Objective Antibiotic resistance has increasingly been recognized as the major cause of treatment failure for Helicobacter pylori infection. The study was designed to compare the propensity of Helicobacter pylori to develop in vitro resistance to five commonly used antibiotics and to investigate the rates of resistance to these five antibiotics. Methods The serial passage tests were done in 7 sensitive Helicobacter pylori strains (2 type strains and 5 clinical isolates) to induce the resistance to amoxycillin, tetracycline, furazolidone, metronidazole or clarithromycin in vitro. The agar dilution tests detecting the minimal inhibitory concentration (MIC) were performed in 165 strains of Helicobacter pylori isolated from 2000 to 2001 to determine the resistance rates to the 5 antibiotics mentioned above. Results Serial passage tests showed that 5 of 7 strains of Helicobacter pylori were induced to be resistant to metronidazole and tetracycline; the inducible multiple of metronidazole was the highest. No strain was induced to be resistant to clarithromycin, but the inducible multiple of one strain was relatively high. No strain was induced to be resistant to amoxycillin or furazolidone, and the inducible multiple of furazolidone was the lowest. The resistance rates of Helicobacter pylori to metronidazole, clarithromycin, amoxycillin, tetracycline and furazolidone were 49.7% (82/165), 7.3%(12/165), 1.2% (2/165), 2.4%(4/165) and 1.2%(2/165), respectively. Conclusions Our study indicate that it is quite easy to induce the resistance to metronidazole,not difficult to clarithromycin, and relatively difficult to furazolidone or amoxycillin. The relative degree of difficulty in inducing the resistance to the drugs other than tetracycline is associated with the resistance rates detected, the fact that may help predict the changing trend of resistance rates in general population.

Objective To study the feasibility and timing of early laparoscopic cholecystectomy (LC) for the patients with mild-to-moderate acute pancreatitis with gallbladder stone.Methods 26 patients with mild-to-moderate acute pancreatitis with gallbladder stone underwent early laparoscopic cholecystectomy.The patients were initially treated with conservative treatment.When the diagnosis was confirmed and the patients were stable,LC was carried out within 48 hours of hospitalization.The results were compared with a delayed group of patients who received delayed LC for acute pancreatitis.Results All the LC operations were successfully carried out.There were no significant differences between the two groups in alkaline phosphatase,alanine aminotransferase,aspartate aminotransferase,blood amylase and urine armylase on postoperative day 1,3,5,7.Patients who received early laparoscopic cholecystectomy had a shorter hospital stay.There were no significant differences between the two groups in the operation time,intraoperative blood loss,postoperative complication rates and recurrence of acute pancreatifis.Conclusion After CBD stones have been ruled out,it is safe and feasible to carry out early laparoscopic cholecystectomy within 48 hours of hospital admission for patients with mild-to-moderate acute pancreatitis with gallbladder stone.

ObjectiveTo approach the status of leprosy disabilities in newly detected cases in recent 11 years in China.MethodsBased upon the records from the National Leprosy Recording and Reporting System in National Center for STD and Leprosy Control, 24128 leprosy cases detected during 1989-1999 in China were analyzed in terms of leprosy disbility.ResultsThe proportion of disabilies in newly detected leprosy cases in 1989 in whole country was 46.49% and decreased to 32.7% in 1999, and the proportions of cases with grade Ⅱ disabilities were 25.55% (1989) and 22.06% (1999). There were 19 provinces where disability rate was more than 40%. Out of patients with disabilities, those with grades Ⅰ and Ⅱ disabilities and with deformities (loss of eyebrow, facial paralysis or saddle nose) accounted for 37.54%, 61.04% and 1.42%, respectively. There were 20 provinces where grade Ⅱ disabilities accounted for more than 50% of all patients with disabilities. The disability rates in patients aged under 15 years, 15-65 years and over 65 years were 24.74%, 39.3% and 53.33%. The patients with a delay in detection of 2 years had a disability rate of 28.95%, and those with a delay of more than 2 years and 5 years had the rates of 48.06% and 60.95%, respectively. The disability rate was 53.76% in patients with leprosy reactions. The grade Ⅱ disability rate in paucibacillary patients (28.53%) was significantly higher than that in multibacillary ones (22.03%). Conclusions Disability rate of leprosy in newly detected cases is still high although it has decreased in the recent 11 years. The rate is associated with delay in detection, leprosy reaction and leprosy type. It suggests that early detection of leprosy patients, regular treatment with multidrug therapy, and management of leprosy reactions will be the effective measures to prevent disabilities of leprosy.

