Lactobacilli are important colonizing bacteria in female reproductive tract， among which Lactobacillus crispatus is closely associated with reproductive tract health and plays a crucial role in maintaining the vaginal microbiota balance. A decrease in the abundance of Lactobacillus crispatus may be correlated with various female reproductive tract diseases， such as bacterial vaginosis and vulvovaginal candidiasis， and it can even lead to adverse pregnancy outcomes such as infertility and embryo arrest. This article provides an overview of the basic characteristics of Lactobacillus crispatus， relationship between the decrease of its quantity and reproductive tract diseases， its ability to inhibit pathogenic bacteria such as Candida albicans and Chlamydia trachomatis， and the anti-inflammatory effects of Lactobacillus crispatus. The aim is to provide references for the use of Lactobacillus crispatus in vaginal therapeutics.

BACKGROUND: Given the general unavailability, common adverse effects, and complicated administration of tetracycline, the clinical application of classic bismuth quadruple therapy (BQT) is greatly limited. Whether minocycline can replace tetracycline for Helicobacter pylori ( H . pylori ) eradication is unknown. We aimed to compare the eradication rate, safety, and compliance between minocycline- and tetracycline-containing BQT as first-line regimens. METHODS: This randomized controlled trial was conducted on 434 naïve patients with H . pylori infection. The participants were randomly assigned to 14-day minocycline-containing BQT group (bismuth potassium citrate 110 mg q.i.d., esomeprazole 20 mg b.i.d., metronidazole 400 mg q.i.d., and minocycline 100 mg b.i.d.) and tetracycline-containing BQT group (bismuth potassium citrate/esomeprazole/metronidazole with doses same as above and tetracycline 500 mg q.i.d.). Safety and compliance were assessed within 3 days after eradication. Urea breath test was performed at 4-8 weeks after eradication to evaluate outcome. We used a noninferiority test to compare the eradication rates of the two groups. The intergroup differences were evaluated using Pearson chi-squared or Fisher's exact test for categorical variables and Student's t -test for continuous variables. RESULTS: As for the eradication rates of minocycline- and tetracycline-containing BQT, the results of both intention-to-treat (ITT) and per-protocol (PP) analyses showed that the difference rate of lower limit of 95% confidence interval (CI) was >-10.0% (ITT analysis: 181/217 [83.4%] vs . 180/217 [82.9%], with a rate difference of 0.5% [-6.9% to 7.9%]; PP analysis: 177/193 [91.7%] vs . 176/191 [92.1%], with a rate difference of -0.4% [-5.6% to 6.4%]). Except for dizziness more common (35/215 [16.3%] vs . 13/214 [6.1%], P = 0.001) in minocycline-containing therapy groups, the incidences of adverse events (75/215 [34.9%] vs . 88/214 [41.1%]) and compliance (195/215 [90.7%] vs . 192/214 [89.7%]) were similar between the two groups. CONCLUSION: The eradication efficacy of minocycline-containing BQT was noninferior to tetracycline-containing BQT as first-line regimen for H . pylori eradication with similar safety and compliance. TRIAL REGISTRATION ClinicalTrials.gov, ChiCTR 1900023646.
Humans ; Bismuth/therapeutic use* ; Metronidazole/therapeutic use* ; Esomeprazole/pharmacology* ; Minocycline/pharmacology* ; Helicobacter pylori ; Potassium Citrate/therapeutic use* ; Anti-Bacterial Agents ; Tetracycline/adverse effects* ; Helicobacter Infections/drug therapy* ; Drug Therapy, Combination ; Amoxicillin

