Abstract:Objective To explore the independent correlation between sequential organ failure assessment maximum(SOFA Maximum)≥ 11 and heart,brain,lung,kidney and liver dysfunction at 30 d after acute type A aortic dissection(ATAAD)repair,and to evaluate the sensitivity and independence of SOFA Maximum in guiding organ care after ATAAD repair.Methods A total of 114 patients with ATAAD who underwent surgical repair in Beijing Anzhen Hospital,Capital Medical University from August to December 2023 were retrospectively selected.Multiple Logistic regression was used to explore the independent correlation between SOFA Maximum≥11 and the representative end point of organ dysfunction at 30 d after ATAAD repair.Results SOFA Maximum ≥ 11 was independently associated with cardio-cerebral insufficiency(major cardiovascular and cerebrovascular adverse events),pulmonary insufficiency(postoperative pulmonary complications),renal insufficiency(acute kidney injury/failure),and liver insufficiency(acute liver injury/failure)at 30 d after ATAAD repair(odds ratio=5.61,3.94,9.44,2.89,respectively,allP＜0.05).Conclusion SOFA Maximum≥ 11 has good independence and sensitivity in guiding organ nursing after ATAAD repair.In the future,SOFA Maximum≥ 11 will be included in the standardized perioperative management system of ATAAD repair,which has broad application prospects.

Abstract:Objective To evaluate the efficacy and health economics of different minocycline-containing quadruple regimens in newly treated patients with Helicobacter pylori(Hp)infection.Methods From January 1,2022 to July 31,2023,the clinical data of 554 Hp infection patients who received eradication treatment with a quadruple regimen containing minocycline in Beijing Jishuitan Hospital,Capital Medical University were retrospectively analyzed.According to different eradication treatment plans,they were divided into MAPB group(166 cases),MMPB group(81 cases),and MLPB group(307 cases).The MAPB group received minocycline-amoxicillin-proton pump inhibitor(PPI)-bismuth regimen,the MMPB group received minocycline-metronidazole-PPI-bismuth regimen,and the MLPB group received minocycline-levofloxacin-PPI-bismuth regimen,All three groups were treated for 14 d.Outcome measures included Hp eradication rate and incidence of adverse reactions.Using the results of the above studies as parameters,multi-strategy comparison and net benefit method were used to evaluate all treatment strategies and screen the superior one,respectively.Sensitivity analysis was performed to evaluate the stability of the results.Results The Hp eradication rates of patients in the MAPB group,MMPB group,and MLPB group were 92.8％(154/166),84.0％(68/81),and 94.1％(289/307)(x2=9.382,P=0.009).Adverse drug reactions were reported in 185 of 554 patients(33.4％)during eradication therapy.The incidence of adverse events(46.9％)was highest in MMPB group(x2=38.545,P＜0.001).The results of multi-scheme comparison showed that none of the above three schemes was absolutely inferior.The multi-scheme comparison method and the net benefit method results showed that minocycline-levofloxacin-PPI-bismuth regimen might be advantage intervention.Sensitive analysis showed that eradication rate of minocycline-amoxicillin-PPI-bismuth regimen had significant impact on stability of such result.Conclusions Minocycline-containing quadruple therapies showed satisfactory efficacy in the eradication treatment of newly treated patients with Hp infection.Minocycline-levofloxacin-PPI-bismuth regimen might stand optimal health economic value.

Abstract:Objective To investigate the therapeutic effect of glutamine on small intestinal mucosal injury in patients taking aspirin.Methods Patients who were taking aspirin and had small intestinal mucosal injury screened by capsule endoscopy in Beijing Anzhen Hospital,Capital Medical University from January 2022 to January 2024 were selected as the study subjects.They were divided into intervention group and control group by computer random sequence method.The intervention group continued to take aspirin and compound glutamine enteric-coated capsules,while the control group continued to take aspirin without other interventions for aspirin damage.Capsule endoscopy was performed again after 2 months of treatment.The small intestinal mucosal injury of the two groups was evaluated by the small intestinal endoscopic 5-point scale.The primary endpoint of the study was the change in the small intestinal mucosal injury score of the two groups.Results A total of 43 patients were successfully enrolled and completed the whole clinical trial,including 22 cases in the intervention group and 21 cases in the control group.The small intestinal mucosal injury score of the intervention group after treatment was significantly lower than that before treatment[1.0(0.0,1.3)vs 2.0(2.0,3.0),P＜0.001].There was no significant difference in small intestinal mucosal injury score before and after treatment in the control group[2.0(2.0,2.0)vs 2.0(2.0,2.0),P=0.317].Compared with the control group,the small intestinal mucosal injury score of the intervention group decreased more[1.0(1.0,2.0)vs0.0(0.0,0.0),P＜0.001].Conclusion Glutamine can be used to reduce associated small intestinal mucosal injury in patients who are taking aspirin.

