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 explore the safety and feasibility of uni-portal video-assisted thoracic surgery (VATS) for the treatment of bronchopulmonary sequestration (BPS). Methods    The clinical data of BPS patients with surgical resection in Shanghai Pulmonary Hospital from February 2010 to June 2021 were reviewed. The patients were divided into a VATS group and a thoracotomy group according to the operation method. The operation time, intraoperative blood loss, hospital stay and postoperative complication rate were compared between the two groups. The VATS group was subdivided into a uni-portal VATS group and a multi-portal VATS group for subgroup analysis. Results    Finally 131 patients were enrolled, including 62 males and 69 females with an average age of 39.3±13.2 years. There were 103 patients in the VATS group and 28 patients in the thoracotomy group. A total of 104 patients were diagnosed with left lower BPS, 26 with right lower BPS and 1 with bilateral lower BPS. The main symptom was cough (88 patients, 67.2%). There were 119 patients diagnosed by thoracic enhanced CT before operation. Compared with the thoracotomy group, the operation time was not statistically different (P=0.717), but the blood loss was less, the rate of postoperative complication was lower and hospital stay was shorter in the VATS group (P<0.05). The rate of conversion to open surgery in the uni-portal VATS group and multi-portal VATS group was 11.8% and 13.5%, respectively. Meanwhile, patients in the uni-portal VATS group had shorter operation time and postoperative hospital stay, less blood loss and lower postoperative complication rate than those in the multi-portal VATS group (P<0.05). Conclusion     In order to improve the rate of diagnosis, the lung enhanced CT scan should be selected as an optimal noninvasive method in adult suspected patients (especially those with solid cystic and solid lesions in the lower lobe). Uni-portal VATS is a safe and feasible method for BPS which can be widely promoted.

Objective:To summarize our experience in diagnosis and treatment of patients with pulmonary mucosa-associated lymphoid tissue-derived(MALT) lymphoma and to explore the role of surgery.Methods:We retrospectively analyzed the clinical and follow-up data of 86 patients with pulmonary MALT lymphoma in Shanghai Pulmonary Hospital from January 2000 to December 2018. 86 cases were identified with 44 males and 42 females. The mean age was(56.7±10.6) years old. 38(44.2%) cases had symptoms mainly presenting as cough and sputum at diagnosis. The chest CT scan of the patients showed pulmonary consolidation in 39 cases, nodule/mass shadow in 37 cases, usually with air bronchogram. Only 8(9.3%) cases could be diagnosed by non-surgical approach. 58 cases received complete resection, 10 of which followed chemotherapy. 8 of 17 cases who received incomplete resection accepted chemotherapy. The rest 11 cases who experienced surgical biopsy because of uncertain diagnosis were treated by chemotherapy or radio-chemotherapy or just watch-to-wait.Results:The median follow-up of 83 cases was 64 months, ranged from 24 to 219 months. The estimated 5-year and 10-year OS rates were 95.0% and 76.8%, while 5-year and 10-year PFS were 75.7% and 35.1% respectively. Patients who received complete resectionhad better PFS( P<0.001)but similar OS( P=0.395), compared with those received incomplete resection. There were no significant difference in OS and PFS between patients who received complete resection accepted chemotherapy or not( P>0.05). Conclusion:Pulmonary MALT lymphoma has an indolent nature with an excellent long-term survival. Diagnosis is difficult to be made by non-surgical approach. Surgery plays an important role of treatment of pulmonary MALT lymphoma, due to significant improvement of diagnosis rate and radical treatment of localized disease by complete resection.

Objective:To investigate the clinical characteristics and prognosis of cytomegalovirus (CMV) reactivation in patients with liver failure.Methods:A total of 75 patients diagnosed with liver failure and tested for serum CMV DNA between January 2016 and June 2019 in Huashan Hospital, Fudan University were retrospectively analyzed. According to the CMV DNA test results, the patients were divided into CMV DNA positive group and CMV DNA negative group. The classification of liver failure, the use of glucocorticoids, the proportions of T lymphocyte subsets of the two groups were compared and the prognosis was evaluated. Mann-Whitney U test and chi-square test were used to analyze the data. Results:Of the 75 patients with liver failure, 17 were CMV DNA positive and 58 were CMV DNA negative. Among the 17 CMV DNA positive patients, nine were acute (subacute) liver failure, and 13 were treated with glucocorticoids, which were all significantly higher than those in the CMV negative group (20.7%(12/58) and 20.7%(12/58), respectively). The differences were both statistically significant ( χ2=6.70 and 18.40, respectively, both P<0.05). The proportions of CD3 + T lymphocytes and CD8 + T lymphocytes in the CMV DNA positive group were both higher than those in the CMV DNA negative group, and the proportions of CD4 + T lymphocytes, the ratio of CD4 + /CD8 + T lymphocytes and the proportion of B lymphocytes were all lower than those in the CMV DNA negative group. The differences were all statistically significant ( U=274.50, 165.50, 273.00, 185.00 and 189.00, respectively, all P<0.05). Acute (subacute) liver failure (odds ratio ( OR)=4.3, 95% confidence interval ( CI) 1.3-12.6) and glucocorticoid use ( OR=12.5, 95% CI 3.4-38.3) were risk factors for CMV reactivation in patients with liver failure. The disease improvement rate in the CMV DNA negative group was 56.9% (33/58), and five out of 17 patients improved in the CMV DNA positive group, with a statistically significant difference ( χ2=1.99, P=0.04). Conclusions:The use of glucocorticoids increases the risk of CMV reactivation in patients with liver failure, and CMV reactivation in patients with liver failure presents immune disorders which seriously affect their prognosis. Therefore, it is important to pay attention to CMV DNA monitoring in patients with liver failure using glucocorticoids.

