Objective To explore the principle of antibacterial drug therapy and the strategy of program optimization in elderly patients with Helicobacter pylori（Hp）. Methods The common therapeutic regimen of Hp was summarized, and the better therapeutic regimen of elderly Hp patients was screened ultimately. Results Amoxicillin and cefuroxime were relatively safe compared with other recommended antibacterial drugs. Using other commonly antibiotics for Hp should pay attention to the disease of patients and current drug. Conclusion Elderly patients usually suffered from a variety of diseases and required multiple drugs. The application of therapeutic regimen for elderly patients with Hp should be supposed to fully weigh the risks and benefits.

Objective: To analyze the serological phenotypes and molecular genetic characteristics of a proband with ABO forward and reverse typing discrepancy and their family members, and to investigate the molecular genetic mechanism underlying the Ael/AelB phenotype caused by the c. 575T>C variant on an ABO A1.02 background. Methods: Serological testing and adsorption-elution assays were performed for blood group identification of the proband and family members. PCR-SBT, cloning sequencing, and Nanopore third-generation sequencing were used to analyze ABO gene variants and haplotypes. Phyre2 and PyMOL were used to predict the effect of the p. Ile192Thr variant on the structure of glycosyltransferase A (GTA), and plasma GTA activity was evaluated using an in vitro transferase assay. Results: Among thirteen family members, four members showed a serological phenotype consistent with the Ael subtype and one with the AelB subtype. Cloning sequencing and third-generation sequencing confirmed that five family members carried the ABO A1.02 (c. 575T>C) variant, which co-segregated with the weak A phenotype in the family. Structural modeling suggested that p. Ile192Thr may alter the local spatial conformation and hydrogen-bond interactions of GTA. Plasma GTA activity testing showed markedly reduced GTA activity in the tested individuals. Conclusion: The ABO A1.02 (c. 575T>C) variant is associated with the Ael/AelB phenotype. The p. Ile192Thr substitution may weaken A antigen expression by altering GTA conformation and reducing enzymatic activity. This study provides additional evidence for the role of this variant in the Ael/AelB phenotype from the perspectives of familial inheritance, full-length haplotype analysis, and functional assessment, which is important for accurate ABO subtype identification and individualized transfusion strategies.

Objective: To explore the potential classification of 24 hour activity time allocation among college students in Yinchuan and its association with active health levels, so as to provide references for optimizing activity time allocation to enhance active health levels. Methods: From November 18 to December 6, 2024, a stratified cluster random sampling method was used to select 2 422 first and second year college students from full time undergraduate institutions in Yinchuan. The Chinese College Students 24 hour Movement Behaviors Questionnaire (24 h MBQ) and Active Health Behavior Scale were used to assess 24 hour activity time allocation and evaluate active health levels. Latent profile analysis (LPA) was employed to categorize activity types, and a binary Logistic regression analysis was conducted to analyze the relationship between active health levels and activity types. Results: A total of 1 087 students (44.9%) were found of meeting active health standards, and significant statistical differences were found in active health levels across different genders, grades, academic qualities, sources of origin and academic categories ( χ 2= 22.03 , 7.65, 25.50, 10.12, 43.44, all P <0.01). Moreover, significant statistical differences could also be found among college students 24 hour activity time across different genders, ages, grades, sources of origin, academic qualities, and academic categories ( t/Z/H/F=-5.70-111.39, P <0.05).The 24 hour activity time allocation was classified into four types:academic high ( 6.9 %), low activity rest (8.8%), light activity (67.8%), and high activity dynamic (16.4%). Significant statistical differences were observed in activity time allocation categories across different ages, academic qualities and academic categories ( χ 2=15.52-108.46, all P <0.05). Using the high activity dynamic type as a reference, the light activity type ( OR=0.39, 95%CI =0.31-0.50), low activity rest type ( OR=0.10, 95%CI =0.06-0.15), and academic high type ( OR=0.03, 95%CI =0.02-0.07) had lower active health levels among college students (all P <0.01). Conclusion There is a significant difference in 24 hour activity time allocation among college students in Yinchuan, and different activity types are associated with active health levels.

