ObjectiveTo investigate the effects of probiotics combined with bismuth quadruple therapy （BQT） on clinical efficacy、gastrointestinal adverse reactions and intestinal flora in Helicobacter pylori （HP） positive patients. MethodsThe patients who were positive for HP from May 2023 to July 2023 in the department of gastroenterology of Shanghai first people's hospital were randomly divided into2 groups with 40 people in each group. The probiotic group was given 2 weeks of quadruple therapy with probiotics and standard BQT， followed by 4 weeks of oral probiotics after quadruple discontinuation. The placebo group was given 2 weeks of probiotic placebo and standard BQT， followed by 4 weeks of oral probiotic placebo. ¹³C urea breath test was used to evaluate the clinical efficacy， gastrointestinal symptoms rating Scale was used to evaluate the gastrointestinal adverse reactions of patients before and after the intervention， and microbial diversity 16S rDNA sequencing technology was used to detect the level of intestinal flora of patients before and after the intervention. ResultsThere was no significant difference in the eradication rate between the two groups （P>0.05）. Before the intervention， there was no significant difference in the scores of the gastrointestinal symptom rating scale between the probiotic group and the placebo group. After the intervention， patients in the probiotic group had significantly lower pain scores on acid reflux （1.10±0.30 vs 1.35±0.53， P<0.05） and stomach or abdominal hunger than in the placebo group （1.07±0.26 vs 1.30±0.52， P<0.05）. Through the before-and-after comparison of the probiotic group， the scores of abdominal pain （1.24±0.44 vs 1.58±0.71， P<0.05）， stomach or abdominal hunger （1.07±0.26 vs 1.27±0.45， P<0.05） and dry and hard stool （1.24±0.49 vs 1.48±0.75，P<0.05） were significantly lower in the probiotic group than before the intervention in the probiotic group. ConclusionProbiotics combined with BQT can improve the gastrointestinal adverse reactions and intestinal flora disorders in the process of quadruple drug therapy， but it does not improve the eradication rate of HP.

Cohort study is one of the important research methods in analytical epidemiology because of its clear time sequence relationship, which is better than other observational studies in demonstrating causal association. However, screening diagnosis or other methods are often used to exclude the individuals with outcome events during the enrollment process of the subjects in cohort studies. The accuracy of screening diagnosis and the effectiveness of exclusion will affect the accuracy of the baseline status assessment of the subjects included in the study, which may lead to the causal time sequence reversal of exposure-outcome in the estimation of causal effect. Landmark analysis can be used to control reverse causality by excluding subjects with potentially unknown expose-outcome timing. In this paper, we describe the basic principles and analytical steps of landmark analysis, and use data from the Chinese Longitudinal Healthy Longevity Survey to explore the relationship between physical activity and frailty, and introduce the specific application of landmark analysis for the purpose of facilitating its application and inferring causal effects more accurately in cohort studies.

With completing a baseline survey of a large natural population cohort, conducting regular follow-up has become a key factor in further improving the quality of cohort construction and ensuring its sustainable development. Typical cohort follow-up methods include repeat surveys, routine monitoring, and community-oriented surveillance. However, in practical applications, there are often issues such as high costs, difficulty, and high error rates. Telephone follow-up is an important supplementary method to the methods mentioned above, as it has the characteristics of low cost, fast response, and high quality. However, the with difficult organization, quality control is challenging, response rates are low, and management levels vary widely, which limits its widespread use in large-scale population cohort studies. Given the above problems, this study draws on customer relationship management based on the actual needs of the China Northwest Cohort follow-up. It relies on the REDCap electronic data collection platform to build a telephone follow-up management and quality control system. Targeted solutions are provided for key issues in telephone follow-up implementation, including organizational structure, project management, data collection, and process quality control, to improve the quality control level of telephone follow-up comprehensively and thereby enhance the quality and efficiency of follow-up. We hope to provide standardized follow-up programs and efficient quality control tools for newly established and existing cohort studies.

Objective: To understand the awareness of palliative care and its influencing factors in community residents in Hangzhou,so as to provide basis for the development of palliative care service. Methods: By convenient sampling method,the residents in the urban-rural junction of Xihu District were recruited. A self-designed questionnaire was used to investigate their awareness of palliative care. The logistic regression model was employed to analyze the influencing factors. Results : A total of 519 questionnaires were recovered,with a response rate of 97.92%. There were 227 males and 292 females,accounting for 43.74% and 56.26%,respectively. There were 43,218 and 258 residents with more,basic and little understanding about palliative care, accounting for 8.29%,42.00% and 49.71%. The residents learned about palliative care mainly through television and radio,with 245 cases accounting for 47.21%;and they thought that the main reason for low awareness of palliative care was a lack of related knowledge,with 396 cases accounting for 76.30%. The results of multivariate logistic regression analysis showed that 50-59 years old（OR = 0.467,95% CI：0.285-0.767）,primary school education and below（OR = 2.248,95%CI：1.239-4.079）and experience of caring for dying patients（OR = 1.551,95% CI：1.094-2.199）were the influencing factors for the awareness of palliative care. Conclusion The residents in Hangzhou had relatively low awareness of palliative care,which were associated with age,education level and experience of caring for dying patients.

