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 investigate the transfusion and infusion warmer manufacturers, combine the use failures to analyze adverse events, and provide support for enterprise risk management and clinical safe use. METHODS: The sentinels from 7 manufacturing enterprises and 11 medical institutions that participated in Shandong Province's key monitoring program during the "14th Five-Year Plan" period were targeted. This was done by understanding the equipment's principles, structures, and quality control. Additionally, real-world data from January 2019 to December 2023 were collected to count adverse events. RESULTS: During production, there are risks in switching power supply stability and solder joint firmness. Fifteen kinds of faults occurred during use, and common faults such as inability to heat, unable to turn on the machine, and bubbles in the infusion tube accounted for more than 80%. CONCLUSION There are many risk points and failures for transfusion and infusion warmers, so enterprises should improve processes and quality control to address risks, and medical institutions should formulate specifications and maintenance plans to provide targeted theoretical basis for supervision.
Blood Transfusion/instrumentation* ; Risk Factors ; Quality Control ; Humans ; Risk Management ; Equipment Failure

Objective To investigate the relationship between interleukin-1β (IL-1β) and miR-185-5p in the process of joint injury in acute gouty arthritis (AGA). Methods The serum miR-185-5p levels of 89 AGA patients and 91 healthy volunteers were detected by real-time quantitative PCR. The correlation between miR-185-5p expression level and VAS score or IL-1β expression level was evaluated by Pearson correlation coefficient method. Receiver operating characteristic (ROC) curve was used to evaluate the diagnostic value of miR-185-5p in AGA. THP-1 cells were induced by sodium urate (MSU) to construct an in vitro acute gouty inflammatory cell model. After the expression level of miR-185-5p in THP-1 cells was upregulated or downregulated by transfection of miR-185-5p mimics or inhibitors in vitro, inflammatory cytokines of THP-1 cells, such as IL-1β, IL-8 and tumor necrosis factor α (TNF-α), were detected by ELISA. The luciferase reporter gene assay was used to determine the interaction between miR-185-5p and the 3'-UTR of IL-1β. Results Compared with the healthy control group, the expression level of serum miR-185-5p in AGA patients was significantly reduced. The level of serum miR-185-5p was negatively correlated with VAS score and IL-1β expression level. The area under the curve (AUC) was 0.905, the sensitivity was 80.17% and the specificity was 83.52%. Down-regulation of miR-185-5p significantly promoted the expression of IL-1β, IL-8 and tumor necrosis factor (TNF-α), while overexpression of miR-185-5p showed the opposite results. Luciferase reporter gene assay showed that IL-1β was the target gene of miR-185-5p, and miR-185-5p negatively regulated the expression of IL-1β. Conclusion miR-185-5p alleviates the inflammatory response in AGA by inhibiting IL-1β.
Humans ; 3' Untranslated Regions ; Arthritis, Gouty/genetics* ; Interleukin-1beta/genetics* ; Interleukin-8 ; Luciferases ; MicroRNAs/genetics* ; Tumor Necrosis Factor-alpha

Objective: To evaluate the efficacy and safety of bendamustine combined with pomalidomide and dexamethasone (BPD regimen) in the treatment of relapsed multiple myeloma (MM) with extramedullary disease. Methods: This open, single-arm, multicenter prospective cohort study included 30 relapsed MM patients with extramedullary disease diagnosed in seven hospitals including Qingdao Municipal Hospital. The patients were treated with BPD regimen from February 2021 to November 2022. This study analyzed the efficacy and adverse reactions of the BPD regimen. Results: The median age of the 30 patients was 62 (47-72) years, of which 18 (60% ) had first-time recurrence. The overall response rate (ORR) of the 18 patients with first-time recurrence was 100%, of which three (16.7% ) achieved complete remission, 10 (55.5% ) achieved very good partial remission (VGPR), and five (27.8% ) achieved partial remission (PR). The ORR of 12 patients with recurrence after second-line or above treatment was 50%, including zero patients with ≥VGPR and six patients (50% ) with PR. Three cases (25% ) had stable disease, and three cases (25% ) had disease progression. The one-year progression free survival rate of all patients was 65.2% (95% CI 37.2% -83.1% ), and the 1-year overall survival rate was 90.0% (95% CI 76.2% -95.4% ). The common grade 3-4 hematology adverse reactions included two cases (6.7% ) of neutropenia and one case (3.3% ) of thrombocytopenia. The overall adverse reactions are controllable. Conclusions: The BPD regimen has good efficacy and tolerance in relapsed MM patients with extramedullary disease.
Humans ; Middle Aged ; Aged ; Multiple Myeloma/drug therapy* ; Bendamustine Hydrochloride/therapeutic use* ; Prospective Studies ; Dexamethasone/therapeutic use* ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use*