Abstract:Severe acute respiratory syndrome coronavirus 2 has caused a global pandemic of novel corona-virus infection.Although the main manifestation of viral infection is respiratory disease,an increasing number of studies have shown that novel coronavirus can cause a variety of nervous system damage,such as encephalitis,encephalopathy,Guillain-Barre syndrome and"long novel coronavirus infection"syndrome.The exact mechanism of neurological complications caused by the novel coronavirus is still unclear.This article reviews the clinical manifestations and possible pathological mechanisms of nervous system injury caused by novel coronavirus infec-tion,which is helpful to identify neurological symptoms and prevent critical illness in advance.

Abstract:Diabetic foot ulcer(DFU)is a common chronic refractory ulcer,which is also the main cause of amputation and even death in diabetic patients.DFU has become a social public health problem that needs to be solved urgently,which brings a huge economic and psychological burden to patients because of its delayed and difficult cure and easy to relapse.DNA methylation is one of the most intensively studied epigenetic mechanisms in the field of epigenetics,which plays a key role in the occurrence and development of diseases.The regulatory mechanism of many key genes in the development of DNA methylation on DFU is still unclear.This article reviews the role of five DNA methylation-regulated genes in DFU healing,aiming to provide a reference for further guiding the application of DNA methylation in DFU.

Abstract:Objective To investigate the correlation between serum uric acid level and atrial fibrillation in patients with non-alcoholic fatty liver disease(NAFLD).Methods A total of 565 patients diagnosed with NAFLD in the Second Hospital of Shanxi Medical University from January 2020 to December 2022 were retrospectively selected.According to whether they were complicated with atrial fibrillation,they were divided into atrial fibrillation group(224 cases)and non-atrial fibrillation group(341 cases).The clinical data of the two groups were analyzed.Multivariate Logistic regression analysis was used to determine the related factors for the occurrence of atrial fibrillation in NAFLD patients.A trend test was used to analyze the linear trend between serum uric acid level and atrial fibrillation.The nomogram model was constructed to predict the risk of atrial fibrillation,and the calibration curve was drawn to evaluate the accuracy of the nomogram.Finally,the receiver operating characteristic(ROC)curve was drawn to evaluate the predictive value of serum uric acid and the nomogram model for the occurrence of atrial fibrillation in NAFLD patients.Results Multivariate Logistic regression analysis showed that age[odds ratio(OR)=1.096,95％confidence interval(CI):1.071-1.121,P＜0.001],serum creatinine(OR=1.021,95％CI:1.003-1.039,P=0.025)and serum uric acid(OR=1.008,95％CI:1.005-1.011,P＜0.001)were independent risk factors for the occurrence of atrial fibrillation in NAFLD patients,and high-density lipoprotein(P=0.010)was an independent protective factor.The risk of atrial fibrillation increased with the increase of serum uric acid level(P＜0.001 for trend test).The C-index of the nomogram predicted atrial fibrillation was 0.827(95％CI:O.793-0.861),and the Hosmer-Lemeshow test and calibration plots showed that the model was well calibrated.ROC analysis showed that the area under the curve of the nomogram model was 0.827,which was better than that of serum uric acid(0.683).Conclusion Elevated serum uric acid level is an independent risk factor for atrial fibrillation in patients with NAFLD.

Abstract:Recent years,the incidence of gastric cancer has decreased but the rate of gastric signet ring cell carcinoma(GSRCC)has distinctly increased by year.Compared with non-GSRCC,the prognosis of patient with GSRCC is extremely poor,which is closely related to its special pathological and molecular features and poor sensibility of chemotherapy drugs.Moreover,some molecular expressions may be potential therapeutic targets and biomarkers.Now we have reviewed the progress of GSRCC.

