Optimized sequential therapy vs 10- and 14-d concomitant therapy for eradicating Helicobacter pylori: A randomized clinical trial

BACKGROUND A cure for Helicobacter pylori(H.pylori)remains a problem of global concern.The prevalence of antimicrobial resistance is widely rising and becoming a challenging issue worldwide.Optimizing sequential therapy seems to be one of the most attractive strategies in terms of efficacy,tolerability and cost.The most common sequential therapy consists of a dual therapy[proton-pump inhibitors(PPIs)and amoxicillin]for the first period(5 to 7 d),followed by a triple therapy for the second period(PPI,clarithromycin and metronidazole).PPIs play a key role in maintaining a gastric pH at a level that allows an optimal efficacy of antibiotics,hence the idea of using new generation molecules.This open-label prospective study randomized 328 patients with confirmed H.pylori infection into three groups(1:1:1):The first group received quadruple therapy consisting of twice-daily(bid)omeprazole 20 mg,amoxicillin 1 g,clarith-romycin 500 mg and metronidazole 500 mg for 10 d(QT-10),the second group received a 14 d quadruple therapy following the same regimen(QT-14),and the third group received an optimized sequential therapy consisting of bid rabe-prazole 20 mg plus amoxicillin 1 g for 7 d,followed by bid rabeprazole 20 mg,clarithromycin 500 mg and metronidazole 500 mg for the next 7 d(OST-14).AEs were recorded throughout the study,and the H.pylori eradication rate was determined 4 to 6 wk after the end of treatment,using the 13C urea breath test.RESULTS In the intention-to-treat and per-protocol analysis,the eradication rate was higher in the OST-14 group compared to the QT-10 group:(93.5%,85.5%P=0.04)and(96.2%,89.5%P=0.03)respectively.However,there was no statist-ically significant difference in eradication rates between the OST-14 and QT-14 groups:(93.5%,91.8%P=0.34)and(96.2%,94.4%P=0.35),respectively.The overall incidence of AEs was significantly lower in the OST-14 group(P=0.01).Furthermore,OST-14 was the most cost-effective among the three groups.CONCLUSION The optimized 14-d sequential therapy is a safe and effective alternative.Its eradication rate is comparable to that of the 14-d concomitant therapy while causing fewer AEs and allowing a gain in terms of cost.

Accelerated Sequential Deposition Reaction via Crystal Orientation Engineering for Low-Temperature,High-Efficiency Carbon-Electrode CsPbBr_(3) Solar Cells

Low-temperature,ambient processing of high-quality CsPbBr_(3)films is demanded for scalable production of efficient,low-cost carbon-electrode perovskite solar cells(PSCs).Herein,we demonstrate a crystal orientation engineering strategy of PbBr_(2)precursor film to accelerate its reaction with CsBr precursor during two-step sequential deposition of CsPbBr_(3)films.Such a novel strategy is proceeded by adding CsBr species into PbBr_(2)precursor,which can tailor the preferred crystal orientation of PbBr_(2)film from[020]into[031],with CsBr additive staying in the film as CsPb_(2)Br_(5)phase.Theoretical calculations show that the reaction energy barrier of(031)planes of PbBr_(2)with CsBr is lower about 2.28 eV than that of(O2O)planes.Therefore,CsPbBr_(3)films with full coverage,high purity,high crystallinity,micro-sized grains can be obtained at a low temperature of 150℃.Carbon-electrode PSCs with these desired CsPbBr_(3)films yield the record-high efficiency of 10.27%coupled with excellent operation stability.Meanwhile,the 1 cm^(2)area one with the superior efficiency of 8.00%as well as the flexible one with the champion efficiency of 8.27%and excellent mechanical bending characteristics are also achieved.

