BACKGROUND Resistance to clarithromycin(CLA)and levofloxacin(LFX)of Helicobacter pylori(H.pylori)is increasing in severity,and successful eradication is essential.Presently,the eradication success rate has greatly dec...BACKGROUND Resistance to clarithromycin(CLA)and levofloxacin(LFX)of Helicobacter pylori(H.pylori)is increasing in severity,and successful eradication is essential.Presently,the eradication success rate has greatly declined,leaving a large number of patients with previous treatment histories.AIM To investigate secondary resistance rates,explore risk factors for antibiotic resistance,and assess the efficacy of susceptibility-guided therapy.METHODS We recruited 154 subjects positive for Urea Breath Test who attended The First Affiliated Hospital of China Medical University between July 2022 and April 2023.Participants underwent a string test after an overnight fast.The gastric juice was obtained and transferred to vials containing storage solution.Subsequently,DNA extraction and the specific DNA amplification were performed using quantitative polymerase chain reaction(qPCR).Demographic information was also analyzed as part of the study.Based on these results,the participants were administered susceptibility-guided treatment.Efficacy was compared with that of the empiric treatment group.RESULTS A total of 132 individuals tested positive for the H.pylori ureA gene by qPCR technique.CLA resistance rate reached a high level of 82.6%(n=109),LFX resistance rate was 69.7%(n=92)and dual resistance was 62.1%(n=82).Gastric symptoms[odds ratio(OR)=2.782;95%confidence interval(95%CI):1.076-7.194;P=0.035]and rural residence(OR=5.152;95%CI:1.407-18.861;P=0.013)were independent risk factors for secondary resistance to CLA and LFX,respectively.A total of 102 and 100 individuals received susceptibility-guided therapies and empiric treatment,respectively.The antibiotic susceptibility-guided treatment and empiric treatment groups achieved successful eradication rates of 75.5%(77/102)and 59.0%(59/411)by the intention-to-treat(ITT)analysis and 90.6%(77/85)and 70.2%(59/84)by the per-protocol(PP)analysis,respectively.The eradication rates of these two treatment strategies were significantly different in both ITT(P=0.001)and PP(P=0.012)analyses.CONCLUSION H.pylori presented high secondary resistance rates to CLA and LFX.For patients with previous treatment failures,treatments should be guided by antibiotic susceptibility tests or regional antibiotic resistance profile.展开更多
Objective:To compare the clinical efficacy of moxifloxacin and levofloxacin in the treatment of elderly patients with community-acquired pneumonia(CAP).Methods:A total of 80 elderly CAP patients admitted between April...Objective:To compare the clinical efficacy of moxifloxacin and levofloxacin in the treatment of elderly patients with community-acquired pneumonia(CAP).Methods:A total of 80 elderly CAP patients admitted between April 2023 and February 2024 were randomly divided into two groups.The control group(n=40)received treatment with levofloxacin,while the observation group(n=40)was treated with moxifloxacin.Relevant clinical indicators were observed and compared between the two groups.Results:The overall effective treatment rate in the observation group reached 95.00%,significantly higher than the 75.00%observed in the control group(P<0.05).The time required for improvement in clinical symptoms was significantly shorter in the observation group compared to the control group(P<0.001).Pulmonary function indicators,including FVC,FEV1,and FEV1/FVC,improved in both groups after treatment,but the improvement was more pronounced in the observation group(P<0.001).Serum inflammatory factor levels indicated that post-treatment levels of IL-6,PCT,and CRP decreased in both groups compared to pre-treatment levels,with a more significant reduction in the observation group(P<0.001).The incidence of adverse reactions in the observation group was 7.50%,markedly lower than the 25.00%observed in the control group(P<0.05).Conclusion:Moxifloxacin demonstrates better clinical efficacy and safety in the treatment of elderly patients with CAP,making it a valuable option for clinical application.However,the choice of medication should still consider individual patient conditions comprehensively.展开更多
为了探究自适应上行功率控制(Adaptive Uplink Power Control,AUPC)在Q/V频段卫星信关站链路中的应用与优化,针对Q/V频段的高频特性,以及卫星通信面临严重的路径损耗和天气衰减的问题,特别是雨衰的影响,通过仿真对比传统AUPC、比例-积分...为了探究自适应上行功率控制(Adaptive Uplink Power Control,AUPC)在Q/V频段卫星信关站链路中的应用与优化,针对Q/V频段的高频特性,以及卫星通信面临严重的路径损耗和天气衰减的问题,特别是雨衰的影响,通过仿真对比传统AUPC、比例-积分-导数(Proportion Integral Differential,PID)控制和基于机器学习的AUPC这3种功率控制算法。结果表明,基于机器学习的AUPC算法在复杂和极端天气条件下预测表现最佳,能够有效预测链路变化并提前调整功率,保证了链路稳定性和通信质量。此外,还提出了基于多频段链路冗余和动态功率调节的优化策略,以期为高频段卫星通信系统提供重要的技术参考。展开更多
