Dual-priming oligonucleotide-based multiplex PCR using tissue samples in rapid urease test in the detection of Helicobacter pylori infection

AIM:To investigate whether tissue samples processed by the rapid urease test(RUT)kit are suitable for dualpriming oligonucleotide-based multiplex polymerase chain reaction(DPO-PCR)to detect Helicobacter pylori(H.pylori).METHODS:A total of 54 patients with specific gastrointestinal symptom were enrolled in this study.During endoscopy,gastric biopsy specimens were taken for histology,RUT,and DPO-PCR.DPO-PCR was performed on gastric biopsy samples and tissue samples that were analyzed by RUT at 2 separate institutes.In detecting H.pylori,the concordance rate of the DPO-PCR tests between the tissue samples that had been submitted to RUT and the gastric biopsy samples was investigated.RESULTS:H.pylori co-occurred with 76.0%(19/25)of gastric ulcers,64.3%(9/14)of duodenal ulcers,and 33.3%(4/12)of gastritis cases.H.pylori infection was found in 100%(3/3)of the patients with both gastric and duodenal ulcers.Overall,H.pylori was detected in 35 of 54(64.8%)patients.The diagnostic sensitivities of histology,RUT,and DPO-PCR were85.7%(30/35),74.3%(26/35),and 97.1%(34/35),respectively(P=0.02).The positive predictive value(PPV)of DPO-PCR was 94.4%,whereas the negative predictive value(NPV)was 94.7%.In the rapid urease test(CLOtest)-negative cases,the frequency of positive DPO-PCR and histologic results was 20.0%(7/35).The concordance rate of the DPO-PCR tests between the tissue samples from the RUT kit and the gastric biopsy samples was 94.4%(51/54).The rate of DPOPCR and silver stain positivity in the RUT-negative cases was 20.0%(7/35).CONCLUSION:In diagnosing H.pylori infection,DPO-PCR can be performed on tissue samples that have been processed by the RUT kit.Particularly,in patients with RUT-negative results,DPO-PCR on these tissue samples could be helpful in detecting of H.pylori infection.

Concomitant therapy achieved the best eradication rate for Helicobacter pylori among various treatment strategies

AIM: To compare the Helicobacter pylori(H.pylori) eradication rate of clarithromycin-based triple therapy,metronidazole-based triple therapy,sequential therapy and concomitant therapy.METHODS: A total of 680 patients infected with H.pylori were divided into 4 groups and each group was treated with a different eradication therapy.Clarithromycin-based triple therapy was applied to the first group [rabeprazole,amoxicillin and clarithromycin(PAC) group: proton pump inhibitor(PPI),amoxicillin,clarithromycin],whereas the second group was treated with metronidazole-based triple therapy [rabeprazole,amoxicillin and metronidazole(PAM) group: PPI,amoxicillin,metronidazole].The third group was treated with rabeprazole and amoxicillin,followed by rabeprazole,clarithromycin and metronidazole(sequential group).The final group was simultaneously treated with rabeprazole,amoxicillin clarithromycin and metronidazole(concomitant therapy group).In the case of a failure to eradicate H.pylori,second-line quadruple and third-line eradication therapies were administered.RESULTS: The per protocol(PP) analysis was performed on 143,139,141 and 143 patients in the PAC,PAM,sequential and concomitant groups,respectively.We excluded patients who did not receive a C13-urea breath test(22,20,23 and 22 patients,respectively) and patients with less than an 80% compliance level(5,11,6 and 5 patients,respectively).The eradication rates were 76.2%(109/143) in the PAC group,84.2%(117/139) in the PAM group,84.4%(119/141) in the sequential group and 94.4%(135/143) in the concomitant group(P = 0.0002).All 14 patients who failed second-line therapy were treated with thirdline eradication therapy.Among these 14 patients,6 infections were successfully eradicated with the thirdline therapy.Both PP and intention-to-treat analysis showed an eradication rate of 42.9%(6/14).In the PAC group,3 of 4 patients were successfully cured(3/4,75%); 2 of 2 patients in the PAM group(2/2,100%) and 1 of 5 patients in the sequential group(1/5,20%) were also cured.In the concomitant group,all 3 patients failed(0/3,0%).CONCLUSION: The eradication rate for the concomitant therapy was much higher than those of the standard triple therapy or sequential therapy(Clinical Trials.gov number NCT01922765).

