Volume 98 ·  Issue 40 ·  2018

Having been engaged in anesthesia for many years, I often hear some different voices about the decision-making of geriatric orthopedic surgery. Because the combined diseases are not well controlled, "the risk is too great, the operation is suspended, and the preoperative preparation is further strengthened" (withdrawal), and there are also cases of "the earlier the operation, the better the patient's prognosis" and "the conditions have no conditions to create opportunities" (advancement). How should we make scientific decisions?

The widespread application of enhanced recovery after surgery (ERAS) can effectively improve surgical safety, shorten hospital stay and reduce medical expenses^[1]。 However, in clinical practice, despite standardized preoperative nutritional intervention to correct malnutrition according to the requirements of the guidelines, it is still difficult for these patients to reach the goals of ERAS. We can't help but ask why? With regard to these questions, I would like to talk about the following views for my fellow peers' reference.

To investigate the risk factors of postoperative hyperactive-type delirium(PHTD) in geriatric orthopedic patients using nested case-control study.

Seventy-four patients who underwent orthopedic surgeries in the Second Affiliated Hospital of Wenzhou Medical University from January 2008 to December 2013, aged 65 or above, American Society of Anesthesiologists (ASA) physical status Ⅰ-Ⅳ, with complete medical records and confirmed diagnosis of PHTD were selected as case group. A control group of 444 patients, on the basis of 1∶6 versus nested case group, from the same cohort but without PHTD was established. Data patterns such as patient age, gender, ASA classification, status of preoperative/postoperative electrolytes, preoperative blood glucose, preoperative/postoperative plasma albumin and preoperative/postoperative hematocrit(Hct), uses of non-steroidal analgesics, anticholinergic drugs and benzodiazepines drugs, type of anesthesia, anesthesia duration, difference in postoperative analgesia were collected and analyzed.

Univariate Logistic regression analysis showed that gender, age, ASA grade, preoperative electrolytes, anesthesia duration, operative duration, intraoperative hypotension and the difference of postoperative analgesia were risk factors for PHTD. Multiple Logistic regression analysis showed that gender (OR=2.562, 95%CI: 1.438-4.564, P=0.001), age (OR=3.929, 95%CI: 1.788-8.633, P=0.001), preoperative electrolytes(OR=3.714, 95%CI: 2.068-6.670, P<0.001)were the independent risk factors for PHTD.

Male, elderly patients and abnormalities of preoperative electrolyte are the independent risk factors for PHTD in geriatric orthopedic patients.

To explore postoperative delirium (POD)risk factors for geriatric patients who suffered hip fracture under the care of orthogeriatric unit mode.

Patients aged 65 years or older, who were admitted to the orthogeriatric unit in Beijing Jishuitan Hospital from April to October 2017 for hip fracture surgery, were eligible for this prospective cohort study. After univariable analysis, significant risk factors associated with POD were further evaluated with multivariable analysis, to establish independent risk factors associated with POD.

A total of 203 patients with an average age of 80(65-96)years were enrolled in the study. The overall incidence of POD was 9.4%(19/203)in which hyperactive and hypoactive type accounting for 84.2%(16/19)and 15.8%(3/19), respectively. Significant difference was found between POD and non-POD groups in patients′ age (P=0.003), albumin(P=0.006), TSH(P=0.018), PaCO₂ level(P=0.003), visual analogue scale (VAS )both at rest (P=0.013)and movement(P=0.010) on post-operative day 1.The further Logistic stepwise regression analysis showed that significant differences existed between groups in age(P=0.027), albumin(P=0.003), PaCO₂(P=0.014)and VAS at rest(P=0.002).

The independent risk factors of POD in geriatric patients undergoing hip fracture under the orthogeriatric unit mode include patients′ age, pre-operative albumin as well as PaCO₂ level and post-operative VAS at rest.

To compare the effects of different types of anesthesia on postoperative cardiopulmonary complications in patients aged 80 years and above who received unilateral hip fracture surgery.

The perioperative data of patients aged 80 and above who underwent unilateral hip fracture surgery in Peking Union Medical College Hospital from July 2009 to June 2014 were collected and grouped based on the types of anesthesia including general anesthesia, neuraxial anesthesia, and peripheral nerve block. Variables were analyzed including preoperative general conditions (age, sex, type of fracture, ASA physical status classification, preoperative cardiopulmonary complications), intraoperative conditions (type of surgical procedure, operative time, blood loss, total intraoperative fluid infusion), and postoperative conditions (length of hospital stay, postoperative hospital stay, ICU stay, postoperative newly developed cardiopulmonary complications, postoperative in-hospital death, hospitalization costs). The incidences of postoperative cardiopulmonary complications of each group were analyzed and compared.