Abstract:Objective To explore the application effect of internal dental floss traction assisted technique in endoscopic submucosal dissection(ESD)for early colorectal cancer and precancerous lesions.Methods Clinical data of 98 patients with early colorectal cancer and precancerous lesions who underwent ESD in Department of Gastroenterology,Beijing Anzhen Hospital,Capital Medical University from January 2022 to December 2023 were selected to retrospective analysis,and they were divided into the dental floss group(51 cases)and the control group(47 cases)according to endoscopic treatment methods.The control group received standard ESD,while the dental floss group received additional internal dental floss traction during ESD.The ESD procedure time,incidence of intraoperative bleeding,lesion resection effect,incidence of postoperative complications,and length of hospital stay were compared between the two groups.Results Compared to the control group,ESD procedure time and the incidence of intraoperative bleeding in the dental floss group were shorter/lower[25.0(17.3,30.0)min vs 45.0(32.0,64.0)min,39.2％(20/51)vs 53.2％(25/47)](both P＜0.05).There were no significant differences in overall resection rate,complete resection rate,postoperative and length of hospital stay between the two groups(all P＞0.05),and no delayed perforation occurred.Conclusion The application of internal floss traction in ESD for the treatment of early colorectal cancer and precancerous lesions can shorten the procedure time,reduce the incidence of intraoperative bleeding.

Abstract:Objective To analyze the risk factors for delayed extubation after radical surgery in children with tetralogy of Fallot(TOF).Methods A total of 287 children diagnosed with TOF in the Pediatric Heart Center,Beijing Anzhen Hospital,Capital Medical University from January 2018 to December 2021 were enrolled in this study.Based on whether mechanical ventilation time was greater than or equal the median(49 h),they were divided into normal extubation group(144 cases)and delayed extubation group(143 cases).The perioperative clinical data of the two groups were collected for comparative analysis,to explore the single factor affecting the duration of mechanical ventilation,and then multivariate Logistic regression analysis was performed.Results All children underwent radical surgery,and the median mechanical ventilation time was 49(24,93)h.The age,body mass,body surface area,preoperative blood oxygen saturation,Mcgoon ratio,pulmonary artery index measured by ultrasound,proportion of preoperative lateral branch occlusion,proportion of cross valve ring patch surgery,cardiopulmonary bypass time,ascending aorta occlusion time,length of intensive care unit hospital stay,proportion of postoperative capillary leakage syndrome(CLS),and the proportion of serious adverse events in two groups after surgery showed statistically significant differences(all P＜0.05).Multivariate Logistic regression analysis showed that preoperative lateral branch occlusion(odds ratio=2.896),postoperative CLS(odds ratio=6.610),cross valve ring patch surgery(odds ratio=1.800),and lower body mass(odds ratio=0.959)were independent risk factors for postoperative delayed extubation in children with TOF(all P＜0.05).Conclusion Preoperative lateral branch occlusion,postoperative CLS,cross valve ring patch surgery and lower body mass are independent risk factors for postoperative delayed extubation in children with TOF.

Abstract:Acute ethylene glycol poisoning is one of the common causes of poisoning.Due to the lack of rapid and accurate diagnostic methods and safe and effective drugs,it is very difficult in the clinical diagnosis and treatment process,and delayed diagnosis and treatment will directly lead to serious organ damage and even death.Full understanding of the metabolic process in vivo,clinical manifestations,the accuracy and limitations of laboratory tests,and the applicability of treatment regimens are of great significance for rapid diagnosis and improved prognosis.This article reviews the metabolism of ethylene glycol in the body,the clinical manifestations after poisoning,and the research status of the latest diagnosis and treatment methods at home and abroad,so as to provide methods and ideas for early identification and effective treatment of acute ethylene glycol poisoning.

Abstract:Acute chest pain is one of the common symptoms in the emergency department.Early and accurate identification of high-risk and low-risk chest pain is beneficial to timely diagnosis and treatment of high-risk patients and reduce over-treatment of low-risk patients.At the same time,it can improve the prognosis and alleviate the severity of pre-hospital care and emergency department medical resources.In recent years,early risk stratifica-tion tools for patients with acute chest pain have been developed,and their sensitivity and specificity are different.This article reviews the current research progress of early risk assessment in patients with acute chest pain.

Abstract:Intervertebral disc degeneration is a complex degenerative disease affected by many factors,and its mechanism still needs to be further explored.Mechanical stimulation has a significant effect on the nucleus pulposus cells in the intervertebral disc,which is of great significance for understanding the mechanism of degeneration and finding treatment strategies.This article summarizes the animal models,new materials,cytoskeleton,cell pathways,mitochondrial damage and aging,and further explores the role and influence of mechanical stimulation on nucleus pulposus cells,so as to provide a more effective and safer treatment plan for lumbar disc degeneration diseases.