A few study has proven that about 90% of local control rates might be benefit from stereotactic body radiotherapy (SBRT) for patients with medically inoperable stage I non-small cell lung cancer (NSCLC), it is reported SBRT associated overall survival and tumor specific survival is comparable with those treated with surgery. SBRT has been accepted as the first line treatment for inoperable patients with peripheral located stage I NSCLC. However, the role of SBRT in centrally located lesions is controversial for potential toxic effects from the adjacent anatomical structure. This paper will review the definition, indication, dose regimens, dose-volume constraints for organs at risk, radiation technology, treatment side effect of centrally located NSCLC treated with SBRT and stereotactic body proton therapy.
Carcinoma, Non-Small-Cell Lung ; pathology ; radiotherapy ; Humans ; Lung Neoplasms ; pathology ; radiotherapy ; Neoplasm Staging ; Radiotherapy ; instrumentation ; methods

Objective T o detect the genotype of A B O blood group by SN aPshot technology. Methods D N A w ere extracted from the peripheral blood sam ples w ith know n blood groups (obtained by serology) of 107 unrelated individuals in Y unnan. Six SN P loci of the 261th, 297th, 681th, 703th, 802th, and 803th nucleotide positions w ere detected by SN aPshot M ultiplex kit, and relevant genetics param eters w ere cal-culated. Results In 107 blood sam ples, the allele frequencies of types A , B , O A, and O G w ere 0.3551, 0.1682, 0.2300 and 0.2476, respectively, w hile that of types A G and cis A B w ere not detected. T he geno-typing results of A B O blood group w ere consistent w ith that of serologic testing. Conclusion SN aPshot technology can be adapted for genotyping of A B O blood group.

OBJECTIVE:To investigate general regularity and characteristics of tetanus antitoxin (TAT) induced by ADRs,in order to provide reference for rational drug use in the clinic.METHODS:Domestic and foreign literatures on ADRs induced by TAT were retrieved,and related information of 2 636 case of ADR were analyzed statistically.RESULTS:Among patients whose gender and age were recorded,male with ADR induced by TAT was more than female,mainly aged 15-35 years old,accounting for 70.32 ％ (289/411);28.28 ％ (56/198) used water for injection;ADR occurred within 30 min after medication in 5.84％ (154/2 636)cases;main ADR were lesion of skin and its appendents,circulatory system damage,systemic reaction damage.Main clinical manifestations were urticaria,rash,chest tightness and anaphylaetic shock,etc.Ten cases died and 7 cases had sequelae;the rest were all recovered and cured after symptomatic treatment.CONCLUSIONS:TAT has a higher proportion of allergic reactions,especially anaphylactic shock,but great importance should be attached to rare auditory and vestibular dysfunction,visual impairment,elevated white blood cell count and other ADR.It is suggested to strengthen medication monitoring and used drugs strictly in accordance with drug package inserts so as to promote rational drug use.

OBJECTIVE:To explore and analyze signals of Xiyanping injection-induced urticaria from spontaneous reporting system database of Jiangxi province. METHODS:The continuous ADR report monitoring data were collected from spontaneous re-porting system of Jiangxi province,and established database. Bayesian confidence propagation neural network(BCPNN) method was used to calculate information component,IC value of Xiyanping injection-induced urticaria. The year-to-year changes of IC val-ue and its interval were analyzed. RESULTS:A total of 328324 ADR reports were collected in Jiangxi province during 2004-2016. The IC value of Xiyanping injection-induced urticaria detected by BCPNN method was 1.10(the lower limit of IC value was 0.65, and upper limit was 1.54),i.e. there was signal and the IC value ranged from-0.87 to 1.65. CONCLUSIONS:The results of BCPNN method suggest that urticaria is a warning signal of Xiyanping injection. The risk is increasing gradually,and prediction precision increase with the addition of report quantity.