An Overview of Sequential Approximation in Topology Optimization of Continuum Structure

This paper offers an extensive overview of the utilization of sequential approximate optimization approaches in the context of numerically simulated large-scale continuum structures.These structures,commonly encountered in engineering applications,often involve complex objective and constraint functions that cannot be readily expressed as explicit functions of the design variables.As a result,sequential approximation techniques have emerged as the preferred strategy for addressing a wide array of topology optimization challenges.Over the past several decades,topology optimization methods have been advanced remarkably and successfully applied to solve engineering problems incorporating diverse physical backgrounds.In comparison to the large-scale equation solution,sensitivity analysis,graphics post-processing,etc.,the progress of the sequential approximation functions and their corresponding optimizersmake sluggish progress.Researchers,particularly novices,pay special attention to their difficulties with a particular problem.Thus,this paper provides an overview of sequential approximation functions,related literature on topology optimization methods,and their applications.Starting from optimality criteria and sequential linear programming,the other sequential approximate optimizations are introduced by employing Taylor expansion and intervening variables.In addition,recent advancements have led to the emergence of approaches such as Augmented Lagrange,sequential approximate integer,and non-gradient approximation are also introduced.By highlighting real-world applications and case studies,the paper not only demonstrates the practical relevance of these methods but also underscores the need for continued exploration in this area.Furthermore,to provide a comprehensive overview,this paper offers several novel developments that aim to illuminate potential directions for future research.

Attribute Reduction Method Based on Sequential Three-Branch Decision Model

Attribute reduction is a research hotspot in rough set theory. Traditional heuristic attribute reduction methods add the most important attribute to the decision attribute set each time, resulting in multiple redundant attribute calculations, high time consumption, and low reduction efficiency. In this paper, based on the idea of sequential three-branch decision classification domain, attributes are treated as objects of three-branch division, and attributes are divided into core attributes, relatively necessary attributes, and unnecessary attributes using attribute importance and thresholds. Core attributes are added to the decision attribute set, unnecessary attributes are rejected from being added, and relatively necessary attributes are repeatedly divided until the reduction result is obtained. Experiments were conducted on 8 groups of UCI datasets, and the results show that, compared to traditional reduction methods, the method proposed in this paper can effectively reduce time consumption while ensuring classification performance.

Proposal for sequential Stern-Gerlach experiment with programmable quantum processors

The historical significance of the Stern–Gerlach(SG)experiment lies in its provision of the initial evidence for space quantization.Over time,its sequential form has evolved into an elegant paradigm that effectively illustrates the fundamental principles of quantum theory.To date,the practical implementation of the sequential SG experiment has not been fully achieved.In this study,we demonstrate the capability of programmable quantum processors to simulate the sequential SG experiment.The specific parametric shallow quantum circuits,which are suitable for the limitations of current noisy quantum hardware,are given to replicate the functionality of SG devices with the ability to perform measurements in different directions.Surprisingly,it has been demonstrated that Wigner’s SG interferometer can be readily implemented in our sequential quantum circuit.With the utilization of the identical circuits,it is also feasible to implement Wheeler’s delayed-choice experiment.We propose the utilization of cross-shaped programmable quantum processors to showcase sequential experiments,and the simulation results demonstrate a strong alignment with theoretical predictions.With the rapid advancement of cloud-based quantum computing,such as BAQIS Quafu,it is our belief that the proposed solution is well-suited for deployment on the cloud,allowing for public accessibility.Our findings not only expand the potential applications of quantum computers,but also contribute to a deeper comprehension of the fundamental principles underlying quantum theory.

Sequential Inverse Optimal Control of Discrete-Time Systems

This paper presents a novel sequential inverse optimal control(SIOC)method for discrete-time systems,which calculates the unknown weight vectors of the cost function in real time using the input and output of an optimally controlled discrete-time system.The proposed method overcomes the limitations of previous approaches by eliminating the need for the invertible Jacobian assumption.It calculates the possible-solution spaces and their intersections sequentially until the dimension of the intersection space decreases to one.The remaining one-dimensional vector of the possible-solution space’s intersection represents the SIOC solution.The paper presents clear conditions for convergence and addresses the issue of noisy data by clarifying the conditions for the singular values of the matrices that relate to the possible-solution space.The effectiveness of the proposed method is demonstrated through simulation results.

