OBJECTIVE To evaluate the efficacy and safety of amoxicillin combined with proton pump inhibitor （PPI） or potassium-competitive acid blocker （P-CAB） for Helicobacter pylori （Hp） eradication. METHODS Randomized controlled trial （RCTs） on amoxicillin combined with PPI or P-CAB for Hp eradication were retrieved from PubMed， Embase， the Cochrane Library， Web of Science， CNKI， Wanfang， and VIP data. The search time frame was from database inception to September 5， 2025. After literature screening， data extraction， and quality assessment， a network meta-analysis was performed using Stata 17.0 software. RESULTS A total of 12 RCTs involving 5 515 patients were included， encompassing 8 therapeutic regimens： PPI combined with high-dose amoxicillin for 14 days （TR1）， PPI combined with low-dose amoxicillin for 14 days （TR2）， P-CAB combined with high-dose amoxicillin for 7 days （TR3）， P-CAB combined with high-dose amoxicillin for 14 days （TR4）， P-CAB combined with high-dose amoxicillin for 10 days （TR5）， P-CAB combined with low-dose amoxicillin for 7 days （TR6）， P-CAB combined with low-dose amoxicillin for 14 days （TR7）， and P-CAB combined with low-dose amoxicillin for 10 days （TR8）. The network meta-analysis results showed that， in terms of intention-to-treat Hp eradication rates， the eradication rates of TR5 and TR4 were significantly higher than those of TR3， TR8， TR6 and TR1 （ P ＜0.05）. The surface under the cumulative ranking curve （SUCRA） values from highest to lowest were： TR4 （89.7%）＞TR5 （82.3%）＞TR7 （71.5%）＞ TR2 （48.6%）＞TR1 （43.9%）＞TR8 （28.7%）＞TR3 （22.7%）＞TR6 （12.6%）. Regarding safety， the incidence of adverse reactions in TR3 and TR5 was significantly lower than that in TR1 （ P ＜0.05）. The SUCRA values from highest to lowest were： TR1 （91.3%）＞TR4 （79.8%）＞TR5 （55.0%）＞TR7 （50.9%）＞TR8 （41.3%）＞TR2 （36.4%）＞TR3 （27.6%） ＞TR6 （17.7%）. CONCLUSIONS Although the regimen of P-CAB combined with high-dose amoxicillin for 14 days demonstrates the best efficacy， the combination of P-CAB with high-dose amoxicillin for 10 days exhibits a better balanced profile in terms of both efficacy and safety.

Neurofibromatosis type 1 (NF1) presents with a diverse range of symptoms that can affect the skin, bones, eyes, central nervous system, and other organs. This article reports the diagnosis and treatment process of a patient with NF1 complicated by bilateral severe-to-profound sensorineural hearing loss. Genetic testing revealed a heterozygous variant of NF1 NM_ 000267.3: c.4054_ 4058del(p.Ser1352LeufsTer20, supporting the diagnosis of NF1. After thorough evaluation, a right cochlear implantation was performed, yielding satisfactory postoperative results. This case suggests that NF1 patients may exhibit phenotypic heterogeneity and atypicality, providing a reference for clinicians in the diagnosis and treatment of such patients.

