Objective:To investigate the antibiotic resistance of Helicobacter pylori (Hp) and to evaluate the eradication efficacy of individualized treatment for Hp in children. Methods:A retrospective cohort study was conducted on 227 children who visited the Department of Gastroenterology, Capital Center for Children′s Health, Capital Medical University from June 2022 to December 2023 due to gastrointestinal symptoms. All patients underwent gastroscopy and tested positive on 13C-urea breath testing. They were grouqed according to the Hp culture and drug susceptibility test. Children with positive Hp culture received personalized treatment based on the results of their drug sensitivity tests, while the other children who didn′t undergo Hp culture received empirical treatment. The effects of different treatment groups was compared by chi-square test or Fisher exact probability test. Results:A total of 227 children with Hp infection (121 males and 106 females) were included, with the age of 11.7 (8.9, 13.6) years. Among the 131 samples submitted for testing, 105 cases (80.1%) had positive results. Only 9.5% (10/105) of patients were sensitive to 6 antibiotics. The resistance rates to clarithromycin, metronidazole and levofloxacin were 90.5% (95/105), 86.7% (91/105) and 22.9% (24/105) respectively. The resistance rate to both clarithromycin and metronidazole was 77.1% (81/105). The resistance rate to both levofloxacin and metronidazole was 19.0% (20/105). The resistance rate to both levofloxacin and clarithromycin was 21.9% (23/105). The resistance rate to these three antibiotics was 16.2% (17/105). No strains resistant to furazolidone, amoxicillin or tetracycline hydrochloride were found. Eighty-nine cases were treated with bismuth quadruple therapy based on the drug sensitivity results, and the overall eradication rate was 88.8% (79/89), including 42 treatment-naive cases with a 100% eradication rate (42/42) and 47 retreatment cases with a 78.7% eradication rate (37/47). The eradication rate of empirical treatment was 75.7% (56/74). Among them, 65 patients received amoxicillin, clarithromycin and omeprazole because of negative penicillin skin tests, with a 75.4% (49/65) eradication rate; 9 patients received clarithromycin, metronidazole, omeprazole and bismuth with positive penicillin skin tests, achieving 7/9 eradication rate. The comparison of eradication rates between two treatment groups suggested a statistically significant difference ( P<0.05). No statistically significant difference was found in drug reactions such as nausea, vomiting, and rash between the two groups ( P>0.05). Conclusions:Hp strains had a relatively high dual resistance to clarithromycin and metronidazole, especially clarithromycin. For areas with a high resistance rate to clarithromycin, the bismuth quadruplet of clarithromycin removal combined with bismuth agent can be chosen as empirical treatment. In medical institutions where drug susceptibility test can be conducted, personalized treatment plans are recommended as the first-line treatment.

This paper aims to explore the effect of electrical stimulation of triboelectric nanogenerators (TENGs) on the osteogenic and other biological behaviors of mouse embryonic osteoblast precursor cells (MC3T3-E1 cells) on titanium surfaces. First, an origami-type TENG was fabricated, and its electrical output performance was tested. The optimal current of the generator and the feasibility of the experiment were verified by the CCK-8 assay and scratch assay. At the optimal current, the osteogenic conditions of the cells in each group were determined by quantitative analysis of the total protein content, alkaline phosphatase (ALP) activity, and alizarin red staining (ARS) on the titanium surface. Finally, the adhesion and spreading of cells on the titanium surface after electrical stimulation were observed. The results showed that the TENG had good electrical output performance, with an open-circuit voltage of 65 V and a short-circuit current of 42 μA. Compared with the rest of the current, a current strength of 30 μA significantly improved cell proliferation and migration, osteogenesis, and adhesion and spreading capabilities. The above results confirm the safety and operability of TENG in biomedical applications, laying the foundation for future TENG applications in reducing the time of bone integration around titanium implants after surgery.
Titanium/chemistry* ; Osteogenesis ; Animals ; Mice ; Osteoblasts/cytology* ; Electric Stimulation/instrumentation* ; Cell Adhesion ; Cell Proliferation ; Surface Properties ; Cell Differentiation ; Nanotechnology

