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Vonoprazan-amoxicillin dual therapy for Helicobacter pylori eradication in Chinese population:A prospective,multicenter,randomized,two-stage study

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World Journal of gastroenterology 2024年第27期30卷 3304-3313页

作者： Xue-Ping Huang Zhi-Hui Lin Yi-Juan Liu Shao-Wei Lin Yan-Feng Shao Feng Qiu Qing-Wu Qiu Zhang-Kun Xu Jin-Xian Chen Liang-Huo Chen Zhen-Qun Lin Wen-Hua Dai Ming-Qing Zhang Qi Jiang Zhong-Qin Xiao Xian-Xing Cheng Xiang-Fei Zhang Wen-Bin You Wei Chen Long-Qin Li Wei-Xing Lin Yong-Fu Wang Fu-Jin Lai Long-Qun Chen Zhong-Hua Huang Wen-Qi Zheng Jin-Qi Wei department of gastroenterology Shengli Clinical Medical College of Fujian Medical UniversityFuzhou 350000Fujian ProvinceChina department of gastroenterology Fujian Provincial HospitalFuzhou 350001Fujian ProvinceChina department of gastroenterology The First Affiliated Hospital of Fujian Medical UniversityFuzhou 350000Fujian ProvinceChina School of Public Health Fujian Medical UniversityFuzhou 350000Fujian ProvinceChina department of gastroenterology The Third People’s Hospital of Fujian ProvinceFuzhou 350000Fujian ProvinceChina department of gastroenterology Fujian Provincial Hospital North Brance Fujian Provincial Geriatric HospitalFuzhou 350000Fujian ProvinceChina department of gastroenterology Xiaoao HospitalFuzhou 350000Fujian ProvinceChina department of gastroenterology The General Hospital of Fujian Energy GroupFuzhou 350000Fujian ProvinceChina department of gastroenterology The Second Hospital of ZhangzhouZhangzhou 363000Fujian ProvinceChina department of gastroenterology Anxi Country HospitalQuanzhou 362000Fujian ProvinceChina department of gastroenterology Zhangzhou Municipal Hospital of TCMZhangzhou 363000Fujian ProvinceChina department of gastroenterology Zhangpu HospitalZhangzhou 363000Fujian ProvinceChina department of gastroenterology The Affiliated Dongnan Hospital of Xiamen UniversityZhangzhou 363000Fujian ProvinceChina department of gastroenterology First Hospital of Nanping CityNanping 353000Fujian ProvinceChina department of gastroenterology Fujian Nanping Second HospitalNanping 353000Fujian ProvinceChina department of gastroenterology Wuyishan Municipal HospitalNanping 353000Fujian ProvinceChina department of gastroenterology Fuzhou Changle District HospitalFuzhou 350000Fujian ProvinceChina department of gastroenterology Changle City Second HospitalFuzhou 350000Fujian ProvinceChina department of gastroenterology Jinjiang Municipal HospitalQuanzhou 362000Fujian ProvinceChina department of gastroenterology Fuding Hospital Affiliated to Fuj

BACKGROUND The efficacy of Vonoprazan-amoxicillin dual therapy(VAT)in the treatment of Helicobacter pylori(***)is *** To evaluate the efficacy of VAT in the Chinese *** This prospective,multicenter,randomized,open-label,and two-stage study was conducted at 23 centers in Fujian,China(May 2021-April 2022).***-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)*** primary endpoint was the *** eradication *** secondary endpoint was the frequency of adverse *** study was registered with the Chinese Clinical Trial Registry,*** In the first stage,VAT-7 and BQT-V groups were selected for early termination because less than 23 among 28 cases were *** 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 *** 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 ***-infected patients in *** XP et *** for *** eradication.

