The effect of supplementing with Saccharomyces boulardii on bismuth quadruple therapy for eradicating Helicobacter pylori: a systematic review and meta-analysis of randomized controlled trials.

Background and objective: It remains uncertain if the addition of Saccharomyces boulardii (S. boulardii) to bismuth quadruple therapy (BQT) recommended in the current guidelines can enhance the Helicobacter pylori (H. pylori) eradication rate and decrease the incidence of adverse events. We therefore conducted a meta-analysis of randomized controlled trials (RCTs) to address this issue. Methods: We performed comprehensive searches in PubMed, Embase, Web of Science, and Cochrane library databases from the inception of the databases through to November 1, 2023. A meta-analysis was conducted to determine the pooled relative risk (RR) with 95% confidence intervals (CI) using a random-effects model. We utilized the revised Cochrane Risk of Bias Tool to assess the risk of bias of included studies. Results: A total of six RCTs (1,404 patients) included in this meta-analysis. The results of the intention-to-treat analysis showed that the combination of S. boulardii with BQT had a higher eradication rate than BQT alone (87.0% versus 83.3%), with a pooled RR of 1.05 (95% CI: 1.00-1.10, p = 0.03). In the per-protocol analysis, however, there was no statistical significance between the two groups in the eradication rate (93.7% versus 91.0%, RR = 1.03, 95% CI: 1.00-1.06, p = 0.07). The combination of S. boulardii and BQT had a significantly lower rate of overall adverse events (22% vs. 39%, RR = 0.56, 95% CI: 0.44-0.70, p < 0.00001), diarrhea (7.9% vs. 25.7%, RR = 0.29, 95% CI: 0.17-0.48, p < 0.00001), constipation (2.9% vs. 8.4%, RR = 0.35, 95% CI: 0.14-0.88, p = 0.03) and abdominal distention (4.9% vs. 12.7%, RR = 0.41, 95% CI: 0.23-0.72, p = 0.002) than BQT alone. For the assessment of risk of bias, five studies were deemed to have some concerns, while one study was judged to have a low risk. Conclusion: Current evidence suggests that supplementation with S. boulardii in BQT may not have a major effect on the H. pylori eradication rate, but significantly reduces the incidence of overall adverse events, diarrhea, abdominal distention and constipation. Combining S. Boulardii with BQT can help alleviate symptoms, potentially improving patient adherence. Systematic review registration: https://osf.io/n9z7c.

[Regional CT value in prediction of proximal femoral fracture].

OBJECTIVE: To investigate CT values of cancellous bone in femoral neck in adults over 60 years with proximal femoral fractures. METHODS: From January 2020 to December 2020, a retrospective analysis was performed on 280 subjects aged 60 years or older who underwent bilateral hip CT examination, including 85 males and 195 females, 120 on the left side and 160 on the right side, aged 75 (66, 82) years old. One hundred thirty-six patients with proximal femoral fractures were included in study group and 144 patients without fractures were included in control group. GEOptima CT was used to scan and reconstruct horizontal, coronal and sagittal layers of proximal femur. CT values of cancellous bone in femoral neck were measured and compared between two groups. The relationship between CT values of cancellous bone of femoral neck and proximal femoral fracture was analyzed statistically. RESULTS: In terms of age, fracture group aged 79(73.3, 85.0) years old, non-fracture group aged 69.5 (64.0, 78.8) years old, and had significant difference in age between two groups (P<0.05). In terms of CT value, regional CT value in fracture group was 8.62(-3.62, 27.15) HU, which was lower than that in non-fracture group 34.31(-5.93, 71.74) HU(P<0.05). CT value on coronal view in fracture group was -8.48(-30.96, 17.46) HU, which was lower than that in non-fracture group 40.49(5.55, 80.71) HU (P<0.05). CT value on sagittal view in fracture group was -31.28(-54.91, -5.11) HU, which was lower than that in non-fracture group 7.74(-20.12, 44.54) HU (P<0.05). CT values on horizontal view in fracture group was 0.17(-23.13, 24.60) HU, which was lower than that in non-fracture group 46.40(10.42, 85.18) HU(P<0.05). The mean regional CT values among three planes in the fracture group were lower than those in the non-fracture group. Logistic regression analysis showed coronal CT value was influencing factors of proximal femoral fracture, and it could be written into regression equations that predict probability of fracture. CONCLUSION: In adults aged over 60 years old, CT values of cancellous bone of femoral neck decreased with increasing age. The smaller CT value of cancellous bone of femoral neck, the greater risk of proximal femoral fracture.