A total of 219 cases were finally analyzed including general anesthesia (n=46), neuraxial anesthesia (n=90) and nerve block group (n=83). Fewer cases with preoperative pulmonary complications were noticed in general anesthesia group (15 cases, 32.6%) than in neuraxial anesthesia group (45 cases, 50%) and nerve block group (47 cases, 56.6%) (χ²=6.912, P=0.032). No statistical differences were found between groups regarding preoperative cardiovascular complications and other variables. There were no significant differences in postoperative cardiopulmonary complications. However, the cost of hospitalization was lower in neuraxial anesthesia group (45.6±21.4) thousand RMB and nerve block group (48.2±25.8) thousand RMB compared with general anesthesia group (56.3±21.6) thousand RMB, the difference was statistically significant(F=9.951, P=0.007).

For elderly patients undergoing unilateral hip surgery, the type of anesthesia does not affect the incidence of postoperative cardiopulmonary complications. However, neuraxial anesthesia and nerve block may reduce the cost of hospitalization.

To investigate the efficacy of simple device of continuous positive airway pressure (CPAP) in the treatment of obstructive sleep apnea (OSA).

A double-blind study was performed on 53 OSA patients who received overnight simple CPAP and traditional CPAP in a random order during polysomnography. Pressure for CPAP treatment was manual titrated. The sleep apnea hypopnea index (AHI), arousal index (ArI), Oxygen desaturation Index (ODI), sleep structure and the preference for CPAP devices of the patients were observed.

AHI, ArI, ODI decreased significantly from 35.7 (18.1, 58.8)/h, (29.4±18.6)/h, 22.0 (13.9, 47.3)/h before treatment to 1.7 (0.7, 4.4)/h, (11.5±5.1) /h and 1.3 (0.4, 3.6)/h after treatment with simple CPAP, respectively (all P<0.05). There was no statistically significant difference in residual AHI [1.7 (0.7, 4.4)/h vs 1.9 (0.8, 4.3)/h], ArI [(11.5±5.1)/h vs (10.5±4.4)/h] and ODI [1.3 (0.4, 3.6)/h vs 1.3 (0.5, 4.2)/h] between treatment with simple CPAP and traditional CPAP (allP>0.05). The amount of time spent on deep sleep (stage Ⅲ) and rapid eye movement (REM) increased significantly from (6.2+ 6.6)% and (16.3+ 7.0)% before treatment to (11.7±8.5)% and (20.7±5.1)% during treatment with simple CPAP and (11.4±8.6)% and (20.9±5.0)% with traditional CPAP, respectively. The patients had no clear preference for two CPAP devices.

Traditional CPAP can be replaced by the simple CPAP to treat patients with OSA.

To compare the differences of risk factors and prognosis of pulmonary embolism (PE) between the Tibetans and the Hans.

Patients over 18 years old with confirmed PE and complete clinical data from West China Hospital of Sichuan University from January 2010 to January 2016 were prospectively enrolled and divided into Tibetan group and Han group. Clinical data were collected to compare risk factors and short-term prognosis between Han group and Tibetan group. In addition, a 2-year follow-up was conducted among patients after discharge to investigate the long-term prognosis.

A total of 90 patients in Tibetan group and 626 patients in Han group were finally included in this study. Patients in Tibetan group were younger than Han group [(52.2±15.8) vs (59.8±16.6) years old, P<0.001], and the proportion of elderly patients (age ≥70 years) in Tibetan group was significantly lower than that of Han group (15.6% vs 33.7%,P=0.001). The hemoglobin, hematocrit, platelet counts and fibrinogen in Tibetan group were higher than those in Han group [(134.0±32.0) vs (122.2±25.7) g/L, (41.2±9.2)% vs (37.6±7.3)% and (222.2±97.5)×10⁹/L vs (187.5±87.2)×10⁹/L, 3.71(2.51, 4.89) vs 3.31(2.44, 4.42) g/L; P<0.001, <0.001 andP=0.001, 0.048, respectively]. Malignancy and chronic obstructive pulmonary disease were more common in Han group (P=0.011, 0.001), while prior venous thromboembolism history, pregnancy or a history delivery within 1 month were more common in Tibetan group (P=0.041, 0.001). Both short-term and long-term mortality in Tibetan group were significantly lower than that in Han group (2.2% vs 11.5%, 13.6% vs 24.9%; P=0.005, 0.020).

