Helicobacter pylori infection is associated with the risk and phenotypes of cholelithiasis:A multi-center study and meta-analysis

BACKGROUND Helicobacter pylori(H.pylori)is a prevalent pathogen associated with various diseases.Cholelithiasis is also a common condition.H.pylori infection has been identified in the biliary system,suggesting its potential involvement in biliary diseases.However,the specific role of H.pylori in the development of cholelithiasis remains inconclusive.AIM To investigate the potential association between H.pylori infection and the development of cholelithiasis.METHODS We performed a retrospective study in more than 70000 subjects in health examination center from 3 institutions in the middle,northern and eastern China,from October 2018 to December 2021,to explore the potential association between H.pylori and cholelithiasis through univariate and multivariate analysis.Meanwhile,the influence of H.pylori on biliary-related parameters was investigated.A comprehensive analysis of previous studies concerned about H.pylori and cholelithiasis was also executed.RESULTS In our multi-center study,H.pylori was positively associated with cholelithiasis[odds ratio(OR)=1.103,95%confidence interval(CI):1.001-1.216,P=0.049].Furthermore,H.pylori patients had less total and direct bilirubin than uninfected patients,while the total cholesterol and low-density lipoprotein cholesterol were more in H.pyloripositive participants(P<0.05).In the published articles,the cohort studies indicated H.pylori was a risk factor of cholelithiasis(hazard ratio=1.3280,95%CI:1.1810-1.4933,P<0.0001).The pooled results of case-control and crosssectional studies showed positive association between H.pylori and cholelithiasis in Asia(OR=1.5993,95%CI:1.0353-2.4706,P=0.034)but not in Europe(OR=1.2770,95%CI:0.8446-1.9308,P=0.246).Besides,H.pylori was related to a higher choledocholithiasis/cholecystolithiasis ratio(OR=3.3215,95%CI:1.1034-9.9986,P=0.033).CONCLUSION H.pylori is positively correlated with cholelithiasis,choledocholithiasis phenotype particularly,especially in Asia,which may be relevant to bilirubin/cholesterol metabolism.Cohort studies confirm an increased risk of cholelithiasis in H.pylori patients.

CLINICAL REPORT ON MULTI-CENTER RANDOMIZED CONTROLLED TRIAL OF TREATMENT OF MIGRAINE BY ELECTRO-ACUPUNCTURE AT QI■X■(丘墟GB40)

Objective To observe the therapeutic effect of electro acupuncture at QIǖXǖ（丘墟GB40） for treating migraine and provide clinical study for Acupoints Dictionary of People＇s Republic of China. Methods Multi-center （3 First-Class hospitals） study was adopted, and the involved 3 hospitals did clinical observation according to the requirements of the project. The methods are as follows. All cases were randomized into treatment group and control group according to their sequence. QIǖXǖ（丘墟GB40） was selected in treatment group, while Tiānshū （天枢 ST25） was selected in control group. Both groups were performed electro acupuncture, and syndromes indexes of migraine and 5-HT were observed before and after treatment. All data were analyzed by statistic software SPSS11.5. Results There was significant difference of VAS margin between two groups in each center and the combined center （u= -3. 362, P=0. 001 ）. There was significant difference of therapeutic effect of 4-week treatment between two groups in each clinical center and the combined center. The therapeutic effect of 3-month treatment between two groups in No. 1 and No. 3 hospitals, showed significant difference, the treatment group was better; while that of No. 2 hospital had no obvious difference. The therapeutic effect of 6-month treatment between two groups in each center and the combined center had significant difference, the treatment group was better. Conclusion The therapy of electro acupuncture at QIǖXǖ（丘墟GB40） is effective for migraine.

Probing the structure of multi-center molecules with odd–even high harmonics

We study high-order harmonic generation(HHG)from multi-center asymmetric linear molecules numerically and analytically.Our simulations show that odd and even HHG spectra of the asymmetric multi-center system respond differently to the change of the molecular structure.Specifically,when the internuclear distances between these nuclei of the molecule have a small change,the odd spectra usually do not change basically,but the even spectra differ remarkably.Based on this phenomenon,a simple procedure is proposed to probe the positions of these nuclei with odd–even HHG.Our results shed light on attosecond probing of the structure of multi-center molecules using HHG.