[Application of porous tantalum Jumbo cup in revision of hip arthroplasty].

OBJECTIVE: To investigate the clinical effect of porous tantalum Jumbo cup on acetabular reconstruction in revision of total hip arthroplasty. METHODS: From September 2014 to December 2017, 18 patients(18 hips) with acetabular defect were reconstructed by porous tantalum Jumbo cup technology, including 6 males and 12 females;the age ranged from 54 to 76 years old with an average of(63.8±15.3) years. There were 6 cases of paprosky typeⅡA, 8 cases of typeⅡB, 2 cases of typeⅡC and 2 cases of type Ⅲ a. Harris score and visual analogue scale (VAS) were performed before and after operation. Imaging examination was performed to evaluate the position of hip rotation center and prosthesis, and to judge whether acetabular loosening, displacement and complications existed. RESULTS: All cases were followed up for 13 to 49 months, with an average of 20.6 months. Harris score increased from 54.6±4.7 to 86.5±3.2 one year after operation(P<0.01), and VAS score decreased from 6.8±0.7 to 0.8±0.6 one year after operation (P<0.01). The transverse coordinate of hip rotation center was (3.52±0.72) cm before operation and (3.47±0.54) cm after operation (P>0.05). The longitudinal coordinate of hip rotation center was improved from (3.02±0.84) cm before operation to (2.35±0.53) cm after operation (P<0.01). During the follow-up period, the Jumbo cup was well fixed without loosening and displacement, the acetabular cup had bone ingrowth in varying degrees, and no light transmission line and osteolysis around the acetabular cup were found. No complications such as infection and nerve injury occurred. CONCLUSION: The method of reconstructing acetabular bone defect with porous tantalum Jumbo cup is simple and easy, the early stability of acetabulum is good, and the short-term follow-up effect is good.

A new method for identifying causal genes of schizophrenia and anti-tuberculosis drug-induced hepatotoxicity.

Schizophrenia (SCZ) may cause tuberculosis, the treatments for which can induce anti-tuberculosis drug-induced hepatotoxicity (ATDH) and SCZ-like disorders. To date, the causal genes of both SCZ and ATDH are unknown. To identify them, we proposed a new network-based method by integrating network random walk with restart algorithm, gene set enrichment analysis, and hypergeometric test; using this method, we identified 500 common causal genes. For gene validation, we created a regularly updated online database ATDH-SCZgenes and conducted a systematic meta-analysis of the association of each gene with either disease. Till now, only GSTM1 and GSTT1 have been well studied with respect to both diseases; and a total of 23 high-quality association studies were collected for the current meta-analysis validation. Finally, the GSTM1 present genotype was confirmed to be significantly associated with both ATDH [Odds Ratio (OR): 0.71, 95% confidence interval (CI): 0.56-0.90, P = 0.005] and SCZ (OR: 0.78, 95% CI: 0.66-0.92, P = 0.004) according to the random-effect model. Furthermore, these significant results were supported by "moderate" evidence according to the Venice criteria. Our findings indicate that GSTM1 may be a causal gene of both ATDH and SCZ, although further validation pertaining to other genes, such as CYP2E1 or DRD2, is necessary.

The effects of SP110's associated genes on fresh cavitary pulmonary tuberculosis in Han Chinese population.