Hypercoagulable state plays an important role in the pathogenesis of PE in Tibetan patients. Both short-term and long-term prognosis of PE in Tibetan patients are better than that in Han patients.

To discusses the predictive value of typical cataplexy+ HLA-DQB1*0602 positive to hypocretin-1 (HCRT-1) reduction in cerebrospinal fluid (CSF) in patients with narcolepsy.

A total of 165 narcoleptic patients, who were diagnosed at the Sleep Center of Peking University People′s Hospital and Peking University International Hospital from March 2003 to March 2017, were recruited. The CSF HCRT-1 level and DQB1*0602 were measured in all the subjects. The narcoleptic patients were divided into two groups: typical cataplexy+ DQB1*0602 positive were CH group, and others who were not typical cataplexy and DQB1*0602 positive simultaneously were NCH group. The HCRT-1 level in CSF was declared to have a serious reduction when HCRT-1≤110 ng/L. According to this standard, the CH group and NCH group were subdivided into sub-groups and the data was analyzed to investigate the predictive value of typical cataplexy+ HLA-DQB1*0602 positive to HCRT-1 reduction.

There were 142 patients in CH group, including 137 patients with HCRT-1 reduction and 5 patients without. There were 23 patients in NCH group, including 15 patients with HCRT-1 reduction and 8 patients without. The positive predictive value of typical cataplexy+ DQB1*0602 positive for the reduction of HCRT-1 in CSF was 96.5%. Typical cataplexy+ DQB1*0602 positive had a good consistency with the HCRT-1 reduction in CSF (χ²=26.7, P<0.001).

Typical cataplexy+ DQB1*0602 positive has a good predictive value to the HCRT-1 reduction in CSF in patients with narcolepsy.

To investigate the predictors of axillary lymph node metastasis and the breast cancer-specific survival (BCSS) in patients with T1 breast cancer.

A retrospective analysis of clinical and pathological data of 840 T1 invasive breast cancer cases between January 2009 and January 2014 in Henan Cancer Hospital was conducted.Chi square test and Logistic regression analysis were carried out to identify relevant factors of lymph node metastasis. Analysis of prognostic factors were analyzed by Log-rank test and Cox regression.

Among the 840 T1 breast cancer cases, positive axillary lymph nodes were found in 150 (17.9%) cases. Univariate analysis showed that tumor size, histological grade, tumor location, and HER2 status were associated with axillary lymph node status (P<0.05). Multivariate analysis showed that tumor size, histological grade, tumor location, and HER2 status were independent predictive factors of axillary lymph node metastasis (P<0.05). Log-rank test showed that tumor size, histological grade, HER2 status, partial response (PR) status and number of positive lymph nodes were important factors influencing BCSS of the patients with positive axillary lymph nodes (P<0.05). Cox analysis showed that the size of the primary tumors and the number of positive lymph nodes were independent factors affecting the BCSS of the patients(P<0.05).

Tumor size, histological grade, tumor location and HER2 status correlated with axillary lymph nodes status of T1 breast cancer. For T1 breast cancer patients with positive axillary lymph node, more positive lymph nodes involved and smaller primary tumor correlated with worse prognosis.

To investigate whether the assisted reproductive techniques (ART) outcomes can be improved by using magnetic-activated cell sorting combined isolate density gradient centrifugation (MACS-DGC), and to compare the results with the conventional isolate density gradient centrifugation (DGC) method.

In the period from January to December 2014, patients who attended the andrology laboratory for sperm DNA fragmentation analysis and underwent the in vitro fertilization and embryo transfer (IVF-ET) treatment were divided into 3 groups, and each group has two subgroups according to the way of fertilization : in vitro fertilization (IVF) as subgroup 1 and intracytoplasmic sperm injection (ICSI) as subgroup 2. Group A (A1, A2 ): DNA fragmentation index(DFI)≥20 and using MACs; Group B (B1, B2): DFI≥20 and using isolate method; Group C (C1, C2): DFI<20 and using isolate method. The fertilization rate, good-quality embryos, implantation rate, pregnancy rate and live-birth rate of each group were analyzed.

