Startseite Efficacy analysis of empirical bismuth quadruple therapy, high-dose dual therapy, and resistance gene-based triple therapy as a first-line Helicobacter pylori eradication regimen – An open-label, randomized trial
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Efficacy analysis of empirical bismuth quadruple therapy, high-dose dual therapy, and resistance gene-based triple therapy as a first-line Helicobacter pylori eradication regimen – An open-label, randomized trial

  • Xin Jiang , Bin Deng , Xuefeng Gao , Yun Zhang , Guangyao Li , Guiqing Li , Qiang She EMAIL logo und Yanbing Ding EMAIL logo
Veröffentlicht/Copyright: 11. Juli 2023
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Aus der Zeitschrift Open Medicine Band 18 Heft 1

Abstract

This research aimed to evaluate the eradication efficacy, safety, and gastrointestinal symptom relief rates of empirical bismuth quadruple therapy, high-dose dual therapy, and resistance gene-based triple therapy in primary eradication patients in Yangzhou, China. It also investigated the possible factors influencing the success of different Helicobacter pylori eradication regimens. A single-center, prospective, open-label, randomized controlled study was performed from December 2020 and October 2021, in which 255 patients with H. pylori infection were assigned in a 1:1:1 ratio to the three different groups. Our results showed that high-dose dual therapy (91.0%, 71/78) and resistance gene-based triple therapy (94.9%, 75/79) achieved eradication rates and compliance equivalent to those of empirical bismuth quadruple therapy (85.3%, 64/75) in the per-protocol analysis, while high-dose dual therapy had lower rates of adverse events (11.5%, 9/78, P < 0.05), fewer side effects, and greater safety. Most patients’ gastrointestinal discomfort symptoms improved after eradication of H. pylori. Poor compliance (P < 0.05) and antibiotic resistance (P < 0.05) were risk factors for the efficacy of H. pylori eradication. Therefore, the appropriate regimen can be individualized for eradication therapy in clinical practice according to the patient’s resistance and tolerance to the drug.

Keywords: Helicobacter pylori ; empirical bismuth quadruple therapy; high-dose dual therapy; resistance-based triple therapy; eradication efficacy

1 Introduction

Helicobacter pylori is a gram-negative bacillus with a high infection rate and high pathogenicity. The prevalence of H. pylori infection in the Chinese population is nearly 50% [1], while it has slightly decreased in recent years, the rate is still high [2]. With the widespread use of antibiotics, the rate of antibiotic resistance in our population is also increasing [3]. At present, in the Chinese population, clarithromycin (resistance rate 20–40%), metronidazole (resistance rate 40–70%), and levofloxacin (resistance rate 20–40%) have high resistance rates, while the resistance rates of amoxicillin (0–5%), tetracycline (0–5%), and furazolidone (0–3%) are still low [4]. The eradication rate of standard triple therapy has been reduced to unacceptable levels (eradication rate <80%) as the therapy has been widely abandoned [5]. In the Maastricht V consensus report, it was proposed [6] that classical bismuth quadruple therapy is recommended as first-line eradication therapy in areas with high clarithromycin resistance (>15%). Since tetracycline is difficult to obtain in most parts of mainland China classical bismuth quadruple therapy cannot be widely used. Bismuth-containing quadruple therapy is recommended in the fifth national expert consensus on H. pylori infection in China [7], of which the most commonly used regimen with relatively fewer adverse reactions includes proton pump inhibitors (PPI) + amoxicillin + clarithromycin + bismuth. However, in our previous epidemiological survey, the resistance rate to clarithromycin reached 43.65% in the areas of Yangzhou, China. If such therapy was used, the eradication rate of H. pylori would inevitably be reduced and nearly half of the patients misused the antibiotics. The efficacy of clarithromycin-containing bismuth quadruple therapy has not been reported in adults in the areas of Yangzhou, China. In addition, there are many types of quadruple therapy drugs and patients have greater concerns about the occurrence of adverse drug events, which greatly affect medication compliance. Thus, we need to explore H. pylori eradication options that are more appropriate for the patients in the areas of Yangzhou, China.

When we analyzed the influential factors associated with H. pylori eradication failure, we found that antibiotic resistance was one of the most important causes of eradication failure [8]. As an infectious disease, H. pylori should theoretically be eradicated by selecting sensitive antibiotics based on susceptibility testing or local antibiotic resistance profiles. A study from Korea [9] aimed to evaluate the efficacy of drug susceptibility-based individualized therapy for first-line eradication of H. pylori in regions with high antibiotic resistance, with an intention-to-treat (ITT) eradication rate of 93.1% and a per-protocol (PP) eradication rate of 100.0%. Compared to sequential therapy, the eradication rate of drug susceptibility-based individualized therapy in the population was significantly higher. However, the difference in the antibiotic resistance spectrum in various regions, combined with the strict conditions of H. pylori culture and the low success rate of the sensitivity test, limits the selection of medication for H. pylori based on drug sensitivity tests [10]. With the rapid development of molecular biology techniques, antibiotic resistance in H. pylori can be obtained by genetic testing [11]. A multicenter prospective randomized controlled trial including 526 patients [12] was used to detect H. pylori infection and clarithromycin and levofloxacin resistance by a molecular detection method of genotype HelicoDR test, and sensitive antibiotic eradication was selected according to its drug resistance results. The individualized eradication efficiency was higher than that of traditional triple therapy. This molecular biological detection method greatly solves the bottleneck associated with the limited use of drug sensitivity tests in clinical practice.

In our population, the rate of resistance to amoxicillin is very low, and amoxicillin is widely used in infectious diseases [13]. Through an in-depth study of the bactericidal mechanism of amoxicillin, it was found that the antibacterial effect of amoxicillin on H. pylori is pH-dependent [14]. When gastric acid is fully inhibited and the pH level in the stomach can continue to reach greater than 6, amoxicillin can fully exploit its bactericidal effect on H. pylori; more sufficient gastric acid secretion inhibition yields a greater antibacterial efficacy of amoxicillin. A randomized controlled study [15] from a large sample compared the eradication safety of high-dose dual therapy with that of bismuth quadruple therapy. Modified dual therapy at a high dose and high administration frequency was equally effective, safer, and less costly than bismuth-containing quadruple therapy.

Currently, there is a lack of data regarding the appropriate H. pylori eradication regimen in the areas of Yangzhou, China. The aim of this study is to determine whether high-dose dual therapy and resistance-based triple therapy are superior to empirical bismuth quadruple therapy in terms of eradication rates and incidence of adverse events, and to assess the factors that may affect the success of eradication.

2 Materials and methods

2.1 Study population

The study participants included those who took part in the screening program for upper gastrointestinal tumors in Yangshou Town, Hanjiang District, Yangzhou City between December 2020 and October 2021. All patients underwent H. pylori detection and gastroscopy. Patients were considered eligible for enrollment if they were 18–70 years old and had H. pylori infection. H. pylori infection was defined as both positive for H. pylori by 14C-UBT and successful detection of the H. pylori UreA gene. Patients with any one of the following criteria were excluded: (1) H. pylori negative by 14C-UBT, or H. pylori UreA was not detected; (2) previously received H. pylori eradication therapy; (3) had taken H2 receptor blockers, PPI, bismuth, antibiotics, or other drugs with antibacterial effects in the past 4 weeks; (4) allergies or have drug contraindications for PPI, bismuth, amoxicillin, clarithromycin, metronidazole, levofloxacin, furazolidone, or tetracycline drugs used in this study; (5) pregnant or lactating women; (6) history of malignant tumors or gastric surgery; (7) serious liver disease, kidney disease, cardiovascular and cerebrovascular diseases, lung disease, blood diseases, or other serious diseases affecting the evaluation of this study; and (8) unwilling or unable to sign the consent form.

This study protocol was approved by the Ethics Committee of the Affiliated Hospital of Yangzhou University (2020-YKL11-10) and was conducted in accordance with the principles of the Declaration of Helsinki and the standards of Good Clinical Practice. Informed consent was obtained from each participant. This study was registered in the China Clinical Trial Registry (ChiCTR2000040469).

2.2 Study design

This was a single-center, prospective, open-label, randomized controlled study. According to the order of presentation, patients who met the inclusion criteria were divided into an empirical bismuth quadruple therapy group, a high-dose dual therapy group, and a resistance gene-based triple therapy group at a ratio of 1:1:1 using a random number table. We collected general condition data, clinical data, and gastric mucosal tissue of the patients included in the study and performed gastroscopy, 14C-UBT, and H. pylori resistance gene detection. This was an open-label study in which both investigators and patients were aware of the eradication regimen; staff performing epidemiological investigations, gastroscopy, 14C-UBT, and H. pylori resistance gene testing were blinded to group assignment to avoid possible measurement bias.

All patients returned within 1 week after the end of the radical course of treatment, and the patients were asked about the adverse events during treatment to determine the incidence of these adverse events. The remaining drugs in the patients’ bodies were examined to assess medication compliance. After discontinuation for at least 1 month, all patients underwent a repeat 14C-UBT to assess H. pylori infection status and to determine whether eradication of H. pylori was successful.

2.3 Treatment regimens

The groups and intervention strategies of this study are shown in Figures 1 and 2, and patients who met the inclusion criteria were assigned to empirical bismuth quadruple therapy, high-dose dual therapy, and resistance gene-based triple therapy groups. Radical therapy for patients in the empirical bismuth quadruple therapy group (RACB regimen) was as follows: rabeprazole 20 mg, colloidal bismuth pectin 220 mg, amoxicillin 1,000 mg, and clarithromycin 500 mg all twice daily. Radical therapy for patients in the high-dose dual therapy group (RA regimen) was as follows: rabeprazole 20 mg and amoxicillin 750 mg four times daily. Lastly, radical therapy for patients in resistance gene-based triple therapy was as follows: if the patient was resistant to amoxicillin, rabeprazole 20 mg twice daily, furazolidone 100 mg twice daily, and tetracycline 500 mg three times daily (RFT regimen); if the patient was sensitive to amoxicillin and clarithromycin, rabeprazole 20 mg, amoxicillin 1,000 mg, and clarithromycin 500 mg all twice daily (RAC regimen); if the patient was sensitive to amoxicillin and metronidazole, but was resistant to clarithromycin, rabeprazole 20 mg twice daily, amoxicillin 1,000 mg twice daily, and metronidazole 400 mg three times daily (RAM regimen); if the patient was sensitive to amoxicillin and levofloxacin, but was resistant to clarithromycin and metronidazole, rabeprazole 20 mg twice daily, amoxicillin 1,000 mg twice daily, and levofloxacin 500 mg once daily (RAL regimen); and if the patient was sensitive to amoxicillin, but was resistant to clarithromycin, metronidazole, and levofloxacin, rabeprazole 20 mg, amoxicillin 1,000 mg, and furazolidone 100 mg, all twice daily (RAF regimen).

