In this study,the decomposed fast and slow responses of clouds to an abruptly quadrupled CO_(2)concentration(approximately 1139 ppmv)in East Asia(EA)are obtained quantitatively by using a general circulation model,BCC...In this study,the decomposed fast and slow responses of clouds to an abruptly quadrupled CO_(2)concentration(approximately 1139 ppmv)in East Asia(EA)are obtained quantitatively by using a general circulation model,BCC–AGCM2.0.Our results show that in the total response,the total cloud cover(TCC),low cloud cover(LCC),and high cloud cover(HCC)all increased north of 40°N and decreased south of 40°N except in the Tibetan Plateau(TP).The mean changes of the TCC,LCC,and HCC in EA were–0.74%,0.38%,and–0.38%in the total response,respectively;1.05%,–0.03%,and 1.63%in the fast response,respectively;and–1.79%,0.41%,and–2.01%in the slow response,respectively.By comparison,we found that changes in cloud cover were dominated by the slow response in most areas in EA due to the changes in atmospheric temperature,circulation,and water vapor supply together.Overall,the changes in the cloud forcing over EA related to the fast and slow responses were opposite to each other,and the final cloud forcing was dominated by the slow response.The mean net cloud forcing(NCF)in the total response over EA was–1.80 W m^(–2),indicating a cooling effect which partially offset the warming effect caused by the quadrupled CO_(2).The total responses of NCF in the TP,south China(SC),and northeast China(NE)were–6.74 W m^(–2),6.11 W m^(–2),and–7.49 W m^(–2),respectively.Thus,the local effects of offsetting or amplifying warming were particularly obvious.展开更多
Aims:To compare the efficacy and safety of vonoprazan-based bismuth-containing quadruple therapy(VBCQ)versus proton pump inhibitor(PPI)-based bismuth-containing quadruple Therapy(PBCQ)for Helicobacter pylorieradicatio...Aims:To compare the efficacy and safety of vonoprazan-based bismuth-containing quadruple therapy(VBCQ)versus proton pump inhibitor(PPI)-based bismuth-containing quadruple Therapy(PBCQ)for Helicobacter pylorieradication.Methods:We performed a systematic search in PubMed,Embase,Web of Science,Cochrane Library,CNKI,Wanfang databases for relevant randomized controlled trials up to March 2024.Meta-analysis by RevMan 5.4 software.Results:Ten randomized controlled trials were evaluated in this meta-analysis.In intention-to-treat(ITT)analysis and per-protocol(PP)analysis,the eradication rate of VBCQ was signifi cantly higher than PBCQ[ITT overall eradication rate:86.7%vs 82.8%,RR:1.05,95%CI(1.05,1.09),P<0.05;PP overall eradication rate:92.0%vs 88.0%;RR=1.05,95%CI(1.05,1.08),P<0.05].The incidence of adverse events in VBCQ was higher than PBCQ(36.7%vs 36.5%),there was no signifi cant diff erence(P>0.05).Conclusions:VBCQ has a higher eradication rate and comparable safety.展开更多
OBJECTIVE:To evaluate the efficacy and safety of 14-day Qingwei Zhitong pellets(清胃止痛微丸,QZ)-containing quadruple therapy(QZQT)compared to bismuth-containing quadruple therapy(BQT)in treatment-naive patients with ...OBJECTIVE:To evaluate the efficacy and safety of 14-day Qingwei Zhitong pellets(清胃止痛微丸,QZ)-containing quadruple therapy(QZQT)compared to bismuth-containing quadruple therapy(BQT)in treatment-naive patients with Helicobacter pylori(H.pylori)infection.METHODS:This single-center,randomized controlled clinical trial enrolled 333 patients,who were divided into either the QZQT group(QZ pellets,3.2 g,three times daily;rabeprazole,10 mg,twice daily;amoxicillin 1000 mg,twice daily;clarithromycin,500 mg,twice daily)or the BQT group(bismuth potassium citrate,1000 mg,three times daily;rabeprazole,10 mg,twice daily;amoxicillin,1000 mg,twice daily;clarithromycin,500 mg,twice daily)for 14 d.The 13C-urea breath test assessed eradication success at least four weeks after treatment.The primary outcome focused on the eradication rate,with secondary outcomes including safety and patient compliance.RESULTS:From August 2022 to June 2023,342 subjects were screened,and 333 were randomized.The QZQT and BQT groups showed eradication rates of 68.9%and 67.8%(P=0.838)by intention-to-treat(ITT)analysis,respectively,and 71.1%and 68.3%(P=0.612)by perprotocol(PP)analysis,respectively.QZQT was non-inferior to BQT in both ITT and PP analyses.QZQT was associated with fewer side effects(57.8%of patients)than BQT(90.4%)(P<0.001).CONCLUSION:The 14 d QZQT treatment demonstrates equal efficacy in eradicating H.pylori infection and improved patient compliance and safety compared to BQT.These results provide evidence supporting 14-day QZQT as an acceptable treatment for H.pylori infection.展开更多
Objective:To explore the application of“tertiary hospitals-secondary hospitals and nursing care institutions-community-family”four-dimensional linkage care model in peritoneal dialysis patients.Methods:99 cases of p...Objective:To explore the application of“tertiary hospitals-secondary hospitals and nursing care institutions-community-family”four-dimensional linkage care model in peritoneal dialysis patients.Methods:99 cases of peritoneal dialysis patients were divided into 47 cases in the control group and 52 cases in the intervention group.In the control group,the routine discharge follow-up model was adopted;in the intervention group,the hospital-led medical unit was adopted as the basis of the“tertiary hospitals-secondary hospitals and nursing care institutions-community-family”quadruple linkage care model,and the patients’systolic blood pressure was compared with those in the control group before and after discharge.The systolic blood pressure,diastolic blood pressure,N-terminal brain natriuretic peptide,and sodium were compared between the two groups.Results:The systolic blood pressure,diastolic blood pressure,N-terminal brain natriuretic peptide,and blood sodium of patients in the intervention group were significantly better than those of the control group(all P<0.001).Conclusion:Based on the“tertiary hospital-secondary hospital and nursing home-community-family”quadratic care model,the blood pressure control rate of elderly peritoneal dialysis patients can be increased to meet the standard,reduce the symptoms of the disease,and improve the satisfaction.展开更多
BACKGROUND Bismuth quadruple therapy(BQT)induces troublesome gastrointestinal side effects that reduce adherence and efficacy.AIM To evaluate multistrain probiotics efficacy for alleviating gastrointestinal sym-ptoms ...BACKGROUND Bismuth quadruple therapy(BQT)induces troublesome gastrointestinal side effects that reduce adherence and efficacy.AIM To evaluate multistrain probiotics efficacy for alleviating gastrointestinal sym-ptoms during BQT for Helicobacter pylori(H.pylori)eradication.METHODS One hundred seventy-four adults(18-60 years)with confirmed H.pylori infections between July 2022 and December 2023 were randomised to receive BQT plus a multispecies probiotic(n=89)or a maltodextrin placebo(n=85)for 4 weeks.Gastrointestinal Symptom Rating Scale(GSRS)and Bristol Stool Classification Scale scores were collected at baseline,2,4 and 8 weeks;eradication was assessed 8 weeks post-treatment.Intention-to-treat analysis used multiple imputation and SPSS 26.0.RESULTS After 8 weeks,GSRS scores(all dimensions and total)decreased significantly compared with those at baseline.ITT analysis showed significantly greater reductions for the intervention vs the placebo in reflux by week 2,total/diarrhea scores by week 4,and total/dyspepsia scores by week 8.Probiotics provided no protective effect against gastrointestinal symptoms at week 2 but showed significant protection at weeks 4 and 8.Both groups reported decreased diarrhea/constipation-type stools and increased normal-type stools post-intervention.H.pylori eradication rates were slightly higher for the intervention group(88.8%)than for the placebo group(84.7%),but the difference was not significant(P=0.430).CONCLUSION Multistrain probiotics significantly relieved BQT-associated gastrointestinal symptoms without affecting era-dication success.展开更多
