Objective To investigate prevalence and immunological properties of Helicobacter pylori (Hp) infection among chronic gastritis population in Wuhan. Methods A total of 1 866 patients with chronic gastritis in Wuhan were selected from May 2021 to December 2023, and Hp antibody and typing in serum were detected by immunoblotting to analyse the infection rate and typing of patients of different genders and age groups, as well as the correlation between Hp infection and the severity of chronic gastritis. Western blotting technique was utilized to detect the Hp antibodies and typing. The infection rates and subtypes were recorded in patients of different genders and ages. Then the correlation between Hp infection and the severity of chronic gastritis were discussed. Results The overall detection rate of Hp infection was 65.38% (1 220/1 866) in 1866 patients, and the prevalence rate of type I infection was higher than that of type II infection [61.31% (748/1 220) vs 38.69% (472/1 220), P<0.05]. No statistical difference was reported in overall infection rate in terms of gender (P>0.05). In terms of gender, the rate of type I infection was higher than that of type II infection [70.08% (431/615) vs 29.92% (184/615), P<0.05], whereas the prevalence of the two types of infections demonstrated no statistical difference in female patients (P>0.05). In terms of age, the prevalence of Hp infection in patients increased with age (2=64.687, P=0.000). The infection rate of type I was higher than type II in the age groups of below 18, 31-40, 41-50 and 51-60 years old (P<0.05), and infection rates of type I and type II yielded no statistical difference in the age groups of 18-30 and ≥60 years old (P>0.05). With the aggravation of chronic gastritis, the infection rate and percentage of type I infections increased, and the percentage of type I infections was higher than that of type II infections (P<0.05). Conclusion Patients with chronic gastritis in Wuhan suffer a high prevalence rate of Hp infection, and the rate of Hp infection increases with the age of the patients, is positively correlated with the severity of the disease, and presents certain typological features.

OBJECTIVE: To assess the effectiveness of bone acupuncture in improving pain and function in degenerative lumbar spinal stenosis (DLSS) and compare it with Jiaji acupuncture. METHODS: From January to December 2023, 80 DLSS patients were treated with acupuncture and divided into bone acupuncture and Jiaji acupuncture groups. Among them, 40 patients in the bone acupuncture group included 15 males and 25 females, with a mean age of (60.60±6.98) years old;anthor 40 patients in the Jiaji acupuncture group included 16 males and 24 females, with a mean age of (61.48±9.55) years old. The Roland Morris disability questionnaire(RMDQ), walking distance, visual analogue scale(VAS), and the MOS item short from health survey(SF-36) of two groups at baseline, 2 weeks, 4 weeks, and 12 weeks post-treatment were compared. RESULTS: Eighty patients were followed up for 3 to 5 months with an average of (3.62±0.59) months. There was no significant differences in general data and the scores before treatment between two groups(P>0.05). The RMDQ scores in both groups decreased significantly at 2, 4 and 12 weeks after treatment compared with before treatment(P<0.05), at each time point after treatment, the decrease was more significant in the bone acupuncture group than in the Jiaji acupuncture group(P<0.05). The VAS of waist and leg in both groups was significantly lower at 2, 4 and 12 weeks after treatment that before treatment(P<0.05). At all time points after treatment, the waist VAS in the bone acupuncture group was reduced more significant than in the Jiaji acupuncture group(P<0.05);there was no significant difference in leg VAS at 2 and 12 weeks after treatment between two groups(P>0.05), the improvement was more significant in the bone acupuncture group in the 4 weeks after treatment than in the Jiaji acupuncture group. The SF-36 scores in both groups were significantly higher at 2, 4, and 12 weeks after treatment than before treatment(P<0.05);the SF-36 score raised more significant in the bone acupuncture group than in the Jiaji acupunture group(P<0.05). No significant difference in the walking distance between two groups at 2 weeks after treatment(P>0.05);the walking distance in the bone acupuncture group was significantly higher than that in the Jiaji acupuncture group at 4 and 12 weeks after treatment(P<0.05). CONCLUSION Bone-penetrating acupuncture moderately improves functional impairment, pain, and quality of life in patients with DLSS, showing better efficacy than Jiaji acupuncture.
Humans ; Female ; Male ; Middle Aged ; Acupuncture Therapy/methods* ; Spinal Stenosis/physiopathology* ; Aged ; Lumbar Vertebrae/physiopathology* ; Pain Management

