OBJECTIVE To evaluate the efficacy and safety of high-dose ilaprazole combined with amoxicillin for newly diagnosed elderly patients with Helicobacter pylori （Hp） infection， and analyze independent risk factors for failure of Hp infection eradication treatment. METHODS Totally 200 cases of newly diagnosed elderly patients with Hp infection in Xinxiang Central Hospital from August 1， 2021 to December 1， 2024 were selected and randomly divided into control group and study group， with 100 cases in each group. The control group was treated with classic quadruple therapy regimen （Amoxicillin capsules+ Clarithromycin tablets+Bismuth potassium citrate tablets+Ilaprazole enteric-coated tablets）. The study group was treated with high- dose Ilaprazole enteric-coated tablets+Amoxicillin capsules. All patients were administered medication for 2 weeks. Hp eradication rates in the two groups were compared using intention-to-treat （ITT） and per-protocol （PP） analyses. The incidence of adverse reactions in both groups was also recorded. The multiple-factor Logistic regression analysis was used to identify independent risk factors for failure of Hp infection eradication treatment. RESULTS In ITT and PP analyses， there was no significant difference of Hp eradication rates between the two groups （P＞0.05）. There was no significant difference in incidence of mild to moderate adverse reactions between the two groups （P＞0.05）. BMI ≤18.5 kg/m2， BMI ＞23.9 kg/m2， rural residence， concomitant diabetes and concomitant heart disease were identified as independent risk factors influencing the failure of Hp infection eradication treatment （P＜0.05）. CONCLUSIONS The efficacy and safety of high-dose ilaprazole combined with amoxicillin are comparable to classic quadruple therapy regimen in treating newly diagnosed elderly patients with Hp infection. Independent risk factors influencing the failure of Hp infection eradication treatment include BMI ≤18.5 kg/m2， BMI ＞23.9 kg/m2， rural residence， concomitant diabetes and concomitant heart disease.

This paper summarized the key points and methods in terms of the establishment of the guideline working group and the management of conflict of interests， trying to provide reference for the development of clinical practice guidelines for Chinese patent medicine （CPM）. The establishment of the working group is the first important step for developing CPM guidelines. Considering the characteristics of the clinical practice guidelines for CPM， this study suggests that the three key elements of ‘multidisciplinarity’， ‘clinical relevance’ and ‘geographical representativeness’ should be put focus on when forming the working group. The guideline advisory committee， clinical expert group， evidence systematic evaluation group， secretary group and the external review group should be established. All group members should clarify the conflict of interest， and the process and management method of the conflict of interest should be clearly reported.

Recommendations for Chinese patent medicine （CPM） based on key information on rational drug use are one of the important conditions for enhancing guideline enforceability as well as facilitating guideline implementation. In this study， we discussed in detail of the key information on the rational use of CPM in five aspects， which are dosage， drug discontinuation， drug-drug and drug-food interactions， safety and economy. Following the process of multi-source search， synthesis and prioritization， it is suggested to collect key information on the rational use of CPM from a multi-source search of drug instructions， policy documents， literature， and clinical experts' experiences. Then the searched information should be summarized and prioritized with the principle that taking drug instructions as the basis and other-sources information for check and supplementation. Finally， methodological recommendations for the retrieval and synthesis of key information on rational drug use in guideline recommendations has been formed.