Enhancement of vertical phase separation in sequentially deposited organic photovoltaics through the independent processing of additives

Herein,the impact of the independent control of processing additives on vertical phase separation in sequentially deposited (SD) organic photovoltaics (OPVs) and its subsequent effects on charge carrier kinetics at the electron donor-acceptor interface are investigated.The film morphology exhibits notable variations,significantly depending on the layer to which 1,8-diiodooctane (DIO) was applied.Grazing incidence wide-angle X-ray scattering analysis reveals distinctly separated donor/acceptor phases and vertical crystallinity details in SD films.Time-of-flight secondary ion mass spectrometry analysis is employed to obtain component distributions in diverse vertical phase structures of SD films depending on additive control.In addition,nanosecond transient absorption spectroscopy shows that DIO control significantly affects the dynamics of separated charges in SD films.In SD OPVs,DIO appears to act through distinct mechanisms with minimal restriction,depending on the applied layer.This study emphasizes the significance of morphological optimization in improving device performance and underscores the importance of independent additive control in the advancement of OPV technology.

Efficacy and safety of Xileisan combined with mesalazine for ulcerative colitis:A meta-analysis and trial sequential analysis

BACKGROUND The benefits and risks of Xileisan(XLS)in the treatment of ulcerative colitis(UC)remain unclear.AIM The present study aimed to evaluate the efficacy and safety of the combination of XLS and mesalazine when treating UC.METHODS We searched eight databases for clinical trials evaluating the combination of XLS and mesalazine in the treatment of UC,up to January 2024.Meta-analysis and trial sequential analysis(TSA)were performed using Revman 5.3 and TSA 0.9.5.10 beta,respectively.RESULTS The present study included 13 clinical studies involving 990 patients,of which 501 patients received XLS combined with mesalazine while 489 patients received mesalazine alone.The meta-analysis showed that,in terms of efficacy,the combination of XLS and mesalazine significantly improved the clinical efficacy rate by 22%[risk ratio(RR)=1.22;95%CI:1.15–1.28;P<0.00001]and mucosal improvement rate by 25%(RR=1.25;95%CI:1.12–1.39;P=0.0001),while significantly reducing the duration of abdominal pain by 2.25 days[mean difference(MD)=-2.25;95%CI:-3.35 to-1.14;P<0.0001],diarrhea by 2.06 days(MD=-2.06;95%CI:-3.92 to-0.20;P=0.03),hematochezia by 2.32 days(MD=-2.32;95%CI:-4.02 to-0.62;P=0.008),tumor necrosis factor alpha by 16.25 ng/mL(MD=-16.25;95%CI:-20.48 to-12.01;P<0.00001),and interleukin-6 by 14.14 ng/mL(MD=-14.14;95%CI:-24.89 to-3.39;P=0.01).The TSA indicated conclusiveness in the meta-analysis of the efficacy endpoints.In terms of safety,the meta-analysis revealed that the combination of XLS and mesalazine did not increase the occurrence of total and gastrointestinal adverse events,abdominal distension,and erythema(P>0.05).The TSA showed non conclusive findings in the meta-analysis of the safety endpoints.Harbord’s test showed no publication bias(P=0.734).CONCLUSION Treatment with XLS alleviated the clinical symptoms,intestinal mucosal injury,and inflammatory response in patients with UC,while demonstrating good safety.

Exploring Sequential Feature Selection in Deep Bi-LSTM Models for Speech Emotion Recognition