We report a case of chromoblastomycosis caused by , which was successfully treated by long-pulsed 1064 nm Nd: YAG laser combined with terbinafine. A 60-year-old man was admitted for the presence of a 30 mm×40 mm erythematous plaque on the dorsum of his right hand for about 10 months without any subjective symptoms. Both microscopic examination and tissue biopsy of the lesion showed characteristic sclerotic bodies of chromoblastomycosis. Lesion tissue culture on SDA at 26 ℃ for 2 weeks resulted in a black colony, and slide culture identified the isolate as Fonsecaea species. ITS sequence analysis of the isolate showed a 99% homology with strain KX078407. The susceptibility of the isolate to 9 antifungal agents was determined using the microdilution method according to the guidelines of CLSI M38-A2 protocol, and terbinafine showed the lowest MIC (0.125 μg/ml). We subsequently established a Wistar rat model of chromoblastomycosis using the clinical isolate and treated the rats with long-pulsed 1064 nm Nd: YAG laser (pulse width of 3.0 ms, fluence of 24 J/cm, spot size of 3 mm, frequency of 4 Hz, repeated 3 times at an interval of 30 s) twice a week for a total of 8 sessions. Although the laser treatment alone was not able to eliminate the fungi, histopathological examination showed the aggregation of numerous lymphocytes in the local affected tissue, indicating an immune response that consequently facilitate the regression of the lesion. The patient was successfully treated by long-pulsed 1064 nm Nd: YAG laser once a week combined with terbinafine (0.25 /bid) for 8 weeks, and follow-up for 20 months did not reveal any signs of recurrence.
Animals ; Chromoblastomycosis ; Humans ; Laser Therapy ; Lasers, Solid-State ; Male ; Middle Aged ; Rats ; Rats, Wistar ; Terbinafine ; Treatment Outcome

Objective: To evaluate the performence of GeneXpert MTB/RIF and BACTEC-MGIT 960 on detecting Mycobacterium tuberculosis and rifampicin resistance for pneumoconiosis-associated tuberculosis patients. Methods: The recruited 133 suspected active pneumoconiosis-associated tuberculosis hospitalized cases, morning sputum samples were collected to do modified L-J culture, conventional proportion method drug susceptibility test, GeneXpert MTB/RIF and BACTEC-MGIT 960. Analyze the sensitivity and specificity of the 133 sputum from patients, the positive rates of patients with tuberculosis in GeneXpert MTB/RIF test, BACTEC-MGIT 960 and modified L-J culture were 37.59%, 34.59% and 30.08% respectively. There was no significant difference among the three tests respectively (P>0.05) . According to the modified L-J culture, the sensitivity of GeneXpert MTB/RIF and BACTEC-MGIT 960 in detecting tuberculosis were 92.5% and 95.0% respectively, and specificity in rifampicin resistance were 86.0% and 91.4% respectively. There was no significant difference between GeneXpert MTB/RIF and BACTEC-MGIT 960 (P>0.05) . According to conventional proportion method drug susceptibility test, the sensitivity of GeneXpert MTB/RIF and BACTEC-MGIT 960 in detecting rifampicin resistance were 90.0% and 100%, and specificity were 92.6% and 96.4%. There was no significant difference between GeneXpert MTB/RIF and BACTEC-MGIT 960 (P>0.05) . Conclusion The GeneXpert MTB/RIF has good performence of detecting tuberculosis and rifampicin resistance. It has good application value among pneumoconiosis-associated tuberculosis patients.

This study measured the in vitro inhibitory effects of α-amylase(AM), α-glycosidase(AG)and aldose reductase(AR)extraction from Potentilla fruticosa in three solvents: water extract(WE)and 95% methanol extraction of petroleum ether part(MEP), 95% methanol extraction of ethyl acetate part(MEE)and 95% methanol extraction of water part(MEW)through α-amylase inhibitors(AMI), α-glycosidase inhibitors(AGI)and aldose reductase inhibitors(ARI)activity screening models. In vivo effects of different solvents from Potentilla fruticosa on impaired glucose tolerance of mice were also measured. Among them, WE, MEP and MEE exhibited against AMI activity with IC50 values of 0. 432, 1. 193 and 0. 507 mg/mL, respectively. Three solvents against AGI activity with IC50 values of 0. 164, 0. 768 and 0. 466 mg/mL, respectively. Three solvents against ARI activity with IC50 values of 0. 742, 2. 158 and 1. 098 mg/mL, respectively. The study suggests that Potentilla fruticosa in water extract and 95% methanol extraction of ethyl acetate part demonstrated a stronger inhibitory effect on AM, AG and AR. Meanwhile, Potentilla fruticosa in water extract and 95% methanol extraction of ethyl acetate part can be significantly decreased the postprandial blood glucose in mice.