Proto-oncogenic H-Ras, K-Ras, and N-Ras are involved in muscle differentiation via phosphatidylinositol 3-kinase

Oncogenic H 地岬 G12V 和它的变体被显示了禁止肌肉区别。然而，在肌肉区别的 proto-oncogenic 地岬(c 地岬) 的角色仍然保持不清楚。地岬的活跃 GTP 固定的形式包括 Raf， phosphatidylinositol 3-kinase (PI3K ) ， Ral-GDS，和播送下游的信号的另外的分子与多样的受动器为伙伴所知。我们假设那 c 地岬可以由有选择地激活 PI3K 刺激肌肉区别，为肌肉区别的一个重要调停人。在我们的实验，由 farnesyltransferase 禁止者和 H 地岬(地岬 S17N ) 的一种主导的否定形式的 c 地岬的抑制压制了肌肉区别。一致地，由 siRNAs 的 H 地岬， K 地岬，和 N 地岬击倒的个人都堵住了肌肉区别。有趣地，我们发现 c 地岬优先地与 PI3K 而非它的主要有约束力的搭挡 c-Raf 交往，在 myogenic 区别期间，与全部的 c 地岬活动仍然保持未改变。PI3K 和它的下游的 myogenic 小径， Nox2/NF-魏 B /inducible 氮的氧化物 synthase (iNOS ) 小径，被发现被 c 地岬活动的抑制在区别期间压制。而且， PI3K 的一种组成地活跃的形式的表示完全救了区别块并且在 c-Ras-inhibited 房间重新激活 Nox2/NF-魏 B /iNOS 小径。根据我们的结果，我们断定与 oncogenic 地岬相反， proto-oncogenic H 地岬， K 地岬，和 N 地岬直接经由 PI3K 和它的下游的发信号小径涉及肌肉区别的提升。另外， PI3K 小径激活与不同主要激活的 Raf/Mek/Erk 小径的并发的抑制被联系。

Combined pars plana vitrectomy and Baerveldt glaucoma implant placement for refractory glaucoma

AIMTo evaluate outcomes of combined pars plana vitrectomy and Baerveldt glaucoma implant (PPV-BGI) placement for refractory glaucoma.METHODSThe medical records of 92 eyes (89 patients) that underwent PPV-BGI were retrospectively reviewed, including 43 eyes with neovascular glaucoma (NVG) and 49 eyes with other types of glaucoma (non-NVG).RESULTSOutcome measures were visual acuity (VA), intraocular pressure (IOP), glaucoma medical therapy, complications, and success [VA>hand motions (HM), IOP≥6 mm Hg and ≤21 mm Hg, no subsequent glaucoma surgery]. Cumulative success rates for the non-NVG group and NVG group were 79% and 40% at 1y, respectively (P=0.038). No difference in the rates of surgical success were found between pars plana and anterior chamber tube placement. Preoperative IOP (mean±SD) was 30.3±11.7 mm Hg in the Non-NVG group and 40.0±10.6 mm Hg in the NVG group, and IOP was reduced to 15±9.5 mm Hg in the non-NVG group and 15±10.5 mm Hg in the NVG at 1y. Number of glaucoma medications (mean±SD) decreased from 2.7±1.3 in the non-NVG group and 2.8±1.3 in the NVG group preoperatively to 0.76±1.18 in the non-NVG group and 0.51±1.00 in the NVG group at 1y. Improvement in VA of ≥2 Snellen lines was observed in 25 (27%) eyes, although only 33% of non-NVG eyes and 2.3% of NVG eyes maintained VA better than 20/200 at 1y. Nonclearing vitreous hemorrhage was the most common postoperative complication occurring in 16 (17%) eyes, and postoperative suprachoroidal hemorrhages developed in 5 (5.4%) eyes.CONCLUSIONPPV-BGI is a viable surgical option for eyes with refractory glaucoma, but visual outcomes are frequently poor because of ocular comorbidities, especially in eyes with NVG. The location of tube placement does not influence surgical outcome and should be left to the discretion of the surgeon.