Minimum MSE Weights of Adjusted Summary Estimator of Risk Difference in Multi-Center Studies

The simple adjusted estimator of risk difference in each center is easy constructed by adding a value c on the number of successes and on the number of failures in each arm of the proportion estimator. Assessing a treatment effect in multi-center studies, we propose minimum MSE (mean square error) weights of an adjusted summary estimate of risk difference under the assumption of a constant of common risk difference over all centers. To evaluate the performance of the proposed weights, we compare not only in terms of estimation based on bias, variance, and MSE with two other conventional weights, such as the Cochran-Mantel-Haenszel weights and the inverse variance (weighted least square) weights, but also we compare the potential tests based on the type I error probability and the power of test in a variety of situations. The results illustrate that the proposed weights in terms of point estimation and hypothesis testing perform well and should be recommended to use as an alternative choice. Finally, two applications are illustrated for the practical use.

Effect of a disposable endoscope precleaning kit in the cleaning procedure of gastrointestinal endoscope:A multi-center observational study

BACKGROUND Precleaning is a key step in endoscopic reprocessing.AIM To develop an effective and economic endoscope cleaning method by using a disposable endoscope bedside precleaning kit.METHODS Altogether,228 used gastrointestinal endoscopes were selected from five high-volume endoscopy units and precleaned by a traditional precleaning bucket(group T)or a disposable endoscope bedside precleaning kit(group D).Each group was further subdivided based on the replacement frequency of the cleaning solution,which was replaced every time in subgroups T1 and D1 and every several times in subgroups Ts and Ds.The adenosine triphosphate(ATP)level and residual proteins were measured three times:Before and after precleaning and after manual cleaning.RESULTS After precleaning,the precleaning kit significantly reduced the ATP levels(P=0.034)and has a more stable ATP clearance rate than the traditional precleaning bucket.The precleaning kit also saved a quarter of the cost of enzymatic detergent used during the precleaning process.After manual cleaning,the ATP levels were also significantly lower in the precleaning kit group than in the traditional precleaning bucket group(P<0.05).Meanwhile,the number of uses of the cleaning solution(up to four times)has no significant impact on the cleaning effect(P>0.05).CONCLUSION Considering its economic cost and cleaning effect,the use of a disposable endoscope bedside precleaning kit can be an optimal option in the precleaning stage with the cleaning solution being replaced several times in the manual cleaning stage.

Multi-Order and Multi-Center Metallogenic Zoning of Yinshan Cu-Au Polymetallic Ore Deposit,Jiangxi Province,China

Yinshan anticline is the product of tectono-dynamic deformation - metamorphism .Along the axis of the anticline exists a brittle-ductile shearing zone which obviously controls the ore-formation . Mineralization occurs along the axis of the anticline in a width of about 1000m .In the mining area .volcano- subvolcanic rocks of Early Yanshan period are divided into three cycles :Ⅰ intermediate acidic dacite lava and dacite porphyry ;Ⅱ acidic amphibole liparite and quartz porphyry;Ⅲ intermediate andesite porphyrite . Among them activities of ⅠandⅡ cycles are more intensive and are intimately related to the mineralization . Yinshan ore deposit is the result of combinative processes of tectono -dynamic and volcano -magmatic hydrothermal fluids, so that mere are two centers of metallogenic zoning, one being the axial strain zone of Yinshan anticline which is the center of first order, and the other being porphyry stock , 2nd order.

Theoretical study of(e,2e) triple differential cross section of 1b3g orbital of ethylene by vibrational multi-center distorted-wave method

The vibrational motions are usually neglected when calculating(e,2e) triple differential cross sections(TDCSs) of molecules. Here, multi-center distorted-wave method(MCDW) has been modified by including molecular vibrations. This vibrational MCDW method is employed to calculate the TDCSs of 1b3gorbital of ethylene at low(100 eV) and medium(250 eV) incident electron energies in coplanar asymmetric kinematic condition. The results show that molecular vibrations significantly influence the angular distributions of the TDCSs, especially in the binary region along momentum transfer near the Bethe ridge.

Theoretical study of (e,2e) triple differential cross sections of pyrimidine and tetrahydrofurfuryl alcohol molecules using multi-center distorted-wave method

We report theoretical studies of electron impact triple differential cross sections of two bio-molecules,pyrimidine and tetrahydrofurfuryl alcohol,in the coplanar asymmetric kinematic conditions with the impact energy of 250 eV and ejected electron energy of 20 eV at three scattering angles of-5°,-10°,and-15°.Present multi-center distorted-wave method well describes the experimental data,which was obtained by performing(e,2e)experiment.The calculations show that the secondary electron produced by the primary impact electron is strongly influenced by the molecular ionic multi-center potential,which must be considered when the low energy electron interacts with DNA analogues.

