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*

Background and Aims:Radical resection is the only potentially curative treatment for intrahepatic cholangiocarcinoma(ICC),yet the high recurrence rate results in poor prognosis.In recent years,"textbook outcome"(TO)has been proposed as a comprehensive quality metric,but its association with prognosis remains unclear.This study aimed to analyze the risk factors influencing the achievement of TO after radical resection of ICC and to explore the relationship between TO and survival.Methods:A retrospective analysis was conducted on the clinical data of 180 ICC patients who underwent radical resection at the 904th Hospital of the Joint Logistic Support Force of the PLA between February 2018 and February 2023.Univariate and multivariate Logistic regression analyses were performed to identify risk factors associated with TO,and survival analysis was carried out using the Kaplan-Meier method and Log-rank test.Results:Of the 180 patients,66 achieved TO.Multivariate Logistic regression analysis indicated that preoperative total bilirubin＞22 μmol/L,preoperative CA19-9＞35 U/mL,maximum tumor diameter＞5 cm,poor tumor differentiation,microvascular invasion(MVI),and lymph node metastasis were independent risk factors for failing to achieve TO(all P＜0.05).Survival analysis demonstrated that patients who achieved TO had a significantly longer median survival compared with those who did not(36 months vs.16 months,P＜0.001).Conclusion:Preoperative total bilirubin＞22 μmol/L,preoperative CA19-9＞35 U/mL,maximum tumor diameter＞5 cm,poor tumor differentiation,MVI,and lymph node metastasis are independent risk factors for not achieving TO after radical resection of ICC.Patients who achieved TO exhibited markedly longer survival,suggesting that TO not only reflects perioperative treatment quality but also serves as an important prognostic indicator.Greater attention to these risk factors and optimization of perioperative management may improve the likelihood of achieving TO and enhance long-term outcomes.

Background and Aims:Radical resection is the only potentially curative treatment for intrahepatic cholangiocarcinoma(ICC),yet the high recurrence rate results in poor prognosis.In recent years,"textbook outcome"(TO)has been proposed as a comprehensive quality metric,but its association with prognosis remains unclear.This study aimed to analyze the risk factors influencing the achievement of TO after radical resection of ICC and to explore the relationship between TO and survival.Methods:A retrospective analysis was conducted on the clinical data of 180 ICC patients who underwent radical resection at the 904th Hospital of the Joint Logistic Support Force of the PLA between February 2018 and February 2023.Univariate and multivariate Logistic regression analyses were performed to identify risk factors associated with TO,and survival analysis was carried out using the Kaplan-Meier method and Log-rank test.Results:Of the 180 patients,66 achieved TO.Multivariate Logistic regression analysis indicated that preoperative total bilirubin＞22 μmol/L,preoperative CA19-9＞35 U/mL,maximum tumor diameter＞5 cm,poor tumor differentiation,microvascular invasion(MVI),and lymph node metastasis were independent risk factors for failing to achieve TO(all P＜0.05).Survival analysis demonstrated that patients who achieved TO had a significantly longer median survival compared with those who did not(36 months vs.16 months,P＜0.001).Conclusion:Preoperative total bilirubin＞22 μmol/L,preoperative CA19-9＞35 U/mL,maximum tumor diameter＞5 cm,poor tumor differentiation,MVI,and lymph node metastasis are independent risk factors for not achieving TO after radical resection of ICC.Patients who achieved TO exhibited markedly longer survival,suggesting that TO not only reflects perioperative treatment quality but also serves as an important prognostic indicator.Greater attention to these risk factors and optimization of perioperative management may improve the likelihood of achieving TO and enhance long-term outcomes.