One hundred 1-day-old HY-LINE VARIETY BROWN were randomly divided into 5 groups:the blank group,the model group,the Baihuang Zhili decoction low-dose treatment group(1 g/kg),the Baihuang Zhili decoction medium-dose treatment group(2 g/kg)and the Baihuang Zhili decoction high-dose treatment group(4 g/kg).The results showed that:(1)Compared with the model group,Baihuang Zhili decoction could restore the integrity of intestinal mucosal barrier structure and reduce inflammation.It significantly increased the expression of tight junction pro-teins ZO-1,Claudin-1 and Occludin in small intestine(P＜0.05),and significantly decreased the levels of DAO(diamine axidase)and D(-)-lactic acid(P＜0.05).(2)Compared with the model group,Baihuang Zhili decoction could significantly increase the number of goblet cells(P＜0.05).Baihuang Zhili decoction could significantly increase the MUC2 levels of duodenum,and the MUC2 level of ileum in 1 g/kg group and 4 g/kg group was significantly increased(P＜0.05),the MUC2 levels of jejunum in 2 g/kg group were significantly increased(P＜0.05).(3)Compared with the model group,Baihuang Zhili decoction significantly decreased the sIgA level in duodenum and jeju-num(P＜0.05),and the sIgA level in ileum in 1 g/kg group was significantly decreased(P＜0.05).The IgG level in serum was significantly decreased(P＜0.05).Baihuang Zhili decoction could significantly reduce the expression levels of intestinal immune-related genes(IL-1β,IL-2,IL-6,IL-8,TNF-α)(P＜0.05).It could significantly decrease the expression levels of immune-related factors(TNF-α,IFN-γ,IL-1β,IL-2)in tonsil of cecum(P＜0.05).(4)Compared with the model group,Baihuang Zhili decoction could increase Ace,Chao and Shannon index of intestinal flora,reduce Simpson index of intestinal flora,and increase alpha diversity of intestinal microbes.It significantly decreased the relative abundance of Proteobacteria(P＜0.05),and significantly increased the rela-tive abundance of Campylobacterota(P＜0.05).It also significantly decreased the relative abun-dance of Lactobacillus(P＜0.05).In summary,Baihuang Zhili decoction can improve the damage of intestinal mechanical barrier,chemical barrier,immune barrier and microbial barrier caused by pul-lorum disease,and enhance the intestinal immunity.

Liver fibrosis is a common outcome of various chronic hepatic insults, characterized by excessive extracellular matrix (ECM) deposition. The precise mechanisms, however, remain largely undefined. This study identified an elevated expression of platelet-activating factor acetylhydrolase 1B3 (Pafah1b3) in liver tissues from both carbon tetrachloride (CCl₄)-treated mice and patients with cirrhosis. Deletion of Pafah1b3 significantly attenuated CCl₄-induced fibrosis, hepatic stellate cell (HSC) activation, and activation of transforming growth factor-β (TGF-β) signaling. Mechanistically, PAFAH1B3 binds to mothers against decapentaplegic homolog 7 (SMAD7), disrupting SMAD7's interaction with TGF-β receptor 1 (TβR1), which subsequently decreases TβR1 ubiquitination and degradation. Pharmacological inhibition using 3-IN-P11, a specific Pafah1b3 inhibitor, conferred protective effects against CCl₄-induced fibrosis in mice. Furthermore, Pafah1b3 deficiency reduced hepatic inflammation. Overall, these results establish a pivotal role for Pafah1b3 in modulating TGF-β signaling and driving HSC activation.

Liver fibrosis is a common outcome of various chronic hepatic insults,characterized by excessive extracellular matrix(ECM)deposition.The precise mechanisms,however,remain largely undefined.This study identified an elevated expression of platelet-activating factor acetylhydrolase 1B3(Pafah1b3)in liver tissues from both carbon tetrachloride(CCl4)-treated mice and patients with cirrhosis.Deletion of Pafah 1b3 significantly attenuated CCl4-induced fibrosis,hepatic stellate cell(HSC)activation,and acti-vation of transforming growth factor-β(TGF-β)signaling.Mechanistically,PAFAH1B3 binds to mothers against decapentaplegic homolog 7(SMAD7),disrupting SMAD7's interaction with TGF-β receptor 1(TβR1),which subsequently decreases TβR1 ubiquitination and degradation.Pharmacological inhibition using 3-IN-P11,a specific Pafah1b3 inhibitor,conferred protective effects against CCl4-induced fibrosis in mice.Furthermore,Pafah 1b3 deficiency reduced hepatic inflammation.Overall,these results establish a pivotal role for Pafahl b3 in modulating TGF-β signaling and driving HSC activation.