Figure 1 Study flowchart. ITT, intention-to-treat; mITT, modified intention-to-treat; PP, per-protocol.
Figure 1

Study flowchart. ITT, intention-to-treat; mITT, modified intention-to-treat; PP, per-protocol.

Figure 2 Procedures for selecting sensitive antibiotic therapy based on H. pylori resistance gene test results. R, rabeprazole; A, amoxicillin; C, clarithromycin; M: metronidazole; L: levofloxacin; F: furazolidone; T, tetracycline.
Figure 2

Procedures for selecting sensitive antibiotic therapy based on H. pylori resistance gene test results. R, rabeprazole; A, amoxicillin; C, clarithromycin; M: metronidazole; L: levofloxacin; F: furazolidone; T, tetracycline.

The course of radical treatment in all three groups was 14 days, during which rabeprazole and colloidal bismuth pectin were administered half an hour before meals; amoxicillin, clarithromycin, metronidazole, levofloxacin, furazolidone, and tetracycline were administered half an hour after meals; and the drugs that needed to be taken four times daily were taken at bedtime in addition to the three meal times.

2.4 H. pylori detection and resistance gene detection

All eligible participants underwent an upper endoscopy and 14C-UBT after entering the study. A gastric biopsy taken from the antrum was subjected to H. pylori UreA, vacA gene detection as well as resistance gene detection (Hangzhou Meilian Medical Laboratory Co., Ltd). Antibiotics targeted by the resistance genes included amoxicillin (PBP1), clarithromycin (23S rRNA), metronidazole (rdxA), and levofloxacin (gyrA).

14C-UBT was used to confirm the presence of H. pylori infection at least 4 weeks after treatment. The participants swallowed one 14C-urea capsule in a fasting state and sat quietly for 20 min. During this period, participants did not exercise, eat, or drink. After this period, the participants were instructed to gently blow air into a vial with a red indicator through a disposable plastic expiratory tube for 1–3 min. The red indicator disappeared and the vial cap was closed. Scintillation fluid was added first during the measurement, and the disintegrations per minute (DPM) value of the participant was measured for 3 min on the H. pylori tester to determine whether the participant was infected with H. pylori. If the DPM was ≥100, the patient was considered positive for H. pylori.

2.5 Safety and compliance

All participants were informed of medication-related matters, including drug type, dose, frequency, medication time, and possible adverse events, in-person before medication administration. Each participant was given a record sheet of adverse events during medication administration. The participants recorded their medication and adverse events every day. The investigator could be contacted by telephone at any time if the participant had obvious discomfort during medication. It was recommended that the drug should not be discontinued in cases of mild-to-moderate adverse events. We asked the participants to return 1–3 days after eradication for compliance assessment and to determine the incidence of adverse effects. After taking the drug on time for 2 weeks and stopping all drugs for at least 4 weeks, we instructed the participants to perform 14C-UBT to determine whether the eradication of H. pylori was successful. The definition of compliance was ≥80% of all study drugs taken as instructed; otherwise, the patient was considered to have poor compliance.

2.6 Statistical analysis

The main aim of this study was to compare empirical bismuth quadruple therapy with a control. During the pre-test, 20 patients in each group underwent H. pylori eradication, and the eradication rates were 75, 86, and 93% in the empirical bismuth quadruple therapy, high-dose dual therapy group, and resistance gene-based triple therapy, respectively. According to the purpose and design of this study, the hypothesis test type I error α was 0.05, type II error β was 0.2, and the sample size ratio of each group was 1:1:1, assuming the failure rate was 10–15%. It was determined that 85 patients were required in each group for the three radical treatment regimens.

All participants were included in the ITT analysis. The participants who had taken the drug at least once and had the reexamination result from the 14C-UBT were included in the mITT analysis. The participants with good compliance and reexamination results from the 14C-UBT were included in the PP analysis.

Statistical analysis was performed using SPSS for Windows (version 21.0; IBM, Armonk, NY, USA). Two-sided P < 0.05 was considered to be statistically significant when comparing the three groups. Adjustment for multiple comparisons was made by setting a Bonferroni-corrected P level of 0.017. Categorical variables were described as percentages or frequencies, while continuous variables were described as mean ± standard deviation. The eradication rates and 95% CI were calculated. Intergroup differences were evaluated using Pearson chi-square or Fisher’s exact test for categorical variables and Student’s t test for continuous variables. Univariate analysis was performed to evaluate significant predictive variables for H. pylori eradication in participants with mITT analysis. A multiple logistic regression analysis was performed using variables with statistical significance in univariate analysis. Odds ratios (OR) and 95% CI for unsuccessful eradication were calculated according to the different variables.

3 Results

3.1 Characteristics of the participants

According to the inclusion and exclusion criteria, 255 participants were enrolled in this study from December 2020 to October 2021, and were assigned in a 1:1:1 ratio to the empirical bismuth quadruple therapy, high-dose dual therapy, and resistance gene-based triple therapy groups, with 85 patients in each group. Among the empirical bismuth quadruple therapy, two patients were lost to follow-up, one patient refused to have reexamination of 14C-UBT, two patients were intolerant to adverse drug reactions and discontinued halfway, and finally, 80 patients were included in the mITT analysis; excluding five patients with poor compliance, a total of 75 patients were included in the PP analysis. Among the high-dose dual therapy, one patient was lost to follow-up, two patients refused to have reexamination of 14C-UBT, one patient was intolerant to adverse drug reactions and discontinued halfway, and finally, 81 patients were included in the mITT analysis; excluding three patients with poor compliance, a total of 78 patients were included in the PP analysis. Among the resistance gene-based triple therapy, two patients were intolerant to adverse drug reactions and discontinued halfway, and finally, 83 patients were included in the mITT analysis; excluding four patients with poor compliance, a total of 79 patients were included in the PP analysis. The baseline characteristics of participants collected in each group included: sex, age, body mass index, family population, systolic blood pressure, diastolic blood pressure, smoking history, drinking history, hypertension, diabetes, hyperlipidemia, dietary habits, family history of gastrointestinal cancer, previous history of dyspepsia, endoscopic diagnosis, pathological diagnosis, H. pylori virulence gene, antibiotic resistance, and antibiotic resistance pattern. Except for diastolic blood pressure, there were no significant differences in other baseline characteristics among the three groups in the ITT analysis population. Specific baseline characteristics are shown in Table 1.

Table 1

Comparison of baseline data between three therapy groups

Baseline factors Empirical bismuth quadruple therapy (n = 85) High-dose dual therapy (n = 85) Resistance gene-based triple therapy (n = 85) P value
Sex, n/N (%) 0.119
 Male 44/85(51.8%) 31/85(36.5%) 35/85(41.2%)
 Female 41/85(48.2%) 54/85(63.5%) 50/85(58.8%)
Age, mean ± SD, years 54.42 ± 8.85 53.61 ± 8.59 53.51 ± 8.20 0.746
BMI, mean ± SD, kg/m2 23.79 ± 2.65 24.49 ± 2.93 24.38 ± 3.08 0.239
Family populations, n/N (%) 0.182
 ≤3 45/85(52.9%) 33/85(38.8%) 39/85(45.9%)
 >3 40/85(47.1%) 52/85(61.2%) 46/85(54.1%)
Systolic blood pressure, mean ± SD, mmHg 131.22 ± 14.62 134.48 ± 11.81 131.13 ± 13.75 0.180
Diastolic blood pressure, mean ± SD, mmHg 84.21 ± 7.23 87.06 ± 6.76 84.48 ± 7.74 0.020*
Smoking, n/N (%) 28/85(32.9%) 19/85(22.4%) 30/85(35.3%) 0.147
Alcohol intake, n/N (%) 34/85(40.0%) 30/85(35.3%) 25/85(29.4%) 0.349
Hypertension, n/N (%) 20/85(23.5%) 26/85(30.6%) 21/85(24.7%) 0.534
Diabetes, n/N (%) 3/85(3.5%) 5/85(5.9%) 3/85(3.5%) 0.796
Hyperlipemia, n/N (%) 7/85(8.2%) 8/85(9.4%) 2/85(2.4%) 0.142
Dietary habits, n/N (%) 0.467
 Regular diet 76/85(89.4%) 73/85(85.9%) 78/85(91.8%)
 Irregular diet 9/85(10.6%) 12/85(14.1%) 7/85(8.2%)
Feeding rate, n/N (%) 0.339
 Normal 66/85(77.6%) 69/85(81.2%) 61/85(71.8%)
 Too fast or too slow 19/85(22.4%) 16/85(18.8%) 24/85(28.2%)
Food temperature, n/N (%) 0.716
 Moderate 76/85(89.4%) 77/85(90.6%) 79/85(92.9%)
 Too hot or too cold 9/85(10.6%) 8/85(9.4%) 6/85(7.1%)
Family history of gastrointestinal cancer, n/N (%) 0.269
 Yes 28/85(32.9%) 31/85(36.5%) 38/85(44.7%)
 No 57/85(67.1%) 54/85(63.5%) 47/85(55.3%)
Prior history of dyspepsia, n/N (%) 0.606
 Yes 26/85(30.6%) 21/85(24.7%) 21/85(24.7%)
 No 59/85(69.4%) 64/85(75.3%) 64/85(75.3%)
Endoscopic diagnosis, n/N (%) 0.336
 Peptic ulcer 13/85(15.3%) 7/85(8.2%) 9/85(10.6%)
 Nonpeptic ulcer 72/85(84.7%) 78/85(91.8%) 76/85(89.4%)
Pathological diagnosis, n/N (%) 0.212
 Chronic superficial gastritis 22/85(25.9%) 28/85(32.9%) 19/85(22.4%)
 Chronic atrophic gastritis 43/85(50.6%) 45/85(52.9%) 40/85(47.1%)
 Intestinal metaplasia 17/85(20.0%) 11/85(12.9%) 20/85(23.5%)
 Atypical hyperplasia 3/85(3.5%) 1/85(1.2%) 6/85(7.1%)
Vac A, n/N (%) 0.539
 s1/m1 32/85(37.6%) 32/85(37.6%) 26/85(30.6%)
 s1/m2 53/85(62.4%) 53/85(62.4%) 59/85(69.4%)
Antibiotic resistance, n/N (%)
 Amoxicillin resistance 8/85(9.4%) 7/85(8.2%) 5/85(5.9%) 0.684
 Clarithromycin resistance 33/85(38.8%) 42/85(49.4%) 48/85(56.5%) 0.068
 Levofloxacin resistance 44/85(51.8%) 32/85(37.6%) 45/85(52.9%) 0.063
 Metronidazole resistance 29/85(34.1%) 32/85(37.6%) 37/85(43.5%) 0.444
Antibiotic resistance patterns, n/N (%)
 All sensitive 20/85(23.5%) 21/85(24.7%) 12/85(14.1%) 0.176
 Single resistance 27/85(31.8%) 21/85(24.7%) 26/85(30.6%) 0.554
 Double resistance 27/85(31.8%) 37/85(43.5%) 33/85(38.8%) 0.282
 Multidrug resistance 11/85(12.9%) 6/85(7.1%) 14/85(16.5%) 0.165

SD, standard deviation; BMI, body mass index; *P < 0.05.