BACKGROUND The efficacy of Vonoprazan-amoxicillin dual therapy(VAT)in the treatment of Helicobacter pylori(H.pylori)is controversial.AIM To evaluate the efficacy of VAT in the Chinese population.METHODS This prospecti...BACKGROUND The efficacy of Vonoprazan-amoxicillin dual therapy(VAT)in the treatment of Helicobacter pylori(H.pylori)is controversial.AIM To evaluate the efficacy of VAT in the Chinese population.METHODS This prospective,multicenter,randomized,open-label,and two-stage study was conducted at 23 centers in Fujian,China(May 2021-April 2022).H.pylori-infected patients were randomized to bismuth quadruple therapy(BQT),BQT-Vonoprazan(BQT-V),seven-day VAT(VAT-7),ten-day VAT(VAT-10),and fourteen-day VAT(VAT-14)groups.The primary endpoint was the H.pylori eradication rate.The secondary endpoint was the frequency of adverse events.This study was registered with the Chinese Clinical Trial Registry,ChiCTR2100045778.RESULTS In the first stage,VAT-7 and BQT-V groups were selected for early termination because less than 23 among 28 cases were eradicated.In the second stage,the eradication rates for BQT,VAT-10,and VA-14 were 80.2%[95%confidence interval(95%CI):71.4%-86.8%],93.2%(86.6%-96.7%),92.2%(85.3%-96.0%)in the intention-to-treat(ITT)analysis,and 80.9%(95%CI:71.7%-87.5%),94.0%(87.5%-97.2%),and 93.9%(87.4%-97.2%)in the per-protocol analysis.The ITT analysis showed a higher eradication rate in the VAT-10 and VAT-14 groups than in the BQT group(P=0.022 and P=0.046,respectively).The incidence of adverse events in the VAT-10 and VAT-14 groups was lower than in the BQT group(25.27%and 13.73%vs 37.62%,respectively;P<0.001).CONCLUSION VAT with a duration of 10 or 14 days achieves a higher eradication rate than the BQT,with a more tolerable safety profile in H.pylori-infected patients in Fujian.Huang XP et al.VAT for H.pylori eradication.展开更多
Chronic gastritis is the persistent and insidious inflammation of the gastric lining.Helicobacter pylori(H.pylori)has been identified as the most common cause of chronic gastritis and consequently elimination of H.pyl...Chronic gastritis is the persistent and insidious inflammation of the gastric lining.Helicobacter pylori(H.pylori)has been identified as the most common cause of chronic gastritis and consequently elimination of H.pylori can lead to its cure.This editorial explores the use of urinary metabolic profiles before and after eradication to identify biomarkers that can aid in prognosis and treatment.Despite providing promising insights,there are limitations such as a small sample size(17 patients),a narrow treatment period of 2 wk,and treatment heterogeneity,which raise concerns.Nevertheless,these findings have opened a gateway to enhancing the treatment and prognosis of chronic gastritis through urinary metabolomics.展开更多
BACKGROUND A cure for Helicobacter pylori(H.pylori)remains a problem of global concern.The prevalence of antimicrobial resistance is widely rising and becoming a challenging issue worldwide.Optimizing sequential thera...BACKGROUND A cure for Helicobacter pylori(H.pylori)remains a problem of global concern.The prevalence of antimicrobial resistance is widely rising and becoming a challenging issue worldwide.Optimizing sequential therapy seems to be one of the most attractive strategies in terms of efficacy,tolerability and cost.The most common sequential therapy consists of a dual therapy[proton-pump inhibitors(PPIs)and amoxicillin]for the first period(5 to 7 d),followed by a triple therapy for the second period(PPI,clarithromycin and metronidazole).PPIs play a key role in maintaining a gastric pH at a level that allows an optimal efficacy of antibiotics,hence the idea of using new generation molecules.This open-label prospective study randomized 328 patients with confirmed H.pylori infection into three groups(1:1:1):The first group received quadruple therapy consisting of twice-daily(bid)omeprazole 20 mg,amoxicillin 1 g,clarith-romycin 500 mg and metronidazole 500 mg for 10 d(QT-10),the second group received a 14 d quadruple therapy following the same regimen(QT-14),and the third group received an optimized sequential therapy consisting of bid rabe-prazole 20 mg plus amoxicillin 1 g for 7 d,followed by bid rabeprazole 20 mg,clarithromycin 500 mg and metronidazole 500 mg for the next 7 d(OST-14).AEs were recorded throughout the study,and the H.pylori eradication rate was determined 4 to 6 wk after the end of treatment,using the 13C urea breath test.RESULTS In the intention-to-treat and per-protocol analysis,the eradication rate was higher in the OST-14 group compared to the QT-10 group:(93.5%,85.5%P=0.04)and(96.2%,89.5%P=0.03)respectively.However,there was no statist-ically significant difference in eradication rates between the OST-14 and QT-14 groups:(93.5%,91.8%P=0.34)and(96.2%,94.4%P=0.35),respectively.The overall incidence of AEs was significantly lower in the OST-14 group(P=0.01).Furthermore,OST-14 was the most cost-effective among the three groups.CONCLUSION The optimized 14-d sequential therapy is a safe and effective alternative.Its eradication rate is comparable to that of the 14-d concomitant therapy while causing fewer AEs and allowing a gain in terms of cost.展开更多
Stepwise energy transfer is ubiquitous in natural photosynthesis,which greatly promotes the widespread use of solar energy.Herein,we constructed a supramolecular light harvesting system based on sequential energy tran...Stepwise energy transfer is ubiquitous in natural photosynthesis,which greatly promotes the widespread use of solar energy.Herein,we constructed a supramolecular light harvesting system based on sequential energy transfer through the hierarchical self-assembly of M,which contains a cyanostilbene core flanked by two ureidopyrimidinone motifs,endowing itself with both aggregation-induced emission behavior and quadruple hydrogen bonding ability.The monomer M can self-assemble into hydrogen bonded polymers and then form supramolecular polymeric nanoparticles in water through a mini-emulsion process.The nanoparticles were further utilized to encapsulate the relay acceptor ESY and the final acceptor NDI to form a two-step FRET system.Tunable fluorescence including a white-light emission was successfully achieved.Our work not only shows a desirable way for the fabrication of efficient two-step light harvesting systems,but also shows great potential in tunable photoluminescent nanomaterials.展开更多
Dynamic adsorption processes of reaction intermediates for alkaline hydrogen evolution(HER)catalysts are still confusing to understand.Here,we report a series of A-site ordered quadruple perovskite ruthenium-based ele...Dynamic adsorption processes of reaction intermediates for alkaline hydrogen evolution(HER)catalysts are still confusing to understand.Here,we report a series of A-site ordered quadruple perovskite ruthenium-based electrocatalysts ACu_(3)Ru_(4)O_(12)(A=Na,Ca,Nd,and La),with the target sample SrCu_(3)Ru_(4)O_(12)exhibiting a very low overpotential(46 mV@10 mA·cm^(-2))and excellent catalytic stability with little decays after 48-h durability test.Precise tuning A-site cations can change the average valence state of Cu and Ru,thus the plot of HER activity versus the average Ru valence number shows a volcano-type relationship.Density functional theory indicates that the Ru 4d orbitals of SrCu3Ru4O12possesses the most suitable d-band center position among the five samples,which might be the key parameter to determine the catalytic performance.Our work provides further insight into the discovering advanced,efficient hydrogen evolution catalysts through designing precise descriptor.展开更多
BACKGROUND Helicobacter pylori(H.pylori)eradication rates have declined with the rise of antibiotic-resistant strains in recent years.Although highly effective with a low prevalence of resistance,standard dose tetracy...BACKGROUND Helicobacter pylori(H.pylori)eradication rates have declined with the rise of antibiotic-resistant strains in recent years.Although highly effective with a low prevalence of resistance,standard dose tetracycline is associated with frequent adverse events.The efficacy and safety of low-dose tetracycline as part of tetra-cycline and amoxicillin-containing bismuth quadruple therapy are not well described.AIM To compare the efficacy and safety of low-dose compared to standard dose tetracycline with combined amoxicillin-containing bismuth quadruple therapy in patients with H.pylori infection.METHODS Consecutive patients with H.pylori infection receiving tetracycline,amoxicillin,proton pump inhibitor,and bismuth for 14 days at Sir Run Run Shaw Hospital(1/2022-6/2023)were evaluated.The low-dose tetracycline group received tetracycline 500 mg twice daily(bid)while the standard dose group received 750 mg bid or 500 mg three times daily(tid).Primary endpoints were H.pylori eradication rate and treatment-related adverse events.展开更多
