Background::An evidence gap still exists regarding the efficacy and safety of tegoprazan in patients with erosive esophagitis (EE) in China. This study aimed to verify the efficacy and safety of tegoprazan vs. esomeprazole in patients with EE in China. Methods::This study was a multicenter, randomized, double-blind, parallel, active-controlled, non-inferiority phase III trial of patients with EE randomized 1:1 to tegoprazan 50 mg/day vs. esomeprazole 40 mg/day. This study was conducted in 32 sites between October 24, 2018 and October 18, 2019. The primary endpoint was the cumulative endoscopic healing rate at week 8. The secondary endpoint included endoscopic healing rate at week 4, changes in the reflux disease questionnaire (RDQ) and gastroesophageal reflux disease health-related quality of life (GERD-HRQL) scores, and symptom improvement. Results::A total of 261 patients were randomized: 132 to the tegoprazan group and 129 to the esomeprazole group. The cumulative endoscopic healing rate at 8 weeks in the tegoprazan group was non-inferior to that of the esomeprazole group (91.1% vs. 92.8%, difference: -1.7%, 95% confidence interval [CI]: -8.5%, 5.0%, P = 0.008). There were no statistically significant differences in the changes in RDQ (total, severity, and frequency) and GERD-HRQL scores between the two groups (all P >0.05). The percentages of days without symptoms, including daytime and nighttime symptoms based on patients' diaries, were similar between the two groups (all P >0.05). In the tegoprazan and esomeprazole groups, 71.5% (93/130) and 61.7% (79/128) of the participants reported adverse events (AEs), 2.3% and 0 experienced serious AEs, while 70.0% and 60.2% had treatment-emergent AEs, respectively. Conclusion::Tegoprazan 50 mg/day demonstrated non-inferior efficacy in healing EE, symptom improvement, and quality of life, and it has similar tolerability compared with esomeprazole 40 mg/day.

Objective To study the application of constructing a nursing recruitment index system for maternal and child health hospitals based on competency model.Methods Nurses from the Maternal and Child Health Department from January 2021 to November 2022,Children's Health Department,and Women's Health Department of Nanshan District Maternal and Child Health Hospital were selected as the survey subjects.The sample size is calculated based on 5-10 times the number of dimen-sions,and a total of 75 nursing staff are included as observation subjects in the above three departments.Each department selects 25 individuals and categorizes the Maternal and Child Health Department as Group A,the Child Health Department as Group B,and the Women's Health Department as Group C.Through semi-structured interviews,53 cases from the excellent group(with a comprehensive score ≥ 90 points)and 22 cases from the ordinary group(with a comprehensive score below 90 points)were se-lected.Compare the general information and competency scores of each group,compare the competency scores of different scoring groups,construct a competency model for the nursing recruitment indicator system,and analyze the effectiveness of the construc-ted recruitment indicator system in nursing recruitment from January 2022 to December 2023.Results There was no significant difference in general information between the groups(P＞0.05).The comparison of competency scores among different groups showed no significant difference(P＞0.05).The scores of basic nursing ability,health management,evidence-based practice,communication and exchange,professional cultural literacy,ethics and morality,disease assessment ability,and health education ability in the excellent group were higher than those in the ordinary group(P＜0.05).The recruitment index system constructed in 2023 has shown better results in nursing recruitment compared to 2022 without using it(P＜0.05).Conclusion The appli-cation effect of the competency model based nursing recruitment index system construction in maternal and child health care hospi-tals is good,which can effectively serve the nursing recruitment process and can be promoted and applied in recruitment.

