Clinical characteristics of acute non-varicose upper gastrointestinal bleeding and the effect of endoscopic hemostasis

BACKGROUND Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)constitutes a prevalent emergency within Gastroenterology,encompassing 80%-90%of all gastrointestinal hemorrhage incidents.This condition is distinguished by its abrupt onset,swift progression,and notably elevated mortality rate.AIM To gather clinical data from patients with ANVUGIB at our hospital in order to elucidate the clinical characteristics specific to our institution and analyze the therapeutic effectiveness of endoscopic hemostasis.METHODS We retrospectively retrieved the records of 532 patients diagnosed with ANVUGIB by endoscopy at our hospital between March 2021 and March 2023,utilizing our medical record system.Data pertaining to general patient information,etiological factors,disease outcomes,and other relevant variables were meticulously collected and analyzed.RESULTS Among the 532 patients diagnosed with ANVUGIB,the male-to-female ratio was 2.91:1,with a higher prevalence among males.Notably,43.6%of patients presented with black stool as their primary complaint,while 27.4%had hematemesis as their initial symptom.Upon admission,17%of patients exhibited both hematemesis and black stool,while most ANVUGIB patients primarily complained of overt gastrointestinal bleeding.Urgent routine blood examinations at admission revealed that 75.8%of patients had anemia,with 63.4%experiencing moderate to severe anemia,and 1.5%having extremely severe anemia(hemoglobin<30 g/L).With regard to etiology,53.2%of patients experienced bleeding without a definitive trigger,24.2%had a history of using gastric mucosa-irritating medications,24.2%developed bleeding after alcohol consumption,2.8%attributed it to improper diet,1.7%to emotional excitement,and 2.3%to fatigue preceding the bleeding episode.Drug-induced ANVUGIB was more prevalent in the elderly than middle-aged and young individuals,while bleeding due to alcohol consumption showed the opposite trend.Additionally,diet-related bleeding was more common among the young age group compared to the middle-aged group.Gastrointestinal endoscopy identified peptic ulcers as the most frequent cause of ANVUGIB(73.3%),followed by gastrointestinal malignancies(10.9%),acute gastric mucous lesions(9.8%),and androgenic upper gastrointestinal bleeding(1.5%)among inpatients with ANVUGIB.Of the 532 patients with gastrointestinal bleeding,68 underwent endoscopic hemostasis,resulting in an endoscopic treatment rate of 12.8%,with a high immediate hemostasis success rate of 94.1%.

Comparative effects of insulin pump and injection on gestational diabetes mellitus pregnancy outcomes and serum biomarkers

BACKGROUND Insulin injection is the basic daily drug treatment for diabetic patients.AIM To evaluate the comparative impacts of continuous subcutaneous insulin infusion(CSII).METHODS Based on the treatment modality received,the patients were allocated into two cohorts:The CSII group and the multiple daily injections(MDI)group,with each cohort comprising 210 patients.Comparative assessments were made regarding serum levels of serum-secreted frizzled-related protein 5,homocysteine,and C1q/TNF-related protein 9.Furthermore,outcomes such as fasting plasma glucose,2-hour postprandial glucose levels,pain assessment scores,and the incidence of complications were evaluated post-treatment.RESULTS The CSII group displayed notably lower fasting plasma glucose and 2-h postprandial glucose levels in comparison to the MDI group(P<0.05).Subsequent analysis post-treatment unveiled a significantly higher percentage of patients reporting no pain in the CSII group(60.00%)in contrast to the MDI group(36.19%)(P<0.05).Additionally,the CSII group exhibited a markedly reduced occurrence of fetal distress and premature rupture of membranes compared to the MDI group(P<0.05).However,there were no significant variances observed in other pregnancy outcomes between the two groups(P>0.05).A statistical analysis revealed a significant difference in the incidence of complications between the groups(χ^(2)=11.631,P=0.001).CONCLUSION The utilization of CSII via an insulin pump,as opposed to MDI,can significantly enhance the management of insulin administration in patients with GDM by diversifying the sites of insulin delivery.This approach not only promotes optimal glycemic control but also regulates metabolic factors linked to blood sugar,reducing the likelihood of adverse pregnancy outcomes and complications.The clinical relevance and importance of CSII in GDM management highlight its wide-ranging clinical usefulness.