Synergistic carbon emission reduction at the urban scale is an inherent requirement for China to realize its carbon emission reduction commitments and promote sustainable and regional synergistic development.Using 16 ...Synergistic carbon emission reduction at the urban scale is an inherent requirement for China to realize its carbon emission reduction commitments and promote sustainable and regional synergistic development.Using 16 prefectural cities in Shandong Province as an example,this study defines and quantifies the regional carbon emission reduction capacity(CERC)based on the synergistic development of carbon emission reduction,environmental protection,and economic growth objectives.The spatial network characteristics of the(CERC)and its drivers were analyzed using social network analysis and quadratic assignment procedure regression methods.The results revealed that the spatial correlation of the CERC among prefectural cities has been increasing over the years.Jinan−Zibo−Qingdao is the center of the network,while the spatial linkage strength in the southwest and northeast of Shandong Province is weak.Geospatial distance and scientific development differences have a significant negative effect on the intensity of spatial association,while differences in economic and informatization developments have a considerable positive impact.Environmental regulatory differences and transportation differences are not significant.This study offers a methodological reference for similar studies in other countries or regions.At the same time,the findings provide a scientific basis for the government to rationally allocate urban resources and promote regional synergistic carbon emission reduction.展开更多
BACKGROUND Many studies have focused on the femoral tunnel technique and fixation method,but few studies have involved the tibial tunnel technique and fixation method.The all-inside technique is one of the new techniq...BACKGROUND Many studies have focused on the femoral tunnel technique and fixation method,but few studies have involved the tibial tunnel technique and fixation method.The all-inside technique is one of the new techniques that has been described in recent years.All-inside anterior cruciate ligament(ACL)reconstruction is based on a tibial socket instead of a full tunnel.This method has many potential advantages.AIM To compare clinical outcomes of knee ACL autograft reconstruction using allinside quadrupled semitendinosus(AIST)and traditional hamstring tendon(TBT)techniques.METHODS From January 2017 to October 2019,the clinical data of 80 patients with ACL reconstruction were retrospectively analyzed,including 67 males and 13 females.The patients had an average age of 24.3±3.1 years(age range:18-33 years).The AIST technique was used in 42 patients and the TBT technique was used in 38 patients.The time between operation and injury,operative duration,postoperative visual analogue scale(VAS)score and knee functional recovery were recorded and compared between the two groups.The International Knee Documentation Committee(IKDC)and Lysholm scoring system were used to comprehensively evaluate clinical efficacy.RESULTS Eighty patients were followed for 24-36 mo,with an average follow-up duration of 27.5±1.8 mo.There were no significant differences in the time between surgery and injury,operative duration,IKDC and Lysholm scores of the affected knee at the last follow-up evaluation between the two groups.There were significant differences in VAS scores 1 d,3 d,7 d,2 wk and 1 mo after surgery(P<0.05).There was no significant difference in VAS score at 3 mo,6 mo and 1 year after operation.CONCLUSION The efficacy of the AIST ACL reconstruction technique was comparable to the TBT technique,but the postoperative pain was less with the AIST technique.Thus,the AIST technique is an ideal treatment choice for ACL reconstruction.展开更多
Compared with wheeled or tracked robots,legged robots exhibit advantages on agile locomotion and higher survival chance for deadly impacts. A buffering strategy is proposed for quadruped robots with non-extreme initia...Compared with wheeled or tracked robots,legged robots exhibit advantages on agile locomotion and higher survival chance for deadly impacts. A buffering strategy is proposed for quadruped robots with non-extreme initial attitudes from the end of air-righting to the steady standing on the ground.This approach consists of landing phase,buffering phase and recovering phase. The variable stiffness control,proportional-derivative( PD) force control and foot trajectory planning are applied to the joints of quadruped robots until the end of the recovering phase. The PD parameters are tuned according to the desired performance of each phase. The above approach is verified on a virtual platform.展开更多
Background: Achondroplasia is a rare autosomal dominant disorder resulting in skeletal dysplasia. Any injury to the anterior cruciate ligament among people already suffering from achondroplasia results in devastating ...Background: Achondroplasia is a rare autosomal dominant disorder resulting in skeletal dysplasia. Any injury to the anterior cruciate ligament among people already suffering from achondroplasia results in devastating effects. In this report, the outcome of the hamstring graft arthroscopic reconstruction technique for anterior cruciate ligament injury in achondroplasia patients is assessed. The patient in the present case report exhibits the potential for excellent outcomes four months post-surgical follow-up on Lysholm Knee Scoring Scale. This encouraging result, ought to persuade surgeons to use the hamstring graft arthroscopic restoration approach in achondroplasia instances like these. Timely and excellent recovery in such complicated surgical cases, would reduce the obstacle to surgery for several patients with achondroplasia. It would also improve the methods of managing these patients with this particular surgical technique.展开更多
With the rising prevalence of antimicrobial resistance,the treatment success of standard triple therapy has recently declined to unacceptable levels (i.e.,80% or less) in most countries.Therefore,several treatment reg...With the rising prevalence of antimicrobial resistance,the treatment success of standard triple therapy has recently declined to unacceptable levels (i.e.,80% or less) in most countries.Therefore,several treatment regimens have emerged to cure Helicobacter pylori (H.pylori) infection.Novel first-line anti-H.pylori therapies in 2011 include sequential therapy,concomitant quadruple therapy,hybrid (dual-concomitant) therapy and bismuth-containing quadruple therapy.After the failure of standard triple therapy,a bismuth-containing quadruple therapy comprising a proton pump inhibitor (PPI),bismuth,tetracycline and metronidazole can be employed as rescue treatment.Recently,triple therapy combining a PPI,levofloxacin and amoxicillin has been proposed as an alternative to the standard rescue therapy.This salvage regimen can achieve a higher eradication rate than bismuth-containing quadruple therapy in some regions and has less adverse effects.The best second-line therapy for patients who fail to eradicate H.pylori with first-line therapies containing clarithromycin,amoxicillin and metronidazole is unclear.However,a levofloxacin-based triple therapy is an accepted rescue treatment.Most guidelines suggest that patients requiring third-line therapy should be referred to a medical center and treated according to the antibiotic susceptibility test.Nonetheless,an empirical therapy (such as levofloxacin-based or furazolidone-based therapies) can be employed to terminate H.pylori infection if antimicrobial sensitivity data are unavailable.展开更多
