Safety and effectiveness of vonoprazan-based rescue therapy for Helicobacter pylori infection

BACKGROUND Vonoprazan(VPZ)-based regimens are an effective first-line therapy for Helicobacter pylori(H.pylori)infection.However,their value as a rescue therapy needs to be explored.AIM To assess a VPZ-based regimen as H.pylori rescue therapy.METHODS This prospective,single-center,clinical trial was conducted between January and August 2022.Patients with a history of H.pylori treatment failure were administered 20 mg VPZ twice daily,750 mg amoxicillin 3 times daily,and 250 mg Saccharomyces boulardii(S.boulardii)twice daily for 14 d(14-d VAS regimen).VPZ and S.boulardii were taken before meals,while amoxicillin was taken after meals.Within 3 d after the end of eradication therapy,all patients were asked to fill in a questionnaire to assess any adverse events they may have experienced.At least 4-6 wk after the end of eradication therapy,eradication success was assessed using a 13C-urea breath test,and factors associated with eradication success were explored.RESULTS Herein,103 patients were assessed,and 68 patients were finally included.All included patients had 1-3 previous eradication failures.The overall eradication rates calculated using intention-to-treat and per-protocol analyses were 92.6%(63/68)and 92.3%(60/65),respectively.The eradication rate did not differ with the number of treatment failures(P=0.433).The rates of clarithromycin,metronidazole,and levofloxacin resistance were 91.3%(21/23),100.0%(23/23),and 60.9%(14/23),respectively.There were no cases of resistance to tetracycline,amoxicillin,or furazolidone.In 60.9%(14/23)patients,the H.pylori isolate was resistant to all 3 antibiotics(clarithromycin,metronidazole,and levofloxacin);however,eradication was achieved in 92.9%(13/14)patients.All patients showed metronidazole resistance,and had an eradication rate of 91.3%(21/23).The eradication rate was higher among patients without anxiety(96.8%)than among patients with anxiety(60.0%,P=0.025).No severe adverse events occurred;most adverse events were mild and disappeared without intervention.Good compliance was seen in 95.6%(65/68)patients.Serological examination showed no significant changes in liver and kidney function.CONCLUSION VAS is a safe and effective rescue therapy,with an acceptable eradication rate(>90%),regardless of the number of prior treatment failures.Anxiety may be associated with eradication failure.

Prediction of lymph node metastasis in early gastric signet-ring cell carcinoma:A real-world retrospective cohort study

BACKGROUND Signet-ring cell carcinoma(SRCC)was previously thought to have a worse prognosis than other differentiated gastric cancer(GC),however,recent studies have shown that the prognosis of SRCC is related to pathological type.We hypothesize that patients with SRCC and with different SRCC pathological components have different probability of lymph node metastasis(LNM).AIM To establish models to predict LNM in early GC(EGC),including early gastric SRCC.METHODS Clinical data from EGC patients who had undergone gastrectomy at the First Affiliated Hospital of Nanjing Medical University from January 2012 to March 2022 were reviewed.The patients were divided into three groups based on type:Pure SRCC,mixed SRCC,and non-signet ring cell carcinoma(NSRC).The risk factors were identified through statistical tests using SPSS 23.0,R,and EmpowerStats software.RESULTS A total of 1922 subjects with EGC were enrolled in this study,and included 249 SRCC patients and 1673 NSRC patients,while 278 of the patients(14.46%)presented with LNM.Multivariable analysis showed that gender,tumor size,depth of invasion,lymphovascular invasion,ulceration,and histological subtype were independent risk factors for LNM in EGC.Establishment and analysis using prediction models of EGC showed that the artificial neural network model was better than the logistic regression model in terms of sensitivity and accuracy(98.0%vs 58.1%,P=0.034;88.4%vs 86.8%,P<0.001,respectively).Among the 249 SRCC patients,LNM was more common in mixed(35.06%)rather than in pure SRCC(8.42%,P<0.001).The area under the ROC curve of the logistic regression model for LNM in SRCC was 0.760(95%CI:0.682-0.843),while the area under the operating characteristic curve of the internal validation set was 0.734(95%CI:0.643-0.826).The subgroups analysis of pure types showed that LNM was more common in patients with a tumor size>2 cm(OR=5.422,P=0.038).CONCLUSION A validated prediction model was developed to recognize the risk of LNM in EGC and early gastric SRCC,which can aid in pre-surgical decision making of the best method of treatment for patients.