Similar results were obtained among groups for all the parameters compared: On IVF cycles no significant difference was observed in fertilization rate, percentage of good-quality embryos on day 3, implantation rate, positive beta-hCG tests, and live-birth rate among the three subgroups (A1 vs B1 vs C1). Between the subgroups of ICSI cycles (A2 vs B2 vs C2) the percentage of high-quality embryos, pregnancy rate, implantation rate and live-birth rate were all significantly higher in the MACS-DGC (A2) group compared to DGC alone (B2).

Based on the results, MACS as a part of sperm preparation technique will not improve sperm fertilizing potential, embryos quality, implantation rate, pregnancy rate or live-birth rate of IVF, but it may help select the most fertile sperm and to improve clinical outcomes of ICSI.

To investigate the role of high-mobility group box protein 1 (HMGB1) in the signaling pathways of myocardial ischemia-reperfusion injury (MIRI) in rats.

Forty male Sprague-Dawley rats, weighing 200-250 g, were randomly divided into 4 groups (n=10) using a random number table: sham operation group (group sham), MIRI group (group IR-C), anti-HMGB1 antibody group (group IR-H-Ig), contrast antibody control group (group IR-Ig). The rat model of MIRI was established by 30 min occlusion of left anterior descending branch (LAD) of coronary artery followed by 180 min reperfusion. In sham group, no blocking of LAD was adopted after thoracotomy. Anti-HMGB1 antibody and contrast antibody immunoglobulin G (IgG) (2 mg/kg) were injected respectively at 30 min of reperfusion in IR-H-Ig and IR-Ig groups. Blood samples were collected from the femoral vein for determination of interleukin 6 (IL-6), tumor necrosis factor α (TNF-α), HMGB1, creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) concentrations at 180 min of reperfusion. The rats were then sacrificed after blood samples were taken and the pathological changes of myocardial tissue were observed. The mRNA and protein expressions of HMGB1, toll-like receptor 4(TLR4) and nuclear factor (NF)-κB in myocardial tissues were detected by Western blot and real-time quantitative PCR respectively.

Compared with the Sham group, the plasma level of IL-6, TNF-α, HMGB1 increased significantly and HMGB1, TLR4 and NF-κB mRNA and protein levels of myocardial tissues up-regulated in IR-C and IR-Ig groups (allP<0.05). The plasma level of CK-MB and cTnI increased significantly in IR-C, IR-H-Ig, IR-Ig group (allP<0.05). Compared with the IR-C group, the levels of the plasma HMGB1, the cytokines mentioned above, CK-MB and cTnI were significantly decreased, and mRNA and protein expressions of HMGB1, TLR4 and NF-κB of myocardial tissues down-regulated in IR-H-Ig group (allP<0.05). Inflammatory cell infiltration in MIRI groups increased significantly, while it was significantly reduced in IR-H-Ig group.

Blocking the combination of HMGB1 and TLR4 can effectively alleviate the tissue damage caused by myocardial ischemia-reperfusion in rats.

To investigate and analyze the distribution of 121 diseases of China′s First List of Rare Diseases based on hospitalized patients of tertiary hospitals and to explore the current situation of rare diseases in China.

Based on previous data of study from Beijing Society of Rare Diseases, a comparison between China′s First List of Rare Diseases and the survey list from the pre-study was performed. Descriptive analysis was carried out on the current situation of rare diseases on hospitalizations in 96 tertiary hospitals from year of 2014 to 2015.

Nineteen out of 121 diseases on China′s First List of Rare Diseases were not included in the rare diseases survey list of Beijing Society of Rare Diseases. The total number of other 102 rare disease cases was 54 468, accounting for 0.35% of the inpatients during the same period. The top ten most and least cases with rare disease were demonstrated in this study. The number of the top ten most cases was 37 977, accounting for 0.25% of the inpatients during the same period. The number of the top ten least cases was 24, accounting for 0.000 16% of the inpatients during the same period. The top most five types of rare diseases counted on the provinces and municipalities were Beijing, Hunan, Shanghai, Shandong and Guangdong. The top five most cases of rare diseases counted on the provinces and municipalities were Beijing, Shanghai, Guangdong, Shandong and Hubei. The age distribution showed that the cases with rare diseases aged 25-64 years accounted for 45.8%, and the cases in children aged 0-14 accounted for 28.6%. The top ten readmission rate ranged from 28.42% to 64.88%.

