OBJECTIVE To evaluate the efficacy and safety of high-dose ilaprazole combined with amoxicillin for newly diagnosed elderly patients with Helicobacter pylori （Hp） infection， and analyze independent risk factors for failure of Hp infection eradication treatment. METHODS Totally 200 cases of newly diagnosed elderly patients with Hp infection in Xinxiang Central Hospital from August 1， 2021 to December 1， 2024 were selected and randomly divided into control group and study group， with 100 cases in each group. The control group was treated with classic quadruple therapy regimen （Amoxicillin capsules+ Clarithromycin tablets+Bismuth potassium citrate tablets+Ilaprazole enteric-coated tablets）. The study group was treated with high- dose Ilaprazole enteric-coated tablets+Amoxicillin capsules. All patients were administered medication for 2 weeks. Hp eradication rates in the two groups were compared using intention-to-treat （ITT） and per-protocol （PP） analyses. The incidence of adverse reactions in both groups was also recorded. The multiple-factor Logistic regression analysis was used to identify independent risk factors for failure of Hp infection eradication treatment. RESULTS In ITT and PP analyses， there was no significant difference of Hp eradication rates between the two groups （P＞0.05）. There was no significant difference in incidence of mild to moderate adverse reactions between the two groups （P＞0.05）. BMI ≤18.5 kg/m2， BMI ＞23.9 kg/m2， rural residence， concomitant diabetes and concomitant heart disease were identified as independent risk factors influencing the failure of Hp infection eradication treatment （P＜0.05）. CONCLUSIONS The efficacy and safety of high-dose ilaprazole combined with amoxicillin are comparable to classic quadruple therapy regimen in treating newly diagnosed elderly patients with Hp infection. Independent risk factors influencing the failure of Hp infection eradication treatment include BMI ≤18.5 kg/m2， BMI ＞23.9 kg/m2， rural residence， concomitant diabetes and concomitant heart disease.

Objective:To explore the chain mediating role of self-management efficacy and self-perceived burden between family function and decision fatigue in gastric cancer patients.Methods:Convenience sampling was used to select 219 gastric cancer inpatients in Xinxiang Central Hospital of Henan Province from June 2023 to December 2024 as study subjects. Family Assessment Device, Chinese version of the Strategies Used by People to Promote Health, Self-Perceived Burden Scale, and Decision Fatigue Scale were used to conduct the survey. The chain mediating effect were tested using Model 6 in the SPSS PROCESS program.Results:Family function, self-management efficacy, self-perceived burden and decision fatigue scores of gastric cancer patients were (73.08±8.47), (90.15±14.33), (31.64±6.55), and (19.23±3.05), respectively. Univariate analysis showed that age, education level, per capita monthly family income, tumor stage and treatment method were the influencing factors of decision fatigue in gastric cancer patients, and the difference was statistically significant ( P<0.05). Correlation analysis showed that family function was negatively correlated with self-management efficacy ( P<0.05) and positively correlated with self-perceived burden and decision fatigue ( P<0.05), and self-management efficacy was negatively correlated with self-perceived burden and decision fatigue ( P<0.05), and self-perceived burden was positively correlated with decision fatigue ( P<0.05), and the differences of the above were statistically significant. Mediating effect analysis showed that family function positively predicted decision fatigue in gastric cancer patients, with a direct effect of 0.117, accounting for 62.57% of the total effect. Self-management efficacy and self-perceived burden realized the mediating effect between family function and decision fatigue through three mediating pathways. Mediating pathway 1 was family function → self-management efficacy → decision fatigue, with an effect value of 0.032, which accounted for 17.11% of the total effect. Mediating pathway 2 was family function→ self-perceived burden → decision fatigue, with an effect value of 0.026, which accounted for 13.90% of the total effect. Mediating path 3 was family function → self-management efficacy → self-perceived burden → decision fatigue, with an effect value of 0.012, accounting for 6.42% of the total effect. The total mediating effect was 0.070, accounting for 37.43% of the total effect. Conclusions:Family function can not only directly influence decision fatigue in gastric cancer patients, but also indirectly influence decision fatigue through the mediating role of self-management efficacy and self-perceived burden. Decision fatigue of gastric cancer patients could be reduced in the future by improving family function, increasing patients' self-management efficacy, and reducing their self-perceived burden.