3.2 Eradication rates

The primary outcome indicator of this study was to determine whether high-dose dual therapy and resistance gene-based triple therapy were superior to empirical bismuth quadruple therapy for H. pylori eradication. The eradication rate of resistance gene-based triple therapy was superior to that of empirical bismuth quadruple therapy (90.6 vs 77.6%, respectively, with a rate difference of 13.0% in ITT analysis; 94.9 vs 85.3%, respectively, with a rate difference of 9.6% in PP analysis) (Table 2), but the difference was not statistically significant both in the ITT analysis and PP analysis (Figure 3). Moreover, the eradication rate of the high-dose dual therapy group was superior to that of the empirical bismuth quadruple therapy group (84.7 vs 77.6%, respectively, with a rate difference of 7.1% in the ITT analysis; 91.0 vs 85.3%, respectively, with a rate difference of 5.7% in the PP analysis) (Table 2), and also the difference was not statistically significant (Figure 3). We concluded that high-dose dual therapy and resistance gene-based triple therapy could achieve eradication rates equivalent to the efficacy of empirical bismuth quadruple therapy.

Table 2

Comparison of eradication rates between three therapy groups

Eradication rate Empirical bismuth quadruple therapy High-dose dual therapy Resistance gene-based triple therapy P value
n/N 95% CI (%) n/N 95% CI (%) n/N 95% CI (%)
ITT analysis 66/85(77.6%) 67.7–85.2 72/85(84.7%) 75.6–90.8 77/85(90.6%) 82.5–95.2 0.067
mITT analysis 66/80(82.5%) 72.7–89.3 72/81(88.9%) 80.2–94.0 77/83(92.8%) 85.1–96.6 0.124
PP analysis 64/75(85.3%) 75.6–91.6 71/78(91.0%) 82.6–95.6 75/79(94.9%) 87.7–98.0 0.124

CI, confidence interval; ITT, intention-to-treat; mITT, modified intention-to-treat; PP, per-protocol.

Figure 3 Comparison of eradication rates between three therapy groups.
Figure 3

Comparison of eradication rates between three therapy groups.

3.3 Compliance and adverse events

The compliance and incidence of adverse events among the groups are presented in Table 3. The compliance in both the high-dose dual therapy group and the resistance gene-based triple therapy group was comparable to that of empirical bismuth quadruple therapy. In terms of safety, in the empirical bismuth quadruple therapy group, two patients withdrew from the drug because of unbearable bitter taste, nausea, and dark stools; in the high-dose dual therapy group, one patient withdrew from the drug because of a rash with unbearable itching after eating seafood while taking the drug. In the resistance gene-based triple therapy group, one patient withdrew from the drug owing to dizziness and nausea after drinking alcohol while taking the drug, and one patient withdrew from the drug because of abdominal pain, diarrhea, and other gastrointestinal events. The other patients experienced mild or moderate adverse events and were not given specific treatment. There was a statistical difference in the incidence of adverse events between the three radical regimens (P = 0.009), mainly in symptoms such as bitter taste (P = 0.016), darkened stools (P < 0.001), and nausea (P = 0.039). The incidence of adverse events was significantly lower with the high-dose dual therapy than with the empirical bismuth quadruple therapy (P = 0.002) and the incidence of adverse events with resistance gene-based triple therapy was equivalent to empirical bismuth quadruple therapy (P = 0.272).

Table 3

Comparison of safety and compliance between three therapy groups

Safety and compliance Empirical bismuth quadruple therapy (n = 75) High-dose dual therapy (n = 78) Resistance gene-based triple therapy (n = 79) P value
Patients with adverse events 24(32.0%)# 9(11.5%)# 19(24.1%) 0.009*
Mild 13(17.3%) 6(7.7%) 12(15.2%) 0.181
Moderate 9(12.0%) 2(2.6%) 5(6.3%) 0.068
Severe 2(2.7%) 1(1.3%) 2(2.5%) 0.871
Bitter taste 14(18.7%)$ 3(3.8%)$ 10(12.7%) 0.016*
Dark stools 18(24.0)& — 2(2.5%)& <0.001*
Nausea 4(5.3%) 3(3.8%) 11(13.9%) 0.039
Diarrhea 6(8.0%) 5(6.4%) 6(7.6%) 0.925
Constipation 5(6.7%) 1(1.3%) 4(5.1%) 0.224
Abdominal pain/discomfort 3(4.0%) 2(2.6%) 4(5.1%) 0.774
Asthenia 2(2.7%) 1(1.3%) 2(2.5%) 0.871
Decreased appetite 1(1.3%) 1(1.3%) 3(3.8%) 0.624
Rash 3(4.0%) 5(6.4%) 2(2.5%) 0.478
Headache 2(2.7%) 1(1.3%) 1(1.3%) 0.695
Dizziness 1(1.3%) 1(1.3%) 2(2.5%) 1.000
Good compliance 75/85(88.2%) 78/85(91.8%) 79/85(92.9%) 0.537

  1. # P = 0.002 for high-dose dual therapy versus empirical bismuth quadruple therapy; $ P = 0.004 for high-dose dual therapy versus empirical bismuth quadruple therapy; & P < 0.017 for resistance gene-based triple therapy versus empirical bismuth quadruple therapy; * P < 0.017.

3.4 Improvement of gastrointestinal symptoms after eradication therapy

The Global Overall Symptom questionnaires were given to participants before the H. pylori eradication therapy and after 1 month from the eradication therapy completed. The overall relief of gastrointestinal symptoms after eradication therapy was 81.3% (61/75) in patients treated with the empirical bismuth quadruple therapy, 89.7% (70/78) in patients treated with high-dose dual therapy, and 84.8% (67/79) in patients treated with the resistance gene-based triple therapy (Figure 4). Most patients’ discomfort symptoms improved after eradication of H. pylori, and there was no statistical difference between the three groups (P > 0.05).

Figure 4 Improvement in gastrointestinal symptoms after H. pylori eradication.
Figure 4

Improvement in gastrointestinal symptoms after H. pylori eradication.

3.5 Risk factors for eradication failure

Univariate and multivariate analyses were used to investigate the risk factors for eradication failure. Univariate analysis (Table 4) showed poor compliance (40.0 vs 85.3%, P = 0.035), resistance to amoxicillin (50.0 vs 86.1%, P = 0.039), resistance to clarithromycin (61.3 vs 95.9%, P < 0.001), and multidrug resistance (45.5 vs 88.4%, P = 0.002) as risk factors for eradication failure in empirical bismuth quadruple therapy. Meanwhile poor compliance (33.3 vs 91.0%, P = 0.031) and resistance to amoxicillin (57.1 vs 91.9%, P = 0.027) were shown as risk factors for eradication failure in high-dose dual therapy; and poor compliance (50.0 vs 94.9%, P = 0.025) was shown as risk factors for eradication failure in resistance gene-based triple therapy. Multivariate analysis identified poor compliance (OR 13.607, 95% CI 1.249–148.187, P = 0.032) and resistance to clarithromycin (OR 12.582, 95% CI 1.925–82.245, P = 0.008) as independent predictors of eradication failure in empirical bismuth quadruple therapy. Meanwhile, multivariate analysis identified poor compliance (OR 33.500, 95% CI 2.479–452.762, P = 0.008) and resistance to amoxicillin (OR 12.562, 95% CI 2.066–76.391, P = 0.006) as independent predictors of eradication failure in high-dose dual therapy. We found no independent predictor of eradication failure in resistance gene-based triple therapy.