Objective To evaluate the clinical effects and safety of Er:YAG fractional laser for facial rejuvenation.Methods Altogether 559 patients aged from 32 to 58 years old with obvious pigmentary lesions and wrinkles in the face were given 2 courses of restoration treatment with the Pixel Er:YAG fractional laser.The patients paid a return visit a month later after the last treatment.With the results of clinical observation and photograph-based comparison,the therapeutic effects were graded by disappearance of pigmentary lesions and elimination of facial wrinkles.Complications such as hyperpigmentation,depigmentation and hyperplastic scar were observed.Results Among the 559 patients, there were 103 cases (18.4%) of slight effect, 378 cases (67.6%) of moderate effect, and 78 cases (14%) of excellent effect,with the total effective rate of 100% and a satisfactory rate of 81.6%.The was no complication such as hyperpigmentation,depigmentation and hyperplastic scar occurred.Effective maintaining rate within 6 months was 67%.Conclusion Er:YAG fractional laser is safe and effective for facial rejuvenation and worthy of promotion.

Objective To evaluate the efficacy and safety of nonablative radiofrequency in facial rejuvenation.Methods A total of 198 patients with facial skin relaxing or wrinkles in the 153rd Central Hospital of PLA from July 2010 to March 2015 were treated with nonablative radiofrequency,of which 42 cases were male,156 cases were female,the ages were from 30 to 60 years old,Fitzpatrick skin type was Ⅲ~Ⅳ.The nonablative radiofrequency were performed in all the patients.Output:Monopolar RF 90~110W,Bipolar RF 40~45W,Periorbital RF 40~50W.The total course of treatment had 6 times with a fixed 10-day interval after each therapy.Results In 198 facial skin aging patients,the total effective rate was more than 90%,the half-year effective maintenance rate was more than 70%.Complications included slight oedema and mild erythema that were minor and transitory.Side effects such as post-inflammatory hyperpigmentation,epidermal burns and scar formation were not observed.Conclusion The nonablative radiofrequency is safe and effect on facial rejuvenation with less complications.

Objective To observe the 3 years or more effects on optical correction,refraction,and orthokeratology with rigid gas permeable contact lens(RGPCL) wearing in patients with keratoconus.Design Retrospective case series.Participant 73 keratoconus patients(136 eyes) fitted with RGPCL.Methods Patients wearing RGPCL for 3 years or more in Peking University Optometry & Ophthalmology Center were observed.Correct visual acuity was determined before and at 1,2 and 3 years of lens wearing,and the refractive power,corneal curvature,corneal astigmatism and corneal morphological changes were measured with auto-refractomer/keratometer and keratoconus screening analysis system of computer-assisted corneal topography at the same time.The changes of base curve and RGPCL power were also compared.All patients were divided into mild keratoconus group(Group A),moderate and severe keratoconus group (Group B).Main Outcome Measures Visual acuity,refractive power,base curve of RGPCL,corneal topography parameters.Results The patients wore RGPCL for 49.3?15.3 months(36-76 months).At the initial visit,uncorrected visual acuity(UVA) was 3.76?0.45, corrected visual acuity with spectacles(SPVA) was 4.57?0.53,and with RGPCL(RGPVA) was 4.89?0.14.RGPVA was improved significantly (F=171.994,P=0.000).RGPVA at last visit(4.95?0.11) was better than that at initial visit(t=-6.733,P=0.000),which was more significant in group B than that in group A.The rate for RGPVA more than 0.8 at the initial,1 year,2 years and 3 years of lens wearing was 85.13%,86.76%,85.60%and 84.62%respectively.At the initial visit and last visit,the myopia diopters and the corneal astigmatism were 7.13?4.01D vs.6.23?3.42D(P=0.014) and 6.23?3.24D vs.4.42?2.34D(P=0.000) respectively.The RGPCL base curve and lens power were 7.38?0.50 mm vs.7.54?0.42 mm(P=0.000),and -6.22?3.59 D vs.-5.33?3.09 D(P=0.000) respectively. The changes of power and base curve of lens in group B were more significant than that in group A.The decrease of 9 corneal topography parameters between initial visit and last visit was significant statistically(all P