[Efficacy of high-dose dual therapy for Helicobacter pylori infection eradication in servicemen: a randomized controlled trial].

Objective: To assess the efficacy and cost-effectiveness of high-dose dual therapy compared with bismuth-containing quadruple therapy for treating Helicobacter pylori(H.pylori) infection in servicemen patients. Methods: A total of 160 H. pylori-infected, treatment-naive servicemen, including 74 men and 86 women, aged from 20 years to 74 years, with a mean (SD) age of 43 (13) years, tested in the First Center of Chinese PLA General Hospital from March 2022 to May 2022 were enrolled in this open-label, randomized controlled clinical trial. Patients were randomly allocated into 2 groups: the 14-day high-dose dual therapy group and the bismuth-containing quadruple therapy group. Eradication rates, adverse events, patient compliance, and drug costs were compared between the two groups. The t-test was used for continuous variables, and the Chi-square test for categorical variables. Results: No significant difference in H. pylori eradication rates were found between high-dose dual therapy and bismuth-containing quadruple therapy by ITT, mITT and PP analysis[ITT:90.0% (95%CI 81.2%-95.6%) vs. 87.5% (95%CI 78.2%-93.8%), χ2=0.25, P=0.617;mITT:93.5% (95%CI 85.5%-97.9%) vs. 93.3% (95%CI 85.1%-97.8%), χ2<0.01, P=1.000; PP: 93.5% (95%CI 85.5%-97.9%) vs. 94.5% (95%CI 86.6%-98.5%), χ2<0.01, P=1.000 ]. The dual therapy group exhibited significantly less overall side effects compared with the quadruple therapy group [21.8% (17/78) vs. 38.5% (30/78), χ2=5.15,P=0.023]. There were no significant differences in the compliance rates between the two groups [98.7%(77/78) vs. 94.9%(74/78), χ2=0.83,P=0.363]. The cost of medications in the dual therapy was 32.0% lower compared with that in the quadruple therapy (472.10 RMB vs. 693.94 RMB). Conclusions: The dual regimen has a favorable effect on the eradication of H. pylori infection in servicemen patients. Based on the ITT analysis, the eradication rate of the dual regimen is grade B (90%, good). Additionally, it exhibited a lower incidence of adverse events, better compliance and significantly reduced cost. The dual regimen is expected to be a new choice for the first-line treatment of H. pylori infection in servicemen but needs further evaluation.

[Analysis of factors affecting live birth outcome of frozen-thawed embryo transfer cycle].

Objective: To analyze the related factors affecting the success of frozen-thawed embryo transfer (FET). Methods: A total of 563 couples treated in the Reproductive Medicine Center of Guangdong Hospital of Traditional Chinese Medicine from January 2017 to March 2020 were selected as subjects. A total of 736 FET cycles were included to analyze the live birth outcomes of FET. Pregnancy outcomes, pregnancy complications and embryo status of patients between the live birth group and the non-live birth group were compared. A multivariate logistic regression model was used to evaluate the association between the 15 candidate factors and live birth outcomes for identifying independent factors associated with the live birth outcomes of the FET. Results: Among the enrolled subjects, the men were (33±5) years old at sperm extraction while the women were (31±4) years old at ovum pick-up (OPU) and (32±4) years old at embryo transfer (ET) and their infertility duration were (3.5±2.6) years. There were 333 (45.2%) live birth cycles and 403 (54.8%) non-live birth cycles in the 736 FET cycles. Pregnancy complications occurred in 49 cases (14.7%) of the live birth group. The age of the women at ET ((31±4) vs (32±4) years), the age of the women at OPU ((30±4) vs (32±4) years) and the age of the men at sperm extraction ((33±4) vs (34±5) years) in the live birth group were all lower than those in the non-live birth group. The infertility duration was shorter ((3.2±2.2) vs (3.6±2.8) years), and the proportion of primary infertility was higher ((63.1%, 210 cases) vs (49.6%, 200 cases)) in the live birth group (P<0.05) than those in the non-live birth group. Multivariate logistic regression analyses showed that the age of woman at ET (OR (95%CI): 0.50 (0.27-0.92), P=0.026), the types of infertility (0.62 (0.43-0.88), P=0.008), the numbers of optimal embryos transferred (1.60(1.11-2.31), P=0.012), and the types of embryos transferred (2.43 (1.46-4.01), P=0.001) were statistically significant related factors for live birth outcome of FET. Conclusion: The age of the woman at ET, the types of infertility, the numbers of optimal embryos transferred and the types of embryos transferred are associated factors for the outcomes of live birth after FET.