Objective To investigate the regulatory mechanism of Rehmanniae Radix Praeparata and its active components rehmannioside D and catalpol on γ-aminobutyric acid(GABA)in the brain based on the xylosy-transferase I(xylt-1)signaling pathway.Methods(1)SD rats were randomly divided into normal group,model group and treatment group(Rehmanniae Radix Praeparata group,30 g·kg-1),with eight rats in each group,half male and half female.The rat model of yin deficiency was established by intragastric administration of traditional Chinese medicine compound(30 g·kg-1)with acrid-warm nature and dampness-drying and dampness-draining,once in the morning and once in the evening,for 10 consecutive days.After modeling,the treatment group was given Rehmanniae Radix Praeparata decoction by gavage,once in the morning and once in the evening,for 10 consecutive days.The body mass of rats was measured and recorded,and the activity,crossing times and total distance were detected by open field behavior experiment.The levels of serum gonadotropin-releasing hormone(GnRH),thyrotropin-releasing hormone(TRH),corticotropin-releasing hormone(CRH),luteinizing hormone(LH)and follicle-stimulating hormone(FSH)in rats were detected by ELISA.The mRNA and protein expression levels of xylt-1,multiligand proteoglycan 1(SDC-1),early growth response factor 1(EGR1)and glutamate decarboxylase 1(GAD67)in rat brain tissue were detected by qPCR and automatic capillary Western Blot.The content of GABA in brain tissue was detected by HPLC.(2)The xylt-1 gene of rat well-differentiated adrenal pheochromocytoma cells(PC12)was silenced by siRNA.The cells were divided into normal group,negative control group,silencing group,silencing+rehmannioside D(10 μmol·L-1)group,silencing+catalpol(10 μmol·L-1)group.The expression levels of xylt-1,SDC-1,EGR1 and GAD67 mRNA in cells were detected by qPCR.The content of GABA in intracellular and extracellular fluid was detected by HPLC.The expression level of SDC-1 in cells was detected by immunofluorescence.(3)PC12 cells were transfected with lentivirus to overexpress xylt-1 gene.The cells were divided into normal group,negative control group(empty vector group)and overexpression group.The mRNA expression levels of xylt-1,SDC-1,EGR1 and GAD67 in cells were detected by qPCR.Results(1)Compared with the normal group,the body mass of the rats in the model group was significantly decreased(P＜0.01),the activity was significantly increased(P＜0.01),and the number of crossings and the total distance were significantly increased(P＜0.01).The levels of serum LH,FSH,GnRH,CRH and TRH were significantly increased(P＜0.01).The content of GABA in hippocampus and cerebral cortex was significantly decreased(P＜0.05,P＜0.01).The expression of xylt-1,SDC-1,EGR1 and GAD67 mRNA(hippocampus,cerebral cortex)and protein(hypothalamus,cerebral cortex)in brain tissue were significantly down-regulated(P＜0.05,P＜0.01).Compared with the model group,the body mass of the rats in the treatment group was significantly increased(P＜0.05),the activity was significantly decreased(P＜0.01),and the total distance was significantly shortened(P＜0.05).The levels of serum LH,FSH,GnRH,CRH and TRH were significantly decreased(P＜0.01).The content of GABA in hippocampus and cerebral cortex was significantly increased(P＜0.05,P＜0.01).The content of GABA in hippocampus and cerebral cortex was significantly increased(P＜0.05,P＜0.01).The expressions of xylt-1,SDC-1,EGR1 and GAD67 mRNA(hippocampus,cerebral cortex)and protein(hypothalamus,cerebral cortex)in brain tissue were significantly up-regulated(P＜0.05,P＜0.01).(2)Compared with the negative control group,the mRNA expressions of xylt-1,SDC-1,EGR1 and GAD67 in the silencing group was significantly down-regulated(P＜0.01).The content of GABA in intracellular and extracellular fluid was significantly decreased(P＜0.05,P＜0.01).The expression of SDC-1 in cells was significantly down-regulated(P＜0.01).Compared with the silencing group,the expression of xylt-1 mRNA in the silencing+rehmannioside D group was up-regulated,but the difference was not statistically significant(P＞0.05).The mRNA expression of xylt-1 in the silencing+catalpol group was significantly up-regulated(P＜0.05).The mRNA expressions of SDC-1,EGR1 and GAD67 in the silencing+rehmannioside D group and the silencing+catalpol group was significantly up-regulated(P＜0.05,P＜0.01),the content of GABA in the intracellular and extracellular fluid was significantly increased(P＜0.01),and the expression of SDC-1 in the cells was significantly up-regulated(P＜0.05,P＜0.01).(3)Compared with the normal group and the negative control group,the mRNA expression of xylt-1 in the overexpression group was significantly up-regulated(P＜0.01).Compared with the negative control group,the mRNA expressions of SDC-1,EGR1 and GAD67 in the overexpression group was significantly up-regulated(P＜0.01),and the GABA content in the intracellular and extracellular fluid was significantly increased(P＜0.01).Conclusion There may be a xylt-1/SDC-1/EGR1/GAD67 pathway that regulates GABA synthesis in the brain.Rehmanniae Radix Praeparata may increase GABA levels in the brain by up-regulating this pathway.