Machine Learning(ML)algorithms play a pivotal role in Speech Emotion Recognition(SER),although they encounter a formidable obstacle in accurately discerning a speaker’s emotional state.The examination of the emotional states of speakers holds significant importance in a range of real-time applications,including but not limited to virtual reality,human-robot interaction,emergency centers,and human behavior assessment.Accurately identifying emotions in the SER process relies on extracting relevant information from audio inputs.Previous studies on SER have predominantly utilized short-time characteristics such as Mel Frequency Cepstral Coefficients(MFCCs)due to their ability to capture the periodic nature of audio signals effectively.Although these traits may improve their ability to perceive and interpret emotional depictions appropriately,MFCCS has some limitations.So this study aims to tackle the aforementioned issue by systematically picking multiple audio cues,enhancing the classifier model’s efficacy in accurately discerning human emotions.The utilized dataset is taken from the EMO-DB database,preprocessing input speech is done using a 2D Convolution Neural Network(CNN)involves applying convolutional operations to spectrograms as they afford a visual representation of the way the audio signal frequency content changes over time.The next step is the spectrogram data normalization which is crucial for Neural Network(NN)training as it aids in faster convergence.Then the five auditory features MFCCs,Chroma,Mel-Spectrogram,Contrast,and Tonnetz are extracted from the spectrogram sequentially.The attitude of feature selection is to retain only dominant features by excluding the irrelevant ones.In this paper,the Sequential Forward Selection(SFS)and Sequential Backward Selection(SBS)techniques were employed for multiple audio cues features selection.Finally,the feature sets composed from the hybrid feature extraction methods are fed into the deep Bidirectional Long Short Term Memory(Bi-LSTM)network to discern emotions.Since the deep Bi-LSTM can hierarchically learn complex features and increases model capacity by achieving more robust temporal modeling,it is more effective than a shallow Bi-LSTM in capturing the intricate tones of emotional content existent in speech signals.The effectiveness and resilience of the proposed SER model were evaluated by experiments,comparing it to state-of-the-art SER techniques.The results indicated that the model achieved accuracy rates of 90.92%,93%,and 92%over the Ryerson Audio-Visual Database of Emotional Speech and Song(RAVDESS),Berlin Database of Emotional Speech(EMO-DB),and The Interactive Emotional Dyadic Motion Capture(IEMOCAP)datasets,respectively.These findings signify a prominent enhancement in the ability to emotional depictions identification in speech,showcasing the potential of the proposed model in advancing the SER field.

Embryo Transfer Strategies for Women with Recurrent Implantation Failure During the Frozen-thawed Embryo Transfer Cycles:Sequential Embryo Transfer or Double-blastocyst Transfer?

Objective Both sequential embryo transfer(SeET)and double-blastocyst transfer(DBT)can serve as embryo transfer strategies for women with recurrent implantation failure(RIF).This study aims to compare the effects of SeET and DBT on pregnancy outcomes.Methods Totally,261 frozen-thawed embryo transfer cycles of 243 RIF women were included in this multicenter retrospective analysis.According to different embryo quality and transfer strategies,they were divided into four groups:group A,good-quality SeET(GQ-SeET,n=38 cycles);group B,poor-quality or mixed-quality SeET(PQ/MQ-SeET,n=31 cycles);group C,good-quality DBT(GQ-DBT,n=121 cycles);and group D,poor-quality or mixed-quality DBT(PQ/MQ-DBT,n=71 cycles).The main outcome,clinical pregnancy rate,was compared,and the generalized estimating equation(GEE)model was used to correct potential confounders that might impact pregnancy outcomes.Results GQ-DBT achieved a significantly higher clinical pregnancy rate(aOR 2.588,95%CI 1.267–5.284,P=0.009)and live birth rate(aOR 3.082,95%CI 1.482–6.412,P=0.003)than PQ/MQ-DBT.Similarly,the clinical pregnancy rate was significantly higher in GQ-SeET than in PQ/MQ-SeET(aOR 4.047,95%CI 1.218–13.450,P=0.023).The pregnancy outcomes of GQ-SeET were not significantly different from those of GQ-DBT,and the same results were found between PQ/MQ-SeET and PQ/MQ-DBT.Conclusion SeET relative to DBT did not seem to improve pregnancy outcomes for RIF patients if the embryo quality was comparable between the two groups.Better clinical pregnancy outcomes could be obtained by transferring good-quality embryos,no matter whether in SeET or DBT.Embryo quality plays a more important role in pregnancy outcomes for RIF patients.