Abstract:Objective To explore the mechanism of 5-fluorouracil(5-FU)combined with oxaliplatin(L-OHP)on cisplatin(DDP)resistance in non-small cell lung cancer through microRNA-92a(miR-92a)/Wnt/β-catenin pathway.Methods Cultivate human non-small cell lung cancer cells(A549)in vitro and construct the DDP resistance model.The experimental groups are as follows:A549 group was the normal A549 cells,A549/DDP group was the DDP resistant model cells,A549+DDP group was the A549 group co-cultured with DDP,A549/DDP+DDP group was the A549/DDP group co-cultured with DDP,A549/DDP+miR-92a inhibitor group was the A549/DDP group transfected with miR-92a inhibitor,5-FU+L-OHP group was the A549/DDP group co-cultured with 5-FU+L-OHP,5-FU+L-OHP+miR-92a mimics group was the 5-FU+L-OHP group transfected with miR-92a mimics,5-FU+L-OHP+miR-92a mimics+Wnt/β-catenin inhibitor group was the 5-FU+L-OHP+miR-92a mimics group transfected with Wnt/β-catenin inhibitor.5-Ethynyl-2'-deoxyuridine experiment was used to detect cell proliferation rate,wounding healing assay was used to detect cell migration rate,Transwell experiment was used to detect cell invasion ability,fluorescence in situ hybridization was used to detect the expression of miR-92a;quantitative real-time polymerase chain reaction was used to detect the expression of miR-92a,Wnt4,and β-catenin;Western Blot was used to detect protein expression of Wnt4,β-catenin and CD44.Results Compared with A549 group,the expression level of miR-92a in A549/DDP group was significantly increased(P＜0.05).Compared with A549/DDP group,the migration rate and cells invasion number in A549/DDP+miR-92a inhibitor group were significantly reduced(both P＜0.05).Compared with A549/DDP group,the cell proliferation rate,cell invasion number and expression levels of miR-92a,Wnt4,β-catenin,and CD44 proteins in 5-FU+L-OHP group were significantly reduced(all P＜0.05).Compared with 5-FU+L-OHP group,5-FU+L-OHP+miR-92a mimics group showed a significant increase(all P＜0.05).Compared with 5-FU+L-OHP+miR-92a mimics group,5-FU+L-OHP+miR-92a mimics+Wnt/β-catenin inhibitor group showed a significant decrease[miR-92a:(0.49±0.07)vs(0.97±0.14),Wnt4:(0.37±0.05)vs(1.19±0.16),β-catenin:(0.27±0.04)vs(1.54±0.20)](all P＜0.05).Conclusion The combination of 5-FU and L-OHP can effectively improve the DDP resistance of A549 cells,inhibit cell proliferation and invasion,which may be related to downregulating the expression of proteins related to the miR-92a/Wnt/β-catenin signaling pathway.

Abstract:Objective To investigate the correlation of serum cystatin C and uric acid levels with bone mineral density in patients with type 2 diabetes mellitus(T2DM)in Qinghai region.Methods A total of 141 T2DM patients who were treated in the Department of Endocrinology,Qinghai Provincial People's Hospital from January to December 2023 were selected.According to the diagnostic criteria of osteoporosis,the patients were divided into normal bone mass group(56 cases),osteopenia group(53 cases)and osteoporosis group(32 cases).The general data of the patients were collected,serum cystatin C,uric acid and other biochemical indicators and bone mineral density data were measured,and the correlation between related indicators and bone mineral density was analyzed.Results There were significant differences in gender distribution,age,and levels of 25-hydroxyvi-tamin D,cystatin C,total cholesterol,and high-density lipoprotein cholesterol among the three groups(all P＜0.05).The variables with statistically significant differences in univariate analysis were included in the multivariate ordinal Logistic regression analysis model as independent variables.The results showed that age and cystatin C were risk factors for osteopenia and osteoporosis,while male sex and 25-hydroxyvitamin D were protective factors(odds ratios=0.434,0.922,1.100,3.555,all P＜0.05).Conclusion High level of serum cystatin C,female,old age and low level of 25-hydroxyvitamin D may be risk factors for osteopenia and osteoporosis in T2 DM patients in Qinghai province.There is no significant correlation between serum uric acid level and bone mineral density in T2DM patients.

