Clinical study on Sun's sequential therapy of allergic rhinitis with lung deficiency and cold syndrome / 国际中医中药杂志

Objective:To evaluate the efficacy of Sun's sequential therapy (SST) of Chinese Medicine on allergic rhinitis with lung deficiency and cold syndrome.Methods:A total of 60 AR patients with lung deficiency and cold syndrome in otolaryngology clinic of Guang'anmen Hospital, from January to July 2020, who met the inclusion criteria, were randomly divided into 2 groups according to the random number table method, with 30 patients in each group. The Traditional Chinese Medicine (TCM) group was treated with oral Yupingfeng Powder and Cang'erzi Powder and the SST group was treated with oral and nasal steaming of Yupingfeng Powder and Cang'erzi Powder. Both groups were treated for 14 days. The clinical symptoms were scored before and after treatment, and the Nasal mucosa eosinophil (EOS) count was graded by Sheldon method to evaluate the clinical efficacy.Results:Twenty five patients in the SST group and 28 in the TCM group were analyzed. The total effective rate was 88.0% (22/25) in the SST group and 89.3% (25/28) in the TCM group, and there was no significant difference between the two groups ( χ2=2.83, P=0.883). The scores of nasal obstruction, runny nose, sneeze and total score in the SST group were significantly lower than those in the TCM group ( P<0.01), and the difference of Nasal mucosa EOS grade in SST group (2.76±0.27 vs. 1.52±0.36) was significantly higher than that of the TCM group ( P=0.01). Conclusion:The SST of Chinese medicine can improve the symptoms of nasal congestion, runny nose and sneezing in AR patients with lung deficiency and cold syndrome, and reduce the distribution of Nasal mucosa EOS.

WU Xu's experience of sequential therapy for peripheral facial paralysis / 中国针灸

The paper introduces professor WU Xu 's experience of sequential therapy for peripheral facial paralysis. The sequential therapy refers to a staging treatment, but not rigidly adheres to it. With this therapy, the acupuncture- moxibustion regimen is modified flexibly in line with the specific symptoms of illness. At the acute phase of peripheral facial paralysis, warm acupuncture at Wangu (GB 12) is predominated and electroacupuncture is not recommended at the acupoints on the face. At the recovery phase, warm acupuncture at Zusanli (ST 36) is the main therapy and electroacupuncture is applied to the acupoints on the face appropriately. Besides, for the intractable case, the tapping technique with plum-blossom needle or skin needle should be combined and exerted in the local affected region. At the sequelae phase, in order to shorten the duration of illness, depending on the different types of facial paralysis, i.e. stiffness type, spasmodic type and flaccid type, the corresponding needling techniques are provided, i.e. bloodletting and moxibustion, strong stimulation with contralateral acupuncture and the technique for promoting the governor vessel and warming up yang.

Doxycycline-moxifloxacin sequential therapy for Mycoplasma genitalium urethritis/cervicitis: a clinical observation / 中华皮肤科杂志

Objective:To investigate outcomes and safety of doxycycline-moxifloxacin sequential regimen in the treatment of Mycoplasma genitalium urethritis/cervicitis. Methods:From June 2019 to December 2020, patients with Mycoplasma genitalium urethritis/cervicitis confirmed by nucleic acid amplification testing were successively recruited at Department of Sexually Transmitted Diseases, Hospital of Dermatology, Chinese Academy of Medical Sciences, and received sequential therapy with oral doxycycline for 7 days followed by oral moxifloxacin for 7 days. Clinical and/or etiological assessment was conducted 2 to 3 weeks after the end of treatment. Fisher′s exact test was used to analyze factors influencing the treatment outcome. Results:Totally, 36 eligible subjects were enrolled, including 30 males and 6 females. Among them, 18 (50%) patients completed post-treatment etiological assessment, which showed that 12 achieved microbiological cure, and treatment failures occurred in 6; another 18 patients achieved clinical cure. The overall response rate to doxycycline-moxifloacin sequential therapy was 83.3% (30/36, 95% confidence interval[ CI]: 70.5%, 96.1%) . The treatment outcome showed no significant association with the patients′ age, gender, marital status, number of sexual partners in the past 1 month, history of sexually transmitted diseases, history of antibiotic use in the past 1 month, or co-infections (all P > 0.05) . Conclusion:The efficacy of doxycycline-moxifloacin sequential regimen is limited in the treatment of Mycoplasma genitalium infections in Nanjing area, and clinicians should be alerted to the possibility of treatment failure in clinical practice.