AIM： To compare the efficacy and side effect profiles of three furazolidone and amoxicillin-based quadruple rescue therapies for the eradication of Helicobacter pylori （H pylonS. METHODS： Patients who failed in the...AIM： To compare the efficacy and side effect profiles of three furazolidone and amoxicillin-based quadruple rescue therapies for the eradication of Helicobacter pylori （H pylonS. METHODS： Patients who failed in the Hpylori eradication therapy for at least one course were randomly allocated into three groups. Group A received rebaprazole 10 mg＋ amoxicillin 1 g ＋ furazolidone 100 mg, and bismuth subcitrate 220 mg, twice daily for 1 wk; group B received the same regimen of group A but for 2 wk; and group C received the same regimen of group B, but furazolidone was replaced by furazolidone 100 mg three times daily. To record the side effect profiles at the end of the treatment, Hpylori eradication was assessed with 13C-urea breath test 4 wk after therapy. RESULTS： Sixty patients were enrolled including 28 males, and 20 patients in each group. The average age of the patients was 49.2 years, ranging from 18 to 84 years. H pylori eradication rates with per-protocol analysis were 82%, 89% and 90% in the three groups, respectively. Side effects were found in 11 patients, including mild dizziness, nausea, diarrhea and increased bowel movement. None of the 11 patients needed treatment for their side effects. CONCLUSION： One- or two-week furazolidone and amoxicillin-based quadruple rescue therapy with a low dose furazolidone （100 mg bid） for the eradication of Hpylori is effective. Extending the antibiotic course to 14 d could improve the eradication rates.展开更多
AIM To evaluate the outcomes of furazolidone-and amoxicillin-based quadruple therapy for treatment of Helicobacter pylori(H. pylori) infection and identify predictors of failed eradication.METHODS Patients with H. pyl...AIM To evaluate the outcomes of furazolidone-and amoxicillin-based quadruple therapy for treatment of Helicobacter pylori(H. pylori) infection and identify predictors of failed eradication.METHODS Patients with H. pylori infection treated with furazolidone, amoxicillin, bismuth, and proton pump inhibitor therapy(January 2015 to December 2015) who received the ^(13)C-urea breath test > 4 wk after treatment were evaluated. Demographic and clinical data including prior H. pylori treatment attempts, medication adherence, alcohol and cigarette consumption during therapy, and treatment-related adverse events were recorded by reviewing medical records and telephone surveys. H. pylori eradication rates for overall and subgroups were evaluated. Multivariate analysis was performed to identify independent predictors of failed H. pylori eradication.RESULTS Of the 992 patients treated and retested for H. pylori infection, the overall eradication rate was 94.5% [95% confidence interval(CI): 94.1%-95.9%]. H. pylori eradication rate of primary therapy was 95.0%(95%CI: 93.5%-96.5%), while that of rescue therapy was 91.3%(95%CI: 86.8%-95.8%). Among the 859 patients who completed the study protocol, 144(17%) reported treatment-related adverse events including 24(3%) leading to premature discontinuation. On multivariate analysis, poor medication adherence [adjusted odds ratio(AOR) = 6.7, 95%CI: 2.8-15.8], two or more previous H. pylori treatments(AOR = 7.4, 95%CI: 2.2-24.9), alcohol consumption during therapy(AOR = 4.4, 95%CI: 1.5-12.3), and possibly smoking during therapy(AOR = 1.9, 95%CI: 0.9-4.3) were associated with failed H. pylori eradication. CONCLUSION Furazolidone-and amoxicillin-based quadruple therapy for H. pylori infection in an area with a high prevalence of clarithromycin resistance demonstrated high eradication rates as primary and rescue therapies with a favorable safety profile. Patient education targeting abstinence from alcohol during therapy and strict medication adherence may further optimize H. pylori eradication.展开更多
AIM: To compare the effectiveness of standard triple, bismuth pectin quadruple and sequential therapies for Helicobacter pylori (H. pylori ) eradication in a randomized, double-blinded, comparative clinical trial in C...AIM: To compare the effectiveness of standard triple, bismuth pectin quadruple and sequential therapies for Helicobacter pylori (H. pylori ) eradication in a randomized, double-blinded, comparative clinical trial in China. METHODS: A total of 215 H. pylori -positive patients were enrolled in the study and randomly allocated into three groups: group A (n = 72) received a 10-d bismuth pectin quadruple therapy (20 mg rabeprazole bid , 1000 mg amoxicillin bid , 100 mg bismuth pectin qid , and 500 mg levofloxacin qd ); group B (n = 72) received the sequential therapy (20 mg omeprazole bid , 1000 mg amoxicillin bid , in 5 d, followed by 20 mg omeprazole bid , 500 mg tinidazole bid , 500 mg clarithromycin bid , for another 5 d); group C (n = 71) received a standard 1-wk triple therapy (20 mg omeprazole bid , 1000 mg amoxicillin bid , 500 mg clarithromycin bid ). After all these treatments, 20 mg omeprazole bid was administrated for 3 wk. H. pylori status was assessed by histology, 13C-urea breath test and rapid urease test at baseline and 4-6 wk after completion of treatment. Ulcer cicatrization was assessed by gastroscopy. χ 2 test (P < 0.05) was used to compare the eradication rates and ulcer cicatrisation rates among the three groups. RESULTS: The eradication rate was 83.33% (60/72) in group A, 88.89% (64/72) in group B, and 80.56% (58/71) in group C. The ulcer cicatrisation rate was 86.44% (51/59) in group A, 90.16% (55/61) in group B, and 84.91% (45/53) in group C. The sequential therapy yielded a higher eradication rate and ulcer cicatrisation rate than the standard triple and bismuth pectin quadruple therapies. Statistically, the eradication rate of group B was significantly different from groups A and C (P < 0.05), but the difference of ulcer cicatrisation rate and side effects was not statistically significant among the three groups (P > 0.05). The three protocols were generally well tolerated. CONCLUSION: The sequential therapy has achieved a significantly higher eradication rate, and is a more suitable first-line alternative protocol for anti-H. pylori infection compared with the standard triple and bismuth pectin quadruple therapies.展开更多
At present, the best rescue therapy for Helicobacter pylori(H. pylori) infection following failure of firstline eradication remains unclear. The Maastricht Ⅴ/Florence Consensus Report recommends bismuth quadruple the...At present, the best rescue therapy for Helicobacter pylori(H. pylori) infection following failure of firstline eradication remains unclear. The Maastricht Ⅴ/Florence Consensus Report recommends bismuth quadruple therapy, or fluoroquinolone-amoxicillin triple/quadruple therapy as the second-line therapy for H. pylori infection. Meta-analyses have shown that bismuth quadruple therapy and levofloxacin-amoxicillin triple therapy have comparable eradication rates, while the former has more adverse effects than the latter. There are no significant differences between the eradication rates of levofloxacin-amoxicillin triple and quadruple therapies. However, the eradication rates of both levofloxacin-containing treatments are suboptimal. An important caveat of levofloxacin-amoxicillin triple or quadruple therapy is poor eradication efficacy in the presence of fluoroquinolone resistance. High-dose dual therapy is an emerging second-line therapy and has an eradication efficacy comparable with levofloxacinamoxicillin triple therapy. Recently, a 10-d tetracyclinelevofloxacin(TL) quadruple therapy comprised of a proton pump inhibitor, bismuth, tetracycline and levofloxacin has been developed, which achieves a markedly higher eradication rate compared with levofloxacin-amoxicillin triple therapy(98% vs 69%) in patients with failure of standard triple, bismuth quadruple or non-bismuth quadruple therapy. The present article reviews current second-line anti-H. pylori regimens and treatment algorisms. In conclusion, bismuth quadruple therapy, levofloxacin-amoxicillin triple/quadruple therapy, high-dose dual therapy and TL quadruple therapy can be used as second-line treatment for H. pylori infection. Current evidence suggests that 10-d TL quadruple therapy is a simple and effective regimen, and has the potential to become a universal rescue treatment following eradication failure by all firstline eradication regimens for H. pylori infection.展开更多
基金supported by the National Key R&D Program of China(2017YFA0603502)the National Natural Science Foundation of China(Grant No.41905081)S&T Development Fund of CAMS(2021KJ004&2022KJ019).
