[Clinical characteristics of 42 children with focal atrial tachycardia originated from the right atrial appendage].

Objective: To investigate the feature and treatment of atrial tachycardia (AT) originated from right atrial appendage (RAA) in children. Methods: The data of 42 children with AT originated from RAA, who were admitted the First Hospital of Tsinghua University from January 2010 to September 2022 were analyzed retrospectively.The clinical characteristics, treatment and efficacy were analyzed. The children were divided into tachycardia cardiomyopathy group and normal cardiac function group. The differences in the ablation age and the heart rate during AT between two groups were compared by independent sample t-test. Results: Among 42 children, there were 20 males and 22 females. The age of onset was 2.7 (0.6, 5.1) years. Their age at radiofrequency ablation was (6.5±3.6) years, and the weight was (23.4±10.0) kg. Thirty-two children (76%) had sustained AT. The incidence of tachycardia cardiomyopathy was 43% (18/42). Compared to that of the normal cardiac function group, the ablation age and the heart rate at atrial tachycardia of the tachycardia cardiomyopathy group were higher ((8.1±3.8) vs. (5.3±3.1) years, t=-2.63, P=0.012; (173±41) vs. (150±30) beats per minute, t=-2.05, P=0.047. Thirty-eight children (90%) responded poorly to two or more antiarrhythmic drugs. The immediate success rate of radiofrequency ablation (RFCA) was 57% (24/42), and the AT recurrence rate was 17% (4/24). Twenty-two children underwent RAA resection, and their AT were all converted to sinus rhythm after the surgery. During the RAA resection, 10 cases of right atrial appendage aneurysm were found, 9/18 of which failed the RFCA. Conclusions: The AT originated from the RAA in children tend to present with sustained AT, respond poorly to antiarrhythmic drugs, and has a low success rate of RFCA as well as high recurrence rate. Resection of the RAA is a safe and effective complementary treatment.

[The clinical value of classification of hilar cholangiocarcinoma based on actual anatomy].

Objective: To examine the significance and prognostic value of the classification of hilar cholangiocarcinoma based on actual anatomical location. Methods: A retrospective study was conducted including 120 patients of hilar cholangiocarcinoma treated at the Second Affiliated Hospital,Zhejiang University School of Medicine and Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2019 to December 2021. Patients with hilar cholangiocarcinoma were classified for seven types according to the site of tumor location. The clinicopathological and prognostic data of 120 patients were retrospectively analyzed(There were 57 males and 63 females,the age (M(IQR)) was 61(22)years(range:42 to 85 years)). All patients received radical resection without visible intraoperative tumor residue and negative bile duct resection margin according to intraoperative pathological biopsy. The classification variables were analyzed by Pearson χ2 test or Fisher's exact probability test,one-way ANOVA or Kruskal-Wallis rank sum test.Kaplan-Meier method was used for survival analysis. Cox proportional risk model was used for prognostic factors. Results: The coincidence rate of preoperative surgical planning and actual operational styles was verified in 33 cases. Twenty-six cases were consistent,and 7 cases were inconsistent,with a coincidence rate of 78.8%. According to the actual anatomical location,patients in type of secondary branch experienced a significantly longer operation duration,a higher portal vein resection rate,margin positive rate and more advanced T stage(all P<0.05). The median overall survival time of the unilateral main trunck group was 27.0 months,and the bilateral group was 17.0 months. Survival analysis based on the tumor classification of the actual anatomical location showed that the unilateral or main trunck group predicted less aggressive clinical features and favorable outcomes(HR=1.931,95%CI:1.066 to 3.499,P<0.05). Multivariate analysis demonstrated that the actual anatomical location of the tumor type(HR=2.269,95%CI:1.333 to 3.861,P=0.003),combined liver resection(HR=0.464,95%CI:0.253 to 0.848,P=0.013) and N stage(HR=6.317,95%CI:3.083 to 12.944,P<0.01) were independent factors affecting the prognosis of patients. Conclusion: The classification based on the actual anatomy can be used as a promising scheme in refining patient stratification and predicting survival in hilar cholangiocarcinoma,and it can guide the selection of surgical methods,and predict operative safety and radical resection rate.

[Clinical characteristics and prognostic analyses of cervical neuroblastoma].