Sequential treatment and prognostic factors of traumatic root fracture in permanent anterior teeth / 口腔疾病防治

@#Root fracture is a kind of dental trauma involving dentin, cementum, pulp tissue, periodontal membrane ligament and even the surrounding alveolar bone. It occurs frequently between the ages of 10-20, mostly in the area of the maxillary anterior teeth with high aesthetic requirements. The treatment goal for root fracture in permanent teeth is to maintain the physiological and functional integrity of the tooth as much as possible and to reduce the incidence of complications. Clinicians usually classify the affected teeth according to the position of the root fracture, including the apical, mid-root, cervical-mid-root and cervical segments, since it determines the treatment plan and the prognosis of the affected teeth. CBCT examination can avoid misdiagnosis and missed diagnosis of root fracture to the greatest extent. The sequential treatment plan of root fracture after permanent anterior tooth trauma includes initial emergency treatment, pulp vitality monitoring and complication management during follow-up. Emergency treatment mainly includes local anesthesia and repositioning, if displaced, the coronal segment of the tooth as soon as possible. Then, after checking its position radiographically, adjustment occlusion and flexible splinting for 4 weeks (4 months for cervical root fracture). The process of root fracture repair includes many tissues and is affected by many clinical factors. Timely and standardized treatment and close follow-up according to the Dental Trauma Guideline guarantee a good prognosis of root fracture. The closer the root fracture line is to the apex, the higher the survival rate is. In addition to the location of the root fracture line, the prognosis is affected by many other clinical factors, such as the displacement of the coronal fragment of the root fracture, the pathological state of the dental pulp, patient age, developmental stage of the root, timely and good replacement of the root fracture, splinting method, and the presence of other dental trauma complications. Pulp vitality should be monitored regularly, and root canal therapy of the coronal segment should be carried out only when infection of the pulp is established. This article reviews the classification, diagnosis, emergency treatment, sequential follow-up treatment, and prognostic assessment of root fracture trauma to provide suggestions for clinicians to manage root fracture trauma in permanent teeth.

Helicobacter Pylori Sequential Eradication Therapy: Clarithromycin based Therapy Versus Levofloxacin based Therapy. Study from Kashmir Valley

Introduction: Various regimens have been used for H-pylorieradication. Sequential therapy is an alternative to classicaltriple therapy. This study was designed for evaluatingthe efficacy of levofloxacin based sequential therapyvs clarithromycin based sequential therapy in H-pylorieradication.Material and methods: It is a randomized clinical trial. Twohundred H. Pylori infected patients diagnosed by rapid ureasetest (RUT) on UGI endoscopy were randomly divided intotwo groups A and B. Group B Levofloxacin based sequentialregimen and group A clarithromycin based sequential regimen.H-pylori eradication status was evaluated with rapid ureasetest on UGI endoscopy 6 weeks after completion of sequentialtherapy.Results: As per protocol, eradication rates for group B and Awere 86% and 81% respectively. Eradication rate for H-pyloriis greater with levofloxacin based sequential therapy ascompared to that of clarithromycin based sequential therapybut it is not statistically significant p >0.05.Conclusion: Levofloxacin based sequential therapy has highereradication rate than clarithromycin based sequential therapy.Although not statistically significant in our study, levofloxacinbased sequential therapy could be better alternative forthe treatment of H-pylori in areas with high clarithromycinresistance.