Air in the main pancreatic duct:A case of innocent air

Air in the main pancreatic duct has been reported only rarely and might be associated with either a spontaneous or a surgically induced alteration of the anatomy of the biliary tract.We report a case of "innocent" air found incidentally in the main pancreatic duct.To our knowledge,this is only the third such case reported.A 54-year-old woman presented with hemoptysis that had lasted for 3 d.She underwent a chest computed tomography scan,which revealed not only focal bronchiectasis in the left lower lobe,but also air in the main pancreatic duct and dilatation of the common bile duct.She was managed conservatively for the hemoptysis and no further problems developed.She had no specific gastrointestinal symptoms and had no history of surgery or medication.Her laboratory parameters were normal.Magnetic resonance cholangiopancreatography also demonstrated air in the main pancreatic duct and a dilated common bile duct(CBD).Duodenoscopy revealed separate biliary and pancreatic orifices with patulous openings and some air bubbles appearing in the pancreatic orifice.Endoscopic retrograde cholangiopancreatography(ERCP) showed the dilated CBD and pancreatic duct with some air bubbles,but no other abnormal lesions.She was discharged with no further problems.Most patients with air in the main pancreatic duct have had a pancreatobiliary disease,or a history of pancreatobiliary disease,pancreatobiliary surgery or sphincterotomy.If the air is innocent,as in our case,ERCP should be performed to evaluate any altered sphincteric function or anatomy such as patulous openings.

Factors associated with axial length elongation in high myopia in adults

AIM:To investigate the association of axial length(AL)and ocular factors on AL elongation.METHODS:A retrospective chart review of patients who underwent two or more AL examinations for more than two years.Totally 4 groups were divided according to initial AL(<24 mm,24-26 mm,26-28 mm,≥28 mm).Initial fundus photograph was used to find risk factors associated AL elongation.RESULTS:The mean age of the patients was 47.21±7.79 y.AL remained almost unchanged in the groups with AL<24 mm and 24≤AL<26 mm.On the contrary,AL increased by 0.011 mm/y in the group with 26≤AL<28 mm and 0.035 mm/y in the group with AL≥28 mm(P<0.001).In high myopia,AL elongation increased in eye with longer AL(r=0.003,P=0.024),female gender(r=0.014,P=0.019),eye with larger peripapillary chorioretinal atrophic area(r=0.002,P=0.019),and smaller vascular arcade angle(r=-0.004,P=0.006).The risk of elongation 0.03 mm/y in high myopia was increased in female gender(P=0.040),and gradually increased in eye with large peripapillary chorioretinal atrophy area(P<0.01).CONCLUSION:AL elongate significantly in the eye with longer AL,female gender,and the eye with larger atrophic area and smaller arcade angle on fundus photography.

Comparative study on multibody vehicle dynamics models based on subsystem synthesis method using Cartesian and joint coordinates

The subsystem synthesis method has been developed in order to improve computational efficiency for a multibody vehicle dynamics model. Using the subsystem synthesis method, equations of motion of the base body and each subsystem can be solved separately. In the subsystem synthesis method, various coordinate systems can be used and various integration methods can be applied in each subsystem, as long as the effective mass matrix and the effective force vector are properly produced. In this paper, comparative study has been carried out for the subsystem synthesis method with Cartesian coordinates and with joint relative coordinates. Two different integration methods such as an explicit integrator and an explicit implicit integrator are employed. In order to see the accuracy and computational efficiency from the different models based on the different coordinate systems and different integration methods, a rough terrain run simulations has been carried out with a 6 × 6 off-road multibody vehicle model.