Clinical and genetic features of Kenny-Caffey syndrome type 2 with multiple electrolyte disturbances:A case report

BACKGROUND Hypoparathyroidism,which can be sporadic or a component of an inherited syndrome,is the most common cause of hypocalcemia.If hypocalcemia is accompanied by other electrolyte disturbances,such as hypokalemia and hypomagnesemia,then the cause,such as renal tubular disease,should be carefully identified.CASE SUMMARY An 18-year-old female visited our clinic because of short stature and facial deformities,including typical phenotypes,such as low ear position,depression of the nasal bridge,small hands and feet,and loss of dentition.The lab results suggested normal parathyroid hormone but hypocalcemia.In addition,multiple electrolyte disturbances were found,including hypokalemia,hypocalcemia and hypomagnesemia.The physical signs showed a short fourth metatarsal bone of both feet.The X-ray images showed cortical thickening of long bones and narrowing of the medulla of the lumen.Cranial computed tomography indicated calcification in the bilateral basal ganglia.Finally,the genetic investigation showed a de novo heterogenous mutation of“FAM111A”(c.G1706A:p.R569H).Through a review of previously reported cases,the mutation was found to be the most common mutation site in Kenny-Caffey syndrome type 2(KCS2)cases reported thus far(16/23,69.6%).The mutation was slightly more prevalent in females than in males(11/16,68.8%).Except for hypocalcemia,other clinical manifestations are heterogeneous.CONCLUSION As a rare autosomal dominant genetic disease of hypoparathyroidism,the clinical manifestations of KCS2 are atypical and diverse.This girl presented with short stature,facial deformities and skeletal deformities.The laboratory results revealed hypocalcemia as the main electrolyte disturbance.Even though her family members showed normal phenotypes,gene detection was performed to find the mutation of the FAM111A gene and confirmed the diagnosis of KCS2.

陕西省某医院2014—2017年新生儿医院内感染分析

目的探讨陕西省某医院新生儿科医院感染的流行特点,为预防和控制新生儿医院感染提供科学依据。方法回顾性分析2014年1月—2017年12月入住陕西省人民医院新生儿科的患儿,收集在住院期间发生医院感染的患儿临床资料,对数据进行分析。结果近4年来共监测新生儿9 634例,其中发生院内感染328例,院内感染例次为332例,2014—2017年医院感染(NI)发生率比较,差异无统计学意义(P>0.05)。近4年日感染率为5.51‰,发生导管相关血流感染率为6.00‰,2014—2017年导管相关血流感染率比较,差异无统计学意义(P>0.05)。呼吸机使用时间为1 078 d,呼吸机相关肺炎发生率为19.48‰;2014—2017年呼吸机相关肺炎感染率比较,差异无统计学意义(P>0.05);医院感染部位以血液相关感染居首位,其次为呼吸道感染,2014—2017年胃肠道感染、呼吸道感染及其他部位感染率比较,差异有统计学意义(P<0.05)。不同出生体重患儿NI发生率比较,差异有统计学意义(P<0.05)。2014—2017年每个季度的NI发生率比较,差异无统计学意义(P <0.05)。结论陕西省人民医院新生儿科医院感染控制效果尚可,但仍需加强院感监控;重点应预防极低出生体重组和血液相关感染,采取针对性的预防控制措施,减少医院内感染的发生。

Effect of matrine on transforming growth factor β1 and hepatocyte growth factor in rat liver fibrosis model

