This paper reports the diagnosis and treatment process of a patient with severe anemia caused by hookworm and Ascaris lumbricoides co-infections, so as to provide insights into clinical diagnosis and treatment and avoid misdiagnosis and under-diagnosis of parasitic infections. Living parasites were found by endoscopy, which were morphologically identified as hookworm and A. lumbricoides, and routine stool examinations detected hookworm and A. lumbricoides eggs. The patient was diagnosed with severe anemia caused by hookworm and A. lumbricoides co-infections by means of clinical symptoms, epidemiological history, endoscopic findings, and laboratory tests. Following blood transfusion, hemostasis, oral administration with albendazole, and symptomatic treatments, the patient showed remarkable symptomatic improvement and had a good prognosis.

Objective:To investigate the efficacy and safety of linaclotide(LIN) combined with polyethylene glycol(PEG) for bowel preparation in patients with functional constipation (FC).Methods:From August 1, 2022 to April 30, 2023, a total of 300 patients with FC (FC group) and 300 subjects with non-functional constipation (NFC, NFC group) undergoing colonoscopy at the Affiliated Hospital of Qingdao University were selected. According to simple random sampling method, both FC group and NFC group were divided into 3 L PEG subgroup, 3 L PEG+ LIN subgroup, and 2 L PEG+ LIN subgroup, respectively, with 100 cases in each group and a total of 6 subgroups. All subjects were enrolled based on a random number table and received the corresponding bowel preparation protocols. The Ottawa bowel preparation score (OBPS) and the rate of adequate bowel preparation were calculated. Ordered logistic regression analysis was used to analyze the independent influencing factors of OBPS. The incidence of adverse events (such as bloating) and the repetition rate of regimen intention were analyzed. One-way ANOVA, least significant difference analysis, and chi-square test were used for statistical analysis.Results:The OBPS of the 3 L PEG subgroup, 3 L PEG+ LIN subgroup, and 2 L PEG+ LIN subgroup in the FC group were 6.06±1.67, 3.86±2.20, and 4.06±2.03, respectively, while the OBPS of the 3 corresponding subgroups in the NFC group were 5.08±1.92, 3.42±2.04, and 3.63±1.93, respectively. The OBPS scores of the 2 L PEG+ LIN and 3 L PEG+ LIN subgroups in FC and NFC group were lower than those of the 3 L PEG subgroup within the respective group, and the differences were statistically significant ( t=7.16, 7.55, 4.59, and 6.06; all P<0.001). The rates of adequate bowel preparation of the 3 L PEG subgroup, 3 L PEG+ LIN subgroup, and 2 L PEG+ LIN subgroup in the FC group were 83.0% (78/94), 95.6% (87/91), and 96.8% (92/95), respectively, while the rates of adequate bowel preparation of the 3 subgroups in the NFC group were 88.0% (88/100), 96.9%(94/97), and 97.0%(96/99), respectively. The rates of adequate bowel preparation of 2 L PEG+ LIN and 3 L PEG+ LIN subgroups in FC and NFC group were higher than those of the 3 L PEG subgroup in the respective group, and the differences were statistically significant( χ2=10.04, 7.64, 5.74, and 5.55, P=0.001, 0.008, 0.029, 0.029). The FC group was divided into 2 L PEG+ LIN compared to 3 L PEG+ LIN subgroup, as well as 3 L PEG+ LIN compared to 3 L PEG subgroup for ordinal logistic regression analysis, and the result showed that the bowel preparation regimen was an independent influencing factor for OBPS ( OR=0.940 and 3.072, 95% confidence interval 0.368 to 1.483 and 1.564 to 3.252; both P<0.001). The incidence of abdominal distension of the 3 L PEG subgroup in FC group and NFC group was higher than that of the 2 L PEG+ LIN subgroup in the respective group (11.7%(11/94) vs. 3.2%(3/95), 12.0%(12/100) vs. 4.0%(4/99)), and the differences were statistically significant( χ2=5.03 and 4.26, P=0.028 and 0.045). The repetition rates of regimen intention of the 2 L PEG+ LIN and 3 L PEG+ LIN subgroups in FC and NFC groups were higher than that of the 3 L PEG subgroup in respective group (93.7%(89/95), 93.4%(85/91) vs. 80.9%(76/94); 92.9%(92/99), 92.8%(90/97) vs. 82.0%(82/100)), and the differences were statistically significant ( χ2=5.25, 8.70, 4.31, and 5.40; P=0.009, 0.015, 0.020, and 0.023). Conclusions:The 2 L PEG+ LIN regimen can effectively decrease OBPS, improve qualified rate of bowel preparation and repetition rate of regimen intention, and reduce adverse events and the amount of fluid intake, in order to improve the tolerance and compliance of patients. Therefore, the 2 L PEG+ LIN regimen is recommended as a bowel preparation for colonoscopy in patients with FC.

