用泮托拉唑与奥美拉唑对服用非甾体类抗炎药导致消化性溃疡出血的老年患者进行治疗的效果对比

目的:比较用泮托拉唑与奥美拉唑对服用非甾体类抗炎药导致消化性溃疡出血的老年患者进行治疗的效果。方法:将2018年1月至2019年3月期间宝鸡市岐山县医院收治的90例服用非甾体类抗炎药导致消化性溃疡出血的老年患者平均分为对照组和观察组。在两组患者入院后,均对其进行常规治疗。在此基础上,为对照组患者采用奥美拉唑进行治疗,为观察组患者采用泮托拉唑进行治疗。然后比较两组患者治疗的总有效率、消化道出血停止的时间、胃液的pH、不良反应的发生率。结果:观察组患者治疗的总有效率高于对照组患者,P<0.05;其消化道出血停止的时间短于对照组患者,P<0.05;其胃液的pH小于对照组患者,P<0.05;其不良反应的发生率低于对照组患者,P<0.05。结论:与用奥美拉唑对服用非甾体类抗炎药导致消化性溃疡出血的老年患者进行治疗的效果相比,用泮托拉唑对其进行治疗的效果更为理想。

老年非甾体抗炎药相关性上消化道出血患者临床特征的分析

目的:探讨并分析老年非甾体抗炎药(Nonsteroidal Antiinflammator y Drugs,NSAIDs)相关性上消化道出血患者的临床特征。方法:选择2011年1月至2016年12月青海省大通县桥头镇元朔卫生院收治的50例老年NSAIDs相关性上消化道出血患者与50例老年消化性溃疡所致上消化道出血患者作为研究对象。将其中50例老年NSAIDs相关性上消化道出血患者作为观察组,将其中50例老年消化性溃疡所致上消化道出血患者作为对照组。对两组患者的临床资料进行对比分析,总结老年NSAIDs相关性上消化道出血患者的临床特点。结果:观察组患者中无消化道症状患者的占比、存在病灶糜烂和弥漫性病变患者的占比均高于对照组患者中此类患者的占比,差异有统计学意义(P<0.05)。观察组患者血红蛋白的水平低于对照组患者,其止血的时间和住院的时间均长于对照组患者,差异有统计学意义(P<0.05)。结论:老年NSAIDs相关性上消化道出血患者多无明显的消化道症状,其多存在弥漫性病变和病灶糜烂的情况,且对其进行止血治疗的难度较大。

重组人凝血因子

[通用名称]recombinant human coagulation Ⅶ forinjection。

Helicobacter pylori infection in bleeding peptic ulcer patients after non-steroidal antiinflammatory drug consumption

AIM： TO establish the prevalence of He/icobacterpy/on （H. pylori） infection in patients with a bleeding peptic ulcer after consumption of non-steroidal antiinflammatory drugs （NSAIDs）.METHODS： A very early upper endoscopy was performed to find the source of upper gastrointestinal bleeding and to take biopsy specimens for analysis of H. pylori infection by the rapid urease （CLO） test, his- tological examination, and bacterial culture. TgG anti- CagA were also sought. The gold standard for identifying H. pylori infection was positive culture of biopsy specimens or contemporary positivity of the CLO test and the presence of H. pylori on tissue sections.RESULTS： Eighty patients, 61 males （76.3%）, mean age 61.2 ~ 15.9 years, were consecutively enrolled. Forty-seven （58.8%） patients occasionally consumed NSAIDs, while 33 （41.3%） were on chronic treatment with low-dose aspirin （LD ASA）. Forty-four （55.0%） patients were considered infected by H. pylori. The infection rate was not different between patients who occasionally or chronically consumed NSAIDs. The culture of biopsy specimens had a sensitivity of 86.4% and a specificity of 100%; corresponding figures for histological analysis were 65.9% and 77.8%, for the CLO test were 68.2% and 75%, for the combined use of histology and the CLO test were 56.8% and 100%, and for IgG anti-CagA were 90% and 98%. The high- est accuracy （92.5%） was obtained with the culture of biopsy specimens.CONCLUSION： Patients with a bleeding peptic ulcer after NSAID/LD ASA consumption frequently have H. pylori infection. Biopsy specimen culture after an early upper gastrointestinal tract endoscopy seems the most efficient test to detect this infection.

Discovery of novel aspartate derivatives as highly potent and selective FXIa inhibitors

As a coagulation factor in the intrinsic coagulation pathway,factor XIa(FXIa)is an effective and safe target for the development of antithrombotic drugs.Many small-molecule FXIa inhibitors have been discovered,some of which are being evaluated in clinical trials.However,none of them have been approved.In the present study,a highly selective potent FXIa inhibitor with poor solubility reported in our previous work was selected as a lead compound to be further modified to improve FXIa potency and physicochemical properties.The structure-based drug design and structure-activity relationship study led to the discovery of LY8,LY17,and LY25,which demonstrated enhanced FXIa potency and maintained excellent selectivity.In addition,LY8 exhibited significantly improved aqueous solubility,suggesting that it could be a promising compound to be further evaluated.