AIM:To establish a mouse model of pulmonary fibrosis induced by multiple intratracheal instilla-tions of bleomycin(BLM).METHODS:C57BL/6J mice were randomly divided into five groups:control group(n=5),multiple high-dose BLM(BLM-MH)group(n=10),multiple medium-dose BLM(BLM-MM)group(n=8),multiple low-dose BLM(BLM-ML)group(n=7),and single medium-dose BLM(BLM-SM)group(n=6).The pulmonary fibrosis mod-el was induced by single or multiple intratracheal instillations of BLM.Survival curves were plotted at day 56,and lung tis-sue was collected for lung coefficient calculation.Pathological changes in lung tissue were assessed using hematoxylin-eo-sin(H&E)staining and Masson staining.Indicators of lung fibrosis,such as hydroxyproline(HYP),were measured.Dif-ferentially expressed genes in patients with IPF were screened using the GEO database,and kyoto encyclopedia of genes and genomes(KEGG)pathway enrichment analysis was performed to identify pathways associated with IPF.Western blot was used to detect changes in these pathways in the lung tissues of the model mice.RESULTS:The survival rates were 50%in the BLM-MH group and 87.5%in the BLM-MM group,with no deaths in other groups.Compared with the control group,the BLM-MH and BLM-MM groups showed significantly increased lung coefficients(P＜0.05),lung tissue dam-age,inflammation levels,degree of pulmonary fibrosis(P＜0.05 or P＜0.01),and HYP content.The BLM-MH and BLM-MM groups,compared with the BLM-SM group,showed significantly elevated levels of inflammation,fibrosis,and HYP content(P＜0.05 or P＜0.01).GEO database and KEGG enrichment analysis revealed that the extracellular matrix-recep-tor interaction pathway(ECM-RIP)may be involved in IPF development.The expression levels of ECM-RIP pathway-re-lated proteins,such as phosphorylated focal adhesion kinase(p-FAK)and phosphorylated Src protein(p-Src),were in-creased in the lung tissues of the model mice compared with the control group.Compared with the BLM-SM group,the BLM-MH group exhibited significant increases in the protein levels of p-FAK and p-Src in the lung tissue(P＜0.05).CONCLUSION:The murine model of pulmonary fibrosis established through repeated intratracheal instillations of BLM effectively mimics the pathological characteristics of the disease,providing a valuable experimental model for the investiga-tion of idiopathic pulmonary fibrosis pathogenesis and for the development of therapeutic agents.

AIM:To establish a mouse model of pulmonary fibrosis induced by multiple intratracheal instilla-tions of bleomycin(BLM).METHODS:C57BL/6J mice were randomly divided into five groups:control group(n=5),multiple high-dose BLM(BLM-MH)group(n=10),multiple medium-dose BLM(BLM-MM)group(n=8),multiple low-dose BLM(BLM-ML)group(n=7),and single medium-dose BLM(BLM-SM)group(n=6).The pulmonary fibrosis mod-el was induced by single or multiple intratracheal instillations of BLM.Survival curves were plotted at day 56,and lung tis-sue was collected for lung coefficient calculation.Pathological changes in lung tissue were assessed using hematoxylin-eo-sin(H&E)staining and Masson staining.Indicators of lung fibrosis,such as hydroxyproline(HYP),were measured.Dif-ferentially expressed genes in patients with IPF were screened using the GEO database,and kyoto encyclopedia of genes and genomes(KEGG)pathway enrichment analysis was performed to identify pathways associated with IPF.Western blot was used to detect changes in these pathways in the lung tissues of the model mice.RESULTS:The survival rates were 50%in the BLM-MH group and 87.5%in the BLM-MM group,with no deaths in other groups.Compared with the control group,the BLM-MH and BLM-MM groups showed significantly increased lung coefficients(P＜0.05),lung tissue dam-age,inflammation levels,degree of pulmonary fibrosis(P＜0.05 or P＜0.01),and HYP content.The BLM-MH and BLM-MM groups,compared with the BLM-SM group,showed significantly elevated levels of inflammation,fibrosis,and HYP content(P＜0.05 or P＜0.01).GEO database and KEGG enrichment analysis revealed that the extracellular matrix-recep-tor interaction pathway(ECM-RIP)may be involved in IPF development.The expression levels of ECM-RIP pathway-re-lated proteins,such as phosphorylated focal adhesion kinase(p-FAK)and phosphorylated Src protein(p-Src),were in-creased in the lung tissues of the model mice compared with the control group.Compared with the BLM-SM group,the BLM-MH group exhibited significant increases in the protein levels of p-FAK and p-Src in the lung tissue(P＜0.05).CONCLUSION:The murine model of pulmonary fibrosis established through repeated intratracheal instillations of BLM effectively mimics the pathological characteristics of the disease,providing a valuable experimental model for the investiga-tion of idiopathic pulmonary fibrosis pathogenesis and for the development of therapeutic agents.

