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
Clonorchis sinensis infection is still a major public health problem.It is estimated that more than 15 million people worldwide are infected,especially in Northeast China,Taiwan,South Korea,and North Vietnam.The detec...Clonorchis sinensis infection is still a major public health problem.It is estimated that more than 15 million people worldwide are infected,especially in Northeast China,Taiwan,South Korea,and North Vietnam.The detection of Clonorchis sinensis eggs in feces and bile is still the only gold standard for the diagnosis of Clonorchis sinensis infection,and new detection methods are needed to improve the detection rate.After Clonorchis sinensis invades the human body,it mainly parasitizes the hepatobiliary tract.Therefore,it is closely related to hepatobiliary diseases such as cholangitis,bile duct stones,liver fibrosis,and cholangiocarcinoma.The increase in immunoglobulin G4(IgG4)caused by Clonorchis sinensis infection is rare and there are few reports about the relevant mechanism.It may be related to the inflammatory factors interleukin(IL)-4,IL-10,and IL-13 produced by human phagocytes,T cells,B cells,and other immune cells in the process of resisting the invasion of Clonorchis sinensis.However,this finding still needs further clarification and confirmation.This article reviews the epidemiology,clinical manifestations,serology,imaging,pathogenic mechanism,and control measures of Clonorchis sinensis infection to help establish the diagnostic process for Clonorchis sinensis.We report novel mechanisms of IgG4 elevation due to Clonorchis sinensis infection to provide more experience and a theoretical basis for clinical diagnosis and treatment of this infection.展开更多
The southern part of the Kyushu-Palau Ridge(KPR)is located at the conjunction of the West Philippine Basin,the Parece Vela Basin,the Palau Basin,and the Caroline Basin.This area has extremely complex structures and is...The southern part of the Kyushu-Palau Ridge(KPR)is located at the conjunction of the West Philippine Basin,the Parece Vela Basin,the Palau Basin,and the Caroline Basin.This area has extremely complex structures and is critical for the research on the tectonic evolution of marginal seas in the Western Pacific Ocean.However,only few studies have been completed on the southern part,and the geophysical fields and deep structures in this part are not well understood.Given this,this study finely depicts the characteristics of the gravity and magnetic anomalies and extracts information on deep structures in the southern part of the KPR based on the gravity and magnetic data obtained from the 11th expedition of the deep-sea geological survey of the Western Pacific Ocean conducted by the Guangzhou Marine Geological Survey,China Geological Survey using the R/V Haiyangdizhi 6.Furthermore,with the data collected on the water depth,sediment thickness,and multichannel seismic transects as constraints,a 3D density model and Moho depths of the study area were obtained using 3D density inversion.The results are as follows.(1)The gravity and magnetic anomalies in the study area show distinct zoning and segmentation.In detail,the gravity and magnetic anomalies to the south of 11°N of the KPR transition from high-amplitude continuous linear positive anomalies into low-amplitude intermittent linear positive anomalies.In contrast,the gravity and magnetic anomalies to the north of 11°N of the KPR are discontinuous and show alternating positive and negative anomalies.These anomalies can be divided into four sections,of which the separation points correspond well to the locations of deep faults,thus,revealing different field-source attributes and tectonic genesis of the KPR.(2)The Moho depth in the basins in the study area is 6-12 km.The Moho depth in the southern part of KPR show segmentation.Specifically,the depth is 10‒12 km to the north of 11°N,12‒14 km from 9.5°N to 11°N,14-16 km from 8.5°N to 9.5°N,and 16‒25 km in the Palau Islands.(3)The KPR is a remnant intra-oceanic arc with the oceanic-crust basement.which shows noticeably discontinuous from north to south in geological structure and is intersected by NEE-trending lithospheric-scale deep faults.With large and deep faults F3 and F1(the Mindanao fault)as boundaries overall,the southern part of the KPR can be divided into three zones.In detail,the portion to the south of 8.5°N(F3)is a tectonically active zone,the KPR portion between 8.5°N and 11°N is a tectonically active transition zone,and the portion to the north of 11°N is a tectonically inactive zone.(4)The oceanic crust in the KPR is slightly thicker than that in the basins on both sides of the ridge,and it is inferred that the KPR formed from the thickening of the oceanic crust induced by the upwelling of deep magma in the process of rifting of remnant arcs during the Middle Oligocene.In addition,it is inferred that the thick oceanic crust under the Palau Islands is related to the constant upwelling of deep magma induced by the continuous northwestward subduction of the Caroline Plate toward the Palau Trench since the Late Oligocene.This study provides a scientific basis for systematically understanding the crustal attributes,deep structures,and evolution of the KPR.