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

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.

Effects of three-dimensional quality assessment nursing intervention on efficacy and disease management of patients undergoing esophageal cancer surgery

BACKGROUND Esophageal cancer is one of the most common malignant tumors.The three-dimensional quality structure model is a quality assessment theory that includes three dimensions:Structure,process,and results.AIM To investigate the effects of nursing interventions with three-dimensional quality assessment on the efficacy and disease management ability of patients undergoing esophageal cancer surgery.METHODS In this prospective study,the control group received routine nursing,and the intervention group additionally received a three-dimensional quality assessment intervention based on the above routine care.Self-efficacy and patient disease management abilities were evaluated using the General Self-Efficacy Scale(GSES)and Exercise of Self-Care Agency scale,respectively.IBM SPSS Statistics for Windows,version 17.0,was used for the data processing.RESULTS This study recruited 112 patients who were assigned to the control and experi-mental groups(n=56 per group).Before the intervention,there was no significant difference in GSES scores between the two groups(P>0.05).After the inter-vention,the GSES scores of both groups increased,with the experimental group showing higher values(P<0.05).At the time of discharge and three months after discharge,the scores for positive attitudes,self-stress reduction,and total score of health promotion in the experimental group were higher than those in the control group(P<0.05).CONCLUSION The implementation of a three-dimensional quality structure model for postoperative patients with esophageal cancer can effectively improve their self-management ability and self-efficacy of postoperative patients.

抽水蓄能电站输水发电系统布置设计探讨

抽水蓄能电站作为电力系统中绿色低碳清洁电源,作用日益凸显,输水发电系统在整个工程枢纽造价中占比大,因此,如何优化设计输水发电系统显得格外重要。本文从输水线路布置、输水系统立面布置、衬砌形式选择、洞机组合方式选择、水力-机械过渡过程计算等方面,总结了输水发电系统布置的关键点与优化点,为抽水蓄能电站输水发电系统的布置设计提供一定的借鉴思路。

Influence of Unconscious Emotional Control Goals Priming on Anticipatory Anxiety and Physiological Activity

Individuals frequently generate emotion during the anticipation process and the anticipatory emotion has an important adaptive significance, especially the negative anticipative emotion. Many researches used conscious emotion regulation strategy and successfully reduced negative anticipatory emotion. However, it is costly for our limited cognition. In the present study, we used sentence unscrambling tasks to prime unconscious emotion control goal and investigated its effect on anticipatory anxiety, including experience and physiological activity. The results showed that 1) relative to anticipating neutral images, participations’ anxiety experience and skin conductance level were higher when anticipating negative and unknown images;2) participants who had a unconscious emotion control goal primed achieved the same decrease in skin conductance as those explicitly instructed to reappraise, compared to a control group;3) heart rate was not affected by experiment condition and anticipation type. Together, these findings suggest that unconscious emotion regulation may provide an effective mean of regulating negative anticipatory emotion.

竹枝歌舞原始艺术形态研究

竹枝歌舞是巴渝地区传统的民间乐舞,它集诗、乐、舞三位一体,以描写风土人情,抒发百姓情怀为主,主要用于祭祀、迎神、求偶等社会功能。对竹枝歌舞的原始艺术形态进行探究,分析竹枝歌舞的文化背景,可为竹枝歌舞的艺术研究与发展提供理论借鉴。

核糖体DNA转录的表观调控与肿瘤发生

近年来,表观遗传机制的研究结果提示核糖体DNA (rDNA)表观调控机制的缺陷可能诱导肿瘤发生。ATRX/DAXX复合物通过介导H3.3的H3K9me3修饰,建立和维持rDNA转录沉默。ATRX/DAXX基因在部分肿瘤中经常发生突变,可能刺激rDNA转录而促进肿瘤发生发展。本文主要阐述rDNA转录表达异常对肿瘤发生的促进作用,介绍rDNA基因转录的表观遗传调控机制,以期为针对rDNA转录调控机制的药物研发提供新的理论支持。