关键词： Helicobacter pylori Vonoprazan Amoxicillin Dual therapy Bismuth quadruple therapy

Anti-vascular endothelial growth factor drugs combined with laser photocoagulation maintain retinal ganglion cell integrity in patients with diabetic macular edema: study protocol for a prospective, non-randomized, controlled clinical trial

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Neural Regeneration Research 2024年第4期19卷 923-928页

作者： Xiangjun Li Chunyan Li Hai Huang Dan Bai Jingyi Wang Anqi Chen Yu Gong Ying Leng department of Ophthalmology Affiliated Hospital of Beihua University department of endocrinology Affiliated Hospital of Beihua University

The integrity of retinal ganglion cells is tightly associated with diabetic macular degeneration that leads to damage and death of retinal ganglion cells,affecting *** major clinical treatments for diabetic macular edema are anti-vascular endothelial growth factor drugs and laser ***,although the macular thickness can be normalized with each of these two therapies used alone,the vision does not improve in many *** might result from the incomplete recovery of retinal ganglion cell ***,a prospective,non-randomized,controlled clinical trial was designed to investigate the effect of anti-vascular endothelial growth factor drugs combined with laser photocoagulation on the integrity of retinal ganglion cells in patients with diabetic macular edema and its relationship with vision *** this trial,150 patients with diabetic macular edema will be equally divided into three groups according to therapeutic methods,followed by treatment with anti-vascular endothelial growth factor drugs,laser photocoagulation therapy,and their *** patients will be followed up for 12 *** primary outcome measure is retinal ganglion cell-inner plexiform layer thickness at 12 months after *** secondary outcome measures include retinal ganglion cell-inner plexiform layer thickness before and 1,3,6,and 9 months after treatment,retinal nerve fiber layer thickness,best-corrected visual acuity,macular area thickness,and choroidal thickness before and 1,3,6,9,and 12 months after *** measure is the incidence of adverse events at 1,3,6,9,and 12 months after *** study protocol hopes to validate the better efficacy and safety of the combined treatment in patients with diabetic macula compared with the other two monotherapies alone during the 12-month follow-up *** trial is designed to focus on clarifying the time-effect relationship between imaging measures related to the integrity of retinal

关键词： choroidal thickness diabetic macular edema laser photocoagulation retinal ganglion cell-inner plexiform layer thickness retinal ganglion cells retinal nerve fiber layer thickness thickness of the macular area vascular endothelial growth factor visual acuity

A BBS4 mutation causes autosomal dominant polycystic liver disease

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Genes & Diseases 2024年第1期11卷 72-75页

作者： Yalu Cui Wenping Xu Jinpei Liu Shuqing Liu Wei Huang Yihai Shi Xin Zhang Cuihua Lu Weifen Xie department of gastroenterology Changzheng HospitalNaval Medical UniversityShanghai 200003China department of gastroenterology Gongli Hospital of Shanghai Pudong New AreaShanghai 200135China department of gastroenterology Affiliated Hospital of Nantong UniversityNantong UniversityNantongJiangsu 226001China

Autosomal dominant polycystic liver disease(ADPLD)refers to a condition characterized by the presence of numerous cholangiocytes-lined and fluid-filled cysts in the liver and the absence of polycystic kidney disease.1 Although patients with ADPLD may be asymptomatic,some patients suffer from abdominal pain,gastroesophageal reflux,and nausea,because of hepatomegaly.

关键词： liver polycystic patients

Development and validation of a novel criterion of histologic healing in ulcerative colitis defined by inflammatory cell enumeration in lamina propria mucosa:A multicenter retrospective cohort in China

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Chinese Medical Journal 2024年第11期137卷 1316-1323页

作者： Han Gao Kangsheng Peng Yadi Shi Shenshen Zhu Ruicong Sun Chunjin Xu Ping Liu Zhi Pang Lanxiang Zhu Weichang Chen Baisui Feng Huili Wu Guangxi Zhou Mingsong Li Junxiang Li Baijing Ding Zhanju Liu Center for IBD Research and department of gastroenterology Shanghai Tenth People’s HospitalTongji University School of MedicineShanghai 200085China Clinical Medicine Sanquan College of Xinxiang Medical UniversityXinxiangHenan 453003China department of gastroenterology The First People’s Hospital of Shangqiu City Affiliated to Xinxiang Medical UniversityShangqiuHenan 476100China department of gastroenterology Wuhu First People’s HospitalWuhuAnhui 241000China department of gastroenterology Suzhou Municipal Hospital Affiliated to Nanjing Medical UniversitySuzhouJiangsu 215008China department of gastroenterology The First Affiliated Hospital of Soochow UniversitySuzhouJiangsu 251006China department of gastroenterology The Second Affiliated Hospital of Zhengzhou UniversityZhengzhouHenan 450014China department of gastroenterology Zhengzhou Central Hospital Affiliated to Zhengzhou UniversityZhengzhouHenan 450000China department of gastroenterology The Affiliated Hospital of Jining Medical CollegeJiningShandong 272004China department of gastroenterology The Third Affiliated Hospital of Guangzhou Medical UniversityGuangzhouGuangdong 510140China department of gastroenterology Dongfang Hospital of Beijing University of Chinese MedicineBeijing 100078China