Objective: To determine the characteristics of cervical neuroblastoma and the effect of resection extent on survival and outcomes. Methods: We performed a retrospective review of 32 children with cervical neuroblastoma treated at Beijing Children's Hospital between April 2013 and August 2020. Data were collected from the medical record. The individualized therapy was designed based on staging and risk group. Based on the extent of resection, patients were divided into incomplete and complete resection groups. Event free and overall survival rates were compared between two groups using the Kaplan-Meier method. Results: The ages of patients ranged from 1 month to 81 months, with a median age of 11 months, including 7 males and 15 females. Twenty-nine patients (90.6%) presented with cervical painless mass. The average diameter of the primary tumors was (5.12±1.43) cm. Tumors were located in the parapharyngeal space in 25 cases (78.1%) and in the root of the neck in 7 cases (21.9%). None had MYCN amplification. According to International Neuroblastoma Staging System (INSS), 15 patients (46.9%) were identified as stage 1, 11 patients (34.3%) as stage 2B, 3 patients (9.4%) as stage 3 and 3 patients (9.4%) as stage 4. There were 12 patients (37.5%) at low risk, 17 patients (53.1%) at intermediate risk and 3 patients at high risk according to Children's Oncology Group (COG) risk classification system. All patients underwent tumor resection. Postoperatively Horner's syndrome occurred in 13 patients (40.6%), pneumonia in 9 patients (28.1%), pharyngeal dysfunction in 8 patients (25.0%) and transient hoarseness in 4 patients (12.5%). At a median follow-up of 36.5 months, the overall survival rate was 96.4%, with no significant difference between incomplete and complete resection groups (100.0% vs. 96.3%, χ2=0.19, P=0.667); the event free survival rate was 78.1%, with a significant difference between the two groups (40.0% vs. 85.2%, χ²=6.71, P=0.010). Conclusions: Primary cervical neuroblastoma has a young onset age, mostly in low and medium risk groups, and represents favorable lesions with good outcomes after multidisciplinary therapy. Less aggressive surgery with preservation of important structures is recommended. Complete resection should not be attempted if it would compromise vital structures.

[Long-term outcome of 48 unoperated adult patients with Ebstein's anomaly].

Objective: To analyze the long-term outcome of unoperated Ebstein's anomaly (EA) patients aged over 18 years, and to evaluate the related factor of outcomes. Methods: The data of 48 unoperated EA patients from March 2004 to December 2008 in the First Hospital of Tsinghua University, were analyzed. The clinical data of the patients were collected, and patients received regular echocardiography, ECG and chest X-ray examinations. Septal leaflet attachment ratio (SLAr) was calculated based on transthoracic echocardiography imagines. The patients were divided into 3 groups according to SLAr: SLAr<0.45 (n=18), 0.45≤SLAr≤0.60 (n=21) and SLAr>0.60 (n=9). Chest X-ray was used for measurement of cardiothoracic ratio (CTR). Kaplan Meier survival curve was used to calculate the long-term survival rate. Cox proportional hazards regression model was used to analyze the influencing factors of death. Results: There were 19 males, and the mean age at diagnosis was (21.3±11.1) years. Forty-two patients (87.5%) were complicated with arrhythmia, including W-P-W syndrome (n=4), supraventricular tachycardia (n=16), right bundle branch block (n=37), and atrial fibrillation (n=2). The mean duration of follow-up was (148.8±16.8) months, the follow-up rate was 100% with no loss-to-follow up. Nine cases (18.8%) died during follow-up: 6 cases (12.5%) died of cardiac origin, including 3 cases of heart failure, 1 case of arrhythmia, and 2 cases of sudden death; 1 case died of accident; 2 cases died from unknown causes. During the follow-up period, the survival rates were 17/18, 19/21 (90.5%) and 3/9 in the SLAr<0.45, 0.45≤SLAr≤0.60 and SLAr>0.60 group, respectively. According to Kaplan-Meier survival curve, the 5-year survival rates among the three groups were 100%, 100% and 78%, respectively. The 10-year survival rates among the three groups were 94%, 95% and 44%, respectively. Decreased activity tolerance and heart failure were found in 7 patients (6 patients in SLAr>0.60 group and 1 patient in 0.45≤SLAr≤0.60 group). Two patients had cerebrovascular embolism. There were 3 cases with tachyarrhythmia lasting more than 24 hours. Cox regression analysis showed that the risk of death was higher in patients with SLAr>0.60 than in patients with SLAr<0.45 (HR=12.375, 95%CI 1.692-22.146, P=0.015); the risk of death in patients with CTR≥0.65 was 1.306 times higher than that in patients with CTR<0.65 (HR=1.306, 95%CI 0.417-12.754, P=0.038). Conclusions: EA patients often combines with arrhythmia. For unoperated EA patients, SLAr>0.60 and CTR≥0.65 are risk factors of death. EA patients with arrhythmia should be actively treated with drugs or radiofrequency ablation.