This study preliminarily investigates the number, type, province and municipality distribution, age distribution, and readmission rate of 121 rare diseases from China′s First List of Rare Diseases in the hospitalized patients of tertiary hospitals, which provides important data for registration study, medical and drug policy making and other relevant work on rare diseases in China in the future.

To study bacterial resistance in children and newborns aged less than 14 years across China from 2014 to 2017.

Bacterial resistance data on children and newborns were extracted from the national bacterial resistance surveillance reports from 2014 to 2017. Resistance trends in children and newborns were analyzed over the past four years, and compared with the adult and elderly groups.

Among all strains, the isolates collected from children and newborns from 2014 to 2017 accounted for 16.2%, 13.8%, 15.3% and 16.3%, respectively. The proportions of gram-positive bacteria among strains isolated from children and newborns, which were apparently higher than that of the adult and elderly groups, were 42.6%, 44.3%, 45.8% and 45.5%, respectively. The top five isolates of gram-positive bacteria were Staphylococcus aureus, Streptococcus pneumoniae, coagulase-negative staphylococci, Enterococcus faecium and E. faecalis. The top five isolates of gram-negative bacteria were Escherichia coli, Klebsiella pneumonia, Haemophilus influenzae, Pseudomonas aeruginosa and Acinetobacter baumannii. The proportion of urine-derived bacteria isolated from children and newborns (6.1%-7.1%) was apparently lower than that of the adult and elderly groups, while sputum (49.2%-52.8%) and blood-derived (11.4%-13.8%) were higher than the adult group. The prevalence of cefotaxime-resistant E. coli and K. pneumoniae decreased from 58.3% to 52.0% and 51.2% to 45.0%, respectively. The prevalence of imipenem-resistant E. coli and K. pneumoniae increased from 1.2% to 1.9% and 5.6% to 8.8%, respectively. The prevalence of imipenem-resistant P. aeruginosa increased from 11.0% to 12.4%, however, the prevalence of imipenem-resistant A. baumannii decreased from 27.2% to 24.6%. The prevalence of methicillin-resistant S. aureus increased from 27.5% to 29.5%. The prevalence of vancomycin-resistant-E.faecalis/E.faecium decreased from 0.6% to 0.2% and 0.9% to 0.3%, respectively. The proportion of non-cerebrospinal fluid-derived penicillin-resistant S. pneumoniae decresed from 5.1% to 2.7%.

The prevalence of several drug-resistant bacteria isolated from children and newborns were decreasing, but the prevalence of imipenem-resistant E. coli, imipenem-resistant K. pneumoniae and methicillin-resistant S. aureus increased slowly. It is still necessary to strengthen antibiotics rational application management and hospital infection control, and maintain good practice in bacterial resistance surveillance work.

The scapula is a triangular flat bone located behind the thorax, and the front and back are surrounded by muscles. Therefore, scapula fracture is not common. However, with the rapid development of transportation industry, the incidence of scapula fracture caused by high energy injury has increased significantly^[1]。 Patients with scapular fracture are associated with obvious displacement of the fracture end and various degrees of combined injuries, including rib fracture, clavicle fracture, hemopneumothorax, brain contusion, skull fracture, proximal injury of upper limb, spinal fracture and spinal cord injury. The mortality rate of scapular fracture is 10% ~15%, and the death causes are mostly lung infection and head injury^[2,3,4]。 Body fractures of scapula with obvious displacement or angular deformity need surgical treatment, and general anesthesia is mostly used clinically^[5]。 At present, there are no reports of simple nerve block for scapular fracture surgery at home and abroad. The clinical data and anesthesia management of two cases of scapular fracture undergoing open reduction and internal fixation with simple nerve block in our hospital are retrospectively analyzed as follows.

