Objective:To evaluate the effectiveness of empiric eradication therapy recommendations and medication principles for refractory infections based on the 2022 Helicobacter pylori ( H. pylori) infection treatment guidelines in China in clinical practice. Methods:A retrospective analysis was conducted to evaluate the eradication efficacy of H. pylori and the safety and treatment compliance among of 637 patients with refractory H. pylori infection in our center over the past 10 years. Risk factors affecting efficacy of H. pylori eradication were evaluated. Results:The overall eradication rate, incidence of adverse reactions and medication percentage of 14-day bismuth quadruple therapy were 92.3%, 40.3% and 92.2%, respectively. The eradication rate, incidence of adverse reactions, and proportion of administered treatments were as follows: 87.3%, 36.4% and 92.7% for amoxicillin+metronidazole; 91.1%, 39.2% and 93.7% for amoxicillin+tetracycline; 92.9%, 23.8% and 94.0% for amoxicillin+furazolidone; 92.1%, 47.1% and 90.0% for tetracycline+metronidazole; 94.5%, 41.7% and 92.0% for tetracycline+furazolidone, and 91.3%, 46.3% and 92.5% for furazolidone+metronidazole. Poor compliance was a risk factor for the failure of eradication therapy (94.7% vs. 64.0%, P<0.05). There was no statistically significant difference ( P>0.05) in the eradication rate among patients in terms of sex, age, body mass index, smoking status, alcohol consumption, previous eradication frequency, eradication interval, or eradication regimens. Conclusion:The empirical treatment regimens and medication principles recommended in the 2022 H. pylori infection treatment guidelines in China achieve good eradication efficacy, safety, and compliance.

Objective A comprehensive evaluation of three kinds of closed triple therapy(fluticasone furoate,umeclidinium bromide and vilanterol trifenatate powder for inhalation,budesonide,glycopyrronium bromide and formoterol fumarate inhalation aerosol,beclometasone dipropionate,formoterol fumarate and glycopyrrolate inhalation aerosol)for stable maintenance treatment of chronic obstructive pulmonary disease(COPD)is conducted to provide reference for drug selection and rational clinical use in medical institutions.Methods Based on the Quick Guidelines for Drug Evaluation and Selection in Chinese Medical Institutions(Second Edition),this study collected drug instructions,clinical guidelines,and relevant literature from databases such as China National Knowledge Infrastructure(CNKI),Wanfang Database,VIP Database for Chinese Technical Periodicals(VIP),PubMed,Embase and Cochrane Library.Quantitative indicators were established to evaluate three inhalations that closed triple therapy formulations from five dimensions:effectiveness,pharmacological characteristics,safety,economy,and other attributes.Results The comprehensive scores of the formulations included in the evaluation are all above 80 points,among which the comprehensive score of fluticasone furoate,umeclidinium bromide and vilanterol trifenatate powder for inhalation is the highest at 89.2 points,followed by budesonide,glycopyrronium bromide and formoterol fumarate inhalation aerosol at 87.6 points,and the lowest score of beclometasone dipropionate,formoterol fumarate and glycopyrrolate inhalation aerosol at 82.9 points.Conclusions All three formulations have shown good clinical efficacy,and different triple formulations have different advantages in clinical treatment.Through the comprehensive evaluation of three types of inhalation triple preparations,it can provide a reference for drug selection in medical institutions,and provide a basis for clinical scientific,rational,safe,and personalized medication.

Objective A comprehensive evaluation of three kinds of closed triple therapy(fluticasone furoate,umeclidinium bromide and vilanterol trifenatate powder for inhalation,budesonide,glycopyrronium bromide and formoterol fumarate inhalation aerosol,beclometasone dipropionate,formoterol fumarate and glycopyrrolate inhalation aerosol)for stable maintenance treatment of chronic obstructive pulmonary disease(COPD)is conducted to provide reference for drug selection and rational clinical use in medical institutions.Methods Based on the Quick Guidelines for Drug Evaluation and Selection in Chinese Medical Institutions(Second Edition),this study collected drug instructions,clinical guidelines,and relevant literature from databases such as China National Knowledge Infrastructure(CNKI),Wanfang Database,VIP Database for Chinese Technical Periodicals(VIP),PubMed,Embase and Cochrane Library.Quantitative indicators were established to evaluate three inhalations that closed triple therapy formulations from five dimensions:effectiveness,pharmacological characteristics,safety,economy,and other attributes.Results The comprehensive scores of the formulations included in the evaluation are all above 80 points,among which the comprehensive score of fluticasone furoate,umeclidinium bromide and vilanterol trifenatate powder for inhalation is the highest at 89.2 points,followed by budesonide,glycopyrronium bromide and formoterol fumarate inhalation aerosol at 87.6 points,and the lowest score of beclometasone dipropionate,formoterol fumarate and glycopyrrolate inhalation aerosol at 82.9 points.Conclusions All three formulations have shown good clinical efficacy,and different triple formulations have different advantages in clinical treatment.Through the comprehensive evaluation of three types of inhalation triple preparations,it can provide a reference for drug selection in medical institutions,and provide a basis for clinical scientific,rational,safe,and personalized medication.

