Abstract Background and aims: Potassium-Competitive Acid Blockers (P-CABs) have been used in Helicobacter pylori (H. pylori) eradication therapies in recent years. However, the efficacy and safety of P-CABs compared to ProtonPump Inhibitors (PPIs) in this setting remain controversial. Methods: The efficacy and safety of P-CABs and PPIs for H. pylori eradication were compared in a meta-analysis based on a systematic literature search of major electronic databases for relevant Randomized Controlled Trials (RCTs). Results: Seven studies and 1,168 patients were included. The pooled eradication rate determined by Intention-ToTreat (ITT) analysis was 90.2% for P-CAB-based and 75.5% for PPI-based triple therapy (pooled RR [95% CI] = 1.17 [1.08-1.28], p < 0.001). The Per-Protocol (PP) analysis also demonstrated significant superiority of P-CABs (pooled eradication rate = 92.4% vs. 77.8%; pooled RR [95% CI] = 1.14 [1.03–1.26], p < 0.01). In a subgroup evaluation, P-CABs were significantly better than PPIs as a first-line eradication therapy, in both the ITT analysis (pooled eradication rate = 91.8% vs. 76.4%; pooled RR [95% CI] = 1.18 [1.10-1.28], p < 0.0001) and the PP analysis (pooled eradication rate = 93.0% vs. 78.6%; pooled RR [95% CI] = 1.13 [1.02 –1.26], p < 0.05). However, P-CABs were not superior to PPIs when administered as salvage therapy, as determined in the ITT (75.0% vs. 66.0%, pooled RR [95% CI] = 1.11 [0.69–1.78], p = 0.66) and PP (85.7% vs. 70.0%, pooled RR [95% CI] = 1.20 [0.82–1.75], p = 0.34) analyses. In a subgroup analysis limited to Japanese patients, both the ITT analysis (pooled eradication rate = 89.6% vs. 73.9%; RR [95% CI] = 1.21 [1.14 –1.29], p < 0.01) and the PP analysis (pooled eradication rate = 92.0% vs. 75.7%; RR [95% CI] = 1.18 [1.06 –1.32], p < 0.01) showed that P-CABs were significantly superior compared to PPIs as triple eradication therapy. However, in the subgroup analysis of patients from other countries, there was no significant difference in either the ITT analysis (pooled eradication rate = 93.8% vs. 85.2%; RR [95% CI] = 1.10 [0.99-1.22], p = 0.07) or PP analysis (pooled eradication rate = 95.0% vs. 90.8%; RR [95% CI] = 1.05 [0.98–1.14], p = 0.17). The incidence of adverse events associated with the two regimens did not significantly differ (P-CABs vs. PPIs: 33.6% vs. 40.0%; RR [95% CI] = 0.84 [0.71‒1.00], p = 0.05). The incidence of serious adverse events and dropout rate due to adverse events also did not differ (p = 0.44 and p = 0.67, respectively). Conclusions: The efficacy of P-CAB-based triple therapy is superior to that of PPI-based triple therapy as a first-line approach to H. pylori eradication, particularly in Japanese patients. As salvage therapy, the efficacy of the two treatments did not significantly differ. The tolerability of P-CAB-based and PPI-based triple therapy was comparable, as was the incidence of adverse events. HIGHLIGHTS The efficacy of P-CAB-based triple therapy is superior to that of PPI-based triple therapy as a first-line approach to H. pylori eradication, particularly in Japanese patients. P-CABs were not superior to PPIs as a salvage triple eradication therapy. The safety and tolerability of P-CAB are comparable to PPI in H. pylori triple eradication therapies. Further large RCTs conducted in multiple regions and countries are necessary.

ABSTRACT Introduction: Severe fever with thrombocytopenia syndrome virus (SFTSV) is a newly emerged virus that poses a great threat to human health because of high fatality rate. Methods: To develop sensitive and specific sero-diagnostic systems for SFTSV infections, monoclonal antibodies (MAbs) against recombinant SFTSV nucleocapsid (rSFTSV-N) protein were developed by immunizing BALB/C mice with rSFTSV-N protein and fusing the spleen cells with SP2/0 myeloma cells. Three hybridoma cell lines secreting MAbs against rSFTSV-N were obtained. MAb based IgG sandwich enzyme linked immunosorbent assay (ELISA) and IgM capture ELISA systems were established by using the newly developed MAbs. One hundred fifteen clinical suspected SFTS patients serum samples were used to evaluate the newly established systems by comparing with the total antibody detecting sandwich ELISA system and indirect ELISA systems. Results: The MAbs based sandwich IgG ELISA was perfectly matched with that of the total antibody sandwich ELISA and the indirect IgG ELISA. IgM capture ELISA results perfectly matched with that of the total antibody sandwich ELISA while detecting eight additional positive samples missed by the indirect IgM ELISA. Conclusions: The MAbs against rSFTSV-N protein offer new tools for SFTSV studies and our newly developed MAb-based IgG and IgM capture ELISA systems would offer safe and useful tools for diagnosis of SFTS virus infections and epidemiological investigations.

