Comparison of vonoprazan-based dual therapy with vonoprazan-based bismuth quadruple therapy for treatment-naive patients with Helicobacter pylori infection: A propensity score matching analysis

Vonoprazan, a novel acid suppressant and the first potassium-competitive acid blocker, has the potential to enhance the eradication rate of Helicobacter pylori due to its robust acid-suppressing capacity. This study aimed to compare the efficacy of vonoprazan-based dual therapy (vonoprazan-amoxicillin, VA) with vonoprazan-based bismuth quadruple therapy (VBQT) as a first-line treatment for H pylori infection. This retrospective single-center non-inferiority study was conducted in China. Treatment-naive H pylori-positive patients aged 18 to 80 received one of the 2 treatment regimens at our center. The VA group received vonoprazan 20 mg twice daily and amoxicillin 1000 mg 3 times daily for 14 days, whereas the VBQT group received vonoprazan 20 mg, amoxicillin 1000 mg, clarithromycin 500 mg, and bismuth potassium citrate 220 mg twice daily for 14 days. The eradication rate was evaluated 4 to 6 weeks after treatment using the carbon-13/14 urea breath test. Propensity score matching was used to analyze eradication rates, adverse events (AEs), and patient compliance between the 2 groups. Initially, 501 patients were included, and after propensity score analysis, 156 patients were selected for the study. Intention-to-treat analysis showed eradication rates of 87.2% (95% CI, 79.8-94.6%) for the VA group and 79.5% (95% CI, 70.5-88.4%) for the VBQT group (P = .195). Per-protocol analysis demonstrated rates of 94.4% (95% CI, 89.2-99.7%) for the VA group and 96.8% (95% CI, 92.4-100%) for the VBQT group (P = .507). Non-inferiority was confirmed between the 2 groups, with P values < .025. The VA group showed a lower rate of AEs (10.3% vs 17.9%, P = .250) compared to the VBQT group. There were no significant differences in patient compliance between the 2 groups. In treatment-naive patients with H pylori infection, both the 14-day VA and VBQT regimens demonstrated comparable efficacy, with excellent eradication rates. Moreover, due to reduced antibiotic usage, lower rate of AEs, and lower costs, VA dual therapy should be prioritized.

[Investigation and analysis of airborne allergenic pollen in 4 districts and 5 counties of Hohhot City]

Objective: To investigate the species, concentration and seasonal trends of main airborne allergenic pollen in 4 districts and 5 counties of Hohhot City. Methods: The Department of allergy, Beijing Shijitan Hospital Affiliated to Capital Medical University conducted a cross-sectional study about monitoring the airborne allergenic pollen from August 1, 2021 to July 31, 2022 by the gravitational method in 4 districts and 5 counties of Hohhot City, which include Yuquan District, Xincheng District, Huimin District, Saihan District, Tuoketuo County, Helingeer County, Tumotezuoqi County, Wuchuan County and Qingshuihe County. Daily pollens were counted and identified by optical microscopy, and the data were analyzed. Results: The airborne allergenic pollen was collected every month all year round in 4 districts and 5 counties of Hohhot city. Through the whole year of the total quantity of pollens ranged from 24 850 to 50 154 grains per 1 000 mm2 and two peaks of pollen concentration in air were observed,which happened in spring (from March to May) and in summer and autumn (from July to September). In spring, the main pollens were tree pollens, which principally distributed in Populus pollen (18.29%), Ulmus pollen (8.36%), Pinus pollen (6.20%), Cupressaceae pollen (5.23%), Betulaceae pollen (2.73%), Salix pollen (1.80%) and Quercus pollen (1.16%). In summer and autumn, the main pollens were weed pollens, which mainly included Artemisia pollen (42.73%), Chenopodiaceae pollen or Amaranthaceae pollen (7.46%), Poaceae pollen (2.26%), Humulus pollen or Cannabis pollen (0.60%). Conclusion: There were two peaks of main airborne allergenic pollen in 4 districts and 5 counties of Hohhot City. In the spring peak of pollen, the main airborne pollens were tree pollens. In the summer and autumn peak of pollen, the main airborne pollens were weed pollens. The Artemisia pollen was the most major airborne pollen in this area.

Pediatric case of colonic perivascular epithelioid cell tumor complicated with intussusception and anal incarceration: A case report

BACKGROUND

Perivascular epithelioid cell tumor (PEComa) represents a group of rare mesenchymal tumors. PEComa can occur in many organs but is rare in the colorectum, especially in children. Furthermore, PEComa is a rare cause of intussusception, the telescoping of a segment of the gastrointestinal tract into an adjacent one. We describe a rare case of pediatric PEComa complicated with intussusception and anal incarceration, and conduct a review of the current literature.