Background:Histological healing is closely associated with improved long-term clinical outcomes and lowered relapses in patients with ulcerative colitis(UC).Here,we developed a novel diagnostic criterion for assessing histological healing in UC ***:We conducted a retrospective cohort study in UC patients,whose treatment was iteratively optimized to achieve mucosal healing at Shanghai Tenth People’s Hospital of Tongji University from January 2017 to May *** identified an inflammatory cell enumeration index(ICEI)for assessing histological healing based on the proportions of eosinophils,CD177^(+)neutrophils,and CD40L^(+)T cells in the colonic lamina propria under high power field(HPF),and the outcomes(risks of symptomatic relapses)of achieving histological remission *** histological inflammation using Kaplan-Meier *** reliability and inter-reader reliability were evaluated by each *** relationships to the changes in the Nancy index and the Geboes score were also assessed for *** ICEI was further validated in a new cohort of UC patients from other nine university ***:We developed an ICEI for clinical diagnosis of histological healing,i.e.,Y=1.701X_(1)+0.758X_(2)+1.347X_(3)-7.745(X_(1),X_(2),and X_(3)represent the proportions of CD177^(+)neutrophils,eosinophils,and CD40L^(+)T cells,respectively,in the colonic lamina propria under HPF).The receiver operating characteristics curve(ROC)analysis revealed that Y<-0.391 was the cutoff value for the diagnosis of histological healing and that an area under the curve(AUC)was 0.942(95%confidence interval[CI]:0.905-0.979)with a sensitivity of 92.5%and a specificity of 83.6%(P<0.001).The intraclass correlation coefficient(ICC)for the intrareader reliability was 0.855(95%CI:0.781-0.909),and ICEI had good inter-reader reliability of 0.832(95%CI:0.748-0.894).During an 18-month follow-up,patients with histological healing had a substantially better outcome com

关键词： Ulcerative colitis Histological healing Inflammatory cell enumeration index Prognosis

Risk factors for lymph node metastasis in superficial esophageal squamous cell carcinoma

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World Journal of gastroenterology 2024年第13期30卷 1810-1814页

作者： Yan-Bo Yu department of gastroenterology Laboratory of Translational GastroenterologyQilu HospitalShandong UniversityJinan 250012Shandong ProvinceChina

In this editorial,we comment on the article by Wang et al published in the recent issue of the World Journal of gastroenterology in *** focused on identifying risk factors for lymph node metastasis(LNM)in superficial esophageal squamous cell carcinoma(SESCC)patients and how to construct a simple and reliable clinical prediction model to assess the risk of LNM in SESCC patients,thereby helping to guide the selection of an appropriate treatment *** current standard treatment for SESCC is radical esophagectomy with lymph node ***,esophagectomy is associated with considerable morbidity and *** resection(ER)offers a safer and less invasive alternative to surgical resection and can enable the patient's quality of life to be maintained while providing a satisfactory ***,since ER is a localized treatment that does not allow for lymph node dissection,the risk of LNM in SESCC limits the effectiveness of *** LNM status can aid in determining whether patients with SESCC can be cured by ER without the need for additional *** studies have shown that tumor size,macroscopic type of tumor,degree of differentiation,depth of tumor invasion,and lymphovascular invasion are factors associated with LNM in patients with *** addition,tumor budding is commonly associated with LNM,recurrence,and distant metastasis,but this topic has been less covered in previous *** comprehensively evaluating the above risk factors for LNM,useful evidence can be obtained for doctors to select appropriate treatments for SESCC patients.

