Background:A large number of studies have confirmed that the combination therapy of high-dose proton pump inhibitor(PPI)and amoxicillin has a good efficacy for eradication of Helicobacter pylori(Hp).As a new high-efficiency acid inhibitor,vonoprazan is expected to improve the efficacy of Hp eradication and has a good application prospect.Aims:To compare the efficacy and safety of the dual therapy of vonoprazan-amoxicillin and bismuth-containing quadruple therapy,so as to provide new treatment idea and choice for Hp eradication therapy.Methods:This is a single-center,prospective,randomized controlled clinical trial.Two hundred and ten patients positive for Hp infection and naive to eradication therapy were recruited consecutively and randomly divided into two groups.One group received dual therapy of vonoprazan-amoxicillin:vonoprazan 20 mg bid and amoxicillin 1 g tid for 14 days;the other group received bismuth-containing quadruple therapy:rabeprazole 20 mg bid,potassium bismuth citrate 600 mg bid,clarithromycin 500 mg bid,and amoxicillin 1 g bid for 14 days.After 4-6 weeks of treatment completion,the Hp eradication rate(primary outcome)was evaluated by 14C-urea breath test.Safety and compliance(secondary outcomes)were also observed and recorded in the treatment course.Results:In intention-to-treat(ITT)analysis,the Hp eradication rate of dual therapy of vonoprazan-amoxicillin was 89.6%,and that of bismuth-containing quadruple therapy was 92.3%(P＞0.05).In per-protocol(PP)analysis,the eradication rates of these two groups were 90.5%and 94.1%,respectively(P＞0.05).The adverse events rate of dual therapy was significantly lower than that of the quadruple therapy(5.7%vs.20.2%,P＜0.05).Conclusions:The efficacy of 14-day dual therapy of vonoprazan-amoxicillin for initial eradication of Hp is equal to bismuth-containing quadruple therapy,with fewer adverse events and simpler medications.It can be considered as the first-line treatment scheme of empirical treatment of Hp infection.

Background:A large number of studies have confirmed that the combination therapy of high-dose proton pump inhibitor(PPI)and amoxicillin has a good efficacy for eradication of Helicobacter pylori(Hp).As a new high-efficiency acid inhibitor,vonoprazan is expected to improve the efficacy of Hp eradication and has a good application prospect.Aims:To compare the efficacy and safety of the dual therapy of vonoprazan-amoxicillin and bismuth-containing quadruple therapy,so as to provide new treatment idea and choice for Hp eradication therapy.Methods:This is a single-center,prospective,randomized controlled clinical trial.Two hundred and ten patients positive for Hp infection and naive to eradication therapy were recruited consecutively and randomly divided into two groups.One group received dual therapy of vonoprazan-amoxicillin:vonoprazan 20 mg bid and amoxicillin 1 g tid for 14 days;the other group received bismuth-containing quadruple therapy:rabeprazole 20 mg bid,potassium bismuth citrate 600 mg bid,clarithromycin 500 mg bid,and amoxicillin 1 g bid for 14 days.After 4-6 weeks of treatment completion,the Hp eradication rate(primary outcome)was evaluated by 14C-urea breath test.Safety and compliance(secondary outcomes)were also observed and recorded in the treatment course.Results:In intention-to-treat(ITT)analysis,the Hp eradication rate of dual therapy of vonoprazan-amoxicillin was 89.6%,and that of bismuth-containing quadruple therapy was 92.3%(P＞0.05).In per-protocol(PP)analysis,the eradication rates of these two groups were 90.5%and 94.1%,respectively(P＞0.05).The adverse events rate of dual therapy was significantly lower than that of the quadruple therapy(5.7%vs.20.2%,P＜0.05).Conclusions:The efficacy of 14-day dual therapy of vonoprazan-amoxicillin for initial eradication of Hp is equal to bismuth-containing quadruple therapy,with fewer adverse events and simpler medications.It can be considered as the first-line treatment scheme of empirical treatment of Hp infection.