Objective:To observe the preventive and control effect of matrine on transforming growth factor(TCF- β1) and hepatocyte.growth factor(HCF) of liver fibrosis tissue in rals.Methods:A total of48 SD rats were randomly divided into A,B,C,D groups with 12 in each,group A as the normal control group and groups B.C,D as liver fibrosis models using composite modulus method with carbon tetrachloride(CCL_4).Group B was the model group,group C adopted γ— interferon lavage therapy in the second day of modeling,and group D adopted matrine lavage treatment,at 4 and8 weeks after treatment.Six rats were executed for detection of TGF- β1 and HGF,liver tissue histology and comparison fibrosis degree changes of rat liver tissue between groups.Results:Croups B,C,D showed a more significantly increased TCF- β1 at each time point compared with group A(P<0.05);Group B showed a more significantly increased TGF- β1 than groups C and D at weeks 4 and 8(P<0.05);group D showed a lowest level of TGF-β1,followed by groups C and B.HGF of group B decreased more significantly than A group at weeks 4 and 8(P<0.05);HGF of groups C and D was significantly elevated at 4 and 8 weeks than groups A and B(P<0.05),in which the group D showed the highest level of HGF.According to tissue histologic observation,rat liver tissue structure of group A was clear and normal,tissue structure of group B was destroyed with obvious fibrous tissue hyperplasia and fatty change of hepatic cells;groups C and D showed a slighter liver tissue damage,cell necrosis and connective tissue hyperplasia in collect abbacy than group B with a trend of obvious improvement.Conclusions:Matrine can reduce TGF- β1expression and enhance the activity of HGF,so as to realize the inhibition effect on liver fibrosis in rats.

Residual Dipolar Couplings in Structure Determination of Natural Products

The determination of natural products stereochemistry remains a formidable task.Residual dipolar couplings(RDCs)induced by anisotropic media are a powerful tool for determination of the stereochemistry of organic molecule in solution.This review will provide a short introduction on RDCs-based methodology for the structural elucidation of natural products.Special attention is given to the current availability of alignment media in organic solvents.The applications of RDCs for structural analysis of some examples of natural products were discussed and summarized.Graphical Abstract This review provides a short introduction on RDCs-based methodology for the structural elucidation of natural products.Special attention is given to the current availability of alignment media in organic solvents.The applications of RDCs for structural analysis of some examples of natural products were discussed and summarized.

The bothersomeness of female urinary incontinence and its influencing factors: Study from a Chinese city

Purpose:To investigate the bothersomeness of female urinary incontinence(UI)and analyse its influencing factors.Methods:A purposive sample of 506 women with UI from three communities in Jinan was studied using the International Consultation on Incontinence QuestionnaireeUrinary Incontinence Short Form,modified Social Impact Scale,and a coping efficacy questionnaire.The influencing factors of bothersomeness were identified using one-way analysis of variance,χ^(2) test,and logistic regression.Results:Of the participants,33.4%were bothered byUI symptoms;logistic regression indicated that severity of UI,stigma,coping efficacy,and duration of symptoms were independent factors of bothersomeness,which clarified 49.8%of the variation.Conclusion:UI patients should receive individualised intervention.Healthcare workers can provide targeted intervention to patients bothered by UI to alleviate symptoms,decrease the senseof stigma,andincreaseconfidence incopingwithsymptomstodecrease bothersomeness.

Analysis of the Phytochemistry and Bioactivity of the Genus Polygonum of Polygonaceae

The main chemical constituents of the genus Polygonum(Polygonaceae)are flavonoids,quinones,phenylpropanoids,and terpenoids,which show anticancer,antitumor,anti-oxidative,anti-inflammatory,analgesic,antibacterial,insecticidal,and other pharmacological effects.This paper summarizes research on the chemical constituents and pharmacological effects of compounds from the genus Polygonum in last15years.

