Objective:To investigate the knowledge and practice of the Sixth Chinese national consensus report on the management of Helicobacter pylori ( H. pylori) infection (treament excluded) (referred to as sixth national consensus)and 2022 Chinese national clinical practice guideline on H. pylori eradication treatment (referred to as guideline) among gastroenterologists in China, so as to provide out relevant training in the future. Methods:A questionnaire was designed according to sixth national consensus and guideline, including knowledge and practice of sixth national consensus and guideline, and the detection, indications of eradication, the relationship between infection and gastrointestinal microbiota, and eradication of H. pylori. From November 1 to 30 in 2023, the questionnaire-based survey was conducted among 1 506 gastroenterologists from secondary and tertiary hospitals of 24 provinces, autonomous regions and municipalities in China with convenience sampling method using the "Questionnaire Star" online questionnaire platform and the questionnaire link was sent by WeChat. Descriptive methods were used for statistical analysis. Results:A total of 1 442 valid questionnaires were collected. The awareness rate of sixth national consensus and guideline of gastroenterologists was 83.7% (1 207/1 442), and 47.2% (680/1 442) had read the relevant content in detail. Urea breath test (97.4%, 1 404/1 442) was the most commonly used method for diagnosing current H. pylori infection, however, more than half of the physicians chose serological test (53.3%, 769/1 442) for the diagnosis of current infection. The common indications of H. pylori eradication could be identified by 84.3%(1 215/1 442) of gastroenterologists. The most well-known eradication regimen was bismuth quadruple regimen (98.5%, 1 421/1 442), while some physicians still believed that the standard triple regimen (31.8%, 459/1 442) and sequential regimen (21.9%, 316/1 442) were recommended by the guideline. A further 20.2% (291/1 442) frequently prescribed a triple regimen combined with gastric mucosal protectants and the awareness rate of high-dose dual regimen was 59.1% (852/1 442). Amoxicillin + clarithromycin (65.4%, 943/1 442) and amoxicillin+ furazolidone (20.1%, 290/1 442) were commonly used antibiotic combinations in bismuth quadruple therapy. Potassium-competitive acid blockers and double-dose proton pump inhibitors were commonly used in bismuth quadruple therapy by 45.4% (655/1 442) and 46.0% (664/1 442) of physicians, respectively. For patients with multiple failed eradications, furazolidone was the most commonly used antibiotic for re-eradication(71.7%, 1 034/1 442). Conclusion:The knowledge and practice of gastroenterologists on H. pylori infection in China deviates from the new consensus and guideline, and more publicity and training should be carried out in future to improve the ability of gastroenterologists to standardise the diagnosis and treatment of H. pylori infection.

Novel coronavirus Omicron variant infection can cause severe illness and even death in certain populations. Omicron variant infection may lead to systemic inflammatory response, coagulation disorder, multi-organ dysfunction and other pathophysiological changes, which are different from other Novel coronavirus variants to a certain extent, so therapeutic strategies should not be the same. The National Medical Center for Major Public Health Events invited experts in fields of infectious diseases, respiratory medicine, intensive care, pediatrics and fever clinic to develop this quick guideline based on the current best evidence and extensive clinical practices. This quick guideline aims to standardize the diagnosis and treatment of novel coronavirus Omicron infection, and to improve the disease management abilities of clinicians.

Since 2010, the incidence of severe fever with thrombocytopenia syndrome (SFTS) has been increased. Owing the progress in diagnosis and treatment, the overall mortality of SFTS in China has decreased, while the mortality in critical SFTS patients is still high. In order to provide guidance and working procedures for clinicians to diagnose and treat critical SFTS, the National Medical Center for Major Public Health Events invited experts to discuss and formulate this consensus based on their experience and up-to-date knowledge on SFTS.

Quality of care and safety are the lifeline of hospital performance and hospital management.With reference to the KTQ hospital quality certification system of Germany,Tongji Hospital built platforms to supervise outpatient,emergency,inpatient,surgical operation,nursing, hospital-acquired infection,and pharmacy management.By the connection and reaction of both online and offline systems,Tongji Hospital has built a systematic,informationized and precise medical quality and safety system for large public hospitals,safeguarding quality of care and safety of patients.

Objective To investigate current status of narcotic analgesic use in patients with cancer pain in our hospital, in order to promote the rationalization of prescribing narcotic drugs and the rational use of analgesics. Methods A total of 400 narcotic prescriptions ( 100 of outpatients and 300 of inpatients ) in Tongji hospital were randomly selected from March to May in 2014.Basic index and consumption of anesthetic drugs, money consumption distribution on different tumor types, and unreasonable prescription were analyzed. Results The overall prevalence of irrational prescriptions was 11. 00%, with 13.00% from inpatient and 10. 33% from outpatient, respectively. Reasons for irrational prescriptions mainly included vague instructions on dosage and administration, incomplete clinical diagnosis, lack of pharmacist check and inappropriate dosage. In the basic indexes, proportions of reasonable prescription and drugs within the national formulary were higher in the inpatient than in the outpatient service.The average money consumption of outpatient prescription was significantly higher than that of inpatient prescription.Most types of diagnosis were lung cancer in outpatient and inpatient departments, and total cost of lung cancer drugs was the highest.Morphine hydrochloride of outpatient had the highest average consumption, followed by codeine phosphate of the outpatient and the inpatient, and oxycodone hydrochloride controlled-release tablets cost more in inpatient. Conclusion The narcotic analgesic used in our hospital is basically rational. Most doctors prescribe according to the guidelines, but standardized training of prescription for cancer patients with pain medication needs to be strengthened, and supervision of narcotic analgesic medication should be enhanced.

