Objective:To evaluate the efficacy of eradication therapy based on potassium-competitive acid blocker (P-CAB) for Helicobacter pylori( HP) infection in re-eradication therapy (the second-line therapy treatment after initial eradication failure of HP infection) and determine whether it can achieve the ideal eradication rate (90%). Methods:From January 2022 to December 2023, the clinical data of patients who received vonoprazan-based HP re-eradication therapy were collected in Department of Gastroenterology, the First Affiliated Hospital of Soochow University. The patients were divided into 4 groups according to their different HP treatment regimens, including VAMB group (vonoprazan 20 mg, quaque die( qd)+ amoxicillin 1 g, bis in die( bid)+ minocycline 100 mg, bid+ potassium bismuth citrate 220 mg, bid; 156 cases), VA group (vonoprazan 20 mg, bid+ amoxicillin 1 g, ter in die( tid); 44 cases), VMFB group (vonoprazan 20 mg qd+ minocycline 100 mg, bid+ furazolidone 100 mg, bid+ potassium bismuth citrate 220 mg, bid; 42 cases), and VAFB group (vonoprazan 20 mg, qd+ amoxicillin 1 g, bid+ furazolidone 100 mg, bid + potassium bismuth citrate 220 mg, bid; 13 cases). All the 4 groups of patients took the medication for 14 days. The 13C or 14C urea breath test would be conducted 4 weeks after the treatment. The overall eradication rate to evaluate the treatment efficacy. The eradication rate and adverse reaction rate were calculated for each group, and the eradication rates and adverse reaction rates between groups were compared using the chi-square test or Fisher′s exact test. Results:The total eradication rate of HP infection based on P-CAB therapy was 91.8% (234/255), and the total adverse reaction rate was 5.1% (13/255). The eradication rate and adverse reaction rate were 92.9% (145/156) and 3.2% (5/156) in the VAMB group, 84.1% (37/44) and 0 in the VA group 95.2% (40/42) and 11.9% (5/42) in the VMFB group, 12/13 and 3/13 in the VAFB group, respectively. Additionally, there was no statistical difference in the eradication rate among the 4 groups (Fisher′s exact test, P=0.227), but there was a statistical difference in the adverse reaction rates (Fisher′s exact test, P=0.002), and the adverse reaction rate of the VAFB group was higher than that of VAMB and VA groups and the differences were statistically significant (both Fisher′s excact test, P=0.016 and 0.010). Conclusions:The total HP re-eradication rate based on P-CAB therapies can reach 91.8%, achieving the ideal eradication rate of HP infection. The VA therapeutic regimen has the lowest incidence of adverse reactions, representing a novel therapeutic option for HP re-eradication.

Objective:To evaluate the efficacy of eradication therapy based on potassium-competitive acid blocker (P-CAB) for Helicobacter pylori( HP) infection in re-eradication therapy (the second-line therapy treatment after initial eradication failure of HP infection) and determine whether it can achieve the ideal eradication rate (90%). Methods:From January 2022 to December 2023, the clinical data of patients who received vonoprazan-based HP re-eradication therapy were collected in Department of Gastroenterology, the First Affiliated Hospital of Soochow University. The patients were divided into 4 groups according to their different HP treatment regimens, including VAMB group (vonoprazan 20 mg, quaque die( qd)+ amoxicillin 1 g, bis in die( bid)+ minocycline 100 mg, bid+ potassium bismuth citrate 220 mg, bid; 156 cases), VA group (vonoprazan 20 mg, bid+ amoxicillin 1 g, ter in die( tid); 44 cases), VMFB group (vonoprazan 20 mg qd+ minocycline 100 mg, bid+ furazolidone 100 mg, bid+ potassium bismuth citrate 220 mg, bid; 42 cases), and VAFB group (vonoprazan 20 mg, qd+ amoxicillin 1 g, bid+ furazolidone 100 mg, bid + potassium bismuth citrate 220 mg, bid; 13 cases). All the 4 groups of patients took the medication for 14 days. The 13C or 14C urea breath test would be conducted 4 weeks after the treatment. The overall eradication rate to evaluate the treatment efficacy. The eradication rate and adverse reaction rate were calculated for each group, and the eradication rates and adverse reaction rates between groups were compared using the chi-square test or Fisher′s exact test. Results:The total eradication rate of HP infection based on P-CAB therapy was 91.8% (234/255), and the total adverse reaction rate was 5.1% (13/255). The eradication rate and adverse reaction rate were 92.9% (145/156) and 3.2% (5/156) in the VAMB group, 84.1% (37/44) and 0 in the VA group 95.2% (40/42) and 11.9% (5/42) in the VMFB group, 12/13 and 3/13 in the VAFB group, respectively. Additionally, there was no statistical difference in the eradication rate among the 4 groups (Fisher′s exact test, P=0.227), but there was a statistical difference in the adverse reaction rates (Fisher′s exact test, P=0.002), and the adverse reaction rate of the VAFB group was higher than that of VAMB and VA groups and the differences were statistically significant (both Fisher′s excact test, P=0.016 and 0.010). Conclusions:The total HP re-eradication rate based on P-CAB therapies can reach 91.8%, achieving the ideal eradication rate of HP infection. The VA therapeutic regimen has the lowest incidence of adverse reactions, representing a novel therapeutic option for HP re-eradication.