The Volume Effect and Safety of 6% Hydroxyethyl Starch 130/0.4 in Patients Undergoing Major Elective Surgery: An Uncontrolled, Open-Labeled, Multi-Center Study

Purpose: The primary aim of this study was to investigate volume effect and safety of up to 50 mL/kg BW 6% hydroxyethyl starch (HES) 130/0.4 in adult and pediatric patients undergoing major elective surgery. The need to infuse human albumin may be reduced or avoided in Japan if these large doses 6% HES 130/0.4 can be infused. Methods: The study was an uncontrolled, open-labeled, multi-center trial. Fifteen adult and 5 pediatric patients undergoing major elective surgery received 6% HES 130/0.4 (Voluven&#174) with a maximum dose of 50 mL/kg from the start of surgery until 2 hours after the end of surgery according to a treatment algorithm. The primary efficacy endpoint was the volume effect of 6% HES 130/0.4 determined by the volume of saved albumin during the investigational period and the time course of hemodynamic stability in adult and pediatric patients. Safety parameters were fluid balance, hemodynamic and laboratory parameters ECG, local and systemic tolerance and adverse events. Results: Adult patients received a mean of 32.0 mL/kg of 6% HES 130/0.4. For 12 out of 15 adult patients an average amount of 1033.8 mL (18.6 mL/kg) albumin could be saved. The other 3 adult patients did not receive more than 1000 mL of HES 130/0.4. All pediatric patients received approximately 50 mL/kg of HES 130/0.4;for these patients an average amount of 39.9 mL/kg body weight albumin could be saved. The majority of adult patients, and all pediatric patients were hemodynamically stable at all 3 time points. The observed changes of the assessed laboratory parameters including hematological and coagulation parameters or in any other safety parameter determined did not reveal any safety concern related to the administration of 6% HES 130/0.4 up to doses of 50 mL/kg body weight. Conclusion: The study results indicate that 6% HES 130/0.4 has a reliable volume effect, could contribute to significant human albumin savings and was safe and well tolerated up to a maximum dose of 50 mL/kg body weight in adult and pediatric patients undergoing major elective surgery.

Xi-Feng-Hua-Shi granules for diarrhea-predominant irritable bowel syndrome:protocol for a randomized,double-blind,placebo-controlled multi-center clinical trial

Background:Irritable bowel syndrome(IBS)is a common functional bowel disorder that can severely affect the quality of life of patients.Limited drugs have been reported for modern medical IBS treatment.The advantages of traditional Chinese medicine(TCM)treatment are gradually becoming prominent.Xi-Feng-Hua-Shi granules have been clinically used for diarrhea-predominant IBS(IBS-D)treatment for many years in TCM practice.Thus,this study aimed to further verify the effectiveness and safety of Xi-Feng-Hua-Shi(XFHS)granules in IBS-D treatment through a randomized,double-blind,placebo-controlled multi-center clinical trial and provide high-quality evidence for its effectiveness and safety in treatment,as well as provide a basis for clinical rational drug use and explore new clinical IBS-D treatment plans.Methods:A randomized,double-blind,placebo-controlled multi-center clinical trial will be performed in 23 hospitals.A total of 300 participants will be randomly divided into the experimental group(prescribed with XFHS granules)and the control group(prescribed with the placebo granules),with 150 participants in each group.The appearance,shape,color,and taste of the placebo granules are the same as those of XFHS granules.All participants will receive a 4-week treatment and a 6-month follow-up.The primary outcome is the overall clinical efficacy;the secondary outcomes are the IBS-Symptom Severity Score(IBS-SSS),TCM Syndrome Evaluation,and the IBS-Quality of Life(IBS-QoL)score,mental state assessment,and recurrence rate.Outcome measures(including primary and secondary outcome measures)are collected at baseline,as well as 2,4,16,and 28 weeks post-intervention.Discussion:This randomized,placebo-controlled,multi-center trial may provide high-quality evidence for the clinical XFHS granule efficacy in IBS-D treatment.Additionally,this study will conduct safety evaluations to provide a basis for clinical rational drug use.

Minimally invasive perventricular VSD closure without cardiopulmonary bypass mid-term results from multi-centers

Objective Transesophageal echocardiography (TEE) guided,minimally invasive perventricular device occlusion of ventricular septal defects (VSDs) without cardiopulmonary bypass (CPB) has been applied in multiple centers. We reported experiences and the mid-term results. Methods Four hundred and thirty-two cases from 4 cardiac centers were involved in the study. There were 235 maled and 197 females,aged from 3 months to 15 years,with a body weight varying from 4.0 to 26.0 kg.