Sequential Therapy with Induction Chemotherapy Followed by Concurrent Chemoradiation in Locally Advanced Squamous Cell Carcinomas of the Head and Neck

Introduction: Induction chemotherapy in locally advancedhead and neck cancers prior to local therapy has beendemonstrated to be non-inferior to concurrent chemoradiationin terms of overall survival (OS). Despite possible lack ofsurvival advantage, downsizing of tumours, allowing organpreservation along with the possible benefit of eradication ofmicrometastases earlier in the course of therapy makes thisa desirable approach for many heads and neck oncologistsworldwide. Study aimed to assess the immediate locoregionalresponse rates and to assess the toxicity profile of sequentialtherapy with three cycles of induction PFT followed byConcurrent Chemo-Radiation with weekly Cisplatin inLocally Advanced Head and Neck Cancers.Material and methods: 30 consecutive patients with locallyadvanced head and neck cancers attending the OPD at ourinstitute were included in the study. All patients were treatedwith 3 cycles of Induction chemotherapy with PFT regimen(Paclitaxel 175mg/m2 Day1, Cisplatin 100 mg/m² split to(Day 1-3), 5-FU 750 mg/m² Day 1 to 3) every 21 days. Thepatients were then taken up for concurrent chemoradiation(66 Gy RT along with weekly Cisplatin 40mg/sq.m.). Theimmediate locoregional response rates were assessed byclinical and radiological imaging. The toxicity profile of thetreatment was assessed with RTOG acute morbidity scoringcriteria and CTCAE Version 4.Results: 30 patients (3 female) were recruited for the study.Among them 3 were laryngeal cancer patients and thehypopharyngeal, oropharyngeal and the oral cavity cancerswere 9 each. 63% of them had complete response and 30%had partial response. The sub-sites of the hypopharynx andthe oropharynx had the best outcomes from this treatmentprotocol. 2 patients did not complete the planned treatment.11patients had grade 3 leukopenia and 2 patients had grade 4/febrile neutropenia. There was no grade 3 thrombocytopeniain the study group.Conclusion: Sequential therapy with three cycles of inductionPFT followed by concurrent chemoradiation is a feasiblealternative for moderately advanced and very advanced headand neck cancer. Patient selection and supportive care duringtreatment are very important for successful outcome.

Effect of sequential therapy of antibacterial drugs on acute mesenteric lymphadenitis caused by bacterial infection in children / 中国基层医药

Objective@#To investigate the effect of cephalosporin sequential therapy on acute mesenteric lymphadenitis caused by bacterial infection.@*Methods@#From December 2015 to December 2018, 66 patients with acute mesenteric lymphadenitis caused by bacterial infection in Shaoxing Central Hospital were randomly selected.The control group(33 cases) received intravenous infusion of cefuroxime.The observation group(33 cases) was treated with intravenous infusion of cefuroxime, after the abdominal pain disappeared and the peripheral blood cell count returned to normal, the cefuroxime axetil tablet was given orally.The clinical efficacy of the two groups was evaluated, and the treatment costs and adverse reactions of the two groups were counted.@*Results@#The total effective rate of the observation group was 96.97%(32/33), compared with 90.91%(30/33) of the control group, the difference was not statistically significant(χ2=1.26, P=0.53). The total cost of treatment in the observation group was (326.85±51.88)CNY, which was lower than that of the control group[(576.82±72.17)CNY], the difference was statistically significant(t=16.15, P=0.00). There were no significant adverse reactions in the two groups during treatment periods.@*Conclusion@#Sequential therapy with cefuroxime and venous infusion of cefuroxime for the treatment of acute mesenteric lymphadenitis in children with bacterial infection is safe, but sequential therapy is less expensive and therefore recommended.

Strategies for Activating Blood Circulation-Regulating Gan (Liver)-Tonifying Shen (Kidney) Sequential Therapy of Endometriosis-Associated Infertility / 中国结合医学杂志

Endometriosis (EM) is a major cause of infertility and has a complex pathogenesis, which brings severe challenges in both clinical treatment and scientific research. Current clinical research focuses on the difficult problem of improving the pregnancy rate of EM patients. Our studies found that Chinese medicine has significant advantages in terms of improving the pregnancy rate of EM patients.