ObjectiveTo investigate the pharmacokinetic characteristics of sofosbuvir tablets, and to evaluate the bioequivalence and safety of two preparations. MethodsHealthy volunteers were recruited through the platform of clinical trial recruitment in The Affiliated Hospital of Changchun University of Chinese Medicine. Screening physical examination was performed for fasting group on September 18, 2018 and for postprandial group on September 28, 2018, and the volunteers were enrolled after their physical examination results met the inclusion criteria. The fasting group and the postprandial group, with 40 volunteers in each group, were given oral administration of the test preparation sofosbuvir tablets or the reference preparation sofosbuvir tablets (SOVALDI, 400 mg). This was a randomized, open-label, two-sequence, four-cycle, single-dose, and completely repeated cross-over bioequivalence test in the fasting or postprandial state in the healthy population; in the fasting group, 20 volunteers each received oral administration of the test preparation and the reference preparation, and in the postprandial group, 20 volunteers each received oral administration of the test preparation and the reference preparation. Liquid chromatography-tandem mass spectrometry was used to measure the content of sofosbuvir and its major metabolite GS-331007 in human EDTA-K2 plasma; the plasma concentration of sofosbuvir was measured at 15 time points from 0 hour to 8 hours after administration, and that of GS-331007 was measured at 16 time points from 0 hour to 72 hours after administration. WinNonlin software was used to calculate pharmacokinetic parameters and evaluate bioequivalence. ResultsAfter the administration of the test preparation and the reference preparation in the fasting state, when the pharmacokinetic parameters of sofosbuvir was used to evaluate the bioequivalence of the test preparation and the reference preparation, the ratios of the geometric means of Cmax, AUC0-t, and AUC0-inf were 90.55%, 97.26%, and 94.62%, respectively; when the pharmacokinetic parameters of GS-331007 was used to evaluate the bioequivalence of the test preparation and the reference preparation, the ratios of the geometric means of Cmax, AUC0-t, and AUC0-inf were 98.91%, 98.98%, and 99.46%, respectively. All of the above values were within the range of 80.00%-125.00%. An analysis of variance was performed after the pharmacokinetic parameters of sofosbuvir Cmax, AUC0-t, and AUC0-inf were transformed by natural logarithm, and the results showed that sequence, cycle, and preparation had no marked influence on Cmax, AUC0-t, and AUC0-inf (all P＞0.05). ConclusionThe test preparation of sofosbuvir tablets is bioequivalent to the reference preparation in the fasting and postprandial states.

Objective:To investigate the efficacy and safety of rivaroxaban combined with antiplatelet in ischemic stroke patients with non-valvular atrial fibrillation and moderate or severe intracranial artery stenosis.Methods:The consecutive ischemic stroke patients with non-valvular atrial fibrillation and moderate or severe intracranial artery stenosis admitted to Yantai Yuhuangding Hospital of Qingdao University from August 2019 to March 2022 were retrospectively included. According to the secondary prevention drugs, the patients were divided into rivaroxaban and rivaroxaban combined with antiplatelet treatment group. The basic characteristics of the two groups were compared. The primary outcome was the recurrence rate of stroke at 3 months, and the secondary outcome included the incidence of any bleeding event at 3 months, the all-cause mortality rate, the improvement rate of neurological function, and the good outcome rate. The good outcome was defined as the modified Rankin Scale ≤2 points at 3 months.Results:A total of 108 patients aged 70.72±8.08 years old were included in the study. There were 56 patients (51.9%) in the rivaroxaban group and 52 (48.1%) in the combined treatment group. In terms of primary outcome, the recurrence rate of stroke in the combined treatment group was significantly lower than that in the rivaroxaban group at 3 months (7.69% vs. 21.43%; P<0.05). In terms of secondary outcomes, the incidence of bleeding events in the combined treatment group at 3 months was significantly higher than that in the rivaroxaban group (26.92% vs. 7.14%; P<0.05), with one death event in each group. The rate of good outcome in the combined treatment group was significantly higher than that in the rivaroxaban group (75.00% vs. 51.79%; P=0.013). Multivariate logistic regression analysis showed that high National Institutes of Health Stroke Scale (NIHSS) score at admission was an independent risk factor for poor outcome (odds ratio 1.370, 95% confidence interval 1.057-1.776; P=0.018), while the rivaroxaban combined antiplatelet treatment was an independent protective factor for stroke recurrence (odds ratio 0.203, 95% confidence interval 0.054-0.758; P=0.018). Conclusion:After ischemic stroke in patients with non-valvular atrial fibrillation complicated with moderate and severe stenosis of intracranial artery, rivaroxaban combined with antiplatelet treatment can reduce the recurrence rate of stroke and improve the clinical outcome, but it may increase the risk of bleeding.