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Clonorchis sinensis infection is still a major public health problem.It is estimated that more than 15 million people worldwide are infected,especially in Northeast China,Taiwan,South Korea,and North Vietnam.The detection of Clonorchis sinensis eggs in feces and bile is still the only gold standard for the diagnosis of Clonorchis sinensis infection,and new detection methods are needed to improve the detection rate.After Clonorchis sinensis invades the human body,it mainly parasitizes the hepatobiliary tract.Therefore,it is closely related to hepatobiliary diseases such as cholangitis,bile duct stones,liver fibrosis,and cholangiocarcinoma.The increase in immunoglobulin G4(IgG4)caused by Clonorchis sinensis infection is rare and there are few reports about the relevant mechanism.It may be related to the inflammatory factors interleukin(IL)-4,IL-10,and IL-13 produced by human phagocytes,T cells,B cells,and other immune cells in the process of resisting the invasion of Clonorchis sinensis.However,this finding still needs further clarification and confirmation.This article reviews the epidemiology,clinical manifestations,serology,imaging,pathogenic mechanism,and control measures of Clonorchis sinensis infection to help establish the diagnostic process for Clonorchis sinensis.We report novel mechanisms of IgG4 elevation due to Clonorchis sinensis infection to provide more experience and a theoretical basis for clinical diagnosis and treatment of this infection.
基金This work was supported by the project of China Geological Survey(DD20191002)the Key Special Project for Introduced Talents Team of Southern Marine Science and Engineering Guangdong Laboratory(Guangzhou)(GML2019ZD0208)the National Natural Science Foundation of China(41606080,41576068)。
文摘The southern part of the Kyushu-Palau Ridge(KPR)is located at the conjunction of the West Philippine Basin,the Parece Vela Basin,the Palau Basin,and the Caroline Basin.This area has extremely complex structures and is critical for the research on the tectonic evolution of marginal seas in the Western Pacific Ocean.However,only few studies have been completed on the southern part,and the geophysical fields and deep structures in this part are not well understood.Given this,this study finely depicts the characteristics of the gravity and magnetic anomalies and extracts information on deep structures in the southern part of the KPR based on the gravity and magnetic data obtained from the 11th expedition of the deep-sea geological survey of the Western Pacific Ocean conducted by the Guangzhou Marine Geological Survey,China Geological Survey using the R/V Haiyangdizhi 6.Furthermore,with the data collected on the water depth,sediment thickness,and multichannel seismic transects as constraints,a 3D density model and Moho depths of the study area were obtained using 3D density inversion.The results are as follows.(1)The gravity and magnetic anomalies in the study area show distinct zoning and segmentation.In detail,the gravity and magnetic anomalies to the south of 11°N of the KPR transition from high-amplitude continuous linear positive anomalies into low-amplitude intermittent linear positive anomalies.In contrast,the gravity and magnetic anomalies to the north of 11°N of the KPR are discontinuous and show alternating positive and negative anomalies.These anomalies can be divided into four sections,of which the separation points correspond well to the locations of deep faults,thus,revealing different field-source attributes and tectonic genesis of the KPR.(2)The Moho depth in the basins in the study area is 6-12 km.The Moho depth in the southern part of KPR show segmentation.Specifically,the depth is 10‒12 km to the north of 11°N,12‒14 km from 9.5°N to 11°N,14-16 km from 8.5°N to 9.5°N,and 16‒25 km in the Palau Islands.(3)The KPR is a remnant intra-oceanic arc with the oceanic-crust basement.which shows noticeably discontinuous from north to south in geological structure and is intersected by NEE-trending lithospheric-scale deep faults.With large and deep faults F3 and F1(the Mindanao fault)as boundaries overall,the southern part of the KPR can be divided into three zones.In detail,the portion to the south of 8.5°N(F3)is a tectonically active zone,the KPR portion between 8.5°N and 11°N is a tectonically active transition zone,and the portion to the north of 11°N is a tectonically inactive zone.(4)The oceanic crust in the KPR is slightly thicker than that in the basins on both sides of the ridge,and it is inferred that the KPR formed from the thickening of the oceanic crust induced by the upwelling of deep magma in the process of rifting of remnant arcs during the Middle Oligocene.In addition,it is inferred that the thick oceanic crust under the Palau Islands is related to the constant upwelling of deep magma induced by the continuous northwestward subduction of the Caroline Plate toward the Palau Trench since the Late Oligocene.This study provides a scientific basis for systematically understanding the crustal attributes,deep structures,and evolution of the KPR.