梵净山自然保护区珙桐萌蘖繁殖在种群数量中的作用

为探讨梵净山自然保护区珙桐(Davidia involucrata)的繁殖策略,揭示萌蘖苗和实生苗在维持种群数量中的作用。采用每木调查法调查贵州省梵净山自然保护区标水岩珙桐种群,根据调查数据绘制径级结构图。以珙桐径级结构代替年龄结构,采用匀滑技术分别编制了萌蘖苗和实生苗种群静态生命表,并绘制存活曲线、死亡率曲线、消失率曲线及4个生存函数曲线。结果显示:(1)珙桐种群年龄结构存在一定的波动性,按萌蘖苗统计则幼龄个体占78.78%,按实生苗统计则幼龄个体占21.45%,两种统计的珙桐种群的生存曲线接近于DeeveyⅡ型。(2)珙桐种群整体是增长的,萌蘖苗V_(spi)高于V_(sepi)(6.50%>2.30%)。(3)珙桐种群生存率呈单调下降趋势,萌蘖苗较明显。(4)珙桐种群累计死亡率呈单调上升的趋势,萌蘖苗更明显。(5)珙桐种群生存率和消失率曲线呈单调上升趋势,萌蘖苗和实生苗基本一致。标水岩珙桐种群属于增长型种群,存活曲线为DeeveyⅡ型,后期种群保持稳定,萌蘖繁殖有利于维持种群数量,在维持种群稳定中具有十分重要的作用。

An overview of prostate diseases and their characteristics specific to Asian men

In this paper, we reviewed the features of common prostate diseases, such as benign prostatic hyperplasia （BPH）, prostate cancer （PCa） and chronic prostatitis （CP） that are specific to Asian men. Compared to the Westerners, Asians exhibit particular characteristics of prostate diseases. Through summarizing the epidemiology, symptomatology, diagnostics and therapeutics of these diseases, we find that Asians have a lower incidence of PCa than whites, but the incidences of BPH and CP are similar. Asian men with CP often suffer from fewer disease sites, but have a higher frequency of pain during urination rather than after sexual climax. Prostate-specific antigen （PSA） is a widely used marker for the diagnosis of PCa in both Asian and Western countries. Although the PSA level may be lower in Asians, the threshold used is based on whites. After reviewing the treatments available for these diseases, we did not find a fundamental difference between Asians and whites. Furthermore, the selection for the most appropriate treatment based on the individual needs of patients remains a challenge to urologists in Asia. After considering the traits of prostate diseases that are specific to Asian men, we hope to pave the way for the development of specific diagnostic and therapeutic strategies targeted specifically to Asian men.

新型分子检测技术在基层实验室诊断肺结核的效能分析

目的分析与比较GeneXpert MTB/RIF(简称“GeneXpert”)与交叉引物核酸恒温扩增(cross-priming amplification,CPA)技术在基层实验室结核病快速诊断中的效能。方法连续收集黑龙江省五常市结核病防治所2014年4月至2017年7月初诊肺结核可疑患者的痰标本,分别进行改良罗氏固体培养基培养法(简称“固体培养法”)与快速分子检测(A组采用GeneXpert检测了787例;B组采用CPA检测了501例)。以固体培养法为标准,计算2种分子检测技术的敏感度、特异度、Kappa值。结果A组共检测787例患者痰标本,其中培养阳性229例,GeneXpert阳性300例,GeneXpert检测的敏感度、特异度分别为99.1%(227/229)、86.9%(485/558),Kappa=0.788。B组共检测501例患者痰标本,其中培养阳性129例,CPA检测阳性125例。CPA检测的敏感度、特异度分别为81.4%(105/129)、94.6%(352/372),Kappa=0.768。2种分子检测技术与固体培养法检测结果的一致率比较,差异无统计学意义[90.5%(712/787)vs91.2%(457/501);χ^2=0.204,P=0.652)]。结论CPA检测的准确性与GeneXpert相当,但其成本低、无需检测仪器、允许每批次大量样本同时操作,更适用于基层实验室对肺结核患者的早期诊断。

Interchange between grooming and infant handling in female Tibetan macaques(Macaca thibetana)