Overexpression of AdeABC efflux pump associated with tigecycline resistance in clinical Acinetobacter nosocomialis isolates.

OBJECTIVES: Tigecycline non-susceptible Acinetobacter nosocomialis (TNAN) has been discovered in clinical isolates. The resistance-nodulation-cell division (RND)-type efflux system plays a major role in tigecycline non-susceptible Acinetobacter baumannii, but the mechanism in A. nosocomialis remains unknown. Our aim was to analyse the contribution of efflux-based tigecycline resistance in clinical A. nosocomialis isolates collected from multiple medical centres in Taiwan. METHODS: A total of 57 A. nosocomialis isolates, including 46 TNAN and 11 tigecycline-susceptible A. nosocomialis (TSAN) isolates, were analysed. Of these, 46 TNAN isolates were clustered to ST410 (43 isolates) and ST68 (three isolates) by multi-locus sequence typing. RESULTS: The relationship between the RND efflux pump and tigecycline resistance was indirectly verified by successfully reducing tigecycline resistance with NMP, an efflux pump inhibitor. The three RND efflux systems (AdeABC, AdeIJK and AdeFGH) were detected in all clinical isolates. The transcript level of adeB gene increased significantly and was correlated with tigecycline resistance. Moreover, the AdeRS two-component system was further classified into four different types of AdeRS patterns considering the amino acid sequence. Further analysis showed that tigecycline resistance was related to the transcript level of adeB gene and the AdeRS pattern. CONCLUSION: This study showed that the dissemination of TNAN isolates in Taiwan is attributable mainly to the spread of ST410. The AdeABC efflux pump appeared to play an important role in the tigecycline resistance of A. nosocomialis.

Bioaugmented soil aquifer treatment for P-nitrophenol removal in wastewater unique for cold regions.

P-nitrophenol (PNP) is a toxic and recalcitrant organic pollutant and a usual intermediate in the production of fine chemicals, which has posed a significant threat to subsurface environment safety. Soil aquifer treatment (SAT) is a promising method to remove and remediate contamination in vadose zone with low cost and high efficiency. However, there are still research gaps for the treatment of recalcitrant contaminants by SAT in cold regions, such as un-robust indigenous microbes and low temperature constraint in vadose zone. The bioaugmentation technology was first introduced into SAT in order to enhance the removal ability of PNP by SAT operated in cold regions in this study. A high-efficiency PNP-degrading bacterium was successfully isolated, which can efficiently degrade PNP below 200 mg L-1 with a degradation rate above 99% at 15 °C close to the real subsurface temperature in cold regions, and added into SAT for bioaugmentation. The feasibility of bioaugmented SAT and associated PNP removal process were investigated by laboratory sand columns, along with effects of the SAT operative parameters (namely PNP loading concentration, flow rate and soil saturation level of SAT). Within the range of PNP loading stresses tested (1-200 mg L-1), PNP removal efficiency was optimal at constant flow rate of 219 mL d-1 in unsaturated operating condition of SAT under 15 °C among all the investigated experimental conditions. Longer hydraulic residence time increased the PNP removal rate, although the accumulated mass removed reduced and the removal efficiencies remained constant in unsaturated operating condition of SAT. It is found from the comparison between the PNP removals via both unsaturated and saturated columns that slight difference only in the removal rate of PNP was observed and the highly efficient bioaugmented SAT can completely degrade PNP of 10 mg L-1 within 5 wetting/drying cycles under both scenarios.

