Effectiveness and safety of vonoprazan-based regimen for Helicobacter pylori eradication: A meta-analysis of randomized clinical trials.

WHAT IS KNOWN AND OBJECTIVE: The Helicobacter pylori (H. pylori) eradication rate of proton pump inhibitor (PPI)-based regimen remains decreasing. Vonoprazan (VPZ), a stronger and longer-lasting acid blocker, has been proposed to treatment of H. pylori infection. However, previous reviews did not have a pre-established study protocol and did not conduct a comprehensive search of the database, so the results obtained were not robust. We aimed to perform a meta-analysis to assess the effectiveness and safety of VPZ-based regimens for treatment of H. pylori infection in comparison with other regimens. METHODS: We conducted a systematic literature search on PubMed, Embase, Cochrane Library, Web of Science, ClinicalTrials and ChiCTR Register. Randomized clinical trials comparing VPZ-based regimens with similar eradication regimens without VPZ in the treatment of H. pylori infection were included. Eradication rate, compliance of the patients and side effects were specified as the primary outcomes. RevMan 5.4 software was used to analyze the RCTs and provide pooled risk ratio (RR) with 95% confidence intervals (CI). Systematic searches, study selection, data extraction, risk of bias assessment and statistical analysis were performed by two independent researchers according to the predesigned criteria on the PROSPERO. RESULTS AND DISCUSSION: A total of 8 RCTs with 2012 patients qualified for evaluation. The results showed that the eradication rate of VPZ-containing regimens was significantly superior to PPI-containing regimens for both intention-to-treat (RR, 1.14; 95% CI: 1.06-1.23; p = 0.0006) and per-protocol analyses (RR, 1.12; 95% CI: 1.04-1.20; p = 0.003). Subgroup analysis based on treatment regimens, eradication experience and clarithromycin resistance, as well as sensitivity analysis further confirmed this finding. In addition, there was no significant difference in compliance (RR, 1.02; 95% CI: 0.98-0.1.05; p = 0.35) and the frequency of adverse events (RR, 0.84; 95% CI: 0.70-1.00; p = 0.05) between the regimens. WHAT IS NEW AND CONCLUSION: Compared with PPI-based regimens, the VPZ-containing regimens showed a comparable or even superior eradication rate of H. pylori in terms of overall comparison and comparison of different treatment regimens, eradication experience and clarithromycin resistance. In addition, VPZ-based regimens have better tolerability and fewer adverse events. More future studies are needed to evaluate the impact of some differences in patient characteristics. TRIAL REGISTRATION: PROSPERO CRD42021229598.

Methimazole and α-lipoic acid as metallo-ß-lactamases inhibitors.

The emergence of bacterial resistance poses a serious threat to public health. One of the most important resistance mechanisms against ß-lactam antibiotics is the production of metallo-ß-lactamases (MBLs). In this study, α-lipoic acid (LA) and methimazole (MMI), which have been used in clinical practice as non-antibacterial drugs and as a supplement, were chosen to explore their potential to be metallo-ß-lactamases inhibitors (MBLIs). Enzyme inhibition assays showed that LA and MMI had moderate inhibitory activity against NDM-1 but no activity against VIM-2 and IMP-7. Antibacterial assays to determine synergy, demonstrated that the combination of LA or MMI with meropenem (MER) reduced the MIC value of MER against NDM-1 producing E. coli 16 times and 4 times, respectively, lower than that of MER alone. The fractional inhibitory concentration index (FICI) values were calculated to be less than 0.5, indicating that both LA and MMI had synergistic antibacterial effects with MER against all three MBLs expressing E. coli strains. The time-kill studies also suggested that LA and MMI were effective in restoring the antibacterial effect of MER. These findings revealed that LA and MMI are potential carbapenem enhancers, and provide a starting point for the development of potent MBLIs.

[Simultaneous Determination of Three Components in Ficus microcarpa Leaves by HPLC].

OBJECTIVE: To develop an HPLC method for the content determination of benzoic acid, 4-hydroxyphenylacetic acid and acetosyringonecas in Ficus microcarpa Leaves. METHODS: The determination was performed on Purospher® STAR C18 (250 mm x 4.6 mm,5 µm). The mobile phase was consisted of acetonitrile-0.2% phosphoric acid aqueous solution with linear gradient elution and the flow rate of 1.0 mL/min. The column temperature was set at 35 °C and the detection wavelength was 270 nm. RESULTS: The linear range of benzoic acid, 4-hydroxyphenylacetic acid and acetosyringonecas was 0.0121-1.21 µg (r = 0.9995), 0.423-42.32 [Lg ( r = 0.9999) and 0.047-4.70 pg( r = 0. 9996) , respectively. The average recovery was 100.7, 101.2 and 96.5 respectively. CONCLUSION: This method is simple,reproducible,and can be used for determination of three components of benzoic acid, 4-hydroxyphenylacetic acid and acetosyringonecas in Ficus microcarpa Leaves.

[Comparative Study on Volatile Constituents of Plumeriae Flos from Different Origins].

OBJECTIVE: To compare the volatile constituents of Plumeriae Flos from different origins. METHODS: Water distillation method according to the Chinese Pharmacopeia was used to extract the volatile constituents of fresh Plumeriae Flos samples (red flower and white flower) and dried samples. GC-MS method combined with NIST MS Search 2.0 data base was carried out to identify the volatile constituents and to calculate the relative percentage content. RESULTS: 55 peaks were detected in the GC-MS spectrum. Among of them, 26 volatile constituents were confirmed and calculated, which were mainly fatty alcohols and esters. The relative percentage content of geranyl benzoate in fresh Plumeriae Flos samples was significantly higher than the dried samples. CONCLUSION: The compositions of volatile constituents in Plumeriae Flos have no obvious correlation with the color of flowers, but are related to the flower fresh or dried.

[Study on Effective Parts of Ficus microcarpa Leaves by Serum HPLC Fingerprint].

OBJECTIVE: To study the relevance between the drug effects and serum HPLC fingerprint of chemical constituents in blood from Ficus microcarpa leaves. METHODS: Fingerprints of the preparation and drug-containing serum of rats were established by HPLC. Based on the fingerprints, chemical constituents in blood were investigated. RESULTS: There were seven common peaks in the HPLC fingerprints of drug-containing serum of rats. Polarity fraction of the chemical constituents in blood existed in the ethyl acetate extract, and five fingerprint peaks of serum HPLC fingerprint existed in n-butanol extract. CONCLUSION: Determination of the component groups in blood provides some data on material basis study in vivo for Ficus microcarpa leaves.