BACKGROUND Patients with BRAF V600E mutant metastatic colorectal cancer(mCRC)have a low incidence rate,poor biological activity,suboptimal response to conventional treatments,and a poor prognosis.In the previous cohor...BACKGROUND Patients with BRAF V600E mutant metastatic colorectal cancer(mCRC)have a low incidence rate,poor biological activity,suboptimal response to conventional treatments,and a poor prognosis.In the previous cohort study on mCRC conducted by our team,it was observed that integrated Chinese and Western medicine treatment could significantly prolong the overall survival(OS)of patients with colorectal cancer.Therefore,we further explored the survival benefits in the population with BRAF V600E mutant mCRC.AIM To evaluate the efficacy of integrated Chinese and Western medicine in the treatment of BRAF V600E mutant metastatic colorectal cancer.METHODS A cohort study was conducted on patients with BRAF V600E mutant metastatic colorectal cancer admitted to Xiyuan Hospital of China Academy of Chinese Medical Sciences and Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region from January 2016 to December 2022.The patients were divided into two cohorts.RESULTS A total of 34 cases were included,with 23 in Chinese-Western medicine cohort(cohort A)and 11 in Western medicine cohort(cohort B).The median overall survival was 19.9 months in cohort A and 14.2 months in cohort B,with a statistically significant difference(P=0.038,hazard ratio=0.46).The 1-3-year survival rates were 95.65%(22/23),39.13%(9/23),and 26.09%(6/23)in cohort A,and 63.64%(7/11),18.18%(2/11),and 9.09%(1/11)in cohort B,respectively.Subgroup analysis showed statistically significant differences in median OS between the two cohorts in the right colon,liver metastasis,chemotherapy,and first-line treatment subgroups(P<0.05).CONCLUSION Integrated Chinese and Western medicine can prolong the survival and reduce the risk of death in patients with BRAF V600E mutant metastatic colorectal cancer,with more pronounced benefits observed in patients with right colon involvement,liver metastasis,combined chemotherapy,and first-line treatment.展开更多
基金The study was reviewed and approved by the the Human Ethics Review Committee of the First Affiliated Hospital of China Medical University(Approval No.2021325).
文摘BACKGROUND Resistance to clarithromycin(CLA)and levofloxacin(LFX)of Helicobacter pylori(H.pylori)is increasing in severity,and successful eradication is essential.Presently,the eradication success rate has greatly declined,leaving a large number of patients with previous treatment histories.AIM To investigate secondary resistance rates,explore risk factors for antibiotic resistance,and assess the efficacy of susceptibility-guided therapy.METHODS We recruited 154 subjects positive for Urea Breath Test who attended The First Affiliated Hospital of China Medical University between July 2022 and April 2023.Participants underwent a string test after an overnight fast.The gastric juice was obtained and transferred to vials containing storage solution.Subsequently,DNA extraction and the specific DNA amplification were performed using quantitative polymerase chain reaction(qPCR).Demographic information was also analyzed as part of the study.Based on these results,the participants were administered susceptibility-guided treatment.Efficacy was compared with that of the empiric treatment group.RESULTS A total of 132 individuals tested positive for the H.pylori ureA gene by qPCR technique.CLA resistance rate reached a high level of 82.6%(n=109),LFX resistance rate was 69.7%(n=92)and dual resistance was 62.1%(n=82).Gastric symptoms[odds ratio(OR)=2.782;95%confidence interval(95%CI):1.076-7.194;P=0.035]and rural residence(OR=5.152;95%CI:1.407-18.861;P=0.013)were independent risk factors for secondary resistance to CLA and LFX,respectively.A total of 102 and 100 individuals received susceptibility-guided therapies and empiric treatment,respectively.The antibiotic susceptibility-guided treatment and empiric treatment groups achieved successful eradication rates of 75.5%(77/102)and 59.0%(59/411)by the intention-to-treat(ITT)analysis and 90.6%(77/85)and 70.2%(59/84)by the per-protocol(PP)analysis,respectively.The eradication rates of these two treatment strategies were significantly different in both ITT(P=0.001)and PP(P=0.012)analyses.CONCLUSION H.pylori presented high secondary resistance rates to CLA and LFX.For patients with previous treatment failures,treatments should be guided by antibiotic susceptibility tests or regional antibiotic resistance profile.