关键词： Superficial esophageal squamous cell carcinoma Endoscopic resection Lymph node metastasis Risk factors Tumor budding Predictive model

Insights into the role of RNA m^(6)A modification in the metabolic process and related diseases

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Genes & Diseases 2024年第4期11卷 270-295页

作者： Haiming Hu Zhibin Li Xia Xie Qiushi Liao Yiyang Hu Chunli Gong Nannan Gao Huan Yang Yufeng Xiao Yang Chen department of gastroenterology Xinqiao HospitalArmy Medical UniversityChongqing 400037China

According to the latest consensus,many traditional diseases are considered meta-bolic diseases,such as cancer,type 2 diabetes,obesity,and cardiovascular ***,metabolic diseases are increasingly prevalent because of the ever-improving living standards and have become the leading threat to human *** therapy methods have been applied to treat these diseases,which improves the quality of life of many patients,but the overall effect is still ***,intensive research on the metabolic process and the pathogenesis of metabolic diseases is imperative.N6-methyladenosine(m^(6)A)is an important modification of eukaryotic *** is a critical regulator of gene expression that is involved in different cellular functions and physiological *** studies have indi-cated that m^(6)A modification regulates the development of many metabolic processes and metabolic *** this review,we summarized recent studies on the role of m^(6)A modifica-tion in different metabolic processes and metabolic ***,we highlighted the potential m^(6)A-targeted therapy for metabolic diseases,expecting to facilitate m^(6)A-targeted strategies in the treatment of metabolic diseases.

关键词： Cancer mm^(6)A-targeted therapy Metabolic disease Metabolism N6-methyladenosine

Optimized sequential therapy vs 10- and 14-d concomitant therapy for eradicating Helicobacter pylori: A randomized clinical trial

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World Journal of gastroenterology 2024年第6期30卷 556-564页

作者： Hassan Seddik Jihane Benass Sanaa Berrag Asmae Sair Reda Berraida Hanae Boutallaka department of gastroenterology II Mohammed V Military Teaching Hospital of RabatRabat 10100Morocco department of gastroenterology Mohammed V University in RabatRabat 10100Morocco department of gastroenterology I Mohammed V Military Teaching Hospital of RabatRabat 10100Morocco

BACKGROUND A cure for Helicobacter pylori(***)remains a problem of global *** prevalence of antimicrobial resistance is widely rising and becoming a challenging issue *** sequential therapy seems to be one of the most attractive strategies in terms of efficacy,tolerability and *** 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 *** open-label prospective study randomized 328 patients with confirmed *** 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 *** eradication rate was determined 4 to 6 wk after the end of treatment,using the 13C urea breath *** 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)***,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),*** 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 *** The optimized 14-

关键词： Helicobacter pylori Quadruple therapy Sequential Proton-pump inhibitor Optimization

Effect and Safety of Herbal Medicine Foot Baths in Patients with Diabetic Peripheral Neuropathy:A Multicenter Double-Blind Randomized Controlled Trial

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Chinese Journal of Integrative Medicine 2024年第3期30卷 195-202页

作者： HUANG Hao-yue LIN Yu-ping WEI Hua FU Yu ZHOU Yue-hong FANG Zhao-hui QIU Xiao-tang WANG Mei LI Qing-bo LI Shan-shan WANG Shi-dong DAI Fang LIU Zhen-jie ZHAO Ling WEN Jian-xuan WU Li-yan ZENG Hui-yan ZHANG Jin-ming LU Qi-yun HE Liu SONG Wei SUN Lu LUO Lu-lu HE Jia-li XIE Wen-wen LIANG Qing-shun HUANG Yuan ZHU Sheng-ling LONG Jie-er GAO Zhi-juan WEN Ze-huai LI Chun-ji OUYANG Wen-wei LI Geng WU Ming-hui LI An-xiang HUANG Jin-zhu Sanjoy K Paul TANG Xian-yu FAN Guan-jie department of endocrinology Guangdong Provincial Hospital of Chinese MedicineGuangzhou510120China The Second Clinical College of Guangzhou University of Chinese Medicine Guangzhou510120China department of endocrinology The Second Affiliated Hospital of Guangzhou University of Chinese MedicineGuangzhou510120China Guangdong Provincial Academy of Chinese Medical Sciences Guangzhou510120China department of endocrinology The First Affiliated Hospital of Henan University of Chinese MedicineZhengzhou450000China department of endocrinology Liuyang Hospital of Chinese MedicineChangsha410000China department of endocrinology The First Affiliated Hospital of Anhui University of Chinese MedicineHefei230000China department of endocrinology Hainan Provincial Hospital of Traditional Chinese MedicineHaikou570100China department of endocrinology The Affiliated Hospital of Liaoning University of Traditional Chinese MedicineShenyang110000China department of Geriatric Luoyang No.1 Hospital of Traditional Chinese MedicineLuoyangHenan Province471000China department of endocrinology The Second Affiliated Hospital of Guizhou University of Traditional Chinese MedicineGuiyang550000China department of endocrinology Beijing University of Chinese Medicine Affiliated Dongzhimen HospitalBeijing100000China department of endocrinology The First Affiliated Hospital of Guizhou University of Traditional Chinese MedicineGuiyang550000China Melbourne EpiCentre The University of Melbourne and Melbourne HealthMelbourne3013Australia