Objective To discuss the accuracy and effectiveness of digital subtraction angiography(DSA)in determining the cause of limb ischemia after extra corporeal membrane oxygenation(ECMO.Methods The clinical data of 3 child patients,who developed 4 times of acute limb ischemia during perioperative period of ECMO at the Affiliated Children's Hospital of Zhengzhou University of China from July to October of 2023,were retrospectively analyzed.In all the child patients,emergency angiography was carried out to quickly identify the cause,then,appropriate treatment plan was adopted to open the blood vessels of the right lower limb.Results After the child patients entered the operating room and received DSA examination,the causes of the limb ischemia were quickly identified.After treatment,the blood supply to the lower limbs was restored.Except for one child who experienced irreversible necrosis of the distal limb due to repeated ischemia-reperfusion injury and required amputation,the other two child patients recovered well.Conclusion It is of great significance to perform DSA examination as soon as possible when the child patients develop limb ischemic manifestations after ECMO so as to quickly identify the cause,promptly restore blood supply to ischemic limbs and increase limb preservation rate,besides,DSA examination can also be used as a preventive measure for child patients after ECMO.

Objective To explore the safety and efficacy of semiconductor laser combined with sclerotherapy in the treatment of venous malformations(VM)in child patients.Methods The clinical data of 68 child patients with VM,who were admitted to the Affiliated Children's Hospital of Zhengzhou University of China from April 2023 to April 2024,were retrospectively analyzed.The child patients were divided into semiconductor laser combined with sclerotherapy group(laser+sclerotherapy group)and simple sclerotherapy group(sclerotherapy group),with 34 child patients in each group.The reduction rate of lesion size and the incidence of complications were compared between the two groups.Results The total effective rate and significant effective rate in the laser+sclerotherapy group were 100％ and 79.41％(27/34)respectively,which were higher than 82.35％(28/34)and 29.41％(10/34)respectively in the sclerotherapy group.The incidences of blister and pigmentation complications in the laser+sclerotherapy group were 11.76％(4/34)and 14.71％(5/34)respectively,which were lower than 41.18％(14/34)and 38.24％(13/34)respectively in the sclerotherapy group,and the differences between the two groups were statistically significant(all P＜0.05).Conclusion In treating child patients with VM,the combination use of semiconductor laser and sclerotherapy has higher clinical safety and effectiveness.

Objective To discuss the application value of intracavitary semiconductor laser therapy in improving facial appearance for child patients with facial venous malformations(VM)after receiving sclerotherapy.Methods The clinical data of 12 child patients with facial VM after receiving sclerotherapy,for whom the improvement of their facial appearance was difficult and who were admitted to the Affiliated Children's Hospital of Zhengzhou University of China from February 2023 to February 2024,were retrospectively analyzed.Intracavitary semiconductor laser treatment was adopted in all the 12 child patients.All the child patients were followed up to check the degree of appearance improvement and lesion volume reduction,and the curative effect was evaluated.Results Three months after intracavitary semiconductor laser treatment,obvious improvement of facial appearance was obtained in all the 12 child patients.The mean postoperative PAC-QOL psychological discomfort score was(10.4±3.9)points,when compared with the preoperative(23.7±4.3)points the difference was statistically significant(P＜0.05).MRI examination showed that after treatment no obvious improvement of the lesion was seen in 0 case,moderate improvement in one case,significant improvement in 4 cases,and cure in 7 cases.Conclusion Intracavitary semiconductor laser therapy has significant therapeutic effect in improving facial appearance for child patients with facial VM after receiving sclerotherapy,for whom the improvement of their facial appearance is difficult,therefore,this therapy has high clinical application value.