Objective To study the application of constructing a nursing recruitment index system for maternal and child health hospitals based on competency model.Methods Nurses from the Maternal and Child Health Department from January 2021 to November 2022,Children's Health Department,and Women's Health Department of Nanshan District Maternal and Child Health Hospital were selected as the survey subjects.The sample size is calculated based on 5-10 times the number of dimen-sions,and a total of 75 nursing staff are included as observation subjects in the above three departments.Each department selects 25 individuals and categorizes the Maternal and Child Health Department as Group A,the Child Health Department as Group B,and the Women's Health Department as Group C.Through semi-structured interviews,53 cases from the excellent group(with a comprehensive score ≥ 90 points)and 22 cases from the ordinary group(with a comprehensive score below 90 points)were se-lected.Compare the general information and competency scores of each group,compare the competency scores of different scoring groups,construct a competency model for the nursing recruitment indicator system,and analyze the effectiveness of the construc-ted recruitment indicator system in nursing recruitment from January 2022 to December 2023.Results There was no significant difference in general information between the groups(P＞0.05).The comparison of competency scores among different groups showed no significant difference(P＞0.05).The scores of basic nursing ability,health management,evidence-based practice,communication and exchange,professional cultural literacy,ethics and morality,disease assessment ability,and health education ability in the excellent group were higher than those in the ordinary group(P＜0.05).The recruitment index system constructed in 2023 has shown better results in nursing recruitment compared to 2022 without using it(P＜0.05).Conclusion The appli-cation effect of the competency model based nursing recruitment index system construction in maternal and child health care hospi-tals is good,which can effectively serve the nursing recruitment process and can be promoted and applied in recruitment.

Background::An evidence gap still exists regarding the efficacy and safety of tegoprazan in patients with erosive esophagitis (EE) in China. This study aimed to verify the efficacy and safety of tegoprazan vs. esomeprazole in patients with EE in China. Methods::This study was a multicenter, randomized, double-blind, parallel, active-controlled, non-inferiority phase III trial of patients with EE randomized 1:1 to tegoprazan 50 mg/day vs. esomeprazole 40 mg/day. This study was conducted in 32 sites between October 24, 2018 and October 18, 2019. The primary endpoint was the cumulative endoscopic healing rate at week 8. The secondary endpoint included endoscopic healing rate at week 4, changes in the reflux disease questionnaire (RDQ) and gastroesophageal reflux disease health-related quality of life (GERD-HRQL) scores, and symptom improvement. Results::A total of 261 patients were randomized: 132 to the tegoprazan group and 129 to the esomeprazole group. The cumulative endoscopic healing rate at 8 weeks in the tegoprazan group was non-inferior to that of the esomeprazole group (91.1% vs. 92.8%, difference: -1.7%, 95% confidence interval [CI]: -8.5%, 5.0%, P = 0.008). There were no statistically significant differences in the changes in RDQ (total, severity, and frequency) and GERD-HRQL scores between the two groups (all P >0.05). The percentages of days without symptoms, including daytime and nighttime symptoms based on patients' diaries, were similar between the two groups (all P >0.05). In the tegoprazan and esomeprazole groups, 71.5% (93/130) and 61.7% (79/128) of the participants reported adverse events (AEs), 2.3% and 0 experienced serious AEs, while 70.0% and 60.2% had treatment-emergent AEs, respectively. Conclusion::Tegoprazan 50 mg/day demonstrated non-inferior efficacy in healing EE, symptom improvement, and quality of life, and it has similar tolerability compared with esomeprazole 40 mg/day.

