Background: Helicobacter pylori resistance to amoxicillin remains rare in many regions. Proton pump inhibitor-amoxicillin-containing high dose dual therapy (HDDT) has been proposed to treat H. pylori infection. We aimed to assess the effectiveness and safety of PPI-amoxicillin HDDT for treatment of H. pylori infection in comparison with other regimens. Methods: Databases, including PubMed, Embase, and the Cochrane Register of Controlled Trials, were searched to find relevant publications. Randomized controlled trials comparing HDDT with control regimens for H. pylori eradication in adult patients were included. The primary outcome was eradication rate by intention-to-treat analysis. Adverse events were analyzed as second outcome. Results: A total of 15 trials with 3818 patients qualified for inclusion. The eradication rate of HDDT was neither significantly inferior nor superior to the recommended regimens such as triple therapy, bismuth quadruple therapy, and non-bismuth quadruple therapy [relative risk (RR): 1.00, 95% confidence interval (CI): 0.96–1.05, p = 0.870]. This finding was robust through subgroup analyses and sensitivity analyses. Trial sequential analysis showed that HDDT was equivalent to control regimens, and further similar trials were unlikely to alter the conclusions of this analysis. The frequency of adverse events was significantly lower in HDDT group (RR: 0.48, 95% CI: 0.37–0.64, p < 0.001). Conclusion: HDDT was equivalent to recommended first-line or rescue regimens with fewer adverse effects. The evidence from this meta-analysis supports the use of HDDT as first-line or rescue treatment for H. pylori infection. Trial registration: PROSPERO CRD42019133002

Background Inconsistent eradication rates for Helicobacter pylori have been reported worldwide with dual therapy, perhaps owing to the difference in dose administration and treatment duration. This retrospective study aimed to determine whether high‐dose dual therapy (HDDT) with different regimens leads to different eradication rates. The study compares the efficacy and safety of HDDT 10‐day vs 14‐day and investigates the factors that might affect the eradication rates. Materials and Methods Two comparable treatment groups were based on propensity score matching (PSM). Patients were divided into two groups based on the therapy they underwent: 10‐day HDDT and 14‐day HDDT (20 mg esomeprazole and 750 mg amoxicillin, administered four times daily). The eradication rates, adverse events (AEs), patient compliance, CYP2C19 gene polymorphisms, and antibiotic resistance rates of the two groups were compared. Results The intention to treat (ITT) analysis showed that the eradication rates for 10‐day and 14‐day groups were 78.4% (95% CI 69.6%–87.2%) and 89.7% (95% CI 83.3%–96.2%; p = .039), respectively, while the per‐protocol (PP) eradication rates were 80.0% (95% CI 71.3%–88.7%) and 92.9% (95% CI 87.4%–98.5%; p = .014), respectively. The corresponding drug‐related AEs were 6.8% (6/88) and 5.7% (5/88; p = .755). No significant differences were observed between the compliance rates of the two groups. The CYP2C19 gene polymorphism had no effect on the eradication rates of the two groups. Conclusion The results showed that the 14‐day HDDT affords a higher H. pylori eradication rate than the 10‐day HDDT.

Objective The prevalence of Helicobacter pylori resistance to amoxicillin was less than 5% in most countries. Proton pump inhibitor (PPI)-amoxicillin dual therapy dosing four times daily (q.i.d.) for 14 days could achieve an eradication rate of more than 85%. It is unclear whether dual therapy with shorter treatment duration or lower dosing frequency could also attain a satisfactory cure rate. We conducted a randomized controlled trial to assess the efficacy and safety of two modified esomeprazole-amoxicillin dual therapies, 10-day q.i.d. and 14-day three times daily (t.i.d.) dual therapy, and investigate the factors that might affect the eradication rates. Participants and methods A total of 253 patients were screened for eligibility and 208 patients were randomly assigned to 10-day dual therapy (esomeprazole 20 mg and amoxicillin 750 mg, all given four times daily) or 14-day dual therapy (esomeprazole 20 mg and amoxicillin 1000 mg, all given three times daily). Results In the intention-to-treat analysis, the eradication rates for 10-day and 14-day groups were 79.8% [95% confidence interval (CI): 70.2–87.4%] and 83.5% (95% CI: 74.3–90.5%) as first-line therapies; and 80% (95% CI: 44.4–97.5%) and 76.9% (95% CI: 46.2–95.0%) as rescue therapies. The adverse event rates were 5.9% and 5.0% for 10-day and 14-day groups, respectively. Smoking and compliance significantly affected the efficacy of PPI-amoxicillin dual therapies. Conclusion The eradication rate of 10-day q.i.d. dual therapy was unacceptable, while that of the 14-day t.i.d. dual therapy was borderline acceptable for first-line therapy. The two dual therapies were well tolerated with few adverse effects.