Abstract:A 58-year-old man suffered from bilateral submaxillary swelling and pain with limited mouth opening.Physical examination showed that the opening degree was about a cross finger,and multiple ulcers were found in the oral mucosa,with no obvious swelling and slight tenderness in the bilateral submaxillary area,and no wounds were found in the whole body.During the treatment,the patient developed sudden lockjaw,dyspnea,stiffness of limbs,clinical diagnosis of tetanus infection,treatment of open airway,mechanical ventilation,anti-infection,neutralization of toxins,relief of spasm,nutritional support,correction of autonomic nervous disorders,etc.,the patient improved and was discharged.This paper summarizes the clinical manifestations and treatment of severe systemic tetanus infection in order to improve the level of diagnosis and treatment of this disease.

Abstract:Rheumatoid arthritis(RA)is a chronic systemic immune disease characterized by synovial inflammation and progressive joint destruction.Disorders of cell metabolism are closely related to the pathology of RA.At the site of inflammation,due to the limitation of energy sources,inflammatory cells adapt to perform their homeostatic functions through metabolism.Metabolic abnormalities in immune cells and stromal cells are considered to be important drivers of chronic inflammation in RA.Metabolites such as lactate play a key role in regulating immune cell function.This article reviews the important role of glycolysis,mitochondrial metabolism,lipid and amino acid metabolism in RA and the current status of metabolic-targeted therapy,in order to provide new ideas for the treatment of RA.

Abstract:Objective To explore the efficacy and influencing factors of angiotensin converting enzyme inhibitor(ACEI)/angiotensin Ⅱ receptor blocker(ARB)drugs in the treatment of cardiovascular toxicity induced by bevacizumab,so as to provide reference for clinical improvement of anti-cardiovascular toxicity.Methods A total of 128 cancer patients with cardiovascular toxicity after bevacizumab treatment in Jiangsu Second Hospital of Traditional Chinese Medicine from January 2021 to December 2023 were selected.Patients were divided into two groups according to whether they were treated with ACEI/ARB drugs,95 patients who took ACEI/ARB drugs were included in the observation group,and 33 patients who did not take ACEI/ARB drugs were included in the control group.The levels of cardiac troponin Ⅰ(cTnⅠ),N-terminal pro-brain natriuretic peptide(NT-proBNP),left ventricular ejection fraction(LVEF),systolic blood pressure and diastolic blood pressure were compared between the two groups.Univariate and multivariate analysis were used to analyze the influencing factors of cardiovascular toxicity caused by ACEI/ARB drugs in the treatment of bevacizumab.Results The levels of NT-proBNP,cTnⅠ,systolic blood pressure and diastolic blood pressure in the observation group were lower than those in the control group,and the LVEF was higher than that in the control group(all P＜0.05).In the clinical effect evaluation of ACEI/ARB drugs in the treatment of cardiovascular toxicity,60 cases(63.2％)were cured,30 cases(31.6％)were improved and 5 cases(5.3％)were ineffective.Clinical staging(odds ratio=5.349),concomitant cardio-vascular disease(odds ratio=3.132),cardiac toxicity grade(odds ratio=4.218),plasma NT-proBNP(odds r atio=2.824),and plasma cTnⅠ(odds ratio=3.779)levels were risk factors for cardiovascular toxicity effects of ACEI/ARB drug therapy,while LVEF level(odds ratio=0.333)was a protective factor for cardiovascular toxicity effects of ACEI/ARB drug therapy(all P＜0.05).Conclusion ACEI/ARB drugs have a certain effect in the treatment of cardiovascular toxicity induced by bevacizumab,which can reduce cardiovascular toxicity and myocardial injury.The risk factors for ACEI/ARB treatment included clinical stage,cardiovascular disease,cardiotoxicity grade,NT-proBNP and cTnⅠ,while LVEF was a protective factor.