Soil water movement and deep drainage through thick vadose zones on the northern slope of the Tianshan Mountain: Croplands vs.natural lands

Regional aridity is increasing under global climate change,and therefore the sustainable use of water resources has drawn attention from scientists and the public.Land-use changes can have a significant impact on groundwater recharge in arid regions,and quantitative assessment of the impact is key to sustainable groundwater resources management.In this study,the changes of groundwater recharge after the conversion of natural lands to croplands were investigated and compared in inland and arid region,i.e.,the northern slope of the Tianshan Mountain.Stable isotopes suggest that soil water in topsoil(<2 m)has experienced stronger evaporation under natural lands than croplands,and then moves downward as a piston flow.Recharge was estimated by the tracer-based mass balance method,i.e.,chloride and sulfate.Recharge rates under natural conditions estimated by the chloride mass balance(CMB)method were estimated to be 0.07 mm/a in deserts and 0.4 mm/a in oases.In contrast,the estimated groundwater recharge ranged from 61.2 mm/a to 44.8 mm/a in croplands,indicating that groundwater recharge would increase significantly after land changes from natural lands to irrigated croplands in arid regions.Recharge estimated by the sulfate mass balance method is consistent with that from the CMB method,indicating that sulfate is also a good tracer capable of estimating groundwater recharge.

Measurement Uncertainty Assessment for Determination of Allura Red in Puffed Food by HPLC

This study aimed to assess the measurement uncertainty of a new method for determination of allura redin food by high performance liquid chromatography （HPLC）. The uncertainty of mathematical model of allura red is based on Europe for Analytical Chemistry（EURACHEM） guidelines. The sources and components of uncertainty were calculated, including recovery, working solution, sample mass, final volume, response of standard solution, response of sample solution. The expanded uncertainty was 0.0024 （k=2）. Uncertainty of working solution was the most significant factor contributing to the total uncertainty, accounting for 86.2%. The uncertainty of volume accounted for the minimum at 0.025%. The developed method is simple and accurate, which can be used for the determination of allura redin puffed samples.

Ultrafast Electron Transfer in All-Small-Molecule Photovoltaic Blends Promoted by Intermolecular Interactions in Cyanided Donors

Cyano substitution has been established as a viable approach to optimize the performance of all-small-molecule organic solar cells.However,the effect of cyano substitution on the dynamics of photo-charge generation remains largely unexplored.Here,we report an ultrafast spectroscopic study showing that electron transfer is markedly promoted by enhanced intermolecular charge-transfer interaction in all-small-molecule blends with cyanided donors.The delocalized excitations,arising from intermolecular interaction in the moiety of cyano-substituted donor,undergo ultrafast electron transfer with a lifetime of∼3 ps in the blend.In contrast,some locally excited states,surviving in the film of donor without cyano substitution,are not actively involved in the charge separation.These findings well explain the performance improvement of devices with cyanided donors,suggesting that manipulating intermolecular interaction is an efficient strategy for device optimization.

Two-Dimensional Electronic Spectroscopy with Active Phase Management

Two-dimensional elec tronic spec troscopy(2DES)is a powerful met hod to probe the coherent electron dynamics in complicated systems.Stabilizing the phase difference of the incident ultrashort pulses is the mos t challenging par t for experimen tal demonstration of 2DES.Here,we present a tuto rial review on the 2DES proto cols based on active phase managements which are originally developed for quantum optics experiments.We introduce the 2DES techniques in box and pump-probe geometries with phase stabilization realized by interferometry,and outline the fully collinear 2DES approach with the frequency tagging by acoustic optical modulators and frequency combs.The combination of active phase managements,ultrashort pulses and other spectroscopic methods may open new opportunities to tackle essential challenges related to excited states.