Helicobacter pylori (H. pylori) neutrophil-activating protein (HP-NAP) is one of the newly discovered main virulence factors of H. pylori, and is expressed in almost all strains of H. pylori. After being activated, HP-NAP can participate in the development of inflammation and tissue damage by stimulating neutrophils, monocytes, dendritic cells, mast cells and lymphocytes. This paper reviewed the latest research progress of HP-NAP in the prevention and treatment of related diseases.

Colonoscopy with polypectomy significantly reduces the incidence of colorectal cancer and cancer - related mortality. However, a pooled miss rate of 22% for polyps was documented. Aims: To explore the clinical application value of an artificial intelligence (AI)-based colorectal polyp diagnostic system for polyp detection. Methods: A total of 400 patients who underwent colonoscopy in the First Affiliated Hospital of Soochow University from September to November 2021 were selected according to the inclusion and exclusion criteria and were randomly divided into two groups: one group received routine colonoscopy, and the other group received AI system assisted colonoscopy. There were 200 cases in each group. The Boston Bowel Preparation Scale (BBPS) was used to evaluate bowel preparation quality. The primary outcome was polyp detection rate (PDR), and the secondary outcome was polyps per colonoscopy (PPC). Results: AI system significantly increased PDR and PPC (37.0% vs. 23.0%, 0.775 vs. 0.495, all P<0.05), especially for diminutive and small polyps (diminutive polyps: 23.0% vs. 13.0%, 0.410 vs. 0.295; small polyps: 16.0% vs. 8.0%, 0.255 vs. 0.095; all P<0.05). No significant difference in large polyp detection was observed between the two groups (all P>0.05). The bowel preparation quality was classified as“poor”(BBPS 0-5 points),“qualified”(BBPS 6-7 points) and“excellent”(BBPS 8-9 points). There were no significant differences in polyp detection between the two groups when the bowel preparation quality was“poor”or “excellent”(all P>0.05). PDR and PPC were significantly increased in AI group when the bowel preparation quality was “qualified”(33.0% vs. 20.0%, 0.670 vs. 0.450, all P<0.05). Conclusions: AI-based colorectal polyp diagnostic system can significantly improve PDR and PPC because of the significant increase in the number of diminutive and small polyps detected. In addition, when the bowel preparation is qualified, the AI system can play better for polyp detection.

Objective To investigate the expression of elongation of very long-chain fatty acids family member 6 (ELOVL6) in high-grade serous ovarian carcinoma (HSOC), and explore the correlation between its expression and clinical prognosis in these patients. Methods The expression of ELOVL6 at mRNA and protein levels were respectively detected by reverse transcription (RT)-PCR and immune histochemistry method in 12 cases with normal ovarian tissues and 172 cases with HSOC from primary tumor site, forty of which had paired peritoneal metastatic tissues. Results (1) The results tested by RT-PCR showed that ELOVL6 expression in normal ovarian tissue was 4.8±1.1, while 1.2±0.7 in primary tumors and 1.8 ± 0.9 peritoneal metastatic sites in HSOC. Compared with normal ovarian tissue, the level of ELOVL6 mRNA was significantly lower in HSOC (P<0.05). There was no significant difference between primary and peritoneal metastatic sites in HSOC (P=0.610). It was shown that ELOVL6 protein localized in cytoplasm of ovarian cancer cell by immunostaining assay. (2) ELOVL6 expression was observed in all normal ovarian tissue, 70.2%of G1-G2 and 48.8%of G3 HSOC (P<0.05). ELOVL6 expression in drug-resistant group were significantly lower than that in non-resistant group (39.1% vs 65.0%, P<0.01). The median disease-free survival was 41 months in the ELOVL6-positive group and 39 months in ELOVL6-negative group (P>0.05). The total median survival was 52 months in ELOVL6-positive group and 44 months in ELOVL6-negative group (P>0.05). Conclusion Low expression of ELOVL6 may correlate with the poor differentiation and drug resistance in HSOC.