BACKGROUND: The effect of the interval between previous Helicobacter pylori (H. pylori) eradication and rescue treatment on therapeutic outcomes remains unknown. The aim of this study was to investigate the association between eradication rates and treatment interval durations in H. pylori infections. METHODS: This prospective observational study was conducted from December 2021 to February 2023 at six tertiary hospitals in Shandong, China. We recruited patients who were positive for H. pylori infection and required rescue treatment. Demographic information, previous times of eradication therapy, last eradication therapy date, and history of antibiotic use data were collected. The patients were divided into four groups based on the rescue treatment interval length: Group A, ≥4 weeks and ≤3 months; Group B, >3 and ≤6 months; Group C, >6 and ≤12 months; and Group D, >12 months. The primary outcome was the eradication rate of H. pylori . Drug compliance and adverse events (AEs) were also assessed. Pearson's χ2 test or Fisher's exact test was used to compare eradication rates between groups. RESULTS: A total of 670 patients were enrolled in this study. The intention-to-treat (ITT) eradication rates were 88.3% (158/179) in Group A, 89.6% (120/134) in Group B, 89.1% (123/138) in Group C, and 87.7% (192/219) in Group D. The per-protocol (PP) eradication rates were 92.9% (156/168) in Group A, 94.5% (120/127) in Group B, 94.5% (121/128) in Group C, and 93.6% (190/203) in Group D. There was no statistically significant difference in the eradication rates between groups in either the ITT ( P = 0.949) or PP analysis ( P = 0.921). No significant differences were observed in the incidence of AEs ( P = 0.934) or drug compliance ( P = 0.849) between groups. CONCLUSION: The interval duration of rescue treatment had no significant effect on H. pylori eradication rates or the incidence of AEs. REGISTRATION ClinicalTrials.gov , NCT05173493.
Humans ; Helicobacter Infections/drug therapy* ; Helicobacter pylori/pathogenicity* ; Male ; Female ; Prospective Studies ; Middle Aged ; Anti-Bacterial Agents/adverse effects* ; Adult ; Aged ; Treatment Outcome ; Proton Pump Inhibitors/therapeutic use*

Objective:To externally validated the intra-aortic balloon pump (IABP) shockⅡ score and CardShock score for predicting in-hospital mortality in patients with acute myocardial infarction complicated by cardiogenic shock (AMI-CS) and compared them with the Acute Physiology and Chronic Health EvaluationⅡ (APACHEⅡ) score.Methods:According to the inclusion and exclusion criteria, patients admitted to the cardiac care center (CCU) of our center from December 2010 to May 2019 were enrolled in this study. Patients’ baseline characteristics, in-hospital interventions, and outcomes were collected. The APACHEⅡ score was calculated during hospitalization by clinicians and collected by researchers. Two researchers independently calculated the IABP-ShockⅡ score and CardShock score; any disagreement was discussed with the third researcher. The performance of risk scores was evaluated by discrimination and calibration. The discriminative ability of risk scores was evaluated using the area under the receiver operating characteristic curve (AUC) and compared by the Delong method. The calibration of these risk scores was examined by the Hosmer-Lemeshow goodness-of-fit test. The calibration plot was also built.Results:A total of 150 patients enrolled in our study, and the in-hospital mortality was 60%. According to the IABP-ShockⅡ score, patients scored as low risk (0-2), moderate risk (3-4), and high risk (5-9) had in-hospital mortality of 29%, 68%, and 80%, respectively. According to the CardShock score, patients scored as low risk (0-3), moderate risk (4-5), and high risk (6-9)had in-hospital mortality of 21%, 57%, and 82%, respectively. According to the APACHEⅡ score, patients scored<20, 20-30, and >30 had in-hospital mortality of 19%, 69%, and 93%, respectively. For predicting the in-hospital mortality, the APACHEⅡ score demonstrated excellent discrimination (AUC=0.90, 95% CI: 0.84-0.95). The IABP-ShockⅡ score and CardShock score showed good discrimination (AUC=0.76, 95% CI: 0.68-0.83 and AUC=0.79, 95% CI: 0.72-0.85). The discriminative ability did not significantly differ between the IABP-ShockⅡ score and the CardShock score (0.76 vs 0.79, P>0.05), but both of which were significantly lower than the APACHEⅡ score (0.76 vs 0.90, P<0.05, and 0.79 vs 0.90, P<0.05). At the same time, it was not significantly different between the IABP-ShockⅡ score and the CardShock score (0.76 vs 0.79, P>0.05). All of these three scores were adequately calibrated according to the Hosmer-Lemeshow goodness-of-fit test ( P>0.05).The calibration plot showed accurate calibration of these three scores. Conclusions:Although less accurate than the APACHEⅡ score, the IABP-ShockⅡ score and CardShock score can show accurate prediction for in-hospital mortality of AMI-CS patients.