文摘Objective:To compare the clinical efficacy of moxifloxacin and levofloxacin in the treatment of elderly patients with community-acquired pneumonia(CAP).Methods:A total of 80 elderly CAP patients admitted between April 2023 and February 2024 were randomly divided into two groups.The control group(n=40)received treatment with levofloxacin,while the observation group(n=40)was treated with moxifloxacin.Relevant clinical indicators were observed and compared between the two groups.Results:The overall effective treatment rate in the observation group reached 95.00%,significantly higher than the 75.00%observed in the control group(P<0.05).The time required for improvement in clinical symptoms was significantly shorter in the observation group compared to the control group(P<0.001).Pulmonary function indicators,including FVC,FEV1,and FEV1/FVC,improved in both groups after treatment,but the improvement was more pronounced in the observation group(P<0.001).Serum inflammatory factor levels indicated that post-treatment levels of IL-6,PCT,and CRP decreased in both groups compared to pre-treatment levels,with a more significant reduction in the observation group(P<0.001).The incidence of adverse reactions in the observation group was 7.50%,markedly lower than the 25.00%observed in the control group(P<0.05).Conclusion:Moxifloxacin demonstrates better clinical efficacy and safety in the treatment of elderly patients with CAP,making it a valuable option for clinical application.However,the choice of medication should still consider individual patient conditions comprehensively.
文摘为了探究自适应上行功率控制(Adaptive Uplink Power Control,AUPC)在Q/V频段卫星信关站链路中的应用与优化,针对Q/V频段的高频特性,以及卫星通信面临严重的路径损耗和天气衰减的问题,特别是雨衰的影响,通过仿真对比传统AUPC、比例-积分-导数(Proportion Integral Differential,PID)控制和基于机器学习的AUPC这3种功率控制算法。结果表明,基于机器学习的AUPC算法在复杂和极端天气条件下预测表现最佳,能够有效预测链路变化并提前调整功率,保证了链路稳定性和通信质量。此外,还提出了基于多频段链路冗余和动态功率调节的优化策略,以期为高频段卫星通信系统提供重要的技术参考。
基金Supported by National Natural Science Foundation of China,No.82174461Hospital Capability Enhancement Project of Xiyuan Hospital,CACMS,No.XYZX0201-22Technology Innovation Project of China Academy of Chinese Medical Sciences,No.CI2021A01811.
文摘BACKGROUND Patients with BRAF V600E mutant metastatic colorectal cancer(mCRC)have a low incidence rate,poor biological activity,suboptimal response to conventional treatments,and a poor prognosis.In the previous cohort study on mCRC conducted by our team,it was observed that integrated Chinese and Western medicine treatment could significantly prolong the overall survival(OS)of patients with colorectal cancer.Therefore,we further explored the survival benefits in the population with BRAF V600E mutant mCRC.AIM To evaluate the efficacy of integrated Chinese and Western medicine in the treatment of BRAF V600E mutant metastatic colorectal cancer.METHODS A cohort study was conducted on patients with BRAF V600E mutant metastatic colorectal cancer admitted to Xiyuan Hospital of China Academy of Chinese Medical Sciences and Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region from January 2016 to December 2022.The patients were divided into two cohorts.RESULTS A total of 34 cases were included,with 23 in Chinese-Western medicine cohort(cohort A)and 11 in Western medicine cohort(cohort B).The median overall survival was 19.9 months in cohort A and 14.2 months in cohort B,with a statistically significant difference(P=0.038,hazard ratio=0.46).The 1-3-year survival rates were 95.65%(22/23),39.13%(9/23),and 26.09%(6/23)in cohort A,and 63.64%(7/11),18.18%(2/11),and 9.09%(1/11)in cohort B,respectively.Subgroup analysis showed statistically significant differences in median OS between the two cohorts in the right colon,liver metastasis,chemotherapy,and first-line treatment subgroups(P<0.05).CONCLUSION Integrated Chinese and Western medicine can prolong the survival and reduce the risk of death in patients with BRAF V600E mutant metastatic colorectal cancer,with more pronounced benefits observed in patients with right colon involvement,liver metastasis,combined chemotherapy,and first-line treatment.