Objective:To evaluate the effectiveness of empiric eradication therapy recommendations and medication principles for refractory infections based on the 2022 Helicobacter pylori ( H. pylori) infection treatment guidelines in China in clinical practice. Methods:A retrospective analysis was conducted to evaluate the eradication efficacy of H. pylori and the safety and treatment compliance among of 637 patients with refractory H. pylori infection in our center over the past 10 years. Risk factors affecting efficacy of H. pylori eradication were evaluated. Results:The overall eradication rate, incidence of adverse reactions and medication percentage of 14-day bismuth quadruple therapy were 92.3%, 40.3% and 92.2%, respectively. The eradication rate, incidence of adverse reactions, and proportion of administered treatments were as follows: 87.3%, 36.4% and 92.7% for amoxicillin+metronidazole; 91.1%, 39.2% and 93.7% for amoxicillin+tetracycline; 92.9%, 23.8% and 94.0% for amoxicillin+furazolidone; 92.1%, 47.1% and 90.0% for tetracycline+metronidazole; 94.5%, 41.7% and 92.0% for tetracycline+furazolidone, and 91.3%, 46.3% and 92.5% for furazolidone+metronidazole. Poor compliance was a risk factor for the failure of eradication therapy (94.7% vs. 64.0%, P<0.05). There was no statistically significant difference ( P>0.05) in the eradication rate among patients in terms of sex, age, body mass index, smoking status, alcohol consumption, previous eradication frequency, eradication interval, or eradication regimens. Conclusion:The empirical treatment regimens and medication principles recommended in the 2022 H. pylori infection treatment guidelines in China achieve good eradication efficacy, safety, and compliance.

BACKGROUND: Given the general unavailability, common adverse effects, and complicated administration of tetracycline, the clinical application of classic bismuth quadruple therapy (BQT) is greatly limited. Whether minocycline can replace tetracycline for Helicobacter pylori ( H . pylori ) eradication is unknown. We aimed to compare the eradication rate, safety, and compliance between minocycline- and tetracycline-containing BQT as first-line regimens. METHODS: This randomized controlled trial was conducted on 434 naïve patients with H . pylori infection. The participants were randomly assigned to 14-day minocycline-containing BQT group (bismuth potassium citrate 110 mg q.i.d., esomeprazole 20 mg b.i.d., metronidazole 400 mg q.i.d., and minocycline 100 mg b.i.d.) and tetracycline-containing BQT group (bismuth potassium citrate/esomeprazole/metronidazole with doses same as above and tetracycline 500 mg q.i.d.). Safety and compliance were assessed within 3 days after eradication. Urea breath test was performed at 4-8 weeks after eradication to evaluate outcome. We used a noninferiority test to compare the eradication rates of the two groups. The intergroup differences were evaluated using Pearson chi-squared or Fisher's exact test for categorical variables and Student's t -test for continuous variables. RESULTS: As for the eradication rates of minocycline- and tetracycline-containing BQT, the results of both intention-to-treat (ITT) and per-protocol (PP) analyses showed that the difference rate of lower limit of 95% confidence interval (CI) was >-10.0% (ITT analysis: 181/217 [83.4%] vs . 180/217 [82.9%], with a rate difference of 0.5% [-6.9% to 7.9%]; PP analysis: 177/193 [91.7%] vs . 176/191 [92.1%], with a rate difference of -0.4% [-5.6% to 6.4%]). Except for dizziness more common (35/215 [16.3%] vs . 13/214 [6.1%], P = 0.001) in minocycline-containing therapy groups, the incidences of adverse events (75/215 [34.9%] vs . 88/214 [41.1%]) and compliance (195/215 [90.7%] vs . 192/214 [89.7%]) were similar between the two groups. CONCLUSION: The eradication efficacy of minocycline-containing BQT was noninferior to tetracycline-containing BQT as first-line regimen for H . pylori eradication with similar safety and compliance. TRIAL REGISTRATION ClinicalTrials.gov, ChiCTR 1900023646.
Humans ; Bismuth/therapeutic use* ; Metronidazole/therapeutic use* ; Esomeprazole/pharmacology* ; Minocycline/pharmacology* ; Helicobacter pylori ; Potassium Citrate/therapeutic use* ; Anti-Bacterial Agents ; Tetracycline/adverse effects* ; Helicobacter Infections/drug therapy* ; Drug Therapy, Combination ; Amoxicillin

