Helicobacter pylori(H.pylori)infection is a prevalent global health issue that can lead to indiges-tion,peptic ulcer disease,and gastric cancer.With ongoing research advancements,significant progress has been made in the eradication of H.pylori.Based on these important findings from North America,the American College of Gastroenterology(ACG)has released updated clinical practice guideline(CPG),published in the American Journal of Gastroenterology in September 2024.Compared to previous guidelines,key updates include:increased resistance rates to critical antibiotics used for H.pylori treatment,such as clarithromycin and levofloxacin,which have reduced the efficacy of common treatment regimens containing these antibiotics;and research on novel treat-ment options for newly diagnosed patients,including new antibiotic alternatives(e.g.,rifampicin)or more potent next-generation gastric acid inhibitors(e.g.,potassium-competitive acid blockers,PCABs).These updates provide the latest evidence and reference for the clinical management of H.pylori infection.

Objective:To investigate the association between peak growth hormone(GH) levels and body fat mass as well as body fat percentage in children with short stature.Methods:This retrospective study included 477 children diagnosed with short stature at the Affiliated Hospital of Jining Medical University between January 2021 and November 2024, based on data from the Growth and Development Disease Follow-up Cohort Study(GDDSD) in Shandong Province. Clinical data including anthropometric measurements, laboratory tests, and body composition were collected. The relationship between GH peak and body fat mass and percentage were analyzed using smooth curve fitting and multiple piecewise linear regression models.Results:In univariate linear regression analysis, both body fat mass and body fat percentage were positively correlated with age, height, weight, body mass index, triglycerides, low density lipoprotein-cholesterol, fasting blood glucose, total body water, protein, and skeletal muscle mass(all P<0.05), and negatively correlated with GH peak and high density lipoprotein-cholesterol. After adjusting for potential confounding factors, a nonlinear relationship was observed between GH peak and both body fat mass and body fat percentage, with inflection points at 6.80 ng/mL and 7.75 ng/mL, respectively. When GH peak was below the inflection point, it was significantly negatively correlated with body fat mass and percentage( P<0.001). However, when GH peak exceeded the inflection point, the associations were no longer statistically significant( P>0.05). Conclusions:This study demonstrates a nonlinear relationship between peak GH levels and body fat percentage in children with short stature. At lower GH peaks, both body fat mass and body fat percentage increase significantly, which may contribute to an elevated future risk of cardiovascular disease.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.

