As one of the common chronic bacterial infections, Helicobacter pylori (Hp) infection is a key pathogenic factor of chronic gastritis, peptic ulcer and gastric cancer. In the formation of gastric ulcer, Hp virulence factors directly damage the gastric mucosal barrier, induce the local inflammation and immune response, interfere with the regulation of gastric acid secretion, and ultimately destroy the mucosal stability. In the occurrence of gastric cancer, Hp-driven chronic inflammation is the basis of inflammation-cancer transformation, and it induces the genomic instability and epigenetic changes by interfering with key signaling pathways in host cells, thereby promoting malignant transformation. This paper systematically reviews the related mechanisms of Hp-induced gastric ulcer and gastric cancer in recent years, holding great significance for the development of new intervention strategies and the precise prevention and treatment of gastric cancer.

Objective To understand the trends in availability and usage for four non-statin lipid-lowering drugs between 2020 and 2023 in China,and to explore the impact of centralized drug procurement and national drug price negotiation policy on the accessibility and utilization trends of these medications.Methods Data processing was performed on four non-statin lipid-lowering drugs(ezetimibe,hybutimibeh,evolocumab,alirocumab)from over 1 000 hospitals within the China Pharmaceutical Association network units from 2020 to 2023 was performed on.SPSS 27.0 was employed for descriptive statistical analysis and x2 tests regarding drug availability,sales revenue,defined daily dose system(DDDs),and cost per DDD(DDDc).Results The availability and DDDs of four cholesterol absorption inhibitors or PCSK9-mAbs increased year by year during the study period,with the most significant increase observed in the first year after centralized drug procurement or national drug price negotiation policy.After the national drug price negotiation policy,alirocumab had the highest availability among the three negotiated drugs.The sales volume of ezetimibe,which was included in the centralized drug procurement program,increased before the negotiation but decreased significantly afterwards,with its share of sales declining year by year.During the study period,the sales volumes and market shares of the three negotiated drugs all increased annually,with evolocumab showing notably higher sales values and percentages than both hybutimibe and alirocumab after the negotiation.The DDDc for all four drugs continued to decrease during the survey period,with the first-year post-centralized drug procurement or national drug price negotiation policy witnessing the largest drop.Conclusion Both of the centralized drug procurement and the national drug price negotiation policy can significantly increase the accessibility to non-statin lipid-lowering drugs and promote their clinical application,however,there is a mismatch between the growth in usage and accessibility for certain varieties.

Objective To understand the trends in availability and usage for four non-statin lipid-lowering drugs between 2020 and 2023 in China,and to explore the impact of centralized drug procurement and national drug price negotiation policy on the accessibility and utilization trends of these medications.Methods Data processing was performed on four non-statin lipid-lowering drugs(ezetimibe,hybutimibeh,evolocumab,alirocumab)from over 1 000 hospitals within the China Pharmaceutical Association network units from 2020 to 2023 was performed on.SPSS 27.0 was employed for descriptive statistical analysis and x2 tests regarding drug availability,sales revenue,defined daily dose system(DDDs),and cost per DDD(DDDc).Results The availability and DDDs of four cholesterol absorption inhibitors or PCSK9-mAbs increased year by year during the study period,with the most significant increase observed in the first year after centralized drug procurement or national drug price negotiation policy.After the national drug price negotiation policy,alirocumab had the highest availability among the three negotiated drugs.The sales volume of ezetimibe,which was included in the centralized drug procurement program,increased before the negotiation but decreased significantly afterwards,with its share of sales declining year by year.During the study period,the sales volumes and market shares of the three negotiated drugs all increased annually,with evolocumab showing notably higher sales values and percentages than both hybutimibe and alirocumab after the negotiation.The DDDc for all four drugs continued to decrease during the survey period,with the first-year post-centralized drug procurement or national drug price negotiation policy witnessing the largest drop.Conclusion Both of the centralized drug procurement and the national drug price negotiation policy can significantly increase the accessibility to non-statin lipid-lowering drugs and promote their clinical application,however,there is a mismatch between the growth in usage and accessibility for certain varieties.