Table 4

Univariate analysis showing factors affecting H. pylori eradication rates

Influencing factors Empirical bismuth quadruple therapy (n = 80) High-dose dual therapy (n = 81) Resistance gene-based triple therapy (n = 83)
Eradication rate P value Eradication rate P value Eradication rate P value
Gender, n/N (%) 0.331 0.838 1.000
 Male 33/42(78.6%) 25/29(86.2%) 32/34(94.1%)
 Female 33/38(86.8%) 47/52(90.4%) 45/49(91.8%)
Age, years, n/N (%) 0.652 0.275 0.483
 ≤50 20/23(87.0%) 29/33(87.9%) 33/36(91.7%)
 51–60 30/36(83.3%) 27/32(84.4%) 26/29(89.7%)
 >60 16/21(76.2%) 16/16(100.0%) 18/18(100.0%)
BMI, kg/m2, n/N (%) 0.563 0.268 0.645
 ≤22 16/19(84.2%) 15/15(100.0%) 13/15(86.7%)
 22–25 31/36(86.1%) 27/30(90.0%) 35/37(94.6%)
 >25 19/25(76.0%) 30/36(83.3%) 29/31(93.5%)
Family populations, n/N (%) 0.918 0.157 0.522
 ≤3 34/41(82.9%) 30/31(96.8%) 34/38(89.5%)
 >3 32/39(82.1%) 42/50(84.0%) 43/45(95.6%)
Smoking, n/N (%) 0.221 1.000 1.000
 Yes 19/26(73.1%) 15/17(88.2%) 27/29(93.1%)
 No 47/54(87.0%) 57/64(89.1%) 50/54(92.6%)
Alcohol intake, n/N (%) 0.400 0.838 0.826
 Yes 25/32(78.1%) 25/29(86.2%) 23/24(95.8%)
 No 41/48(85.4%) 47/52(90.4%) 54/59(91.5%)
Hypertension, n/N (%) 1.000 0.644 0.986
 Yes 16/19(84.2%) 22/26(84.6%) 20/21(95.2%)
 No 50/61(82.0%) 50/55(90.9%) 57/62(91.9%)
Diabetes, n/N (%) 0.443 0.454 0.204
 Yes 2/3(66.7%) 4/5(80.0%) 2/3(66.7%)
 No 64/77(83.1%) 68/76(89.5%) 75/80(93.8%)
Hyperlipemia, n/N (%) 0.539 0.216 1.000
 Yes 6/6(100.0%) 6/8(75.0%) 2/2(100.0%)
 No 60/74(81.1%) 66/73(90.4%) 75/81(92.6%)
Dietary habits, n/N (%) 1.000 1.000 1.000
 Regular diet 59/71(83.1%) 61/69(88.4%) 70/76(92.1%)
 Irregular diet 7/9(77.8%) 11/12(91.7%) 7/7(100.0%)
Feeding rate, n/N (%) 1.000 0.879 1.000
 Normal 51/62(82.3%) 58/66(87.9%) 56/60(93.3%)
 Too fast or too slow 15/18(83.3%) 14/15(93.3%) 21/23(91.3%)
Food temperature, n/N (%) 1.000 1.000 1.000
 Moderate 59/71(83.1%) 65/73(89.0%) 71/77(92.2%)
 Too hot or too cold 7/9(77.8%) 7/8(87.5%) 6/6(100.0%)
Family history of gastrointestinal cancer, n/N (%) 0.269 1.000 0.834
 Yes 20/27(74.1%) 27/30(90.0%) 36/38(94.7%)
 No 46/53(86.8%) 45/51(88.2%) 41/45(91.1%)
Prior history of dyspepsia, n/N (%) 0.847 0.893 1.000
 Yes 19/24(79.2%) 18/21(85.7%) 19/20(95.0%)
 No 47/56(83.9%) 54/60(90.0%) 58/63(92.1%)
Endoscopic diagnosis, n/N (%) 0.621 1.000 0.467
  Peptic ulcer 11/12(91.7%) 6/6(100.0%) 7/8(87.5%)
 Nonpeptic ulcer 55/68(80.9%) 66/75(88.0%) 70/75(93.3%)
Pathological diagnosis, n/N (%) 0.854 0.352 0.254
 Chronic superficial gastritis 18/21(85.7%) 22/26(84.6%) 17/19(89.5%)
 Chronic atrophic gastritis 33/40(82.5%) 41/44(93.2%) 36/39(92.3%)
 Intestinal metaplasia 12/16(75.0%) 8/10(80.0%) 20/20(100.0%)
 Atypical hyperplasia 3/3(100.0%) 1/1(100.0%) 4/5(80.0%)
Compliance 0.035*# 0.031*$ 0.025*
 Good 64/75(85.3%) 71/78(91.0%) 75/79(94.9%)
 Poor 2/5(40.0%) 1/3(33.3%) 2/4(50.0%)
Vac A 0.287 0.443 0.443
 s1/m1 23/30(76.7%) 26/31(83.9%) 32/33(97.0%)
 s1/m2 43/50(86.0%) 46/50(92.0%) 45/50(90.0%)
Amoxicillin resistance 0.039* 0.027*$
  Yes 4/8(50.0%) 4/7(57.1%) —
 No 62/72(86.1%) 68/74(91.9%) —
Clarithromycin resistance <0.001*#
 Yes 19/31(61.3%) — —
 No 47/49(95.9%) — —
Levofloxacin resistance 0.118
 Yes 32/42(76.2%) — —
 No 34/38(89.5%) — —
Metronidazole resistance 0.511
 Yes 25/29(86.2%) — —
  No 41/52(80.4%) — —
All sensitive 0.289
 Yes 16/17(94.1%) — —
 No 50/63(79.4%) — —
Single resistance 0.166
 Yes 25/27(92.6%) — —
 No 41/53(77.4%) — —
Multidrug resistance 0.002*
 Yes 5/11(45.5%) — —
 No 61/69(88.4%) — —

BMI, body mass index; * P < 0.05; #Multivariate analysis identified poor compliance (OR 13.607, 95% CI 1.249–148.187, P = 0.032) and resistance to clarithromycin (OR 12.582, 95% CI 1.925–82.245, P = 0.008) as independent predictors of eradication failure in empirical bismuth quadruple therapy; $Multivariate analysis identified poor compliance (OR 33.500, 95% CI 2.479–452.762, P = 0.008) and resistance to amoxicillin (OR 12.562, 95% CI 2.066–76.391, P = 0.006) as independent predictors of eradication failure in high-dose dual therapy.

4 Discussion

H. pylori, an intragastric parasitic bacterium, has highly pathogenic characteristics [16–18]. China has a particularly high burden of H. pylori infections; the infection rate varies from region to region, and the prevalence of H. pylori infection in adults shows a decreasing trend in urban areas, which seems to be explained by differences in economic and social conditions [19,20]. However, in our previous epidemiological survey, we found that the infection rate of H. pylori in the areas of Yangzhou, China, reached 42.36% and belonged to areas with high infection rates. Recent surveillance reports on the trend of antimicrobial resistance in H. pylori have confirmed that the incidence of antibiotic resistance is increasing [4,21,22], resulting in a declining eradication rate, and that traditional triple therapy for H. pylori eradication is obsolete. Therefore, selection of an appropriate eradication therapy before the initial eradication of H. pylori is the focus of clinical attention. The consensus statement recommends [6,23,24] alternative first-line treatment options, including concomitant, sequential, mixed, and bismuth-containing quadruple therapy. Owing to the influence of clarithromycin and metronidazole resistance, non-bismuth quadruple therapy is not applicable in China. Bismuth-containing quadruple therapy is recommended as the first-line eradication regimen in the Fifth National Consensus Report on the Management of H. pylori infection in China [7]. It is also the most widely used radical regimen in clinical practice and can achieve a good eradication effect. However, there are many types of drugs for bismuth-containing quadruple therapy, and patients have greater concerns about the occurrence of adverse drug events which greatly affects medication compliance.

H. pylori is an infectious disease; theoretically, sensitive antibiotics should be selected for eradication therapy based on susceptibility testing or the local antibiotic resistance spectrum, which can avoid the abuse of antibiotics, reduce the types of drugs taken, and improve compliance [25,26]. However, the resistance rate of H. pylori to amoxicillin is still low, and high-dose dual therapy including PPI combined with amoxicillin has become an increasing concern in recent years. In a clinical study of dual therapy based on systematic review and meta-analysis, 12 randomized controlled studies were included, and the results showed that dual therapy with high-dose PPIs combined with amoxicillin, whether used for primary H. pylori eradication or salvage H. pylori eradication, could achieve better efficacy, with eradication rates of more than 90%, compared with various traditional radical therapies recommended by current mainstream clinical guidelines [27]. However, whether the above radical treatment options can achieve good results in rural areas of China has not been yet reported.

In this study, for the first time, we conducted a clinical study to determine whether high-dose dual therapy and resistance gene-based triple therapy were superior to empirical bismuth quadruple therapy for H. pylori eradication. The results showed that high-dose dual therapy and resistance gene-based triple therapy could achieve an eradication rate equivalent to empirical bismuth quadruple therapy. Due to the reduction in the types of drugs taken and precise radical cures, the adverse events of high-dose dual therapy were much lower than that of empirical bismuth quadruple therapy, and the adverse events of resistance gene-based triple therapy were equivalent to that of empirical bismuth quadruple therapy.

Actually, Swedish scholar Unge et al. [28] first used a PPI and amoxicillin dual regimen to eradicate H. pylori as early as 1989, and since then many scholars have attempted different doses and frequencies of PPI and amoxicillin, but consistent and satisfactory eradication rates have remained difficult to obtain. With the deepening of the study on the kinetics and pharmacodynamics of amoxicillin and PPI, the mechanism of the dual regimen has been gradually elucidated. First, H. pylori strains are not susceptible to amoxicillin resistance because simultaneous mutations in multiple penicillin-binding protein-related genes cause marked resistance to amoxicillin [29]. Second, amoxicillin is a time-dependent antibiotic. The bactericidal effect mainly depends on the percentage of time when the plasma concentration is higher than the minimum inhibitory concentration. The same amoxicillin dose prolonged the percentage of time when divided into multiple doses. Multiple doses can also increase the local drug concentration in the gastric juice. Oral administration of four times per day can result in a better bactericidal effect [30,31]. Third, amoxicillin exerts a bactericidal effect by inhibiting the formation of bacterial cell walls and is effective only when bacteria multiply actively. H. pylori multiplies actively when the intragastric pH is >6.0; thus, amoxicillin has the best bactericidal effect at this pH [5]. In addition, amoxicillin is easily destroyed in an acidic environment, and adequate inhibition of gastric acid is the key to its effective sterilization. As potent antacids, most PPIs are metabolized by CYP2C19 enzymes. When CYP2C19 is a moderate or poor metabolizer, PPI has a better acid-inhibitory effect. When the CYP2C19 gene is an extensive metabolizer, PPI is rapidly metabolized by the body, with a decreased acid-inhibitory effect and decreased H. pylori eradication efficacy. Oral PPI can achieve satisfactory acid suppression in CYP2C19 fast, moderate, and poor metabolizers four times daily [30]. The PPI selected for this study was rabeprazole, which is mainly metabolized by non-enzymatic pathways and is less affected by CYP2C19, which can achieve effective acid suppression.

Antibiotic resistance is one of the most important reasons for the failure of H. pylori eradication. Our previous epidemiological survey found that the resistance rates to clarithromycin, metronidazole, and levofloxacin in the areas of Yangzhou were 41.0, 38.8, and 44.9%, respectively. The rapid increase in drug resistance may be related to the characteristics of antibiotics that can easily induce drug resistance and their widespread irrational use in mainland China. Therefore, it is essential to understand antibiotic resistance in patients before eradication therapy. This study collected complete antibiotic resistance information for each patient, which was very helpful for us to comprehensively and accurately assess the causes and risk factors of radical cure failure. Our univariate and multivariate analyses of the factors affecting H. pylori eradication failure revealed that antibiotic resistance is one of the most important risk factors. In the resistance gene-based triple therapy, we avoided the use of resistant antibiotics and chose sensitive antibiotics to eradicate H. pylori. The results showed that a high eradication rate was achieved despite the use of triple therapy, which indicates that it is necessary to select sensitive antibiotics to eradicate H. pylori based on resistance results in the areas of China with a high resistance rate. This not only achieves a good eradication effect but also avoids secondary resistance due to antibiotic abuse in rural areas.