Analysis of overload-based cascading failure in multilayer spatial networks

Many complex networks in real life are embedded in space and most infrastructure networks are interdependent,such as the power system and the transport network.In this paper,we construct two cascading failure models on the multilayer spatial network.In our research,the distance l between nodes within the layer obeys the exponential distribution P(l)~exp(-l/ζ),and the length r of dependency link between layers is defined according to node position.An entropy approach is applied to analyze the spatial network structure and reflect the difference degree between nodes.Two metrics,namely dynamic network size and dynamic network entropy,are proposed to evaluate the spatial network robustness and stability.During the cascading failure process,the spatial network evolution is analyzed,and the numbers of failure nodes caused by different reasons are also counted,respectively.Besides,we discuss the factors affecting network robustness.Simulations demonstrate that the larger the values of average degree<k>,the stronger the network robustness.As the length r decreases,the network performs better.When the probability p is small,asζdecreases,the network robustness becomes more reliable.When p is large,the network robustness manifests better performance asζincreases.These results provide insight into enhancing the robustness,maintaining the stability,and adjusting the difference degree between nodes of the embedded spatiality systems.

Value and significance of tumor markers as CEA,CA125,SCC-Ag,CA199 and CYFRA21-1 in the diagnosis of cervical cancer

Objective: To investigate the value and significance of serum CEA, CA125, SCC-Ag, CA199 and CYFRA21-1 in the diagnosis of cervical cancer by comparing the detection of five serum markers. Methods: A total of 108 cases were divided into three groups, including 60 cervical cancerpatients and 20 cervical intraepithelial neoplasiain patients treated in our hospital from September 2015 to September 2016 and 28 healthy women. Radioimmunoassay was used to detect and compare the serum levels of CA125, CA199, CYFRA21-1 and ELISA method was used to detect and compare the serum levels of SCC-Ag, CEA. Results: (1) There was no statistically significant difference in the serum CEA, CA125, SCC-Ag, CA199, CYFRA21-1 levels between CIN group and control group. The serums CEA, CA125, SCC-Ag, CA199, CYFRA21-1 levels of cervical cancer patients were significantly higher than the other two groups. The differences were statistically significant. (2)There were statistically significant differences in the serum CEA, CA125, SCC-Ag, CA199, CYFRA21-1 levels between different cervical pathological type groups.The serum CA125, CA199, CEA levels of cervical glandular cancer patients were significantly higher than the other two groups. The differences were statistically significant. The serum SCC-Ag, CYFRA21-1 levels of cervical squamous cancer patients were significantly higher than the other two groups. The differences were statistically significant. Conclusion: The serums CEA, CA125, SCC-Ag, CA199, CYFRA21-1 levels of cervical cancer patients were significantly higher than cervical intraepithelial neoplasiain patients and healthy women. The serum CA125, CA199, CEA levels of cervical glandular cancer patients were significantly higher and the serum SCC-Ag, CYFRA21-1 levels of cervical squamous cancer patients were significantly higher. The five tumor markers can be used in diagnosis of cervical cancer and they are also worthy in distinguishing cervical pathological types.

Ovarian mucinous tumor with mural nodules of anaplastic carcinoma:Three case reports

BACKGROUND Anaplastic carcinoma mural nodules in ovarian mucinous tumors are very rare.This study aimed to report the morphological characteristics,molecular detection results,clinical treatment and prognosis of three ovarian mucinous tumors with mural nodules of anaplastic carcinoma.CASE SUMMARY The pathomorphological features,molecular detection results,clinical treatment and prognosis of anaplastic carcinoma mural nodules were described in three cases.In case 1,sarcoma-like mural nodules(SLMNs)coexisted with anaplastic carcinoma mural nodules.No mutation was found in mucinous tumors.KRAS mutation was found in anaplastic carcinoma nodules and heterotypic cells were found in SLMNs.In case 2,KRAS mutation occurred in the mucinous epithelium and BRAF mutation occurred in mural nodules.In case 3,both mural nodules and mucinous tumors had the same KRAS mutation and a morphological transition between them was observed.All three patients died within 2 years,whether receiving chemotherapy or not.CONCLUSION Anaplastic carcinoma mural nodules may develop from dedifferentiation of mucinous tumors or are unrelated to mucinous tumors.

