Background:A large number of studies have confirmed that the combination therapy of high-dose proton pump inhibitor(PPI)and amoxicillin has a good efficacy for eradication of Helicobacter pylori(Hp).As a new high-efficiency acid inhibitor,vonoprazan is expected to improve the efficacy of Hp eradication and has a good application prospect.Aims:To compare the efficacy and safety of the dual therapy of vonoprazan-amoxicillin and bismuth-containing quadruple therapy,so as to provide new treatment idea and choice for Hp eradication therapy.Methods:This is a single-center,prospective,randomized controlled clinical trial.Two hundred and ten patients positive for Hp infection and naive to eradication therapy were recruited consecutively and randomly divided into two groups.One group received dual therapy of vonoprazan-amoxicillin:vonoprazan 20 mg bid and amoxicillin 1 g tid for 14 days;the other group received bismuth-containing quadruple therapy:rabeprazole 20 mg bid,potassium bismuth citrate 600 mg bid,clarithromycin 500 mg bid,and amoxicillin 1 g bid for 14 days.After 4-6 weeks of treatment completion,the Hp eradication rate(primary outcome)was evaluated by 14C-urea breath test.Safety and compliance(secondary outcomes)were also observed and recorded in the treatment course.Results:In intention-to-treat(ITT)analysis,the Hp eradication rate of dual therapy of vonoprazan-amoxicillin was 89.6%,and that of bismuth-containing quadruple therapy was 92.3%(P＞0.05).In per-protocol(PP)analysis,the eradication rates of these two groups were 90.5%and 94.1%,respectively(P＞0.05).The adverse events rate of dual therapy was significantly lower than that of the quadruple therapy(5.7%vs.20.2%,P＜0.05).Conclusions:The efficacy of 14-day dual therapy of vonoprazan-amoxicillin for initial eradication of Hp is equal to bismuth-containing quadruple therapy,with fewer adverse events and simpler medications.It can be considered as the first-line treatment scheme of empirical treatment of Hp infection.

Background:A large number of studies have confirmed that the combination therapy of high-dose proton pump inhibitor(PPI)and amoxicillin has a good efficacy for eradication of Helicobacter pylori(Hp).As a new high-efficiency acid inhibitor,vonoprazan is expected to improve the efficacy of Hp eradication and has a good application prospect.Aims:To compare the efficacy and safety of the dual therapy of vonoprazan-amoxicillin and bismuth-containing quadruple therapy,so as to provide new treatment idea and choice for Hp eradication therapy.Methods:This is a single-center,prospective,randomized controlled clinical trial.Two hundred and ten patients positive for Hp infection and naive to eradication therapy were recruited consecutively and randomly divided into two groups.One group received dual therapy of vonoprazan-amoxicillin:vonoprazan 20 mg bid and amoxicillin 1 g tid for 14 days;the other group received bismuth-containing quadruple therapy:rabeprazole 20 mg bid,potassium bismuth citrate 600 mg bid,clarithromycin 500 mg bid,and amoxicillin 1 g bid for 14 days.After 4-6 weeks of treatment completion,the Hp eradication rate(primary outcome)was evaluated by 14C-urea breath test.Safety and compliance(secondary outcomes)were also observed and recorded in the treatment course.Results:In intention-to-treat(ITT)analysis,the Hp eradication rate of dual therapy of vonoprazan-amoxicillin was 89.6%,and that of bismuth-containing quadruple therapy was 92.3%(P＞0.05).In per-protocol(PP)analysis,the eradication rates of these two groups were 90.5%and 94.1%,respectively(P＞0.05).The adverse events rate of dual therapy was significantly lower than that of the quadruple therapy(5.7%vs.20.2%,P＜0.05).Conclusions:The efficacy of 14-day dual therapy of vonoprazan-amoxicillin for initial eradication of Hp is equal to bismuth-containing quadruple therapy,with fewer adverse events and simpler medications.It can be considered as the first-line treatment scheme of empirical treatment of Hp infection.