Virtual reality technology is an emerging technology that integrates multiple disciplines. It has the advantages of immersion, interactivity and imagination, which provides convenience for intelligent nursing in the field of rehabilitation treatment. This paper summarizes the application research of virtual reality technology in patients with kinetophobia, focusing on classification, application mechanism, application status, limitations and future development of virtual reality technology in various diseases of kinetophobia, so as to provide reference and basis for the rehabilitation nursing of patients with kinetophobia based on virtual reality technology in the future.

Objective To study the changes of serum metabolites in the patients with chronic kidney disease osteoporosis(CKD-OP)to provide the new biomarkers for the early diagnosis of CKD-OP.Methods A total of 22 patients with definitely diagnosed CKD visiting in this hospital from April to Novem-ber 2023 were selected as the study subjects,and 22 subjects with physical examination in this hospital at the same period were included for conducting the control study.With the lumbar vertebral T value ≤-2.5 as the standard,the subjects were divided into the CKD-OP group(n=11),CKD non-OP group(CKD-NOP group,n=11),simple osteoporosis group(OP group,n=11)and healthy control group(NC group,n=11).The liq-uid chromatography-mass spectrometry(LC-MS)coupling technique was used to analyze the differences in se-rum metabolites among the four groups,the potential biomarkers of CKD-OP was screened,and the correla-tion between the potential biomarkers with lumbar vertebra bone mineral density(BMD),serum bone-derived alkaline phosphatase(BALP)and serum tartrate-resistant acid phosphatase-5b(TRACP-5b)was studied.Re-sults With the receiver's operating characteristic(ROC)curve's area under curve(AUC)＞0.9 as the con-dition,and four potential biomarkers of CKD-OP were screened,which were phosphorylcholine,lysophosphati-dylcholine(18∶2/0∶0),capric acid,and allantoin respectively.Serum phosphorylcholine was positively corre-lated with lumbar vertebra BMD(r=0.601,P＜0.05)and negatively correlated with serum BALP and TRACP-5b(r=-0.729,-0.623,P＜0.05).Serum allantoin was positively correlated with lumbar vertebra BMD(r=0.483,P＜0.05)and negatively correlated with serum BALB(r=-0.494,P＜0.05).Serum lyso-phosphatidylcholine(18∶2/0∶0)was positively correlated with lumbar vertebra BMD(r=0.640,P＜0.05),and negatively correlated with serum BALP and TRACP-5b(r=-0.628,-0.548,P＜0.05).Serum capric acid was negatively correlated with lumbar vertebra BMD(r=-0.444,P＜0.05)and positively corre-lated with serum BALB(r=0.587,P＜0.05).Conclusion The screened four endogenous potential biomarkers provide the new research ideas for the early diagnosis and treatment efficacy monitoring of CKD-OP.

Schizophrenia is a severe mental illness with a significant disease burden.The interaction between oxidative stress and pro-inflammatory factors promotes chronic neuroinflammation and immune damage,leads to dysregulation of dopaminergic and glutamatergic pathways and occurrence of psychotic symptoms and is believed to be closely related to the pathogenesis of schizophrenia.In this paper,we aim to identify biomarkers within the tryptophan kynurenine metabolic pathway,the WNT/β-Catenin pathway and the NF-κB pathway,and dopamine metabolism.These pathways have been extensively studied and are known to be involved in the interac-tion between inflammation and oxidative stress.We will also explore the potential application of related antioxidants in the diagnosis and treatment of schizophrenia,summarizing their current research progress.