Objective To investigate the effects and related mechanism of 5-aza-2'-deoxycytidine (Aza) on endothelial function in Hyperhomocysteinemia rats.Methods Adult male SD rats were divided into 3 groups (n =7 each):control group,hyperhomocysteinemia (HHcy) group and Aza group according to the random number table.Control group rats were fed with normal diet.HHcy group rats were fed with diet adding 3％ L-methionine.Aza group rats were fed with diet adding 3％ L-methionine and Aza (0.5 mg/kg) injection for consecutive three days per week for 8 weeks.After 8 weeks,content of rat plasma homocysteine (Hcy) was detected by enzyme linked immunosorbent assay (ELISA).The rat mesenteric artery endothelium-dependent diastolic function was detected.The nitric oxide synthase (eNOS) activity and asymmetric dimethyl fine ammonia acid (ADMA) content were detected by ELISA,and the content of nitric oxide was detected by nitrate reductase method in the mesenteric arteries.The mRNA expression of DNA methyl transferase 1 (DNMT1) and dimethyl arginine acid dimethylamine hydrolase 2 (DDAH2) in the mesenteric arteries were detected by real-time fluorescence quantitative PCR,and the protein expressions of DNMT1 and DDAH2 in the mesenteric arteries were detected by Western blot.The DDAH2 promoter methylation level in the mesenteric arteries was detected by nested methylation specific PCR.Results (1) The content of plasma Hcy was significantly higher in the HHcy group and Aza group compared to the control group ((29.00 ±0.94) μmol/L and (26.43 ±0.47) μmol/L vs.(10.34 ±0.63) μmol/L,both P ＜ 0.01),which was significantly reduced in the Aza group compared with the HHcy group (P ＜ 0.05).(2) Acetylcholine-mediated relaxation at various concentrations was significantly lower in the HHcy group and the Aza group compared with the control group (both P ＜ 0.05),which was significantly increased in Aza group compared with HHcy group (P ＜ 0.05).SNP-mediated relaxation at various concentrations was similar among the three groups(all P ＞0.05).(3) Compared with the control group,the content of nitric oxide in the HHcy group was significantly decreased ((0.52 ± 0.01) μmol/g vs.(0.42 ± 0.00) μmol/g,P ＜ 0.01),which could be increased by Aza((0.49 ± 0.01) μmol/g,P ＜ 0.05);the eNOS activity in the HHcy group was significantly decreased ((0.74 ± 0.01) U/mg vs.(0.57 ± 0.00) U/mg,P ＜ 0.01),which could be significantly increased by Aza ((0.65 ±0.01) U/mg,P ＜0.01);the content of ADMA in the HHcy group was significantly increased ((0.34 ± 0.01) μmol/g vs.(0.37 ± 0.00) μmol/g,P ＜ 0.05),which could be significantly decreased by Aza ((0.32 ± 0.01) μmo]/g,P ＜ 0.05).(4) Compared with the control group,the relative expression of DDHA2 mRNA in the HHcy group was significantly decreased (0.15 ±0.01 vs.0.12 s0.01,P ＜0.01),which could be significantly increased by Aza (0.13 ± 0.01,P＜ 0.05);the relative expression of DDHA2 protein in the HHcy group was significantly decreased (0.31 ± 0.02 vs.0.24 ± 0.01,P ＜ 0.01),which could be significantly increased by Aza (0.28 ± 0.01,P ＜ 0.01).Compared with the control group,the relative expression of DNMT1 mRNA in the HHcy group was significantly increased (0.23 ± 0.01 vs.0.43 ± 0.01,P ＜ 0.01),which could be significantly decreased by Aza (0.39 ±0.01,P ＜0.05);the relative expression of DNMT1 protein in the HHcy group was significantly increased (0.35 ±0.01 vs.0.50 ±0.01,P ＜0.01),which could be significantly decreased by Aza (0.47 ± 0.01,P ＜ 0.05).(5) Compared with the control group,the methylated/non methylated ratio of DDHA2 promoter in the HHcy group was significantly increased (1.04 ± 0.03 vs.1.26 ± 0.03,P ＜ 0.01),which could be significantly decreased by Aza (0.80 ± 0.03,P ＜ 0.01).Conclusion Aza can inhibit the activity of DNMT1,reduce DDAH2 promoter methylation level,increase the expression of DDAH2,decrease the content of ADMA,increase eNOS activity and content of nitric oxide,thus lead to the improvement of endothelial dysfunction in mesenteric artery of Hyperhomocysteinemia rats.

OBJECTIVE:To promote the rational use of Chinese patent drugs(CPD).METHODS:The efficacy of several groups of CPD which share the similar formulation were compared and the components in each formulation were further analyzed in detail.RESULTS:The origins and pathogenesis of diseases treated with different CPD of the similar formulation varied,so did their indications.CONCLUSION:Only by following the principle of"Syndrome Differentiation Treatment"can the efficacy of CPD be maximized.

OBJECTIVE:To distinguish between the traditional science of Chinese materia medica and the pharmacognosy and discuss the developmental direction of the traditional Chinese medicine.METHODS:The differences between the traditional science of Chinese materia medica and the pharmacognosy in rationale,research contents,medical treatment principles and identification of the quality of the traditional Chinese medicine were compared to clarify that the pharmacognosy and traditional science of Chinese materia medica are completely different concepts.RESULTS:At present,the science of Chinese materia medica is constrained by the theory of pharmacognosy,and the traditional science of Chinese materia medica is tended to be gradually replaced by the western-medicine-theory-based pharmacognosy.CONCLUSION:It is necessary to reconsider and discuss the developmental direction of the traditional Chinese medicine.Modern research on Chinese medicine should follow the natural laws of the Chinese medicine itself rather than following the development mode of the western medicines.

OBJECTIVE:To explore ways to resolve the quality problems of Chinese herbal slice so as to provide reference for producers,processors and users.METHODS:The records of check and accept prepared slice into storeroom in our hospital during 2008 were summed up and sorted out.The number of total batches,the number and proportion of unqualified batches were calculated to analyze the causes of unqualified slice after checking.RESULTS:In 2008 there were 4 519 batches of herbal slice while 94 batches were unqualified and accounted for 2.1% in total.53 batches were refused because of their quality problem,accounting for 56.4% of unqualified batches.CONCLUSION:It is urgent to improve the quality of prepared slice and standardize the processing of herbal slice.