Objective This study aimed to evaluate the influence of ceramic type and thickness on the masking abili-ty and final aesthetic effects of chairside machinable all-ceramic crowns.Methods Six kinds from three types chairside machinable ceramic materials(IPS e.max CAD HT/MT/LT,IPS Empress LT,and VITA Suprinity HT/T)in shade A2 were fabricated to slice specimens into 1.0,1.5,and 2.0 mm-thick sections(n=10).The color parameters of the speci-mens against black and white tiles and four resin substrates(A2,A4,B3,and C4 shade)were measured with a spectro-photometer.The translucency parameter(TP)was calculated using color parameters measured over standard white and black backgrounds.The color differences(ΔE)were cal-culated between there substrate shades(A4,B3,C4)and A2 shade(control group).Two-way analysis of variance(ANOVA)was performed on the TP values.The two va-riables were ceramic type and ceramic thickness.Three-way ANOVA was used to determine the effects of ceramic materials,ceramic thickness,and substrate shades on the ΔE values,followed by Tukey test for multiple comparisons(α=0.05).Results Ceramic type,ceramic thickness,and sub-strate shade significantly affected the ΔE values(P<0.001).The L* and b* values of the specimens increased with in-creasing ceramic thickness,except in substrate A2,whereas the ΔE values decreased.The color difference of all 1.0 mm-thick specimens or all specimens over the substrates C4 shade exceeded the clinically acceptable threshold(ΔE>3.3).Conclusion The masking ability of chairside machinable all-ceramic crowns is influenced by ceramic type and thick-ness,and ceramic material.The thickness of ceramic less than 2.0 mm cannot mask the gray shade abutment.

Objective:To investigate the effects of preoperative oral high glucose solution on postoperative recovery, homeostasis model assessment-insulinresistance and high sensitivity C-reactive protein level in patients with gastric cancer.Methods:A total of 83 patients with gastric cancer diagnosed and treated in Hefei Hospital of Anhui Medical University from Jan. 2018 to Jun. 2020 were selected and divided into study group (42 cases) and control group (41 cases) according to whether or not they were given oral glucose solution before operation. In the first 4 hours, 500 ml of 10% glucose solution (glucose solution, GS) was taken orally, and the control group did not take it before surgery. The postoperative recovery (time of first exhaust after operation, time of first defecation, length of hospitalization after operation) , postoperative complications, HOMA-IR and serum hsCRP levels between the two groups were observed and compared.Results:The two groups had very small differences in general information such as gender, age, BMI, TNM staging, and surgical methods ( P>0.05) . In comparison of HOMA-IR index, before treatment, the difference of HOMA-IR index between the two groups was small ( P>0.05) ; after treatment, the difference of HOMA-IR index between the two groups increased (1.80±0.45 vs 5.65±1.46 for the study group before and after treatment, 1.92±0.43 vs 11.70±3.05 for the control group before and after treatment) , and the HOMA-IR index of the control group was higher than that of the study group ( P<0.05) . In comparison of hsCRP levels, before treatment, there was little difference in hsCRP levels between the two groups ( P>0.05) ; after treatment, hsCRP levels in the two groups increased (1.23±0.90 vs 40.40±27.05 for the study group before and after treatment, and 1.40±1.15 vs 80.05±38.85 for the control group before and after treatment) , and the hsCRP level of the control group was higher than that of the study group ( P<0.05) . In terms of postoperative recovery, the study group’s first exhaust time, first defecation time, and postoperative hospital stay were significantly shorter than those of the control group [ (3.35±0.50, 4.05±0.50, 14.65±1.90) vs (4.30±0.90, 5.70±1.15, 16.15±2.05) , P<0.05]. In comparison with postoperative complications, the total incidence of postoperative gastric bleeding, anastomotic leakage, intestinal obstruction, and other complications was 11.9% for the study group and the total incidence of complications was 14.63% in the control group ( P>0.05) . Conclusions:After operation, oral GS can reduce insulin resistance and inflammation in patients with gastric cancer. It has positive significance to promote postoperative rehabilitation.