Objective To observe the influence of Azithromycin on helper T lymphocyte 9 cells ( Th9 ) and Th17 in peripheral blood of children with bronchial asthma,and to investigate the immunomodulating effect of Azithro-mycin. Methods Twenty-six asthmatic children were selected as the experimental group,and 17 healthy children as a control group. Peripheral blood mononuclear cells(PBMC)were isolated from venous blood by density gradient cen-tri-fugation under aseptic conditions. PBMC were split by phytohemagglutinin( PHA) in vitro. Different concentrations of Azithromycin (0,0. 1,1. 0,10. 0 mg/L)were added into the cultures in the experimental group. The control group was not interfered with azithromycin. The supematant was collected after 72 h. The levels of interleukin ( IL)-4, IL-9,IL-17 and IL-23 in the supematant were determined by enzyme-linked immunosorbent assay(ELISA). SPSS 17. 0 software was used to analyze data. Results (1) The levels of IL-4,IL-9,IL-17 and IL-23 produced from PBMC of the experimental group were significantly higher than those in the control group(t=9. 210,3. 040,8. 965,2. 796,P<0. 05). (2) The levels of IL-9 and IL-4 in Azithromycin 10. 0 mg/L were significantly lower than those in the Azithromycin 0 mg/L(P<0. 05). But there were no differences among other groups(P>0. 05). The levels of IL-17 and IL-23 of Azithromycin 10 mg/L were lower than those in Azithromycin 0 mg/L and 0. 1 mg/L(P<0. 05),but there were no significant differences among other groups(P>0. 05). (3)IL-9 level was negatively correlated with IL-4 level in the experimental group(r=-0. 255,P>0. 05). The levels of IL-23 and IL-17 secreted by Th17 in asthmatic chil-dren had correlation. The secretion of IL-17 levels rose with the secretion of IL-23 rise(r=0. 64,P<0. 05). Conclu-sions The function of Th9 and Th17 in asthmatic children was enhanced;Azithromycin could restrain the function of Th9 and Th17 at higher tissue concentrations (10. 0 mg/L),the former was unrelated to changes in the secretion of IL-9 levels,and the latter with the secretion of IL-23 levels decreased close. Azithromycin can play a role of immune modulators in higher concentrations,inflammatory cytokines are inhibited in the asthmatic children,and Azithromycin relieves airway inflammation.

In order to explore the role of p15(INK4B) gene with highly methylated CpG island in the pathogenesis of leukemia, the expression levels of p15(INK4B) gene was detected in patients with AML and CML. Methylation-specific PCR (MSP) assay was employed in the experiments. The methylation incidence was 83.9% (26/31) in AML and 0% (0/28) in CML. The results showed that methylation of p15(INK4B) gene was the one of the major ways for inactivation of the gene, and the methylation could be appeared in clinical development of the disease and patients condition worsened. Methylation of p15(INK4B) did not occur and its function probably is normal in CML.

AIM: To illustrate the expression of hypermethylation p15 gene in 53 non-Hodgkin’s lymphoma (NHL). METHODS: The methylation of p15 gene in 53 cases of non-Hodgkin’s lymphoma was detected by using methylation-specific PCR (MSP) technique. RESULTS: 18.9% (10/53) in NHL were methylation in p15 gene. p15 gene was frequently in high malignant NHL patients (27.3%) compared with in low malignant patients (0%). CONCLUSION: The result suggested that the hypermethylation of p15 may play an important role in non-Hodgkin’s lymphoma.

AIM: To study the effect of IL-12 on T lymphocytes apoptosis, the expression of Fas/FasL and TNFR/TNF?. METHODS: Terminal dUTP nick end labeling(TUNEL) and Annexin V assay were used. Anti-TNFR were labeled with FITC, anti-CD95 was labeled with PE and Anti-FasL with biotin. Three kinds of T cells (HTB176,TIB152 and human normal T cells) were analysed through flow cytometry. RESULTS: At 1st hour after being treated with IL-12, the expression of FasL protein and FasL mRNA in HTB176 and TIB152 began to increase and reached peak value in 24 hours. In the normal T cells, FasL just began to increase in 1 hour and maintained stability in 6, 12 and 24 hours through the later experiment period. All three kinds of T cells displayed no change in the expression of CD95 and TNFR/TNF? under the stimulation of IL-12. CONCLUSION: Expression of such apoptosis regulating factors were different in the apoptosis of T cells induced by IL-12.