Objective To evaluate the efficacy of uterine artery embolization(UAE)for the treatment of adenomyosis(AM)and to discuss the factors predicting efficacy.Methods The clinical data of 44 patients with AM,who received UAE at The Second Affiliated Hospital of Soochow University from January 2020 to August 2022,were retrospectively analyzed.Based on the MRI findings,serum CA125 levels and follow-up dysmenorrhea scores,the efficacy of UAE and the factors predicting efficacy were analyzed.Results A single UAE treatment was performed in all 44 patients with AM.Follow-up check with MRI at 12 months after treatment showed that the mean uterine volume decreased from preoperative(299.60±182.42)cm3 to postoperative(173.14±104.00)cm3,with a volume reduction of 36.64％(P＜0.05).The dysmenorrhea score decreased from preoperative(7.70±2.60)points to postoperative(2.20+2.37)points,with a relief rate of 88.64％(P＜0.05),and no severe adverse reactions occurred.Enhanced MRI demonstrated that in 30 patients(68.18％)the AM lesions presented as complete necrosis foci.In the patients whose preoperative lesions were completely necrotic,the mean preoperative serum CA125 level was(101.97±60.30)U/mL,the mean ADC value was(1.012+0.271)mm2/s,which were obviously lower than those in the patients whose preoperative lesions were incompletely necrotic(P＜0.05).The mean T2 signal ratio(T2SR)value in the patients whose preoperative lesions were completely necrotic was(0.582±0.198),which was significantly higher than that in the patients whose preoperative lesions were incompletely necrotic(P＜0.05).The analysis of receiver operating characteristic(ROC)curve showed that the preoperative area under the curve(AUC),sensitivity,and specificity for preoperative CA125 were 0.844,60％and 80％respectively;the AUC,sensitivity,and specificity for preoperative ADC were 0.760,80％and 65％respectively;and the AUC,sensitivity,and specificity for preoperative T2SR were 0.760,80％and 70％respectively.ADC＜1.116 × 10-3 mm2/s,T2SR＞0.479,and CA125＜109.10 U/mL could be used as the reliable predictive factors for the efficacy of UAE treatment for AM.Conclusion UAE can effectively alleviate dysmenorrhea symptoms in patients with AM,and it is clinically safe and effective.ADC,T2SR,and CA125 can be used as the reliable predictive factors for the efficacy of UAE treatment for AM,which are helpful in predicting the lesion response and selecting the reasonable therapeutic options for patients.

Obejective Based on the Citespace software,this study aims to comb the research hotspots and core contents of the development process of the TMD field in China,and carefully understand the research evolution process of the Temporo-mandibular Disorders(TMD)related fields in China,clarify its development timeline.Methods Using CNKI as the database source,through CiteSpace 6.1R6,we completed keyword co-occurrence,keyword clustering and emergence,and timeline knowledge mapping,and conducted a retrospective analysis of TMD-related literature published in China.Results A total of 2,034 domestic articles related to TMD were counted,and the development characteristics were obtained through data analysis:the treatment methods of TMD had evolved from combining traditional Chinese and Western medicine to Western medicine taking the dominant position,the research population had evolved from special populations to the general population,the focus had shifted from TMD itself to TMD-related and concurrent diseases,and the scope of research had continued to expand.Conclusions The development of literature on TMD disease has gone through three different periods,and there has been a significant shift in the research hotspots of TMD in China.The popularization rate of disease knowledge in TMD is not high,and further education needs to be provided to the general public.

Objective:To evaluate the epidemiological characteristics and influencing factors of out-of-hospital sudden cardiac death (SCD) in Hangzhou from 2016 to 2019.Methods:SCD events recorded by Hangzhou Emergency Center from January 1, 2016 to December 31, 2019 were reviewed. Demographic and mortality data were recorded, and the distribution patterns of SCD events in terms of date, time, and population with different characteristics were observed. Time series analysis method and a distributed lag nonlinear model based on quasi-Poisson distribution were used to explore the possible nonlinear association between ambient temperature and SCD incidence.Results:A total of 4 744 out-of-hospital sudden death events were recorded by Hangzhou Emergency Center from January 1, 2016 to December 31, 2019. After excluding non-SCD events and observed events with missing items, 3 743 SCD events were finally included in the study. The survey results showed that the incidence of out-of-hospital SCD in Hangzhou was 96.5 cases per 100 000 person-years. Most of the people who experienced SCD were aged ≥60 years. The incidence in males (2 462 cases, 66%) was significantly higher than that in females (1 281 cases, 34%), and the proportion of events occurring during the day (2 737 cases, 73%) was significantly higher than that at night (1 006 cases, 27%), mainly occurring between 7: 00 and 9: 00. High temperature was associated with an increased risk of SCD. When the average daily temperature was higher than 25.5 ℃, the risk of SCD increased with the further increase of average daily temperature.Conclusions:SCD events mainly occur in the elderly population aged ≥60 years, with a significantly higher incidence in males than in females, and more frequently during the day than at night, mainly between 7: 00 and 9: 00 in the morning. High temperature is closely related to the risk of SCD. It is particularly important to carry out targeted SCD screening and prevention for different populations and implement appropriate prevention strategies for high-risk groups of SCD in high-temperature weather.