CASE SUMMARY

A 12-year-old girl presented with abdominal pain and abdominal ultrasound suggested intussusception. Endoscopic direct-vision intussusception treatment and colonoscopy was performed. A spherical tumor was discovered in the transverse colon and removed by surgery. Postoperative pathologic analyses revealed that the tumor volume was 5.0 cm × 4.5 cm × 3.0 cm and the tumor tissue was located in the submucosa of the colon, arranged in an alveolar pattern. The cell morphology was regular, no neoplastic necrosis was observed, and nuclear fission was rare. The immunohistochemical staining results were as follows: Human melanoma black 45 (HMB 45) (+), cluster of differentiation 31 (CD31) (+), cytokeratin (-), melanoma-associated antigen recognized by T cells (-), smooth muscle actin (-), molleya (-), desmin (-), S-100 (-), CD117 (-), and Ki67 (positive rate in hot spot < 5%). Combined with the results of pathology and immunohistochemistry, we diagnosed the tumor as PEComa. Postoperative recovery was good at the 4 mo follow-up.

CONCLUSION

The diagnosis of PEComa mainly depends on pathology and immunohistochemistry. Radical resection is the preferred treatment method.

[Inhibition of the TGF-β/Smad3 signaling pathway by SB431542: A study of the intervention effect of SB431542 on silicotic fibrosis in rats]

Objective: To investigate the intervention effect of SB431542, which inhibits the TGF-β/Smad3 signaling pathway, on silicotic fibrosis in rats. Methods: A total of 40 specific pathogen-free Sprague-Dawley rats were divided into normal saline control group, model group, SB431542 inhibitor group, and SB431542 inhibitor control group using a random number table, with 10 rats in each group. All rats except those in the normal saline control group were given non-exposed single intratracheal instillation of free silicon dioxide dust suspension 1 mL (50 mg/mL) ; the rats in the SB431542 inhibitor group were given intraperitoneal injection of SB431542 (5 mg/kg) on days 7 and 30 after dust exposure, those in the SB431542 inhibitor control group were given intraperitoneal injection of SB431542 cosolvent (5 mg/kg) on days 7 and 30 after dust exposure, and those in the normal saline control group were given intratracheal instillation of an equal volume of normal saline (5 mg/kg). On day 60 after dust exposure, the paraffin-embedded section of the right upper lobe of lung was collected for HE staining; the left upper lobe of lung was collected to measure the mRNA levels of fibronectin (FN) , collagen type I (COL-I) , and collagen type III (COL-III) by quantitative real-time PCR; the right inferior lobe of lung was collected to measure the protein levels of FN, COL-I, COL-III, phosphorylated Smad3 (p-Smad3) , and Smad3. Results: Compared with the normal saline control group, the model group had nodules with various sizes in lung tissue, with rupture of some alveolar septa, emphysema changes, and pulmonary interstitial fibrosis, as well as significant increases in the mRNA expression of FN, COL-I, and COL-III and the protein expression of FN, COL-I, COL-III, p-Smad3, and Smad3 in lung tissue (P<0.05) . Compared with the SB431542 inhibitor control group, the SB431542 inhibitor group had a relatively complete structure of lung tissue without marked nodules and with a small amount of exudate in alveolar space and the lumen of bronchioles, as well as significant reductions in the mRNA expression of FN, COL-I, and COL-III and the protein expression of FN, COL-I, COL-III, p-Smad3, and Smad3 in lung tissue (P<0.05) . There were no significant differences in the mRNA expression of FN, COL-I, and COL-III and the protein expression of FN, COL-I, COL-III, p-Smad3, and Smad3 between the model group and the SB431542 inhibitor control group (P>0.05) . Conclusion: SB431542 exerts an intervention effect on silicotic fibrosis by blocking the TGF-β/Smad3 signaling pathway and reducing the expression of the downstream fibrosis factors FN, COL-I, and COL-III.

[Screening of serum biomarkers by isobaric tags for relative and absolute quantitation in patients with HBV-related acute-on-chronic liver failure]

Objective: To investigate the screening of serum biomarkers in patients with HBV-related acute-on-chronic liver failure (HBV-ACLF) by isobaric tags for relative and absolute quantitation (iTRAQ). Methods: Gel electrophoresis was used to isolate and remove high-abundant proteins. Each group of peptides was labeled by the iTRAQ reagents and then tested with an UltiMateTM 3000 nanoliter high-performance liquid chromatograph, and a Q-Exactive tandem mass spectrometer. The Protein Discovery software was used to analyze mass spectrometry data and perform bioinformatic analysis for differentially expressed proteins. Results: Ten samples each were included in the HBV-ACLF group and the chronic hepatitis B (CHB) group, and six samples each were included in the HBV-ACLF survival group and the HBV-ACLF death group. Compared with the CHB group, the HBV-ACLF group had 43 differentially expressed proteins, among which 34 were downregulated and 9 were upregulated. Compared with the HBV-ACLF survival group, the HBV-ACLF death group had 33 differentially expressed proteins, among which 18 were upregulated and 15 were downregulated. Conclusion: Keratin,α1-acid glycoprotein, and zinc-α₂-glycoprotein identified in the serum may be used as potential biomarkers for predicting the prognosis of patients with HBV-ACLF.

[Prevalence of deep venous thrombosis in burn patients and its influencing factors]

OBJECTIVE

To investigate the prevalence of deep venous thrombosis (DVT) in burn patients, and to explore its influencing factors.