We found that most patients were able to alleviate their gastrointestinal discomfort after H. pylori eradication. First, almost all patients with H. pylori infection have chronic active gastritis, with high acidity in the stomach and a high inflammatory reaction. PPI can increase the pH of the stomach and reverse damage to the gastric mucosa, thus relieving gastric discomfort [32]. Second, microbiota dysbiosis can also cause gastrointestinal discomfort. In a study on the effect of H. pylori infection on the gastrointestinal microbiota [33], it was found that the microbial diversity of H. pylori-infected patients was significantly lower than that of H. pylori-uninfected patients, leading to a disruption of the flora, while successful eradication of H. pylori resulted in a transient decrease in microbial diversity due to the use of antibiotics. However, in the long term it significantly increased the microbiota of H. pylori-positive patients. The hypogastric microbial richness and homogeneity of the intragastric environment in H. pylori-positive patients were similar to those in H. pylori-negative patients.

Two notable points were observed in this study. First, we collected comprehensive and complete pre-radical baseline data, including demographic data and clinical characteristics, as well as information on antibiotic resistance in all patients, which increased the reliability of our findings. Second, we chose to collect gastric mucosal samples for molecular biological detection of H. pylori virulence genes and drug resistance genes, avoiding the drawbacks of low positive rates and long durations of drug sensitivity test cultures, which cause an inability to routinely perform detection in clinical practice. This method greatly shortened the time of antibiotic resistance results, allowed patients to begin treatment as early as possible, and enabled more extensive individualized diagnosis and treatment in clinical practice.

This study had some limitations. First, it was a prospective, single-center study with a small sample size. Therefore, a multicenter study with a lager sample size is needed to verify the effectiveness of eradication efficacy. Second, we did not detect genetic polymorphisms of CYP2C19 enzyme in patient blood samples. Although we selected rabeprazole, which is less affected by CYP2C19 enzymes, recent studies have shown that rabeprazole metabolism is also affected to some extent by the CYP2C19 genotype, which may have an impact on patients who choose high-dose dual therapy. At present, a potassium-competitive acid blocker (P-CAB) has been selected for H. pylori eradication. It is a novel antacid with reversible and competitive inhibitory effects on H+, K+ ATPase-mediated gastric acid secretion. It is considered to have an antacid effect on PPI and has potential benefits for H. pylori eradication. A meta-analysis of 1,599 H. pylori-positive patients showed no significant difference in eradication rates between P-CAB-based therapy and conventional PPI therapy in clarithromycin-sensitive patients. However, P-CAB-based therapy was more effective than PPI-based regimens in clarithromycin-resistant patients [34]. Therefore, P-CAB is expected to be a strong first-line therapy for H. pylori eradication in the future.

5 Conclusions

In summary, in patients with the first-time eradication of H. pylori infection in the areas of Yangzhou, high-dose dual therapy and resistance gene-based triple therapy achieved eradication rates and compliance equivalent to those of empirical bismuth quadruple therapy. Meanwhile high-dose dual therapy had lower rates of adverse events, fewer side effects, and greater safety. Eradication of H. pylori improves gastrointestinal discomfort in most patients with the infection. Eradication failure is primarily related to antibiotic resistance and poor compliance. Therefore, the appropriate regimen can be individualized for eradication therapy in clinical practice according to the patient’s resistance and tolerance to the drug.

# These authors contributed equally to this work.

Acknowledgments

We thank all the study participants and research staff their contributions and commitment to the present study.

  1. Funding information: This work was supported by the Key Project for Social Development in Jiangsu Province (BE2019698), Strengthening Health Care via Science and Education Project and Clinical Medical Innovation Platform Foundation of Yangzhou (2018, YXZX20184, Gastroenterology), and Major public health projects in Yangzhou: Screening projects of early gastrointestinal diseases (2018).

  2. Author contributions: Xin Jiang performed clinical study, statistical analysis, and manuscript preparation; Bin Deng and Qiang She enrolled participants, collected data; Yun Zhang performed laboratory study; Xin Jiang, Xuefeng Gao, Guangyao Li, and Guiqing Li performed the gathering of clinical data on efficacy, compliance, and adverse events; Yanbing Ding contributed to study conceptualization, study design, funding acquisition, and manuscript editing. All authors have read and approved the final draft of this article.

  3. Conflict of interest: All the authors disclose no conflict of interest.

  4. Data availability statement: The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Received: 2022-12-05
Revised: 2023-04-23
Accepted: 2023-05-12
Published Online: 2023-07-11

© 2023 the author(s), published by De Gruyter

This work is licensed under the Creative Commons Attribution 4.0 International License.