The gradient coils of MRI equipment can induce vibrations in implantable medical devices, causing periodic vibrations of implantable medical devices with respect to the surrounding tissue. This not only results in instrument failure but also causes discomfort to the patient. Therefore, studying the vibration characteristics of implantable devices under different scanning sequences and the orientation of the device relative to the magnetic field is crucial for comprehending vibration performance. This study observed the vibration spectra of a full cranial bone-implanted neurostimulator by using laser vibrometry under typical rapid imaging sequences and explored the impact of different magnetic field orientations on vibration. The results demonstrated that the rapid echo sequences induced diverse and rich vibration components, whereas the planar echo sequences caused relatively simple vibrations. Additionally, the strongest vibrations normally occurred in the maximum conductive surface parallel to the phase-coded direction. It revealed the factors influencing the vibrations of skull fixation active implantable devices and provided guidance for enhancing device safety and protecting patient well-being during MR examinations.
Vibration ; Magnetic Resonance Imaging ; Deep Brain Stimulation/instrumentation* ; Magnetic Fields ; Humans

OBJECTIVE: To evaluate the dynamic changes of glucocorticoid (GC) dose and the feasibility of GC discontinuation in rheumatoid arthritis (RA) patients under the background of Chinese medicine (CM). METHODS: This multicenter retrospective cohort study included 1,196 RA patients enrolled in the China Rheumatoid Arthritis Registry of Patients with Chinese Medicine (CERTAIN) from September 1, 2019 to December 4, 2023, who initiated GC therapy. Participants were divided into the Western medicine (WM) and integrative medicine (IM, combination of CM and WM) groups based on medication regimen. Follow-up was performed at least every 3 months to assess dynamic changes in GC dose. Changes in GC dose were analyzed by generalized estimator equation, the probability of GC discontinuation was assessed using Kaplan-Meier curve, and predictors of GC discontinuation were analyzed by Cox regression. Patients with <12 months of follow-up were excluded for the sensitivity analysis. RESULTS: Among 1,196 patients (85.4% female; median age 56.4 years), 880 (73.6%) received IM. Over a median 12-month follow-up, 34.3% (410 cases) discontinued GC, with significantly higher rates in the IM group (40.8% vs. 16.1% in WM; P<0.05). GC dose declined progressively, with IM patients demonstrating faster reductions (median 3.75 mg vs. 5.00 mg in WM at 12 months; P<0.05). Multivariate Cox analysis identified age <60 years [P<0.001, hazard ratios (HR)=2.142, 95% confidence interval (CI): 1.523-3.012], IM therapy (P=0.001, HR=2.175, 95% CI: 1.369-3.456), baseline GC dose ⩽7.5 mg (P=0.003, HR=1.637, 95% CI: 1.177-2.275), and absence of non-steroidal anti-inflammatory drugs use (P=0.001, HR=2.546, 95% CI: 1.432-4.527) as significant predictors of GC discontinuation. Sensitivity analysis (545 cases) confirmed these findings. CONCLUSIONS RA patients receiving CM face difficulties in following guideline-recommended GC discontinuation protocols. IM can promote GC discontinuation and is a promising strategy to reduce GC dependency in RA management. (Trial registration: ClinicalTrials.gov, No. NCT05219214).
Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Arthritis, Rheumatoid/drug therapy* ; Glucocorticoids/therapeutic use* ; Medicine, Chinese Traditional ; Retrospective Studies

Acupuncture is an ancient treatment method used in traditional Chinese medicine and has been popularized worldwide. Over the past decade, there has been an increase in the amount of acupuncture research, mostly comprised of randomized controlled trials (RCTs) that aimed to answer the question on the efficacy of acupuncture. However, poor methodology and low replicability in these acupuncture RCTs have resulted in uncertainty about the efficacy of acupuncture. In this review, current advancements and challenges in acupuncture RCTs, regarding the methodological aspects of randomization, blinding, sham acupuncture and quality of reporting, were discussed. While there have been advancements in various aspects, current acupuncture RCTs still face pressing issues such as inadequate randomization and blinding, unviable sham acupuncture controls, and poor reporting quality. Given these limitations, this review seeks to identify the methodological problems that are responsible for these problems and to suggest solutions that could help to overcome them so as to improve the quality of future studies evaluating the efficacy of acupuncture. Please cite this article as: Seetoh WS, Lim RQR, Xu RB, Sun MX, Zhang P, Wang MN. Advancements and challenges of acupuncture randomized controlled trials. J Integr Med. 2025; 23(4): 333-343.
Acupuncture Therapy ; Humans ; Randomized Controlled Trials as Topic/methods* ; Research Design