Expression and significance of NF-κB, TGF-β1 and other biochemical indicators in patients with polycystic ovary syndrome

Objective: To explore the expression and significance of serum NF-κB, TGF-β1, VEGF, sFlt-1, leptin, adiponectin, LH, FSH and PRL in patients with polycystic ovary syndrome by comparing serum levels of the various biochemical indicators among the cases. Methods:A total of 30 patients with polycystic ovary syndrome in our hospital from May 2016 to June 2017 were selected as the observation group. At the same time, 30 patients who were treated for other causes of infertility or tubal ovarian cysts were selected as control group. ELISA method was used to detect the serum levels of NF-κB, TGF-β1, VEGF, sFlt-1. Radioimmunoassay was used to detect the serum levels of leptin and adiponectin. Chemiluminescence immunoassay was used to detect the serum levels of LH, FSH and PRL. Results: The serum NF-κB, TGF-β1, VEGF, leptin, LH levels of observation group were significantly higher than control group. The serum sFlt-1, adiponectin, FSH and PRL levels of observation group were significantly lower than control group. The differences were statistically significant. Conclusion: NF-κB, TGF-β1, VEGF, sFlt-1, leptin, adiponectin, LH, FSH and PRL may play a role in pathogenesis of PCOS.

Features of the new climate normal 1991-2020 and possible influences on climate monitoring and prediction in China

An update on the climate norms each decade is recommended by the World Meteorological Organization(WMO)partly to keep pace with conditions as climate changes over time.In accordance with such update,this study documents the features of the new climate normal defined for 1991-2020 and its impacts on climate monitoring and prediction in China.With on-site observation and model prediction datasets,our analysis reveals that the new normal of national average precipitation of China during winter and summer is respectively 3.0 and 10.8 mm higher than that of the period 1981-2010.As a result,precipitation observations during 1961-2020 consistently fall below the new normal.The adjustment of thresholds for precipitation extremes with new climate normals results in a decrease of extreme precipitation occurrence by 0.2-0.8 d on average over the winter and summer seasons during 1961-2020.Meanwhile,the application of new climate normals induces more pronounced negative temperature anomalies across most areas of China.The adjustments of extreme temperature thresholds have led to an increased occurrence of extremely cold days by 1-2 d on average over 1961-2020,while the frequency of extremely hot days decreases by more than 1.4 d.Furthermore,it is implied that with the development of global warming,the baselines for temperature and precipitation are rising.The application of the new climate normal may result in the omission of relative threshold based extreme events,promoting increased focus on climate risk reduction studies.Additionally,the average anomaly sign consistency rates(Pcs)of precipitation and temperature anomaly predictions,relative to the new normal and produced by the Beijing Climate Center,are consistently lower than those relative to the old normal.This decrease in Pcs implies new challenges for climate prediction,especially for temperature prediction.

川中地区侏罗系天然气与原油轻烃地球化学特征对比

天然气伴生凝析油及轻质油的轻烃地球化学参数常常被用于天然气成因和油—气对比研究,但蒸发分馏等次生作用对天然气和伴生原油的轻烃组成会产生一定的影响。基于川中地区16件侏罗系天然气与伴生凝析油或轻质油样品气相色谱分析,探讨了轻烃组成及相关地球化学参数在天然气和原油中的差异。研究表明:蒸发分馏作用对油气轻烃组成影响明显,相对于伴生原油,天然气轻烃组成具有高异构烷烃和正构烷烃相对含量,而贫环烷烃和芳香烃的特征。蒸发分馏作用对甲基环己烷指数、环己烷指数、Mango参数K1等成因参数影响不大,伴生原油的这类指标均可以较好地反映天然气的成因类型。蒸发分馏作用对成熟度参数异庚烷值影响较小,而对庚烷值、2,4-DMC5/2,3-DMC5值影响明显。轻烃化合物沸点的不同可能是导致天然气与原油中不同类型化合物相对含量存在差异的主要原因,并且沸点较低的化合物在天然气中相对含量更高。组成轻烃参数的化合物的沸点差异越大,该参数受蒸发分馏作用影响越大,天然气与伴生原油的该参数值相差也越显著。而当比值参数中组成分子与分母的化合物的沸点之差小于2℃时,该参数基本不受蒸发分馏作用的影响。