Effect of meridian sinew row needling combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis: a multi-center randomized controlled trial

Objective To explore the effect of meridian sinew row needling combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis. Methods Four hundred and eighty-eight cases of post-stroke patients with upper limb spasticity were randomly divided into two groups at the ratio of 1： 1, the group of meridian sinew row needling combined with dermal needling （group A, 244 cases） and western medication group （group B, 244 cases）. Coupled with rehabilitation, the patients in the group A were given meridian sinew row needling combined with dermal needling where five shu points were specifically selected, and three yang meridians of the hand were treated with acupuncture with muscle region, and three yin meridians of the hand were treated with dermal needles; the patients in the group B was treated with conventional western medication with piracetam injection and cerebroprotein hydrolysate included. Clinical efficacy was evaluated among patients in the two groups after three weeks of continuous treatment, and upper limb spasticity and motor functions were observed through modified Asworth Scale and FugI-Meyer Assessment Scale （FMA） before and after treatment. Results For Asworth Scale, group A was significantly superior to group B （3.04 ± 1.29 vs 3.88 ± 1.54, P〈0.05）; for FMA scale, group A was also significantly superior to group B （48.67± 15.64 vs 42.96±14.72, P〈0.05）; mitigations of motor status of upper limb joints in group A, such as remission of shoulder adduction （90.5%）, pronation of forearm （70.7%）, elbow joint flexion （73.1%）, wrist joint flexion （80.9%） and finger flexion （88.1%）, were superior to those of group B （70.0%, 60.0%, 61.9%, 57.4%, 63.2%, all P〈0.05）. Conclusion Good clinical efficacy of the treatment with combined with dermal needling on spasticity of post-stroke patients with upper limb hemiparalysis is achieved.

A multi-center investigation of breast-conserving surgery based on data from the Chinese Society of Breast Surgery(CSBrS-005)

Background:Although breast-conserving surgery is one of the standard treatments for breast cancer,few studies have assessed its recent implementation in China.We aimed to clarify the current real-world status of breast-conserving surgery in China.Methods:This cross-sectional survey relied on data collected by the Chinese Society of Breast Surgery(CSBrS)to examine patients who underwent this surgery between January 2018 and December 2018.The survey was conducted using a uniform electronic questionnaire to collect information,including clinical and pathological data on these patients.Results:Overall,4459 breast-conserving surgeries were performed in 34 member units of CSBrS,accounting for 14.6%of all breast cancer surgeries performed in these units during the study period.In patients who underwent breast-conserving surgery with information on tumor size available,more than half(61.2%)of the tumors were smaller than 2 cm in diameter,and only 87(3.2%)tumors were larger than 4 cm in diameter.Among patients who underwent breast-conserving surgeries,457(10.2%)patients received neoadjuvant therapy before the surgery.Among patients with a reported margin width,34(2.0%)patients had a margin of≤2 mm,and 1530(88.2%)of them had a margin of>5 mm.Conclusions:This study demonstrated the rates of breast-conserving surgery in member units of the CSBrS,and introduced the characteristics and surgical margins of patients who underwent this surgery.This information helps describe the real-world status of breast-conserving surgery in China.

Multi-center Study Finds Therapy Boosts Kvidney Transplants in "Highly Sensitized" Patients

到目前为止,对于肾脏疾病晚期患者的最好的救治方法是实施肾脏移植手术,但是手术后患者不得不做大量透析以抵抗肾脏移植引起的排异。现在,科学家们发明了一种治疗排异的药物来替代费用昂贵且痛苦的透析,那就是静脉内免疫球蛋白(IVIG)。与其他抗排异药物不同,它不会破坏人本身的免疫系统。

A multi-center clinical observation on safety and efficacy of a plasma derived coagulator factor Ⅷ for treatment of patients with hemophilia A

Objective To evaluate the efficacy and safety of home-made plasma derived coagulation factorⅧin patients with hemophilia A.Methods Patients with congenital hemophilia A who met the inclusive and exclusive criteria were enrolled in the study after informed consent.

