Intracranial atherosclerotic stenosis (ICAS) is a common cause of ischemic stroke. The evaluation of its structure and function is of great significance for formulating clinical intervention strategies. The indications for endovascular treatment of ICAS lesions in the past were mainly based on the degree of luminal stenosis showed by cerebral angiography, which had certain limitations. The translesional pressure ratio (PR), as an important indicator for functional assessment after arterial stenosis, has gradually received attention in the evaluation of ICAS lesions in recent years. This article reviews the evaluation methods and clinical significance of PR in ICAS lesions.

Objective To explore the mechanism underlying the anti-hemorrhoid effects of Qingji Liangxue mixture(QLM).Methods Models of acute hemorrhoid in rats were established using a croton oil preparation(COP)and glacial acetic acid.A total of 80 SD female rats were randomly divided into two major groups:the COP group and the glacial acetic acid group,each consisting of 40 rats.In the COP group,rats were further randomly assigned to the following subgroups:control group 1(group CA),model group 1(group CB),low-dose QLM group 1-1(group CC),high-dose QLM group 1-2(group CD),and diosmin group 1(group CE),with eight rats in each subgroup.In the glacial acetic acid group,rats were randomly divided into the following subgroups:control group 2(group GA),model group 2(group GB),low-dose QLM group 2-1(group GC),high-dose QLM group 2-2(group GD),and diosmin group 2(group GE),with eight rats in each subgroup.Except for the control groups,all other subgroups were treated with COP or glacial acetic acid then treated with various drugs for 7 days.HE staining was used to observe anorectal histomorphology induced by COP and glacial acetic acid.ELIS As were used to measure serum levels of IL-6 and TNF-α induced by COP.Additionally,the area of perianal ulcers induced by glacial acetic acid was recorded.Twenty-four C57 mice were randomly divided into a control group(group A),low-dose QLM group(group B),high-dose QLM group(group C),and adrenal chromazone tablet group(group D).Results QLM significantly improved the pathological injury of animal models with similar hemorrhoids,reduced the score of pathological changes induced by COP(P＜0.05),reduced the serum levels of IL-6 and TNF-α(P＜0.05),reduced the area of perianal ulcers induced by glacial acetic acid(P＜0.05),and shortened the time of coagulation and bleeding(P＜0.05).Conclusions QLM has a good anti-hemorrhoid activity,which may be achieved by anti-inflammatory effects,hemostasis,and reducing tissue damage.

Helicobacter pylori infection is an important causative factor in a variety of gastrointestinal diseases,such as atrophic gastritis,peptic ulcer disease,and gastric cancer.Timely eradication treatment is con-ducive to maintaining the health of patients.With the increase of drug resistance in Helicobacter pylori,dual therapy with proton pump inhibitors combined with high-dose amoxicillin has gradually gained attention.Potassium-competitive acid blockers are new types of antacids that have a faster onset of action and a longer lasting acid sup-pression effect than traditional proton pump inhibitors,making it more suitable for dual therapy.In recent years,scholars have carried out a lot of exploration,improvement and verification of potassium-competitive acid blockers dual therapy,and this article reviews its research progress.

Spinal cord injury (SCI) is a serious nervous system disease that usually leads to the impairment of the motor, sensory, and autonomic nervous functions of the spinal cord, and it places a heavy burden on families and healthcare systems every year. Due to the complex pathophysiological mechanism of SCI and the poor ability of neurons to regenerate, the current treatment scheme has very limited effects on the recovery of spinal cord function. In addition, due to their unique advantages, exosomes can be used as carriers for cargo transport. In recent years, some studies have confirmed that treatment with mesenchymal stem cells (MSCs) can promote the recovery of SCI nerve function. The therapeutic effect of MSCs is mainly related to exosomes secreted by MSCs, and exosomes may have great potential in SCI therapy. In this review, we summarized the repair mechanism of mesenchymal stem cells-derived exosomes (MSCs-Exos) in SCI treatment and discussed the microRNAs related to SCI treatment based on MSCs-Exos and their mechanism of action, which is helpful to further understand the role of exosomes in SCI.