In some non-human primates, infants function as a social tool that can bridge relationships among group members. Infants are a desired commodity for group members, and mothers control access to them. The biological market theory suggests that grooming is widespread and represents a commodity that can be exchanged for infant handling. As a limited resource, however, the extent to which infants are interchanged between mothers(females with an infant) and non-mothers(potential handlers,females without an infant) remains unclear. In this study, we collected behavioral data to investigate the relationship between grooming and infant handling in free-ranging Tibetan macaques(Macaca thibetana)at Mt. Huangshan, China. Our results showed that females with infants received more grooming than females without infants. After her infant was handled,mother females received more grooming than they did during daily grooming interactions. However, with the increasing number of infants within the social group, both the grooming that mothers received and the grooming that non-mothers invested for handling infants decreased. We also found that non-mothers invested more time in grooming to gain access to younger infants than older infants. Our results provide evidence that infants are social commodities for both mother and non-mother females. Mothers use infants for obtain grooming and non-mothers use grooming to gain access to infants. The current study implies a bidirectional and complex interchange pattern between grooming and infant handling to compensate for the dyadic grooming disparity in non-human primates.

带充电设施的电动班车路径规划问题研究

针对公司班车运行的实际情况,考虑电动班车续航能力有限、客户预约服务时间窗不同等因素,构建了带充电设施的电动班车路径规划问题的混合整数规划模型,该模型可以提高电动班车运行的准时性,并提高其使用效率。然后,提出了求解该模型的遗传算法,测试结果表明,本文提出的算法是有效的。

Construction of nitrogen and phosphorus co-doped graphene quantum dots/Bi5O7I composites for accelerated charge separation and enhanced photocatalytic degradation performance

Nitrogen and phosphorus co-doped graphene quantum dot-modified Bi5O7 I(NPG/Bi5O7 I)nanorods were fabricated via a simple solvothermal method.The morphology,structure,and optical properties of the as-prepared samples were investigated by X-ray diffraction,scanning electron microscopy,high-resolution transmission electron microscopy,X-ray photoelectron spectroscopy(XPS),and diffused reflectance spectroscopy.The photocatalytic performance was estimated by degrading the broad-spectrum antibiotics tetracycline and enrofloxacin under visible light irradiation.The photodegradation activity of Bi5O7 I improved after its surface was modified with NPGs,which was attributed to an increase in the photogenerated charge transport rate and a decrease in the electron-hole pair recombination efficiency.From the electron spin resonance spectra,XPS valence band data,and free radical trapping experiment results,the main active substances involved in the photocatalytic degradation process were determined to be photogenerated holes and superoxide radicals.A possible photocatalytic degradation mechanism for NPG/Bi5O7 I nanorods was proposed.

RTRC:A Reputation-Based Incentive Game Model for Trustworthy Crowdsourcing Service

The ubiquity of mobile devices have promoted the prosperity of mobile crowd systems, which recruit crowds to contribute their resources for performing tasks. Yet, due to the various resource consumption, the crowds may be reluctant to join and contribute information. Thus, the low participation level of crowds will be a hurdle that prevents the adoption of crowdsourcing. A critical challenge for these systems is how to design a proper mechanism such that the crowds spontaneously act as suppliers to contribute accurate information. Most of existing mechanisms ignore either the honesty of crowds or requesters respectively. In this paper, considering the honesty of both, we propose a game-based incentive mechanism, namely RTRC, to stimulate the crowds to contribute accurate information and to motivate the requesters to return accurate feedbacks. In addition, an evolutionary game is designed to model the dynamic of user-strategy selection. Specially, the replicator dynamic is applied to model the adaptation of strategy interactions taking into account the dynamic nature in time dependence and we also derive the evolutionarily stable strategies(ESSs) for users. Finally, empirical results over the simulations show that all the requesters and suppliers will select honest strategy to maximize their profit.

乡村教育振兴背景下的乡村教师智慧阅读平台建设研究

振兴乡村教育,教师是关键,阅读作为促进乡村教师专业发展的有效路径正面临诸多挑战,成为了制约乡村教师成长的重要因素。在教育信息化、数字化的背景之下,以网络学习空间为基础,借助智能技术搭建乡村教师智慧阅读平台,有助于拓宽阅读之路,撬动乡村教师专业发展;深化学习研究,促进乡村教师深度学习;延展发展环境,重塑乡村教师成长空间;优化学习生态,重构乡村教育文化场域。

Effect of burden and origin sites of premature ventricular contractions on left ventricular function by 7-day Holter monitor