Effect of sequential nursing care combined with communication intervention on visual recovery and pain after cataract ultrasound emulsification

BACKGROUND Cataracts are a common ophthalmic disease and postoperative vision recovery is crucial to patient quality of life.Rational and efficient care models play an impor-tant role in promoting vision recovery.AIM To evaluate the clinical effectiveness of procedural nursing care combined with communication intervention in vision recovery after cataract ultrasound emulsi-fication.METHODS A randomized controlled study was conducted on 100 patients with cataracts who underwent ultrasound emulsification surgery.They were randomly assigned to an experimental group or a control group.The experimental group received procedural nursing combined with Connect,Introduce,Communicate,Ask,Respond,Exit(CICARE)communication intervention,whereas the control group received conventional nursing.The effectiveness of the nursing model was assessed by comparing differences in vision recovery,pain scores,and mental health status between the two groups.RESULTS It was found that over time the visual acuity of patients in both groups gradually recovered and patients in the experimental group had lower pain scores and superior mental health status than the control group(P<0.05).CONCLUSION Procedural nursing combined with CICARE communication intervention has positive effects on vision recovery in patients after cataract ultrasound emulsification.

Sequential neoadjuvant chemotherapy using pegylated liposomal doxorubicin and cyclophosphamide followed by taxanes with complete trastuzumab and pertuzumab treatment for HER2-positive breast cancer: A phase Ⅱ single-arm study

Objective: Despite cardiotoxicity overlap, the trastuzumab/pertuzumab and anthracycline combination remains crucial due to significant benefits. Pegylated liposomal doxorubicin(PLD), a less cardiotoxic anthracycline, was evaluated for efficacy and cardiac safety when combined with cyclophosphamide and followed by taxanes with trastuzumab/pertuzumab in human epidermal growth factor receptor-2(HER2)-positive early breast cancer(BC).Methods: In this multicenter, phase II study, patients with confirmed HER2-positive early BC received four cycles of PLD(30-35 mg/m^(2)) and cyclophosphamide(600 mg/m^(2)), followed by four cycles of taxanes(docetaxel,90-100 mg/m^(2) or nab-paclitaxel, 260 mg/m^(2)), concomitant with eight cycles of trastuzumab(8 mg/kg loading dose,then 6 mg/kg) and pertuzumab(840 mg loading dose, then 420 mg) every 3 weeks. The primary endpoint was total pathological complete response(tp CR, yp T0/is yp N0). Secondary endpoints included breast p CR(bp CR),objective response rate(ORR), disease control rate, rate of breast-conserving surgery(BCS), and safety(with a focus on cardiotoxicity).Results: Between May 27, 2020 and May 11, 2022, 78 patients were treated with surgery, 42(53.8%) of whom had BCS. After neoadjuvant therapy, 47 [60.3%, 95% confidence interval(95% CI), 48.5%-71.2%] patients achieved tp CR, and 49(62.8%) achieved bp CR. ORRs were 76.9%(95% CI, 66.0%-85.7%) and 93.6%(95% CI,85.7%-97.9%) after 4-cycle and 8-cycle neoadjuvant therapy, respectively. Nine(11.5%) patients experienced asymptomatic left ventricular ejection fraction(LVEF) reductions of ≥10% from baseline, all with a minimum value of >55%. No treatment-related abnormal cardiac function changes were observed in mean N-terminal pro-BNP(NT-pro BNP), troponin I, or high-sensitivity troponin.Conclusions: This dual HER2-blockade with sequential polychemotherapy showed promising activity with rapid tumor regression in HER2-positive BC. Importantly, this regimen showed an acceptable safety profile,especially a low risk of cardiac events, suggesting it as an attractive treatment approach with a favorable risk-benefit balance.

Solving the Generalized Traveling Salesman Problem Using Sequential Constructive Crossover Operator in Genetic Algorithm

The generalized travelling salesman problem(GTSP),a generalization of the well-known travelling salesman problem(TSP),is considered for our study.Since the GTSP is NP-hard and very complex,finding exact solutions is highly expensive,we will develop genetic algorithms(GAs)to obtain heuristic solutions to the problem.In GAs,as the crossover is a very important process,the crossovermethods proposed for the traditional TSP could be adapted for the GTSP.The sequential constructive crossover(SCX)and three other operators are adapted to use in GAs to solve the GTSP.The effectiveness of GA using SCX is verified on some GTSP Library(GTSPLIB)instances first and then compared against GAs using the other crossover methods.The computational results show the success of the GA using SCX for this problem.Our proposed GA using SCX,and swap mutation could find average solutions whose average percentage of excesses fromthe best-known solutions is between 0.00 and 14.07 for our investigated instances.