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  37. Single-arm trial to evaluate the efficacy and safety of baclofen in treatment of intractable hiccup caused by malignant tumor chemotherapy
  38. Genetic polymorphisms of MRPS30-DT and NINJ2 may influence lung cancer risk
  39. Efficacy of immune checkpoint inhibitors in patients with KRAS-mutant advanced non-small cell lung cancer: A retrospective analysis
  40. Pyroptosis-based risk score predicts prognosis and drug sensitivity in lung adenocarcinoma
  41. Upregulation of lncRNA LANCL1-AS1 inhibits the progression of non-small-cell lung cancer via the miR-3680-3p/GMFG axis
  42. CircRANBP17 modulated KDM1A to regulate neuroblastoma progression by sponging miR-27b-3p
  43. Exosomal miR-93-5p regulated the progression of osteoarthritis by targeting ADAMTS9
  44. Downregulation of RBM17 enhances cisplatin sensitivity and inhibits cell invasion in human hypopharyngeal cancer cells
  45. HDAC5-mediated PRAME regulates the proliferation, migration, invasion, and EMT of laryngeal squamous cell carcinoma via the PI3K/AKT/mTOR signaling pathway
  46. The association between sleep duration, quality, and nonalcoholic fatty liver disease: A cross-sectional study
  47. Myostatin silencing inhibits podocyte apoptosis in membranous nephropathy through Smad3/PKA/NOX4 signaling pathway
  48. A novel long noncoding RNA AC125257.1 facilitates colorectal cancer progression by targeting miR-133a-3p/CASC5 axis
  49. Impact of omicron wave and associated control measures in Shanghai on health management and psychosocial well-being of patients with chronic conditions
  50. Clinicopathological characteristics and prognosis of young patients aged ≤45 years old with non-small cell lung cancer
  51. TMT-based comprehensive proteomic profiling identifies serum prognostic signatures of acute myeloid leukemia
  52. The dose limits of teeth protection for patients with nasopharyngeal carcinoma undergoing radiotherapy based on the early oral health-related quality of life
  53. miR-30b-5p targeting GRIN2A inhibits hippocampal damage in epilepsy
  54. Long non-coding RNA AL137789.1 promoted malignant biological behaviors and immune escape of pancreatic carcinoma cells
  55. IRF6 and FGF1 polymorphisms in non-syndromic cleft lip with or without cleft palate in the Polish population
  56. Comprehensive analysis of the role of SFXN family in breast cancer
  57. Efficacy of bronchoscopic intratumoral injection of endostar and cisplatin in lung squamous cell carcinoma patients underwent conventional chemoradiotherapy
  58. Silencing of long noncoding RNA MIAT inhibits the viability and proliferation of breast cancer cells by promoting miR-378a-5p expression
  59. AG1024, an IGF-1 receptor inhibitor, ameliorates renal injury in rats with diabetic nephropathy via the SOCS/JAK2/STAT pathway
  60. Downregulation of KIAA1199 alleviated the activation, proliferation, and migration of hepatic stellate cells by the inhibition of epithelial–mesenchymal transition
  61. Exendin-4 regulates the MAPK and WNT signaling pathways to alleviate the osteogenic inhibition of periodontal ligament stem cells in a high glucose environment
  62. Inhibition of glycolysis represses the growth and alleviates the endoplasmic reticulum stress of breast cancer cells by regulating TMTC3
  63. The function of lncRNA EMX2OS/miR-653-5p and its regulatory mechanism in lung adenocarcinoma
  64. Tectorigenin alleviates the apoptosis and inflammation in spinal cord injury cell model through inhibiting insulin-like growth factor-binding protein 6
  65. Ultrasound examination supporting CT or MRI in the evaluation of cervical lymphadenopathy in patients with irradiation-treated head and neck cancer
  66. F-box and WD repeat domain containing 7 inhibits the activation of hepatic stellate cells by degrading delta-like ligand 1 to block Notch signaling pathway
  67. Knockdown of circ_0005615 enhances the radiosensitivity of colorectal cancer by regulating the miR-665/NOTCH1 axis
  68. Long noncoding RNA Mhrt alleviates angiotensin II-induced cardiac hypertrophy phenotypes by mediating the miR-765/Wnt family member 7B pathway
  69. Effect of miR-499-5p/SOX6 axis on atrial fibrosis in rats with atrial fibrillation
  70. Cholesterol induces inflammation and reduces glucose utilization
  71. circ_0004904 regulates the trophoblast cell in preeclampsia via miR-19b-3p/ARRDC3 axis
  72. NECAB3 promotes the migration and invasion of liver cancer cells through HIF-1α/RIT1 signaling pathway
  73. The poor performance of cardiovascular risk scores in identifying patients with idiopathic inflammatory myopathies at high cardiovascular risk
  74. miR-2053 inhibits the growth of ovarian cancer cells by downregulating SOX4
  75. Nucleophosmin 1 associating with engulfment and cell motility protein 1 regulates hepatocellular carcinoma cell chemotaxis and metastasis
  76. α-Hederin regulates macrophage polarization to relieve sepsis-induced lung and liver injuries in mice
  77. Changes of microbiota level in urinary tract infections: A meta-analysis
  78. Identification of key enzalutamide-resistance-related genes in castration-resistant prostate cancer and verification of RAD51 functions
  79. Falls during oxaliplatin-based chemotherapy for gastrointestinal malignancies – (lessons learned from) a prospective study
  80. Outcomes of low-risk birth care during the Covid-19 pandemic: A cohort study from a tertiary care center in Lithuania
  81. Vitamin D protects intestines from liver cirrhosis-induced inflammation and oxidative stress by inhibiting the TLR4/MyD88/NF-κB signaling pathway
  82. Integrated transcriptome analysis identifies APPL1/RPS6KB2/GALK1 as immune-related metastasis factors in breast cancer
  83. Genomic analysis of immunogenic cell death-related subtypes for predicting prognosis and immunotherapy outcomes in glioblastoma multiforme
  84. Circular RNA Circ_0038467 promotes the maturation of miRNA-203 to increase lipopolysaccharide-induced apoptosis of chondrocytes
  85. An economic evaluation of fine-needle cytology as the primary diagnostic tool in the diagnosis of lymphadenopathy
  86. Midazolam impedes lung carcinoma cell proliferation and migration via EGFR/MEK/ERK signaling pathway
  87. Network pharmacology combined with molecular docking and experimental validation to reveal the pharmacological mechanism of naringin against renal fibrosis
  88. PTPN12 down-regulated by miR-146b-3p gene affects the malignant progression of laryngeal squamous cell carcinoma
  89. miR-141-3p accelerates ovarian cancer progression and promotes M2-like macrophage polarization by targeting the Keap1-Nrf2 pathway
  90. lncRNA OIP5-AS1 attenuates the osteoarthritis progression in IL-1β-stimulated chondrocytes
  91. Overexpression of LINC00607 inhibits cell growth and aggressiveness by regulating the miR-1289/EFNA5 axis in non-small-cell lung cancer
  92. Subjective well-being in informal caregivers during the COVID-19 pandemic
  93. Nrf2 protects against myocardial ischemia-reperfusion injury in diabetic rats by inhibiting Drp1-mediated mitochondrial fission
  94. Unfolded protein response inhibits KAT2B/MLKL-mediated necroptosis of hepatocytes by promoting BMI1 level to ubiquitinate KAT2B
  95. Bladder cancer screening: The new selection and prediction model
  96. circNFATC3 facilitated the progression of oral squamous cell carcinoma via the miR-520h/LDHA axis
  97. Prone position effect in intensive care patients with SARS-COV-2 pneumonia
  98. Clinical observation on the efficacy of Tongdu Tuina manipulation in the treatment of primary enuresis in children
  99. Dihydroartemisinin ameliorates cerebral I/R injury in rats via regulating VWF and autophagy-mediated SIRT1/FOXO1 pathway
  100. Knockdown of circ_0113656 assuages oxidized low-density lipoprotein-induced vascular smooth muscle cell injury through the miR-188-3p/IGF2 pathway
  101. Low Ang-(1–7) and high des-Arg9 bradykinin serum levels are correlated with cardiovascular risk factors in patients with COVID-19
  102. Effect of maternal age and body mass index on induction of labor with oral misoprostol for premature rupture of membrane at term: A retrospective cross-sectional study
  103. Potential protective effects of Huanglian Jiedu Decoction against COVID-19-associated acute kidney injury: A network-based pharmacological and molecular docking study
  104. Clinical significance of serum MBD3 detection in girls with central precocious puberty
  105. Clinical features of varicella-zoster virus caused neurological diseases detected by metagenomic next-generation sequencing
  106. Collagen treatment of complex anorectal fistula: 3 years follow-up
  107. LncRNA CASC15 inhibition relieves renal fibrosis in diabetic nephropathy through down-regulating SP-A by sponging to miR-424
  108. Efficacy analysis of empirical bismuth quadruple therapy, high-dose dual therapy, and resistance gene-based triple therapy as a first-line Helicobacter pylori eradication regimen – An open-label, randomized trial
  109. SMOC2 plays a role in heart failure via regulating TGF-β1/Smad3 pathway-mediated autophagy
  110. A prospective cohort study of the impact of chronic disease on fall injuries in middle-aged and older adults
  111. circRNA THBS1 silencing inhibits the malignant biological behavior of cervical cancer cells via the regulation of miR-543/HMGB2 axis
  112. hsa_circ_0000285 sponging miR-582-3p promotes neuroblastoma progression by regulating the Wnt/β-catenin signaling pathway
  113. Long non-coding RNA GNAS-AS1 knockdown inhibits proliferation and epithelial–mesenchymal transition of lung adenocarcinoma cells via the microRNA-433-3p/Rab3A axis
  114. lncRNA UCA1 regulates miR-132/Lrrfip1 axis to promote vascular smooth muscle cell proliferation
  115. Twenty-four-color full spectrum flow cytometry panel for minimal residual disease detection in acute myeloid leukemia
  116. Hsa-miR-223-3p participates in the process of anthracycline-induced cardiomyocyte damage by regulating NFIA gene
  117. Anti-inflammatory effect of ApoE23 on Salmonella typhimurium-induced sepsis in mice
  118. Analysis of somatic mutations and key driving factors of cervical cancer progression
  119. Hsa_circ_0028007 regulates the progression of nasopharyngeal carcinoma through the miR-1179/SQLE axis
  120. Variations in sexual function after laparoendoscopic single-site hysterectomy in women with benign gynecologic diseases
  121. Effects of pharmacological delay with roxadustat on multi-territory perforator flap survival in rats
  122. Analysis of heroin effects on calcium channels in rat cardiomyocytes based on transcriptomics and metabolomics
  123. Risk factors of recurrent bacterial vaginosis among women of reproductive age: A cross-sectional study
  124. Alkbh5 plays indispensable roles in maintaining self-renewal of hematopoietic stem cells
  125. Study to compare the effect of casirivimab and imdevimab, remdesivir, and favipiravir on progression and multi-organ function of hospitalized COVID-19 patients
  126. Correlation between microvessel maturity and ISUP grades assessed using contrast-enhanced transrectal ultrasonography in prostate cancer
  127. The protective effect of caffeic acid phenethyl ester in the nephrotoxicity induced by α-cypermethrin
  128. Norepinephrine alleviates cyclosporin A-induced nephrotoxicity by enhancing the expression of SFRP1
  129. Effect of RUNX1/FOXP3 axis on apoptosis of T and B lymphocytes and immunosuppression in sepsis
  130. The function of Foxp1 represses β-adrenergic receptor transcription in the occurrence and development of bladder cancer through STAT3 activity
  131. Risk model and validation of carbapenem-resistant Klebsiella pneumoniae infection in patients with cerebrovascular disease in the ICU
  132. Calycosin protects against chronic prostatitis in rats via inhibition of the p38MAPK/NF-κB pathway
  133. Pan-cancer analysis of the PDE4DIP gene with potential prognostic and immunotherapeutic values in multiple cancers including acute myeloid leukemia
  134. The safety and immunogenicity to inactivated COVID-19 vaccine in patients with hyperlipemia
  135. Circ-UBR4 regulates the proliferation, migration, inflammation, and apoptosis in ox-LDL-induced vascular smooth muscle cells via miR-515-5p/IGF2 axis
  136. Clinical characteristics of current COVID-19 rehabilitation outpatients in China
  137. Luteolin alleviates ulcerative colitis in rats via regulating immune response, oxidative stress, and metabolic profiling
  138. miR-199a-5p inhibits aortic valve calcification by targeting ATF6 and GRP78 in valve interstitial cells
  139. The application of iliac fascia space block combined with esketamine intravenous general anesthesia in PFNA surgery of the elderly: A prospective, single-center, controlled trial
  140. Elevated blood acetoacetate levels reduce major adverse cardiac and cerebrovascular events risk in acute myocardial infarction
  141. The effects of progesterone on the healing of obstetric anal sphincter damage in female rats
  142. Identification of cuproptosis-related genes for predicting the development of prostate cancer
  143. Lumican silencing ameliorates β-glycerophosphate-mediated vascular smooth muscle cell calcification by attenuating the inhibition of APOB on KIF2C activity
  144. Targeting PTBP1 blocks glutamine metabolism to improve the cisplatin sensitivity of hepatocarcinoma cells through modulating the mRNA stability of glutaminase
  145. A single center prospective study: Influences of different hip flexion angles on the measurement of lumbar spine bone mineral density by dual energy X-ray absorptiometry
  146. Clinical analysis of AN69ST membrane continuous venous hemofiltration in the treatment of severe sepsis