Objective: To investigate the effects of 1, 25-dihydroxy vitamin D₃[1, 25(OH)₂D₃] on food allergy(FA) in mice and its mechanism. Methods: A total of 40 BALB/c mice were randomly divided into 5 groups, 8 in each group, including control group (group C) and FA model group (FA group), according to the dose of 1, 25(OH)₂D₃ intervention, the mice of the FA group were divided into FA₀ group (0), FA_l group [10 μg/(kg·d)], FA_m group [50 μg/(kg·d)] and FA_h group[100 μg/(kg·d)]. Egg albumin was used to establish a food allergy model, with different doses of 1, 25(OH)₂D₃ for gastric intervention, and the control group was replaced by 9 g/L saline.The serum levels of ovalbumin-immunoglobulin E(OVA-IgE), interleukin(IL)-9 and IL-17 of mice were measured by using enzyme linked immunosorbent assay after the last excitation, and HE staining and histopathological examination were carried out in the small intestine of mice. Results: Compared with group C, FA₀ group and FA_h group small intestinal mucosa in mice had different degrees of damage, partial peeling off, structure disorder, villi epithelial cell focal falls peeling off, necrosis, lamina propria edema, congestion, a large number of inflammatory cells infiltration, low but the FA_l group and FA_m group had light mucosa damage, intestinal epithelial basically intact, with integrity, no congestion, edema, and inflammatory cells infiltration to a lesser degree.The mean concentrations of serum IgE, IL-9 and IL-17 in different groups were statistically significant (F=40.770, 9.530, 5.624, all P<0.05). Compared with the FA₀ group [(41.87±3.19) ng/L], the OVA-IgE of the FA_l group [(22.71±4.77) ng/L] and the FA_m group [(16.34±2.81) ng/L] were significantly reduced (t=5.533, 11.835, all P<0.01), but there was no significant difference between the FA_h group [(36.29±6.52) ng/L] (t=1.673, P>0.05). Compared with the FA₀ group [(161.77±50.44) ng/L], the IL-9 levels of the FA_l group [(94.29±18.79) ng/L] and the FA_m group[(84.45±30.88) ng/L] were significantly lower (t=3.267, 3.366, all P<0.01), while that of the FA_h group [(36.29±6.52) ng/L] was not significantly lower (t=0.777, P>0.05). Compared with FA₀ group [(81.55±29.37) ng/L], IL-17 levels of FA_h group [(133.58±47.05) ng/L] was significantly increased (t=2.653, P<0.05), while IL-17 level of FA_l group [(79.41±25.15) ng/L] and FA_m group [(58.81±26.00) ng/L] were lower than that of FA₀ group [(81.55±29.37) ng/L], but the difference was not statistically significant (t=0.154, 1.640, all P>0.05). Conclusions Low, medium dose of 1, 25(OH)₂D₃ supplements can inhibit mice food allergies, but high doses of 1, 25(OH)₂D₃ improve performance in mice food allergies, and 1, 25(OH)₂D₃′s influence on the secretion of IL-9 is one that influences mechanism of food allergy.

Objective To analyze the changes of ultrasonography and Ki-67 before and after neoadjuvant chemotherapy for breast cancer ,and to assess the value of ultrasonography and Ki-67 in the evaluation of neoadju-vant chemotherapy for breast cancer. Methods The focus changes of 122 cases of breast cancer before and after neoadjuvant chemotherapy were observed by Color Doppler ultrasonography. The therapeutic effect was evaluated by RECIST standard,and the changes of Ki-67 before and after chemotherapy were observed. Results There were significant differences in size and internal blood flow signal of breast cancer before and after chemotherapy (P <0.05). The sensitivity of ultrasonography in the evaluation of neoadjuvant chemotherapy for breast cancer was 89.3%and specificity 53.8%. The clinical efficiency of neoadjuvant chemotherapy for breast cancer with high Ki-67 expression was higher than that with low Ki-67 expression. Conclusion Ultrasonography shows high clinical value in the evaluation of neoadjuvant chemotherapy for breast cancer ,and the expression of Ki-67 could predict the effi-cacy of neoadjuvant chemotherapy.

Breast cancer has become the main malignant tumors which pose a serious threat to women's health .Selective estrogen receptor modulators ,which served as the effective drug treatment ,have been attracting more attention .Present re‐search progress on the selective estrogen receptor modulators was summarized in this paper .

In order to explore the role of p15(INK4B) gene with highly methylated CpG island in the pathogenesis of leukemia, the expression levels of p15(INK4B) gene was detected in patients with AML and CML. Methylation-specific PCR (MSP) assay was employed in the experiments. The methylation incidence was 83.9% (26/31) in AML and 0% (0/28) in CML. The results showed that methylation of p15(INK4B) gene was the one of the major ways for inactivation of the gene, and the methylation could be appeared in clinical development of the disease and patients condition worsened. Methylation of p15(INK4B) did not occur and its function probably is normal in CML.