Characteristics and failure risk factors of sequential high-flow nasal cannula oxygen therapy after weaning from invasive ventilation in patients of surgical intensive care unit / 中华危重病急救医学

Objective To investigate the characteristics and failure risk factors of sequential high-flow nasal cannula oxygen therapy (HFNC) after weaning from invasive ventilation. Methods The patients who received sequential HFNC after weaning from invasive ventilation admitted to surgical intensive care unit (ICU) of Peking University People's Hospital from June 1st 2016 to May 31st 2018 were retrospectively analyzed. Clinical variables, respiratory therapy parameters, respiratory variables, cardiac variables and outcomes were reviewed and analyzed. Treatment characteristics of HFNC after weaning was analyzed. Patients were divided into HFNC success group and HFNC failure group according to the failure of HFNC, and the differences between the two groups were compared. The independent risk factors of HFNC treatment failure were analyzed by Logistic regression analysis. The value of predictive treatment failure of risk factors and regression models were analyzed by receiver operating characteristic (ROC) curve. Results A total of 99 patients were included, 61 men, and the median age was 67.0 (57.0, 76.0) years old. The medianinitial HFNC flow was 50 (50, 60) L/min, and inspired oxygen concentration (FiO2) was 0.50 (0.40, 0.60). Eighteen patients experienced HFNC failure (18.2%). Compared with the HFNC success group, the sequential organ failure assessment (SOFA) score in the HFNC failure group was higher [4 (3, 5) vs. 2 (1, 3), P < 0.01], B type natriuretic peptide (BNP) before HFNC therapy were significant higher [ng/L: 647.2 (399.2, 1 331.3) vs. 127.2 (55.2, 369.5), P < 0.01], and respiratory frequency (RR) and heart rate (HR) were significant faster, mean arterial pressure (MAP) was significant higher, oxygen index (PaO2/FiO2) was significant lower after 30 minutes HFNC treatment [RR (times/min): 26 (22, 28) vs. 19 (17, 21), HR (bpm): 105 (97, 107) vs. 85 (77, 90), MAP (mmHg, 1 mmHg = 0.133 kPa): 104.3 (101.7, 110.7) vs. 92.3 (88.3, 97.7), PaO2/FiO2 (mmHg): 207.3 (185.8, 402.8) vs. 320.2 (226.2, 361.5), all P < 0.05]. It was shown by multiple Logistic regression analysis that the SOFA score [odds ratio (OR) = 2.818, P = 0.022, β = 1.036], BNP before HFNC treatment (OR = 1.002, P = 0.033, β = 0.002) and HR after HFNC treatment 30 minutes (OR = 1.140, P = 0.032, β = 0.131) were independent risk factors for HFNC treatment failure. It was shown by ROC curve that the area under the ROC curve (AUC) for the prediction of HFNC failure was 0.840, 0.859, 0.860 and 0.962 for SOFA, BNP before HFNC treatment, HR after HFNC treatment 30 minutes, and regression model, all had good forecast values (all P < 0.01). Conclusions HFNC is one of the commonly used oxygen therapy methods in the ICU, but not all patients who are treated as a sequential therapy after invasive mechanical ventilation weaning can benefit from it. SOFA score, BNP before HFNC treatment and HR after 30 minutes HFNC treatment were independent risk factors of HFNC failure. Each independent risk factor and regression model can predict the success of HFNC treatment.

Effect of sequential therapy of antibacterial drugs on acute mesenteric lymphadenitis caused by bacterial infection in children / 中国基层医药

To investigate the effect of cephalosporin sequential therapy on acute mesenteric lymphadenitis caused by bacterial infection.Methods From December 2015 to December 2018,66 patients with acute mesenteric lymphadenitis caused by bacterial infection in Shaoxing Central Hospital were randomly selected .The control group(33 cases) received intravenous infusion of cefuroxime.The observation group (33 cases) was treated with intravenous infusion of cefuroxime ,after the abdominal pain disappeared and the peripheral blood cell count returned to normal,the cefuroxime axetil tablet was given orally.The clinical efficacy of the two groups was evaluated , and the treatment costs and adverse reactions of the two groups were counted .Results The total effective rate of the observation group was 96.97%(32／33),compared with 90.91%(30／33) of the control group,the difference was not statistically significant(χ2 ＝1.26,P＝0.53).The total cost of treatment in the observation group was (326.85 ± 51.88)CNY,which was lower than that of the control group [(576.82 ±72.17)CNY],the difference was statistically significant(t＝16.15,P ＝0.00).There were no significant adverse reactions in the two groups during treatment periods.Conclusion Sequential therapy with cefuroxime and venous infusion of cefuroxime for the treatment of acute mesenteric lymphadenitis in children with bacterial infection is safe , but sequential therapy is less expensive and therefore recommended.