Objective:To evaluate the efficacy and safety of anaprazole (40 mg and 60 mg) and compared with rabeprazole (20 mg) in the treatment of reflux esophagitis (RE).Methods:This multicenter, randomized, double-blinded, positive drug parallel controlled study was led by the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital) and a total of 24 clinical trial institutions nationwide including the First Affiliated Hospital of Nanchang University, Yichun People′s Hospital, Meihekou Central Hospital, the First Affiliated Hospital of Gannan Medical University, and Jinhua Central Hospital, participated in this research. A total of 156 patients with RE (Los Angeles grade A to D) were enrolled and randomly divided into 3 groups, anaprazole 40 mg group, anaprazole 60 mg group and rabeprazole 20 mg group, using a random number table in a ratio of 1∶1∶1. Patients in the above 3 groups were treated with the appropriate trial medication once per day for 4 or 8 weeks. The endoscopic healing rates were evaluated by Blinded Independent Central Review (BICR) and investigators. In addition, the improvement in the severity of individual symptoms (daytime reflux, daytime heartburn, nighttime reflux, nighttime heartburn) and medication safety were also evaluated. The endoscopic healing rates and 95% confidence intervals (95% CI) at week-8 and -4 were calculated by groups, as well as the difference in the healing rates and their 95% CI among groups. The chi-square test was used for statistical analysis. Results:A total of 153 subjects were included in the full analysis set (FAS), 144 in the per-protocol analysis set (PPS) and 151 in the safety set (SS). In the FAS, after 8 weeks of treatment, the endoscopic healing rates of anaprazole 40 mg group, anaprazde 60 mg group and raberazole 20 mg group blindly assessed by BICR were 86.0% (43/50), 86.5% (45/52) and 86.3% (44/51), respectively, and the 95% CI were 76.4% to 95.6%, 77.3% to 95.8% and 76.8% to 95.7%, respectively.The endoscopic healing rates of anaprazole 40 mg group, anaprazde 60 mg group and raberazole 20 mg group blindly evaluated by investigators were 88.0% (44/50), 90.4% (47/52) and 86.3% (44/51), respectively, and the 95% CI were 79.0% to 97.0%, 82.4% to 98.4% and 76.8% to 95.7%, respectively. The endoscopic healing rates were similar among groups. In the FAS, the differences in healing rates(95% CI) assessed by BICR and investigators between anaprazole 40 mg, anaprazole 60 mg and rabeprazole 20 mg group were -0.3%(-13.7% to 13.2%), 0.6%(-12.3% to 13.6%), respectively and 1.7%(-11.3% to 14.8%), 3.9%(-8.5% to 16.3%), respectively. The results of the PPS were consistent with those of the FAS. After 8 weeks of treatment, the severity scores of individual symptoms (daytime reflux, daytime heartburn, nighttime reflux, nighttime heartburn) decreased in all groups. The differences between post-treatment and baseline in anaprazole 40 mg group, anaprazole 60 mg group and rabeprazole 20 mg group were -1.54±1.00, -1.91±1.00, -1.51±0.76, -1.45±0.71; -1.30±0.94, -1.59±0.96, -1.33±0.65, -1.42±0.60; and -1.74±0.85, -1.76±0.93, -1.45±0.66, -1.66±0.79, respectively. The incidence of treatment emergent adverse event of anaprazole 40 mg group, anaprazole 60 mg group and rabeprazole 20 mg group were 57.1% (28/49), 48.1% (25/52) and 60.0% (30/50), respectively, and the incidence of treatment related adverse event were 18.4% (9/24), 25.0% (13/52) and 24.0% (12/50), respectively. There were no statistically significant differences in the incidence of treatment emergent adverse event and treatment related adverse event among 3 groups (all P>0.05). Conclusion:The efficacy and safety of anaprazole 40, 60 mg/d, and rabeprazole 20 mg/d in the treatment of RE are comparable.

