BACKGROUND: The effect of the interval between previous Helicobacter pylori (H. pylori) eradication and rescue treatment on therapeutic outcomes remains unknown. The aim of this study was to investigate the association between eradication rates and treatment interval durations in H. pylori infections. METHODS: This prospective observational study was conducted from December 2021 to February 2023 at six tertiary hospitals in Shandong, China. We recruited patients who were positive for H. pylori infection and required rescue treatment. Demographic information, previous times of eradication therapy, last eradication therapy date, and history of antibiotic use data were collected. The patients were divided into four groups based on the rescue treatment interval length: Group A, ≥4 weeks and ≤3 months; Group B, >3 and ≤6 months; Group C, >6 and ≤12 months; and Group D, >12 months. The primary outcome was the eradication rate of H. pylori . Drug compliance and adverse events (AEs) were also assessed. Pearson's χ2 test or Fisher's exact test was used to compare eradication rates between groups. RESULTS: A total of 670 patients were enrolled in this study. The intention-to-treat (ITT) eradication rates were 88.3% (158/179) in Group A, 89.6% (120/134) in Group B, 89.1% (123/138) in Group C, and 87.7% (192/219) in Group D. The per-protocol (PP) eradication rates were 92.9% (156/168) in Group A, 94.5% (120/127) in Group B, 94.5% (121/128) in Group C, and 93.6% (190/203) in Group D. There was no statistically significant difference in the eradication rates between groups in either the ITT ( P = 0.949) or PP analysis ( P = 0.921). No significant differences were observed in the incidence of AEs ( P = 0.934) or drug compliance ( P = 0.849) between groups. CONCLUSION: The interval duration of rescue treatment had no significant effect on H. pylori eradication rates or the incidence of AEs. REGISTRATION ClinicalTrials.gov , NCT05173493.
Humans ; Helicobacter Infections/drug therapy* ; Helicobacter pylori/pathogenicity* ; Male ; Female ; Prospective Studies ; Middle Aged ; Anti-Bacterial Agents/adverse effects* ; Adult ; Aged ; Treatment Outcome ; Proton Pump Inhibitors/therapeutic use*

Objective: To investigate the prevalence and influencing factors of menopausal syndrome among postmenopausal women in Pan'an County, Zhejiang Province, so as to provide the basis for guiding the health management of postmenopausal women. Methods: From May 2023 to April 2024, the postmenopausal women aged 40 to 69 years in Pan'an County were selected using the random cluster sampling method. Demographic information, lifestyle and prevalence of gynecological diseases were collected through questionnaire surveys. The prevalence of menopausal syndrome was assessed by modified Kupperman Score Scale. Factors affecting menopausal syndrome were analyzed by a multivariable logistic regression model. Results: A total of 816 postmenopausal women were surveyed, with an mean age of (57.63±2.92) years and a mean natural menopause age of (49.85±2.13) years. There were 574 cases with menopausal syndrome, with a prevalence of 70.34%. Flashes and sweating, insomnia and irritability were common symptoms, accounting for 62.87%, 47.43% and 41.18%, respectively. Multivariable logistic regression analysis showed that monthly personal income of ≤5 000 yuan (<3 000 yuan, OR=3.124, 95%CI: 1.829-5.335; 3 000-5 000 yuan, OR=2.399, 95%CI: 1.370-4.201) and having gynecological diseases (OR=1.970, 95%CI: 1.292-3.004) were associated with a higher risk of menopausal syndrome, while average (OR=0.141, 95%CI: 0.072-0.276) or sufficient sleep quality (OR=0.095, 95%CI: 0.049-0.185) were associated with a lower risk of menopausal syndrome. Conclusion The prevalence of menopausal syndrome among postmenopausal women in Pan'an County is relatively high, and is mainly influenced by personal economic status, sleep quality and the presence of gynecological diseases.