Peripheral arterial disease (PAD) can impair healing of diabetic foot (DF) in patients with diabetes mellitus. To determine whether carotid intima-media thickness (CIMT) can predict lower limb arterial lesions in patients with DF, this cross-sectional study enrolled patients with DF at West China Hospital (China) between January 2012 and December 2015. Ultrasonography was used to measure CIMT, assess the internal carotid arteries (ICA) for plaques, and evaluate lower limb segmental arteries for stenosis. The optimal CIMT cutoff for detecting lower limb PAD was determined by receiver operating characteristic (ROC) curve analysis. Factors associated with PAD were identified by logistic regression analyses. A total of 167 patients (mean age: 69.7±10.3 years; 102 men) were included. Patients with PAD were older and had higher levels of total cholesterol and low-density lipoprotein than patients without PAD (P<0.05). The area under the ROC curve was 0.747 (P<0.001). At the optimal CIMT cutoff of 0.71 mm, the sensitivity, specificity, positive predictive value, and negative predictive value were 79.65, 61.11, 81.08, and 58.93%, respectively. Compared with those without PAD, more patients with PAD had CIMT ≥0.71 mm (79.65 vs 38.89%; P<0.001) and ICA plaques (66.37vs 11.11%; P<0.001). Multivariate logistic regression revealed that age (odds ratio [OR]: 1.118; 95% confidence interval [95%CI]: 1.056–1.183; P<0.001), ICA plaques (OR: 13.452; 95%CI: 4.450–40.662; P<0.001), and CIMT ≥0.71 mm (OR: 2.802; 95%CI: 1.092–7.188; P=0.032) were associated with PAD.CIMT may be a surrogate marker of PAD in patients with DF.

Objective:To evaluate whether or not highly active antiretroviral therapy is associated with carotid artery stiffness in human immunodeficiency virus-positive patients in Henan Province, China.Method:Fifty human immunodeficiency virus-positive patients with at least a 5-year history of highly active antiretroviral therapy use and 50 human immunodeficiency virus-positive patients without a history of highly active antiretroviral therapy use were enrolled in this study. Carotid artery intima-media thickness and stiffness were determined by quantitative inter-media thickness and quantitative artery stiffness, respectively.Results:No statistically significant difference in carotid artery intima-media thickness and stiffness was observed between groups. A significant association between human immunodeficiency virus infection time and carotid artery stiffness was observed, but no significant association between human immunodeficiency virus infection time and intima-media thickness was found. No significant association between intima-media thickness, stiffness, and CD4+ and CD8+ T-cell counts were observed.Conclusion:The first-line highly active antiretroviral therapy currently used in China is not associated with carotid artery stiffness in human immunodeficiency virus-positive patients with good highly active antiretroviral therapy compliance. Human immunodeficiency virus may play a role in the development of atherosclerosis.

Objective To investigate risk factors for chronic noncommunicable diseases (NCDs) and their determinants in Chinese women. Methods Data from the 2010 China Chronic Disease and Risk Factor Surveillance survey, comprising a nationally representative sample of women, were obtained to determine the prevalence of eight risk factors for chronic NCDs: current smoking, harmful use of alcohol, insufficient intake of fruit and vegetables, physical inactivity, overweight and obesity, raised blood pressure, raised fasting blood glucose and raised total serum cholesterol. The mean number of risk factors per woman was estimated. Their independent demographic and socioeconomic covariates were also examined with ordinal logistic regression. Findings The following prevalences were found: insufficient intake of fruit and vegetables, 51.7%; overweight and obesity, 32.3%; raised blood pressure, 29.7%; physical inactivity, 18.3%; raised total serum cholesterol, 18.1%; raised blood glucose, 7.0%; current smoking, 2.4%; and harmful use of alcohol, 1.3%. The mean number of risk factors per woman was 1.61; 48.0% of the women had at least two risk factors. Women who were older, poorer, from rural areas or from eastern or central China had more risk factors, but only being more than 35 years old, poorly educated and a resident of eastern or central China independently increased the likelihood of having multiple risk factors. Conclusion Risk factors for chronic NCDs are common among Chinese women aged 18 or older. Interventions to reduce these factors are needed and should target women who are older, who live in eastern or central China or who are poorly educated.

