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ObjectiveTo investigate the effects of probiotics combined with bismuth quadruple therapy （BQT） on clinical efficacy、gastrointestinal adverse reactions and intestinal flora in Helicobacter pylori （HP） positive patients. MethodsThe patients who were positive for HP from May 2023 to July 2023 in the department of gastroenterology of Shanghai first people's hospital were randomly divided into2 groups with 40 people in each group. The probiotic group was given 2 weeks of quadruple therapy with probiotics and standard BQT， followed by 4 weeks of oral probiotics after quadruple discontinuation. The placebo group was given 2 weeks of probiotic placebo and standard BQT， followed by 4 weeks of oral probiotic placebo. 13C urea breath test was used to evaluate the clinical efficacy， gastrointestinal symptoms rating Scale was used to evaluate the gastrointestinal adverse reactions of patients before and after the intervention， and microbial diversity 16S rDNA sequencing technology was used to detect the level of intestinal flora of patients before and after the intervention. ResultsThere was no significant difference in the eradication rate between the two groups （P>0.05）. Before the intervention， there was no significant difference in the scores of the gastrointestinal symptom rating scale between the probiotic group and the placebo group. After the intervention， patients in the probiotic group had significantly lower pain scores on acid reflux （1.10±0.30 vs 1.35±0.53， P<0.05） and stomach or abdominal hunger than in the placebo group （1.07±0.26 vs 1.30±0.52， P<0.05）. Through the before-and-after comparison of the probiotic group， the scores of abdominal pain （1.24±0.44 vs 1.58±0.71， P<0.05）， stomach or abdominal hunger （1.07±0.26 vs 1.27±0.45， P<0.05） and dry and hard stool （1.24±0.49 vs 1.48±0.75，P<0.05） were significantly lower in the probiotic group than before the intervention in the probiotic group. ConclusionProbiotics combined with BQT can improve the gastrointestinal adverse reactions and intestinal flora disorders in the process of quadruple drug therapy， but it does not improve the eradication rate of HP.
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Antiangiogenic therapy is an essential approach in the treatment of malignant tumors along with the development of preci-sion medicine. However, the occurrence of antiangiogenic therapy-induced hypertension, which is the most common toxicity of this agent, influences its broad clinical use (in some cases). Researches on its mechanisms, prevention, and management, have been con-ducted, but clinical guidelines or expert consensuses have not been reached. In this review, we presented the epidemiology, current re-search status, and systematic management of antiangiogenic therapy-induced hypertension.
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Objective To compare the therapeutic effects of bone marrow stem treatment by different bone marrow mobilization,distinct separation methods or cell suspension density, and to explore the optimal treatment plan of autologous bone marrow stem cell transplantation for decompensated cirrhosis.Methods Twenty three patients with decompensated cirrhosis were studied.100 ~200 mL bone marrow from each patient was harvested in aseptic condition, after isolation and purification by density gradient centrifugation,the stem cells were obtained and transplanted into the liver via hepatic artery.The serum glutamic acid alanine aminotransferase (ALT), albumin (ALB), prothrombin time (PT) and total bilirubin (TBIL) were checked before and l, 2, 3 months after therapy respectively,changes in these indicators of each group were compared by different bone marrow mobilization, distinct separation methods, or cell suspension density.Results After transplantation, levels of albumin increased significantly 1, 2, 3 months after treatment compared with baseline(P<0.05).Patients in bone marrow mobilization group obtained higher stem cell density (P<0.05), which had no significant difference in improving liver function ( ALT, TBIL, ALB, PT) compared with non-bone marrow mobilization group.Patients using the kit significantly improved their albumin (3 months after treatment, P<0.05), which had no significant difference in improving liver function (ALT, TBIL, ALB, PT) compared with using ordinary lymphocyte isolation method group.There was no significant difference in improving liver function ( ALT, TBIL, ALB, PT) between lower magnitude stem cell density group(≤1 ×1010/L) and higher magnitude stem cell density group(1 ×1010/L).Conclusion The treatment for decompensated cirrhosis by transplantation of autologous bone nlarrow stem cells is safe and effective, which can significantly increase the level of albumin in patients with decompensated cirrhosis.Preoperative bone marrow mobilization can increase the rate of stem cells obtained, and the method using the kit improves the leves of protein respectively.They are helpful to improve the efficacy.