Objective:To evaluate the specific changes and importance of the proportions of the eyebrows and eyes after surgery by analyzing and measuring the changes of the values of the eyebrows and eyes in elderly patients with aponeurotic ptosis before.Methods:A total of 54 cases (108 eyes) of elderly patients with aponeurotic ptosis who were treated in our department from 2019.01 to 2020.12 were collected preoperatively and 6 months postoperatively, and they were set as the study group. At the same time, the data of 48 cases (96 eyes) of healthy people with good face were collected and set as the young control group, and the data of 50 cases (100 eyes) of elderly healthy people without ptosis were collected and set as the elderly control group. The corresponding objective data were analyzed, and the specific changes and proportional relationship of eyebrows and eyes after surgery were evaluated.Results:Compared with the preoperative data, the marginal reflex distance 1 (MRD1), the height of the palpebral fissure (HPF) in the study group increased at 6 months after the operation, and the distance between the eyebrow and eye at each site increased or shortened ( P<0.05). Six months after the operation, the brow height from medial canthus (MBH), the central brow and eye distance (brow height from upper eyelid margin on midpupillary level, CBH), and the lateral brow and eye distance (brow height from lateral, LBH) had been changed. The change rates of canthus compared with preoperatively were that (88.29±11.69)%, (85.04±14.96)%, and (93.61±13.56)%, respectively, among which CBH shortened most significantly, and the shortened distance was (3.76±2.43) mm. The MRD1 and HPF in the group increased significantly at 6 months after operation, which were significantly greater than those in the elderly control group ( P<0.05). CBH was significantly shortened ( P<0.05); compared with preoperative, the ratio of HPF/CBH, HPF/length of the palpebral fissure (LPF) in the study group increased at 6 months after operation, and the lateral canthus brow tail line [ratio of lateral canthus to lateral end of eyebrow (LLE)]/LPF decreased ( P<0.05); HPF/CBH in the study group was lower than that in the young control group at 6 months after operation, but greater than that in the elderly control group ( P<0.05). Monthly HPF/LPF was significantly higher than that of the elderly control group ( P<0.05), and the LLE/LPF of the study group was significantly higher than that of the young control group at 6 months after operation ( P<0.05); intraoperative levator muscle shortening (LMS) was negatively correlated with postoperative MBH, CBH and LBH ( P<0.05), among which LMS had the greatest correlation with CBH ( r=-0.587). Conclusions:After ptosis correction, the palpebral fissures are larger, the distance between the eyebrows and the eyes is shortened, and there is a certain proportional relationship. After surgery, the patient's eyebrow-eye ratio is better than that of the elderly in the same age group, and it is closer to the young people, and the intraoperative LMS has a correlation with the eyebrow-eye distance, which can be used as a factor to predict the shortened distance of the eyebrow-eye distance.