Objective:To evaluate the efficacy and safety of anaprazole (40 mg and 60 mg) and compared with rabeprazole (20 mg) in the treatment of reflux esophagitis (RE).Methods:This multicenter, randomized, double-blinded, positive drug parallel controlled study was led by the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital) and a total of 24 clinical trial institutions nationwide including the First Affiliated Hospital of Nanchang University, Yichun People′s Hospital, Meihekou Central Hospital, the First Affiliated Hospital of Gannan Medical University, and Jinhua Central Hospital, participated in this research. A total of 156 patients with RE (Los Angeles grade A to D) were enrolled and randomly divided into 3 groups, anaprazole 40 mg group, anaprazole 60 mg group and rabeprazole 20 mg group, using a random number table in a ratio of 1∶1∶1. Patients in the above 3 groups were treated with the appropriate trial medication once per day for 4 or 8 weeks. The endoscopic healing rates were evaluated by Blinded Independent Central Review (BICR) and investigators. In addition, the improvement in the severity of individual symptoms (daytime reflux, daytime heartburn, nighttime reflux, nighttime heartburn) and medication safety were also evaluated. The endoscopic healing rates and 95% confidence intervals (95% CI) at week-8 and -4 were calculated by groups, as well as the difference in the healing rates and their 95% CI among groups. The chi-square test was used for statistical analysis. Results:A total of 153 subjects were included in the full analysis set (FAS), 144 in the per-protocol analysis set (PPS) and 151 in the safety set (SS). In the FAS, after 8 weeks of treatment, the endoscopic healing rates of anaprazole 40 mg group, anaprazde 60 mg group and raberazole 20 mg group blindly assessed by BICR were 86.0% (43/50), 86.5% (45/52) and 86.3% (44/51), respectively, and the 95% CI were 76.4% to 95.6%, 77.3% to 95.8% and 76.8% to 95.7%, respectively.The endoscopic healing rates of anaprazole 40 mg group, anaprazde 60 mg group and raberazole 20 mg group blindly evaluated by investigators were 88.0% (44/50), 90.4% (47/52) and 86.3% (44/51), respectively, and the 95% CI were 79.0% to 97.0%, 82.4% to 98.4% and 76.8% to 95.7%, respectively. The endoscopic healing rates were similar among groups. In the FAS, the differences in healing rates(95% CI) assessed by BICR and investigators between anaprazole 40 mg, anaprazole 60 mg and rabeprazole 20 mg group were -0.3%(-13.7% to 13.2%), 0.6%(-12.3% to 13.6%), respectively and 1.7%(-11.3% to 14.8%), 3.9%(-8.5% to 16.3%), respectively. The results of the PPS were consistent with those of the FAS. After 8 weeks of treatment, the severity scores of individual symptoms (daytime reflux, daytime heartburn, nighttime reflux, nighttime heartburn) decreased in all groups. The differences between post-treatment and baseline in anaprazole 40 mg group, anaprazole 60 mg group and rabeprazole 20 mg group were -1.54±1.00, -1.91±1.00, -1.51±0.76, -1.45±0.71; -1.30±0.94, -1.59±0.96, -1.33±0.65, -1.42±0.60; and -1.74±0.85, -1.76±0.93, -1.45±0.66, -1.66±0.79, respectively. The incidence of treatment emergent adverse event of anaprazole 40 mg group, anaprazole 60 mg group and rabeprazole 20 mg group were 57.1% (28/49), 48.1% (25/52) and 60.0% (30/50), respectively, and the incidence of treatment related adverse event were 18.4% (9/24), 25.0% (13/52) and 24.0% (12/50), respectively. There were no statistically significant differences in the incidence of treatment emergent adverse event and treatment related adverse event among 3 groups (all P>0.05). Conclusion:The efficacy and safety of anaprazole 40, 60 mg/d, and rabeprazole 20 mg/d in the treatment of RE are comparable.

Objective:To establish the normal reference range of the ratio of fetal umbilical venous flow rate to umbilical artery pulsatility index (VAI).Methods:A total of 816 normal fetuses underwent prenatal examination and delivery were randomly selected from October 2018 to December 2020 in Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region. Fetal weight was obtained by measuring fetal biparietal diameter, head circumference, abdominal circumference, and femoral length.Umbilical venous flow (Quv) was measured. Umbilical artery pulsatility index (UA-PI) was obtained in the free segment of amniotic fluid. Quv was standardized according to fetal size to calculate the umbilical venous flow rate (nQuv) and VAI. The association between Quv, nQuv, UA-PI, VAI and the fetal gestational week were analyzed using correlation analysis. VAI was presented as ± s, the upper limit of 95% reference value and the lower limit of 5% reference value were taken as the standards of VAI increase and decrease, respectively. Twenty-six fetuses whose VAI were lower than limit of 5% and 20 fetuse whose VAI were than limit of 95% were chosed as the case group. Results:①Fetal Quv was positively correlated with gestational week ( r=0.893, P<0.001), nQuv and UA-PI were negatively correlated with gestational week ( r=-0.552, -0.827; all P<0.001), and VAI had no significant correlation with gestational week ( r=0.000, P=0.758); ②The mean, standard deviation, lower 5% reference value, and upper 95% reference value of VAI were 195.81, 55.61, 105.95, and 293.33, respectively; ③In the cases with abnormal VAI, 26 fetuses with reduced VAI, of whom there were 16 cases of maternal hypertension, and 13 cases complicated by severe preeclampsia; 1 case with 40 turns of umbilical cord torsion, 3 cases of stillbirth, 16 cases of preterm delivery, 19 cases of low neonatal birth body weight, 4 cases of 1-min Apgar score ≤7, 6 cases of umbilical artery blood pH<7.2, and 1 case without abnormalities in fetus during pregnancy and follow-up newborn. Among the 20 fetuses with increased VAI, there were 10 cases of fetal severe thalassemia, 2 cases of thalassemia, 1 case of sacrococcygeal teratoma, 1 case of portal venous shunt, 3 cases of placental chorioangioma, and 3 cases without abnormalities in fetus during pregnancy and follow-up newborn. Conclusions:The measurement and calculation of fetal VAI is simple and easy to perform. As a comprehensive index, fetal VAI remains constant in mid and late pregnancy, facilitates the follow-up of abnormal fetuses, and has potential clinical application.