Self-made pressure-resistant cap cotton cover in the evidence-based practice of sequential non-invasive ventilation therapy / 中华危重病急救医学

Objective To apply the concept of evidence-based nursing to the practice of non-invasive ventilation,and to introduce the method of using self-made pressure-resistant cap cotton cover and its application effect.Methods Fifty patients on non-invasive ventilation admitted to intensive care unit (ICU) of Harrison International Peace Hospital Affiliated to Hebei Medical University from September 2017 to April 2018 were enrolled as observation group.By retrieved the relevant literature at home and abroad to look for clinical evidence,the concept of evidence-based nursing care program was formulated and implemented,and self-made pressure-resistant cap cotton cover was used to prevent facial pressure sores in patients on non-invasive ventilation.Forty non-invasive ventilation patients admitted from January to August in 2017 were enrolled as the historical control group,and conventional nursing was conducted by using traditional hydrocolloid dressings to prevent pressure ulcers.The incidence of facial pressure ulcers,ocular complications,dressing replacement time and cost were compared between the two groups.Results All patients were enrolled in the final analysis.The incidence of pressure ulcers in the observation group was significantly lower than that in the control group [4.0％ (2/50) vs.22.5％ (9/40),P ＜ 0.05],and the incidences of ocular complications such as eyelid swelling [2.0％ (1/50) vs.5.0％ (2/40)],conjunctival congestion [2.0％ (1/50) vs.5.0％ (2/40)] and irritant keratitis [0％ (0/50) vs.7.5％ (3/40)] were also significantly lower than those in the control group (P ＜ 0.05).Because the pressure-resistant cap cotton cover made by ourselves was easy to be replaced at any time,the interval time of dressing change in the observation group was significantly shorter than that in the control group (minutes:1.5 ± 0.5 vs.2.0 ± 0.5,P ＜ 0.05).In addition it could be cleaned,used alternately,and the cost was low,so the dressing cost in the observation group was significantly lower than that in the control group (Yuan:30±10 vs.123±20,P ＜ 0.01).Conclusion The application of self-made pressure-resistant cap cotton cover could obviously reduce the occurrence of complications such as facial pressure sores in patients on non-invasive ventilation.

Sequential Therapy Based on Evolvement of Patterns: A New Model for Treatment of Alzheimer's Disease / 中国结合医学杂志

In order to solve the problem of long-term (>9 months) efficacy in the treatment of Alzheimer's disease (AD) by conventional therapy (CT), a staged and multiply-targeted sequential therapy based on the evolvement of patterns (STEP) was developed. Its main innovations include: (1) the time order of evolution of patterns defined by Chinese medicine (CM) in AD was found, that is, "the orderly pattern evolution starting from Shen (Kidney) deficiency, progressing to phlegm, stasis and fire, and worsening to severe toxin as well as functional collapse"; (2) the cascade hypothesis of Shen deficiency in AD and its sequential therapy based on Shen-reinforcing was proposed, that is, "reinforcing Shen in the early stage and throughout the whole process, resolving phlegm, activating blood and purging fire in the middle stage, detoxifying and replenishing vitality to stop the collapse in the advanced stage", and through meta-analysis, clinical drug use was optimized, thus the leap from "inferential selection" to "evidence-based selection" was realized; (3) the STEP regimen combined with CT maintained cognitive and behavioral stability in AD patients for at least 12 months, with cognitive enhancement and behavioral synergy after 9 months, and cognitive benefit was superior to CT at 9, 12, 15, 18, 21, and 24 months, respectively. The 2-year cognitive improvement rate was increased by 25.64% (P=0.020) and the cognitive deterioration rate was decreased by 48.71% (P=0.000). Among them, the cognitive and functional benefits of Shen-reinforcing therapy for very early AD (350 cases) for 1 year were better than the placebo (P<0.001), and the dementia conversion rate was reduced by 8.85% (P=0.002). The behavioral symptomatic relief of patients with vascular dementia received fire-purging therapy (540 cases) was superior to those received CT (P=0.016). These data suggested that the STEP regimen has synergistic effects on CTs at least in terms of cognitive benefit, and the earlier the use, the greater the benefit will have. Therefore, the STEP regimen should be considered as one of the clinical options, particularly for the dearth of effective pharmaceutical or immunological interventions that are currently available for AD.

