Bismuth, esomeprazole, metronidazole, and minocycline or tetracycline as a first-line regimen for Helicobacter pylori eradication: A randomized controlled trial / 中华医学杂志(英文版)

BACKGROUND@#Given the general unavailability, common adverse effects, and complicated administration of tetracycline, the clinical application of classic bismuth quadruple therapy (BQT) is greatly limited. Whether minocycline can replace tetracycline for Helicobacter pylori ( H . pylori ) eradication is unknown. We aimed to compare the eradication rate, safety, and compliance between minocycline- and tetracycline-containing BQT as first-line regimens.@*METHODS@#This randomized controlled trial was conducted on 434 naïve patients with H . pylori infection. The participants were randomly assigned to 14-day minocycline-containing BQT group (bismuth potassium citrate 110 mg q.i.d., esomeprazole 20 mg b.i.d., metronidazole 400 mg q.i.d., and minocycline 100 mg b.i.d.) and tetracycline-containing BQT group (bismuth potassium citrate/esomeprazole/metronidazole with doses same as above and tetracycline 500 mg q.i.d.). Safety and compliance were assessed within 3 days after eradication. Urea breath test was performed at 4-8 weeks after eradication to evaluate outcome. We used a noninferiority test to compare the eradication rates of the two groups. The intergroup differences were evaluated using Pearson chi-squared or Fisher's exact test for categorical variables and Student's t -test for continuous variables.@*RESULTS@#As for the eradication rates of minocycline- and tetracycline-containing BQT, the results of both intention-to-treat (ITT) and per-protocol (PP) analyses showed that the difference rate of lower limit of 95% confidence interval (CI) was >-10.0% (ITT analysis: 181/217 [83.4%] vs . 180/217 [82.9%], with a rate difference of 0.5% [-6.9% to 7.9%]; PP analysis: 177/193 [91.7%] vs . 176/191 [92.1%], with a rate difference of -0.4% [-5.6% to 6.4%]). Except for dizziness more common (35/215 [16.3%] vs . 13/214 [6.1%], P = 0.001) in minocycline-containing therapy groups, the incidences of adverse events (75/215 [34.9%] vs . 88/214 [41.1%]) and compliance (195/215 [90.7%] vs . 192/214 [89.7%]) were similar between the two groups.@*CONCLUSION@#The eradication efficacy of minocycline-containing BQT was noninferior to tetracycline-containing BQT as first-line regimen for H . pylori eradication with similar safety and compliance.@*TRIAL REGISTRATION@#ClinicalTrials.gov, ChiCTR 1900023646.

Research Progress in Immune Checkpoint Inhibitors Combination Therapy Applied to Non-small Cell Lung Cancer after EGFR Mutation-targeted Therapy Resistance / 中国肺癌杂志

With the development of precision medicine for lung cancer, targeted therapy has greatly improved the survival and prognosis of patients with advanced non-small cell lung cancer (NSCLC), but the occurrence of acquired drug resistance ultimately leads to patients with no targeted drugs available and no standard treatment options for this group of patients afterwards. The emergence of immune checkpoint inhibitors (ICIs) has revolutionized the treatment of advanced NSCLC. However, due to the unique features of NSCLC with epidermal growth factor receptor (EGFR) mutation, such as immunosuppressive tumor microenvironment (TME), single ICIs treatment has limited clinical benefits in NSCLC patients with EGFR mutation, and the combination of ICIs with chemotherapy and/or targeted therapies is the trend. This review further discusses potential subpopulations with EGFR mutations that may benefit from ICIs treatment, and analyzes how decisions can be made in the era of combined immunotherapy to maximize the efficacy of ICIs treatment in EGFR mutation targeted therapy for NSCLC patients with drug resistance, with the aim of achieving individualized treatment.

Overview of traditional Chinese medicine treatment for atopic dermatitis / 国际中医中药杂志

According to the traditional Chinese medicine (TCM), atopic dermatitis (AD) is believed that it is caused by innate constitutional insufficiency and dysfuction of heart and spleen. Thus, the treatment includes strengthening the spleen and clearing dampness, nourishing blood and moisturing skin. This paper reviewed literature about the researches on AD, and summarized the etiology and pathogenesis of the disease in order to investigate new treatment.

Induced differentiation of human umbilical cord mesenchymal stem cells into neural stem cells in vitro / 中国组织工程研究

BACKGROUND:Compared with mesenchymal stem cells from bone marrow and fat, human umbilical cord-derived mesenchymal stem cells, as one of the most potential cellsources to repair the central nervous system, are easy-based, more primitive, and not limited by ethical and legal. OBJECTIVE:To explore differentiation of human umbilical cord-derived mesenchymal stem cells into neural stem cells induced by the recombinant human basic fibroblast growth factor and recombinant human epidermal growth factor. METHODS:The human umbilical cord-derived mesenchymal stem cells were induced by basic fibroblast growth factor and epidermal growth factor in vitro. The cellmorphology was observed by invert microscope. The differentiation status was detected by immunofluorescence. The Nestin expression in mRNA level before and after induction was detected by real-time PCR. RESULTS AND CONCLUSION:The neural stem cellbal s were observed after induction. And the Nestin was detected by immunofluorescence and real-time PCR. Nestin could further differentiate to the neuronal markproteins neuron-specific enolase, microtubule-associated protein 2 protein and glial fibril ary acidic protein. Results from this study show that basic fibroblast growth factor and epidermal growth factor can induce human umbilical cord-derived mesenchymal stem cells to differentiate to neural stem cells, neurons and glial cells.