Objetivo Investigar los factores de riesgo de las enfermedades crónicas no transmisibles (ENT) y sus factores decisivos entre las mujeres chinas. Métodos Se extrajeron los datos del Estudio sobre enfermedades crónicas y control de los factores de riesgo en China realizado en 2010, que incluye una muestra representativa a nivel nacional de las mujeres, a fin de determinar la prevalencia de ocho factores de riesgo causantes de enfermedades no transmisibles crónicas: tabaquismo, consumo nocivo de alcohol, ingesta insuficiente de frutas y verduras, inactividad física, sobrepeso y obesidad, presión arterial elevada, nivel elevado de la glucemia en ayunas y nivel elevado del colesterol de lipoproteínas de baja densidad. Se calculó el promedio de factores de riesgo por mujer. Asimismo, se analizaron las covariables demográficas y socioeconómicas independientes mediante una regresión logística ordinal. Resultados Se hallaron las siguientes prevalencias: ingesta insuficiente de frutas y verduras en el 51,7 %, sobrepeso y obesidad en el 32,3 %, presión arterial elevada en el 29,7 %, inactividad física en el 18,3 %, nivel elevado del colesterol de lipoproteínas de baja densidad en el 18,1 %; nivel elevado de glucosa en sangre en el 7,0 %, tabaquismo en el 2,4 % y consumo nocivo de alcohol en el 1,3 %. El promedio de factores de riesgo por mujer fue de 1,61. El 48,0 % de las mujeres presentaban al menos dos factores de riesgo. Los factores de riesgo eran más elevados entre las mujeres más pobres y de edad más avanzada de las zonas rurales, o del este o centro de China. Sin embargo, las probabilidades de presentar factores de riesgo múltiples aumentaban independientemente por el único hecho de ser mayor de 35 años, tener una educación deficiente y residir en el este o el centro de China. Conclusión Los factores de riesgo de las enfermedades no transmisibles crónicas son comunes entre las mujeres chinas a partir de los 18 años. Para reducir estos factores, son necesarias intervenciones dirigidas a mujeres mayores, con una educación deficiente o residentes en el este o el centro de China.

Objectif Analyser les facteurs à risque pour les maladies non transmissibles (MNT) chroniques et leurs déterminants chez les femmes chinoises. Méthodes Des données de l'enquête de surveillance des maladies chroniques et des facteurs à risque de 2010 en Chine couvrant un échantillon de femmes représentatif à l'échelle nationale ont été collectées pour déterminer la prévalence de huit facteurs à risque pour les MNT chroniques: tabagisme, consommation nocive d'alcool, consommation insuffisante de fruits et légumes, sédentarité, surpoids et obésité, hypertension artérielle, hyperglycémie et hypercholestérolémie. Le nombre moyen de facteurs à risque par femme a été estimé. Les covariables démographiques et socioéconomiques indépendantes ont également été analysées au moyen d'une régression logistique ordinaire. Résultats Les prévalences suivantes ont été constatées: consommation insuffisante de fruits et légumes, 51,7%; surpoids et obésité, 32,3%; hypertension artérielle, 29,7%; sédentarité, 18,3%; hypercholestérolémie, 18,1%; hyperglycémie, 7,0%; tabagisme, 2,4%; consommation nocive d'alcool, 1,3%. Le nombre moyen de facteurs à risque par femme était de 1,61; on a constaté au moins deux facteurs à risque chez 48,0% des femmes. Les femmes plus âgées, plus pauvres, provenant de régions rurales ou de Chine centrale ou orientale présentaient plus de facteurs à risque mais le fait d'être âgée de plus de 35 ans, peu éduquée ou d'habiter en Chine centrale ou orientale augmentait indépendamment la probabilité de présenter des facteurs à risque multiples. Conclusion Les facteurs à risque pour les MNT chroniques sont courants parmi les femmes chinoises âgées de 18 ans ou plus. Les interventions visant à réduire ces facteurs sont nécessaires et devraient s'adresser à des femmes plus âgées, vivant en Chine centrale ou orientale, ou peu éduquées.

OBJECTIVE: Recent studies have shown that circulating microRNAs might be useful, novel biomarkers for the diagnosis of acute myocardial infarction. The aims of this study were to evaluate the expression of cardiac-specific miRNAs (miR-1, -133a, -208b, and -499) in patients with acute myocardial infarction and to compare the diagnostic values of these miRNAs with that of cardiac troponin T. METHODS: Sixty-seven plasma samples obtained from patients with acute myocardial infarction and 32 plasma specimens collected from healthy volunteers were analyzed in this study. The levels of cardiac-specific miRNAs (miR-1, -133a, -208b, and -499) were measured by quantitative reverse transcription-polymerase chain reaction, and the concentrations of plasma cardiac troponin T were measured using electrochemiluminescence-based methods and an Elecsys 2010 Immunoassay Analyzer. RESULTS: The levels of plasma miR-1, -133a, -208b, and -499 were significantly higher in acute myocardial infarction patients (all p<0.001) than in healthy volunteers. The expression of the cardiac-specific miRNAs in acute myocardial infarction patients decreased to close to the baseline levels at the time of hospital discharge (all p>0.05). There were no correlations between the levels of the four circulating miRNAs and the clinical characteristics of the study population (all p>0.05). Furthermore, receiver operating characteristic curve analyses showed that the four plasma miRNAs were not superior to cardiac troponin T for the diagnosis of acute myocardial infarction (all p>0.05). CONCLUSION: Our results demonstrate that circulating miR-1, -133a, -208b, and -499 may be useful biomarkers in acute myocardial infarction patients but that these miRNAs are not superior to cardiac troponin T for the diagnosis of acute myocardial infarction.