Recent studies have shown that premature ventricular contractions （PVCs） could enlarge the heart, but its risk factors are incompletely understood as a single 24-hour recording cannot reflect the true PVC burden due to day-to-day variability. Our purpose was to investigate the effect of burden and origin sites on left ventricular （LV） function in patients with PVCs by 7-day Holter electrocardiography （ECG）. From May 2012 to August 2013, 112 consecutive patients with PVCs were recruited from the authors＇ affiliated hospital. All patients received 2-dimensional transthoracic echocardiography, 12-lead routing ECG and 7-days Holter ECG. Serum N-terminal pro- brain natriuretic peptide （NT-proBNP） levels were measured. A total of 102 participants with PVCs were included in the final analysis. Origin of PVCs from the tricuspid annulus had the highest burden and NT-proBNP level. LV papillary muscle had a higher LV ejection fraction （EF） level and a lower LV end-systolic dimension （ESD） than other PVC foci （P〈0.05）. The high burden group had a higher LV end-diastolic dimension （EDD） and LVESD but lower LVEF than the other two groups （P〈0.05）. Female, older age, physical work, and history of PVCs had a significantly positive correlation with symptoms. Male, older age, physical work, and high burden were positive predictors of enlarged LVEDD, LVESD and higher serum NT-proBNP level, but lower LVEF. Seven-day dynamic ECG Holter monitor showed the true PVC burden on patients with PVCs. PVCs with a lower burden or origin from the LV papillary muscle and the fascicle were relatively benign, while PVCs with a higher burden or origin from the tricuspid annulus may lead to cardiac dysfunction.

Androgen receptors expressed by prostatic stromal cells obtained from younger versus older males exhibit opposite roles in prostate cancer progression

Aging is a major risk factor for prostate cancer （PCa）, and prostatic stromal cells may also promote PCa progression. Accordingly, stromal cells do not equally promote PCa in older males and younger males. Therefore, it is also possible that the expression of androgen receptors （ARs） by prostatic stromal cells in older versus younger males plays different roles in PCa progression. Using a gene knockdown technique and coculture system, we found that the knockdown of the AR in prostatic stromal cells obtained from younger males could promote the invasiveness and metastasis of cocultured PC3/LNCaP cells in vitro. By contrast, the invasiveness and metastasis of LNCaP cells was inhibited when cocultured with prostatic stromal cells from older males that when AR expression was knocked down. Moreover, after targeting AR expression with small hairpin RNA （shRNA）, matrix metalloproteinase （MMP） expression in stromal cells was observed to increase in the younger group, but decreased or remained unchanged in the older group. One exception, however, was observed with MMP9. In vivo, after knocking down AR expression in prostatic stromal cells, the incidence of metastatic lymph nodes was observed to increase in the younger age group, but decreased in the older age group. Together, these data suggest that the AR in prostatic stromal cells played opposite roles in PCa metastasis for older versus younger males. Therefore, collectively, the function of the AR in prostatic stromal cells appears to change with age, and this may account for the increased incidence of PCa in older males.

Alpha-fetoprotein-producing hepatoid adenocarcinoma of the lung responsive to sorafenib after multiline treatment:A case report

BACKGROUND Hepatoid adenocarcinoma of the lung(HAL) is an extremely rare malignant tumor,and many patients with HAL exhibit high levels of alpha-fetoprotein(AFP) expression.Currently,there is no standardized treatment strategy for advanced HAL and its prognosis is poor.CASE SUMMARY We report a 55-year-old man with unresectable AFP-related HAL.The largest cross-sectional area of the mass in the upper lobe of the left lung at the beginning of treatment was 8.46 cm × 6.53 cm.The patient’s serum AFP level was 9283 ng/m L.The mass increased in size to 8.86 cm × 8.21 cm after two courses of platinum-based combination chemotherapy and immunotherapy,and serum AFP reached its highest level(71232.2 ng/m L).The patient was treated with sorafenib(400 mg twice daily,per os).Forty days later,the mass was reduced to 5.63 cm × 5.29 cm and serum AFP level dropped to 786.8 ng/m L.The patient achieved partial remission for > 9 mo with sorafenib and an excellent biomarker response,as well as survival > 13 mo,which is among the longest reported for unresectable stage IV HAL.CONCLUSION This is the first report to document successful treatment of unresectable AFPrelated HAL with single-agent sorafenib after multiline therapy.