Objective To observe conventional ultrasound and contrast-enhanced ultrasound(CEUS)manifestations of Ewing sarcoma(ES)in children.Methods Fifteen children with pathologically confirmed ES were retrospectively collected.Conventional ultrasound and CEUS characteristics of lesions were analyzed.Results Among 15 cases,ES of bone(ESB)was found in 7 cases,while extraskeletal ES(EES)was observed in the other 8 cases.Solitary tumor was noticed in 14 cases,with a median maximum diameter of 7.50 cm,while multiple abdominal masses were found in 1 case.The tumors had irregular shapes and poorly defined boundaries,with medium echogenicity in 7 cases,low echogenicity in 6 cases,while in other 2 cases present as cystic-solid lesions.CDFI showed sparse blood flow in 11 cases,abundant or slightly abundant blood flow in 2 and 1 case,respectively,while no obvious blood flow was observed in 1 case.Rapid high enhancement and rapid washout were found in all 7 cases underwent CEUS,while patchy no-enhancement areas were detected in 4 cases.Conclusion Conventional ultrasonic manifestations of ES had certain specificities,which demonstrated a rapid enhancement and rapid washout pattern during CEUS and may be accompanied by necrosis.

Objective To observe conventional ultrasound and contrast-enhanced ultrasound(CEUS)manifestations of Ewing sarcoma(ES)in children.Methods Fifteen children with pathologically confirmed ES were retrospectively collected.Conventional ultrasound and CEUS characteristics of lesions were analyzed.Results Among 15 cases,ES of bone(ESB)was found in 7 cases,while extraskeletal ES(EES)was observed in the other 8 cases.Solitary tumor was noticed in 14 cases,with a median maximum diameter of 7.50 cm,while multiple abdominal masses were found in 1 case.The tumors had irregular shapes and poorly defined boundaries,with medium echogenicity in 7 cases,low echogenicity in 6 cases,while in other 2 cases present as cystic-solid lesions.CDFI showed sparse blood flow in 11 cases,abundant or slightly abundant blood flow in 2 and 1 case,respectively,while no obvious blood flow was observed in 1 case.Rapid high enhancement and rapid washout were found in all 7 cases underwent CEUS,while patchy no-enhancement areas were detected in 4 cases.Conclusion Conventional ultrasonic manifestations of ES had certain specificities,which demonstrated a rapid enhancement and rapid washout pattern during CEUS and may be accompanied by necrosis.

Objective To evaluate the impact of poor sleep quality on occurrence of post-traumatic stress disorder(PTSD)in trauma patients.Methods We prospectively recruited 256 trauma patients hospitalized in 4 general hospitals in Zunyi during the period from October,2021 to November,2022,and 226 of the participants completed the PTSD survey and assessment.The patients'sleep quality within a month before trauma was estimated using Pittsburgh Sleep Quality Index(PSQI),and their sleep quality within 7 days after admission was monitored by smart bracelet sleep monitoring;the PTSD Checklist-Civilian Version(PCL-C)was used to detect the occurrence of PTSD during the follow-up.Results The detection rate of PTSD in the patients was 19.47%at 1 month and 17.61%at 3 months after trauma.The patients who developed PTSD had poorer sleep quality before the trauma,as shown by significantly higher PSQI scale scores(P<0.001),than those without PTSD,and they showed a sleep abnormality rate as high as 72.73%prior to PTSD onset.Within 7 days after admission,the patients developing PTSD had lower sleep quality scores with more frequent night awakenings(P<0.05).A 1 month and 3 months after trauma,the patients with PTSD had significantly higher PSQI scores than those without PTSD(P<0.05).Conclusion PTSD is more likely to occur in trauma patients with poor sleep quality before trauma.