Objective To investigate the clinical efficacy and safety of simultaneous treatment of small hepatocellular carcinoma(HCC)with transarterial chemoembolization(TACE)combined with cone-beam computed tomography-guided(CBCT-guided)microwave ablation(MWA).Methods The clinical data of 69 patients with small HCC(72 lesions in total),who underwent TACE combined with CBCT-guided MWA simultaneous treatment from March 2018 to December 2022 at First Affiliated Hospital of Soochow University hospital,were retrospectively analyzed.Follow-up check was performed at 1,3,6,and 12 months after treatment.The mRECIST criteria was used to evaluate the tumor response.The objective response rate(ORR),disease control rate(DCR),progression-free survival(PFS),local tumor progression(LTP),and adverse reactions were analyzed.Results The initial complete remission(CR)rate,ORR and DCR of TACE combined with CBCT-guided MWA simultaneous treatment for small HCC was 94.2％(65/69),100％and 100％respectively.44.9％(31/69)of patients experienced tumor progression,and 20.3％(14/69)of patients experienced local tumor progression.Univariate and multivariate analyses showed that the maximum tumor diameter(≥2 cm and＜3 cm)was the main risk factor for PFS(HR=4.498,P＜0.001).No serious adverse events occurred during the study.Conclusion TACE combined with CBCT-guided MWA simultaneous treatment for small HCC is clinically effect and safe,and this therapy is particularly suitable for the treatment of lesions where the use of traditional image-guided methods is limited.

Objective To investigate the protective effect of miR-193a-5p on cardiac function and the regulation of IL-33/ST2 signaling pathway in rats with chronic heart failure(CHF).Methods Forty SPF-grade Wistar rats were randomly divided to four groups:Sham group,CHF group,NC group,and miR-193a-5p group,10 rats in each group.The model of chronic heart failure was duplicated in the CHF group,NC group,and miR-193a-5p group.Subsequently,the rats in the NC group and miR-193a-5p group were received 5 nmol/L of NC-agomiR or miR-193a-5p-agomiR,respectively,via tail vein injection every 3 days for 4 weeks.In contrast,the rats in the Sham and CHF groups were received an equal amount of saline injection.At the endpoint of the experiment,doppler color ultrasonography was used to detect the left ventricular posterior wall thicknesses(LVPWs),left ventricular posterior wall thickness at end-diastole(LVPWd),systolic interventricular septal thicknesses IVSs,end-diastolic interventricular septal thicknesses(IVSd),and left ventricular ejection fractions(LVEFs)in the above rats,and the changes in the cardiac phenotypic indices of HW/BW vs.LVW/BW in the 4 groups,and cardiac tissues of the rats of the 4 groups were selected.Histomorphological analysis was performed,and the expression levels of miR-193a-5p in the cardiac tissues of the four groups of the rats were detected by qPCR;apoptosis was detected by Tunel staining;the levels of the inflammatory factors interleukin-6(IL-6)and tumor necrosis factor alpha(TNF-alpha)in the myocardial tissues were measured by Elisa;Western blot was used to detect the expression levels of IL-33 and ST2 protein in myocardial tissues.Results Compared with the Sham group,the hearts in the CHF and NC groups showed increased volume,altered geometry,thinning of the myocardium,and pallor in the infarcted area,whereas the miR-193a-5p group showed partial remission.In addition,the expression levels of miR-193a-5p in cardiac tissues of the CHF and NC groups showed a decreasing trend,whereas showed a significant increase in the miR-193a-5p group(P<0.01).In CHF group and NC group,LVPWs,LVPWd,IVSS,IVSD HW/BW and LVW/BW increased significantly,and LVEF decreased significantly(P<0.01).In miR-193a-5p group,LVPWs,LVPWd,IVSs,IVSd,HW/BW and LVW/BW decreased significantly but higher than sham group,and LVEF increased significantly but lower than sham group(P<0.01).The expression of miR-193a-5p increased significantly in CHF group and NC group,decreased significantly in miR-193a-5p group but still higher than sham group(P<0.01).The expression of IL-33 and ST2 protein increased significantly in CHF group and NC group,and decreased significantly in miR-193a-5p group(P<0.01).Conclusion miR-193a-5p has a protective effect on cardiac function in the rats with chronic heart failure.The mechanism might be related to inhibiting the release of inflammatory factors,reducing cardiomyocyte apoptosis and the inhibition of IL-33/ST2 signaling pathway.