Background::Helicobacter pylori ( H. pylori) infection is an infectious disease with a prevalence rate of up to 50% worldwide. It can cause indigestion, gastritis, peptic ulcer, and gastric cancer. H. pylori eradication treatment can effectively control disease progression and reduce the risk of the above conditions. However, the escalating trend of antibiotic resistance presents a global challenge for H. pylori eradication. We aim to provide guidance on pharmacological treatment of H. pylori infection. Methods::This clinical practice guideline is developed following the World Health Organization’s recommended process, adopting Grading of Recommendations Assessment, Development and Evaluation in assessing evidence quality, and utilizing Evidence to Decision framework to formulate clinical recommendations, minimizing bias and increasing transparency of the clinical practice guideline development process. We used the Reporting Items for practice Guidelines in HealThcare (RIGHT) statement and The Appraisal of Guidelines for Research and Evaluation II (AGREE II) as reporting and conduct guides to ensure the guideline’s completeness and transparency.Results::Though decreasing in developed countries, the prevalence of H. pylori remains high in developing countries, causing a major public health burden. This clinical practice guideline contains 12 recommendations concerning pharmacological treatment for H. pylori eradication. Among them, it is worth highlighting that bismuth preparations are inexpensive, safe, and effective, consequently making bismuth quadruple therapy a preferred choice for initial and rescue treatment. In empirical treatment, high-dose dual therapy is equally effective compared with bismuth quadruple therapy. Conclusions::The 12 recommendations in this clinical practice guideline are formed with consideration for stakeholders’ values and preferences, resource use, feasibility, and acceptability. Recommendations are generalizable to resource limited settings with similar antibiotic resistance pattern as China, and lower middle-income countries facing comparable sociological and technical challenges.Registration::Guidelines International Network (GIN) website, https://guidelines.ebmportal.com/node/69996.

Objective:To analyze the impact of previous exposure to macrolide, quinolones and nitroimidazole antibiotics on eradication rate of bismuth quadruple therapy (BQT) in newly diagnosed patients with Helicobacter pylori( H. pylori). Methods:A total of 469 patients with H. pylori initially treated at the Third Hospital of Peking University from September 2017 to August 2020 were retrospectively recruited. The therapeutic regimens were BQT containing clarithromycin/levofloxacin/metronidazole recommended by Chinese guidelines. Clinical data were collected, including general demographic data, exposure history of antibiotics, CYP2C16 metabolic pattern, endoscopic diagnosis, bacterial density, H.pylori resistance, eradication results, etc. Univariate analysis, Chi-square test, Fisher exact probability test, Kruskal-Wallis H test and Logistic regression model were used as statistical methods. Results:Among different eradication therapies, univariate and multivariate analyses suggested that previous exposure to macrolides ( OR=3.37,95 %CI 1.04-10.98, P<0.05) was relevant to the decreased eradication rate of BQT containing clarithromycin. This may be due to increased resistance to clarithromycin ( OR=6.12,95 %CI 3.99-9.40, P<0.01).The previous exposure to quinolones ( OR=3.65, 95 %CI 1.27-10.49, P<0.05) was relevant to the decreased eradication rate of BQT containing levofloxacin, which was probably explained by the increased resistance to levofloxacin ( OR=2.50, 95 %CI 1.69-3.71, P<0.01). But the previous history of nitroimidazole did not impact the efficacy of BQT containing metronidazole. Conclusions:In patients newly diagnosed with H.pylori infection, the previous exposure to macrolide or quinolones antibiotics is related to lower eradiation rates of H. pylori. Although the exposure to nitroimidazole also indicates drug resistance to metronidazole, the clinical efficacy of BQT with metronidazole 400 mg four times a day is not affected.