Scientific research is important for the improvement of the health-care techniques,and is certainly important for the health of women and children of the whole society.With the development of medical science,research ability of maternal and child healthcare professionals is deemed essential.And the evaluation of their research ability,stimulation,and creativity have been important topics to address.Here we introduce an evaluation system for research capacity of maternal and child healthcare professionals established in our hospital,which is the fruit of constant exploration and practice for several years.It is proved to be practical,simple and feasible.The establishment methods,practices and experiences of the evaluation system are presented in this paper.

Objective To study the pathological and immunohistochemical features of alimentary tract mesenchymal tumors and compare with computed tomographic virtue endoscopy (CTVE) imaging technology to evaluate the diagnostic value of CTVE in alimentary tract mesenchymal tumors. Methods Seventy-four pathological specimens of alimentary tract mesenchymal tumors were collected. The pathological features and the expression of CD117, CD34, SMA and S-100 were observed by immunohistochemical method with light microscope. The pathological types and characteristics were determined by pathologists and compared with CTVE imaging technology. Results In the 74 cases of alimentary tract mesenchymal tumors,40 cases were diagnosed as stromal tumor with pathological and immunohistochemical methods (54. 1%).Sixteen of them were malignant, accounting for 40% of the stromal tumor while 33 cases were diagnosed as leiomyoma(44. 6%)and 1 case as schwannoma(1.4%) . In the 74 GIMTs cases ,33 were jejunum GIMTs,21 were ileum GIMTs and 20 were large intestine GIMTs. Immunohistochemistry assay in the 74 GIMTs cases showed that 51.4% GIMTs were positive for CD117, approximately 36. 5% were positive for CD34 , 62.2% were positive for smooth-muscle actin (SMA) and 1. 4% were positive for S-100 protein. In the 74 GIMTs cases,69 cases were diagnosed right in the accuracy for location with CTVE(93. 2%) with 51 cases in small intestinal (94. 4%) and 18 cases in large intestinal (90. 0%). The sensitivity and the specificity of CTVE to distinguish benign from malignant stromal tumors by CTVE characteristics were 84. 2% and 85. 7%respectively. Conclusions GIST is common in GIMTs and is often originated from the small intestinal. The immunohistochemistry has great value in diagnosing alimentary tract mesenchymal tumors. The CTVE imaging technology also has great value in diagnosing alimentary tract mesenchymal tumors which can show the localization, shape size and artery of the tumor clearly. The diagnostic sensitivity and specificity of CTVE are high to distinguish benign from malignant alimentary tract GISTs. CTVE plays an important role in guiding the clinical management of GISTs.

The indices of the average level of major development and research capacity of the municipal Maternal and Child Health Institutions (MCH)in Sichuan Province were compared with the same indices of the national municipal MCH. we have noticed that the gap relating to the research capacity is significantly greater than the gap relating to the major development indices between Sichuan municipal MCH and the national municipal MCH. The result demonstrates the importance and necessity of strengthening the core subject construction in municipal MCH in Sichuan Province . Furthermore, it provides the ideas and methods of carrying out the core subject as references.

Objective To investigate the expressions of PI3K, AKT and MRP protein in pancreatic carcinoma and to determine the clinicopathological significance and the correlation among three protein expressions. Methods The immunohistochemical method was used to detect the expressions of PI3K, AKT and MRP in forty three pancreatic carcinoma, nine chronic pancreatitis and eight normal pancreatic tissue samples. Results The positive expression rates of PI3K, AKT and MRP were 46.51%, 55.81% and 39.53%, respectively in pancreatic carcinoma, which were remarkably higher than those in normal pancreatic tissue and in chronic pancreatitis (P<0.01 and P<0.05, respectively). The aberrant expression of PI3K, AKT and MRP were associated with lymph node metastasis and TNM stages (P<0.05). The abnormal expression rate in both MRP and PI3K was 32.56%, the normal expression rate of both MRP and PI3K was 46.51%, and there was positive correlation between the expression of MRP and PI3K(r=0.581, P<0.01). The abnormal expression rate of both MRP and AKT was 32.56%, the normal expression rate was 37.21%, and there was a positive correlation between MRP and PI3K (r=0.432,P<0.05). The abnormal expression rate of both MRP and PI3K was 37.21%, the normal expression rate of both MRP and PI3K was 32.56%, there was also a positive correlation between MRP and PI3K (r=0.306,P<0.05). Conclusions The expressions of PI3K, AKT and MRP were up-regulated in pancreatic carcinoma. The expressions of PI3K and AKT may be related to the lymph node metastasis and TNM staging.

This study studied the use of ERCP and nasobiliary tube in the diagnosis of fungal infection of biliary tract and the efficacy of combined use of local administration via nasobiliary tube and intravenous antifungal treatment for severe biliary tract fungal infection. 5 patients in our series,with age ranging from 47 to 68 y (mean 55.8), were diagnosed as having mixed bacterial and fungal infection of biliary tract as confirmed by smear or/and culture of bile obtained by ERCP and nasobiliary drainage. Besides routine anti-bacteria therapy, all patients received local application of fluconazole through nasobiliary tube and intravenous administration of fluconazole or itraconazole in terms of the results of in vitro sensitivity test. The mean duration of intravenous fluconazole or itraconazole was 30 days (24-40 days), and that of local application of fluconazole through nasobiliary drainage tube was 19 days (8-24 days). During a follow-up period of 3-42 months, all patient's fungal infection of biliary tract was cured. It is concluded that on the basis of typical clinical features of biliary tract infection, fungal detection of smear/culture of bile obtained by ERCP was the key for the diagnosis of fungal infection of biliary tract. Local application antifungal drug combined with intravenous anti-fungal drugs might be an effective and safe treatment for fungal infection of biliary tract.