCLUSIONSThe non-invasive measurements by PASP, PADP, and CO in patients with pulmonary hypertension correlate well with the invasive determinations. Transthoracic echocardiography (TTE) was inappropriate for estimating PCWP and PAMP.

Adolescent ; Adult ; Cardiac Catheterization ; Cardiac Output ; Echocardiography ; Female ; Hemodynamics ; Humans ; Hypertension, Pulmonary ; physiopathology ; Male ; Middle Aged ; Prospective Studies ; Pulmonary Wedge Pressure

OBJECTIVETo explore the pathogenic form, epidemic features and serotype distribution of the pathogenic bacteria causing infectious diarrhea in Beijing.

METHODSA total of 2118 samples of rectal swabs and stool specimens of diarrheal patients were collected from 6 surveillant intestinal tract clinics during the period between April and October, 2010. Enteric multiple pathogens including Vibrio cholerae, Vibrio parahaemolyticus, Salmonella, Shigella and diarrheagenic Escherichia coli were detected by the isolation culture, biochemical identification and serotyping methods. The population distribution, temporal distribution and serotype distribution of the above pathogenic bacteria were analyzed by descriptive statistical methods.

RESULTS478 strains isolated from the total 2118 specimens were positive for pathogen detection, accounting to 22.6%. Among the 478 strains of pathogenic bacteria, Shigella accounting for 40.8% (195/478) was the most frequent pathogen, followed by Vibrio parahaemolyticus accouting for 23.8% (114/478), Salmonella accounting for 19.0% (91/478) and diarrheagenic Escherichia coli accounting for 4.8% (23/478). Enteric pathogenic bacteria spread mainly among adults aging between 20 and 39; and the distribution was different among different age groups, while the highest detected rate was in 30 - 39 age group, accounting for 27.2% (92/338). The detected rate of pathogenic bacteria showed evident seasonal variations, with a peak from July to October, whose detected rates were 23.5% (114/486), 32.8% (176/536), 36.1% (90/249) and 25.9% (29/112) respectively. The detected rates in other months were all under 16.0%. Shigella Sonnei was the dominant serotype, accounting for 83.1% (162/195). O3:K6 was the dominant serotype among Vibrio parahaemolyticus, accounting for 63.2% (72/114). Salmonella Enteritidis and Salmonella Typhimurium were dominant serotypes among Salmonella, accounting for 13.2% (12/91) and 12.1% (11/91) separately. Enterpathogenic Escherichia coli and enterotoxigenic Escherichia coli were the dominant serotypes among Diarrheagenic Escherichia coli, accounting for 69.6% (16/23) and 30.4% (7/23) respectively.

CONCLUSIONThe three main pathogenic bacteria causing infectious diarrhea in Beijing are Shigella, Vibrio parahaemolyticus, Salmonella; and there are obvious changes in the serotype distribution of Shigella and Samonella compared to previous years.

Adolescent ; Adult ; Aged ; Bacterial Infections ; epidemiology ; Child ; China ; epidemiology ; Diarrhea ; epidemiology ; microbiology ; Female ; Humans ; Male ; Middle Aged ; Salmonella ; isolation & purification ; Serotyping ; Shigella ; isolation & purification ; Vibrio parahaemolyticus ; isolation & purification ; Young Adult

To study the intervention programs on smoking cessation in a general hospital and to evaluate its effects of the programs. Four methods including: a) the intervention through specialists in the smoking cessation clinic, b) short-time intervention in the out-patient department,c) free medical intervention, d) group intervention, were adopted for different smokers, with health counseling, psychological intervention and drug treatment. Intervention effect was evaluated by standard methods. During the 20-month period of the project, we treated 690 cases and 402 completed 6-month follow-up. Preliminary results in 402 cases showed that the three methods of smoking cessation interventions could reduce the amount of cigarette smoking and increase the quitting rate. Motivation to quit smoking, intervention methods and intensity of intervention seemed cessation clinic (31.6%) and in the group intervention (30.9%) was higher than short-time intervention in free medical events (15.1%). The successful rate of smoking cessation depended on the motivation of quitters, and the attitude, methods and intervention skills of the physicians.Therefore, it is necessary to explore and develop smoking cessation service models suitable to national context and individual intervention methods in China.