Incidence of Pleural Effusion in Patients with Pulmonary Embolism

Background： No data on the incidence ofpleural effusion （PE） in Chinese patients with pulmonary embolism are available to date. The aim of the current study was to investigate the frequency of PE in a Chinese population of patients with pulmonary embolism. Methods： This was a retrospective observational single-center study. All data of computed tomography pulmonary angiography （CTPA） performed over 6-year period on adult patients with clinically suspected pulmonary embolism were analyzed. Results： From January 2008 until December 2013, PE was identified in 423 of 3141 patients （13.5%） with clinically suspected pulmonary embolism who underwent CTPA, The incidence of PE in patients with pulmonary embolism （19.9%） was significantly higher than in those without embolism （9.4%） （P 〈 0.001 ）. Majority of PEs in pulmonary embolism patients were small to moderate and were unilateral. The locations of emboli and the numbers of arteries involved, CT pulmonary obstruction index, and parenchymal abnormalities at CT were not associated with the development of PE, Conclusions： PEs are present in about one fifth of a Chinese population of patients with pulmonary embolism, which are usually small, unilateral, and unsuitable for diagnostic thoracentesis.

Panax japonicus and chikusetsusaponins: A review of diverse biological activities and pharmacology mechanism

Panax japonicus, which in the Tujia dialect is known as "Baisan Qi" and "Zhujieshen", is a classic "qi" drug of Tujia ethnomedicine and it has unique effects on disease caused by "qi" stagnation and blood stasis.This paper serves as the basis of further scientific research and development of Panax japonicus. The pharmacology effects of molecular pharmacology were discussed and summarized. P. japonicus plays an important role on several diseases, such as rheumatic arthritis, cancer, cardiovascular agents, and this review provides new insights into P. japonicus as promising agents to substitute ginseng and notoginseng.

Management of Urinary Incontinence before and after Total Pelvic Reconstruction for Advanced Pelvic Organ Prolapse with and without Incontinence

Background： The effectiveness of an anti-incontinence procedure concomitant with prolapse reconstruction for pelvic organ prolapse （POP） in preventing urinary incontinence （UI） after surgery remains controversial. Our study aimed to describe the incidence of pre- and postoperative UI for pelvic reconstructive surgery and evaluate the management of POP associated with U1. Methods： A total of 329 patients who underwent total pelvic reconstruction between June 2009 and February 2015 at a single institution were identified. These patients were divided into two groups （Group A [Prolift reconstruction]： n = 190 and Group B [modified total pelvic reconstruction]： n = 139）. Data regarding surgical procedures and patient demographic variables were recorded. Chi-square and Student＇s t-tests were used for two independent samples. Results： A total of 115 patients presented with UI preoperatively. The average follow-up time was 46.5 months, with 20 patients lost to tbllow-up （6.1%）. The cure rates of stress UI （SUI）, urgency UI （UUI）, and mixed UI （MUI） were 51% （30/59）, 80% （16/20）, and 48% （14/29）, respectively. The cure rate of UUI after total pelvic reconstruction （80% [16/20]） was higher than that of SUI （50.8% [30/59], χ2 = 5.219, P = 0.03）, and the cure rate of MUl （48%, 14/29） was the lowest. The cure rate of patients with UI symptoms postoperatively was lower than that of those with symptoms preoperatively （9.1% [28/309] vs. 16.2% [50/309], χ2 = 7.101, P = 0.01）. There was no difference in the incidence of Ul postoperatively between Groups A and B （P 〉 0.05）. The cure rate of SUl in patients undergoing tension-free vaginal tape-ohturator was not higher than that in those who did not undergo the procedure （42.9% [6/14] vs. 53.3% [24/45], χ2 = 0.469, P = 0.49）. There were no differences in the cure rate for POP or U1 between these two types of reconstructions （P 〉 0.05）. Conclusions： No correlation between the incidence of UI and POP was identified. The results suggest that UI treatment should be performed after POP surgery for patients with both conditions.