Objective: To observe and compare the clinical effects of different electroacupuncture waveforms on primary dysmenorrhea. Methods: This was a prospective, randomized, three-group, parallel-controlled trial. Participants with primary dysmenorrhea were randomly divided into dense-sparse wave, continuous wave, and discontinuous wave groups in a 1:1:1 ratio. Two lateral Ciliao (BL 32) points were used. All three groups started treatment 3–5 days before menstruation, once a day for six sessions per course of treatment, one course of treatment per menstrual cycle, and three menstrual cycles. The primary outcome measure was the proportion with an average visual analog scale (VAS) score reduction of ≥50% from baseline for dysmenorrhea in the third menstrual cycle during treatment. The secondary outcome measures included changes in dysmenorrhea VAS scores, Cox Menstrual Symptom Scale scores and the proportion of patients taking analgesic drugs. Results: The proportion of cases where the average VAS score for dysmenorrhea decreased by ≥50% from baseline in the third menstrual cycle was not statistically significant (P > .05). Precisely 30 min after acupuncture and regarding immediate analgesia on the most severe day of dysmenorrhea, there was a statistically significant difference in the dense-sparse wave group compared with the other two groups during the third menstrual cycle (P < .05). Additionally, there was a statistically significant difference between the dense-sparse wave and discontinuous wave groups 24 h after acupuncture (P < .05). Conclusions Waveform electroacupuncture can alleviate primary dysmenorrhea and its related symptoms in patients. The three groups showed similar results in terms of short- and long-term analgesic efficacy and a reduction in the number of patients taking analgesic drugs. Regarding achieving immediate analgesia, the dense-sparse wave group was slightly better than the other two groups.

Objective To evaluate the impact of poor sleep quality on occurrence of post-traumatic stress disorder(PTSD)in trauma patients.Methods We prospectively recruited 256 trauma patients hospitalized in 4 general hospitals in Zunyi during the period from October,2021 to November,2022,and 226 of the participants completed the PTSD survey and assessment.The patients'sleep quality within a month before trauma was estimated using Pittsburgh Sleep Quality Index(PSQI),and their sleep quality within 7 days after admission was monitored by smart bracelet sleep monitoring;the PTSD Checklist-Civilian Version(PCL-C)was used to detect the occurrence of PTSD during the follow-up.Results The detection rate of PTSD in the patients was 19.47%at 1 month and 17.61%at 3 months after trauma.The patients who developed PTSD had poorer sleep quality before the trauma,as shown by significantly higher PSQI scale scores(P<0.001),than those without PTSD,and they showed a sleep abnormality rate as high as 72.73%prior to PTSD onset.Within 7 days after admission,the patients developing PTSD had lower sleep quality scores with more frequent night awakenings(P<0.05).A 1 month and 3 months after trauma,the patients with PTSD had significantly higher PSQI scores than those without PTSD(P<0.05).Conclusion PTSD is more likely to occur in trauma patients with poor sleep quality before trauma.

Purpose: The risk stratification of pediatric anaplastic large cell lymphoma (ALCL) has not been standardized. In this study, new risk factors were included to establish a new risk stratification system for ALCL, and its feasibility in clinical practice was explored. Materials and Methods: On the basis of the non-Hodgkin’s lymphoma Berlin–Frankfurt–Munster 95 (NHL-BFM-95) protocol, patients with minimal disseminated disease (MDD), high-risk tumor site (multiple bone, skin, liver, and lung involvement), and small cell/lymphohistiocytic (SC/LH) pathological subtype were enrolled in risk stratification. Patients were treated with a modified NHL-BFM-95 protocol combined with an anaplastic lymphoma kinase inhibitor or vinblastine (VBL). Results: A total of 136 patients were enrolled in this study. The median age was 8.8 years. The 3-year event-free survival (EFS) and overall survival of the entire cohort were 77.7% (95% confidence interval [CI], 69.0% to 83.9%) and 92.3% (95% CI, 86.1% to 95.8%), respectively. The 3-year EFS rates of low-risk group (R1), intermediate-risk group (R2), and high-risk group (R3) patients were 100%, 89.5% (95% CI, 76.5% to 95.5%), and 67.9% (95% CI, 55.4% to 77.6%), respectively. The prognosis of patients with MDD (+), stage IV cancer, SC/LH lymphoma, and high-risk sites was poor, and the 3-year EFS rates were 45.3% (95% CI, 68.6% to 19.0%), 65.7% (95% CI, 47.6% to 78.9%), 55.7% (95% CI, 26.2% to 77.5%), and 70.7% (95% CI, 48.6% to 84.6%), respectively. At the end of follow-up, one of the five patients who received maintenance therapy with VBL relapsed, and seven patients receiving anaplastic lymphoma kinase inhibitor maintenance therapy did not experience relapse. Conclusion This study has confirmed the poor prognostic of MDD (+), high-risk site and SC/LH, but patients with SC/LH lymphoma and MDD (+) at diagnosis still need to receive better treatment (ClinicalTrials.gov number, NCT03971305).