Objective:To explore the chain mediating role of self-management efficacy and self-perceived burden between family function and decision fatigue in gastric cancer patients.Methods:Convenience sampling was used to select 219 gastric cancer inpatients in Xinxiang Central Hospital of Henan Province from June 2023 to December 2024 as study subjects. Family Assessment Device, Chinese version of the Strategies Used by People to Promote Health, Self-Perceived Burden Scale, and Decision Fatigue Scale were used to conduct the survey. The chain mediating effect were tested using Model 6 in the SPSS PROCESS program.Results:Family function, self-management efficacy, self-perceived burden and decision fatigue scores of gastric cancer patients were (73.08±8.47), (90.15±14.33), (31.64±6.55), and (19.23±3.05), respectively. Univariate analysis showed that age, education level, per capita monthly family income, tumor stage and treatment method were the influencing factors of decision fatigue in gastric cancer patients, and the difference was statistically significant ( P<0.05). Correlation analysis showed that family function was negatively correlated with self-management efficacy ( P<0.05) and positively correlated with self-perceived burden and decision fatigue ( P<0.05), and self-management efficacy was negatively correlated with self-perceived burden and decision fatigue ( P<0.05), and self-perceived burden was positively correlated with decision fatigue ( P<0.05), and the differences of the above were statistically significant. Mediating effect analysis showed that family function positively predicted decision fatigue in gastric cancer patients, with a direct effect of 0.117, accounting for 62.57% of the total effect. Self-management efficacy and self-perceived burden realized the mediating effect between family function and decision fatigue through three mediating pathways. Mediating pathway 1 was family function → self-management efficacy → decision fatigue, with an effect value of 0.032, which accounted for 17.11% of the total effect. Mediating pathway 2 was family function→ self-perceived burden → decision fatigue, with an effect value of 0.026, which accounted for 13.90% of the total effect. Mediating path 3 was family function → self-management efficacy → self-perceived burden → decision fatigue, with an effect value of 0.012, accounting for 6.42% of the total effect. The total mediating effect was 0.070, accounting for 37.43% of the total effect. Conclusions:Family function can not only directly influence decision fatigue in gastric cancer patients, but also indirectly influence decision fatigue through the mediating role of self-management efficacy and self-perceived burden. Decision fatigue of gastric cancer patients could be reduced in the future by improving family function, increasing patients' self-management efficacy, and reducing their self-perceived burden.

Objective:To investigate the influencing factors associated with the difficulty in endoscopic submucosal dissection (ESD) for early esophageal cancer and precancerous lesions.Methods:The retrospective case-control study was conducted. The clinicopathological data of 331 patients with early esophageal cancer and precancerous lesions who were admitted to Xinxiang Central Hospital from December 2011 to December 2021 were collected. There were 229 males and 102 females, aged (72.6±2.7)years. All patients underwent ESD. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Count data were represented as absolute numbers, and comparison between groups was analyzed using the chi-square test. The univariate analysis was performed using statistical methods appropriate to the data type. Multivariate analysis was conducted using the Logistic stepwise regre-ssion model. Results:(1) Surgical situations of ESD. The operation time of 331 patients was (67±8)minutes. There were 327 patients with en bloc resection, and 4 patients with piecemeal resection. Of the 331 patients, adverse events included bleeding in 1 case, pneumomediastinum in 2 cases, esophageal stenosis in 2 cases, and esophageal perforation in 3 cases. All of these adverse events were treated conservatively without surgical intervention. Of the 331 patients, the depth of tumor invasion was epithelial layer in 109 cases, lamina propria in 155 cases, muscularis mucosa in 9 cases, submucosal layer (<0.2 mm) in 12 cases, and submucosal layer (≥0.2 mm) in 42 cases. Of the 331 pati-ents, there were squamous cell carcinoma in 302 cases and adenocarcinoma in 29 cases. Of the 331 pati-ents, 57 cases had difficulties in ESD. (2)Analysis of Influencing factors associated with difficulty in ESD for early esophageal cancer and precancerous lesions. Results of multivariate analysis showed that esophageal cancer located in the left wall, longitudinal tumor diameter>30 mm, and tumor circumference exceeding half of the esophageal circumference were independent risk factors for difficulty in ESD for early esophageal cancer and precancerous lesions ( odds ratio=3.903, 6.699, 5.387, 95% confidence interval as 1.423-10.702, 1.222-36.735, 1.492-19.468, P<0.05). Conclusion:Esophageal cancer located in the left wall, tumor size greater than 30 mm and tumor circumference exceeding half of the esophageal circumference are independent risk factors for difficulty in ESD for early esophageal cancer and precancerous lesions.