文摘In this study,the decomposed fast and slow responses of clouds to an abruptly quadrupled CO_(2)concentration(approximately 1139 ppmv)in East Asia(EA)are obtained quantitatively by using a general circulation model,BCC–AGCM2.0.Our results show that in the total response,the total cloud cover(TCC),low cloud cover(LCC),and high cloud cover(HCC)all increased north of 40°N and decreased south of 40°N except in the Tibetan Plateau(TP).The mean changes of the TCC,LCC,and HCC in EA were–0.74%,0.38%,and–0.38%in the total response,respectively;1.05%,–0.03%,and 1.63%in the fast response,respectively;and–1.79%,0.41%,and–2.01%in the slow response,respectively.By comparison,we found that changes in cloud cover were dominated by the slow response in most areas in EA due to the changes in atmospheric temperature,circulation,and water vapor supply together.Overall,the changes in the cloud forcing over EA related to the fast and slow responses were opposite to each other,and the final cloud forcing was dominated by the slow response.The mean net cloud forcing(NCF)in the total response over EA was–1.80 W m^(–2),indicating a cooling effect which partially offset the warming effect caused by the quadrupled CO_(2).The total responses of NCF in the TP,south China(SC),and northeast China(NE)were–6.74 W m^(–2),6.11 W m^(–2),and–7.49 W m^(–2),respectively.Thus,the local effects of offsetting or amplifying warming were particularly obvious.
文摘Aims:To compare the efficacy and safety of vonoprazan-based bismuth-containing quadruple therapy(VBCQ)versus proton pump inhibitor(PPI)-based bismuth-containing quadruple Therapy(PBCQ)for Helicobacter pylorieradication.Methods:We performed a systematic search in PubMed,Embase,Web of Science,Cochrane Library,CNKI,Wanfang databases for relevant randomized controlled trials up to March 2024.Meta-analysis by RevMan 5.4 software.Results:Ten randomized controlled trials were evaluated in this meta-analysis.In intention-to-treat(ITT)analysis and per-protocol(PP)analysis,the eradication rate of VBCQ was signifi cantly higher than PBCQ[ITT overall eradication rate:86.7%vs 82.8%,RR:1.05,95%CI(1.05,1.09),P<0.05;PP overall eradication rate:92.0%vs 88.0%;RR=1.05,95%CI(1.05,1.08),P<0.05].The incidence of adverse events in VBCQ was higher than PBCQ(36.7%vs 36.5%),there was no signifi cant diff erence(P>0.05).Conclusions:VBCQ has a higher eradication rate and comparable safety.
基金the China Zhongguancun Precision Medicine Science and Technology Foundation:Study on the Evaluation of Eradication Rate and Safety of Helicobacter Pylori in a Quadruple Therapy using Qingwei Zhitong Pellets as a Substitute for Bismuth Agent(320.6799.2022.09.24)。
文摘OBJECTIVE:To evaluate the efficacy and safety of 14-day Qingwei Zhitong pellets(清胃止痛微丸,QZ)-containing quadruple therapy(QZQT)compared to bismuth-containing quadruple therapy(BQT)in treatment-naive patients with Helicobacter pylori(H.pylori)infection.METHODS:This single-center,randomized controlled clinical trial enrolled 333 patients,who were divided into either the QZQT group(QZ pellets,3.2 g,three times daily;rabeprazole,10 mg,twice daily;amoxicillin 1000 mg,twice daily;clarithromycin,500 mg,twice daily)or the BQT group(bismuth potassium citrate,1000 mg,three times daily;rabeprazole,10 mg,twice daily;amoxicillin,1000 mg,twice daily;clarithromycin,500 mg,twice daily)for 14 d.The 13C-urea breath test assessed eradication success at least four weeks after treatment.The primary outcome focused on the eradication rate,with secondary outcomes including safety and patient compliance.RESULTS:From August 2022 to June 2023,342 subjects were screened,and 333 were randomized.The QZQT and BQT groups showed eradication rates of 68.9%and 67.8%(P=0.838)by intention-to-treat(ITT)analysis,respectively,and 71.1%and 68.3%(P=0.612)by perprotocol(PP)analysis,respectively.QZQT was non-inferior to BQT in both ITT and PP analyses.QZQT was associated with fewer side effects(57.8%of patients)than BQT(90.4%)(P<0.001).CONCLUSION:The 14 d QZQT treatment demonstrates equal efficacy in eradicating H.pylori infection and improved patient compliance and safety compared to BQT.These results provide evidence supporting 14-day QZQT as an acceptable treatment for H.pylori infection.
文摘Objective:To explore the application of“tertiary hospitals-secondary hospitals and nursing care institutions-community-family”four-dimensional linkage care model in peritoneal dialysis patients.Methods:99 cases of peritoneal dialysis patients were divided into 47 cases in the control group and 52 cases in the intervention group.In the control group,the routine discharge follow-up model was adopted;in the intervention group,the hospital-led medical unit was adopted as the basis of the“tertiary hospitals-secondary hospitals and nursing care institutions-community-family”quadruple linkage care model,and the patients’systolic blood pressure was compared with those in the control group before and after discharge.The systolic blood pressure,diastolic blood pressure,N-terminal brain natriuretic peptide,and sodium were compared between the two groups.Results:The systolic blood pressure,diastolic blood pressure,N-terminal brain natriuretic peptide,and blood sodium of patients in the intervention group were significantly better than those of the control group(all P<0.001).Conclusion:Based on the“tertiary hospital-secondary hospital and nursing home-community-family”quadratic care model,the blood pressure control rate of elderly peritoneal dialysis patients can be increased to meet the standard,reduce the symptoms of the disease,and improve the satisfaction.
文摘BACKGROUND Bismuth quadruple therapy(BQT)induces troublesome gastrointestinal side effects that reduce adherence and efficacy.AIM To evaluate multistrain probiotics efficacy for alleviating gastrointestinal sym-ptoms during BQT for Helicobacter pylori(H.pylori)eradication.METHODS One hundred seventy-four adults(18-60 years)with confirmed H.pylori infections between July 2022 and December 2023 were randomised to receive BQT plus a multispecies probiotic(n=89)or a maltodextrin placebo(n=85)for 4 weeks.Gastrointestinal Symptom Rating Scale(GSRS)and Bristol Stool Classification Scale scores were collected at baseline,2,4 and 8 weeks;eradication was assessed 8 weeks post-treatment.Intention-to-treat analysis used multiple imputation and SPSS 26.0.RESULTS After 8 weeks,GSRS scores(all dimensions and total)decreased significantly compared with those at baseline.ITT analysis showed significantly greater reductions for the intervention vs the placebo in reflux by week 2,total/diarrhea scores by week 4,and total/dyspepsia scores by week 8.Probiotics provided no protective effect against gastrointestinal symptoms at week 2 but showed significant protection at weeks 4 and 8.Both groups reported decreased diarrhea/constipation-type stools and increased normal-type stools post-intervention.H.pylori eradication rates were slightly higher for the intervention group(88.8%)than for the placebo group(84.7%),but the difference was not significant(P=0.430).CONCLUSION Multistrain probiotics significantly relieved BQT-associated gastrointestinal symptoms without affecting era-dication success.