Prediction of lime utilization ratio of dephosphorization in BOF steelmaking based on online sequential extreme learning machine with forgetting mechanism

The machine learning models of multiple linear regression(MLR),support vector regression(SVR),and extreme learning ma-chine(ELM)and the proposed ELM models of online sequential ELM(OS-ELM)and OS-ELM with forgetting mechanism(FOS-ELM)are applied in the prediction of the lime utilization ratio of dephosphorization in the basic oxygen furnace steelmaking process.The ELM model exhibites the best performance compared with the models of MLR and SVR.OS-ELM and FOS-ELM are applied for sequential learning and model updating.The optimal number of samples in validity term of the FOS-ELM model is determined to be 1500,with the smallest population mean absolute relative error(MARE)value of 0.058226 for the population.The variable importance analysis reveals lime weight,initial P content,and hot metal weight as the most important variables for the lime utilization ratio.The lime utilization ratio increases with the decrease in lime weight and the increases in the initial P content and hot metal weight.A prediction system based on FOS-ELM is applied in actual industrial production for one month.The hit ratios of the predicted lime utilization ratio in the error ranges of±1%,±3%,and±5%are 61.16%,90.63%,and 94.11%,respectively.The coefficient of determination,MARE,and root mean square error are 0.8670,0.06823,and 1.4265,respectively.The system exhibits desirable performance for applications in actual industrial pro-duction.

Sequential experimental observation on the curative effect of Yingbupu decoction of Zhuang medicine on stage I and II acute kidney injury

Objective:To observe the clinical efficacy of the Zhuang medicine Yingbupu decoction on stage I and II acute kidney injury through sequential test.Methods:The open one-way qualitative response sequential design of experiments was adopted,and the patients with AKI in phase I and II who met the inclusion criteria were divided into the treatment group and the control group according to the order of hospitalization by random number table.On the basis of basic treatment,the treatment group was treated with Zhuang medicine Yingbupu decoction,and the control group was treated with Jinshuibao tablet.The clinical efficacy,TCM syndrome score,24 h urine volume,serum creatinine(Scr),microalbumin in urine(mAlb),neutrophil Gelatinase related lipid delivery albumin(NGAL)of the two groups were compared,and the adverse reactions and complications of the two groups were observed.Results:After 14 d of treatment,when the treatment group reached the 10th case,the experimental line contacted the upper bound U-line and reached the experimental standard to terminate the experiment.The effective hypothesis was accepted,and it was believed that the Zhuang medicine Yingbupu decoction had a therapeutic effect on stage I and II AKI.The conclusion was drawn that the treatment group received the Zhuang medicine Yingbupu.The clinical effective rate and improvement days were similar between the two groups,and there was no significant difference(P>0.05).However,the integral value of traditional Chinese medicine syndrome in the treatment group was lower than that in the control group(P<0.05),After treatment,the Scr,mAlb,and NGAL levels of patients in both groups were lower than before treatment(P<0.05).After treatment,the Scr,mAlb,and NGAL values in the treatment group were significantly lower than those in the control group(P<0.05).After treatment,the 24-hour urine volume in both groups was higher than that before treatment,and the values in the treatment group were significantly higher than those in the control group(P<0.05).During the treatment period,there were no significant adverse reactions or complications in either group.Conclusion:The Zhuang medicine Yingbupu decoction is effective in treating stage I and II AKI,and the Zhuang medicine Yingbupu can significantly improve the symptoms and quality of life of patients with stage I and II AKI.Its improvement of renal function is better than that of Jinshuibao tablets,and its safety is good.

