This paper systematically reviews the current status of integrated traditional Chinese and western medicine in the treatment of Helicobacter pylori （Hp） infection， as well as recent progress in clinical and basic research both in China and internationally. It summarizes the advantages of traditional Chinese medicine （TCM） in Hp infection management， including improving Hp eradication rates， enhancing antibiotic sensitivity， reducing antimicrobial resistance， decreasing drug-related adverse effects， and ameliorating gastric mucosal lesions. These advantages are particularly evident in patients who are intolerant to bismuth-containing regimens， those with refractory Hp infection， and individuals with precancerous gastric lesions. An integrated， whole-process management approach and individualized， staged comprehensive treatment strategies combining TCM and western medicine are proposed for Hp infection. Future prevention and control of Hp infection should adopt an integrative Chinese-western medical strategy， emphasizing prevention， strengthening primary care， implementing proactive long-term monitoring， optimizing screening strategies， and advancing the development of novel technologies and mechanistic studies of Chinese herbal interventions. These efforts aim to provide a theoretical basis and practical pathways for the establishment and improvement of Hp infection prevention and control systems.

Objective To compare the diagnostic performance of three breast MRI measurement methods—RECIST 1.1,the optimal method,and three-dimensional(3D)volumetric assessment—in assessing the efficacy of neoadjuvant chemotherapy(NAC)in breast cancer patients,with the objective of identifying the most clinically practical approach.Methods A total of 110 breast cancer patients who underwent NAC followed by surgical treatment between 2019 and 2023 were included in the study.Breast magnetic resonance imaging(MRI)was conducted within one week before and after the completion of NAC.Tumor response was evaluated using RECIST 1.1 criteria,widely recognized as the optimal method,as well as 3D volume measurement.Pathological response was determined according to the Miller-Payne grading system.Sensitivity,specificity,accuracy,and the area under the receiver operating characteristic curve(AUC)were computed and compared using the DeLong test.Results The AUC values for RECIST 1.1,the optimal method,and 3D volumetric assessment were 0.768,0.795,and 0.883,respectively.The 3D volumetric assessment exhibited significantly better discriminative performance(P＜0.05),with the highest sensitivity(98.9％),specificity(77.8％),and accuracy(95.5％).Additionally,the optimal method demonstrated superior performance over RECIST 1.1 across multiple parameters.Conclusions 3D volumetric mea-surement demonstrates superior performance compared to RECIST 1.1 and the optimal method in evaluating the response to NAC,offering a more accurate and comprehensive assessment tool.Additionally,the optimal method shows advantages over RECIST 1.1 and may serve as a practical alternative in settings where 3D software is not available.

Objective To compare the diagnostic performance of three breast MRI measurement methods—RECIST 1.1,the optimal method,and three-dimensional(3D)volumetric assessment—in assessing the efficacy of neoadjuvant chemotherapy(NAC)in breast cancer patients,with the objective of identifying the most clinically practical approach.Methods A total of 110 breast cancer patients who underwent NAC followed by surgical treatment between 2019 and 2023 were included in the study.Breast magnetic resonance imaging(MRI)was conducted within one week before and after the completion of NAC.Tumor response was evaluated using RECIST 1.1 criteria,widely recognized as the optimal method,as well as 3D volume measurement.Pathological response was determined according to the Miller-Payne grading system.Sensitivity,specificity,accuracy,and the area under the receiver operating characteristic curve(AUC)were computed and compared using the DeLong test.Results The AUC values for RECIST 1.1,the optimal method,and 3D volumetric assessment were 0.768,0.795,and 0.883,respectively.The 3D volumetric assessment exhibited significantly better discriminative performance(P＜0.05),with the highest sensitivity(98.9％),specificity(77.8％),and accuracy(95.5％).Additionally,the optimal method demonstrated superior performance over RECIST 1.1 across multiple parameters.Conclusions 3D volumetric mea-surement demonstrates superior performance compared to RECIST 1.1 and the optimal method in evaluating the response to NAC,offering a more accurate and comprehensive assessment tool.Additionally,the optimal method shows advantages over RECIST 1.1 and may serve as a practical alternative in settings where 3D software is not available.