基金Supported by the Natural Science Foundation of Fujian Province,No.2020J011087 and No.2022J011025Medical Innovation Project of Fujian Provincial Health Commission,No.2020CXA006Zhuhai Science and Technology Project,No.20181117E030040.
文摘BACKGROUND The efficacy of Vonoprazan-amoxicillin dual therapy(VAT)in the treatment of Helicobacter pylori(H.pylori)is controversial.AIM To evaluate the efficacy of VAT in the Chinese population.METHODS This prospective,multicenter,randomized,open-label,and two-stage study was conducted at 23 centers in Fujian,China(May 2021-April 2022).H.pylori-infected patients were randomized to bismuth quadruple therapy(BQT),BQT-Vonoprazan(BQT-V),seven-day VAT(VAT-7),ten-day VAT(VAT-10),and fourteen-day VAT(VAT-14)groups.The primary endpoint was the H.pylori eradication rate.The secondary endpoint was the frequency of adverse events.This study was registered with the Chinese Clinical Trial Registry,ChiCTR2100045778.RESULTS In the first stage,VAT-7 and BQT-V groups were selected for early termination because less than 23 among 28 cases were eradicated.In the second stage,the eradication rates for BQT,VAT-10,and VA-14 were 80.2%[95%confidence interval(95%CI):71.4%-86.8%],93.2%(86.6%-96.7%),92.2%(85.3%-96.0%)in the intention-to-treat(ITT)analysis,and 80.9%(95%CI:71.7%-87.5%),94.0%(87.5%-97.2%),and 93.9%(87.4%-97.2%)in the per-protocol analysis.The ITT analysis showed a higher eradication rate in the VAT-10 and VAT-14 groups than in the BQT group(P=0.022 and P=0.046,respectively).The incidence of adverse events in the VAT-10 and VAT-14 groups was lower than in the BQT group(25.27%and 13.73%vs 37.62%,respectively;P<0.001).CONCLUSION VAT with a duration of 10 or 14 days achieves a higher eradication rate than the BQT,with a more tolerable safety profile in H.pylori-infected patients in Fujian.Huang XP et al.VAT for H.pylori eradication.
文摘Chronic gastritis is the persistent and insidious inflammation of the gastric lining.Helicobacter pylori(H.pylori)has been identified as the most common cause of chronic gastritis and consequently elimination of H.pylori can lead to its cure.This editorial explores the use of urinary metabolic profiles before and after eradication to identify biomarkers that can aid in prognosis and treatment.Despite providing promising insights,there are limitations such as a small sample size(17 patients),a narrow treatment period of 2 wk,and treatment heterogeneity,which raise concerns.Nevertheless,these findings have opened a gateway to enhancing the treatment and prognosis of chronic gastritis through urinary metabolomics.
文摘BACKGROUND A cure for Helicobacter pylori(H.pylori)remains a problem of global concern.The prevalence of antimicrobial resistance is widely rising and becoming a challenging issue worldwide.Optimizing sequential therapy seems to be one of the most attractive strategies in terms of efficacy,tolerability and cost.The most common sequential therapy consists of a dual therapy[proton-pump inhibitors(PPIs)and amoxicillin]for the first period(5 to 7 d),followed by a triple therapy for the second period(PPI,clarithromycin and metronidazole).PPIs play a key role in maintaining a gastric pH at a level that allows an optimal efficacy of antibiotics,hence the idea of using new generation molecules.This open-label prospective study randomized 328 patients with confirmed H.pylori infection into three groups(1:1:1):The first group received quadruple therapy consisting of twice-daily(bid)omeprazole 20 mg,amoxicillin 1 g,clarith-romycin 500 mg and metronidazole 500 mg for 10 d(QT-10),the second group received a 14 d quadruple therapy following the same regimen(QT-14),and the third group received an optimized sequential therapy consisting of bid rabe-prazole 20 mg plus amoxicillin 1 g for 7 d,followed by bid rabeprazole 20 mg,clarithromycin 500 mg and metronidazole 500 mg for the next 7 d(OST-14).AEs were recorded throughout the study,and the H.pylori eradication rate was determined 4 to 6 wk after the end of treatment,using the 13C urea breath test.RESULTS In the intention-to-treat and per-protocol analysis,the eradication rate was higher in the OST-14 group compared to the QT-10 group:(93.5%,85.5%P=0.04)and(96.2%,89.5%P=0.03)respectively.However,there was no statist-ically significant difference in eradication rates between the OST-14 and QT-14 groups:(93.5%,91.8%P=0.34)and(96.2%,94.4%P=0.35),respectively.The overall incidence of AEs was significantly lower in the OST-14 group(P=0.01).Furthermore,OST-14 was the most cost-effective among the three groups.CONCLUSION The optimized 14-d sequential therapy is a safe and effective alternative.Its eradication rate is comparable to that of the 14-d concomitant therapy while causing fewer AEs and allowing a gain in terms of cost.
基金the financial support from the National Natural Science Foundation of China(No.21702020)We also acknowledge the analytical testing support from Analysis and Testing Center,NERC Biomass of Changzhou University.L.Z.acknowledges the Postgraduate Research&Practice Innovation Program of Jiangsu Province(No.KYCX22_3012).
文摘Stepwise energy transfer is ubiquitous in natural photosynthesis,which greatly promotes the widespread use of solar energy.Herein,we constructed a supramolecular light harvesting system based on sequential energy transfer through the hierarchical self-assembly of M,which contains a cyanostilbene core flanked by two ureidopyrimidinone motifs,endowing itself with both aggregation-induced emission behavior and quadruple hydrogen bonding ability.The monomer M can self-assemble into hydrogen bonded polymers and then form supramolecular polymeric nanoparticles in water through a mini-emulsion process.The nanoparticles were further utilized to encapsulate the relay acceptor ESY and the final acceptor NDI to form a two-step FRET system.Tunable fluorescence including a white-light emission was successfully achieved.Our work not only shows a desirable way for the fabrication of efficient two-step light harvesting systems,but also shows great potential in tunable photoluminescent nanomaterials.
基金Project supported financially by the National Key Research and Development Program of China(Grant No.2023YFA1406000)the National Natural Science Foundation of China(Grant Nos.22171283 and 12474002)+3 种基金the Fundamental Research Funds for the Central Universities(Grant Nos.2023ZCJH03 and 2021XD-A041)the Fund of State Key Laboratory of Information Photonics and Optical Communications(Beijing University of Posts and Telecommunications,China)the Teaching Reform Projects at BUPT(Grant No.2022CXCYB03)the BUPT Excellent Ph.D.Students Foundation(Grant No.CX2023108)。
文摘Dynamic adsorption processes of reaction intermediates for alkaline hydrogen evolution(HER)catalysts are still confusing to understand.Here,we report a series of A-site ordered quadruple perovskite ruthenium-based electrocatalysts ACu_(3)Ru_(4)O_(12)(A=Na,Ca,Nd,and La),with the target sample SrCu_(3)Ru_(4)O_(12)exhibiting a very low overpotential(46 mV@10 mA·cm^(-2))and excellent catalytic stability with little decays after 48-h durability test.Precise tuning A-site cations can change the average valence state of Cu and Ru,thus the plot of HER activity versus the average Ru valence number shows a volcano-type relationship.Density functional theory indicates that the Ru 4d orbitals of SrCu3Ru4O12possesses the most suitable d-band center position among the five samples,which might be the key parameter to determine the catalytic performance.Our work provides further insight into the discovering advanced,efficient hydrogen evolution catalysts through designing precise descriptor.