Objective:To investigate the efficacy and safety of linaclotide(LIN) combined with polyethylene glycol(PEG) for bowel preparation in patients with functional constipation (FC).Methods:From August 1, 2022 to April 30, 2023, a total of 300 patients with FC (FC group) and 300 subjects with non-functional constipation (NFC, NFC group) undergoing colonoscopy at the Affiliated Hospital of Qingdao University were selected. According to simple random sampling method, both FC group and NFC group were divided into 3 L PEG subgroup, 3 L PEG+ LIN subgroup, and 2 L PEG+ LIN subgroup, respectively, with 100 cases in each group and a total of 6 subgroups. All subjects were enrolled based on a random number table and received the corresponding bowel preparation protocols. The Ottawa bowel preparation score (OBPS) and the rate of adequate bowel preparation were calculated. Ordered logistic regression analysis was used to analyze the independent influencing factors of OBPS. The incidence of adverse events (such as bloating) and the repetition rate of regimen intention were analyzed. One-way ANOVA, least significant difference analysis, and chi-square test were used for statistical analysis.Results:The OBPS of the 3 L PEG subgroup, 3 L PEG+ LIN subgroup, and 2 L PEG+ LIN subgroup in the FC group were 6.06±1.67, 3.86±2.20, and 4.06±2.03, respectively, while the OBPS of the 3 corresponding subgroups in the NFC group were 5.08±1.92, 3.42±2.04, and 3.63±1.93, respectively. The OBPS scores of the 2 L PEG+ LIN and 3 L PEG+ LIN subgroups in FC and NFC group were lower than those of the 3 L PEG subgroup within the respective group, and the differences were statistically significant ( t=7.16, 7.55, 4.59, and 6.06; all P<0.001). The rates of adequate bowel preparation of the 3 L PEG subgroup, 3 L PEG+ LIN subgroup, and 2 L PEG+ LIN subgroup in the FC group were 83.0% (78/94), 95.6% (87/91), and 96.8% (92/95), respectively, while the rates of adequate bowel preparation of the 3 subgroups in the NFC group were 88.0% (88/100), 96.9%(94/97), and 97.0%(96/99), respectively. The rates of adequate bowel preparation of 2 L PEG+ LIN and 3 L PEG+ LIN subgroups in FC and NFC group were higher than those of the 3 L PEG subgroup in the respective group, and the differences were statistically significant( χ2=10.04, 7.64, 5.74, and 5.55, P=0.001, 0.008, 0.029, 0.029). The FC group was divided into 2 L PEG+ LIN compared to 3 L PEG+ LIN subgroup, as well as 3 L PEG+ LIN compared to 3 L PEG subgroup for ordinal logistic regression analysis, and the result showed that the bowel preparation regimen was an independent influencing factor for OBPS ( OR=0.940 and 3.072, 95% confidence interval 0.368 to 1.483 and 1.564 to 3.252; both P<0.001). The incidence of abdominal distension of the 3 L PEG subgroup in FC group and NFC group was higher than that of the 2 L PEG+ LIN subgroup in the respective group (11.7%(11/94) vs. 3.2%(3/95), 12.0%(12/100) vs. 4.0%(4/99)), and the differences were statistically significant( χ2=5.03 and 4.26, P=0.028 and 0.045). The repetition rates of regimen intention of the 2 L PEG+ LIN and 3 L PEG+ LIN subgroups in FC and NFC groups were higher than that of the 3 L PEG subgroup in respective group (93.7%(89/95), 93.4%(85/91) vs. 80.9%(76/94); 92.9%(92/99), 92.8%(90/97) vs. 82.0%(82/100)), and the differences were statistically significant ( χ2=5.25, 8.70, 4.31, and 5.40; P=0.009, 0.015, 0.020, and 0.023). Conclusions:The 2 L PEG+ LIN regimen can effectively decrease OBPS, improve qualified rate of bowel preparation and repetition rate of regimen intention, and reduce adverse events and the amount of fluid intake, in order to improve the tolerance and compliance of patients. Therefore, the 2 L PEG+ LIN regimen is recommended as a bowel preparation for colonoscopy in patients with FC.

Objective:To determine the prevalence of Helicobacter pylori (Hp) infection in orthotopic liver transplantation (LT) recipients, and to study the efficacy and safety of Hp eradication therapy.Methods:13C-urea breath test was carried out between July 2018 and October 2019. There were 104 males and 26 females with an average age of 52.1 year for these LT recipients who were regularly followed-up in the Organ Transplant Center, the Affiliated Hospital of Qingdao University. Propensity scoring was used to match age and gender in a ratio of 1∶3. A healthy group of individuals consisting of 299 males and 91 females, with an average age of 51.8 years, were selected as the control group also in a ratio of 1∶3. All patients underwent 13C-urea breath test to evaluate Hp infection and results of quadruple therapy. Results:The prevalence of Hp infection among the LT recipients was 18.5%(24/130) which was significantly lower than the control group 36.4% (142/390) (χ 2=14.400, P<0.001). Among the recipients who received LT and 13C-urea breath test for less than 1 year, 1-3 years and more than 3 years, the prevalences of Hp infection were 14.3% (6/42), 17.8%(8/45) and 23.3%(10/43), respectively. Although the prevalence of Hp showed a gradually increasing trend, no correlation between Hp infection and duration from LT was observed (χ 2=1.321, P=0.517). Seventeen Hp positive recipients underwent Hp eradication therapy. The success rate of Hp eradication was 100.0%(17/17). Immunosuppressant concentration was monitored regularly in 10 patients. During Hp eradication, the blood concentration of immunosuppressant increased from 1.7 to 3.6 times, and the drug dosage was reduced to one half to one third of what it was before Hp eradication. Seven of these 17 recipients suffered from adverse effects caused by increased levels of blood concentration of immunosuppressants, including headache, hypertension, insomnia and irritability. Normal liver and kidney functions were observed during eradication. Conclusion:In this study, the prevalence of Hp infection among liver transplant recipients was 18.5%. The success rate of Hp eradication was 100% using bismuth-containing quadruple therapy. The dosage of immunosuppressant required to be monitored, and if necessary, adjusted during eradication to reduce adverse side effects.