Objective: To investigate reduction and fixation of complex acetabular fractures using three-dimensional (3D) printing technique and personalized acetabular wing-plate via lateral-rectus approach. Methods: From March to July 2016, 8 patients with complex acetabular fractures were surgically managed through 3D printing personalized acetabular wing-plate via lateral-rectus approach at Department of Orthopedics, the Third Affiliated Hospital of Southern Medical University. There were 4 male patients and 4 female patients, with an average age of 57 years (ranging from 31 to 76 years). According to Letournel-Judet classification, there were 2 anterior+ posterior hemitransverse fractures and 6 both-column fractures, without posterior wall fracture or contralateral pelvic fracture. The CT data files of acetabular fracture were imported into the computer and 3D printing technique was used to print the fractures models after reduction by digital orthopedic technique. The acetabular wing-plate was designed and printed with titanium. All fractures were treated via the lateral-rectus approach in a horizontal position after general anesthesia. The anterior column and the quadrilateral surface fractures were fixed by 3D printing personalized acetabular wing-plate, and the posterior column fractures were reduction and fixed by antegrade lag screws under direct vision. Results: All the 8 cases underwent the operation successfully. Postoperative X-ray and CT examination showed excellent or good reduction of anterior and posterior column, without any operation complications. Only 1 case with 75 years old was found screw loosening in the pubic bone with osteoporosis after 1 month′s follow-up, who didn′t accept any treatment because the patient didn′t feel discomfort. According to the Matta radiological evaluation, the reduction of the acetabular fracture was rated as excellent in 3 cases, good in 4 cases and fair in 1 case. All patients were followed up for 3 to 6 months and all patients had achieved bone union. According to the modified Merle D′Aubigné and Postel scoring system, 5 cases were excellent, 2 cases were good, 1 case was fair. Conclusions Surgical management of complex acetabular fracture via lateral-rectus approach combine with 3D printing personalized acetabular wing-plate can effectively improve reduction quality and fixation effect. It will be truly accurate, personalized and minimally invasive.

Objective To investigate the impact of carotid artery stenting (CAS) combined with hyperbaric oxygen (HBO) on cerebral hemodynamics in patients with internal carotid artery stenosis.Methods Seventy-eight patients with severe unilateral carotid artery stenosis were randomly divided into the control group (n =36) and the experimental group (n =42),which all received carotid artery stenting.After surgery,the control group was treated with anti-platelet and other routine treatment,while the experimental group received HBO therapy within 24 hours after surgery,in addition to routine treatment.Trancranial Doppler (TCD) and Computed tomography perfusion (CTP) were used to detect changes in cerebral hemodynamics both before and after surgery,as well as 2 weeks after surgery,and the rate of stroke recurrence was also observed within one year of surgery.Results Mean velocity (Vm) of blood flow,peak systolic velocity (PSV),pulse index (PI) and cerebrovascular reserve (CVR) of the affected middle cerebral artery were significantly increased after surgery.Moreover,2 weeks after surgery,regional cerebral blood volume and flow (rCBV and rCBF) of the experimental group were also significantly higher,as compared with those before surgery (P ＜ 0.05).Mean transit time (rMTT) and peak time (rTTP) were all lower than those before surgery.Changes in rCBF,rMTT and rTTP 2 weeks after surgery were all greater than those of the control group(P ＜ 0.05).Oneyear follow-up indicated that stroke recurrence rate of the experimental group was lower than that of the control group (11.9％ vs.16.7％,P ＜ 0.05).Conclusions Carotid artery stenting combined with HBO intervention could improve cerebral hemodynamics in patients with severe internal carotid artery stenosis,and at the same time could reduce stroke recurrence rate.