[Transthoracic implantation of dual-chamber pacemaker for synchronous treatment of cardiac dysfunction due to idiopathic complete left bundle branch block in children].

Objective: To investigate the efficacy and feasibility of transthoracic implantation of permanent left atrial and left ventricular dual-chamber pacemaker for synchronous treatment of cardiac dysfunction due to idiopathic complete left bundle branch block (CLBBB) in children. Methods: The clinical data of five children with cardiac dysfunction due to idiopathic CLBBB and accepting implantation of permanent left atrial and left ventricular epicardial dual chamber pacemaker from January 2015 to July 2019 at the Pediatric Cardiologic Department of the First Hospital of Tsinghua University were analyzed retrospectively. The effects of pacemaker implantation on patients' cardiac function and cardiac synchrony were evaluated by echocardiogram. Results: Among 5 patients, 2 were males and 3 females. At the time of pacemaker implantation, the age of these patients was 0.5-5.7 years, the left ventricle ejection fraction (LVEF) was 29%-46%, the left ventricle end stage of diastolic diameter was 30-53 mm and the mean Z score was 4.0-34.0. Pacemaker was successfully implanted for all the patients. After the implantation, medications that can suppress atrioventricular node conduction were used and sensed atrioventricular delay (SAV) parameters were modulated until patients' QRS duration became shortest and the percentage of left ventricular pacing increased to and maintained at 97% to 100%. Patients' QRS duration was 120-160 ms before implantation and 90-120 ms after implantation. Patients' cardiac function began to improve 1 day to 1 month after implantation. Patients' cardiac function normalized after a mean of 1-12 months. LVEF increased from 29%-46% to 55%-67%. During the follow-up, interventricular mechanical delay, septal-to-posterior wall motion delay, and left ventricular systolic dyssynchrony index decreased significantly: IVMD decreased from 31-62 ms to 26-50 ms; SPWMD decreased from 40-63 ms to 10-50 ms and Ts-SD decreased from 34.3-50.3 ms to 16.3-31.4 ms. The global longitudinal strain of left ventricle decreased from -7.7%--13.8% to -13.5%--20.3%. Conclusion: Cardiac dysfunction due to CLBBB in children can be treated with transthoracic implantation of permanent epicardial left atrial and left ventricular dual chamber pacemaker which can substitute three chamber pacemaker to achieve the effects of synchronous therapy that lead to reversion and normalization of cardiac function.

[Clinical analysis of right atrial appendage aneurysms complicated by atrial tachyarrhythmias in three children].