Objective:To conduct a scoping review on the critical values for lifestyle risk factors in young and middle-aged patients with prediabetes progressing to diabetes, so as to provide a reference for clinical screening, prevention, intervention, and patient self-management.Methods:Guided by the scoping review methodology and framework developed by Arksey et al., research questions were identified. Through systematic searches of Chinese and English literature databases, studies on risk factors in young and middle-aged patients with prediabetes progressing to diabetes published from the establishment of the database to August 11, 2024 were screened. Studies examining critical values for lifestyle risk factors were selected for data extraction, summary of findings, and qualitative analysis.Results:A total of 19 articles were ultimately included. Lifestyle risk factors encompassed diet, exercise, smoking, drinking, and step count. Specific indicators included daily sugar intake >25 grams, weekly exercise time <150 min, daily exercise time <30 min, weekly drinking ≥3 times with ≥180 ml of clear liquor per session, and daily step count <5 000 steps.Conclusions:There are different characteristics and critical values of the influence of various factors on the progress of diabetes. Future research should further standardize criteria and conduct large-scale, multicenter, long-term follow-up studies to establish optimal critical values for lifestyle factors, thereby providing evidence for diabetes screening, prevention, and intervention.

Objective:To conduct a scoping review on the critical values for lifestyle risk factors in young and middle-aged patients with prediabetes progressing to diabetes, so as to provide a reference for clinical screening, prevention, intervention, and patient self-management.Methods:Guided by the scoping review methodology and framework developed by Arksey et al., research questions were identified. Through systematic searches of Chinese and English literature databases, studies on risk factors in young and middle-aged patients with prediabetes progressing to diabetes published from the establishment of the database to August 11, 2024 were screened. Studies examining critical values for lifestyle risk factors were selected for data extraction, summary of findings, and qualitative analysis.Results:A total of 19 articles were ultimately included. Lifestyle risk factors encompassed diet, exercise, smoking, drinking, and step count. Specific indicators included daily sugar intake >25 grams, weekly exercise time <150 min, daily exercise time <30 min, weekly drinking ≥3 times with ≥180 ml of clear liquor per session, and daily step count <5 000 steps.Conclusions:There are different characteristics and critical values of the influence of various factors on the progress of diabetes. Future research should further standardize criteria and conduct large-scale, multicenter, long-term follow-up studies to establish optimal critical values for lifestyle factors, thereby providing evidence for diabetes screening, prevention, and intervention.

One hundred 1-day-old HY-LINE VARIETY BROWN were randomly divided into 5 groups:the blank group,the model group,the Baihuang Zhili decoction low-dose treatment group(1 g/kg),the Baihuang Zhili decoction medium-dose treatment group(2 g/kg)and the Baihuang Zhili decoction high-dose treatment group(4 g/kg).The results showed that:(1)Compared with the model group,Baihuang Zhili decoction could restore the integrity of intestinal mucosal barrier structure and reduce inflammation.It significantly increased the expression of tight junction pro-teins ZO-1,Claudin-1 and Occludin in small intestine(P＜0.05),and significantly decreased the levels of DAO(diamine axidase)and D(-)-lactic acid(P＜0.05).(2)Compared with the model group,Baihuang Zhili decoction could significantly increase the number of goblet cells(P＜0.05).Baihuang Zhili decoction could significantly increase the MUC2 levels of duodenum,and the MUC2 level of ileum in 1 g/kg group and 4 g/kg group was significantly increased(P＜0.05),the MUC2 levels of jejunum in 2 g/kg group were significantly increased(P＜0.05).(3)Compared with the model group,Baihuang Zhili decoction significantly decreased the sIgA level in duodenum and jeju-num(P＜0.05),and the sIgA level in ileum in 1 g/kg group was significantly decreased(P＜0.05).The IgG level in serum was significantly decreased(P＜0.05).Baihuang Zhili decoction could significantly reduce the expression levels of intestinal immune-related genes(IL-1β,IL-2,IL-6,IL-8,TNF-α)(P＜0.05).It could significantly decrease the expression levels of immune-related factors(TNF-α,IFN-γ,IL-1β,IL-2)in tonsil of cecum(P＜0.05).(4)Compared with the model group,Baihuang Zhili decoction could increase Ace,Chao and Shannon index of intestinal flora,reduce Simpson index of intestinal flora,and increase alpha diversity of intestinal microbes.It significantly decreased the relative abundance of Proteobacteria(P＜0.05),and significantly increased the rela-tive abundance of Campylobacterota(P＜0.05).It also significantly decreased the relative abun-dance of Lactobacillus(P＜0.05).In summary,Baihuang Zhili decoction can improve the damage of intestinal mechanical barrier,chemical barrier,immune barrier and microbial barrier caused by pul-lorum disease,and enhance the intestinal immunity.