多中心协同治理:何以可能,何以可为?——基于江苏C县农村人居环境治理的经验诠释

从多中心协同治理的理论逻辑出发,构建“政府、企业、村民、社会组织”多中心主体下的协同治理机制,聚焦主体之间互动关系的生成机制和运行逻辑,并以江苏省C县农村人居环境的治理实践作为典型案例进行解析。研究表明,多中心协同治理是一种节本增效且具备操作性的治理方案,具备中国乡村场域的现实支撑,即主要通过沟通协作、资源整合、目标耦合以及利益联结,明确治理体系中各主体的功能定位,进而对行政规制、市场经济、村民自治、社会参与等进行界定分工,由此有效调动各方的积极性和能动性,实现激励相容与优势互补,最终形成治理合力。

“里和”与“外应”:气候变化下环湖地区的适应性治理

气候变化给青藏高原带来显著影响,更是对当地农牧民的生计造成冲击,研究当地气候变化影响及牧民应对策略,不仅是提高气候变化适应能力的起点,也是建立适应气候变化区域格局的重要支撑。基于2020和2023年对案例地Z村的两次实地调研,通过牧户问卷调查和深度访谈,按照适应性治理的三层特征,分析当地气候变化适应的成效与挑战。研究发现:面对降水和气温的变化、湖面扩大、植被变化和灾害影响,牧民积极采取多种办法来减少气候变化的影响,呈现较高的适应性与恢复力。这些适应行动的成功经验源于“里和”,包括人与人之间的合作以及人与自然间的和谐律动。但是“外应”不足仍是挑战,即案例地缺少必要的外部支持,不仅包括直接灾害救助,还包括对其适应能力可持续性的保护和应对潜在的草原生态变化。如果“外应”持续低迷,现有的适应能力终会耗尽。提出建立适应气候变化区域格局应遵循多中心治理的思路,将多个利益相关者联合起来,汇总不同地区气候变化应对的成功经验,形成多种知识的融合,才能形成对地方的有效“外应”,提高中国气候变化适应能力。

多中心产业共治的区域现代产业集群建设策略——以广东省精密仪器设备产业集群为例

在国际高端技术封锁日益严峻的新形势下,从任务解构的角度将区域现代产业集群建设进行分层任务细化尤为重要,且需要从目标需求导向的角度出发,针对具体分层任务明确多元治理主体的结构关系及对应主体的治理举措。基于现代产业体系的内涵特征提出区域现代产业集群建设逻辑,并基于多中心治理理论构建多中心产业共治建设区域现代产业集群的理论框架。研究认为,面向区域现代产业集群建设的战略层、发展层、支撑层等五大分层建设任务,政府部门、企业、科研机构、行业协会与服务机构等多元主体通过自发互动博弈,形成分类主导的多中心产业共治模式。为进一步阐述及试验理论,以广东省精密仪器设备产业集群主导咨询机构的集群治理为实践案例,认为其存在多中心联动的积极性和共治模式均有待加强的问题,且关键核心技术短缺问题较为突出。针对此,提出健全多中心联动协调工作机制、政企双中心共治提升产业安全度、多维支撑中心有序推进关键核心技术攻关、政府牵引多中心集聚融通、数字治理创新助推区域产业集群智慧建设等共治效能提升的建议。

基于云数据中心的多源异构数据治理技术研究

目前常规的多源异构数据治理方法主要通过对数据属性进行判断,从而实现分区域数据清洗,由于缺乏对非线性数据的分析,导致治理性能不佳;对此,提出基于云数据中心的多源异构数据治理技术;采用关系型数据库中的ETL功能对数据进行清洗,对数据转换模式以及数据清洗规则进行定义;引入互信息系数对数据相关程度进行判定,并进行非线性数据相关性分析;以云数据中心作为载体,对多源异构数据治理体系进行构建;在实验中,对提出的数据治理技术进行了治理性能的检验;最终的实验结果表明,提出的数据治理技术具备较高的查准率,对云数据中心多源异构数据具备较为理想的数据治理效果。

Generating attosecond pulses with controllable polarization from cyclic H_(3)^(2+) molecules by bichromatic circular fields

We investigate the polarization properties of harmonics from the cyclic H_(3)^(2+) molecular ions in tailored bichromatic counter-rotating circularly polarized(BCCP)fields by solving the time-dependent Schrödinger equation.The allowed harmonics and their helicities are associated with the symmetry compatibility of the field-target systems,and large intensity difference between adjacent harmonics with opposite helicities appears in a wide spectral range when the BCCP field is at certain rotation angles.We try to explain the intensity difference by using a recombination model based on the quantum-orbit theory and by analyzing the ionization pathways.Moreover,to synthesize attosecond pulse trains with tunable polarization,the intensity difference is manipulated by introducing a seed XUV field,and by changing the relative amplitude ratio as well as the helicity of BCCP fields.