Objectives: To investigated the safety and efficacy of treating patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) and elevated levels of N-terminal pro-hormone B-type natriuretic peptide (NT-proBNP) with levosimendan within 24 hours of first medical contact (FMC). Methods: This multicenter, open-label, block-randomized controlled trial (NCT03189901) investigated the safety and efficacy of levosimendan as an early management strategy of acute heart failure (EMS-AHF) for patients with NSTEMI and high NT-proBNP levels. This study included 255 patients with NSTEMI and elevated NT-proBNP levels, including 142 males and 113 females with a median age of 65 (58-70) years, and were admitted in the emergency or outpatient departments at 14 medical centers in China between October 2017 and October 2021. The patients were randomly divided into a levosimendan group (n=129) and a control group (n=126). The primary outcome measure was NT-proBNP levels on day 3 of treatment and changes in the NT-proBNP levels from baseline on day 5 after randomization. The secondary outcome measures included the proportion of patients with more than 30% reduction in NT-proBNP levels from baseline, major adverse cardiovascular events (MACE) during hospitalization and at 6 months after hospitalization, safety during the treatment, and health economics indices. The measurement data parameters between groups were compared using the t-test or the non-parametric test. The count data parameters were compared between groups using the χ² test. Results: On day 3, the NT-proBNP levels in the levosimendan group were lower than the control group but were statistically insignificant [866 (455, 1 960) vs. 1 118 (459, 2 417) ng/L, Z=-1.25,P=0.21]. However, on day 5, changes in the NT-proBNP levels from baseline in the levosimendan group were significantly higher than the control group [67.6% (33.8%,82.5%)vs.54.8% (7.3%,77.9%), Z=-2.14, P=0.03]. There were no significant differences in the proportion of patients with more than 30% reduction in the NT-proBNP levels on day 5 between the levosimendan and the control groups [77.5% (100/129) vs. 69.0% (87/126), χ²=2.34, P=0.13]. Furthermore, incidences of MACE did not show any significant differences between the two groups during hospitalization [4.7% (6/129) vs. 7.1% (9/126), χ²=0.72, P=0.40] and at 6 months [14.7% (19/129) vs. 12.7% (16/126), χ²=0.22, P=0.64]. Four cardiac deaths were reported in the control group during hospitalization [0 (0/129) vs. 3.2% (4/126), P=0.06]. However, 6-month survival rates were comparable between the two groups (log-rank test, P=0.18). Moreover, adverse events or serious adverse events such as shock, ventricular fibrillation, and ventricular tachycardia were not reported in both the groups during levosimendan treatment (days 0-1). The total cost of hospitalization [34 591.00(15 527.46,59 324.80) vs. 37 144.65(16 066.90,63 919.00)yuan, Z=-0.26, P=0.80] and the total length of hospitalization [9 (8, 12) vs. 10 (7, 13) days, Z=0.72, P=0.72] were lower for patients in the levosimendan group compared to those in the control group, but did not show statistically significant differences. Conclusions: Early administration of levosimendan reduced NT-proBNP levels in NSTEMI patients with elevated NT-proBNP and did not increase the total cost and length of hospitalization, but did not significantly improve MACE during hospitalization or at 6 months.
Male ; Female ; Humans ; Aged ; Natriuretic Peptide, Brain ; Simendan/therapeutic use* ; Non-ST Elevated Myocardial Infarction ; Heart Failure/drug therapy* ; Peptide Fragments ; Arrhythmias, Cardiac ; Biomarkers ; Prognosis

Carcinoma ; Carcinoma, Papillary ; Humans ; Thyroglossal Cyst/surgery* ; Thyroid Neoplasms

OBJECTIVETo investigate the blood test patterns for blood donors after nucleic acid detection in blood center.

METHODSThe collected blood samples after voluntary blood donors first were detected by conventional ELISA, then 31981 negative samples were detected via HBV/HCV/HIV combined nucleic acid test of 6 mixed samples(22716 cases) or single samples(9265 cases) by means of Roche cobas s201 instrument. The combined detection method as follows: the blood samples were assayed by conventional nucleic acid test of 6 mixed samples, at same time, 6 mixed samples were treated with polyethylene glycol precipitation method to concentrate the virus, then the nucleic acid test of blood samples was performed; the single detection method as follows: firstly the conventional nucleic acid test of single sample was performed, then the positive reactive samples after re-examination were 6-fold diluted to simulate the nucleic acid test of 6-mixed samples. The positive rate of positive samples detected by combined nucleic acid test, positive samples detected by nucleic acid test of mixed virus concentration and positive samples detected by single nucleic acid test was statistically analyzed. In addition, for HBVpersons the serological test yet should be performed.

RESULTSIn 22 716 samples detected by nucleic acid test of 6 mixed samples (MP-6-NAT) , 9 cases were HBV(0.40‰, 9/22716); at same time, the detection of same samples by nucleic acid test of mixed sample virus concentration showed 29 cases of HBV(1.28‰, 29/22716). In 9265 samples detected by single nucleic acid test(ID-NAT) 12 cases showed HBV(1.30‰, 12/9265), meanwhile the detection of these 12 samples with HBVby 6-fold dilution for virus concentration found only 4 samples with HBV. In serological qualified samples, ID-NAT unqualified rate was 1.28‰, which was higher than that of MP-6-NAT(0.4‰) (χ=8.11, P<0.05); but there was no statistical difference between unqualified rate of ID-NAT and MP-6-NAT(1.3‰ vs 1.28‰)(χ=0.00, P>0.05). In 41 samples with HBsAgHBV DNAdetected by ELISA, 36 samples were confirmed to be occult HBV infective(OBI) by HBsAb, HBcAb test of ELISA; out of these 41 samples, 33 samples showed HBcAb(91.66% of OBI), 5 might be HBV "window period" infective, moreover the HCV RNA and HIV RNA positive samples were not found.

