Objective To investigate the efficacy of different courses of saccharomyces boulardii powder combined with triple therapy in eradicating helicobacter pylori(Hp)in children.Methods A total of 135 children with Hp-related gastritis who received initial treatment in the Department of Pediatrics,Affiliated Hospital of Xuzhou Medical University from October 2021 to June 2022 were selected and divided into three groups according to random number table method:group A,group B and group C,with 45 cases in each group.Group A:triple therapy(omeprazole + clarithromycin + amoxicillin)for 14 days;group B and group C:on the basis of triple therapy,saccharomyces boulardii powder was added from the first day of treatment for 2 weeks and 4 weeks,respectively.The adverse reactions during treatment were recorded,the levels of serum pepsinogen Ⅰ(PGⅠ)and pepsinogen Ⅱ(PGⅡ),clinical efficacy and Hp eradica-tion rate were observed 4 weeks after the end of treatment.Results The levels of serum PGⅠ and PGⅡ in the three groups after treat-ment were significantly lower than those before treatment(P<0.05),the levels of serum PGⅠ and PGⅡ in group B and group C after treatment were lower than those in group A(P<0.05),and the levels of serum PGⅠ and PGⅡ in group B were lower than those in group C after treatment(P<0.05).The clinical effective rates of group B(93.0%)and group C(90.4%)were higher than those of group A(62.5%)(P<0.05).The clinical effective rate of group B was higher than that of group C(P>0.05).The Hp eradication rate of group B and group C was significantly higher than that of group A(P<0.05),and the Hp eradication rate of group B was higher than that of group C(P>0.05).The incidence of diarrhea and loss of appetite in group B and group C were lower than those in group A(P<0.05);the incidence of diarrhea and loss of appetite in group B was lower than that in group C(P<0.05).There was no signifi-cant difference in the incidence of abdominal pain,nausea and vomiting among the three groups(P>0.05).Conclusion Saccharomy-ces boulardii decoction combined with triple therapy for 2 or 4 weeks can effectively regulate PG level,improve the eradication rate of Hp,and reduce the incidence of adverse reactions.It is suggested that 2 weeks is the best course of treatment.

Objective:To explore the expression of the nucleotide-binding oligomerization domain-like receptor containing pyrin domain protein 6 (NLR family,pyrin domain containing 6,NLRP6) in the gastric tissue and gastric juice of children with chronic non-atrophic gastritis (CNG), and to analyze the influence of Helicobacter pylori (Hp) infection on the expression of NLRP6.Methods:A case-control study was conducted to select 120 CNG patients in pediatrics of Department of Pediatrics, The Affiliated Hospital of Xuzhou Medical University from October 2020 to July 2021. According to pathological diagnosis, endoscopic gastric mucosal damage and Hp infection, they were divided into 4 groups: mild CNG group Hp negative, Moderate to severe CNG group Hp negative, Mild CNG group Hp positive, Moderate to severe CNG group Hp positive. The enzyme-linked immunosorbent assay (ELISA) was used to detect the expression level of NLRP6 in the four groups of gastric tissue and gastric juice, and Western blot was used to detect the expression of NLRP6 in the gastric tissue of the 4 groups, and the significance of expression in CNG of children is analyzed. Independent sample t-test was used to compare the mean between the two groups. One way ANOVA was used to compare the mean of multiple groups of samples, and LSD t-test was used for pairwise comparison. Comparison between count data groups χ 2 inspection. Results:The positive rate of Hp in the moderate to severe chronic non-atrophic gastritis group was 62.96% (34/54) higher than that in the mild chronic non-atrophic gastritis group 37.04% (20/54), and the difference was statistically significant (χ 2=18.32, P<0.001). Under the same Hp conditions, the expression of NLRP6 in the mild chronic non-atrophic gastritis group (Hp negative mild CNG: gastric tissue (653.73±37.71) ng/L, gastric juice (471.75±38.47) ng/L; Hp positive mild CNG: Gastric tissue (616.69±43.33) ng/L, gastric juice (445.29±36.39) ng/L was higher than the moderate to severe chronic non-atrophic gastritis group (Hp negative moderate to severe CNG: gastric tissue (623.82±52.99) ng/L, gastric juice (446.48±47.49) ng/L; Hp positive Moderate to severe CNG: gastric tissue (580.43±62.75) ng/L, gastric juice (406.88±51.85) ng/L, the difference is statistically significant (under Hp negative, mild compared with moderate to severe CNG: gastric tissue P=0.035; gastric juice P=0.046; Under Hp positive, mild compared with moderate to severe CNG: gastric tissue P=0.010;gastric juice P=0.002); in the same degree of gastric mucosal injury, NLRP6 expression in Hp-negative group (Hp-negative mild CNG: gastric tissue (653.73±37.71) ng/L, gastric juice (471.75±38.47) ng/L; Hp negative moderate to severe CNG: gastric tissue (623.82±52.99) ng/L, gastric juice (446.48±47.49) ng/L higher than the positive group (Hp positive mild CNG: gastric tissue (616.69±43.33) ng/L, gastric juice (445.29±36.39) ng/L; Hp positive moderate to severe CNG: gastric tissue (580.43±62.75) ng/L, gastric juice (406.88±51.85) ng/L, the difference is statistically significant (under mild CNG, Hp negative is compared with positive: Gastric tissue P=0.005; gastric juice P=0.023; under moderate to severe CNG, negative versus positive: gastric tissue P=0.004; gastric juice P=0.003). Conclusion:Under the same Hp conditions, the more severe the gastric mucosal damage, the lower the NLRP6; under the same degree of mucosal damage, the expression level of NLRP6 in the Hp-negative group was significantly higher than that of the Hp-positive group. It is suggested that NLRP6 plays a role in inhibiting inflammation in chronic gastritis, maintaining the integrity of epithelial cells, and Hp can inhibit the expression of NLRP6.