Objective: To investigate the clinical features and results of treatment for right atrial appendage aneurysms complicated by atrial tachyarrhythmias in children. Methods: This retrospective study included three children with right atrial appendage aneurysm complicated by atrial tachyarrhythmias (aged 1.0 to 5.3 years, weight 10 to 17.1 kg) who were hospitalized at the Pediatric Cardiology Department (Heart Center) of the First Hospital of Tsinghua University (Beijing Huaxin Hospital) during the period from January 2016 through April 2018. The patients' clinical features, the results of electrocardiogram (ECG) and echocardiography, the effects of therapeutic interventions (antiarrhythmics, radiofrequency ablation, and surgical resection of right atrial appendage aneurysm) and the results of pathological assessment were analyzed. Results: Three cases of right atrial appendage aneurysm were diagnosed at 36 weeks of gestational age, 1 month and 4 months after birth respectively. In two cases, ECG showed alternating episodes of atrial tachyarrhythmias including atrial tachycardia, atrial flutter, and atrial fibrillation, and echocardiography showed aneurysmal dilatation of right atrial appendage. These two cases underwent right atrial appendage aneurysm resection. In the remaining one case of atrial tachycardia, echocardiography did not visualize important lesions in the right atrium, thus the intracardiac electrophysiologic study and radiofrequency ablation were performed; and focal atrial tachycardia originating from the apex of right atrial appendage was mapped but failed to be ablated; consequently, the patient received the right atrial appendage resection, in which the right atrial appendage aneurysm was found. Preoperative multiple antiarrhythmics showed only modest or no efficacy for all the three cases. The atrial tachyarrhythmias disappeared in all the three cases after right atrial appendage aneurysm resection. Postoperative atrial tachycardias associated with new foci of impulse formation developed in two cases. These two patients reverted to normal sinus rhythm and remained in this rhythm by using antiarrhythmics. Pathological assessment showed cystic dilation of parts of atrial cavity, fibrosis of cyst wall, generalized fibrosis of atrial myocardium combined with myocardial atrophy and cystic dilation, as well as uneven myocardial thickness with generalized myocardial interstitial fibrosis. Conclusions: For patients with congenital right atrial appendage aneurysm, atrial tachyarrhythmias might develop during fetal stage or early postpartum period. Reliance on echocardiography might often lead to the missed diagnosis. These patients with atrial tachyarrhythmias responded poorly to antiarrhythmics. Radiofrequency ablation might be associated with a high risk and limited efficacy. Surgical resection of right atrial appendage aneurysm showed satisfactory results and should be highly recommended.

[The outcomes of operation for 237 patients with Ebstein anomaly].

Objective: To evaluate the early and long-term outcomes cardiac surgery of patients with Ebstein anomaly. Methods: The clinic data of 237 patients with Ebstein anomaly received surgical procedures from March 2004 to December 2017 at Department of Cardiac Surgery, First Hospital of Tsinghua University was analyzed retrospectively. There were 105 male and 132 female patients with age of (19.4±16.7) years (ranging from 3 months to 64 years). The surgical procedures include anatomical repair in 188 patients, one and a half ventricle repair in 37 patients, tricuspid valve repair in 4 patients, tricuspid valve replacement in 10 patients, and Fontan procedure in 3 patients (total cavopulmonary connection in 2 patients; Glenn procedure in 1 patient). Results: The early mortality was 2.1% (n=5). One case of atrioventricular (0.4%) newly occurred. There were 228 patients available to follow-up. The range of follow-up duration was 3 to 168 months. Late survival was 99.1% (2 cases of late death) at 10 years. Three patients received reoperation (1.3%), including tricuspid valve repair of 1 patient and one and a half ventricle repair of 2 patients). Indication of tricuspid valve regurgitation improved from 3.6±0.3 to 1.5±0.4. Survival rate at 5 and 10 years was 98.6% and 98.2%, respectively. Conclusions: The principle of the techniques is to reconstruct the tricuspid valve and right ventricle anatomically. For most cases, the anatomical repair was demonstrated with low mortality, less complications and excellent durability at long-term follow-up. If the tricuspid valve is severely hypoplastic, one and a half ventricle repair and valve replacement may be alternatie.

[The difference expression and diagnostic value of RPL5 in papillary thyroid carcinoma of children and adults].

Objective: To study the difference expression and diagnostic value of ribosomal protein L5 (RPL5) in papillary thyroid carcinoma (PTC) of children and adults. Methods: Realtime-PCR was performed to detect the expression of RPL5 in 22 PTC tissues and 13 pericarcinous tissues. Receiver operating characteristic (ROC) curve and Youden's index were used to evaluate the diagnostic value of RPL5 in PTC of children and adults. Results: The expression of RPL5 in PTC tissues was higher than in pericarcinous tissues. The area under curve (AUC) was 0.820 (P=0.001), and Youden's index was 0.568. The expression of RPL5 in PTC of adults was higher than children (P<0.05). The AUC and Youden's index were respectively 0.721 (P=0.069) and 0.414 in children, whereas being respectively 0.896 (P=0.0005) and 0.709 in adults. RPL5 in diagnosis of PTC of adults was better than CK19, Galectin-3 and TPO, which are commonly used for the pathologic diagnosis of PTC. Conclusion: The expression of RPL5 in PTC is higher than pericarcinous tissues, and its expression in PTC of adults is higher than children. Furthermore, PTC is a potential indicator for diagnosis of PTC.

Changes in the activity and the expression of detoxification enzymes in silkworms (Bombyx mori) after phoxim feeding.