Purpose: This study examined the diagnostic value of high-frequency ultrasound (HFUS) features in differentiating between benign and malignant skin lesions. Methods: A total of 1,392 patients with 1,422 skin lesions who underwent HFUS examinations were included in an initial dataset (cohort 1) to identify features indicative of malignancy. Qualitative clinical and HFUS characteristics were recorded for all lesions. To determine which HFUS and clinical features were suggestive of malignancy, univariable and multivariable logistic regression analyses were employed. The diagnostic performance of HFUS features combined with clinical information was evaluated. This assessment was validated using internal data (cohort 2) and multicenter external data (cohort 3). Results: Features significantly associated with malignancy included age above 60 years; lesion location in the head, face, and neck or genital regions; changes in macroscopic appearance; crawling or irregular growth pattern; convex or irregular base; punctate hyperechogenicity; blood flow signals; and feeding arteries. The area under the receiver operating characteristic curve, sensitivity, and specificity of HFUS features combined with clinical information were 0.946, 92.5%, and 86.9% in cohort 1; 0.870, 93.1%, and 80.8% in cohort 2 (610 lesions); and 0.864, 86.2%, and 86.6% in cohort 3 (170 lesions), respectively. However, HFUS is not suitable for evaluating lesions less than 0.1 mm in thickness or lesions exhibiting surface hyperkeratosis. Conclusion In a clinical setting, the integration of HFUS with clinical information exhibited good diagnostic performance in differentiating malignant and benign skin lesions. However, its utility was limited in evaluating extremely thin lesions and those exhibiting hyperkeratosis.

Purpose: This study examined the diagnostic value of high-frequency ultrasound (HFUS) features in differentiating between benign and malignant skin lesions. Methods: A total of 1,392 patients with 1,422 skin lesions who underwent HFUS examinations were included in an initial dataset (cohort 1) to identify features indicative of malignancy. Qualitative clinical and HFUS characteristics were recorded for all lesions. To determine which HFUS and clinical features were suggestive of malignancy, univariable and multivariable logistic regression analyses were employed. The diagnostic performance of HFUS features combined with clinical information was evaluated. This assessment was validated using internal data (cohort 2) and multicenter external data (cohort 3). Results: Features significantly associated with malignancy included age above 60 years; lesion location in the head, face, and neck or genital regions; changes in macroscopic appearance; crawling or irregular growth pattern; convex or irregular base; punctate hyperechogenicity; blood flow signals; and feeding arteries. The area under the receiver operating characteristic curve, sensitivity, and specificity of HFUS features combined with clinical information were 0.946, 92.5%, and 86.9% in cohort 1; 0.870, 93.1%, and 80.8% in cohort 2 (610 lesions); and 0.864, 86.2%, and 86.6% in cohort 3 (170 lesions), respectively. However, HFUS is not suitable for evaluating lesions less than 0.1 mm in thickness or lesions exhibiting surface hyperkeratosis. Conclusion In a clinical setting, the integration of HFUS with clinical information exhibited good diagnostic performance in differentiating malignant and benign skin lesions. However, its utility was limited in evaluating extremely thin lesions and those exhibiting hyperkeratosis.

Purpose: This study examined the diagnostic value of high-frequency ultrasound (HFUS) features in differentiating between benign and malignant skin lesions. Methods: A total of 1,392 patients with 1,422 skin lesions who underwent HFUS examinations were included in an initial dataset (cohort 1) to identify features indicative of malignancy. Qualitative clinical and HFUS characteristics were recorded for all lesions. To determine which HFUS and clinical features were suggestive of malignancy, univariable and multivariable logistic regression analyses were employed. The diagnostic performance of HFUS features combined with clinical information was evaluated. This assessment was validated using internal data (cohort 2) and multicenter external data (cohort 3). Results: Features significantly associated with malignancy included age above 60 years; lesion location in the head, face, and neck or genital regions; changes in macroscopic appearance; crawling or irregular growth pattern; convex or irregular base; punctate hyperechogenicity; blood flow signals; and feeding arteries. The area under the receiver operating characteristic curve, sensitivity, and specificity of HFUS features combined with clinical information were 0.946, 92.5%, and 86.9% in cohort 1; 0.870, 93.1%, and 80.8% in cohort 2 (610 lesions); and 0.864, 86.2%, and 86.6% in cohort 3 (170 lesions), respectively. However, HFUS is not suitable for evaluating lesions less than 0.1 mm in thickness or lesions exhibiting surface hyperkeratosis. Conclusion In a clinical setting, the integration of HFUS with clinical information exhibited good diagnostic performance in differentiating malignant and benign skin lesions. However, its utility was limited in evaluating extremely thin lesions and those exhibiting hyperkeratosis.