OBJECTIVE To observe the short-term efficacy and safety of venetoclax combined with homoharringtonine and cytarabine in the treatment of acute myeloid leukemia （AML）. METHODS The data of 40 newly diagnosed AML patients admitted to our hospital from October 2022 to November 2023 were retrospectively collected and divided into observation group and control group according to treatment plan， with 20 cases in each group. The patients in the control group were given Daunorubicin hydrochloride for injection+Cytarabine for injection， and the patients in the observation group were given Venetoclax tablets+ Homoharringtonine injection+Cytarabine for injection. The patients in both groups were given relevant medicine， with 28 days as one cycle. The short-term efficacy， negative rate of minimal residual disease （MRD）， duration of granulocyte deficiency， duration of platelet （PLT） ＜20×109 L－1， transfusion volume of suspended red blood cells and platelet， and the occurrence of adverse drug reactions were evaluated in both groups after 1 cycle of induction chemotherapy. RESULTS The complete remission or complete remission with incomplete hematologic recovery （CR/CRi） rate in the observation group was significantly higher than control group （P＜0.05）， and the negative rate of MRD in the observation group was also significantly higher than control group （P＜0.05）. However， in low-， medium- and high-risk patients， there was no statistical significance in CR/CRi rates between the two groups （P＞0.05）. There were no significant differences in the duration of agranulocytosis， the duration of PLT ＜20×109 L－1， the amount of suspended red blood cell transfusion， the amount of platelet transfusion， the incidence of hematologic toxicity and the incidence of non-hematologic toxicity between 2 groups （P＞0.05）. CONCLUSIONS Venetoclax combined with homoharringtonine and cytarabine show good short-term efficacy and safety in the treatment of AML.

Objective To investigate the expression level and clinical significance of serum long noncoding RNA(lncRNA)H19,CHAST in patients with coronary heart disease(CHD).Methods A total of 135 patients with CHD who were admitted to the Department of Cardiovascular Medicine of Lianyungang Second People's Hospital from June 2021 to May 2022 were selected,including 76 cases of a-cute coronary syndrome and 59 cases of chronic coronary syndrome.We selected 62 patients in the control group who were hospitalized and excluded from CHD by coronary angiography.Real-time fluorescent quantitative PCR(RT-PCR)was used to detect the relative expres-sion level of lncRNA H19 and lncRNA CHAST in the circulating serum of the subjects.Meanwhile,the high sensitivity C-reactive pro-tein(hs-CRP)、tumor necrosis factor-α(TNF-α)、interleukin-6(IL-6)、low density lipoprotein(LDL)、high density lipoprotein(HDL)and other related indicators of each group were collected.The receiver operating characteristic(ROC)curve was used to analyze the clinical diagnostic value of circulating serum lncRNA H19 and lncRNA CHAST expression level in the diagnosis of CHD.Pearson cor-relation coefficient was used to analyze the correlation between serum lncRNA H19,lncRNA CHAST level,and other related indicators.Multivariate Logistic regression was used to analyze the risk factors of CHD.Results The serum expression levels of lncRNA H19 and ln-cRNA CHAST in the CHD group were higher than those in the control group(P＜0.05).The serum levels of hs-CRP、TNF-α、IL-6、and LDL in the experimental group were higher than those in the control group(P＜0.05),and the serum levels of HDL were lower than those in the control group(P＜0.05).The expression levels of lncRNA H19 and lncRNA CHAST were positively correlated with hs-CRP,IL-6 and LDL,and were negatively correlated with HDL.lncRNA H19 and lncRNA CHAST are risk factors for CHD,which may have a higher value in the diagnosis of CHD.Conclusion lncRNA H19 and lncRNA CHAST are risk factors for CHD and can be used as serum indicators for the diagnosis of CHD,and the combination of the two has a higher value in the diagnosis of CHD.In addition,the ex-pression levels of both were correlated with the levels of inflammatory factors and apolipoproteins.

Objective:To investigate the hot topics and trends of implementation science in the transformation of clinical practice guidelines, in order to provide ideas and references for clinical managers to reasonably apply and implement scientific promotion guidelines.Methods:CiteSpace6.2.R3 software was used to visualize the literature, which retrieved from the core database of Web of Science, including the number of articles, countries and high-frequency keywords and keyword clustering and emergence for visual analysis, etc.Results:A total of 4 593 articles were included in the final analysis. Since 1993, the number of published papers had increased year by year. The hot topics focused on primary care, attitudes, knowledge translation, clinical trials, risk factors and machine learning. The research trends included older adults and artificial intelligence.Conclusions:The rapid development of implementation science in guideline translation research suggests that scholars from various countries, especially hospital administrators should reasonably apply implementation science framework to integrate evidence into clinical practice, and promote the implementation of clinical practice guidelines.