Acute lateral ankle sprain (ALAS) is one of the most common sport injuries, with high incidence, recurrence and disability rates. Currently, exercise rehabilitation-based non-surgical treatment is the primary management approach for ALAS. However, there remain improper practices such as excessive immobilization or uncontrolled activity, which contribute to recurrent sprains and chronic ankle instability, significantly impairing patients′ athletic function and quality of life. To standardize the non-surgical management of ALAS, improve the cure rates, and reduce the recurrence and disability rates, Chinese Sports Rehabilitation Medicine Training Project of Chinese Medical Association, Foot and Ankle Basics and Orthopedics Group, Orthopedic Branch of Chinese Medical Doctor Association, and Sports Medicine Branch of Jiangsu Medical Association organized relevant experts to formulate Expert consensus on non-surgical treatment for acute lateral ankle sprain ( version 2025), following the principles of scientific vigor, practicality, and innovation. Thirteen recommendations were proposed for standardized treatment protocols across different healing phases, aiming to provide references for standard management of ALAS and improve the therapeutic outcomes.

Objective:To investigate the correlation between mutations in KRAS, NRAS, BRAF, and PIK3 CA and the clinical characteristics of elderly colorectal cancer(CRC)patients. Methods:Paraffin-embedded tissue samples were obtained from 191 elderly CRC patients who consulted at Huadong Hospital, affiliated to Fudan University, between January 2022 and July 2023.Following deoxyribonucleic acid(DNA)extraction, the amplification refractory mutation system polymerase chain reaction(ARMS-PCR)was employed to detect the mutation profiles of KRAS, NRAS, BRAF, and PIK3 CA.Concurrently, serum samples collected prior to radical resection were analyzed for carcinoembryonic antigen(CEA), carbohydrate antigen 19-9(CA19-9), and carbohydrate antigen 72-4(CA72-4)using electrochemical luminescence.A comparative analysis of the clinical characteristics and preoperative serological tumor marker concentrations among patients with different gene mutations was conducted to elucidate their correlation. Results:A total of 191 elderly CRC patients were enrolled in the study, with ages ranging from 60 to 94 years(mean age 72.1±7.8 years), including 112 males.The mutation rate of KRAS, NRAS, BRAF, and PIK3 CA, as determined by combined detection, was found to be 49.21%(94/191)among elderly CRC patients. KRAS exhibited the highest mutation rate at 35.08%, with statistically significant differences observed in gender, primary site, degree of differentiation, and neurovascular invasion between patients with and without KRAS mutations( P<0.05 for all comparisons).The BRAF mutation rate was 8.90%, and significant differences in gender, age, primary site, and degree of differentiation were also noted between patients with and without BRAF mutations( P<0.05 for all).The mutation rates for NRAS and PIK3 CA were 2.62% and 5.24%, respectively, with no statistically significant differences in the clinical characteristics of patients across different groups( P>0.05 for all).Additionally, the proportion of patients over the age of 90 in the double mutation group was significantly higher( P<0.01).Significant differences in serum CA19-9 concentrations were observed among the various mutation types( P<0.05). Conclusions:There are notable differences in age, gender, primary site, degree of differentiation, and neurovascular invasion among elderly CRC patients with varying mutation statuses of KRAS, NRAS, BRAF, and PIK3 CA.Patients with double mutations exhibited higher concentrations of CA19-9 in preoperative serum.