Objective:To compare the short-term clinical effect of gastrointestinal or enterointestinal dominant channels after radical proximal gastrectomy combined with dual-channel anastomosis for upper gastric cancer.Methods:A total of 72 patients in Hefei Second People's Hospital from Jan 2017 to Jul 2021 were retrospectively analyzed, including 29 patients in the total gastrectomy group, and 43 patients in the group of radical proximal gastrectomy+dual-channel anastomosis, and by imaging results it was futher stratified into gastrointestinal dominant channel sub-group (26 cases) and intestinal dominant channel sub-group (17 cases).Results:The number of lymph node dissection in the total gastrectomy group was more than that in the proximal stomach group (27.9±3.2 vs. 25.4±2.9, t=3.441, P<0.05). While the 12 months post operation albumin [(36.1±2.4) g/L vs. (34.1 ± 2.3) g/L, t=3.526, P=0.001], hemoglobin [(122.9 ± 6.9) g/L vs. (115.9 ± 6.0) g/L, t=4.444, P=0.000], vitamin B12 [(349.0±21.7) pmol/ml vs. (77.9±8.5) pmol/ml, t=63.931, P=0.000] level, and the body mass index [(23.01±0.78) kg/m 2vs. (21.95±0.67) kg/m 2, t=5.978, P=0.000] decline level was unfavored ( P<0.05). The 12 months post operation vitamin B12 level, body mass index, albumin and hemoglobin level had no statistical difference in the two subgroups of proximal gastrectomy (all P>0.05). Conclusions:Laparoscopic proximal gastrectomy with double tract reconstruction for proximal gastric cancer is safe and reliable, which can effectively improve the postoperative nutritional status, prevent postoperative anemia.

Objective:To investigate the relationship between single nucleotide polymorphism (SNPs) of Zeste homolog enhancer 2 (EZH2) gene and the risk of breast cancer.Methods:Recruiting 1 039 breast cancer patients and 1 040 controls at 22 referral hospitals nationwide in China, the genotype distribution of 3 SNPs loci of EZH2 genes was observed to detect the correlation between different genotypes and the risk of breast cancer genotypes EZH2 expression in breast cancer tissues and its correlation with patient prognosis were analyzed using breast cancer data from the database.Results:EZH2 rs6464926 CC genotype was compared with TT genotype (TT vs. CC: OR=1.362, 95% CI: 1.063-1.746, P=0.015) and dominant model (TC+TT vs .CC: OR=1.22, 95% CI: 1.004-1.483, P=0.045) .In women with BMI ≥24 kg/m 2, the TC genotype ( P=0.050), TT genotype ( P=0.025) and dominant model (TC+TT, P=0.021) of rs6464926 locus were significantly different from CC genotype in cancer risk. rs6464926 was correlated with EZH2 gene expression ( P=6.89E-47). EZH2 gene is highly expressed in breast cancer tissues, and patients with high expression were associated with shorter OS ( HR=1.27, P=0.013), DMFS ( HR=1.37, P<0.01), and RFS ( HR=1.44, P<0.01). Conclusions:The polymorphism rs6464926 of EZH2 gene is associated with breast cancer susceptibility in Chinese women. rs6464926 might regulate breast cancer risk and prognosis by changing EZH2 expression.

Objective To evaluate the intraoperative identification of ectopic parathyroid tissue in the central neck region using autofluorescence point-spectral analysis(AFPSA)combined with immune colloidal gold technique(ICGT),for guiding total parathyroidectomy(TPTX)or clean parathyroidectomy(CPTX)in the management of secondary hyperparathyroidism(SHPT).Methods Retrospectively collected and compared the clinical data of 64 patients with SHPT from October 2019 to June 2023.In the observation group,TPTX was performed as the initial procedure in 36 cases,followed by sampling of suspicious targets using AFPSA in the central neck area and subsequent detection through ICGT.CPTX was then conducted if a positive result was obtained.On the other hand,the control group consisted of 28 cases where only TPTX was performed without any additional tests during surgery.The surgical data,parathyroid hormone(PTH)levels,blood calcium levels,blood phosphorus levels,alkaline phosphatase(ALP)levels,regression of clinical symptoms,changes in parathyroid function and occurrence of hypocalcemia were compared between these two groups.Results In the observation group,there were 9 cases of AFPSA-ICGT positivity,including 2 left-sided cases,4 right-sided cases,and 3 thymic cases;among these posi-tive cases,there were a total of 10 locations with mildly hyperplastic or nonhyperplastic microscopic parathyroid tissue.The difference in the number of total parathyroid glands removed(including ectopic)between the two groups was statistically significant(P<0.05).At both 3 and 6 months postoperatively,ALP levels in the observation group were significantly lower than those in the control group(P<0.01 and P<0.001 respectively);at 6 months postoperatively,differences in PTH and blood phosphorus levels between the two groups were also statistically significant(P<0.05 and P<0.001 respectively).Joint bone pain and skin itching recurred in some patients within the control group at six months after surgery(P<0.05),whereas recurrence of SHPT was less frequent within the observation group compared to controls(P<0.05);however,no statistically significant differences were observed regarding postoperative hypoparathyroidism or hyperparathyroidism as well as hypocalcemia between either groups.Conclusion The AFPSA-ICGT intraoperative test can be utilized to guide surgery for SHPT,enabling accurate and efficient identification as well as safe targeting of parathyroid tissues that may not exhibit obvious hyperplasia in the central cervical region.