Objective To analyze the composition of bacteria and fungi on the facial skin of healthy women aged 20-25 years in Beijing by using high-throughput sequencing technology,and to compare the composition and diversity of microbes among 4 kinds of subjective skin types.Methods Totally,31 female undergraduates were enrolled from Beijing Technology and Business University,and classified into 4 groups,including dry skin group (n =6),neutral skin group (n =8),mixed skin group (n =9) and oily skin group (n =8),according to their subjective feeling of facial skin greasiness and dryness.On 24th December 2017,the facial skin water content,transepidermal water loss (TEWL),sebum content and pH value were determined for these undergraduates,and these physiological parameters of the skin were compared among the 4 kinds of subjective skin types.Skin samples were collected with swabs from the cheeks of these subjects.After DNA extraction and PCR amplification,the bacterial 16S rRNA regions V1-V2 and fungal internal transcribed spacer regions 1 and 2 (ITS-1-ITS-2) were sequenced separately,and sequences were grouped by OUT cluster analysis at 97％ sequence similarity followed by classification and annotation of species.One-way analysis of variance was used for intergroup comparison,and least significant difference (LSD)-t test for multiple comparison.Results The sebum content and bacterial diversity of the facial skin both significantly differed among the 4 kinds of subjective skin types.The skin sebum content in the dry skin group,neutral skin group,mixed skin group and oily skin was 5.50 ±4.60 μg/cm2,7.69±5.26 μg/cm2,10.56 ± 5.42 μg/cm2,22.81 ± 8.53 μg/cm2 respectively (F =11.685,P ＜0.001),and the Shannon index of bacterial diversity in the above 4 groups was 3.49 ± 0.70,2.97 ± 1.43,2.49 ± 0.63 and 1.59 ± 0.59 respectively (F =5.634,P =0.004).Propionibacterium,Staphylococcus and Streptococcus were the main bacterial florae on the face.The relative abundance of Propionibacterium was significantly higher in the oily skin group (68.24％ ± 14.78％) than in the dry skin group (18.83％ ±14.49％,P ＜ 0.001),neutral skin group (32.18％ ± 36.29％,P ＜ 0.001) and mixed skin group (35.22％ ±22.58％,P ＜ 0.001).In addition,the relative abundance of Staphylococcus was highest in the mixed skin group,and the relative abundance of Streptococcus was highest in the neutral skin group.There was no significant difference in the fungal diversity (Shannon index) or richness (Chao index) among the 4 groups (both P ＞ 0.05).The fungi on the facial skin of these subjects mainly consisted of Ascomycota and Basidiomycota,and no significant difference in their relative abundance was observed among the 4 groups (both P ＞ 0.05).Moreover,there was no significant difference in the composition of fungal genera at relative abundance ＞ 1％ among the 4 groups (all P ＞ 0.05).Conclusion The physiological parameters and bacterial diversity of the cheek skin differed among young women of different subjective skin types,while there was no difference in the fungal diversity or richness,suggesting that the colonization of skin bacteria is associated with subjective skin types.

0bjective To evaluate the changes in blood oxygen saturation and pulse rate of the nurses under abrupt highland advancing and provide the fundamentals for those nurses under abrupt highland advancing to Tibet. Methods We selected 12 nursing staffs abruptly advanced to Lhasa at an altitude of 3 650 meters for Abrupt Advancing Group then chose 12 nursing staffs over there for Highland Group from November 2017 to December 2017. To assess whether there is a difference about the change of blood oxygen saturation and pulse rate between these two groups, we measured them in 24 nurses and 360 shifts before work and at 0.5, 1.0, 3.0, 6.0 h after work. Then, we compared the changes in blood oxygen saturation and pulse rate between different ages, sexes, shifts. Results No significant difference in blood oxygen saturation was observed between the two groups before starting work (P > 0.05). Blood oxygen saturation of Abrupt Advancing Group (0.5, 1.0, 3.0, 6.0 h) after work was respectively 0.91±0.01, 0.91±0.02, 0.91±0.02, 0.91±0.01. Meanwhile, the parameters of Highland Group was separately 0.94± 0.02, 0.93 ± 0.01, 0.94 ± 0.01, 0.94 ± 0.01. There was a significant difference between the two groups (t=5.153-8.151, P<0.05 or 0.01). Before work, the pulse rate was (85.38±2.38), (91.62±2.79),(89.79±2.05), (89.12±2.29), (89.72±2.31) times/min for Abruptly Advancing Group, (93.52±2.64), (93.52±2.82), (94.52± 2.73), (94.52±2.56), (93.52±2.96) times/min for Highland Group. The difference between the two groups was statistically significant (t=3.875-10.182, P<0.01). Besides, no difference about the changes in blood oxygen saturation of Abruptly Advancing Group between different shifts was observed (t=3.561-8.321, P<0.05 or 0.01). The difference of pulse rate in Abruptly Advancing Group was statistically significant (t=1.529-4.968, P<0.05 or 0.01). There was no significant difference of blood oxygen saturation and pulse rate in Abruptly Advancing Group between the age of 21 to 30 and 31 to 40 years old, whether before or after work (P > 0.05). A positive difference between the sexes could be found about the changes in the blood oxygen saturation of Abruptly Advancing Group at 0.5, 1.0, 3.0 and 6.0 h after work. What′s more, there was a significant difference in pulse rates before and after work (t=3.283-6.719, P<0.05 or 0.01). Conclusions The nursing staff in the Abruptly Advancing Group shows decreased blood oxygen saturation and increased pulse rate compared to those in the Highland Group during working period. In addition, the changes show more significant in those working at night, but they adapted gradually. Gender and working time have a significant effect on the change in blood oxygen saturation and increased pulse rate of the nursing staff.