目的 探讨翻转课堂在儿科住院医师规范化培训教学过程中的应用效果.方法 选取2018年8月至2020年1月在徐州医科大学附属医院参加儿科住院医师规范化培训的40名学员作为研究对象,随机分为试验组和对照组,每组20名.试验组进行翻转课堂教学活动,对照组进行传统教学活动,比较两组的临床技能考核和理论知识成绩以及教学满意度.结果 试验组学员理论及技能操作成绩明显高于对照组,差异有统计学意义(P＜0.05);试验组学员对自主学习能力、临床实践能力、团队合作精神和学习融会贯通效果的满意度明显高于对照组,差异有统计学意义(P＜0.05).结论 翻转课堂应用于儿科住院医师规范化培训中效果显著,可强化学员理论知识及提升临床技能,同时强化了自主学习能力.

目的 通过分析儿童疣状胃炎(VG)不同类型幽门螺杆菌(helicobacter pylori,Hp)感染情况及其胃黏膜组织和胃液中白细胞介素-1β(IL-1β)、白细胞介素-33(IL-33)和缺氧诱导因子-10(HIF-10)的表达水平变化,探讨儿童疣状胃炎可能的发病因素及机制.方法 随机选取儿童VG患者50例及对照组40例,蛋白质印迹法检测两组患者Hp分型,用ELISA定量检测其胃液及胃黏膜组织中IL-1β、IL-33和HIF-1α的表达水平.比较两组患者Ⅰ型及Ⅱ型Hp感染率、胃液及胃黏膜组织中IL-1β、IL-33和HIF-1α的表达水平.结果 VG组Hp阳性率及Ⅰ型Hp阳性率均高于对照组(P＜0.05);VG组胃液及胃黏膜组织中IL-1β、IL-33、HIF-1α表达水平均高于对照组,差异均有统计学意义(P＜0.05);Ⅰ型Hp感染组患者胃液及胃黏膜组织中的IL-1β、IL-33水平均高于Ⅱ型Hp组及Hp阴性组(P＜0.05),而HIF-1α水平与Ⅱ型Hp组及Hp阴性组比较,差异无统计学意义(P＞0.05).结论 VG组较对照组有更高的Hp感染率及Ⅰ型Hp感染率,儿童疣状胃炎的发生与Hp感染及其分泌的毒素CagA和VacA相关;IL-1β、IL-33和HIF-1α可能参与了儿童VG的发生、发展.

Objective:To investigate the effects of Matrine on collagen secretion and phenotype transformation in cardiac fibroblasts induced by platelet-derived growth factor(PDGF),and to explore the role of PI3K/Akt pathway.Method:The cardiac fibroblasts were isolated and purified from rat hearts by enzymatic digestion and preplate technique.The cells were randomly divided into 5 groups:blank control group (culture without drug);PDGF group (10 μg/L PDGF);low matrine dose group(PDGF10 μg/L+0.25 mmol/L matrine);middle matrine dose group (10μg/LPDGF+0.5 mmol/L matrine);high matrine dose group (10 μg/LPDGF+1.0 mmol/L matrine).After 48 hour Cell culture,ELISA was used to detect the collagen secretion in cell supernatant,the mRNA expressions of PI3K,Akt and smooth muscle-Alpha excited protein (α-SMA) were measured by RT-PCR,and protein levels of α-SMA,p-Akt were detected by Western blot analyses.Result:Compared with blank control group,the synthesis of collagen in PDGF group was significantly increased(P＜0.05),the mRNA expressions of PI3K,Akt,α-SMA and the levels of α-SMA and p-Akt protein were obviously up-regulated(P＜0.05).Compared with PDGF group,significant down-regulations of PI3K,Akt,α-SMA mRNA and α-SMA,p-Akt protein were observed in low,middle,and high matrine dose groups respectively,and the synthesis of collagen was also lower than PDGF group.Conclusion:Matrine may reduce the collagen secretion and inhibit the phenotype transformation by down regulating the PI3K/Akt pathway,and thus play a role in antimyocardial fibrosis.