Objective To establish a clinical-CT model,and to observe its value for evaluating lymphovascular invasion(LVI)and/or perineural invasion(PNI)in esophageal squamous cell carcinoma(ESCC).Methods Data of 156 ESCC patients were retrospectively analyzed.The patients were divided into positive group(n=58,LVI[+]and/or PNI[+])and negative group(n=98,LVI[-]and PNI[-])according to postoperative pathological results.Clinical and CT data were compared between groups.Logistic regression analysis was performed to establish a model,and its efficacy of evaluating ESCC LVI and/or PNI was analyzed.Results Significant differences of carcinoembryonic antigen(CEA),carbohydrate antigen 199(CA199),tumor thickness,tumor volume and CT venous phase value(CTV),the difference between CTV and CT plain phase value(CTP)(△CTV-P)and venous phase enhancement rate(V％)were found between groups(all P＜0.05),and the area under the curve(AUC)of the above parameters for evaluating ESCC LVI and/or PNI was 0.702,0.690,0.731,0.744,0.621,0.631 and 0.599,respectively.CEA,CA199,tumor thickness,tumor volume and CTV were all independent predictive factors for ESCC LVI and/or PNI.A combined model was established based on the above features,and its accuracy,sensitivity and specificity for evaluating ESCC LVI and/or PNI was 82.05％,65.52％and 91.84％,respectively,with AUC of 0.838,higher than that of each single parameter(all P＜0.05).Conclusion The established clinical-CT model could effectively evaluate ESCC LVI and/or PNI.

Objective To observe the value of intratumoral and peritumoral CT radiomics for evaluating KRAS gene status in patients with colorectal adenocarcinoma.Methods Totally 245 patients with colorectal adenocarcinoma were retrospectively enrolled and divided into mutant group(n=139)and wild group(n=106)according to KRAS gene status,also divided into training set(n=171)and test set(n=74)at a ratio of 7∶3.Clinical data were compared between groups,and clinical factors were screened with logistic regression analysis to establish a clinical model.Based on enhanced venous phase CT images,intratumoral volume of interest(VOI),peritumoral VOI,and intratumoral+peritumoral VOI were delineated,radiomics features were extracted,and radiomics models were constructed.The combination model was constructed based on the best radiomics model combined with clinical factors.The value of each model for evaluating KRAS gene status in patients with colorectal adenocarcinoma was analyzed.Results Significant differences of patients’gender and carcinoembryonic antigen(CEA)were found between mutant group and wild group(both P＜0.05),which were independent impact factors of KRAS gene status in patients with colorectal adenocarcinoma(both P＜0.05).The area under the curve(AUC)of clinical model for evaluating KRAS gene status in patients with colorectal adenocarcinoma in training set and test set was 0.633 and 0.658,respectively.Intratumoral+peritumoral 3 mm model was the best radiomics model,with AUC of 0.921 and 0.894 in training set and test set,respectively.AUC of the combination model in training set and test set was 0.949 and 0.956,respectively.In training set,significant differences of AUC were found between clinical model and intratumoral+peritumoral 3 mm model,also between clinical model and combination model(both P＜0.001),while in test set,significant differences of AUC were found between each two models(all P＜0.05).Conclusion Intratumoral+peritumoral 3 mm radiomics based on enhanced venous phase CT could help to evaluate KRAS gene status in patients with colorectal adenocarcinoma.Combining with patients’gender and CEA could further improve efficacy of this model.