Ten-Day Concomitant, 10-Day Sequential, and 7-Day Triple Therapy as First-Line Treatment for Helicobacter pylori Infection: A Nationwide Randomized Trial in Korea

BACKGROUND/AIMS: This nationwide, multicenter prospective randomized controlled trial aimed to compare the efficacy and safety of 10-day concomitant therapy (CT) and 10-day sequential therapy (ST) with 7-day clarithromycin-containing triple therapy (TT) as first-line treatment for Helicobacter pylori infection in the Korean population. METHODS: Patients with H. pylori infection were assigned randomly to 7d-TT (lansoprazole 30 mg, amoxicillin 1 g, and clarithromycin 500 mg twice daily for 7 days), 10d-ST (lansoprazole 30 mg and amoxicillin 1 g twice daily for the first 5 days, followed by lansoprazole 30 mg, clarithromycin 500 mg, and metronidazole 500 mg twice daily for the remaining 5 days), or 10d-CT (lansoprazole 30 mg, amoxicillin 1 g, clarithromycin 500 mg, and metronidazole 500 mg twice daily for 10 days). The primary endpoint was eradication rate by intention-to-treat (ITT) and per-protocol (PP) analyses. RESULTS: A total of 1,141 patients were included. The 10d-CT protocol achieved a markedly higher eradication rate than the 7d-TT protocol in both the ITT (81.2% vs 63.9%) and PP analyses (90.6% vs 71.4%). The eradication rate of the 10d-ST protocol was superior to that of the 7d-TT protocol (76.3% vs 63.9%, ITT analysis; 85.0% vs 71.4%, PP analysis). No significant differences in adherence or serious side effects were found among the three treatment arms. CONCLUSIONS: The 10d-CT and 10d-ST regimens were superior to the 7d-TT regimen as standard first-line treatment in Korea.

Eradication Rates of 10-day Sequential Therapy for Helicobacter pylori: Results of an 8-year Prospective Study Conducted at a Tertiary Korean Hospital / 대한소화기학회지

BACKGROUND/AIMS: The Helicobacter pylori (H. pylori) eradication rate of standard triple therapy is unsatisfactory in Korea, and sequential therapy (SQT) has been suggested to be a practical first-line alternative regimen. The aim of this prospective study was to document changes in annual eradication rates of SQT. METHODS: A total of 983 H. pylori-positive subjects were enrolled from 2010 to 2018 and their data were subjected to intention-to-treat (ITT) and per-protocol (PP) analysis. All subjects received 10-day sequential therapy consisting of 40 mg esomeprazole and 1 g amoxicillin b.i.d for 5 days followed by 40 mg esomeprazole b.i.d, 500 mg clarithromycin b.i.d and 500 mg metronidazole t.i.d for 5 days. The 13C-urea breath test, rapid urease test (CLO test®), and histology were used to confirm eradication. Compliance and side effects were also investigated. RESULTS: ITT and PP eradication rates of SQT were 69.9% (687 of 983) and 87.1% (657 of 754), respectively. The annual eradication rate of ITT remained consistent over the 8-year study period (p for trend=0.167), whereas PP analysis showed the eradication rate increased (p for trend=0.042). The overall adverse event rate for SQT was 41.7% (410 subjects). CONCLUSIONS: Despite high antibiotic resistance rates in Korea, the eradication rate of SQT did not decrease over the 8-year study period.