Background Irritable bowel syndrome with diarrhea(IBS-D)is a common gastrointestinal dysfunction disease,but currently,single Western medicine treatments have significant side effects and are prone to recurrence.Probiotics and traditional Chinese medicine have certain therapeutic effects on IBS-D,but the exact treatment mechanism is still unclear,and there is limited research on the combination of the two.Objective To investigate the effects of Chongkang Capsules combined with Bifidobacterium on gut microbiota,mucosal barrier function,and neurotransmitter levels in patients with IBS-D and comorbid anxiety and depression,and to analyze its therapeutic mechanisms.Methods A total of 150 patients with irritable bowel syndrome with diarrhea(IBS-D)and anxiety and depression who were treated in the gastroenterology department of our hospital from January 2021 to June 2022,were selected as the study subjects.A randomized controlled trial was designed with three treatment groups:50 patients in the observation group received Chongkang Capsules combined with Bifidobacterium for 4 weeks;50 patients in the positive control group received Rifaximin combined with Bifidobacterium for 4 weeks;and 50 patients in the blank control group received Bifidobacterium alone for 4 weeks(to exclude interference from the bacterial species in the Bifidobacterium capsules in intestinal flora detection).The changes in IBS-D symptom severity,stool consistency,anxiety and depression scores(HAM-A/HAM-D),intestinal flora(lactobacilli,Bifidobacterium,bacteroides,enterobacteria),intestinal barrier markers(serum D-lactic acid,DAO),inflammatory factors(IL-6,IL-8,TNF-α),intestinal tight junction proteins(Occludin,ZO-1),neurotransmitters(5-HT),and recurrence rates were compared among the three groups before and after treatment.Results Symptom improvement:the improvement in IBS-SSS scores,stool classification,and HAM-A/HAM-D scores in the observation and positive control groups was significantly better than that in the blank control group(all P<0.001),but there was no significant difference between the two groups(P>0.05).Flora regulation:after treatment,the observation and positive control groups showed a significant increase in beneficial bacteria(lactobacilli and Bifidobacterium)and a significant decrease in pathogenic bacteria(bacteroides and enterobacteria)compared to the blank control group(all P<0.001).The improvement in flora persisted up to 6 months after treatment(P<0.001).Barrier and inflammation:the reduction in serum D-lactic acid,DAO,and IL-6/IL-8/TNF-α levels was significantly greater in the observation and positive control groups than in the blank control group(all P<0.001).The expression of intestinal barrier proteins(Occludin and ZO-1)was significantly upregulated(P<0.001).Neurotransmitters:the increase in serum 5-HT levels were significantly higher in the two groups than in the blank control group(P<0.001).Recurrence rate:the 3-month recurrence rates in the observation group(8.0%)and positive control group(10.0%)were significantly lower than that in the blank control group(30.0%).The 6-month recurrence rates(14.0%vs.16.0%vs.44.0%)also showed significant differences(all P<0.05).Conclusion Chongkang Capsules combined with Bifidobacterium can effectively alleviate clinical symptoms in patients with IBS-D and comorbid anxiety and depression.The mechanism may be related to regulating intestinal flora balance,repairing the intestinal mucosal barrier,suppressing inflammatory responses,and increasing 5-HT levels.Additionally,the low recurrence rate suggests its clinical application value.

Background Irritable bowel syndrome with diarrhea(IBS-D)is a common gastrointestinal dysfunction disease,but currently,single Western medicine treatments have significant side effects and are prone to recurrence.Probiotics and traditional Chinese medicine have certain therapeutic effects on IBS-D,but the exact treatment mechanism is still unclear,and there is limited research on the combination of the two.Objective To investigate the effects of Chongkang Capsules combined with Bifidobacterium on gut microbiota,mucosal barrier function,and neurotransmitter levels in patients with IBS-D and comorbid anxiety and depression,and to analyze its therapeutic mechanisms.Methods A total of 150 patients with irritable bowel syndrome with diarrhea(IBS-D)and anxiety and depression who were treated in the gastroenterology department of our hospital from January 2021 to June 2022,were selected as the study subjects.A randomized controlled trial was designed with three treatment groups:50 patients in the observation group received Chongkang Capsules combined with Bifidobacterium for 4 weeks;50 patients in the positive control group received Rifaximin combined with Bifidobacterium for 4 weeks;and 50 patients in the blank control group received Bifidobacterium alone for 4 weeks(to exclude interference from the bacterial species in the Bifidobacterium capsules in intestinal flora detection).The changes in IBS-D symptom severity,stool consistency,anxiety and depression scores(HAM-A/HAM-D),intestinal flora(lactobacilli,Bifidobacterium,bacteroides,enterobacteria),intestinal barrier markers(serum D-lactic acid,DAO),inflammatory factors(IL-6,IL-8,TNF-α),intestinal tight junction proteins(Occludin,ZO-1),neurotransmitters(5-HT),and recurrence rates were compared among the three groups before and after treatment.Results Symptom improvement:the improvement in IBS-SSS scores,stool classification,and HAM-A/HAM-D scores in the observation and positive control groups was significantly better than that in the blank control group(all P<0.001),but there was no significant difference between the two groups(P>0.05).Flora regulation:after treatment,the observation and positive control groups showed a significant increase in beneficial bacteria(lactobacilli and Bifidobacterium)and a significant decrease in pathogenic bacteria(bacteroides and enterobacteria)compared to the blank control group(all P<0.001).The improvement in flora persisted up to 6 months after treatment(P<0.001).Barrier and inflammation:the reduction in serum D-lactic acid,DAO,and IL-6/IL-8/TNF-α levels was significantly greater in the observation and positive control groups than in the blank control group(all P<0.001).The expression of intestinal barrier proteins(Occludin and ZO-1)was significantly upregulated(P<0.001).Neurotransmitters:the increase in serum 5-HT levels were significantly higher in the two groups than in the blank control group(P<0.001).Recurrence rate:the 3-month recurrence rates in the observation group(8.0%)and positive control group(10.0%)were significantly lower than that in the blank control group(30.0%).The 6-month recurrence rates(14.0%vs.16.0%vs.44.0%)also showed significant differences(all P<0.05).Conclusion Chongkang Capsules combined with Bifidobacterium can effectively alleviate clinical symptoms in patients with IBS-D and comorbid anxiety and depression.The mechanism may be related to regulating intestinal flora balance,repairing the intestinal mucosal barrier,suppressing inflammatory responses,and increasing 5-HT levels.Additionally,the low recurrence rate suggests its clinical application value.