Background: The adductor canal block (ACB) has emerged as an alternative to the femoral nerve block (FNB) after total knee arthroplasty. This meta-analysis was conducted to investigate which ACB method provides better pain relief and functional recovery after total knee arthroplasty Methods: We conducted a meta-analysis to identify randomized controlled trials involving single-shot adductor canal block (SACB) and continuous catheter ACB (CACB) after TKA up to December 2019 by searching databases including the PubMed, Web of Science, Embase, Cochrane Controlled Trials Register, Cochrane Library, CBM, CNKI, VIP, and Wanfang databases. Finally, we included 8 randomized controlled trials involving 702 knees in our study. We used Review Manager Software and Grading of Recommendations Assessment, Development, and Evaluation profiler to perform the meta-analysis. Results: Compared with SACB, CACB can achieve better postoperative pain relief at 24 and 48 h both at rest and after mobilization, lower amount of opioid consumption at 72 h, a shorter length of hospital stay (LOH) and larger range of motion (ROM). In addition, the Timed Up and Go (TUG) test results; quadriceps strength; and incidence of complications, including postoperative nausea and vomiting, DVT, catheter-related infections, catheter dislodgement and neurologic deficits, showed no significant difference between the two ACB methods. Conclusion: The results of this study demonstrate that CACB is an effective alternative to SACB and can provide better pain relief, a shorter LOH, more degrees of maximum flexion and a lower amount of opioid consumption over time, but it provides a comparable level of recovery of quadriceps strength and mobility with a similar risk of catheter-related complications. Thus, CACB may be a better analgesia strategy than SACB after TKA at present.

Objectives To screen and verify differential genes affecting the prognosis of breast cancer. Methods Breast cancer gene expression datasets were downloaded from the GEO database, and original data were analyzed in R. The TIMER database was used to analyze the relationship between ANLN and UBE2T and immune cell infiltration. Results Ten hub-key genes were identified, and survival analysis showed that UBE2T and ANLN were upregulated in breast cancer and their upregulation was associated with a poor prognosis. ANLN and UBE2T upregulation was associated with the prevalence of Th1 and Th2 cells, shifting the Th1/Th2 balance to Th2 in Basal and Luminal-B breast cancers, which indicates a poor prognosis (P < 0.05). Conclusion ANLN and UBE2T are potential biomarkers for predicting the prognosis of breast cancer.

Tendinopathy is a type of chronic injury caused by repeated pulling. Previous studies have reported that long non-coding RNA MALAT1 (MALAT1) regulates a variety of genes affecting bone metabolism. This study aimed to explore the role of the MALAT1 in tendon injury in vivo and in vitro . Human tendon-derived stem cells (TDSCs) were treated with TGF β1. Eighteen Sprague-Dawley rats were used to establish the tendinopathy animal model. Sirius Red staining and colorimetric assays were conducted to analyze the collagen content. RT-qPCR was performed to measure the mRNA levels. Western blotting was performed to measure the MAPK1 protein levels. Additionally, hematoxylin and eosin (HE) and immunohistochemical staining were used to analyze the cell number and the content of collagen type 1 and Thbs, respectively. MALAT1 expression was upregulated in TGF β1 treated TDSCs, and MALAT1 knockdown downregulated Scleraxis, Mohawk homeobox, Collagen 1A1, Fibromodulin, Matrix metallopeptidase 3, and Thrombospondin 4 in TGF β1 treated TDSCs. Bioinformatics analysis showed that miR-378a-3p was the target of MALAT1 and MAPK1, and dual-luciferase reporter assay indicated that both MALAT1 and MAPK1 could bind to miR-378a-3p. Furthermore, miR-378a-3p knockdown reversed the effect of si-MALAT1, whereas overexpression of MAPK1 reversed the effect of the miR-378a-3p mimic. Finally, MALAT1 expression was downregulated in tendinopathy rats, and MALAT1 overexpression healed tendon injury in them. MALAT1 regulated the tenogenic differentiation of TDSCs by regulating the miR-378a-3p/MAPK1 axis. Our results therefore indicate that targeting the MALAT1/miR-378a-3p/MAPK1 axis may be a promising avenue for the treatment of tendinopathy.

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