Objective:To analyze the impact of previous exposure to macrolide, quinolones and nitroimidazole antibiotics on eradication rate of bismuth quadruple therapy (BQT) in newly diagnosed patients with Helicobacter pylori( H. pylori). Methods:A total of 469 patients with H. pylori initially treated at the Third Hospital of Peking University from September 2017 to August 2020 were retrospectively recruited. The therapeutic regimens were BQT containing clarithromycin/levofloxacin/metronidazole recommended by Chinese guidelines. Clinical data were collected, including general demographic data, exposure history of antibiotics, CYP2C16 metabolic pattern, endoscopic diagnosis, bacterial density, H.pylori resistance, eradication results, etc. Univariate analysis, Chi-square test, Fisher exact probability test, Kruskal-Wallis H test and Logistic regression model were used as statistical methods. Results:Among different eradication therapies, univariate and multivariate analyses suggested that previous exposure to macrolides ( OR=3.37,95 %CI 1.04-10.98, P<0.05) was relevant to the decreased eradication rate of BQT containing clarithromycin. This may be due to increased resistance to clarithromycin ( OR=6.12,95 %CI 3.99-9.40, P<0.01).The previous exposure to quinolones ( OR=3.65, 95 %CI 1.27-10.49, P<0.05) was relevant to the decreased eradication rate of BQT containing levofloxacin, which was probably explained by the increased resistance to levofloxacin ( OR=2.50, 95 %CI 1.69-3.71, P<0.01). But the previous history of nitroimidazole did not impact the efficacy of BQT containing metronidazole. Conclusions:In patients newly diagnosed with H.pylori infection, the previous exposure to macrolide or quinolones antibiotics is related to lower eradiation rates of H. pylori. Although the exposure to nitroimidazole also indicates drug resistance to metronidazole, the clinical efficacy of BQT with metronidazole 400 mg four times a day is not affected.

Objective To explore whether fluid-attenuated inversion recovery can be used to estimate the onset time of acute ischemic stroke (ALS) based on the analysis of signal strength through the fluid-attenuated inversion-recov?ery (FLAIR)and volume of interest (ROI) in ALS patients with known time of onset. Method Forty-seven AIS patients who met the inclusion criteria were recruited from Baotou Central Hospital, Department of Neurology from January 2011 to December 2012. The patients had stroke onset within 12 hours and completed MRI scan including diffusion-weighted imaging DWI, apparent diffusion and coefficient ADC FLAIR. Based on MRI findings, patients were divided into, three groups:0~180 min, 180~360 min and 360~720 min groups. Signal strength values of the DWI、FLAIR and ADC in ipsi?lateral and contralateral sides were measured. Result There was a significant difference in the FLAIR signal strength among these three groups.The FLAIR signal strength was significantly lower in 0~180 min and 180~360 min groups than in 360-720 min. FLAIR positive rate was 16.7%, 62.5%, and 70.6% in 0~180 min, 180~360 min and 360~729 min groups, respectively. Conclusion FLAIR positive rate gradually increases as the onset prolongs. Thus, lower FLAIR posi?tive rate indicates shorter onset time of AIS, which can be used to assist acute intravenous thrombolytic therapy.

The ongoing health reform encourages pharmacists of public hospitals to change their traditional role positioning to satisfy patients’urgent needs in medical dosage guidance.This calls for greater capacity of hospital pharmacy services.Pharmaceutical consultation constitutes a major means of quality service of pharmacists for the people.The paper introduced the standard of establishing the pharmaceutical consultation center and the content of assessment system which are jointly worked out by Beijing Municipal Hospital Authority and the hospitals under the administration of the Beijing Municipal Government,and share the practice & effect in assessing and improving their performance.

Objective To explore the expression of the nerve growth factor receptors p75 (p75NGFR) in human bladder carcinoma samples, and the effects of hypoxia on the expression of p75NGFR in human bladder cancer ceils. Methods The expression of p75NGFR in 107 bladder cancer and lymph node specimens were immunohistochemically investigated. The expression of p75NGFR in bladder cancer cell line (T24) was assessed by immunocytochemistry, and reverse tran-scription-PCR in the Normoxic Condition (air, 5%CO2) and in hypoxia condition(10%O2, 5%CO2, 85%N2). Results p75NGFR expressed in 46 of 107(43.0%) tumor samples. There was no signifi-cant correlation between p75NGFR and the factors such as gender, age, extent of the tumors, and pathologic grading(P0.05), p75NGFR was expressed in examined cell line T24, and also expressed in 5 of 24 bladder tumors in metastasized lymph node specimens. Hypoxia markedly down-regulated the expression of p75NGFR of T24 cell line at third day. Conclusions It is suggested that p75NGFR is expressed less in lymph node metastasis. Hypoxia markedly inhibited expression of p75NGFR of T24 cell lines.