Background:Helicobacter pylori(Hp)drug resistance rate is increasing,rapid Hp drug resistance genotypic testing technology has become the focus of today's research,but its current clinical application is still very limited.Aims:To investigate the antibiotic resistance of Hp in Nanjing through the use of fecal Hp drug resistance gene testing.Additionally,the eradication effect of personalized Hp treatment guided by this technique was evaluated.Methods:The study included patients who underwent fecal Hp resistance gene testing at six hospitals in Nanjing between September 2022 and September 2024.Clarithromycin and levofloxacin resistance were obtained from the stool samples by detecting the presence of mutations in clarithromycin-associated resistance gene 23S rRNA and levofloxacin-associated resistance gene gyrA.In light of the test results,the patients were instructed to accept personalized eradication treatment for Hp.To this end,the patient's medical record was searched to obtain the treatment plan and review results.All participants signed an informed consent form.Results:A total of 780 patients with positive fecal Hp gene test were included in this study,and a total of 736 records of 23S rRNA/gyrA genotype testing were collected.The resistance rate of clarithromycin,levofloxacin and dual resistance was 51.36%,37.77%and 30.84%,respectively.These findings were statistically significant(P<0.001).The overall eradication rate of Hp was 90.06%(299/332).The eradication rate of the bismuth quadruple regimen of amoxicillin and furazolidone,the bismuth quadruple regimen of amoxicillin and clarithromycin,the bismuth quadruple regimen of amoxicillin and doxycycline,the bismuth quadruple regimen of amoxicillin and levofloxacin,the bismuth quadruple regimen of furazolidone and doxycycline was 92.39%,89.66%,91.43%,73.33%and 77.78%,respectively.The difference in Hp eradication rates for treatment regimens using different combinations of antibiotics was statistically significant(P=0.045).Conclusions:The prevalence of resistance to clarithromycin and levofloxacin among Hp strains in Nanjing has reached a high level.The fecal Hp resistance gene test has achieved satisfactory results in guiding the eradication of Hp,with an overall eradication rate of more than 90%,and deserves to be widely used in the clinical eradication of Hp.

Background:Helicobacter pylori(Hp)drug resistance rate is increasing,rapid Hp drug resistance genotypic testing technology has become the focus of today's research,but its current clinical application is still very limited.Aims:To investigate the antibiotic resistance of Hp in Nanjing through the use of fecal Hp drug resistance gene testing.Additionally,the eradication effect of personalized Hp treatment guided by this technique was evaluated.Methods:The study included patients who underwent fecal Hp resistance gene testing at six hospitals in Nanjing between September 2022 and September 2024.Clarithromycin and levofloxacin resistance were obtained from the stool samples by detecting the presence of mutations in clarithromycin-associated resistance gene 23S rRNA and levofloxacin-associated resistance gene gyrA.In light of the test results,the patients were instructed to accept personalized eradication treatment for Hp.To this end,the patient's medical record was searched to obtain the treatment plan and review results.All participants signed an informed consent form.Results:A total of 780 patients with positive fecal Hp gene test were included in this study,and a total of 736 records of 23S rRNA/gyrA genotype testing were collected.The resistance rate of clarithromycin,levofloxacin and dual resistance was 51.36%,37.77%and 30.84%,respectively.These findings were statistically significant(P<0.001).The overall eradication rate of Hp was 90.06%(299/332).The eradication rate of the bismuth quadruple regimen of amoxicillin and furazolidone,the bismuth quadruple regimen of amoxicillin and clarithromycin,the bismuth quadruple regimen of amoxicillin and doxycycline,the bismuth quadruple regimen of amoxicillin and levofloxacin,the bismuth quadruple regimen of furazolidone and doxycycline was 92.39%,89.66%,91.43%,73.33%and 77.78%,respectively.The difference in Hp eradication rates for treatment regimens using different combinations of antibiotics was statistically significant(P=0.045).Conclusions:The prevalence of resistance to clarithromycin and levofloxacin among Hp strains in Nanjing has reached a high level.The fecal Hp resistance gene test has achieved satisfactory results in guiding the eradication of Hp,with an overall eradication rate of more than 90%,and deserves to be widely used in the clinical eradication of Hp.

The gastrointestinal microbiome is the most important and complex microecosystem in the human microecosystem,which participates in a variety of physiological processes of the human body and is related to a variety of disease processes.In recent years,the relationship between gastrointestinal microbiome and gastrointestinal tumors has attracted the attention of scholars,and a series of studies have been carried out on the exploration of gastrointestinal microbiota as a new non-invasive biomarker.This article reviewed the relationship between gastrointestinal microbiome and the diagnosis,occurrence and treatment of gastrointestinal tumors through esophageal cancer,gastric cancer,colorectal cancer,gastrointestinal microbiome and tumor treatment,so as to provide new ideas for finding potential molecular targets for prevention,treatment and intervention of tumors.

Since 2020, the Chinese Society of Gastroenterology, the Japanese Society of Gastroenterology and the American College of Gastroenterology have updated consensus or guidelines for gastroesophageal reflux disease (GERD). This article reviewed and compared the above ⁃ mentioned files in terms of definition, symptoms, diagnosis, treatment, management of refractory GERD, and adverse effects of long⁃term proton pump inhibitor (PPI) treatment, so as to provide references for the standardized diagnosis and treatment of GERD.