文摘BACKGROUND Helicobacter pylori(H.pylori)eradication rates have declined with the rise of antibiotic-resistant strains in recent years.Although highly effective with a low prevalence of resistance,standard dose tetracycline is associated with frequent adverse events.The efficacy and safety of low-dose tetracycline as part of tetra-cycline and amoxicillin-containing bismuth quadruple therapy are not well described.AIM To compare the efficacy and safety of low-dose compared to standard dose tetracycline with combined amoxicillin-containing bismuth quadruple therapy in patients with H.pylori infection.METHODS Consecutive patients with H.pylori infection receiving tetracycline,amoxicillin,proton pump inhibitor,and bismuth for 14 days at Sir Run Run Shaw Hospital(1/2022-6/2023)were evaluated.The low-dose tetracycline group received tetracycline 500 mg twice daily(bid)while the standard dose group received 750 mg bid or 500 mg three times daily(tid).Primary endpoints were H.pylori eradication rate and treatment-related adverse events.
基金supported by the Department of Science and Technology of Shandong Province [Grant No.2021SFGC0904-05]Shandong Natural Science Foundation [Grant No.ZR2023MD079]+3 种基金Shandong Province Social Science Planning Research Project [Grant No.22CKRJ04]Taishan Scholar Project [Grant No.tsqn202103010]Zaozhuang Science and Technology Bureau [Grant No.2021GH22]the Key R&D Program of Shandong Province,China [Grant No.2023SFGC0101].
文摘Synergistic carbon emission reduction at the urban scale is an inherent requirement for China to realize its carbon emission reduction commitments and promote sustainable and regional synergistic development.Using 16 prefectural cities in Shandong Province as an example,this study defines and quantifies the regional carbon emission reduction capacity(CERC)based on the synergistic development of carbon emission reduction,environmental protection,and economic growth objectives.The spatial network characteristics of the(CERC)and its drivers were analyzed using social network analysis and quadratic assignment procedure regression methods.The results revealed that the spatial correlation of the CERC among prefectural cities has been increasing over the years.Jinan−Zibo−Qingdao is the center of the network,while the spatial linkage strength in the southwest and northeast of Shandong Province is weak.Geospatial distance and scientific development differences have a significant negative effect on the intensity of spatial association,while differences in economic and informatization developments have a considerable positive impact.Environmental regulatory differences and transportation differences are not significant.This study offers a methodological reference for similar studies in other countries or regions.At the same time,the findings provide a scientific basis for the government to rationally allocate urban resources and promote regional synergistic carbon emission reduction.
文摘BACKGROUND Many studies have focused on the femoral tunnel technique and fixation method,but few studies have involved the tibial tunnel technique and fixation method.The all-inside technique is one of the new techniques that has been described in recent years.All-inside anterior cruciate ligament(ACL)reconstruction is based on a tibial socket instead of a full tunnel.This method has many potential advantages.AIM To compare clinical outcomes of knee ACL autograft reconstruction using allinside quadrupled semitendinosus(AIST)and traditional hamstring tendon(TBT)techniques.METHODS From January 2017 to October 2019,the clinical data of 80 patients with ACL reconstruction were retrospectively analyzed,including 67 males and 13 females.The patients had an average age of 24.3±3.1 years(age range:18-33 years).The AIST technique was used in 42 patients and the TBT technique was used in 38 patients.The time between operation and injury,operative duration,postoperative visual analogue scale(VAS)score and knee functional recovery were recorded and compared between the two groups.The International Knee Documentation Committee(IKDC)and Lysholm scoring system were used to comprehensively evaluate clinical efficacy.RESULTS Eighty patients were followed for 24-36 mo,with an average follow-up duration of 27.5±1.8 mo.There were no significant differences in the time between surgery and injury,operative duration,IKDC and Lysholm scores of the affected knee at the last follow-up evaluation between the two groups.There were significant differences in VAS scores 1 d,3 d,7 d,2 wk and 1 mo after surgery(P<0.05).There was no significant difference in VAS score at 3 mo,6 mo and 1 year after operation.CONCLUSION The efficacy of the AIST ACL reconstruction technique was comparable to the TBT technique,but the postoperative pain was less with the AIST technique.Thus,the AIST technique is an ideal treatment choice for ACL reconstruction.
基金Supported by the National High Technology Research and Development Program of China(No.2015AA042201)the National Natural Science Foundation of China(No.61233014,61305130)+1 种基金the Shandong Provincial Natural Science Foundation(No.ZR2013FQ003,ZR2013EEM027)China Postdoctoral Science Foundation(No.2013M541912)
文摘Compared with wheeled or tracked robots,legged robots exhibit advantages on agile locomotion and higher survival chance for deadly impacts. A buffering strategy is proposed for quadruped robots with non-extreme initial attitudes from the end of air-righting to the steady standing on the ground.This approach consists of landing phase,buffering phase and recovering phase. The variable stiffness control,proportional-derivative( PD) force control and foot trajectory planning are applied to the joints of quadruped robots until the end of the recovering phase. The PD parameters are tuned according to the desired performance of each phase. The above approach is verified on a virtual platform.
文摘Background: Achondroplasia is a rare autosomal dominant disorder resulting in skeletal dysplasia. Any injury to the anterior cruciate ligament among people already suffering from achondroplasia results in devastating effects. In this report, the outcome of the hamstring graft arthroscopic reconstruction technique for anterior cruciate ligament injury in achondroplasia patients is assessed. The patient in the present case report exhibits the potential for excellent outcomes four months post-surgical follow-up on Lysholm Knee Scoring Scale. This encouraging result, ought to persuade surgeons to use the hamstring graft arthroscopic restoration approach in achondroplasia instances like these. Timely and excellent recovery in such complicated surgical cases, would reduce the obstacle to surgery for several patients with achondroplasia. It would also improve the methods of managing these patients with this particular surgical technique.
文摘With the rising prevalence of antimicrobial resistance,the treatment success of standard triple therapy has recently declined to unacceptable levels (i.e.,80% or less) in most countries.Therefore,several treatment regimens have emerged to cure Helicobacter pylori (H.pylori) infection.Novel first-line anti-H.pylori therapies in 2011 include sequential therapy,concomitant quadruple therapy,hybrid (dual-concomitant) therapy and bismuth-containing quadruple therapy.After the failure of standard triple therapy,a bismuth-containing quadruple therapy comprising a proton pump inhibitor (PPI),bismuth,tetracycline and metronidazole can be employed as rescue treatment.Recently,triple therapy combining a PPI,levofloxacin and amoxicillin has been proposed as an alternative to the standard rescue therapy.This salvage regimen can achieve a higher eradication rate than bismuth-containing quadruple therapy in some regions and has less adverse effects.The best second-line therapy for patients who fail to eradicate H.pylori with first-line therapies containing clarithromycin,amoxicillin and metronidazole is unclear.However,a levofloxacin-based triple therapy is an accepted rescue treatment.Most guidelines suggest that patients requiring third-line therapy should be referred to a medical center and treated according to the antibiotic susceptibility test.Nonetheless,an empirical therapy (such as levofloxacin-based or furazolidone-based therapies) can be employed to terminate H.pylori infection if antimicrobial sensitivity data are unavailable.