Lab-based investigation of enhanced BTEX attenuation driven by groundwater table fluctuation.

Groundwater fluctuation is often overlooked and lack of study in the field contaminant hydrogeology. Hydraulic force from fluctuating groundwater tables leads to dissolution and subsequent enhanced advective transport of petroleum (e.g. BTEX) in contaminated subsurface system. A laboratory investigation of effect of the groundwater table fluctuation (GTF) on BTEX transport, taking toluene as a typical compound, in a typical representative model of aquifers subjected to a daily water-table fluctuation was undertaken in this work. Results showed that toluene in effluent degraded significantly with cycles of GTF, and the attenuation rates differed in porous media types with higher value for fine-coarse sand media (13.7 mg L-1 d-1) and lower for fine sand-clay media (2.8 mg L d-1). Hydraulic and hydrochemical evidences inferred that toluene attenuation was controlled mainly by flushing effect in the initial GTF cycle stages, followed by dissolution and mixing action in the later stages. Meanwhile, adsorption was found to take effects in toluene behavior throughout the whole GTF process, particularly obvious in fine sand-clay media with its toluene attenuation rate of only 2.8 mg L d-1.

Risk factors and outcome for colistin-resistant Acinetobacter nosocomialis bacteraemia in patients without previous colistin exposure.

The clinical characteristics of patients with colistin-resistant Acinetobacter baumannii bacteraemia have been documented, but those of patients with bacteraemia caused by other Acinetobacter species remain unknown. Previous exposure to colistin has been shown to be associated with the emergence of colistin resistance, but may be not the only predisposing factor. In the current study, we highlight the risk and outcome of patients without previous exposure to colistin who acquired colistin-resistant Acinetobacter nosocomialis (ColRAN) bacteraemia. This 11-year single-centre retrospective study analysed 58 patients with ColRAN bacteraemia and 213 patients with colistin-susceptible A. nosocomialis (ColSAN) bacteraemia. Antimicrobial susceptibilities were determined with an agar dilution method. The clonal relationship of ColRAN isolates was determined with pulsed-field gel electrophoresis. A conjugation mating-out assay was conducted to delineate the potential transfer of colistin resistance genes. Multivariable analysis was performed to evaluate the risk factors for ColRAN bacteraemia. Chronic obstructive pulmonary disease (COPD) was independently associated with ColRAN bacteraemia (OR 3.04; 95% CI 1.45-6.37; p 0.003). Patients with ColRAN bacteraemia had higher APACHE II scores, but the two groups showed no significant differences in 14-day mortality (10.3% vs. 10.3%) or 28-day mortality (15.5% vs. 15.0%). ColRAN isolates had greater resistance than ColSAN isolates to all antimicrobial agents except for ciprofloxacin (0% vs. 6.6%). There were 16 different ColRAN pulsotypes, and two major clones were found. Colistin resistance did not transfer to colistin-susceptible A. baumannii or A. nosocomialis. These results show that COPD is an independent risk factor for acquisition of ColRAN bacteraemia. The mortality rates were similar between patients with ColRAN and ColSAN bacteraemia.

Hydrogeo-chemical impacts of air sparging remediation on a semi-confined aquifer: evidences from field monitoring and modeling.

Air sparging (AS) was explored for remediation of a petroleum contaminated semi-confined groundwater system in NE China. Physical, hydro-chemical and hydraulic behaviors in subsurface environment during AS were investigated with support of modeling to understand the hydrogeo-chemical impacts of AS on the aquifer. The responses of groundwater, dissolved oxygen and temperature indicated that the radius of influence of AS was up to 8-9 m, and a 3D boundary of the zone of influence (ZOI) was accordingly obtained with volume of 362 m(3). Water mounding unlike normal observations was featured by continuous up-lift and blocked dissipation. AS induced water displacement was calculated showing no obvious spreading of contaminant plume under this AS condition. Slug tests were employed before and after AS to reveal that the physical perturbation led to sharp increase in permeability and porosity. Modeling indicated that the regional groundwater flow field was not affected by AS except the physical perturbation in ZOI. Hydro-chemically increase of pH and Eh, and reduction of TDS, electrical conductivity and bicarbonate were observed in ZOI during AS. PHREEQC modeling inferred that these chemical phenomena were induced by the inorganic carbon transfer during air mixing.