Objective To investigate whether the application of automated software for computed tomography angiography(CTA)and computed tomography perfusion imaging(CTP)can improve in-hospital workflow for endovascular treatment(EVT)in acute ischemic stroke patients.Methods We included patients with acute ischemic stroke who received CTA and CTP evaluation followed by EVT through the stroke emergency pathway at the Affiliated Hospital of Southwest Medical University between January 1,2020 and December 30,2022.The patients were divided into two groups:control group and artificial intelligence(Al)group based on whether automated software was used for assessment.The control group consisted of patients who underwent manual post-processing of multimodal imaging before June 2021,while the AI group was composed of patients whose imaging was processed with automated software from July 2021 onwards.The primary outcome was door-to-puncture time(DPT),and the secondary outcome was the 90-day modified Rankin Scale(mRS)score.Results A total of 312 patients were included,with 145 in the control group and 167 in the AI group.The median age of all the patients was 68 years(range:58-74 years),and 55.4％(173 patients)were male.The median National Institutes of Health Stroke Scale(NIHSS)score at presentation was 16 scores(range:12-19 scores).The median DPT was reduced from 110 min(range:80-150 min)before the use of automated software to 95 min(range:65-125 min)after its implementation(P＜0.001).However,there was no significant difference in the proportion of patients achieving functional independence(mRS score of 0-2)between the two groups(39.3％vs.41.3％,P=0.719).Conclusion The application of multimodal CT automated software improves the in-hospital workflow for acute ischemic stroke patients by reducing the time to EVT.However,the software did not significantly impact neurological functional outcomes as measured by the mRS.

Objective To investigate whether the application of automated software for computed tomography angiography(CTA)and computed tomography perfusion imaging(CTP)can improve in-hospital workflow for endovascular treatment(EVT)in acute ischemic stroke patients.Methods We included patients with acute ischemic stroke who received CTA and CTP evaluation followed by EVT through the stroke emergency pathway at the Affiliated Hospital of Southwest Medical University between January 1,2020 and December 30,2022.The patients were divided into two groups:control group and artificial intelligence(Al)group based on whether automated software was used for assessment.The control group consisted of patients who underwent manual post-processing of multimodal imaging before June 2021,while the AI group was composed of patients whose imaging was processed with automated software from July 2021 onwards.The primary outcome was door-to-puncture time(DPT),and the secondary outcome was the 90-day modified Rankin Scale(mRS)score.Results A total of 312 patients were included,with 145 in the control group and 167 in the AI group.The median age of all the patients was 68 years(range:58-74 years),and 55.4％(173 patients)were male.The median National Institutes of Health Stroke Scale(NIHSS)score at presentation was 16 scores(range:12-19 scores).The median DPT was reduced from 110 min(range:80-150 min)before the use of automated software to 95 min(range:65-125 min)after its implementation(P＜0.001).However,there was no significant difference in the proportion of patients achieving functional independence(mRS score of 0-2)between the two groups(39.3％vs.41.3％,P=0.719).Conclusion The application of multimodal CT automated software improves the in-hospital workflow for acute ischemic stroke patients by reducing the time to EVT.However,the software did not significantly impact neurological functional outcomes as measured by the mRS.

Purpose/Significance To explore the research progress of health recommender system(HRS),so as to provide refer-ences for medical personnel to build HRS to help intelligent health care.Method/Process The application of common recommendation technology and HRS in the field of health care is summarized by literature research,and the research status and development direction of HRS is discussed.Result/Conclusion HRS has been applied in health service recommendation,diet recommendation,health behavior promotion,disease prognosis characteristics and health risk prediction,chronic disease management,mental health promotion and medi-cation recommendation,and the related research is conducive to the development of intelligent health care.

Objective:To explore the genetic etiology of a child featuring multiple fractures and congenital insensitivity to pain (CIP).Methods:A child who had presented at the West China Hospital of Sichuan University on March 16, 2023 for recurrent fractures and CIP was selected as the study subject. Peripheral blood samples of the child and his parents was collected. Trio-whole exome sequencing was carried out. Candidate variants were verified by Sanger sequencing and bioinformatic analysis. This study has been approved by the Medical Ethics Committee of West China Hospital of Sichuan University (No. 2019-772).Results:Trio-whole exome sequencing revealed that the child has harbored compound heterozygous variants of the SCN9A gene, namely c. 560delC (p.P187Rfs*15) and c. 829C>T (p.R277*), which were respectively inherited from his father and mother. Homozygous c. 829C>T variant had been demonstrated as pathogenic among CIP patients, whilst the c. 560delC (p.P187Rfs*15) variant was unreported previously and predicted to be pathogenic based on the guidelines of the American College of Medical Genetics and Genomics (ACMG). Conclusion:The child was diagnosed with CIP due to the compound heterozygous variants of the SCN9A gene. Above finding has enabled genetic counselling and reproductive guidance for this family.