  147. Antibiotics therapy combined with probiotics administered intravaginally for the treatment of bacterial vaginosis: A systematic review and meta-analysis
  148. Construction of a ceRNA network to reveal a vascular invasion associated prognostic model in hepatocellular carcinoma
  149. A pan-cancer analysis of STAT3 expression and genetic alterations in human tumors
  150. A prognostic signature based on seven T-cell-related cell clustering genes in bladder urothelial carcinoma
  151. Pepsin concentration in oral lavage fluid of rabbit reflux model constructed by dilating the lower esophageal sphincter
  152. The antihypertensive felodipine shows synergistic activity with immune checkpoint blockade and inhibits tumor growth via NFAT1 in LUSC
  153. Tanshinone IIA attenuates valvular interstitial cells’ calcification induced by oxidized low density lipoprotein via reducing endoplasmic reticulum stress
  154. AS-IV enhances the antitumor effects of propofol in NSCLC cells by inhibiting autophagy
  155. Establishment of two oxaliplatin-resistant gallbladder cancer cell lines and comprehensive analysis of dysregulated genes
  156. Trial protocol: Feasibility of neuromodulation with connectivity-guided intermittent theta-burst stimulation for improving cognition in multiple sclerosis
  157. LncRNA LINC00592 mediates the promoter methylation of WIF1 to promote the development of bladder cancer
  158. Factors associated with gastrointestinal dysmotility in critically ill patients
  159. Mechanisms by which spinal cord stimulation intervenes in atrial fibrillation: The involvement of the endothelin-1 and nerve growth factor/p75NTR pathways
  160. Analysis of two-gene signatures and related drugs in small-cell lung cancer by bioinformatics
  161. Silencing USP19 alleviates cigarette smoke extract-induced mitochondrial dysfunction in BEAS-2B cells by targeting FUNDC1
  162. Menstrual irregularities associated with COVID-19 vaccines among women in Saudi Arabia: A survey during 2022
  163. Ferroptosis involves in Schwann cell death in diabetic peripheral neuropathy
  164. The effect of AQP4 on tau protein aggregation in neurodegeneration and persistent neuroinflammation after cerebral microinfarcts
  165. Activation of UBEC2 by transcription factor MYBL2 affects DNA damage and promotes gastric cancer progression and cisplatin resistance
  166. Analysis of clinical characteristics in proximal and distal reflux monitoring among patients with gastroesophageal reflux disease
  167. Exosomal circ-0020887 and circ-0009590 as novel biomarkers for the diagnosis and prediction of short-term adverse cardiovascular outcomes in STEMI patients
  168. Upregulated microRNA-429 confers endometrial stromal cell dysfunction by targeting HIF1AN and regulating the HIF1A/VEGF pathway
  169. Bibliometrics and knowledge map analysis of ultrasound-guided regional anesthesia
  170. Knockdown of NUPR1 inhibits angiogenesis in lung cancer through IRE1/XBP1 and PERK/eIF2α/ATF4 signaling pathways
  171. D-dimer trends predict COVID-19 patient’s prognosis: A retrospective chart review study
  172. WTAP affects intracranial aneurysm progression by regulating m6A methylation modification
  173. Using of endoscopic polypectomy in patients with diagnosed malignant colorectal polyp – The cross-sectional clinical study
  174. Anti-S100A4 antibody administration alleviates bronchial epithelial–mesenchymal transition in asthmatic mice
  175. Prognostic evaluation of system immune-inflammatory index and prognostic nutritional index in double expressor diffuse large B-cell lymphoma
  176. Prevalence and antibiogram of bacteria causing urinary tract infection among patients with chronic kidney disease
  177. Reactive oxygen species within the vaginal space: An additional promoter of cervical intraepithelial neoplasia and uterine cervical cancer development?
  178. Identification of disulfidptosis-related genes and immune infiltration in lower-grade glioma
  179. A new technique for uterine-preserving pelvic organ prolapse surgery: Laparoscopic rectus abdominis hysteropexy for uterine prolapse by comparing with traditional techniques
  180. Self-isolation of an Italian long-term care facility during COVID-19 pandemic: A comparison study on care-related infectious episodes
  181. A comparative study on the overlapping effects of clinically applicable therapeutic interventions in patients with central nervous system damage
  182. Low intensity extracorporeal shockwave therapy for chronic pelvic pain syndrome: Long-term follow-up
  183. The diagnostic accuracy of touch imprint cytology for sentinel lymph node metastases of breast cancer: An up-to-date meta-analysis of 4,073 patients
  184. Mortality associated with Sjögren’s syndrome in the United States in the 1999–2020 period: A multiple cause-of-death study
  185. CircMMP11 as a prognostic biomarker mediates miR-361-3p/HMGB1 axis to accelerate malignant progression of hepatocellular carcinoma
  186. Analysis of the clinical characteristics and prognosis of adult de novo acute myeloid leukemia (none APL) with PTPN11 mutations
  187. KMT2A maintains stemness of gastric cancer cells through regulating Wnt/β-catenin signaling-activated transcriptional factor KLF11
  188. Evaluation of placental oxygenation by near-infrared spectroscopy in relation to ultrasound maturation grade in physiological term pregnancies
  189. The role of ultrasonographic findings for PIK3CA-mutated, hormone receptor-positive, human epidermal growth factor receptor-2-negative breast cancer
  190. Construction of immunogenic cell death-related molecular subtypes and prognostic signature in colorectal cancer
  191. Long-term prognostic value of high-sensitivity cardiac troponin-I in patients with idiopathic dilated cardiomyopathy
  192. Establishing a novel Fanconi anemia signaling pathway-associated prognostic model and tumor clustering for pediatric acute myeloid leukemia patients
  193. Integrative bioinformatics analysis reveals STAT2 as a novel biomarker of inflammation-related cardiac dysfunction in atrial fibrillation
  194. Adipose-derived stem cells repair radiation-induced chronic lung injury via inhibiting TGF-β1/Smad 3 signaling pathway
  195. Real-world practice of idiopathic pulmonary fibrosis: Results from a 2000–2016 cohort
  196. lncRNA LENGA sponges miR-378 to promote myocardial fibrosis in atrial fibrillation
  197. Diagnostic value of urinary Tamm-Horsfall protein and 24 h urine osmolality for recurrent calcium oxalate stones of the upper urinary tract: Cross-sectional study
  198. The value of color Doppler ultrasonography combined with serum tumor markers in differential diagnosis of gastric stromal tumor and gastric cancer
  199. The spike protein of SARS-CoV-2 induces inflammation and EMT of lung epithelial cells and fibroblasts through the upregulation of GADD45A
  200. Mycophenolate mofetil versus cyclophosphamide plus in patients with connective tissue disease-associated interstitial lung disease: Efficacy and safety analysis
  201. MiR-1278 targets CALD1 and suppresses the progression of gastric cancer via the MAPK pathway
  202. Metabolomic analysis of serum short-chain fatty acid concentrations in a mouse of MPTP-induced Parkinson’s disease after dietary supplementation with branched-chain amino acids
  203. Cimifugin inhibits adipogenesis and TNF-α-induced insulin resistance in 3T3-L1 cells
  204. Predictors of gastrointestinal complaints in patients on metformin therapy
  205. Prescribing patterns in patients with chronic obstructive pulmonary disease and atrial fibrillation
  206. A retrospective analysis of the effect of latent tuberculosis infection on clinical pregnancy outcomes of in vitro fertilization–fresh embryo transferred in infertile women
  207. Appropriateness and clinical outcomes of short sustained low-efficiency dialysis: A national experience
  208. miR-29 regulates metabolism by inhibiting JNK-1 expression in non-obese patients with type 2 diabetes mellitus and NAFLD
  209. Clinical features and management of lymphoepithelial cyst
  210. Serum VEGF, high-sensitivity CRP, and cystatin-C assist in the diagnosis of type 2 diabetic retinopathy complicated with hyperuricemia
  211. ENPP1 ameliorates vascular calcification via inhibiting the osteogenic transformation of VSMCs and generating PPi
  212. Significance of monitoring the levels of thyroid hormone antibodies and glucose and lipid metabolism antibodies in patients suffer from type 2 diabetes
  213. The causal relationship between immune cells and different kidney diseases: A Mendelian randomization study
  214. Interleukin 33, soluble suppression of tumorigenicity 2, interleukin 27, and galectin 3 as predictors for outcome in patients admitted to intensive care units
  215. Identification of diagnostic immune-related gene biomarkers for predicting heart failure after acute myocardial infarction
  216. Long-term administration of probiotics prevents gastrointestinal mucosal barrier dysfunction in septic mice partly by upregulating the 5-HT degradation pathway
  217. miR-192 inhibits the activation of hepatic stellate cells by targeting Rictor
  218. Diagnostic and prognostic value of MR-pro ADM, procalcitonin, and copeptin in sepsis
  219. Review Articles
  220. Prenatal diagnosis of fetal defects and its implications on the delivery mode
  221. Electromagnetic fields exposure on fetal and childhood abnormalities: Systematic review and meta-analysis
  222. Characteristics of antibiotic resistance mechanisms and genes of Klebsiella pneumoniae
  223. Saddle pulmonary embolism in the setting of COVID-19 infection: A systematic review of case reports and case series
  224. Vitamin C and epigenetics: A short physiological overview
  225. Ebselen: A promising therapy protecting cardiomyocytes from excess iron in iron-overloaded thalassemia patients
  226. Aspirin versus LMWH for VTE prophylaxis after orthopedic surgery
  227. Mechanism of rhubarb in the treatment of hyperlipidemia: A recent review
  228. Surgical management and outcomes of traumatic global brachial plexus injury: A concise review and our center approach
  229. The progress of autoimmune hepatitis research and future challenges
  230. METTL16 in human diseases: What should we do next?
  231. New insights into the prevention of ureteral stents encrustation
  232. VISTA as a prospective immune checkpoint in gynecological malignant tumors: A review of the literature
  233. Case Reports
  234. Mycobacterium xenopi infection of the kidney and lymph nodes: A case report
  235. Genetic mutation of SLC6A20 (c.1072T > C) in a family with nephrolithiasis: A case report
  236. Chronic hepatitis B complicated with secondary hemochromatosis was cured clinically: A case report
  237. Liver abscess complicated with multiple organ invasive infection caused by hematogenous disseminated hypervirulent Klebsiella pneumoniae: A case report
  238. Urokinase-based lock solutions for catheter salvage: A case of an upcoming kidney transplant recipient
  239. Two case reports of maturity-onset diabetes of the young type 3 caused by the hepatocyte nuclear factor 1α gene mutation
  240. Immune checkpoint inhibitor-related pancreatitis: What is known and what is not
  241. Does total hip arthroplasty result in intercostal nerve injury? A case report and literature review
  242. Clinicopathological characteristics and diagnosis of hepatic sinusoidal obstruction syndrome caused by Tusanqi – Case report and literature review
  243. Synchronous triple primary gastrointestinal malignant tumors treated with laparoscopic surgery: A case report
  244. CT-guided percutaneous microwave ablation combined with bone cement injection for the treatment of transverse metastases: A case report
  245. Malignant hyperthermia: Report on a successful rescue of a case with the highest temperature of 44.2°C
  246. Anesthetic management of fetal pulmonary valvuloplasty: A case report
  247. Rapid Communication
  248. Impact of COVID-19 lockdown on glycemic levels during pregnancy: A retrospective analysis
  249. Erratum
  250. Erratum to “Inhibition of miR-21 improves pulmonary vascular responses in bronchopulmonary dysplasia by targeting the DDAH1/ADMA/NO pathway”
  251. Erratum to: “Fer exacerbates renal fibrosis and can be targeted by miR-29c-3p”
  252. Retraction
  253. Retraction of “Study to compare the effect of casirivimab and imdevimab, remdesivir, and favipiravir on progression and multi-organ function of hospitalized COVID-19 patients”
  254. Retraction of “circ_0062491 alleviates periodontitis via the miR-142-5p/IGF1 axis”
  255. Retraction of “miR-223-3p alleviates TGF-β-induced epithelial-mesenchymal transition and extracellular matrix deposition by targeting SP3 in endometrial epithelial cells”
  256. Retraction of “SLCO4A1-AS1 mediates pancreatic cancer development via miR-4673/KIF21B axis”
  257. Retraction of “circRNA_0001679/miR-338-3p/DUSP16 axis aggravates acute lung injury”
  258. Retraction of “lncRNA ACTA2-AS1 inhibits malignant phenotypes of gastric cancer cells”
  259. Special issue Linking Pathobiological Mechanisms to Clinical Application for cardiovascular diseases
  260. Effect of cardiac rehabilitation therapy on depressed patients with cardiac insufficiency after cardiac surgery
  261. Special issue The evolving saga of RNAs from bench to bedside - Part I
  262. FBLIM1 mRNA is a novel prognostic biomarker and is associated with immune infiltrates in glioma
  263. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part III
  264. Development of a machine learning-based signature utilizing inflammatory response genes for predicting prognosis and immune microenvironment in ovarian cancer
https://doi.org/10.1515/med-2023-0722
Schlagwörter für diesen Artikel
Helicobacter pylori; empirical bismuth quadruple therapy; high-dose dual therapy; resistance-based triple therapy; eradication efficacy
Creative Commons
BY 4.0