Dynamic modeling and analysis on rigid-flexible coupling between vertical chatter and transverse bending vibration in process of cold rolling

Considering the dynamic variation of roll gap and the transverse distribution of dynamic rolling force along the work roll width direction, the movement and deformation of rolls system, influenced by the coupling of vertical chatter and transverse bending vibration, may cause instability and also bring product defect of thickness difference. Therefore, a rigid-flexible coupling vibration model of the rolls system was presented. The influence of dynamic characteristics on the rolling process stability and strip thickness distribution was investigated. Firstly, assuming the symmetry of upper and lower structures of six-high rolling mill, a transverse bending vibration model of three-beam system under simply supported boundary conditions was established, and a semi-analytical solution method was proposed to deal with this model. Then, considering both variation and change rate of the roll gap, a roll vertical chatter model with structure and process coupled was constructed, and the critical rolling speed for self-excited instability was determined by Routh stability criterion. Furthermore, a rigid-flexible coupling vibration model of the rolls system was built by connecting the vertical chatter model and transverse bending vibration model through the distribution of dynamic rolling force, and the dynamic characteristics of rolls system were analyzed. Finally, the strip exit thickness distributions under the stable and unstable rolling process were compared, and the product shape and thickness distribution characteristics were quantitatively evaluated by the crown and maximum longitudinal thickness difference.

模拟研究石墨烯/生物基尼龙复合材料的界面热阻

生物基尼龙(PA56)源于天然产物,具有优良的环保性能和广阔应用前景,有望替代传统的石油基尼龙材料.为了开发基于PA56的导热材料,利用分子动力学模拟研究方法探索了石墨烯/PA56复合材料界面热阻的影响因素.首先,利用实验测试商用PA56样品的玻璃化转变温度(Tg)和导热系数(Tc),验证了PA56模型的模拟参数.接着,通过设计和比较不同表面改性状态对石墨烯/PA56复合材料的界面热阻的影响规律,最后,为了降低界面改性的难度,设计了一种新型的二嵌段共聚物作为石墨烯/PA56复合体系的界面改性剂,研究了界面改性剂的结构对界面热阻的影响规律.研究结果对于实验研究制备生物基尼龙导热复合材料具有重要的参考价值.

Impacts of climate change on optimal mixture design of blended concrete considering carbonation and chloride ingress

Many studies on the mixture design of fly ash and slag ternary blended concrete have been conducted.However,these previous studies did not consider the effects of climate change,such as acceleration in the deterioration of durability,on mixture design.This study presents a procedure for the optimal mixture design of termary blended concrete considering climate change and durability.First,the costs of CO2 emissions and material are calculated based on the concrete mixture and unit prices.Total cost is equal to the sum of material cost and CO2 emissions cost,and is set as the objective function of the optimization.Second,strength,slump,carbonation,and chloride ingress models are used to evaluate concrete properties.The effect of different climate change scenarios on carbonation and chloride ingress is considered.A genetic algorithm is used to find the optimal mixture considering various constraints.Third,ilustrative examples are shown for mixture design of ternary blended concrete.The analysis results show that for termary blended concrete exposed to an atmospheric environment,a rich mix is necessary to meet the challenge of climate change,and for termary blended concrete exposed to a marine environment,the impact of climate change on mixture design is marginal.

Polyethylene glycol phospholipids encapsulated silicon 2,3-naphthalocyanine dihydroxide nanoparticles(SiNcOH-DSPE-PEG(NH2)NPs) for single NIR laser induced cancer combination therapy

Currently,the combination of photothermal therapy（PTT） and photodynamic therapy（PDT） has emerged as a powerful technique for cancer treatment.However,most examples of combined PTT and PDT reported use multi-component nanocomposites under excitation of separate wavelength,resulting in complex treatment process.In this work,a novel theranostic nanoplatform（SiNcOH-DSPE-PEG（NH2）NPs） has been successfully developed by coating silicon 2,3-naphthalocyanine dihydroxide（SiNcOH）with DSPE-PEG and DSPE-PEG-NH2 for photoacoustic（PA） imaging-guided PTT and PDT tumor ablation for the first time.The as-prepared single-agent SiNcOH-DSPE-PEG（NH2） NPs not only have good water solubility and biocompatibility,but also exhibit high photothermal conversion efficiency and singlet oxygen generation capability upon 808 nm NIR laser irradiation.In addition,owing to their high absorption at NIR region,the SiNcOH-DSPE-PEG（NH2） NPs can also be employed as an effective diagnostic nanoagent for photoacoustic（PA） imaging.In vitro and in vivo experimental results clearly indicated that the simultaneously combined PTT and PDT under the guidance of PA imaging with single NIR laser excitation can effectively kill cancer cells or eradicate tumor tissues.Taking facile synthesis and high efficiency in cancer treatment by SiNcOH-DSPE-PEG（NH2） NPs into consideration,our study provides a promising strategy to realize molecular imaging-guided combination therapy.