Centralized isolation of Helicobacter pylori from multiple centers and transport condition influences

AIM:To evaluate the efficacy of centralized culture and possible influencing factors.METHODS:From January 2010 to July 2012,66452 patients with suspected Helicobacter pylori(H.pylori) infection from 26 hospitals in Zhejiang and Jiangsu Provinces in China underwent gastrointestinal endoscopy.Gastric mucosal biopsies were taken from the antrum for culture.These biopsies were transported under natural environmental temperature to the central laboratory in Hangzhou city and divided into three groups based on their transport time:5,24 and 48 h.The culture results were reported after 72 h and the positive culture rates were analyzed by a χ2 test.An additional 5736 biopsies from H.pylori-positive patients(5646 rapid urease test-positive and 90 14C-urease breath test-positive) were also cultured for quality control in the central laboratory setting.RESULTS:The positive culture rate was 31.66%(21036/66452) for the patient samples and 71.72%(4114/5736) for the H.pylori-positive quality control specimens.In the 5 h transport group,the positiveculture rate was 30.99%(3865/12471),and 32.84%(14960/45553) in the 24 h transport group.In contrast,the positive culture rate declined significantly in the 48 h transport group(26.25%; P < 0.001).During transportation,the average natural temperature increased from 4.67 to 29.14℃,while the positive culture rate declined from 36.67%(1462/3987) to 24.12%(1799/7459).When the temperature exceeded 24℃,the positive culture rate decreased significantly,especially in the 48 h transport group(23.17%).CONCLUSION:Transportation of specimens within 24 h and below 24℃ is reasonable and acceptable for centralized culture of multicenter H.pylori samples.

Prevention against diffuse spinal cord astrocytoma: can the Notch pathway be a novel treatment target?

This study was designed to investigate whether the Notch pathway is involved in the develop-ment of diffuse spinal cord astrocytomas. BALB/c nude mice received injections of CD133＋and CD133？ cell suspensions prepared using human recurrent diffuse spinal cord astrocytoma tissue through administration into the right parietal lobe. After 7–11 weeks, magnetic resonance imaging was performed weekly. Xenografts were observed on the surfaces of the brains of mice receiving the CD133＋ cell suspension, and Notch-immunopositive expression was observed in the xenografts. By contrast, no xenografts appeared in the identical position on the surfaces of the brains of mice receiving the CD133？ cell suspension, and Notch-immunopositive expres-sion was hardly detected either. Hematoxylin-eosin staining and immunohistochemical staining revealed xenografts on the convex surfaces of the brains of mice that underwent CD133＋ astro-cytoma transplantation. Some sporadic astroglioma cells showed pseudopodium-like structures, which extended into the cerebral white matter. However,it should be emphasized that the sub-cortex xenograft with Notch-immunopositive expression was found in the fourth mouse received injection of CD133？ astrocytoma cells. However, these ifndings suggest that the Notch pathway plays an important role in the formation of astrocytomas, and can be considered a novel treat-ment target for diffuse spinal cord astrocytoma.

Characteristics of Liver Functions in Patients With COVID-19 and Construction of a Prognostic Evaluation Decision Model Based on Liver Functions

A number of studies have suggested that coronavirus disease 2019(COVID-19)can cause liver damage.However,clinical features and outcome of COVID-19 in patients with liver injury remain to be further investigated.In this study,the clinical data of 265 COVID-19 patients admitted to seven tertiary hospitals were collected.Based on a threshold for transaminase or total bilirubin levels at two times the normal upper limit,patients were divided into mild or moderate/severe liver injury groups.Among the 265 patients,183 patients showed liver injury within 48 hours of admission.Aspartate aminotransferase levels were predominantly elevated in the liver injury group,but albumin levels were reduced.Moreover,fibrinogen and D-dimer were significantly increased.Furthermore,68%of the patients with moderate/severe liver injury had one or more underlying diseases.Almost half of these patients developed acute respiratory distress syndrome(44%)and secondary infections(46%).These patients showed increased interleukin-6 and interleukin-10 levels and a decrease in PaO2 and the oxygenation index.In addition,levels of alanine aminotransferase,aspartate aminotransferase,and albumin were correlated with the oxygenation index,D-dimer and lymphocyte counts.Furthermore,a novel prognostic assessment model based on liver function was established,which accuracy reached 88%and was able to accurately assess the prognosis of COVID-19 patients.

Improved local control without elective nodal radiotherapy in patients with unresectable NSCLC treated by 3D-CRT

To investigate the influence of prophylactic elec-tive nodal irradiation on the therapeutic results of definitive radiotherapy for patients with stage IIIA or stage IIIB unre-sectable non-small-cell lung cancer,55 patients with clini-cally inoperable advanced non-small-cell lung cancer were studied.After four cycles of induction chemotherapy,the patients were divided into two groups at random.In one group,the elective nodal irradiation was included in clinical tumor volume(CTV)of definitive radiotherapy(ENI group);and in the other group,elective nodal irradiation was not included in CTV(non-ENI group).For the patients in the ENI group,the mean prescription dose for gross tumor volumes was 58.4 Gy,while for the patients in the non-ENI group,it was 65.8 Gy(P<0.05).The responsive rates were 45.8%and 74.0%(P<0.05),and the rate of the elective nodal failure(ENF)was 4.2%and 11.1%,respectively.Kaplan-Meier analysis showed that the mean local-progression-free survival time was 11.0 and 15.0 months,and one-year local-failure rates were 51.9%and 24.5%(P<0.05).The median overall survival time was 13.0 and 15.0 months,respectively(P=0.084).The one-year survival rates were 55.7%and 72.5%,and two-year survival rates were 0%and 19.9%.There was no significant difference in the occurrences of radiation-associated complications between the two groups.Our results showed that omitting elective nodal irradiation did not result in a high incidence of elective nodal failure.On the contrary,it decreased local failure by increasing prescrip-tion doses to the primary diseases and lymphadenopaphy,and thereby it may further prolong the patients’survival.