The treatment of Helicobacter pylori (H. pylori) infection is a challenge for those who cannot use amoxicillin.
Objective
To evaluate the eradication rate and adverse effects of vonoprazan and tetracycline dual therapy as first-line and rescue treatment regimens used in special populations with penicillin allergy or failed in previous amoxicillin-containing therapies.
Design
Patients enrolled were those who were H. pylori-positive with selected conditions: (1) allergic to penicillin, either naïve to treatment or had failed before; or (2) failed in previous amoxicillin-containing therapies. All enrolled patients accepted 14-day vonoprazan and tetracycline dual therapy (VT dual therapy) as follows: vonoprazan (20 mg b.i.d.) and tetracycline (500 mg t.i.d. [body weight < 70 kg] or 500 mg q.i.d. [body weight ≥ 70 kg]). H. pylori status was evaluated by 13C-urease breath test 6 weeks after treatment. All adverse effects were recorded. Some patients underwent bacterial culture and antibiotic susceptibility testing.
Results
A total of 62 patients were enrolled; 18 of them received VT dual therapy as first-line treatment, 44 patients received VT dual therapy as rescue treatment. Overall, 58 of 62 patients achieved successful eradication (93.5%), while all involved (100%,18/18) succeeded in the first-line treatment group and 40 cases (90.9%, 40/44) succeeded in the rescue treatment group. Sixty-one (61/62, 98.4%) patients completed the whole course of treatment. Adverse events occurred in 6 patients (6/62, 9.7%), while one patient quit because of skin rash. All adverse effects were mild and relieved spontaneously after H. pylori treatment. Five patients achieved successful H. pylori culture, and all strains isolated were sensitive to tetracycline.
Conclusions
For the treatment of H. pylori infection in special populations with penicillin allergy or failed in previous amoxicillin-containing therapies, a 14-day vonoprazan and tetracycline dual therapy was effective and safe as first-line and rescue treatment in our study. Further study is warranted to verify its efficacy, especially for those who cannot use amoxicillin. 相似文献
Nonalcoholic fatty liver disease (NAFLD) is a strong stimulant of cardiovascular diseases, affecting one-quarter of the world's population. TBC1 domain family member 25 (TBC1D25) regulates the development of myocardial hypertrophy and cerebral ischemia–reperfusion injury; however, its effect on NAFLD/nonalcoholic steatohepatitis (NASH) has not been reported. In this study, we demonstrated that TBC1D25 expression is upregulated in NASH. TBC1D25 deficiency aggravated hepatic steatosis, inflammation, and fibrosis in NASH. In vitro tests revealed that TBC1D25 overexpression restrained NASH responses. Subsequent mechanistic validation experiments demonstrated that TBC1D25 interfered with NASH progression by inhibiting abnormal lipid accumulation and inflammation. TBC1D25 deficiency significantly promoted NASH occurrence and development. Therefore, TBC1D25 may potentially be used as a clinical therapeutic target for NASH treatment. 相似文献
Journal of Plant Growth Regulation - Zinc is an important micronutrient for the growth and development of human body and plants. Proper use of nitrogen fertilizer and foliar application of Zn have... 相似文献
Water stress is one of the most important factors limiting sustainable crop production. Therefore, the effects of the plant growth regulators (PGRs) fulvic acid (FA), brassinolide (BR), and uniconazole (Uni) on seedling growth and physiology of two maize (Zea mays L.) varieties were evaluated under???0.7 MPa water stress induced by polyethylene glycol-6000. Under drought stress, the PGRs promoted seedling growth, altered the root-to-shoot ratio, and significantly increased root biomass, length, surface area, diameter, and volume. In addition, depending on the PGR, net photosynthesis rate, SPAD value (indicating chlorophyll content), and water use efficiency increased significantly, under drought stress, whereas transpiration rate decreased. The PGRs also significantly increased antioxidant enzyme activities and significantly decreased malondialdehyde accumulation in leaves and roots under drought stress. Zhengdan958 showed greater variation in physiological responses and stronger drought resistance than Xundan20. In alleviating drought stress in maize seedlings, FA had the greatest effects on shoot growth and leaf physiology; Uni exerted its effects by regulating root structure, and BR effects were intermediate. Under drought stress, the three PGRs increased maize seedling growth, which reduced drought stress-induced damage and improved plant ability to resist the adversity. Based on a comprehensive analysis of physiological indices of drought resistance, Uni is recommended as the best PGR to improve maize seedlings resistance to drought.