Objective To investigate the impact of carotid artery stenting (CAS) combined with hyperbaric oxygen (HBO) on cerebral hemodynamics in patients with internal carotid artery stenosis.Methods Seventy-eight patients with severe unilateral carotid artery stenosis were randomly divided into the control group (n =36) and the experimental group (n =42),which all received carotid artery stenting.After surgery,the control group was treated with anti-platelet and other routine treatment,while the experimental group received HBO therapy within 24 hours after surgery,in addition to routine treatment.Trancranial Doppler (TCD) and Computed tomography perfusion (CTP) were used to detect changes in cerebral hemodynamics both before and after surgery,as well as 2 weeks after surgery,and the rate of stroke recurrence was also observed within one year of surgery.Results Mean velocity (Vm) of blood flow,peak systolic velocity (PSV),pulse index (PI) and cerebrovascular reserve (CVR) of the affected middle cerebral artery were significantly increased after surgery.Moreover,2 weeks after surgery,regional cerebral blood volume and flow (rCBV and rCBF) of the experimental group were also significantly higher,as compared with those before surgery (P ＜ 0.05).Mean transit time (rMTT) and peak time (rTTP) were all lower than those before surgery.Changes in rCBF,rMTT and rTTP 2 weeks after surgery were all greater than those of the control group(P ＜ 0.05).Oneyear follow-up indicated that stroke recurrence rate of the experimental group was lower than that of the control group (11.9％ vs.16.7％,P ＜ 0.05).Conclusions Carotid artery stenting combined with HBO intervention could improve cerebral hemodynamics in patients with severe internal carotid artery stenosis,and at the same time could reduce stroke recurrence rate.

Objective To investigate the incidence of atherosclerotic renal artery stenosis (ARAS), the relationship between ARAS and cerebral artery stenosis, and the risk of ARAS in patients with brain infarction. Methods The clinical data of 1 650 brain infarction patients were analyzed, which were carried out digital subtraction angiography(DSA) of cerebral and renal artery.The incidence of ARAS was counted out, and the relationship was analyzed between the different degree and number of cerebral artery stenosis and the rate of RAS. The demographic characteristics and the common risk factors of atherosclerosis were recorded, and the risk factors of ARAS were analyzed. Results The rate of ARAS in moderate stenosis group and severe stenosis and occlusion group of cerebral artery were all significantly higher than that in mild stenosis group and no stenosis group (all P < 0.01). The rates of ARAS in severe stenosis and occlusion group were significantly significantly higher than those in moderate stenosis group (P < 0.01). The rates of ARAS in 2 branch stenosis group and ≥3 branch stenosis group were both significantly higher than those in no stenosis group and 1 branch stenosis group (P < 0.01). The rates of ARAS of ≥3 branch stenosis group were significantly higher than those in 2 branch stenosis group (P<0.05). The rate of ARAS of 1 branch stenosis group were significantly higher than those in no stenosis group (P < 0.05). Age, hypertension, moderate or more artery stenosis or occlusion, and≥2 branch stenosis was independent risk factor of ARAS. Conclusions The incidence of ARAS increasesd with the increase of the degree of cerebral artery stenosis and the number of branch involved.Older age, hypertension, moderate or more artery stenosis or occlusion, and≥2 branch stenosis is risk factor for ARAS.

Background and objective As the prevalence of tobacco and the aging of the population, the incidence of lung cancer in the elderly rises. However, few elderly patients (older than 70 years old) with lung squamous cell carcinoma were involved into the clinical trials, which offered insuffcient clinical evidence for these patients. Lung squamous cell carcino-ma patients older than 80 years old were included in our study to analyze the clinical characteristics, treatment and prognostic factors, and to explore the optimal treatment choices for these patients.Methods We retrospectively analyzed the clinical fea-tures of 38 elderly patients with lung squamous carcinoma and summarized the treatment under the clear diagnosis and clini-cal staging.Results Elderly patients with squamous cell carcinoma can choose surgery, radiotherapy and chemotherapy based on diagnosis and clinical staging when their physical condition is permitted.Conclusion Because of the short life expectancy of patients more than 80 years old, fewer of them could receive completed and effective treatment, comparing with patients between 70 and 80 years old.