文摘AIM： To compare the efficacy and side effect profiles of three furazolidone and amoxicillin-based quadruple rescue therapies for the eradication of Helicobacter pylori （H pylonS. METHODS： Patients who failed in the Hpylori eradication therapy for at least one course were randomly allocated into three groups. Group A received rebaprazole 10 mg＋ amoxicillin 1 g ＋ furazolidone 100 mg, and bismuth subcitrate 220 mg, twice daily for 1 wk; group B received the same regimen of group A but for 2 wk; and group C received the same regimen of group B, but furazolidone was replaced by furazolidone 100 mg three times daily. To record the side effect profiles at the end of the treatment, Hpylori eradication was assessed with 13C-urea breath test 4 wk after therapy. RESULTS： Sixty patients were enrolled including 28 males, and 20 patients in each group. The average age of the patients was 49.2 years, ranging from 18 to 84 years. H pylori eradication rates with per-protocol analysis were 82%, 89% and 90% in the three groups, respectively. Side effects were found in 11 patients, including mild dizziness, nausea, diarrhea and increased bowel movement. None of the 11 patients needed treatment for their side effects. CONCLUSION： One- or two-week furazolidone and amoxicillin-based quadruple rescue therapy with a low dose furazolidone （100 mg bid） for the eradication of Hpylori is effective. Extending the antibiotic course to 14 d could improve the eradication rates.
基金Supported by the Zhejiang Science and Technology Project,No.LGF18H160012
文摘AIM To evaluate the outcomes of furazolidone-and amoxicillin-based quadruple therapy for treatment of Helicobacter pylori(H. pylori) infection and identify predictors of failed eradication.METHODS Patients with H. pylori infection treated with furazolidone, amoxicillin, bismuth, and proton pump inhibitor therapy(January 2015 to December 2015) who received the ^(13)C-urea breath test > 4 wk after treatment were evaluated. Demographic and clinical data including prior H. pylori treatment attempts, medication adherence, alcohol and cigarette consumption during therapy, and treatment-related adverse events were recorded by reviewing medical records and telephone surveys. H. pylori eradication rates for overall and subgroups were evaluated. Multivariate analysis was performed to identify independent predictors of failed H. pylori eradication.RESULTS Of the 992 patients treated and retested for H. pylori infection, the overall eradication rate was 94.5% [95% confidence interval(CI): 94.1%-95.9%]. H. pylori eradication rate of primary therapy was 95.0%(95%CI: 93.5%-96.5%), while that of rescue therapy was 91.3%(95%CI: 86.8%-95.8%). Among the 859 patients who completed the study protocol, 144(17%) reported treatment-related adverse events including 24(3%) leading to premature discontinuation. On multivariate analysis, poor medication adherence [adjusted odds ratio(AOR) = 6.7, 95%CI: 2.8-15.8], two or more previous H. pylori treatments(AOR = 7.4, 95%CI: 2.2-24.9), alcohol consumption during therapy(AOR = 4.4, 95%CI: 1.5-12.3), and possibly smoking during therapy(AOR = 1.9, 95%CI: 0.9-4.3) were associated with failed H. pylori eradication. CONCLUSION Furazolidone-and amoxicillin-based quadruple therapy for H. pylori infection in an area with a high prevalence of clarithromycin resistance demonstrated high eradication rates as primary and rescue therapies with a favorable safety profile. Patient education targeting abstinence from alcohol during therapy and strict medication adherence may further optimize H. pylori eradication.
文摘AIM: To compare the effectiveness of standard triple, bismuth pectin quadruple and sequential therapies for Helicobacter pylori (H. pylori ) eradication in a randomized, double-blinded, comparative clinical trial in China. METHODS: A total of 215 H. pylori -positive patients were enrolled in the study and randomly allocated into three groups: group A (n = 72) received a 10-d bismuth pectin quadruple therapy (20 mg rabeprazole bid , 1000 mg amoxicillin bid , 100 mg bismuth pectin qid , and 500 mg levofloxacin qd ); group B (n = 72) received the sequential therapy (20 mg omeprazole bid , 1000 mg amoxicillin bid , in 5 d, followed by 20 mg omeprazole bid , 500 mg tinidazole bid , 500 mg clarithromycin bid , for another 5 d); group C (n = 71) received a standard 1-wk triple therapy (20 mg omeprazole bid , 1000 mg amoxicillin bid , 500 mg clarithromycin bid ). After all these treatments, 20 mg omeprazole bid was administrated for 3 wk. H. pylori status was assessed by histology, 13C-urea breath test and rapid urease test at baseline and 4-6 wk after completion of treatment. Ulcer cicatrization was assessed by gastroscopy. χ 2 test (P < 0.05) was used to compare the eradication rates and ulcer cicatrisation rates among the three groups. RESULTS: The eradication rate was 83.33% (60/72) in group A, 88.89% (64/72) in group B, and 80.56% (58/71) in group C. The ulcer cicatrisation rate was 86.44% (51/59) in group A, 90.16% (55/61) in group B, and 84.91% (45/53) in group C. The sequential therapy yielded a higher eradication rate and ulcer cicatrisation rate than the standard triple and bismuth pectin quadruple therapies. Statistically, the eradication rate of group B was significantly different from groups A and C (P < 0.05), but the difference of ulcer cicatrisation rate and side effects was not statistically significant among the three groups (P > 0.05). The three protocols were generally well tolerated. CONCLUSION: The sequential therapy has achieved a significantly higher eradication rate, and is a more suitable first-line alternative protocol for anti-H. pylori infection compared with the standard triple and bismuth pectin quadruple therapies.
文摘At present, the best rescue therapy for Helicobacter pylori(H. pylori) infection following failure of firstline eradication remains unclear. The Maastricht Ⅴ/Florence Consensus Report recommends bismuth quadruple therapy, or fluoroquinolone-amoxicillin triple/quadruple therapy as the second-line therapy for H. pylori infection. Meta-analyses have shown that bismuth quadruple therapy and levofloxacin-amoxicillin triple therapy have comparable eradication rates, while the former has more adverse effects than the latter. There are no significant differences between the eradication rates of levofloxacin-amoxicillin triple and quadruple therapies. However, the eradication rates of both levofloxacin-containing treatments are suboptimal. An important caveat of levofloxacin-amoxicillin triple or quadruple therapy is poor eradication efficacy in the presence of fluoroquinolone resistance. High-dose dual therapy is an emerging second-line therapy and has an eradication efficacy comparable with levofloxacinamoxicillin triple therapy. Recently, a 10-d tetracyclinelevofloxacin(TL) quadruple therapy comprised of a proton pump inhibitor, bismuth, tetracycline and levofloxacin has been developed, which achieves a markedly higher eradication rate compared with levofloxacin-amoxicillin triple therapy(98% vs 69%) in patients with failure of standard triple, bismuth quadruple or non-bismuth quadruple therapy. The present article reviews current second-line anti-H. pylori regimens and treatment algorisms. In conclusion, bismuth quadruple therapy, levofloxacin-amoxicillin triple/quadruple therapy, high-dose dual therapy and TL quadruple therapy can be used as second-line treatment for H. pylori infection. Current evidence suggests that 10-d TL quadruple therapy is a simple and effective regimen, and has the potential to become a universal rescue treatment following eradication failure by all firstline eradication regimens for H. pylori infection.