CONCLUSIONTo avoid the missdiagnosis of donors with low level of virus, the nucleic acid test must be carried out after virus concentration of mixed samples when the blood test pattern of donors is nucleic acid test of mixed samples, otherwise the single nucleic acid test must be performed to obtain more high detected rate of virus nucleic acid. The HBcAb serologic test and physical examination of donors before blood donation must be enhanced on basis of serological test of HBsAg; for high risk people, the persuading no blood donation is simplest pattern.

OBJECTIVETo explore the key technique for preparation of the frozen platelet and efficacy of its clinical application.

METHODSThe influences of the donators' peripheral platelet count, starting time of freeze, injection rate and evenness of the freeze-protective agent, storage mode, re-melting temperature and the capacity of water-bath etc. on the quality of the frozen platelets were analyzed retrospectively in 3 257 samples of frozen platelets before platelet pheresis. Then, the platelet counts were examined in 150 cases transfused with frozen platelets at the time-points of 1, 24, 48 and 72 hrs after transfusion, 90 cases suffered from the obstetrical bleeding were transfused with 200 parts of the re-melting frozen platelets, and then the peripheral blood platelet count, platelet increasing index(CCI), bleeding time and blood clot retraction rate etc. were observed for determining the clinical efficiency of the frozen platelets.

RESULTSThe floccule in the re-melting frozen platelets from the donators with (175-250)×10(9)/L platelets were decreased significantly(P<0.01). The quality of frozen platelets was influenced by the following factors, such as injection of DMSO at a too fast and heterogeneous rate, blood bags stored in a multilamminar space, and re-melting in a water-bath of small capacity etc. The routine storage for 0 and 3 days did not influence the quality of the frozen platelets. The recovery rate of one year-freezing platelets all was higher than 80%. The effects of the frozen platelets transfused into the patients with obstetrical bleeding displayed good haemostatic results, and the blood transfusion reaction did not occur. However, the frozen platelets immediately were exhausted and displayed their function, but the counting after 48 hrs could not display a good effect of raising platelet number.

CONCLUSIONSThe peripheral platelet count before platelet pheresis, the injection rate and evenness of the protective agent, the number of stratum for blood bags and the capacity of re-melting water-bath etc. all are the key factors influencing the quality of the frozen platelets. The frozen platelets prepared in this study shows a good efficacy of clinical application.

Blood Platelets ; Blood Preservation ; Blood Transfusion ; Freezing ; Hemostasis ; Humans ; Platelet Count ; Platelet Transfusion ; Plateletpheresis ; Transfusion Reaction

OBJECTIVETo investigate the effects of obstructive sleep apnea-hypopnea syndrome (OSAHS) and age on sleep architecture and the therapeutic effects of continuous positive airway pressure (CPAP).

METHODSWe retrospectively analyzed 222 subjects undergoing polysomnography (PSG) for snoring, who received CPAP under PSG on the next day following the initial PSG. The sleep architecture of the subjects in different age groups and in groups with different severities of OSAHS was analyzed before and after adjustment for apnea-hypopnea index (AHI) or age. The sleep architecture and ventilation function of the patients with OSAHS were also analyzed after CPAP.

RESULTSN3 sleep showed the strongest correlation with AHI (r=-0.361), and REM sleep and wake after sleep onset (WASO) were the most strongly correlated with age (r=-0.211 and 0.216, respectively). The 4 age groups showed significant differences in sleep efficiency (P<0.001), N1 (P=0.015), N2 (P=0.013) and REM (P=0.030) sleeps, and WASO (P=0.001) but not in AHI (P=0.185). REM sleep decreased and WASO increased with an increasing age. The sleep efficiency and architecture were still significant different after adjustment for AHI. In 4 groups with different severity of OSAHS, N1, N2 and N3 sleeps were significant different after adjustment for age (P=0.011, 0.017, 0.001). In patients with moderate or severe OSAHS, N3 sleep increased with the increase of AHI. After CPAP for OSAHS, N1 and N2 sleeps significantly decreased, and N3 and REM sleeps increased (P<0.001).

CONCLUSIONBetween OSAHS and age, REM sleep and WTSO are more importantly affected by age, while OSAHS more strongly affects N3 sleep. CPAP can improve the sleep quality of patients with OSAHS.

Age Factors ; Continuous Positive Airway Pressure ; Humans ; Polysomnography ; Retrospective Studies ; Sleep Apnea, Obstructive ; Sleep Stages ; Snoring