Objective To investigate the expression of centromeric protein F(CENPF)and microribonucleic acid 1-3p(miR-1-3p)in the serum of patients with advanced gastric cancer and their correlation with prognosis.Methods Sixty patients with advanced gastric cancer admitted to our hospital from March 2019 to March 2020 were collected as the study group,while 60 healthy volunteers who underwent physical examinations at our hospital's physical examination center during the same period were collected as the control group.Real-time fluorescence quantitative PCR(qRT-PCR)method was applied to detect the expression levels of serum CENPF and miR-1-3p in each group;Pearson method was applied to analyze the correlation between serum levels of CENPF and miR-1-3p;Kaplan-Meier method was applied to analyze the relationship between the expression of CENPF,miR-1-3p,and prognosis in patients with advanced gastric cancer;and COX regression was applied to analyze risk factors affecting the prognosis of patients with advanced gastric cancer.Results Compared with the control group,the CENPF level in the study group was obviously increased,while the miR-1-3p level was obviously reduced(P＜0.05).The correlation analysis results showed that there was a negative correlation between serum CENPF and miR-1-3p levels in patients with advanced gastric cancer(r =-0.650,P＜0.001).There were obvious differences in CENPF and miR-1-3p levels among different TNM stages and lymph node metastasis status(P＜0.05).The 3-year survival rate of patients in the high expression group of CENPF was 19/30(63.33%),which was obviously lower than that in the low expression group,28/30(93.33%)(χ2 = 7.954,P＜0.001);the 3-year survival rate of patients in high expression group of miR-1-3p was 29/30(96.67%),which was obviously higher than that in the low expression group,18/30(60.00%)(χ2 = 11.882,P = 0.001).Multivariate COX regression analysis showed that TNM staging,lymph node metastasis,CENPF,and miR-1-3p expression were risk factors affecting the prognosis of patients with advanced gastric cancer(P＜0.05).Conclusion The serum CENPF level in patients with advanced gastric cancer obviously increase,while miR-1-3p level obviously decrease,both of which are related to prognosis.

Objective To explore the application effect of"three-station"teaching rounds in standardized training teach-ing rounds of general surgery residents.Methods 50 trained doctors from the general surgical base from July 2022 to July 2023 were randomly selected and divided into two groups,with 25 patients in each.The observation group used a"three-station"teaching ward round,while the control group used a traditional teaching ward round mode.The exam scores,ward round effects,satisfaction,and experience were compared.Results The total scores of the observation group were significantly higher than those of the control group(P＜0.05),and the scores of the medical history collection and physical examination in the case anal-ysis test and skill test were significantly higher than those of the control group(P＜0.05).There was no significant difference in the theoretical test scores between the two groups(P＞0.05).The proportion of"Yes"in the questionnaire of the observation group was higher than that of the control group in the aspects of improving the diagnosis and treatment of diseases,clinical think-ing,doctor-patient communication ability and increasing learning interest(P＜0.05).The satisfaction of questionnaire teaching round in the observation group was 84.0％,significantly higher than that in the control group(60.0％)(P＜0.05).In the observation group,the percentages of the attending physicians and the teaching rounds were 64.0％and 68.0％,respectively,which were significantly higher than those of the control group(28.0％and 32.0％,P＜0.05).Conclusion The"three-sta-tion"teaching ward round can improve the exam scores,ward round effectiveness and satisfaction,improve the experience of attending physicians and teaching ward round subjects,and is worth promoting in various resident training bases.