Comparison between different first-line therapy protocols of eradicating Helicobacter pylori in children / 中国小儿急救医学

Objective To determine the efficacy of different first-line regimens for Helicobacter pylori(Hp) eradication,and to suggest an alternative first-line therapy particularly in children.Methods One hundred and twenty-four patients who diagnosed as peptic ulcer or chronic gastritis by gastroscope with Hp infection were included and randomly divided into four groups,each receiving different first-line eradication therapy.A group:standard triple therapy for 10 days;B group:standard triple therapy for 14 days;C group:triple therapy containing bismuth agent;D group:sequential therapy.The eradication rates of Hp and adverse event rates in four groups were compared.Results The highest eradication rate was in D group (90.9％,P ＜ 0.05),there was no significant difference between the other three groups (P ＞ 0.05).The main adverse reactions during treatment were abdominal pain,fullness,nausea and vomiting.Among them,adverse event rate was the highest in C group (41.4％,P ＜ 0.05),there was no significant difference between the other three groups (P ＞ 0.05).Conclusion The sequential therapy is significantly more effective than standard triple therapy and triple therapy containing bismuth agent.Adverse event rate is the highest in the triple therapy containing bismuth agent.

Antibiotics and probiotics for Helicobacter pylori infection / 国际儿科学杂志

Eradication the infection of Helicobacter pylori is essential for the treatment of gastrointestinal diseases such as gastrointestinal ulcer and gastric cancer.Because of the increased resistance rate of H.pylori to antibiotics,clarithromycin triple therapy is no longer the best treatment for H.pylori,especially in some parts of the country with over 20％ resistance to this antibiotic.Alternative therapies for eradicate of H.pylori have been proposed,including some new antibiotics or different combinations of classical antibiotics,which are used in regular clinical practice as a new and more effective treatment.Other treatments are antibiotic-related probiotics to treat the infection.The mechanism of which is not fully understood and needs further study.

Effect of Nourishing Yin and Nonifying Yang Sequential Therapy Combined with Western Medicine on Expression Levels of Smad2 ,Smad3 ,Smad7 mRNA in Rats with Diminished Ovarian Reserve / 华中科技大学学报(医学版)

Objective To investigate the effect of Nourishing Yin and Nonifying Yang sequential therapy (NYNYST )com-bined with western medicine on expression levels of Smad2 ,Smad3 ,Smad7 mRNA in rats with diminished ovarian reserve (DOR).Methods Totally 40 female rats were randomly divided into 5 groups ,the normal control group ,the model group ,the western medicine group ,the NYNYST group and the combination group(western medicine combined with NYNYST ) ,8 in each group. The DOR model was established through orally administering tripterygium pill for continuous 2 weeks. The normal con-trol group and the model group were administered with saline for 10 days. The western medicine group was treated with hor-mone replacement therapy(HRT ) and ovarian stimulation. The NYNYST group was administered with Nourishing Yin herbs in proestrus and Nonifying Yang herbs in late estrus and the combination group was administered with combination of Chinese herb and western drugs for 10 days ,with the same dose in the former two groups.Serum levels of FSH ,LH ,E2 ,anti-Müllerian hormone(AMH) ,Transforming growth factor beta 1(TGF-β1)and Inhibin B(INHB)were measured by ELISA.Changes of Smad2 ,Smad3 ,Smad7 mRNA in ovaries were detected by real-time PCR.Results Compared with the model group ,the serum levels of FSH ,LH were decreased significantly in western medicine group ,NYNYST group and combination group(P＜0.01) , the serum levels of E2 ,AMH ,TGF-β1 and INHB increased in the rats of the treatment group(P＜0.05 ,P＜0.01) ,and efficacy of the combination group was significantly superior to that of the western medicine group (P＜0.01 ,P＜0.05);compared with the model group ,Smad2 mRNA increased significantly in NYNYST group and combination group ,Smad3 mRNA increased sig- nificantly in combination group(P＜0.01) ,the efficacy of combination group was superior to that of the western medicine group (P＜0.05);compared with the model group ,Smad7 mRNA of treatment groups was decreased significantly (P＜0.01).Conclu-sion NYTYST combined with western medicine can improve the function of ovaries by up-regulating the expression of Smad2 , Smad3 mRNA and down-regulating the expression of Smad7 mRNA in DOR rats.