Objective Mouse models of sepsis-induced myocardial injury by intraperitoneal injection of lipopolysaccharide (LPS) was established in order to provide a reliable method for the research of pathogenesis of sepsis-induced myocardial injury. Methods According to the method of random number table, a total of 150 male C57BL/6 mice were divided into five groups: NC group, sham group, and LPS 10, 12, 15 mg/kg groups, with 30 in each group. Septic myocardial injury was induced by intraperitoneal injection LPS in mice; sham group was injected with equal 0.9% saline; while there was no treatment in mice of NC group. Fifteen of the 30 mice in each group were used to observe the general status of mice before and after LPS or saline injection. Twenty-four hours after LPS or saline injection, the left ventricular function was assessed by echocardiography, serum level of cardiac troponin (cTnI) was determined by enzyme linked immunosorbent assays (ELISA), and the cardiac histomorphology and ultrastructure were observed; the other 15 mice were used to monitor the 7-day mortality after LPS or saline injection. Results The mice challenged to LPS displayed symptoms of sepsis, such as depression, ruffled fur, and diarrhea. Compared with NC group, left ventricular ejection fraction (LVEF), left ventricular fraction shortening (LVFS) were significantly decreased at 24 hours after LPS administration in LPS 10, 12, 15 mg/kg groups [LVEF: 0.459±0.044, 0.432±0.034, 0.348±0.064 vs. 0.588±0.019, LVFS: (22.36±2.60)%, (20.78±1.91)%, (16.27±3.31)% vs. (30.55±1.30)%, all P < 0.01], and cTnI levels were significantly increased (ng/L: 270.40±43.50, 281.14±41.79, 298.39±42.05 vs. 192.59±16.90, all P <0.01). Myocardium injury was observed in three LPS groups, myocardial fibrosis, interstitial edema, erythrocyte leakage and infiltrating inflammatory cells were observed under light-microscope; ultrastructural changes disorderly arranged in cardiac muscle fibers, mitochondrial swelling and even partly missing mitochondria cristae were found under transmission electron microscope (TEM), and the higher of the dose, the more sever of the damage. There was no significant difference between sham group and NC group. The 7-day mortality in LPS 10, 12, 15 mg/kg groups were 33.3%, 53.3% and 86.7%, respectively, while no death in the NC group and sham group. Conclusion For establishing the mouse model of sepsis-induced myocardial injury, intraperitoneal injection with 12 mg/kg LPS is a preferable choice in our research.