METHODS

Clinical data of 2 506 burn patients admitted to our ward from January 2009 to January 2014, conforming to the study criteria, were retrospectively analyzed. Patients were divided into DVT group (n=26) and non-DVT group (n=2 480) according to whether or not DVT occurred during hospitalization. The incidence of DVT was calculated. The diagnosis time and type of DVT were recorded. The data of gender, age, depth of burn, total burn area, location of injury, cause of injury, infection of wound, venous transfusion of fluid (hypertonic solution and blood), location of intravenous catheterization, skin grafting, timing of first skin grafting after injury, D-dimer, bedridden duration after injury among patients between two groups were compared with chi-square test and Wilcoxon test. Indexes with statistically significant differences between two groups were selected, and they were processed with multivariate logistic stepwise regression analysis to screen the independent risk factors of DVT.

RESULTS

(1) The incidence of DVT was 1.04% (26/2 506). The diagnosis time of DVT was 16-62(40±12)d, and patients diagnosed as having DVT after the 20th day post injury accounted for 92.3% (24/26). All DVT occurred in lower limbs, with 1 case of central type, 24 cases of peripheral type, and 1 case of mixed type. (2) There were no statistically significant differences in gender, location of injury (upper limbs, trunk, head and face), cause of injury, jugular vein catheterization, skin grafting, and timing of first skin grafting after injury among patients between two groups (with χ(2) values from 1.853 to 3.742, Z=3.342, P values above 0.05). There were statistically significant differences in age, depth of burn, total burn area, burn in lower limbs, infection of wound, venous transfusion of hypertonic solution and blood, femoral vein and subclavian vein catheterization, D-dimer, and bedridden duration after injury among patients between two groups (with χ(2) values from 4.569 to 11.324, Z values respectively 7.357 and 7.012, P<0.05 or P<0.01). (3) Age, total burn area, burn in lower limbs, infection of wound, and D-dimer were the independent risk factors of DVT (with odds ratio respectively 2.904, 2.655, 3.574, 2.786, 3.142, 95% confidence interval respectively 1.504-7.652, 1.368-6.594, 1.958-8.511, 1.459-7.001, 1.922-8.062, P values below 0.05).

CONCLUSIONS

The incidence of DVT in burn patients is relatively low; it is diagnosed after the 20th day post injury in most patients, and the overwhelming majority is the peripheral type. Age, total burn area, burn in lower limbs, infection of wound, and D-dimer are the independent risk factors of DVT in burn patients, with which its occurrence could be predicted.

Upregulation of microRNA-132 in gastric cancer promotes cell proliferation via retinoblastoma 1 targeting

Gastric cancer is one of the most frequent malignancies and a leading cause of cancer-related mortality worldwide. MicroRNAs (miRs), a class of small non‑coding RNAs, have been shown to be critical in tumorigenesis. In the present study, the expression levels of miR‑132 were analyzed in gastric cancer samples using quantitative reverse transcription‑polymerase chain reaction. In addition, the cell viability, proliferation and invasion abilities were determined in two gastric cancer cell lines, NCI‑N87 and MGC80‑3, that were transfected with miR‑132 mimics or antisense oligos. It was found that miR‑132 expression was significantly upregulated in gastric cancer tissues when compared with adjacent non‑cancerous tissues. At the molecular level, the data demonstrated that miR‑132 inhibits the protein levels of retinoblastoma 1 (RB1) by targeting the 3'‑untranslated region. Furthermore, reintroduction of RB1 markedly attenuated the proliferative roles of miR‑132 overexpression. Therefore, the present results indicate that the miR‑132/RB1 regulatory axis may be a potential novel diagnostic and therapeutic target for the treatment of gastric cancer.

Rat Dlx5 is expressed in the subventricular zone and promotes neuronal differentiation

The molecular mechanisms and potential clinical applications of neural precursor cells have recently been the subject of intensive study. Dlx5, a homeobox transcription factor related to the distal-less gene in Drosophila, was shown to play an important role during forebrain development. The subventricular zone (SVZ) in the adult brain harbors the largest abundance of neural precursors. The anterior SVZ (SVZa) contains the most representative neural precursors in the SVZ. Further research is necessary to elucidate how Dlx5-related genes regulate the differentiation of SVZa neural precursors. Here, we employed immunohistochemistry and molecular biology techniques to study the expression of Dlx5 and related homeobox genes Er81 and Islet1 in neonatal rat brain and in in vitro cultured SVZa neural precursors. Our results show that Dlx5 and Er81 are also highly expressed in the SVZa, rostral migratory stream, and olfactory bulb. Islet1 is only expressed in the striatum. In cultured SVZa neural precursors, Dlx5 mRNA expression gradually decreased with subsequent cell passages and was completely lost by passage four. We also transfected a Dlx5 recombinant plasmid and found that Dlx5 overexpression promoted neuronal differentiation of in vitro cultured SVZa neural precursors. Taken together, our data suggest that Dlx5 plays an important role during neuronal differentiation.