SP110 is a promising anti-Mycobacterium tuberculosis (MTB) gene. To investigate the effects of SP110 and its associated genes, i.e., MYBBP1A and RELA, on pathological progression of MTB infection, an association study with 424 patients of fresh pulmonary tuberculosis (PTB) and 424 healthy controls was performed. Moreover, classification and regression tree and multifactor dimensionality reduction were employed to explore the effects of gene-gene interactions on cavitary PTB. The results indicated that both the heterozygous genotype GC and homozygous genotype CC in rs3809849 had significant effects on the risk of PTB (OR 1.42, 95 % CI 1.06-1.92, p 0.019; OR 1.55, 95 % CI 1.04-2.33, p = 0.033, respectively), and heterozygous genotype CT in rs9061 also had similar effects (OR 1.43, 95 % CI 1.07-1.90, p = 0.014). The rs3809849 and rs9905742 in MYBBP1A were also significantly associated with cavitary PTB (p = 0.00046 and 0.039, respectively), while rs9061 in SP110 had no such association (p = 0.06931) except its significant association with non-cavitary PTB (p = 0.0093). The interaction of MYBBP1A and RELA had significant effect on cavitary PTB (OR 4.24, 95 % CI 1.44-12.49, p = 0.005). These suggest that MYBBP1A instead of SP110 may be a genetic risk factor for cavitary PTB and play important effects on its whole progress.

Meta-Analysis-Based Preliminary Exploration of the Connection between ATDILI and Schizophrenia by GSTM1/T1 Gene Polymorphisms.

Anti-tuberculosis drugs have some adverse effects such as anti-tuberculosis drug-induced liver injury (ATDILI) and mental disorders. The involvement of glutathione S-transferase (GST) genes in pathogenesis of ATDILI or schizophrenia (SCZ) has been reported. Therefore, GST genes may exemplify molecular connectors between ATDILI and SCZ. However, association studies of GSTM1/T1 polymorphisms with these two diseases have yielded conflicting results. After searching case-control association studies in PubMed, ISI Web of Science, EMBASE, Chinese National Knowledge Infrastructure (CNKI), and Chinese BioMedical Literature Database, we performed meta-analyses across a total of 20 published association studies on 3146 subjects for the association of GSTM1 and ATDILI, 2587 for the GSTT1-ATDILI association, 2283 for GSTM1-SCZ and 1116 for GSTT1-SCZ to test the associations of GSTM1/T1 polymorphisms with ATDILI and SCZ. The GSTM1 present genotype was significantly associated with decreased risks of ATDILI (risk ratio(RR): 0.81, 95% confidence interval (CI): 0.75-0.88, P < 0.0001) and SCZ (RR: 0.88, 95%CI: 0.80-0.96, P = 0.004) according to the fixed-effect model, while the GSTT1 present genotype was significantly associated only with a high risk of SCZ (RR: 1.17, 95%CI: 1.04-1.32, P = 0.01) according to both the random- and fixed-effect models, but not with ATDILI (P = 0.82) according to the fixed-effect model. Moreover, these significant results were supported with moderate evidence according to the Venice criteria. These results indicate that GSTM1 represents a genetic connection between ATDILI and SCZ, and suggest that ATDILI and SCZ may be co-occurring for the subjects with GSTM1 null genotype.

[Treatment of urinary tract calculi in preschool children with endoscopy].

OBJECTIVES: To investigate the safety and feasibility of endoscopy in treating urinary tract calculi in preschool children. METHODS: From August 2004 to August 2008, 28 preschool children with urinary tract calculi were treated by endoscopy, 11 cases received ureterolithotripsy (URL) and 17 cases received minimally invasive percutaneous nephrolithotomy (MPCNL). RESULTS: Of 11 cases with ureteric calculi, 5 cases were rendered stone free in the first session, the other 6 cases received passive dilation by indwelling of ureteric stents for 1 to 3 weeks and underwent successful ureteroscopy with a 8/9.8 Fr rigid ureteroscope. Seventeen cases with renal calculi received MPCNL and were rendered stone free. CONCLUSION: Our study shows that endoscopy in treating urinary tract calculi is safe and feasible in preschool children.