Objective To evaluate the efficacy and safety of common therapy and individualized treatment in newly diagnosed patients with Helicobacter pylori (H.pylori) infection.Methods From March 2008 to February 2010,September 2013 to April 2014,January to October 2015,a total of 1 440 patients with H.pylori infection who received eradication therapy and with complete clinical data were retrospectively enrolled.Each was 350 cases in individualized treatment group,clarithromycin and bismuth containing quadruple therapy group and concomitant therapy group.A total of 100 cases were in standard triple therapy group,90 cases in sequential therapy group,and 200 cases in levofloxacin and bismuth-containing quadruple therapy group.The eradication rate of H.pylori,incidence of adverse events and compliance rate were compared in the six groups.Chi square test was performed for statistical analysis.Results The results of intention-to-treat analysis indicated that there was no statistically significant difference in H.pylori eradication rates among six groups (x2 =0.985,P=0.323).However,the results of modified intention-to-treat analysis showed that H.pylori eradication rate of individualized treatment group was the highest (92.5％ (282/305) and 93.3％ (278/298)),second was levofloxacin and bismuth-containing quadruple therapy group (90.3％ (167/185) and 91.6％ (164/179)),and the differences were statistically significant (x2 =11.285 and 13.981,both P＜0.01).There was statistically significant difference in indcidence of adverse events among the six groups (x2 =5.692,P=0.018),the incidence of adverse events in levofloxacin and bimuth-containing quadruple therapy group was lowest (16.2 ％ (30/185)),and second was individualized treatment group (21.0％ (64/305)).There was statistically significant difference in compliance rates among the six groups (x2 =4.712,P=0.023),the compliance rates of standard triple therapy group and sequential therapy group were highest (100％ (100/100) and 100％ (90/90)),and second was individualized treatment group (97.7％ (298/305)).Conclusions Both the levofloxacin and bimuth-containing quadruple therapy group and individualized treatment group can effectively eradicate H.pylori infection.The former may be safe and effective to patients unable to receive individualized therapy.

Objective To identify and analyze the homology of Ochrobactrum isolated from clinical blood samples of children.Methods The 26 strains of Ochrobactrum anthropi were identified by Vitek 2 Compact and test strips of API 20 NE bacterial identification system.The biochemical phenotypes were identified by manual tests.The 16S rRNA and recA gene were amplified by PCR and sequenced.The drug sensitivity tests of Ochrobactrum anthropi were performed by Vitek 2 Compact and matched GN13 card.The homology was analyzed by pulsed field gel electrophoresis.Results Based on the identification of the instruments and the manual tests for biochemical phenotype,all the 26 experimental strains were Ochrobactrum anthropi.The results of sequencing for 16S rRNA and recA gene amplification products showed 25 strains were Pseudochrobactrum saccharolyticum and the other 1 was O.grignonensein.Drug sensitivity analysis showed that the all the 26 strains were resistant to aztreonam,but the sensitive rates to quinolones,aminoglycosides,trimethoprim sulfamethoxazole,four generation of cephalosporins and the antibiotics compound of piperacillin/tazobactam were all more than 80％.Pulsed field gel electrophoresis analysis showed that the 25 strains were highly homologous with differences of only 1 to 3 bands in fingerprint profiles.Conclusion Based on the biochemical phenotype and the sequencing of 16S rRNA and recA gene,the Ochrobactrum-like bacteria could be identified to the level of species.The highly homologous strains of Pseudochrobactrum saccharolyticum may be sourced from a clustered infection.

Objective To analyze the CYP2C19 genetic polymorphisms in patients suffering from gastric diseases in Beijing and Shandong, and to evaluate the possibility of using the same gastric biopsy samples for the isolation of Helicobacter pylori ( H.pylori) strains.Methods A total of 1649 gastric biopsy samples positive for rapid urease test ( RUT) were collected from patients with gastric diseases in Beijing and Shandong.Each sample was grinded and equally divided into two parts for the isolation of H.pylori strains and the analysis of CYP2C19 genetic polymorphisms, respectively.H.pylori strains were isolated from the samples and identified with catalase and urease.CYP2C19*2 and CYP2C19*3 specific primers were used for the PCR amplification of DNA extracts.The PCR products were analyzed by electrophoresis and nucleo-tide sequencing.The metabolic types of CYP2C19 were analyzed based on the results of nucleotide sequen-cing.Results Altogether 1415 (85.81%) H.pylori strains were isolated successfully from the 1649 gastric biopsy samples.The products of CYP2C19 specific PCR for all DNA extracts showed clear bands in electro-phoresis and were further confirmed with sequencing analysis.Statistical analysis revealed that there were no statistical differences with the percentages of CYP2C19 metabolic types between Beijing and Shandong, nor between males and females (P>0.05).Conclusion It showed the possibility of using the same gastric bi-opsy samples for the isolation of H.pylori strains and the analysis of CYP2C19 genetic polymorphisms.No significant differences with the percentages of CYP2C19 metabolic types were found between patients from Beijing and Shandong.