Silkworm (Bombyx mori) is an economically important insect. However, non-cocoon caused by chemical insecticide poisoning has largely hindered the development of sericulture. To explore the roles of detoxification enzymes in B. mori after insecticide poisoning, we monitored the activity changes of cytochrome P450 monooxygenase, glutathione-S-transferase, and carboxylesterase in B. mori midgut and fatbody after phoxim feeding. At the same time, the expression levels of detoxification enzyme-related genes were also determined by real-time quantitative PCR. Compare to the control levels, the activity of P450 in the midgut and fatbody was increased to 1.72 and 6.72 folds; the activity of GST was no change in midgut, and in fatbody increased to 1.11 folds; the activity of carboxylesterase in the midgut was decreased to 0.69 folds, and in fatbody increased to 1.13 folds. Correspondingly, the expression levels of detoxifying enzyme genes CYP6ae22, CYP9a21, GSTo1 and Bmcce were increased to 15.99, 3.32, 1.86 and 2.30 folds in the midgut and to 3.58, 1.84, 2.14 and 4.21 folds in the fatbody after phoxim treatment. These results demonstrated the important roles of detoxification enzymes in phoxim metabolism. In addition, the detected activities of such enzymes were generally lower than those in cotton bollworms (Helicoverpa armigera), which may contribute to the high susceptibility of B. mori to insecticides. Our findings laid the foundation for further investigations of the molecular mechanisms of organophosphorus pesticide metabolism in B. mori.

Estimation of atmospheric mixing heights over large areas using data from airport meteorological stations.

For this study, ground and sounding meteorological data at 16 airports were used for estimating the atmospheric mixing heights in Hebei Province of China, including Beijing and Tanjing areas. Three methods were compared for this purpose, which are the dry adiabatic method, the conventional Nozaki model, and a modified Nozaki model. The feasibility of using airport meteorological data to determine mixing heights in large area was verified through the use of measured mixing heights and observed SO2 vertical profiles. The study not only estimated the mixing heights over large areas but also compared different early morning sounding temperature profiles to identify feasibility of using 2:00 a.m. sounding profiles to estimate mixing height by the dry adiabatic method. The paper also described the mixing heights over different areas such as mountain, sea boundary and plain areas. The results have considerable significance for air quality prediction and environmental management. A novel approach to estimation of atmospheric mixing heights over large area is introduced, requiring only the input of readily available airport meteorological data.

ESTIMATION OF ATMOSPHERIC MIXING HEIGHTS OVER LARGE AREAS USING DATA FROM AIRPORT METEOROLOGICAL STATIONS.

For this study, ground and sounding meteorological data at 16 airports were used for estimating the atmospheric mixing heights in Hebei Province of China, including Beijing and Tanjing areas. Three methods were compared for this purpose, which are the dry adiabatic method, the conventional Nozaki model, and a modified Nozaki model. The feasibility of using airport meteorological data to determine mixing heights in large area was verified through the use of measured mixing heights and observed SO2 vertical profiles. The study not only estimated the mixing heights over large areas but also compared different early morning sounding temperature profiles to identify feasibility of using 2:00 a.m. sounding profiles to estimate mixing height by the dry adiabatic method. The paper also described the mixing heights over different areas such as mountain, sea boundary and plain areas. The results have considerable significance for air quality prediction and environmental management. A novel approach to estimation of atmospheric mixing heights over large area is introduced, requiring only the input of readily available airport meteorological data.

[Clinical observation on multiple organ dysfunction syndrome due to fish gall bladder poisoning].

OBJECTIVE: To study the functional changes of liver, kidney, myocardium and gastro-intestine after fish gall bladder poisoning and the pathogenic mechanism of acute renal failure. METHODS: The liver and kidney function, myocardial enzyme, urinary N-acetyl-beta-D-glucosaminidase (N-AG), 24 hrs intake and output volume of liquid and kidney B-ultrasonographic examination in 11 patients of severe acute fish gall bladder poisoning were observed. And kidney biopsy was carried out in one patient under B-ultrasonography for understanding the renal pathological changes. RESULTS: All the 11 patients were cured with disappearance of clinical symptoms. After the poisoning the order of the severity of organ damage were kidney, liver, myocardium and gastro-intestine tract. The levels of blood creatinine, blood urea nitrogen, urinary N-AG, glutamic-pyruvic transaminase, total bilirubin were lowered significantly after treatment. Biopsy examination under light microscope showed toxic damage of renal tubules mainly in proximal tubules, and under electron microscope, the pathologic changes were mitochondrial vacuolar degeneration of tubular epithelial cells, swelling of epithelial cells, partial fusion of processes in glomeruli and narrowing of saccular cavity. CONCLUSION: Fish gall bladder poisoning could cause acute multiple organ dysfunction syndrome (MODS), the affected organs in order of severity of damage were kidney, liver, myocardium and gastro-intestine tract. In kidney the damage was mainly at the proximal tubules. Urinary NAG is a sensitive criterion for determining the diagnosis and prognosis of renal tubular dysfunction.