Objective:To compare the role and efficacy of serum Helicobacter pylori ( HP) antibody combined with pepsinogen (PG) (ABC method), serum PG combined with gastrin-17 (G-17) (new ABC method) and a new gastric cancer screening scoring system for early gastric cancer screening in healthy people. Methods:Serological examinations were performed on healthy people who underwent physical examination and gastroscopy at the Physical Examination Center of Shanghai Songjiang District Central Hospital from January 2019 to December 2021. The population were divided into low-risk population, medium-risk population and high-risk population based on the above three primary screening methods for gastric cancer. Using gastroscopy and biopsy pathology as the gold standard, the ratio of each risk stratification and the detection rate of gastric cancer of the three screening methods were calculated. Advantages and disadvantages of the three methods were evaluated.Results:A total of 3 199 people who completed physical examination and gastroscopy were included in the study. Ten cases (0.31%) of esophageal cancer were detected by endoscopy, all of whom were early esophageal cancer. Thirty-seven cases (1.16%) of gastric cancer were detected,and the detection rate of early gastric cancer was 86.49%(32/37). The three gastric cancer screening methods were used to evaluate the risk of gastric cancer. According to ABC method, there were 1 853 cases (7.92%) in the low-risk group, 1 339 cases (41.86%) in the medium-risk group, and 7 cases (0.22%) in the high-risk group. The detection rates of gastric cancer were 0.97% (18/1 853), 1.42% (19/1 339), and 0.00%, respectively. According to the new ABC method, there were 2 362 cases (73.84%) in the low-risk group, 804 cases (25.13%) in the medium-risk group, and 33 cases (1.03%) in the high-risk group. The detection rates of gastric cancer were 1.14% (27/2 362), 1.24% (10/804), and 0.00%, respectively. According to the new gastric cancer screening scoring system, there were 1 448 cases (45.26%) in the low-risk group, 1 213 cases (37.92%) in the medium-risk group and 538 cases (16.82%) in the high-risk group. The detection rates of gastric cancer were 0.28% (4/1 448), 1.32% (16/1 213) and 3.16% (17/538), respectively. The detection rate of gastric cancer in the medium- and high-risk groups in total was significantly higher than that in the low-risk group with significant difference ( χ 2=17.935, P<0.001). The ROC curve showed that the AUC of the ABC method, the new ABC method and the new gastric cancer screening scoring system were 0.546, 0.503 and 0.760, respectively. The AUC of the new gastric cancer screening scoring system was significantly higher than those of the ABC method and the new ABC method, and the differences were statistically significant ( P<0.001). Conclusion:The detection rate of gastric cancer in the medium- and high-risk groups of the new gastric cancer screening scoring system is higher than that of the low-risk group, and the missed diagnosis rate of the new gastric cancer screening scoring system is lower than those of the ABC method and the new ABC method. The screening score is of high value for early gastric cancer screening in the healthy population.

【Objective】 To research the genetic polymorphism of HPA 1-6/10/15/21 in platelet donors in Zhongshan area, and establish a gene bank of platelet donors with HPA locus. 【Methods】 The HPA 1-6/10/15/21 system genotyping was performed by Real time fluorescent PCR combined with TaqMan probe technology on 192 platelet donors in Zhongshan area, and the genotype frequency and gene frequency were calculated. 【Results】 Only HPA-aa genotype was found within HPA-4/10, and no allele HPA-b had been detected. The majority of HPA-1, 2, 5, 6 and 21 genotypes were aa. HPA-3 and HPA-15 showed high heterozygosity, with genotype frequency of 0.307 3, 0.494 8 and 0.197 9 for HPA- 3aa, HPA-3ab and HPA-3bb, while 0.270 8, 0.505 2 and, 0.224 0 for HPA -15aa, HPA-15ab and HPA-15bb, respectively. 【Conclusion】 The distribution characteristics of HPA 1-6 /10/15/21 of platelet donors in Zhongshan shows regional differences compared with similar researches from other regions. The establishment of HPA gene bank is helpful to avoid alloimmunization caused by incompatible platelet transfusion.

The vaccination of patients with inflammatory bowel disease (IBD) is different from that of the general population due to the disorder of autoimmune function and the influence of therapeutic medications on immune system. In this article, the vaccination of IBD patients and the influence of IBD therapeutic medications on vaccine immune response are reviewed, in order to improve the understanding of gastroenterologists on vaccination of IBD patients and provide reference for clinical decision-making.