[摘 要] 目的：探讨miR-875-5p对胃癌细胞增殖、迁移和侵袭的影响及其机制。方法：采用qPCR法检测胃癌细胞BGC-823、HGC-27、MGC-803、SGC-7901、AGS、MKN-45 和胃黏膜上皮细胞GES-1中miR-875-5p的表达水平。利用脂质体转染技术，分别将miR-875-5p模拟物/抑制剂（mimic/inhibitor）及其阴性对照质粒（miR-NC/Anti-miR-NC）转染至AGS细胞/MKN-45细胞，构建过表达/抑制miR-875-5p的细胞模型，空白对照组（Control组）不转染。通过CCK-8、克隆形成、Transwell等实验分别检测miR-875-5p表达变化对细胞增殖、克隆形成、迁移和侵袭的影响。采用双荧光素酶报告基因实验验证miR-875-5p与上游刺激因子2（USF2）的靶向关系，WB实验验证miR-875-5p对USF2的调控作用并检测USF2蛋白的表达。构建MKN-45细胞裸鼠移植瘤模型，验证miR-875-5p过表达对MKN-45细胞成瘤能力的影响。结果：miR-875-5p在6种胃癌细胞中表达水平显著低于胃黏膜上皮细胞GES-1（均P<0.01）。与Control组和miR-NC组相比，miR-875-5p mimic组AGS细胞的增殖、克隆形成率、迁移和侵袭细胞数，以及USF2蛋白的表达均显著降低（P<0.05或P<0.01）；miR-875-5p inhibitor组MKN-45细胞的增殖、克隆形成率、迁移和侵袭细胞数，以及USF2蛋白的表达均显著提高（P<0.05或P<0.01）。双荧光素酶报告基因实验证明，miR-875-5p能够直接靶向USF2基因。体内成瘤实验结果表明，过表达miR-875-5p显著抑制MKN-45细胞移植瘤的生长（均P<0.01）。结论：miR-875-5p通过靶向USF2抑制胃癌细胞的增殖、迁移和侵袭。

OBJECTIVE: To observe the clinical curative effect on attention deficit hyperactivity disorder (ADHD) and explore the relevant mechanism of acupuncture in treatment. METHODS: A total of 100 ADHD children were randomized into an observation group (50 cases, 2 cases dropped off) and a control group (50 cases, 1 case dropped off). In the control group, the routine psychological intervention was used. In the observation group, on the base of the treatment as the control group, acupuncture was applied to Taichong (LR 3), Neiguan (PC 6), Shenmen (HT 7), Sanyinjiao (SP 6), Baihui (GV 20), Sishencong (EX-HN 1), etc., once daily, for 3 months. The Cambridge neuropsychological tests automated battery (CANTAB) was adopted to evaluate attention and response inhibition in two groups before and after treatment. Digi-Lite color transcranial Doppler was used to measure cerebral arterial blood velocity. The therapeutic effect was compared between the two groups. RESULTS: Regarding evaluation of attention, the mean delay time in the observation group after treatment was shorter than that before treatment and that in the control group separately ( CONCLUSION Acupuncture combined with psychological intervention may improve attention and response inhibition in ADHD children, which is possibly related to the regulation of cerebral blood flow.
Acupuncture Points ; Acupuncture Therapy ; Attention Deficit Disorder with Hyperactivity/therapy* ; Cerebrovascular Circulation ; Child ; Humans ; Psychosocial Intervention

Objective: To investigate the status of knowledge about acquired immune deficiency syndrome(AIDS) among college freshmen in Jiangsu Province, and to analyze the influences of AIDS-related knowledge on their sexual attitudes and behaviors. Methods: A total of 8 633 freshmen from 20 colleges and universities in Jiangsu Province were enrolled by multi-stage stratified sampling. The questionnaire for young students about the eight items of AIDS basic knowledge were used to investigate the AIDS-related knowledge, sexual attitudes and behaviors. Multivariate Logistic regression model was used to analyze the influencing factors of the AIDS-related knowledge and to adjust the influences of AIDS-related knowledge on sexual attitudes and behaviors. Results: The overall qualified rate of AIDS-related knowledge among college freshmen in Jiangsu Province was 87.6% and the qualified rate of 8 items were between 59.8% and 98.3%. The types of schools, nationality, mother s education level and whether only child or not were identified as independent factors for qualified rate of AIDS-related knowledge(P<0.05). The awareness of AIDS-related knowledge had significant impacts on the sexual attitudes and behaviors of college freshmen. Students with insufficient knowledge were more likely to approve premarital sexual behaviors(OR=1.31, 95%CI=1.11-1.63), willing to use condoms consistently(OR=1.67, 95%CI=1.43-1.92) and to accept the HIV tests(OR=4.54, 95%CI=3.13-6.52). Students with unqualified knowledge were more likely to have sexual behavior(OR=1.89, 95%CI=1.42-2.49), while those with sexual experiences and insufficient AIDS knowledge were more likely to use condoms consistently(OR=2.13, 95%CI=1.22-3.78). Conclusion The education on AIDS-related knowledge for teenagers was helpful to construct correct sexual concepts and develop healthy sexual behaviors. However, the AIDS-related knowledge of college freshmen in Jiangsu Province is not sufficient and needed to improve.