Objective To observe the effect of ligustrazine on angiotensinⅡ(AngⅡ) induced cardiac fibroblasts(CFs)fibrosis and its mechanisms.Methods The CFs of neonatal Sprague Dawley (SD)rats were isolated with the method of trypsin digestion and dif-ferential anchoring velocity,then cultured in vitro.The generation 2 4 of CFs were used for the experiment and randomly divided into 5 groups which were control group cultured without AngⅡ or ligustrazine(group A),AngⅡ group cultured with AngⅡ 10-6 mol/L (group B),and ligustrazine groups(group C,group D,group E)cultured with AngⅡ 10-6 mol/L and ligustrazine 5,10,20 mg/L,respec-tively.CFs were cultured for 48 h and the smooth muscle alpha actin (α SMA),beta isoform of calcineurin (CnAβ)mRNA expres-sion were examined by reverse transcription polymerase chain reaction (RT PCR),theα SMA,nuclear factor of activated T lym-phocyte 3 (NFAT3)protein expression by western blot analyses.Results Compared with group A,the expressions ofα SMA,CnAβmRNA andα SMA,NFAT3 protein were upregulated in group B(al P<0.05).Compared with group B,the expressions ofα SMA, CnAβmRNA andα SMA,NFAT3 protein in group D and group E were obviously decreased(al P<0.05).Conclusion Within a giv-en concentration range,ligustrazine can inhibit the expression ofα SMA in a dose dependent manner to delay the differentiation of CFs induced by AngⅡ.Ligustrazine can inhibit the expression of CaN and downstream signaling molecules NFAT3, which indicates that the inhibition of CFs fibrosis process may be related to the CaN signaling pathway.

目的:探讨γ-分泌酶抑制剂(DAPT)抑制Notch信号通路对心肌成纤维细胞(CFs)平滑肌肌动蛋白-α(α-SMA)的表达及细胞外基质(ECM)降解平衡变化的影响.方法:采用胰酶消化法和差速贴壁法分离和纯化SD乳鼠CFs进行体外培养,将CFs分为正常组(N组,培养时不加干预药物)和尾加压素Ⅱ组(U组,加UⅡ10-8 mol/L)和DAPT+尾加压素Ⅱ组(D组,同时加入UⅡ10-8 mol/L和DAPT 75 μmol/L),培养干预48 h后采用RT-PCR法测基质金属蛋白酶-1(MMP-1)、组织金属蛋白酶抑制剂-1(TIMP-1)、d-SMA和Notch蛋白胞内段(Notch1) mRNA的表达;Western Blot检测c-SMA及Notch1蛋白的表达.结果:U组TIMP-1、α-SMA及Notch1的mRNA表达水平明显高于N组(均P＜0.01),MMP-1 mRNA的表达和MMP-1 mRNA/TIMP-1 mRNA比值低于N组(均P＜0.01);D组TIMP-1、α-SMA、Notch1的mRNA表达以及α-SMA和Notch1蛋白的表达均较U组下调(均P＜0.01),MMP-1mRNA的表达和MMP-1 mRNA/TIMP-1 mRNA比值较U组上调(P＜0.01);但D组上述指标与N组相比差异无统计学意义.结论:DAPT可通过阻断Notch信号通路抑制尾加压素Ⅱ诱导的CFs表型转换,激活胶原降解途径,并可重调MMP-1/TIMP-1平衡,此作用有助于抑制心肌纤维化.

Objective To study the expression of basic ifbroblast grouth factor (bFGF) and transforming growth factorβ1 (TGF-β1) in different stages of myocardial ifbrosis (CFs). Methods CFs of neonatal Sprague-Dawley rats were isolated with the method of trypsin digestion and differential anchoring velocity, then cultured in vitro. The generation 2-4 of CFs were used for the experiment and randomly divided into 2 groups:the control group were cultured without AngII , and the test group were cultured with AngII 10-6 mol/L. The test group were cultured for 12, 24, 48, and 72 h respectively, and then the synthesis of col agen were measured by ELISA, the bFGF, TGF-β1-mRNA expression was measured by RT-PCR, and the bFGF and TGF-β1 protein expression was measured by western blot analyses. Results Compared with those of control group, the expressions of bFGF and TGF-β1 both in gene and in protein in the test groups increased gradual y with the timing (P?<?0.01). Correlation analysis found that the expression of bFGF mRNA and protein were positively associated with TGF-β1 mRNA and protein (r?=?0.967, 0.947, P?<0?.05), and both bFGF and TGF-β1 were positively associated with the supernatant col agen. (r?=?0.932, 0.881, 0.930, 0.896, P?<0?.05). Conclusion bFGF and TGF-β1 may be involved in the occurrence and development of myocardial ifbrosis.