A 47-year-old female was admitted to Peking Union Medical College Hospital on January 4, 2018 due to "dry mouth and eyes for 7 years, increased nocturia for 3 months, fatigue and multiple bone pain throughout the body for 1 month". The patient began to have dry mouth, dry eyes and flaky tooth loss 7 years ago. In the past 7 years, the denture was gradually replaced, and photosensitivity gradually developed, which was not diagnosed and treated. In the past six months, I feel that the above symptoms have obviously aggravated, without tears, and I need to take water when I eat dry food. In the past 3 months, nocturia increased with polydipsia, 6-7 times/night, without urgency and painful urination. One month ago, there was fatigue, pain in both lower limbs, pain when moving the right hip joint, squat and stand up, and difficulty climbing stairs; At the same time, there was pain in the right hypochondrium, which was obvious when the position was changed, and the pain numerical score (NRS) score was 6 to 7 (0 to 10). In the past 1 week, the pain site was shifted to the right to the axillary line position. Visit our hospital for further diagnosis and treatment. The patient denied skin rash, oral and vulvar ulcers. Since the disease, there has been no obvious change in appetite, constipation in the past 3 months, defecation once in about 5 to 6 days, and weight loss of about 5 kg. Past history, personal history, marriage, childbirth, menstrual history, and family history are no different.

A 38-year-old female was admitted to the Department of Internal Medicine, Jinshan Campus, Fujian Provincial Hospital on September 26, 2017 due to proteinuria found in physical examination for 1 month. Physical examination 1 month ago found urine routine: protein + +, occult blood + + +, red blood cells 16/μ L; Blood routine: white blood cells 5.21×10⁹/L, hemoglobin 88 g/L, platelets 152×10⁹/L; Blood biochemistry: albumin 35.4 g/L, urea nitrogen 8.45 mmol/L, serum creatinine 139 μ mol/L, uric acid 557.2 μ mol/L. There were no edema, oliguria, low back pain, macroscopic hematuria, rash, joint pain and oral ulcer. No previous special medical history. Personal History: Resident in Singapore, Housewives, No toxic and chemical exposure history. Have 1 son. Diagnosis: proteinuria to be examined, moderate anemia.

Diabetes is one of the earliest described diseases, but people's perception of it is long and tortuous. As early as 1500 BC, a manuscript from Egypt has written accounts of similar clinical manifestations of diabetes. In his book, Aretaeus of Cappadocia, an ancient Greek physician in the 2nd century BC, described the symptoms of diabetic patients and proposed the term diabetes. In the late 18th century, the British scholar John Rolle added "mellitus" (that is, "derived from honey") after diabetes. In this way, an ancient disease was given a new name-diabetes mellitus^[1]。

Inflammatory complex is a protein complex composed of various proteins in cells, which mainly exists in the cytoplasm of myeloid cells such as monocytes and macrophages. Its concept was first developed by Martinon et al.^[1]Proposed in 2002. The inflammatory complex is one of the fundamental units of the structure and function of the innate immune system, which can recognize or sense pathogen/injury-related molecular patterns, activate interleukin (IL) 1 β and IL-18, and mediate a range of immune responses^[2]。 The biological behavior of multiple tumors is associated with activated inflammatory complexes. Overexpression and sustained activation of nucleotide-binding oligomerization domain-like receptor family thermoprotein domain protein 3 (NLRP3) inflammasomes in melanoma and brain malignant gliomas suggest continued tumor progression^[3]。 This paper reviews the role of inflammatory complex in hematological malignancies and its research progress.

Uterine arteriovenous malformation (UAVM) refers to abnormal communication between the branches of the uterine artery and the uterine venous plexus that does not occur through the capillary network. The typical clinical manifestation of UAVM is irregular and uncontrollable massive vaginal bleeding without obvious inducement. If not treated in time, it can be life-threatening in severe cases^[1]。 UAVM accounts for 1% to 2% of reproductive system hemorrhage-related diseases^[2]。 UAVM can be divided into two types: congenital and secondary. Congenital UAVM is extremely rare. Due to the abnormal development of the primitive vascular structure in the embryonic period, the primitive plexiform structure persists, thus forming various arteriovenous malformations of different numbers and sizes^[3,4]。

On August 3-4, 2018, the 13th National Clinical Forum on the Diagnosis and Treatment of Helicobacter Pylori and Digestive Diseases and the 2nd National Summit Forum on the Integration of Traditional Chinese and Western Medicine of Helicobacter Pylori and Gastrointestinal Ecology were held in Beijing. Professor Hu Fulian of Department of Gastroenterology, Peking University First Hospital served as the chairman of the conference, and Professor Wang Huahong served as the executive chairman. The core contents of the conference are: (1) the release and interpretation of the National Consensus on the Integrated Treatment of Helicobacter Pylori-Related Diseases and Syndromes with Traditional Chinese and Western Medicine; (2) Advances in new therapeutic pathways for Helicobacter pylori; (3) 2018 Helicobacter Pylori Youth Forum and Case Sharing.