Background::The pharmacokinetic and clinical behaviors of many proton pump inhibitors (PPIs) in peptic ulcer treatment are altered by CYP2C19 genetic polymorphisms. This non-inferiority study evaluated the efficacy and safety of the novel PPI anaprazole compared with rabeprazole. We also explored the influence of Helicobacter pylori ( H. pylori) infection status and CYP2C19 polymorphism on anaprazole. Methods::In this multicenter, randomized, double-blind, double-dummy, positive-drug parallel-controlled, phase III study, Chinese patients with duodenal ulcers were randomized 1:1 to receive rabeprazole 10 mg + anaprazole placebo or rabeprazole placebo + anaprazole 20 mg once daily for 4 weeks. The primary efficacy endpoint was the 4-week ulcer healing rate assessed by blinded independent review. Secondary endpoints were the proportion of patients with improved overall and individual duodenal ulcer symptoms at 4 weeks. Furthermore, exploratory subgroup analysis of the primary endpoint by H. pylori status and CYP2C19 polymorphism was conducted. Adverse events were monitored for safety. Non-inferiority analysis was conducted for the primary endpoint. Results::The study enrolled 448 patients (anaprazole, n = 225; rabeprazole, n = 223). The 4-week healing rates were 90.9% and 93.7% for anaprazole and rabeprazole, respectively (difference, -2.8% [95% confidence interval, -7.7%, 2.2%]), demonstrating non-inferiority of anaprazole to rabeprazole. Overall duodenal ulcer symptoms improved in 90.9% and 92.5% of patients, respectively. Improvement rates of individual symptoms were similar between the groups. Healing rates did not significantly differ by H. pylori status or CYP2C19 genotype for either treatment group. The incidence of treatment-emergent adverse events was similar for anaprazole (72/220, 32.7%) and rabeprazole (84/219, 38.4%). Conclusions::The efficacy of anaprazole is non-inferior to that of rabeprazole in Chinese patients with duodenal ulcers.Registration::ClinicalTrials.gov, NCT04215653.

Fusidane-type antibiotics, represented by helvolic acid, fusidic acid and cephalosporin P

Objective:To investigate the diagnostic efficacy of inflammatory biomarkers [neutrophil/lymphocyte (NLR), monocyte/lymphocyte (MLR), platelet/lymphocyte (PLR)] combined with tumor markers [carbohydrate antigen (CA)125, CA199] in mature cystic teratoma (MCT) patients possess torsion.Methods:The clinical data of patients with MCT diagnosed by surgery and pathology in the third Affiliated Hospital of Sun Yat-Sen University from March 2013 to October 2019 were retrospectively analyzed. A total of 31 MCT patients with torsion were included in observation group , another 101 MCT patients without torsion were assigned to the control group.Clinical characteristics and the levels of NLR, MLR, PLR, CA125, CA199 were assessed and analyzed.Results:The inflammatory biomarkers (NLR, MLR, PLR) and tumor markers (CA125) in the observation group were higher than those in the control group ( P<0.05). Univariate regression analysis was used to screen variables with statistical significance, including NLR, PLR, CA125 and CA199 ( P<0.05), and multivariate logistic regression was used to construct a prediction model for diagnose MCT patients with torsion , which combined NLR and CA199 ( P<0.05). The area under curve (AUC) of NLR, PLR, CA125, CA199 and the combined prediction models of NLR and CA199 were 0.83, 0.72, 0.69, 0.60 and 0.86, respectively. Among them, the joint prediction model of NLR and CA199 had the highest diagnostic efficiency, with a sensitivity of 77.42% and a specificity of 82.18% ( P<0.05). In the observation group, the accuracy of combined prediction model of NLR and CA199 in the diagnosis of MCT pedicle torsion was higher than that of ultrasound (87.10% vs 61.29%), but according to the clinical symptoms and ultrasonic examination, 90.32% of the patients were diagnosed as MCT pedicle torsion. Conclusions:The inflammatory biomarkers and tumor markers have useful clinical significance in the diagnosis of MCT with torsion, especially the combine measurement of NLR and CA199. Associated with the patient's symptoms, signs, examination included doppler ultrasound may assist in improving the diagnostic accuracy .