Objective: To investigate the effectiveness of preoperative 3D-CTA in assisting the preparation of free thinned anterolateral thigh lobulated perforator flap with nerve in repairing soft tissue defect of limb. Methods: Between February, 2010 and May, 2018, free super-thin anterolateral thigh lobulated perforator flap with nerve was transferred to repair soft tissue defect of limbs in 11 cases. There were 8 males and 3 females with an average age of 35 (range, 22-56) years. The defect area was 8.0 cm×11.0 cm-9.0 cm×23.0 cm. Preoperation CT scan of the free flap donor site was performed to obtain 3D images of the region with arterial blood supply by digital 3D reconstruction CT, and to determine the origin, direction, classification, length, diameter and the position of pedicle perforator. Postoperative regular followed-up was carried according to the Upper Limb Function Evaluation Trial Standards of Chinese Medical Association of Hand Surgery and Enneking Evaluation System. Results: All 11 flaps survived. No vascular crisis happened. All 11 cases were followed-up for 3 to 12 (average, 5) months. The flaps were supple and elastic with near normal color. There was no bulkiness. Sensory function was recovered well and two point discrimination was 3.0-6.0 mm. According to the Upper Limb Function Evaluation of Upper Limb of Chinese Medical Association of Hand Surgery, the results were excellent in 1 case, good in 3 cases and fair in 1 case. The Enneking system was used to assesse the lower limbs recovery. The average score was 21, an average of 70% of limb function restored. Conclusion The free super-thin anterolateral thigh lobulated perforator flap with nerve offers advantages to the traditional anterolateral thigh flap. The survived flaps are ideal in terms of covering limb defects and restoring functions. Preoperative 3D-CTA in the anterolateral thigh perforator flap transplantation is an accurate and useful method. It helps a safer and successful operation with optimal outcome.

Objective: To investigate the prognostic value of pretreatment albumin to globulin ratio(AGR)in prostate cancer(Pca)patients treated with maximal androgen blockade(MAB). Methods: Clinical and pathological data of 210 Pca patients who underwent MAB as first-line therapy between January 2013 and June 2018 were retrospectively analyzed.The ages of patients in our cohort ranged from 61 to 90 years, with a mean of(77.0±6.5)years.According to the cut-off point for AGR calculated by the receiver-operating curve analysis, patients were categorized into two groups: the high-AGR group and the low-AGR group.Clinical and pathological features were compared between the groups.Independent factors affecting prognosis were analyzed by using univariate and multivariate analysis. Results: The median follow-up duration was 44.0 months.Of the 210 patients, 99 cases had castration resistance, 100 patients(47.6%)had disease progression and 67 patients(31.8%)died.The cut-off point for AGR calculated by the receiver-operating curve analysis was 1.56.There were 103 cases in the low-AGR group(AGR<1.56)and 107 cases in the high-AGR group(AGR≥1.56). Univariate analysis revealed that the progression-free survival(PFS), cancer-specific survival(CSS)and overall survival(OS)were lower in the low-AGR group than in the high-AGR group[1.773(1.298~2.442), 1.948(1.220~3.213), 1.965(1.217~2.996), all P<0.05]. Multivariate Cox regression analysis showed that Gleason score, regional lymph nodes and bone metastases and AGR were independent prognostic factors for PFS(P=0.007, 0.040 and 0.022, P=0.031), CSS(P=0.003, 0.035 and 0.041, P=0.009)and OS(P=0.003, 0.026 and 0.023, P=0.002). Conclusions Pretreatment AGR<1.56 is an independent predictor for poor prognosis in Pca patients treated with MAB.