Objective:To investigate the influencing factors associated with the difficulty in endoscopic submucosal dissection (ESD) for early esophageal cancer and precancerous lesions.Methods:The retrospective case-control study was conducted. The clinicopathological data of 331 patients with early esophageal cancer and precancerous lesions who were admitted to Xinxiang Central Hospital from December 2011 to December 2021 were collected. There were 229 males and 102 females, aged (72.6±2.7)years. All patients underwent ESD. Measurement data with normal distribution were represented as Mean± SD, and comparison between groups was analyzed using the t test. Count data were represented as absolute numbers, and comparison between groups was analyzed using the chi-square test. The univariate analysis was performed using statistical methods appropriate to the data type. Multivariate analysis was conducted using the Logistic stepwise regre-ssion model. Results:(1) Surgical situations of ESD. The operation time of 331 patients was (67±8)minutes. There were 327 patients with en bloc resection, and 4 patients with piecemeal resection. Of the 331 patients, adverse events included bleeding in 1 case, pneumomediastinum in 2 cases, esophageal stenosis in 2 cases, and esophageal perforation in 3 cases. All of these adverse events were treated conservatively without surgical intervention. Of the 331 patients, the depth of tumor invasion was epithelial layer in 109 cases, lamina propria in 155 cases, muscularis mucosa in 9 cases, submucosal layer (<0.2 mm) in 12 cases, and submucosal layer (≥0.2 mm) in 42 cases. Of the 331 pati-ents, there were squamous cell carcinoma in 302 cases and adenocarcinoma in 29 cases. Of the 331 pati-ents, 57 cases had difficulties in ESD. (2)Analysis of Influencing factors associated with difficulty in ESD for early esophageal cancer and precancerous lesions. Results of multivariate analysis showed that esophageal cancer located in the left wall, longitudinal tumor diameter>30 mm, and tumor circumference exceeding half of the esophageal circumference were independent risk factors for difficulty in ESD for early esophageal cancer and precancerous lesions ( odds ratio=3.903, 6.699, 5.387, 95% confidence interval as 1.423-10.702, 1.222-36.735, 1.492-19.468, P<0.05). Conclusion:Esophageal cancer located in the left wall, tumor size greater than 30 mm and tumor circumference exceeding half of the esophageal circumference are independent risk factors for difficulty in ESD for early esophageal cancer and precancerous lesions.

Objective:To monitor the dynamic changes in coagulation function and assess their clinical significance in patients with gas-tric cancer by using thromboelas to gram (TEG). Methods:A total of 178 patients with gastric cancer from March 2014 to May 2015 in Xinxiang Central Hospital were selected as the experimental group. The patients were grouped based on different tumor stages, inva-sion depths, and lymph node metastasis. The TEG results of all patients were dynamically monitored before and after operation, and 60 healthy persons were selected as normal control group. Blood coagulation change was analyzed by comparing the TEG test results. Results:Compared with those of the control group, the TEG parameters of the experimental group showed significantly decreased R and K values, as well as significantly increased Angle, CI, and MA values, and the differences were statistically significant (P<0.05). In the experimental group, the K values were significantly decreased after operation, whereas Angle, MA, and CI were significantly in-creased (P<0.05). No significant changes were observed in R, LY30, and others. TEG values were significantly different in the compari-son of values for tumor patients with different stages, different tumor infiltration degrees, and with or without lymphatic metastasis. Conclusion:Blood hypercoagulability in the perioperative period was observed in patients with gastric cancer and was positively corre-lated with tumor stages, tumor infiltration degrees, and lymphatic metastasis. Dynamic monitoring of gastric cancer perioperative TEG can provide valuable information for clinical treatment, improve the safety of gastric cancer surgery, and reduce postoperative compli-cations associated with active clinical significance.