Objective:To explore the application effect of Kaitianmen point massage on pain, faligue, anxiety and depression in patients with rheumatoid arthritis.Methods:This study was a randomized controlled study, a total of 80 patients with rheumatoid arthritis who were admitted to Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine from May to November 2023 were selected as the research objects. The control group was given routine treatment and nursing, and the experimental group was given Kaitianmen acupoint massage on the basis of routine treatment and nursing. The differences in pain score, fatigue score, anxiety and depression score before and after intervention were compared between the two groups.Results:In the final, there were 37 cases in the experimental group and 36 cases in the control group completed the study. Before intervention, there was no statistically significant difference in pain scores, fatigue scores, anxiety and depression scores between the two groups (all P>0.05). After four weeks of intervention, the pain score of the experimental group was (2.06 ± 0.35), and that of the control group was (3.72 ± 0.59), the difference was statistically significant ( t=14.57, P<0.05). After four weeks of intervention, the fatigue score of the experimental group was (20.11 ± 8.03), and that of the control group was (25.02 ± 8.32), the difference was statistically significant ( t=2.55, P<0.05). After four weeks of intervention, the anxiety score of the experimental group was (48.33 ± 6.13), which was significantly different from (53.99 ± 4.91) of the control group ( t=4.35, P<0.05), and the depression score of the experimental group was (49.99 ± 6.33), compared with the (54.86 ± 4.83) of control group, the difference was statistically significant ( t=3.69, P<0.05). Conclusions:Kaitianmen acupoint massage can relieve limb pain, fatigue, anxiety and depression in patients with rheumatoid arthritis, which is worthy of clinical promotion.

Objective:To explore the application effect of Kaitianmen point massage on pain, faligue, anxiety and depression in patients with rheumatoid arthritis.Methods:This study was a randomized controlled study, a total of 80 patients with rheumatoid arthritis who were admitted to Shanghai Guanghua Hospital of Integrated Traditional Chinese and Western Medicine from May to November 2023 were selected as the research objects. The control group was given routine treatment and nursing, and the experimental group was given Kaitianmen acupoint massage on the basis of routine treatment and nursing. The differences in pain score, fatigue score, anxiety and depression score before and after intervention were compared between the two groups.Results:In the final, there were 37 cases in the experimental group and 36 cases in the control group completed the study. Before intervention, there was no statistically significant difference in pain scores, fatigue scores, anxiety and depression scores between the two groups (all P>0.05). After four weeks of intervention, the pain score of the experimental group was (2.06 ± 0.35), and that of the control group was (3.72 ± 0.59), the difference was statistically significant ( t=14.57, P<0.05). After four weeks of intervention, the fatigue score of the experimental group was (20.11 ± 8.03), and that of the control group was (25.02 ± 8.32), the difference was statistically significant ( t=2.55, P<0.05). After four weeks of intervention, the anxiety score of the experimental group was (48.33 ± 6.13), which was significantly different from (53.99 ± 4.91) of the control group ( t=4.35, P<0.05), and the depression score of the experimental group was (49.99 ± 6.33), compared with the (54.86 ± 4.83) of control group, the difference was statistically significant ( t=3.69, P<0.05). Conclusions:Kaitianmen acupoint massage can relieve limb pain, fatigue, anxiety and depression in patients with rheumatoid arthritis, which is worthy of clinical promotion.