Objective To investigate the prognostic evaluation value of the HALP score composed of hemoglobin,albumin,lymphocytes and platelets before chemotherapy in the patients with diffuse large B-cell lymphoma(DLBCL).Methods The clinical data and laboratory indicators before chemotherapy in the pa-tients with DLBCL newly diagnosed in this hospital from January 2015 to October 2022 were retrospectively analyzed.The optimal cut-off value of HALP was calculated by X-tile software.The patients were grouped ac-cording to the optimal cutoff value,the Chi-square test was used to analyze the difference in the constituent ra-tio of clinical characteristics among different HALP score groups,the survival curves of the progression-free survival(PFS)time and overall survival(OS)time among the groups with different scores were drawn by u-sing the Kaplan-Meier method,the Cox univariate and multivariate analysis regression model was adopted to analyze the prognostic influencing factors in DLBCL patients,and the predictive ability of HALP score for PFS time and OS time in DLBCL patients was evaluated by using the receiver operating characteristic(ROC)curve.Results A total of 132 patients with DLBCL were included,the optimal cutoff value of HALP score was 21.23 points.There were 54 cases in the low HALP score group and 78 cases in the high HALP score group.The low HALP score group was correlated with the later clinical stage,higher IPI and NCCN-IPI scores,higher LDH level and lower overall response rate(ORR)(P＜0.05).Compared to the high HALP score group,the PFS time and OS time in the low HALP score group were shorter(P＜0.05).The Cox uni-variate and multivariate regression model analysis results indicated that the HALP score≤21.23 points was an independent risk factor affecting the PFS time(HR=1.811,P=0.031).The ROC curve results suggested that the combination of HALP score combined with IPI score or NCCN-IPI score had higher predictive value for PFS time and OS time in DLBCL patients compared to use IPI or NCCN-IPI alone.Conclusion The HALP score is correlated with the prognosis of DLBCL patients,and could early identify the high-risk DLBCL patients with poor prognosis.The HALP score,IPI score and NCCN-IPI score combined evaluation has higher predictive value.

Objective To explore the correlation between eosinophils(EOS),interleukin-17A(IL-17A),tumor necrosis factor α(TNF-α)and vascular endothelial growth factor(VEGF)in peripheral blood and my-coplasma pneumoniae infection with wheezing in children.Methods A total of 98 children with mycoplasma pneumoniae infection diagnosed and treated in the hospital from January 2022 to May 2023 were selected as the study group.The study group was divided into wheezing group(32 cases)and non-wheezing group(66 ca-ses)according to whether they were accompanied by wheezing,and 30 children with lobar pneumonia without wheezing who were examined by fiberoptic bronchoscopy during the same period were selected as the control group.The levels of EOS,IL-17A,TNF-α and VEGF in peripheral blood of different groups were compared,and the correlation between the four indexes and mycoplasma pneumoniae infection with wheezing in children was analyzed.Results The levels of EOS,IL-17A,TNF-α and VEGF in peripheral blood of the study group were significantly higher than those of the control group,and the differences were statistically significant(P＜0.05).The differences in the levels of EOS,IL-17A,TNF-α and VEGF in the peripheral blood of the three groups were statistically significant(P＜0.05).Specifically,the levels of EOS,IL-17A,TNF-α and VEGF in the wheezing group were significantly higher than those in the non-wheezing group and the control group,and the differences were statistically significant(P＜0.05),and the levels of EOS,IL-17A,TNF-α and VEGF in the non-wheezing group were significantly higher than those in the control group,and the differences were sta-tistically significant(P＜0.05).Pearson correlation analysis showed that the levels of EOS,IL-17A,TNF-α and VEGF in peripheral blood were positively correlated with mycoplasma pneumoniae infection with wheez-ing in children(P＜0.05).Using wheezing as a state variable and plotting the receiver operating characteristic(ROC)curve,it was found that the area under the curve of peripheral blood EOS,IL-17A,TNF-α and VEGF for distinguishing mycoplasma pneumoniae infection with wheezing in children was 0.658,0.960,0.948,and 0.937.Conclusion Peripheral blood EOS,IL-17A,TNF-α,The level of VEGF is positively correlated with Mycoplasma pneumoniae infection with wheezing in children,which could be used for clinical differentiation of mycoplasma pneumoniae infection with wheezing in children.