Objective To explore the effect of adipose-derived stem cells (ADSCs) on inflammatory factors in rats with lipopolysaccharide (LPS)-induced acute lung injury (ALI) and the possible mechanism of anti-inflammatory. Methods Seventy male Sprague-Dawley (SD) rats were randomly divided into normal control group (n = 10), LPS model group (n = 30), and ADSCs intervention group (n = 30) by random number table. ALI model was reproduced by intraperitoneal injection of 8 mg/kg LPS, and the rats in ADSCs intervention group received tail vein injection of 300 μL ADSCs 30 minutes after the model reproduction, the samples of normal control group were harvested immediately without any intervention, and the specimens in remained two groups were taken at 6, 24, 72 hours respectively. Arterial partial pressure of oxygen (PaO2) and lactate level in femoral artery were determined. Enzyme-linked immunosorbent assay (ELISA) was used to detect the serum myeloperoxidase (MPO) and interleukin-10 (IL-10) in the blood of left ventricle. Lung wet/dry weight (W/D) ratio was detected by thoracotomy, and the pathological changes of lung tissue were observed under an optical microscope. Western Blot was used to detect the protein expression of nuclear factor-κB (NF-κB) in lung tissue of rats. Results Compared with the normal control group, the damage degree of lung tissue of LPS model group was significantly heavier from 6 hours, and lung W/D ratio, blood lactate, MPO, IL-10 and expression level of NF-κB in lung tissue were significantly increased respectively, while PaO2 was decreased significantly. Compared with LPS model group, the damage degree of lung tissue of ADSCs intervention group was significantly reduced from 6 hours, and lung W/D ratio, blood lactate, MPO, and NF-κB expression in lung tissue were significantly decreased, while PaO2 was increased significantly, and it became normal at 72 hours [lung W/D ratio: 5.33±0.29 vs. 5.77±0.42 at 6 hours, 5.14±0.46 vs. 5.43±0.38 at 72 hours; blood lactate (mmol/L): 3.6±1.0 vs. 5.7±1.1 at 6 hours, 3.1±1.0 vs. 3.8±1.2 at 72 hours; blood MPO (μg/L): 1.50±0.90 vs. 2.70±1.85 at 6 hours, 0.46±0.30 vs. 0.71±0.22 at 72 hours; NF-κB (gray value): 0.40±0.11 vs. 0.50±0.09 at 6 hours, 0.24±0.03 vs. 0.33±0.06; PaO2 (mmHg, 1 mmHg = 0.133 kPa): 78.0±4.1 vs. 74.5±3.2 at 6 hours, 89.3±9.4 vs. 81.9±3.4 at 72 hours; all P < 0.05]. The IL-10 level was significantly higher than that of LPS model group only at 24 hours (ng/L: 27.75±15.49 vs. 17.52±6.56, P < 0.05). Conclusion ADSCs can effectively relieve the inflammatory response of ALI induced by LPS, probably by inhibiting the expressions of NF-κB and blocking the release of inflammatory cytokines.

Objective To explore the effect of sequential therapy of transcatheter arterial chemoembolization (TACE) followed by percutaneous microwave coagulation therapy (PMCT) in treating early-stage primary hepatocellular carcinoma (PHC), and to analyze the factors that may affect the prognosis. Methods During the period from Jan. 2011 to Apr. 2014, a total of 66 patients with early-stage PHC were admitted to authors’ hospital. TACE was carried out in all patients, which was followed by PMCT in 5 -7 days. All patients were followed up regularly. CT, MR, ultrasonography, AFP, liver function and other related laboratory tests were performed. Kaplan-Meier estimation was used for the analysis of disease-free survival time. The high-risk factors were analyzed by Chi-square test. Multivariate analysis was conducted by using logistic analysis method. Results After TACE the serum levels of ALT, TBIL and DBIL were increased significantly when compared with preoperative ones (P< 0.01). After sequential PMCT the serum levels of AST, ALT and DBIL were increased significantly when compared with preoperative ones (P< 0.01). When compared with TACE, after sequential PMCT the serum level of AST was increased (P< 0.01), while serum levels of TBIL and DBIL were decreased (P< 0.01). Compared with TACE and preoperative data, the post-PMCT AFP level was decreased (P < 0.01). During the follow-up period one patient died. The 3-year cumulative survival rate was 98.5%. Recurrence was seen in 19 cases. The one-year, 2-year and 3-year disease-free cumulative survival rate was 70.3%, 50.8% and 41.6% respectively. Univariate and multivariate analysis indicated that the risk factors of recurrence in early-stage PHC included AFP ≥ 100 μg/L, viral load≥103 copies/ml and irregularity of tumor border (P<0.05). Conclusion Sequential therapy of TACE followed by PMCT is an ideal treatment for early-stage PHC, sequential PMCT after TACE does not affect liver recovery process. AFP ≥ 100 μg/L, viral load ≥ 103 copies/ml and irregularity of tumor border are the risk factors of recurrence.