Objective:To evaluate the effect and safety of foot baths with Tangbi Waixi Decoction(TW)in treating patients with diabetic peripheral neuropathy(DPN).Methods:It is a multicenter double-blinded randomized controlled *** with DPN were recruited between November 18,2016 and May 30,2018 from 8 hospitals in *** patients received basic treatments for glycemic *** received foot baths with TW herbal granules either 66.9 g(intervention group)or 6.69 g(control group)for 30 min once a day for 2 weeks and followed by a 2-week rest,as a therapeutic *** the Toronto Clinical Scoring System total score(TCSS-TS)6 points,the patients received a total of 3 therapeutic courses(for 12 weeks)and were followed up for 12 *** primary outcome was change in TCSS-TS score at 12 and 24 *** outcomes included changes in bilateral motor nerve conduction velocity(MNCV)and sensory nerve conduction velocity(SNCV)of the median and common peroneal *** was also ***:Totally 632 patients were enrolled,and 317 and 315 were randomized to the intervention and control groups,*** the 12-week intervention,patients in both groups showed significant declines in TCSSTS scores,and significant increases in MNCV and SNCV of the median and common peroneal nerves compared with pre-treatment(P0.05),and no serious adverse event was related with ***:Treatment of TW foot baths was safe and significantly benefitted patients with DPN.A low dose of TW appeared to be more effective than a high dose.(Registry *** CTR-IOR-16009331)

关键词： diabetic peripheral neuropathy herbal medicine foot baths Chinese medicine randomized controlled trial Tangbi Waixi Decoction

Treat to target in Crohn’s disease:A practical guide for clinicians

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World Journal of gastroenterology 2024年第1期30卷 50-69页

作者： Ashish R Srinivasan department of gastroenterology Austin HealthVictoriaMelbourne 3083Australia department of gastroenterology Eastern HealthVictoriaMelbourne 3128Australia department of Medicine University of MelbourneVictoriaMelbourne 3052Australia

A treat-to-target(T2T)approach applies the principles of early intervention and tight disease control to optimise long-term outcomes in Crohn's *** Selecting Therapeutic Targets in Inflammatory Bowel Disease(STRIDE)-II guidelines specify short,intermediate,and long-term treatment goals,documenting specific treatment targets to be achieved at each of these *** appraisal of Crohn’s disease activity against pre-defined treatment targets at these timepoints remains central to determining whether current therapy should be continued or *** treatment targets in Crohn’s disease comprise combination clinical and patient-reported outcome remission,in conjunction with biomarker normalisation and endoscopic *** the STRIDE-II guidelines endorse the pursuit of endoscopic healing,clinicians must consider that this may not always be appropriate,acceptable,or achievable in all *** underscores the need to engage patients at the outset in an effort to personalise care and individualise treatment *** use of non-invasive biomarkers such as faecal calprotectin in conjunction with cross-sectional imaging techniques,particularly intestinal ultrasound,holds great promise;as do emerging treatment targets such as transmural *** randomised clinical trials,namely,CALM and STARDUST,have evaluated the efficacy of a T2T approach in achieving endoscopic endpoints in patients with Crohn’s *** from these studies reflect that patient subgroups and Crohn’s disease characteristics likely to benefit most from a T2T approach,remain to be ***,outside of clinical trials,data pertaining to the real-world effectiveness of a T2T approach remains scare,highlighting the need for pragmatic real-world *** the obvious promise of a T2T approach,a lack of guidance to support its integration into real-world clinical practice has the potential to limit its *** highlights the need to describe st

关键词： Treat to target Inflammatory bowel disease Crohn’s disease Treatment targets Endoscopic remission Transmural healing Time to response Intestinal ultrasound