[Treating renal carcinoma with ablation or ablation combined with 125I seed implantation: a report of eleven cases].

BACKGROUND & OBJECTIVE: Recently, multi-needles radiofrequency ablation and brachyradiotherapy have been used to treat some solid tumors, such as liver cancer and prostate cancer. This study was to explore the feasibility and efficacy of radiofrequency ablation or ablation combined with 125I seed implantation on treating renal carcinoma. METHODS: From Jun. 2000 to Feb. 2004, 11 patients with a total of 13 renal carcinoma lesions were treated with ablation or ablation combined with (125)I seed implantation, including 6 cases of renal carcinoma of solitary kidney, 2 cases of renal carcinoma combined with contralateral renal atrophy resulted from ureteric stone, 1 case of bilateral tumor, and 2 cases with general conditions contraindicated to surgery. Of the 13 lesions, 1 was resected by open operation, 6 were treated with multi-needles radiofrequency ablation, and 6 were treated with ablation and simultaneous (125)I seed implantation around tumor margin. RESULTS: The patients were followed-up for 6-46 months (mean 27 months). One patient died of cardiac muscle infarction 4 months after operation. Of the 10 alive patients, 2 with recurrent tumors 7 months and 13 months after operation were treated with ablation again, 1 with postoperative uremia was treated with intermittent peritoneal dialysis, the rest 7 had normal renal function. CONCLUSION: Multi-needles radiofrequency ablation or ablation combined with (125)I seed implantation would be an option in the treatment for patients with renal carcinoma of solitary kidney or bilateral kidney lesions, or for patients can't suffer from surgery.

[Effects of ureteral stents on rabbit upper urinary tract urodynamics].

OBJECTIVE: To explore the effects of ureteral stent placement on ureteral peristalsis and the time course of renal pelvic pressure changes. METHOD: Forty rabbits were randomized equally into 8 groups, including a control group without placement of ureteral stents. The other 7 groups received ureteral stent placement, which were retained for 0, 1, 2, 3, 4, 7, and 12 weeks respectively. When the rabbits were bred for the specified time periods, ureteral peristalsis was observed and renal pelvic pressure measured. RESULT: The renal pelvic pressure was initially increased after the stent placement, but then followed by gradual decreases. Ureteral peristalsis was not observed after the stent placement. CONCLUSION: Ureteral stent is a factor for causing obstruction in normal ureter.

[Endoscopic management of bilateral ureteral obstruction after radiotherapy].

BACKGROUND & OBJECTIVE: It is difficult to stent the obstructed ureters cystoscopically in patients with renal failure caused by radiotherapy for abdominal or pelvic tumors. Commonly draining the kidney with nephrostomy is the only method for the patients. However, external nephrostomy impacts on life quality of the patients. We reported our experience in stenting the obstructed ureters using minimally invasive percutaneous nephrostomy combined with ureteroscopy, and investigated viability of endoscopic treatment for bilateral ureteral strictures following radiotherapy. METHODS: Indwelling double pigtail stents in ureter by minimally invasive percutaneous nephrostomy combined with ureteroscopy was carried out in 19 patients with bilateral ureteral strictures following radiotherapy. The clinical outcomes including ureteral drainage and renal function were reviewed. RESULTS: Bilateral retrograde placement of double pigtail stent was performed in 2 cases. Indwelling different size double pigtail stents in unilateral ureters were carried out in 17 cases. The patients were followed-up for 1-24 months. Renal function was improved excellently in 17 cases, with serum creatinine level of 45 micromol/L to 113 micromol/L. Two patients had poor renal function improvement after ureteral stenting and were converted to percutaneous nephrostomy for draining the kidney. CONCLUSION: Indwelling different size double pigtail stents simultaneously in unilateral ureter by minimally invasive percutaneous nephrostomy is safe, simple, and effective in treating bilateral ureteral obstruction following radiotherapy.