Objective To observe the effects of Jinghua Weikang Capsule on NF-κB p65 expression in gastric mucosa of Helicobacter pylori (Hp) infected mice;To discuss its mechanism of action. Methods Totally 44 SPF KM mice were randomly divided into blank group, model group, triple therapy group and Jinghua Weikang group. Except for the blank group, Hp infected model was set up by short term immunosuppression combined with peroral infection. The treatment strategies were triple therapy group with lansoprazole, metronidazole and clarithromycin for 1 week, Jinghua Weikang group with Jinghua Weikang volatile oil for 4 weeks, model group with sterile water for 4 weeks, and blank group free of any treatments. All the subjects were sacrificed in the 4th week after the treatment. NF-κB p65 was detected through real-time PCR and immunohistochemical method. Results The relative quantitative expressions of NF-κB p65 mRNA were 3.27±0.53 in blank group, 2.18±0.50 in control group, 4.19±1.21 in triple therapy group, and 7.70±1.41 in Jinghua Weikang group (χ2=86.303, P<0.001). Compared with model group, the expressions of NF-κB p65 mRNA of other three groups increased statistically differently (P=0.004), and there was also statistical difference between triple therapy and Jinghua Weikang group. Through immunohistochemical tests, the values of NF-κB p65 mean optical density of nucleus were 25.18± 7.42 in blank group, 31.17±2.98 in model group, 30.06±4.69 in triple therapy group, and 26.94±5.19 in Jinghua Weikang group (χ2=10.960, P=0.012). The values of NF-κB p65 mean optical density of cytoplasm had no statistical difference (F=1.922, P=0.134), and the nucleus/cytoplasm values were 0.23±0.06 in blank group, 0.28±0.03 in model group, 0.26±0.04 in triple therapy group, and 0.24±0.04 in Jinghua Weikang group (χ2=14.527, P=0.002). The statistical analysis of the nucleus/cytoplasm values showed significance between blank and model group (P=0.002), while triple therapy group was still equal to model group (P=0.420). Jinghua Weikang group was lower than model group (P=0.022) and equal to blank group (P=0.750). Conclusion Jinghua Weikang Capsule can effectively reduce the expression of NF-κB p65 in protein level in Hp infected mice.

Objective To assess the feasibility of semi-quantitative scoring system for contrast-enhanced ultrasound (CEUS)quantitative analysis's color images in the differential diagnosis of breast nodules.Methods Totally 244 BI-RADS 4 breast solid lesions received CEUS before core needle biopsy or surgical resection were included.A semi-quantitative scoring system for color images of CEUS quantitative analysis were built.The scores were given as follows:1 )Color type and its distribution (0 to 4);2)Color scope (0 to 1 );3)Color margin (0 to 1 );4)Color shape (0 to1 ).The total score for each lesion would be from 0 to 7.And the differenital value between benign and malignant lesions were assessed.Results The total semi-quantitative scores of 102 malignant tumors (5.1 ±1 .7)was significant higher than that of benign lesions (3.34±0.7)(P < 0.05 ).In 102 malignant lesions,the total scores of 81 lesions (79.41 %)were more than 4 points,and in 142 benign lesions,the total scores of 89 lesions (62.67%)were less than 4 points.Depending on the Wilcox rank sum test (Mann-Whitney)analysis,the distribution of total scores between benign and malignant lesions was significant different (P <0.000 1).Total score 4 was selected as the best cutoff,the area under ROC curve was 0.749,on which the sensitivity,specificity and accuracy were 79.4%,62.7% and 69.67%,respectively.Conclusions The semi-quantitative scoring system of CEUS quantitative analysis color images showed good sensitivity but not satisfied specificity and accuracy in differential diagnosis between malignant and benign breast lesions.