Objective:To investigate the clinical subtypes of acute aortic dissection (AAD) through latent class analysis.Methods:This study was a multicenter retrospective cohort study. Patients with AAD admitted to five hospitals, including Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Henan Provincial People′s Hospital, Central China Fuwai Hospital of Zhengzhou University (Fuwai Central China Cardiovascular Hospital), the Third Affiliated Hospital of Xinxiang Medical University and the Second Affiliated Hospital of Chongqing Medical University, between August 2010 and December 2021 were enrolled. Based on clinical and biological characteristics, latent class analysis (models with 2 to 5 latent classes) was conducted to classify the enrolled patients. The optimal classification scheme was determined using model fitting evaluations, including log-likelihood (LL), entropy, Lo-Mendell-Rubin adjusted likelihood ratio test and so on. Clinical data of different subtypes were compared, and in-hospital mortality was analyzed across the entire population and among subgroups receiving different treatments.Results:A total of 2 689 AAD patients, aged 54 (46, 63) years were included, with 1 305 (48.5%) having DeBakey type Ⅰ, 156 (5.8%) type Ⅱ, and 1 228 (45. 7%) type Ⅲ dissections. The cohort comprised 2 134 (79.4%) males. The overall in-hospital mortality rate was 22.8% (613/2 689). Latent class analysis indicated that a two-class model was optimal (LL=147 413.242, entropy=0.812, and PLMRT<0.001). Patients were classified into two subtypes, named clinical subtype 1 and clinical subtype 2. Compared to clinical subtype 1, clinical subtype 2 had a higher proportion of females, was older, had more dissections involving the ascending aorta, and exhibited higher rates of organ dysfunction (elevated alanine aminotransferase and creatinine levels) and inflammatory response (neutrophilia) (all P<0.05). Clinical subtype 2 also showed higher in-hospital mortality compared to subtype 1 (26.3% (238/905) vs. 21.0% (375/1 784), P=0.002). Among patients undergoing surgical treatment, clinical subtype 2 had higher mortality than subtype 1 (40.1% (67/167) vs. 30.0% (101/337), P=0.027). However, no significant differences in mortality were observed between the two subtypes among patients receiving medical therapy or endovascular and hybrid procedures (all P>0.05). Conclusions:Comprehensive latent class analysis identifies two subtypes of AAD with distinct clinical characteristics and treatment responses. These findings provide new insights into individualized clinical decision-making and prognostic evaluation for AAD patients.

Purpose To investigate the clinicopathological features and cytogenetic characteristics in the fumarate hydratase(FH)-deficient uterine smooth muscle tumors.Methods A total of 334 paraffin-embedded specimen of be-nign,borderline,and malignant uterine smooth muscle tumors were collected.FH-deficient uterine smooth muscle tumors were screened using the immunohistochemical detection with FH and S-(2-succino)-cysteine(2SC)antibodies.A retrospective analysis of the clinicopathological features and FH mutations was conducted.Results Compared with the 310 non-FH-deficient uterine leiomyomas(non-FH-dUL),14 cases(93.3％)out of the 15 FH-dUL presented with staghorn blood vessels(x2=52.86,P＜0.000 1),8 cases(53.3％)exhibited pulmonary edema-like stroma(x2=26.41,P＜0.000 1),8 cases(53.3％)had cytoplasmic eosinophilic globules(x2=41.85,P＜0.000 1),5 cases(33.3％)showed multifocal bizarre nuclei(x2=72.54,P＜0.000 1),5 cases(33.3％)had large eosino-philic nucleoli with viral inclusion-like halos(x2=38.85,P＜0.000 1),and 5 cases(33.3％)demonstrated a sig-nificant increase in cell density(x2=8.782,P=0.003).The above morphological features were also observed in a case of FH-d uSTUMP and FH-d uLMS.Among the 14 cases with follow-up,except for one death in the FH-d uLMS,none reported the renal cell carcinoma and cutaneous leiomyoma.FH mutations were identified in 11 cases and the hotspot mutations were found in exon 1,2,4,5,6 and 7.Among these variations,c.125C＞T,c.151C＞T and c.704A＞C were found to be the hotspot gene variations.Furthemore,7 gene variations(c.197A＞G,c.426G＞T,c.505C＞T,c.704A＞C,c.812A＞C,c.847T＞C,c.1006A＞G)were not included in COSMIC and ClinVar database and were supposed to be novel.Conclusion The combination of FH/2SC immunohistochemical detection and FH exon mutation analysis are reliable tools for the early identification of FH-deficient uterine smooth muscle tumors or hereditary leiomyomatosis and renal cell carcinoma(HLRCC)syndrome.

