BACKGROUND Helicobacter pylori(H.pylori)infection is highly prevalent worldwide,and rising antibiotic resistance has reduced the efficacy of standard therapy,underscoring the need for simplified and better-tolerated r...BACKGROUND Helicobacter pylori(H.pylori)infection is highly prevalent worldwide,and rising antibiotic resistance has reduced the efficacy of standard therapy,underscoring the need for simplified and better-tolerated regimens.AIM To evaluate the efficacy,safety,and optimal dosing of vonoprazan(VPZ)-amoxicillin(AMO)dual therapy in a non-inferiority randomized trial for H.pylori eradication.METHODS In this multi-center,randomized trial conducted at 17 hospitals in Sichuan Province,China,1717 adults with confirmed infection were assigned(1:1:1)to 14-day regimens:(1)VPZ 20 mg BID+AMO 0.5 g QID;(2)0.75 g QID;or(3)1.0 g TID.The primary endpoint was the eradication rate based on intention-to-treat(ITT)and per-protocol(PP)analyses;secondary endpoints included adverse events(AEs)and treatment compliance.RESULTS Eradication rates were consistently high(92.35%-97.43%).In the 0.5 g QID group,ITT and PP eradication rates were 93.3%(95%CI:91.2-95.1)and 97.4%(95%CI:95.7-98.5),respectively,with no significant differences among groups(P>0.05).Compliance ranged from 98.1%to 98.3%,and AEs were infrequent(5.2%-7.5%),predominantly mild gastrointestinal symptoms,which occurred least often in the 0.5 g QID group.CONCLUSION VPZ-AMO dual therapy achieved excellent eradication,safety,and patient compliance.All regimens were similarly effective,whereas the 0.5 g QID dosing strategy offered the most favorable balance of efficacy and tolerability,supporting its use as a first-line option in high-prevalence settings.展开更多
To construct and express the fusion protein Stx2B-IntiminC300 of EHEC O157 ： H7, and to further investigate its immunoprophylactic potential, the gene of Stx2B （stx2b） from EHEC O157：H7 chromosome was cloned into ...To construct and express the fusion protein Stx2B-IntiminC300 of EHEC O157 ： H7, and to further investigate its immunoprophylactic potential, the gene of Stx2B （stx2b） from EHEC O157：H7 chromosome was cloned into pMD18-T vector. Thereafter, the amplified gene was cloned into prokary- otic expression plasmid pET-28a （ ＋ ）-eaeC300, which was constructed previously. The recombinant pasmid pET-28a（ ＋ ）-stx2b-eaeC300 was transformed into E. coli BL21 （DE3）. After inducement, the protein Stx2B-IntiminC300 was successfully expressed and analyzed with sodium dodecyl sulfate polyacrylamide gel electrophoresis （SDS-PAGE）, Western blotting and N-terminal amino acid residual sequencing. To evaluate its immunoprophylactic potential, it was primarily purified by ion-exchange chromatography and injected into 30 BALB/c mice with AI（OH）3 in the subscapular region. Ten days after the last booster vaccination, 20 mice were attacked with EHEC O157：H7 lysate and the protective efficacy was observed. In the present study, the gene of Stx2B-intiminC300 was successfully cloned into pET-28a （ ＋ ） vector. The results of SDS-PAGE and Western blotting assay showed that the fusion protein was successfully expressed in the inclusion body form, accounting for 25 % of total expression products, and its molecular weight was about 43 kDa. The result of the N-terminal amino acid residual sequencing showed that it was identical to that of the molecular designed. The purity was about 75 % after primary purification. Animal tests revealed that the fusion protein Stx2B-intiminC300 has elicited high titer of protective antibody relatively. These results demonstrate that the fusion protein Stx2B-IntiminC300 is successfully expressed in prokaryotic expression system and shows certain immunoprophylactic potential.展开更多
基金Supported by Project Fund of the Health Commission of Sichuan Province,No.19PJ290。
文摘BACKGROUND Helicobacter pylori(H.pylori)infection is highly prevalent worldwide,and rising antibiotic resistance has reduced the efficacy of standard therapy,underscoring the need for simplified and better-tolerated regimens.AIM To evaluate the efficacy,safety,and optimal dosing of vonoprazan(VPZ)-amoxicillin(AMO)dual therapy in a non-inferiority randomized trial for H.pylori eradication.METHODS In this multi-center,randomized trial conducted at 17 hospitals in Sichuan Province,China,1717 adults with confirmed infection were assigned(1:1:1)to 14-day regimens:(1)VPZ 20 mg BID+AMO 0.5 g QID;(2)0.75 g QID;or(3)1.0 g TID.The primary endpoint was the eradication rate based on intention-to-treat(ITT)and per-protocol(PP)analyses;secondary endpoints included adverse events(AEs)and treatment compliance.RESULTS Eradication rates were consistently high(92.35%-97.43%).In the 0.5 g QID group,ITT and PP eradication rates were 93.3%(95%CI:91.2-95.1)and 97.4%(95%CI:95.7-98.5),respectively,with no significant differences among groups(P>0.05).Compliance ranged from 98.1%to 98.3%,and AEs were infrequent(5.2%-7.5%),predominantly mild gastrointestinal symptoms,which occurred least often in the 0.5 g QID group.CONCLUSION VPZ-AMO dual therapy achieved excellent eradication,safety,and patient compliance.All regimens were similarly effective,whereas the 0.5 g QID dosing strategy offered the most favorable balance of efficacy and tolerability,supporting its use as a first-line option in high-prevalence settings.
文摘To construct and express the fusion protein Stx2B-IntiminC300 of EHEC O157 ： H7, and to further investigate its immunoprophylactic potential, the gene of Stx2B （stx2b） from EHEC O157：H7 chromosome was cloned into pMD18-T vector. Thereafter, the amplified gene was cloned into prokary- otic expression plasmid pET-28a （ ＋ ）-eaeC300, which was constructed previously. The recombinant pasmid pET-28a（ ＋ ）-stx2b-eaeC300 was transformed into E. coli BL21 （DE3）. After inducement, the protein Stx2B-IntiminC300 was successfully expressed and analyzed with sodium dodecyl sulfate polyacrylamide gel electrophoresis （SDS-PAGE）, Western blotting and N-terminal amino acid residual sequencing. To evaluate its immunoprophylactic potential, it was primarily purified by ion-exchange chromatography and injected into 30 BALB/c mice with AI（OH）3 in the subscapular region. Ten days after the last booster vaccination, 20 mice were attacked with EHEC O157：H7 lysate and the protective efficacy was observed. In the present study, the gene of Stx2B-intiminC300 was successfully cloned into pET-28a （ ＋ ） vector. The results of SDS-PAGE and Western blotting assay showed that the fusion protein was successfully expressed in the inclusion body form, accounting for 25 % of total expression products, and its molecular weight was about 43 kDa. The result of the N-terminal amino acid residual sequencing showed that it was identical to that of the molecular designed. The purity was about 75 % after primary purification. Animal tests revealed that the fusion protein Stx2B-intiminC300 has elicited high titer of protective antibody relatively. These results demonstrate that the fusion protein Stx2B-IntiminC300 is successfully expressed in prokaryotic expression system and shows certain immunoprophylactic potential.