Efficacy of Ecabet Sodium for Helicobacter pylori Eradication with Sequential Therapy

BACKGROUND/AIMS: We aimed to compare the outcomes of Helicobacter pylori eradication in patients receiving sequential therapy (ST) depending on the use of ecabet sodium (ES). MATERIALS AND METHODS: Between January to December 2015, 176 patients randomly received either ST alone (n=72) or 10-day ES therapy combined with ST (n=104). After applying the exclusion criteria, 56 patients were finally assigned to the ST-only group and 84 to the ST with ES group. We retrospectively reviewed and analyzed the H. pylori eradication rate and adverse events between the two groups. RESULTS: Among the 140 patients, 121 (86.4%) achieved successful H. pylori eradication and 24 (17.1%) had adverse events. Eradication was achieved in 50 patients (89.3%) in the ST-only group and in 71 patients (84.5%) in the ST with ES group (P=0.420). No significant difference in the incidence of adverse events was found between the ST-only and ST with ES groups (12.5% vs. 20.2%, respectively; P=0.234). However, the ST with ES group tended to have a higher prevalence of nausea or vomiting than the ST-only group (11.9% vs. 1.8%; P=0.050). CONCLUSIONS: ST showed a good H. pylori eradication rate without deteriorating the adverse events regardless of adding ES.

Acupuncture combined with acupoint catgut embedding sequential therapy for mild and moderate ulcerative colitis / 中国针灸

<p><b>OBJECTIVE</b>To observe the efficacy of acupuncture combined with acupoint catgut embedding sequential therapy and medication for mild and moderate ulcerative colitis.</p><p><b>METHODS</b>One hundred and twenty patients were randomized into an acupuncture and acupoint catgut embedding sequential therapy group (a combination group) and a mesalazine group, 60 cases in each one. Fifty-seven cases in the combination group and 55 cases in the mesalazine group were included into analysis. In the combination group, acupuncture was applied at Tianshu (ST 25), Shangjuxu (ST 37), Quchi (LI 11) during the activity period, and acupoint catgut embedding was applied at Pishu (BL 20), Zusanli (ST 36), Guanyuan (CV 4) during the alleviate period. The patients in the mesalazine group were treated with mesalazine orally. The treatment was given for 12 weeks. The scores of TCM symptoms, colonoscopy, mucosa healing rate were compared before and after treatment in the two groups. The effects, adverse reactions and the recurrent rates during 1-year follow-up were observed.</p><p><b>RESULTS</b>After treatment, the scores of TCM symptoms decreased in the two groups (both <0.05), and the result in the combination group was better than that in the mesalazine group (<0.05). The total effective rate in the combination group was 87.7% (50/57), which was better than 70.9% (39/55) in the mesalazine group (<0.05). The colonoscopy scores decreased after treatment in the two groups (both <0.05). There was no significant difference between the two groups on colonoscopy score and mucosal healing rate [50.9% (29/57) vs 34.5% (19/55), both >0.05]. The recurrent rate in the combination group was 8.5% (4/47)，which was lower than 32.4% (11/34) in the mesalazine group (<0.05). No severe adverse reaction was found during the treatment in the two groups.</p><p><b>CONCLUSION</b>Acupuncture combined with acupoint catgut embedding sequential therapy can improve mild and moderate ulcerative colitis and reduce the recurrent rate.</p>

Concomitant or Sequential Therapy as the First-line Therapy for Eradication of Helicobacter pylori Infection in Korea: A Systematic Review and Meta-analysis / 대한소화기학회지

BACKGROUND/AIMS: In Korea, increasing clarithromycin resistance has led to the need for an alternative first-line therapy for the eradication of Helicobacter pylori (H. pylori) infection. Concomitant therapy (CT) and sequential therapy (ST) have been proposed as alternative regimens. The aim of this study was to compare the eradication rate from using CT and ST in Korea. METHODS: A literature review was performed on studies comparing the efficacy of CT and ST in Korea. Data were pooled to obtain the odds ratio (OR) of the eradication rate with 95% confidence intervals (CIs). The eradication rates were considered both on an intention-to-treat (ITT) and a per-protocol (PP) bases. RESULTS: Six studies provided data on 1,897 Korean adult patients. The pooled OR was 1.382 (95% CI: 1.031-1.853, p=0.031) for ITT analysis and 2.114 (95% CI: 1.502-2.974, p < 0.001) for PP analysis. There was no difference in the rate of adverse events and compliances between the two regimens. CONCLUSIONS: The efficacy of CT was superior to ST in both ITT and PP analyses. Therefore, CT could be an excellent alternative regimen for the eradication of H. pylori as a first-line therapy in Korea.