Complete response to trastuzumab and chemotherapy in recurrent urothelial bladder carcinoma with HER2 gene amplification: A case report

BACKGROUND Targeted treatments may greatly affect the natural history of urothelial carcinoma based on their pharmacokinetics. A phase II trial has explored the combination of cytotoxic chemotherapy with the anti-HER-2 monoclonal antibody trastuzumab in selected patients with metastatic bladder cancer, but it failed.CASE SUMMARY Here, we report a case of recurrent urothelial bladder carcinoma(UBC) in a patient who has undergone three operations, and further illuminate its diagnosis and treatment. The diagnosis of UBC was rendered according to the pathological indices. Next-generation sequencing on formalin fixed paraffin-embedded(FFPE)tissue was also performed and suggested HER2 gene amplification in the FFPE tissue. Based on HER2 gene amplification in FFPE, the patient was treated with chemotherapy in combination with trastuzumab after his third surgery.Fortunately, the patient got a clinically complete remission to trastuzumab for 34 mo.CONCLUSION There is not enough clinical evidence for incorporating trastuzumab in routine treatment of UBC. This case hinted that recurrent UBC patients with HER2 gene amplification may benefit from targeted trastuzumab. Further studies are needed to further investigate the status of HER2 gene and better determine trastuzumab in the management of UBC.

乙酰半胱氨酸在胶囊内镜检查中的临床应用

目的探讨胶囊内镜(CE)检查前应用乙酰半胱氨酸对CE小肠清洁度及检查结果的影响。方法将150例行CE检查的患者随机分为观察组和对照组(各75例)。对照组在检查前1晚使用复方聚乙二醇电解质散(PEG)3000 mL行肠道准备;观察组在检查前1天给予乙酰半胱氨酸600 mg口服(1天3次),检查前1晚使用PEG 3000 mL行肠道准备。两组CE检查前30 min均口服二甲硅油散,比较两组患者的小肠清洁度、CE在小肠内停留时间、小肠疾病阳性检出率和不良反应发生率。结果两组患者CE在小肠停留时间、不良反应发生率和阳性检出率比较,差异均无统计学意义(P>0.05);观察组小肠清洁度明显高于对照组,两组比较,差异有统计学意义(P<0.05)。结论CE检查前服用乙酰半胱氨酸具有提高小肠清洁度的作用,且不良反应小,值得临床推广。

HER2 changes to positive after neoadjuvant chemotherapy in breast cancer: A case report and literature review

BACKGROUND As the most common cancer in women,breast cancer is the leading cause of death.Most patients are initially diagnosed as stage I-III.Among those without distant metastases,64%are local tumors and 27%are regional tumors.Patients in stage IIA-IIIC and those who meet the breast-conserving criterion with the exception of tumor size can consider neoadjuvant chemotherapy(NACT).It is worth noting that the status of tumor cell biomarkers is not consistently static.Endocrine-related estrogen receptor(ER),progesterone receptor(PR)and human epidermal growth factor receptor 2(HER2)encoded by erythroblastic leukemia viral oncogene homolog 2 gene can all alter from positive to negative or vice versa,especially in luminal B subtype after NACT.In addition,determination of HER2 status currently mainly relies on immunohistochemistry(IHC)and fluorescence in situ hybridization(FISH),but FISH is commonly used when the result of IHC is uncertain.HER2 is regarded as negative when the IHC result is 0/1+without the addition of FISH.To the best of our knowledge,this is the first report of a case harboring HER2 status transformation and IHC1+with positive amplification by FISH after NACT.CASE SUMMARY A 49-year-old woman discovered a mass in her right breast and underwent diagnostic workup.Biopsies of the right breast lesion and axillary lymph nodes were obtained.The results pointed to invasive ductal carcinoma with the IHC result for ER(80%),PR(60%),Ki-67(20%)and ambiguous expression of HER2(IHC 2+)with negative amplification by FISH(HER2/CEP17 ratio of 1.13).She underwent surgery after NACT.The pathological findings of the surgically resected sample supported invasive ductal carcinoma with the tumor measuring 1.1 cm×0.8 cm×0.5 cm and had spread to one of fifteen dissected lymph nodes.Retesting of the specimen showed that the tumor was positive for ER(2+,85%)and PR(2+,10%)but negative for HER2 by IHC(1+).Also Ki-67 had dropped to 2%.The patient was regularly monitored every 3 mo without evidence of recurrence.CONCLUSION Biomarker status should be reassessed after NACT especially in luminal subtypes.