Helicobacter pylori(H.pylori)infection is a prevalent global health issue that can lead to indiges-tion,peptic ulcer disease,and gastric cancer.With ongoing research advancements,significant progress has been made in the eradication of H.pylori.Based on these important findings from North America,the American College of Gastroenterology(ACG)has released updated clinical practice guideline(CPG),published in the American Journal of Gastroenterology in September 2024.Compared to previous guidelines,key updates include:increased resistance rates to critical antibiotics used for H.pylori treatment,such as clarithromycin and levofloxacin,which have reduced the efficacy of common treatment regimens containing these antibiotics;and research on novel treat-ment options for newly diagnosed patients,including new antibiotic alternatives(e.g.,rifampicin)or more potent next-generation gastric acid inhibitors(e.g.,potassium-competitive acid blockers,PCABs).These updates provide the latest evidence and reference for the clinical management of H.pylori infection.

Objective:To investigate the association between peak growth hormone(GH) levels and body fat mass as well as body fat percentage in children with short stature.Methods:This retrospective study included 477 children diagnosed with short stature at the Affiliated Hospital of Jining Medical University between January 2021 and November 2024, based on data from the Growth and Development Disease Follow-up Cohort Study(GDDSD) in Shandong Province. Clinical data including anthropometric measurements, laboratory tests, and body composition were collected. The relationship between GH peak and body fat mass and percentage were analyzed using smooth curve fitting and multiple piecewise linear regression models.Results:In univariate linear regression analysis, both body fat mass and body fat percentage were positively correlated with age, height, weight, body mass index, triglycerides, low density lipoprotein-cholesterol, fasting blood glucose, total body water, protein, and skeletal muscle mass(all P<0.05), and negatively correlated with GH peak and high density lipoprotein-cholesterol. After adjusting for potential confounding factors, a nonlinear relationship was observed between GH peak and both body fat mass and body fat percentage, with inflection points at 6.80 ng/mL and 7.75 ng/mL, respectively. When GH peak was below the inflection point, it was significantly negatively correlated with body fat mass and percentage( P<0.001). However, when GH peak exceeded the inflection point, the associations were no longer statistically significant( P>0.05). Conclusions:This study demonstrates a nonlinear relationship between peak GH levels and body fat percentage in children with short stature. At lower GH peaks, both body fat mass and body fat percentage increase significantly, which may contribute to an elevated future risk of cardiovascular disease.

Body weight abnormalities, including overweight, obesity, and underweight, have become a dual public health challenge in Chinese adults: overweight and obesity lead to a variety of chronic complications, while underweight increases the risks of malnutrition, sarcopenia, and organ dysfunction. To systematically address these issues, multidisciplinary experts in endocrinology, sports science, nutrition, and psychiatry from various regions have held multiple weight management seminars. Based on the latest epidemiological data and clinical evidence, they expanded the guideline to include assessment and intervention strategies for underweight, in addition to the core content of obesity management. This guideline outlines the etiological mechanisms, evaluation methods, and multidimensional management strategies for overweight and obesity, covering key areas such as diagnosis and assessment, medical nutrition therapy, exercise prescription, pharmacological intervention, and psychological support. It is intended to provide a scientific and standardized approach to weight management across the adult population, aiming to curb the rising prevalence of obesity, mitigate complications associated with abnormal body weight, and improve nutritional status and overall quality of life.