[Study on experimental parameters for diagnosing ganyang huafeng syndrome of cerebral infarction].

One hundred patients with cerebral infarction were observed, the results showed that Ganyang Huafeng Syndrome (GYHFS) was the major syndrome of acute cerebral infarction which was accounted for 60% and Qiyin Liangxu Syndrome (QYLXS), Qixu Xueyu Syndrome (QXXYS) were mainly observed at convalescent stage of this disease which was accounted for 37.78% and 31.11% respectively. This study chose plasma norepinephrine (NE), epinephrne (E), thromboxane B2(TXB2), 6-keto-PGF1 alpha, cortisol (F) and serum triiodothyroidoglobulin (T3) as the monitoring parameters, and the results showed that the increase of plasma NE,F,TXB2, the decrease of serum T3 could be considered as the comprehensive experimental parameters for diagnosing GYHFS of cerebral infarction.

[Analysis of nucleotide level of human erythrocytes in patients with liver-fire exuberance syndrome].

Level of erythrocytes in 30 patients with Liver-Fire Exuberance Syndrome (LFES) was observed, and that of 30 healthy persons was determined in the meantime as control by high-performance liquid chromatography. It was found that the adenosine triphosphate in erythrocytes of LFES patients was lower and level of adenosine monophosphate was higher than that of healthy persons. While, the levels of adenylate pool and energy load ratio were lower than that of control. These results showed the metabolism was exuberant, the energy consumption increased and the energy storage reduced in patients of LFES.

[Pathophysiological basis of 3 subtypes in ganfeng neidong syndrome].

The multiple parameters of 3 Subtypes: Ganyang Huafeng Syndrome (GYHFS), Xuexu Shengfeng Syndrome and Yinxu Fengdong Syndrome of Ganfeng Neidong Syndrome were determined for the 1st time. It was found that there were several characteristics in GYHFS. (1) Disturbance of the cerebral blood flow and the damage of brain tissue was manifested by the abnormality of the bulbar conjunctival microcirculation, carotid Doppler ultrasonic determination and brainstem auditory and visual pathway, high blood viscosity, dysmnesia, free radical and lipid peroxidation injury and the changes of Zn, Cu, K and Mg after brain damage. (2) Stress status were expressed by the high plasma levels of cortisol, norepinephrine and epinephrine, decreased serum triiodothyronine level and hyperfunction of sympathetic nerve. (3) The marked changes of the regulating substance of the vessel smooth muscle function including the increased plasma levels of TXB2, TXB2/6-k-PGF1 alpha, and calmodulin, as well as decreased SP, ANP, CGRP. Other 2 subtypes had about the same changes of these parameters, but of milder disorders.

[Treatment of peptic ulcer with jian-wei yu-wang tablets].

This article reports the results of second stage clinical trial on the treatment of peptic ulcer with jian-wei yu-yang (JWYY) tablets in comparison with a control group treated with ranitidine. The results showed that the cure rate for JWYY tablet group was 62.4% and its effective rate was 93. 8% in 354 cases, whereas the cure rate of the control group was 50.7% and its effective rate was 86. 4% in 140 cases. The differences between these two groups were highly significant (P less than 0.01). Based on syndrome differentiation, optimal effect was reached in treating liver stagnation and spleen deficiency syndrome and disharmony of liver and stomach syndrome. After one year follow up studies of the therapeutic effect, the recurrence rate of the JWYY tablet group was 17.7%, while that of the ranitidine group was 54.1%. In addition, JWYY tablet had no side-effects. These data indicated that JWYY tablets were a more effective therapeutic remedy for peptic ulcer.