Phytodegradation of extra heavy oil-based drill cuttings using mature reed wetland: an in situ pilot study.

Environmental contamination caused by extra heavy oil-based drill cuttings (DCs) is a major problem in the Liaohe Oilfield, northeastern China. To study the potential effectiveness of the mature reed wetland in removing extra heavy oil contained in drill cuttings, biodegradation of extra heavy oils and study of the effects on soil property and ecophysiological and quality indices of reeds were carried out in a 2-year in situ pilot experiment. In the wetland, four reed beds were used to treat drill cuttings in various loadings: 0 (control), 5, 20, and 40 kg/m(2), corresponding to 150, 600, and 1200 g/m(2) extra heavy oil hydrocarbons (HCs). The obtained results demonstrate that the mature reed wetland was effective at degrading extra heavy oils without extra fertilization. Removal efficiencies of reed bed 2 in the 0- to 80-cm soil profile increased with time, from 90.1% (first harvest season) to 95.8% (second harvest season). After 2 years, only 4.2% of the initial hydrocarbons residual was retained in the surface soil. There was no apparent adverse effects on the surface soil property during degradation of extra heavy oils and, actually, the deeper soil property and reed quality indices were improved at the end of the experiment. Phytotoxicity, resulting in reduction of reed yield, was observed in the most heavily treated beds in the first year. However, long-term reed yield recovered robustly. During the 2-year period, reed height and leaf number were slightly inhibited.

Fuzzy EMG classification for prosthesis control.

This paper proposes a fuzzy approach to classify single-site electromyograph (EMG) signals for multifunctional prosthesis control. While the classification problem is the focus of this paper, the ultimate goal is to improve myoelectric system control performance, and classification is an essential step in the control. Time segmented features are fed to a fuzzy system for training and classification. In order to obtain acceptable training speed and realistic fuzzy system structure, these features are clustered without supervision using the Basic Isodata algorithm at the beginning of the training phase, and the clustering results are used in initializing the fuzzy system parameters. Afterwards, fuzzy rules in the system are trained with the back-propagation algorithm. The fuzzy approach was compared with an artificial neural network (ANN) method on four subjects, and very similar classification results were obtained. It is superior to the latter in at least three points: slightly higher recognition rate; insensitivity to overtraining; and consistent outputs demonstrating higher reliability. Some potential advantages of the fuzzy approach over the ANN approach are also discussed.

The value of human growth hormone as an adjuvant for ovarian stimulation in a human in vitro fertilization program.

The purpose of this study was to evaluate whether the combined treatment of growth hormone (GH) and gonadotropins can improve ovulation stimulation in previously poor responders. Twelve patients who, had suboptimal responses in previous in vitro fertilization cycle were enrolled. They underwent 1 cycle with gonadotropin-releasing hormone analogue (GnRH-a) and gonadotropins and another cycle with GnRH-a, gonadotropins, and GH. Serum gonadotropins, insulin-like growth factor-1 (IGF-1), and sex steroids, including estradiol (E2), progesterone (P4), testosterone, and androstenedione were measured on Day 2 and during ovulation induction. The serum IGF-1 level was higher in the GH cycle. There were no significant differences in the levels of the serum luteinizing hormone, E2, P4, testosterone, and androstenedione between the 2 cycles, so was IGF-1, E2 and P4 in follicular fluid. Co-treatment with GH did not improve the ovarian response. However, the GH cycles had better performance in terms of the number of oocytes fertilized and the pregnancy rate.