Abstract:Objective To investigate the correlation of serum visfatin and adiponectin levels with clinical features of pediatric febrile seizures(FS)and conversion to epilepsy.Methods A total of 228 children with FS admitted to Department of Emergency,the First Hospital of Hunan University of Chinese Medicine from January 2021 to June 2023 were selected as the FS group,and 114 children with fever and 114 healthy children during the same period were selected as the fever group and the control group,respectively.The serum levels of visfatin and adiponectin were compared among the three groups.Logistic regression was used to analyze the influencing factors of FS converting to epilepsy.The receiver operating characteristic curve was used to evaluate the predictive value of serum visfatin and adiponectin levels for the conversion of FS to epilepsy in children.Results The serum level of visfatin in the control group,fever group and FS group decreased in turn,and the serum level of adiponectin increased in turn in the control group,fever group and FS group(all P＜0.05).The serum levels of visfatin and adiponectin were related to the type of FS,the duration of seizures,and the number of seizures within 24 h(all P＜0.05).After 1 year of follow-up,the incidence of epilepsy in 228 FS children was 25.0％(57/228).Complex FS,the duration of seizure ≥15 min,the number of seizure within 24 h ≥2,and high level of adiponectin were independent risk factors for the conversion of FS to epilepsy,and high level of visfatin was an independent protective factor(all P＜0.05).The area under the curve of serum visfatin combined with adiponectin in predicting FS to epilepsy was 0.872,which was larger than 0.787 and 0.790 predicted by serum visfatin or adiponectin alone(both P＜0.05).Conclusions The decreased level of serum visfatin and the increased level of serum adiponectin are related to the type of FS,the duration and frequency of seizures in children,and are independent factors affecting the conversion of FS to epilepsy.The combination of visfatin and adiponectin has a high value in predicting the conversion of FS to epilepsy in children.

Abstract:Objective To explore the relationship between blood pressure control and cognitive level in patients with hypertension.Methods A total of 7 718 hypertensive patients admitted to the Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University from October 2019 to September 2023 were selected.According to the blood pressure control,the patients were divided into standard group and non standard-group.The cognitive function status[Montreal cognitive assessment(MoCA)and mini-mental state examination(MMSE)scores]were analyzed and compared between the two groups.After adjusting for confounding factors,binary Logistic regression model was used to analyze the relationship between blood pressure control and cognitive scores.Results Among the 7 718 patients,5 618(72.8％)patients had poor blood pressure control and 2 100(27.2％)patients had good blood pressure control.After adjusting for confounding factors,the scores of visuospatial and executive function[odds ratio(OR)=1.09,95％confidence interval(CI):1.03-1.16,P=0.002],attention(OR=1.05,95％CI:1.01-1.09,P=0.027),language(OR=1.05,95％CI:1.01-1.09,P=0.010),abstract ability(OR=1.04,95％CI:1.01-1.08,P=0.022)and the total score of MoCA(OR=1.25,95％CI:1.06-1.47,P=0.007)in the standard group were higher than those in the non standardgroup.The scores of memory(OR=1.05,95％CI:1.01-1.10,P=0.010)and language ability(OR=1.08,95％CI:1.04-1.11,P＜0.001)in MMSE and the total score of MMSE(OR=1.19,95％CI:1.06-1.33,P=0.004)in the standard group were higher than those in the non standardgroup.Conclusions In patients with hypertension,patients with uncontrolled blood pressure have worse cognitive function than those with controlled blood pressure.

Abstract:Objective To investigate the clinical characteristics,endoscopic findings and influencing factors of rebleeding in elderly patients with peptic ulcer complicated with bleeding.Methods A total of 182 elderly patients with peptic ulcer and bleeding who were hospitalized in Xuanwu Hospital,Capital Medical University from January 2022 to August 2024 were retrospectively collected.According to the prognosis,they were divided into rebleeding group(12 cases)and non-rebleeding group(170 cases).The general data,laboratory examination results and endoscopic manifestations of the two groups were compared.Logistic regression analysis was used to explore the influencing factors of rebleeding in elderly patients with peptic ulcer and bleeding.Results The incidence rate of regular abdominal pain in the rebleeding group was higher than that in the non-rebleeding group(P＜0.05).The albumin level in the rebleeding group was lower than that in the non-rebleeding group[(27±6)g/L vs(32±5)g/L](P=0.001).The proportions of Forrest grade Ⅰ a-Ⅱ b,ulcer diameter ≥2 cm and retrobulbar ulcer in the rebleeding group were higher than those in the non-rebleeding group(all P＜0.05).Logistic regression analysis showed that regular abdominal pain was an independent risk factor for rebleeding in elderly patients with peptic ulcer and bleeding(P＜0.05),and albumin was an independent protective factor(P＜0.05).Conclusion Regular abdominal pain is an independent risk factor for rebleeding in elderly patients with peptic ulcer and bleeding,and albumin level is an independent protective factor.