Objective To investigate the expression of N-acetyltransferase 10(NAT10),serine hydroxymethyltransferase 2(SHMT2)and YTH domain family protein 1(YTHDF1)in lung cancer tissues and their correlation with clinicopathological characteristics and prognosis.Methods A total of 98 lung cancer patients admitted to our hospital from April 2020 to April 2021 were regarded as the observation subjects.The cancerous tissues and adjacent tissues of the patient during surgery were collected.Immunohistochemistry was used to detect the expression levels of NAT10,SHMT2 and YTHDF1.The patients were followed up for 3 years and divided into the survival group and the death group according to their prognosis.The data of general clinicopathological characteristics were collected and analyzed.The relationship between NAT10,SHMT2 and YTHDF1 with the prognosis of patients were analyzed.Multivariate Cox regression was used to analyze the influencing factors of lung cancer patients.Results The high expression ratios of NAT10,SHMT2 and YTHDF1 in cancer tissues were obviously higher than those in adjacent tissues(P＜0.05).The expression of NAT10 and YTHDF1 was related to clinical stage,degree of differentiation and lymph node metastasis(P＜0.05),and the expression of SHMT2 was correlated with clinical stage,degree of differentiation,tumor diameter,and lymph node metastasis(P＜0.05).There were statistically significant differences in tumor diameter,clinical stage,degree of differentiation,lymph node metastasis,and expressions of NAT10,SHMT2,and YTHDF1 between the survival group and the death group(P＜0.05).NAT10,SHMT2,YTHDF1 patient survival rates significantly below the low of high expression patients(x2=6.354,P=0.012,x2=8.512,P=0.004,x2=4.791,P=0.029).Lymph node metastasis,high expression of NAT10,SHMT2 and YTHDF1 are all risk factors affecting the prognosis of patients(P＜0.05).Conclusion NAT10,SHMT2,and YTHDF1 are all highly expressed in the tissues of lung cancer,and have a certain correlation with clinical pathological characteristics and prognosis.They may serve as relevant evaluation indicators for the prognosis of lung cancer patients.

Objective:To investigate the characteristics and clinical effects of laparoscopic pneumovesical Cohen and laparoscopic Lich-Gregoir ureteral replantations for the treatment of primary obstructive megaloureter (POM) in children.Methods:A randomized controlled study was conducted.The clinical data of 51 children with unilateral POM admitted to the First Affiliated Hospital of Zhengzhou University from October 2018 to October 2023 were collected.Random number table method was used in the selection of surgical methods.They were divided into the laparoscopic pneumovesical Cohen ureteral replantation group (group A, 22 cases) and the laparoscopic Lich-Gregoir ureteral replantation group (group B, 29 cases) according to the surgical method.The anterior-posterior diameter(APD), maximum ureteral diameter and differential renal function parameters on the affected side were measured by color Doppler ultrasound of the urinary system, and compared between and within the two groups before and after surgery.The operation time, blood loss and postoperative intubation time were compared between the two groups.The incidence of postoperative complications such as reflux, bladder spasm, urinary retention and urinary tract infection was recorded.The independent and paired sample t-tests were used for statistical analysis. Results:The operation time and hematuria duration of group B [(125.7±14.2) min, (1.5±0.6) d] were significantly shorter than those of group A [(142.6±14.7) min, (2.8±0.7) d] (all P<0.05). The APD, maximum ureteral diameter, and differential renal function on the affected side of group A were (21.7±7.9) mm, (11.6±3.2) mm, and (28.2±4.9)% before surgery, and (10.3±4.5) mm, (6.0±2.0) mm and (43.8±4.4)% after surgery, respectively.The APD, maximum ureteral diameter, and differential renal function on the affected side of group B were (21.1±5.6) mm, (11.3±4.6) mm, and (30.2±5.5)% before surgery, and (10.2±4.5) mm, (6.6±2.0) mm, and (42.4±5.2)% after surgery, respectively.There was no statistically significant difference in the values of APD, maximum ureteral diameter, and differential renal function before and after surgery between the two groups of children (all P>0.05). However, there were statistically significant differences in the values of APD, maximum ureteral diameter, and differential renal function before and after surgery between the same group of children (all P<0.01). No significant difference was found in intraoperative blood loss, postoperative intubation time, and postoperative complications between the two groups (all P>0.05). Conclusions:Both surgical methods are effective in the treatment of POM in children.Laparoscopic Lich-Gregoir ureteral replantation has advantages of less operation time compared with laparoscopic pneumovesical Cohen ureteral replantation.