In order to obtain a recombinant fusion protein of porcine β-defensin-2 and interferon αwith broad-spectrum antibacterial and antiviral activities at the same time,the genes encoding both proteins were fused in series and inserted into the pPICZαA vector.This construct was then elec-trotransferred into Pichia pastoris KM71H cells to construct an engineered strain.Following methanol-induced expression,the recombinant protein was concentrated and isolated.The cytotox-icity of the protein was assessed using the MTT assay and a porcine red blood cell hemolysis test.Subsequently,the in vitro antibacterial and antiviral activities of the recombinant fusion protein were evaluated.The results showed that the engineered strain pPICZαA-PBD2-IFNα-KM71H of Pichia pastoris was successfully obtained,and the fusion protein PBD2-IFN-α was obtained by concentrating and purifying the fermentation broth after fermentation induction and expression.Its concentration was 1.116 g/L and molecular weight was 25 kDa.When the concentration of fusion protein was lower than 4-4 g/L,it had no obvious toxicity to PK-15 cells and porcine red blood cells.The diameter of the inhibition zone produced by the fusion protein on the mixed plate of Escherichia coli and Staphylococcus aureus was(15.0±0.9)mm,which had obvious antibacterial activity.The antiviral activity of the fusion protein against VSV in PK-15 cells was 8.89 × 105 U/mL measured by Reed-Muench method.This study laid a theoretical foundation for further develo-ping the recombinant fusion protein as an antibacterial and antiviral product.

In order to obtain a recombinant fusion protein of porcine β-defensin-2 and interferon αwith broad-spectrum antibacterial and antiviral activities at the same time,the genes encoding both proteins were fused in series and inserted into the pPICZαA vector.This construct was then elec-trotransferred into Pichia pastoris KM71H cells to construct an engineered strain.Following methanol-induced expression,the recombinant protein was concentrated and isolated.The cytotox-icity of the protein was assessed using the MTT assay and a porcine red blood cell hemolysis test.Subsequently,the in vitro antibacterial and antiviral activities of the recombinant fusion protein were evaluated.The results showed that the engineered strain pPICZαA-PBD2-IFNα-KM71H of Pichia pastoris was successfully obtained,and the fusion protein PBD2-IFN-α was obtained by concentrating and purifying the fermentation broth after fermentation induction and expression.Its concentration was 1.116 g/L and molecular weight was 25 kDa.When the concentration of fusion protein was lower than 4-4 g/L,it had no obvious toxicity to PK-15 cells and porcine red blood cells.The diameter of the inhibition zone produced by the fusion protein on the mixed plate of Escherichia coli and Staphylococcus aureus was(15.0±0.9)mm,which had obvious antibacterial activity.The antiviral activity of the fusion protein against VSV in PK-15 cells was 8.89 × 105 U/mL measured by Reed-Muench method.This study laid a theoretical foundation for further develo-ping the recombinant fusion protein as an antibacterial and antiviral product.