Learning Sequential and Structural Dependencies Between Nucleotides for RNA N6-Methyladenosine Site Identification

N6-methyladenosine(m6A)is an important RNA methylation modification involved in regulating diverse biological processes across multiple species.Hence,the identification of m6A modification sites provides valuable insight into the biological mechanisms of complex diseases at the post-transcriptional level.Although a variety of identification algorithms have been proposed recently,most of them capture the features of m6A modification sites by focusing on the sequential dependencies of nucleotides at different positions in RNA sequences,while ignoring the structural dependencies of nucleotides in their threedimensional structures.To overcome this issue,we propose a cross-species end-to-end deep learning model,namely CR-NSSD,which conduct a cross-domain representation learning process integrating nucleotide structural and sequential dependencies for RNA m6A site identification.Specifically,CR-NSSD first obtains the pre-coded representations of RNA sequences by incorporating the position information into single-nucleotide states with chaos game representation theory.It then constructs a crossdomain reconstruction encoder to learn the sequential and structural dependencies between nucleotides.By minimizing the reconstruction and binary cross-entropy losses,CR-NSSD is trained to complete the task of m6A site identification.Extensive experiments have demonstrated the promising performance of CR-NSSD by comparing it with several state-of-the-art m6A identification algorithms.Moreover,the results of cross-species prediction indicate that the integration of sequential and structural dependencies allows CR-NSSD to capture general features of m6A modification sites among different species,thus improving the accuracy of cross-species identification.

Effect of Sequential Early Enteral Nutrition on Postoperative Rehabilitation and Complications in Gastric Cancer Patients

Objective:To analyze the effect of sequential early enteral nutrition in patients with gastric cancer after surgery.Methods:A total of 139 gastric cancer patients,treated between October 2021 and October 2023,were randomly selected and divided into two groups:Group A(68 cases,receiving early enteral nutrition)and Group B(71 cases,receiving sequential early enteral nutrition),using computer randomization.The effects of the interventions on both groups were compared.Results:Seven days post-operation,the levels of nutritional indicators in Group B were significantly higher than those in Group A(P<0.05).Group B showed significantly better levels of inflammatory factors and immune factors compared to Group A seven days post-operation(P<0.05).The postoperative complication rate in Group B was 4.23%,2 significantly lower than that in Group A,which was 16.18%(χ=5.477,P=0.019).Conclusion:The utilization of sequential early enteral nutrition in gastric cancer patients after surgery demonstrated notable improvements in nutritional status and inflammation markers,along with enhanced immunity,effectively reducing postoperative complications.

中医体质分型对全麻诱导时七氟醚MAC值的影响

目的:探讨气管插管全麻诱导时,在常见的四种中医体质分型患者中,吸入七氟醚使意识消失的最低肺泡有效浓度的半数有效浓度(EC_(50))的差异。方法:研究纳入80例拟择期行气管插管全麻手术患者,根据《中医体质分类与判定》标准分为平和质(A组)、血瘀质(B组)、阴虚质(C组)、阳虚质(D组)共四组,每组20例。以吸入麻醉药七氟醚诱导麻醉,使患者意识消失,设定起始七氟醚的呼气末浓度为1.72%,并计算出5个阶梯的七氟醚呼吸末浓度值,分别为0.84%、1.21%、1.72%、2.45%和3.50%,最终用序贯法测定患者意识消失时七氟醚最低肺泡浓度的EC_(50)。结果:四组病人意识消失时七氟醚EC_(50)及对应的95%可信区间(CI)分别是:A组EC_(50)为2.37%(95%CI:1.97%~2.85%);B组EC_(50)为2.21%(95%CI:1.88%~2.58%):C组EC_(50)为2.83%(95%CI:2.63%~3.03%);D组EC_(50)为1.85%(95%CI:1.57%~2.18%)。结论:七氟醚最低肺泡有效浓度在不同中医体质患者中的存在一定差异性,阳虚患者七氟醚EC_(50)比阴虚患者明显降低。

