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Objective: To study the risk factors in elderly upper gastrointestinal bleeding and the correlation with HP infection Methods: 300 cases of peptic ulcer patients diagnosed by barium meal, and gastroscopy in our hospital were selected as objects, which included 125 cases that combined with hemorrhage, and 175 cases without hemorrhage. And 310 cases exclusive of peptic ulcer in the same period by endoscopy were considered as control group. HP infection and use of non steroidal anti-inflammatory drugs(NSAIDs) were detected and carried on statistics analysis. Results: ① The OR value of incidence of peptic ulcer in HP combined with NSAIDs group was 20.31, obviously higher than that of HP group 6.97 and NSAIDs group 6.73, and more than the sum of the two, the difference was statistically significant(P0.05); ② for the relationship between peptic ulcer combined with hemorrhage and NSAIDs drug dose and time, the results showed the OR value in B group was 3.79, and 7.88 in C group, 10.41 in D group, group B group Cgroup D, the difference was statistically significant(P0.05); ③ for the occurrence of peptic ulcer combined with hemorrhage, the OR value in HP combined with NSAIDs group was 13.31, significantly higher than that of group HP 1.12 and group NSAIDs 1.54, and more than the sum of the two, the difference was statistically significant(P0.05). Conclusions: The occurrence of elderly upper gastrointestinal hemorrhage is mainly associated with peptic ulcer, and the infection of HP and taking NSAIDs drugs, have synergistic effect in the course of disease. [ABSTRACT FROM AUTHOR]

目的观察缺血后预处理对缺血再灌注大鼠肝内胆管细胞损伤的影响并探讨其机制。方法取健康雄性SD大鼠24只,随机分为假手术组、缺血再灌注组、缺血后处理组,每组8只。假手术组:大鼠麻醉后于上腹部正中取一长3.5 cm纵切口,将腹壁各层依次切开,肝脏显露后进一步游离出肝十二指肠韧带,关腹,无其他干预。缺血再灌注组:在假手术组基础上,游离肝十二指肠韧带,用无损伤动脉夹将肝门区域夹闭,缺血30 min后取下血管夹,使血管开放,对肝脏持续再灌注,最后关腹。缺血后处理组:在缺血再灌注组基础上,血供完全恢复之前再灌注10 s,夹闭10 s,如此反复6个循环(共2 min)后完全恢复血供。比色法测定血清γ-GT、SOD活力,免疫组化法测定胆管组织中Bcl-2和Bax蛋白表达,采用原位缺口末端标记法测算胆管细胞凋亡指数(AI),HE染色后光镜下观察胆管上皮细胞基本形态学变化。结果 IR组、IPO组、SO组血清γ-GT值分别为(34.64±3.28)、(26.30±3.32)、(17.33±2.08)U/L,三组间两两比较,P均<0.05。SO组、IR组、IPO组大鼠血清SOD活力值分别为(58.26±3.00)、(60.28±3.73)、(61.53±7.99)U/m L,各组间比较,P均>0.05。IR组、IPO组、SO组胆管组织中Bcl-2蛋白阳性表达率分别为(42.67±3.73)%、(77.94±5.25)%、(18.21±4.16)%,三组间两两比较,P均<0.05。 IR组、IPO组、SO组胆管组织中Bax蛋白阳性表达率分别为(90.17±2.12)%、(70.10±4.27)%、(30.63±3.00)%,三组间两两比较,P均<0.05。IR组、SO组、IPO组AI分别为79.31±1.12、26.06±2.27、58.90±2.75,三组间两两比较,P均<0.05。IPO组病理改变较IR组明显减轻,肝小叶结构较完整,肝细胞变性程度减轻,汇管区胆管上皮连续完整,炎细胞浸润少。结论缺血后预处理通过促进肝内胆管组织中Bcl-2蛋白表达、抑制Bax蛋白表达,抑制SD大鼠肝脏缺血再灌注过程中肝内胆管细胞凋亡,从而减轻肝脏缺血再灌注过程中肝内胆管细胞的损伤。 [ABSTRACT FROM AUTHOR]