链霉蛋白酶治疗幽门螺杆菌感染的研究进展

幽门螺杆菌(Helicobacter pylori,H.pylori)是一种可引发多系统病变的致病微生物。根除H.pylori能够改善胃黏膜炎性反应,阻止或延缓胃黏膜萎缩、肠化生的发生和发展,并部分逆转萎缩,也可不同程度地降低胃癌的发生率。以往临床常采用三联疗法作为根除H.pylori的一线治疗方案,但近年由于抗生素的广泛使用,导致H.pylori的抗药性增强,根除率降低。国内外研究均表明,链霉蛋白酶可以通过抑制H.pylori生存和影响抗H.pylori抗菌药起到根治的作用,并且在此方面取得良好疗效,为根除H.pylori开辟出一条崭新的道路。本文就链霉蛋白酶治疗H.pylori的进展作一概述。     

非酒精性脂肪性肝病治疗进展

非酒精性脂肪性肝病(non-alcoholic fatty liver disease, NAFLD)已成为目前全球最主要的慢性肝病病因,是当前研究的热点问题,其预防和治疗也成了研究的重点和难点,目前尚无批准上市的特异性药物及明确的治疗方案,本文针对NAFLD的相关治疗及新兴靶向药物作一概述,给临床医师提供参考。     

Potassium-competitive acid blockers and gastroesophageal reflux disease

Proton pump inhibitors (PPIs), the most commonly used antisecretory medi-cations in the management of reflux illness, virtually eliminate elective surgery for ulcer disease, and relegate anti-reflux surgery to patients with gastroesophageal reflux disease (GERD) who are inadequately managed by medical therapy. However, PPI medications still leave some therapeutic demands of GERD unmet. Furthermore, up to 40%-55% of daily PPI users have chronic symptoms, due to PPI refractoriness. Potassium-competitive acid blockers (P-CABs) transcend many of the problems and limits of PPIs, delivering quick, powerful, and extended acid suppression and allowing for treatment of numerous unmet needs. Recently, it has become clear that compromised mucosal integrity plays a role in the etiology of GERD. As a result, esophageal mucosal protection has emerged as a novel and potential treatment approach. An increasing body of research demonstrates that when P-CABs are used as primary drugs or add-on drugs (to regular treatment), they provide a considerable extra benefit, particularly in alleviating symptoms that do not respond to PPI therapy.     

Rifabutin as salvage therapy for Helicobacter pylori eradication: Cornerstones and novelties

When several Helicobacter pylori eradication treatments fail, guidelines recommend a cultured guided approach; however, culture is not widely available. Therefore, a rifabutin based regimen could be the best solution. Rifabutin indeed shows a low rate of antibiotic resistance. Rifabutin is generally used in combination with amoxicillin in a triple therapy, with eradication rates about 80% in third-line regimens. The ideal duration of this therapy should range between 10 and 12 d. Combinations with antibiotics other than amoxicillin have demonstrated even better results, such as vonoprazan, which is a type of novel acid suppressor drug. Finally, a new formulation of triple therapy in a single capsule is under investigation, which is a field that deserves further investigation. Some notes of caution about rifabutin should be mentioned. This drug is used to treat tuberculosis or atypical mycobacteria; therefore, before starting a rifabutin-based eradication regimen, Mycobacterium tuberculosis infection should be thoroughly tested, since its use could promote the development of antibiotic resistance, thus affecting its effectiveness against Koch’s bacillus. Additionally, some serious side effects must be evaluated before starting any rifabutin-based therapy. Adverse effects include fever, nausea, vomiting and bone marrow suppression. For this reason, full blood count surveillance is required.     

白龙港深度脱水污泥集装化运输陆运方案比较研究

针对上海市白龙港污水处理厂深度脱水污泥的集装化运输,提出了3种不同的陆运方案,并对建设周期、设备投资、人员配置、运行经济性、工程验证、以及现有生活垃圾集装化运输的影响等进行了综合分析。工程验证结果表明:推荐采用集装箱竖式装料、竖式短驳车和运输车进行短驳和运输的方案2,不仅人员配置少,且对现有生活垃圾集装化运输无影响。     

窄蒂脐旁穿支皮瓣与股前外侧穿支皮瓣修复手部小面积电烧伤的临床效果比较

目的：比较窄蒂脐旁穿支皮瓣与股前外侧穿支皮瓣在修复手部小面积电烧伤时临床疗效。方法收集2011年3月-2013年12月手部小面积电烧伤患者204例,随机分为试验组和对照组各102例。接受常规电烧伤处理的基础上,试验组患者采用窄蒂脐旁穿支皮瓣修复,对照组患者采用股前外侧穿支皮瓣修复。术后随访6个月,比较2组患者皮瓣成活率、皮瓣色泽、外形、手部运动与感觉功能差异。结果术后随访6个月2组皮瓣移植成活率及创面Ⅰ期愈合的比例差异均无统计学意义（P＞0.05）;试验组皮瓣正常色泽、正常外形、正常感觉功能及正常运动功能的比例均高于对照组,差异均有统计学意义（P＜0.05）。结论窄蒂脐旁穿支皮瓣和股前外侧穿支皮瓣修复存活率相近,但其远期移植效果更为显著。     

Status quo and future prospects of artificial neural network from the perspective of gastroenterologists

Artificial neural networks (ANNs) are one of the primary types of artificial intelligence and have been rapidly developed and used in many fields. In recent years, there has been a sharp increase in research concerning ANNs in gastrointestinal (GI) diseases. This state-of-the-art technique exhibits excellent performance in diagnosis, prognostic prediction, and treatment. Competitions between ANNs and GI experts suggest that efficiency and accuracy might be compatible in virtue of technique advancements. However, the shortcomings of ANNs are not negligible and may induce alterations in many aspects of medical practice. In this review, we introduce basic knowledge about ANNs and summarize the current achievements of ANNs in GI diseases from the perspective of gastroenterologists. Existing limitations and future directions are also proposed to optimize ANN’s clinical potential. In consideration of barriers to interdisciplinary knowledge, sophisticated concepts are discussed using plain words and metaphors to make this review more easily understood by medical practitioners and the general public.     

Erratum: Author’s research-fund support notation correction. Mass forming chronic pancreatitis mimicking pancreatic cystic neoplasm: A case report World J Gastroenterology 2018; Jan 14; 24 (2): (297-302)

Correction to "Mass forming chronic pancreatitis mimicking pancreatic cystic neoplasm: A case report" World J Gastroenterology 2018; 24 (2): 297-302. This article had accidentally omitted the fact of research-fund support notation. It should be added as supported by Dankook University Research Fund (R201600314).