关元命门序贯针刺激活FSHR/cAMP/PKA通路促进早发性卵巢功能不全模型大鼠颗粒细胞增殖的机制研究

【目的】观察关元命门序贯针刺方案对早发性卵巢功能不全(POI)模型大鼠的治疗作用及机制。【方法】将雌性SD大鼠分为空白组、模型组、蛋白激酶A(PKA)抑制剂(H89)+针刺组、针刺组各12只。除空白组,其他3组大鼠采用雷公藤多苷片灌胃制备POI模型。模型成功建立后,空白组和模型组每日捆绑一次;针刺组大鼠在动情间期取关元穴针刺,在动情前期取命门穴针刺;H89+针刺组按照针刺组针刺方案干预,在每次针刺前30 min内腹腔注射H89。连续干预20 d。各组大鼠分别在干预后第1个动情间期和动情前期取材。酶联免疫吸附分析(ELISA)检测动情间期促卵泡激素(FSH)、雌二醇(E2)水平,Western Blot法检测动情间期促卵泡激素受体(FSHR)、芳香化酶P450(P450arom)蛋白表达,细胞计数试剂盒8(CCK-8)法检测动情间期和动情前期颗粒细胞活性,免疫组织化学法检测动情前期增殖细胞核抗原(PCNA)蛋白表达水平。【结果】(1)与空白组比较,模型组和H89+针刺组血清FSH水平显著升高(P<0.01),E2水平显著降低(P<0.001);H89+针刺组FSH水平与模型组无差异(P>0.05),E2水平低于模型组(P<0.05);针刺组FSH水平低于模型组和H89+针刺组(P<0.05),与空白组无差异(P>0.05),E2水平显著高于模型组和H89+针刺组(P<0.01),仍低于空白组(P<0.05)。(2)模型组和H89+针刺组FSHR、P450arom蛋白表达均低于空白组(P<0.01);H89+针刺组FSHR蛋白表达水平与模型组无差异(P>0.05),P450arom蛋白表达水平低于模型组(P<0.05);针刺组FSHR、P450arom蛋白表达水平均高于模型组和H89+针刺组(P<0.05),但仍低于空白组(P<0.05)。(3)模型组和H89+针刺组GCs活性和PCNA平均光密度值均低于空白组(P<0.05);H89+针刺组GCs活性和PCNA平均光密度值均低于模型组(P<0.05);针刺组的GCs活性和PCNA平均光密度值显著高于模型组和H89+针刺组(P<0.05或P<0.01)。【结论】关元命门序贯针刺方案可通过上调促卵泡激素受体(FSHR)/环磷酸腺苷(cAMP)/蛋白激酶A(PKA)通路FSHR、P450arom蛋白的表达,调控性激素水平,提高GCs活性和促进GCs细胞增殖,从而改善POI。

半夏白术天麻汤合泽泻汤治疗眩晕临床疗效的Meta分析与试验序贯分析

目的:系统评价半夏白术天麻汤合泽泻汤治疗眩晕的临床疗效。方法:通过中国知网(CNKI)、万方(WanFang)、维普(VIP)、中国生物医学文献服务系统(SinoMed)、EMbase、PubMed、Web of Science检索半夏白术天麻汤合泽泻汤治疗眩晕的随机对照试验,检索时限为建库至2022年4月30日。根据纳入与排除标准筛选文献,并进行数据提取,采用Corchane 5.1.0系统评价手册进行质量评价,提取的数据使用RevMan 5.4及Stata17分析。结果:共纳入10篇文献,共涉及924例病人,其中对照组457例,治疗组467例。Meta分析结果显示,治疗组总有效率高于对照组[OR=3.95,95%CI(2.63,5.93),P<0.00001],采用Stata软件中的Egger′s检验对总有效率进行发表偏倚分析,结果显示P=0.003。治疗组治疗后全血高切黏度[MD=-0.60,95%CI(-0.88,-0.32),P<0.0001]、全血低切黏度[MD=-2.45,95%CI(-2.73,-2.18),P<0.00001]低于对照组;治疗后中医症状头晕目眩评分[MD=-0.85,95%CI(-0.94,-0.76),P<0.00001]、头重如裹评分、胸闷评分[MD=-0.94,95%CI(-1.05,-0.82),P<0.00001]、呕吐评分[MD=-1.34,95%CI(-1.47,-1.20),P<0.00001]低于对照组。进一步采用试验序贯分析验证了Meta分析结果。结论:现有证据表明,半夏白术天麻汤合泽泻汤治疗眩晕较单纯西药治疗临床疗效更佳。