Artikel in diesem Heft

  1. Research Articles
  2. Exosomes derived from mesenchymal stem cells overexpressing miR-210 inhibits neuronal inflammation and contribute to neurite outgrowth through modulating microglia polarization
  3. Current situation of acute ST-segment elevation myocardial infarction in a county hospital chest pain center during an epidemic of novel coronavirus pneumonia
  4. circ-IARS depletion inhibits the progression of non-small-cell lung cancer by circ-IARS/miR-1252-5p/HDGF ceRNA pathway
  5. circRNA ITGA7 restrains growth and enhances radiosensitivity by up-regulating SMAD4 in colorectal carcinoma
  6. WDR79 promotes aerobic glycolysis of pancreatic ductal adenocarcinoma (PDAC) by the suppression of SIRT4
  7. Up-regulation of collagen type V alpha 2 (COL5A2) promotes malignant phenotypes in gastric cancer cell via inducing epithelial–mesenchymal transition (EMT)
  8. Inhibition of TERC inhibits neural apoptosis and inflammation in spinal cord injury through Akt activation and p-38 inhibition via the miR-34a-5p/XBP-1 axis
  9. 3D-printed polyether-ether-ketone/n-TiO2 composite enhances the cytocompatibility and osteogenic differentiation of MC3T3-E1 cells by downregulating miR-154-5p
  10. Propofol-mediated circ_0000735 downregulation restrains tumor growth by decreasing integrin-β1 expression in non-small cell lung cancer
  11. PVT1/miR-16/CCND1 axis regulates gastric cancer progression
  12. Silencing of circ_002136 sensitizes gastric cancer to paclitaxel by targeting the miR-16-5p/HMGA1 axis
  13. Short-term outcomes after simultaneous gastrectomy plus cholecystectomy in gastric cancer: A pooling up analysis
  14. SCARA5 inhibits oral squamous cell carcinoma via inactivating the STAT3 and PI3K/AKT signaling pathways
  15. Molecular mechanism by which the Notch signaling pathway regulates autophagy in a rat model of pulmonary fibrosis in pigeon breeder’s lung
  16. lncRNA TPT1-AS1 promotes cell migration and invasion in esophageal squamous-cell carcinomas by regulating the miR-26a/HMGA1 axis
  17. SIRT1/APE1 promotes the viability of gastric cancer cells by inhibiting p53 to suppress ferroptosis
  18. Glycoprotein non-metastatic melanoma B interacts with epidermal growth factor receptor to regulate neural stem cell survival and differentiation
  19. Treatments for brain metastases from EGFR/ALK-negative/unselected NSCLC: A network meta-analysis
  20. Association of osteoporosis and skeletal muscle loss with serum type I collagen carboxyl-terminal peptide β glypeptide: A cross-sectional study in elder Chinese population
  21. circ_0000376 knockdown suppresses non-small cell lung cancer cell tumor properties by the miR-545-3p/PDPK1 pathway
  22. Delivery in a vertical birth chair supported by freedom of movement during labor: A randomized control trial
  23. UBE2J1 knockdown promotes cell apoptosis in endometrial cancer via regulating PI3K/AKT and MDM2/p53 signaling
  24. Metabolic resuscitation therapy in critically ill patients with sepsis and septic shock: A pilot prospective randomized controlled trial
  25. Lycopene ameliorates locomotor activity and urinary frequency induced by pelvic venous congestion in rats
  26. UHRF1-induced connexin26 methylation is involved in hearing damage triggered by intermittent hypoxia in neonatal rats
  27. LINC00511 promotes melanoma progression by targeting miR-610/NUCB2
  28. Ultra-high-performance liquid chromatography-tandem mass spectrometry analysis of serum metabolomic characteristics in people with different vitamin D levels
  29. Role of Jumonji domain-containing protein D3 and its inhibitor GSK-J4 in Hashimoto’s thyroiditis
  30. circ_0014736 induces GPR4 to regulate the biological behaviors of human placental trophoblast cells through miR-942-5p in preeclampsia
  31. Monitoring of sirolimus in the whole blood samples from pediatric patients with lymphatic anomalies
  32. Effects of osteogenic growth peptide C-terminal pentapeptide and its analogue on bone remodeling in an osteoporosis rat model
  33. A novel autophagy-related long non-coding RNAs signature predicting progression-free interval and I-131 therapy benefits in papillary thyroid carcinoma
  34. WGCNA-based identification of potential targets and pathways in response to treatment in locally advanced breast cancer patients
  35. Radiomics model using preoperative computed tomography angiography images to differentiate new from old emboli of acute lower limb arterial embolism
  36. Dysregulated lncRNAs are involved in the progress of myocardial infarction by constructing regulatory networks
  37. Single-arm trial to evaluate the efficacy and safety of baclofen in treatment of intractable hiccup caused by malignant tumor chemotherapy
  38. Genetic polymorphisms of MRPS30-DT and NINJ2 may influence lung cancer risk
  39. Efficacy of immune checkpoint inhibitors in patients with KRAS-mutant advanced non-small cell lung cancer: A retrospective analysis
  40. Pyroptosis-based risk score predicts prognosis and drug sensitivity in lung adenocarcinoma
  41. Upregulation of lncRNA LANCL1-AS1 inhibits the progression of non-small-cell lung cancer via the miR-3680-3p/GMFG axis
  42. CircRANBP17 modulated KDM1A to regulate neuroblastoma progression by sponging miR-27b-3p
  43. Exosomal miR-93-5p regulated the progression of osteoarthritis by targeting ADAMTS9
  44. Downregulation of RBM17 enhances cisplatin sensitivity and inhibits cell invasion in human hypopharyngeal cancer cells
  45. HDAC5-mediated PRAME regulates the proliferation, migration, invasion, and EMT of laryngeal squamous cell carcinoma via the PI3K/AKT/mTOR signaling pathway
  46. The association between sleep duration, quality, and nonalcoholic fatty liver disease: A cross-sectional study
  47. Myostatin silencing inhibits podocyte apoptosis in membranous nephropathy through Smad3/PKA/NOX4 signaling pathway
  48. A novel long noncoding RNA AC125257.1 facilitates colorectal cancer progression by targeting miR-133a-3p/CASC5 axis
  49. Impact of omicron wave and associated control measures in Shanghai on health management and psychosocial well-being of patients with chronic conditions
  50. Clinicopathological characteristics and prognosis of young patients aged ≤45 years old with non-small cell lung cancer
  51. TMT-based comprehensive proteomic profiling identifies serum prognostic signatures of acute myeloid leukemia
  52. The dose limits of teeth protection for patients with nasopharyngeal carcinoma undergoing radiotherapy based on the early oral health-related quality of life
  53. miR-30b-5p targeting GRIN2A inhibits hippocampal damage in epilepsy
  54. Long non-coding RNA AL137789.1 promoted malignant biological behaviors and immune escape of pancreatic carcinoma cells
  55. IRF6 and FGF1 polymorphisms in non-syndromic cleft lip with or without cleft palate in the Polish population
  56. Comprehensive analysis of the role of SFXN family in breast cancer
  57. Efficacy of bronchoscopic intratumoral injection of endostar and cisplatin in lung squamous cell carcinoma patients underwent conventional chemoradiotherapy
  58. Silencing of long noncoding RNA MIAT inhibits the viability and proliferation of breast cancer cells by promoting miR-378a-5p expression
  59. AG1024, an IGF-1 receptor inhibitor, ameliorates renal injury in rats with diabetic nephropathy via the SOCS/JAK2/STAT pathway
  60. Downregulation of KIAA1199 alleviated the activation, proliferation, and migration of hepatic stellate cells by the inhibition of epithelial–mesenchymal transition
  61. Exendin-4 regulates the MAPK and WNT signaling pathways to alleviate the osteogenic inhibition of periodontal ligament stem cells in a high glucose environment
  62. Inhibition of glycolysis represses the growth and alleviates the endoplasmic reticulum stress of breast cancer cells by regulating TMTC3
  63. The function of lncRNA EMX2OS/miR-653-5p and its regulatory mechanism in lung adenocarcinoma
  64. Tectorigenin alleviates the apoptosis and inflammation in spinal cord injury cell model through inhibiting insulin-like growth factor-binding protein 6
  65. Ultrasound examination supporting CT or MRI in the evaluation of cervical lymphadenopathy in patients with irradiation-treated head and neck cancer
  66. F-box and WD repeat domain containing 7 inhibits the activation of hepatic stellate cells by degrading delta-like ligand 1 to block Notch signaling pathway
  67. Knockdown of circ_0005615 enhances the radiosensitivity of colorectal cancer by regulating the miR-665/NOTCH1 axis
  68. Long noncoding RNA Mhrt alleviates angiotensin II-induced cardiac hypertrophy phenotypes by mediating the miR-765/Wnt family member 7B pathway
  69. Effect of miR-499-5p/SOX6 axis on atrial fibrosis in rats with atrial fibrillation
  70. Cholesterol induces inflammation and reduces glucose utilization
  71. circ_0004904 regulates the trophoblast cell in preeclampsia via miR-19b-3p/ARRDC3 axis
  72. NECAB3 promotes the migration and invasion of liver cancer cells through HIF-1α/RIT1 signaling pathway
  73. The poor performance of cardiovascular risk scores in identifying patients with idiopathic inflammatory myopathies at high cardiovascular risk
  74. miR-2053 inhibits the growth of ovarian cancer cells by downregulating SOX4
  75. Nucleophosmin 1 associating with engulfment and cell motility protein 1 regulates hepatocellular carcinoma cell chemotaxis and metastasis
  76. α-Hederin regulates macrophage polarization to relieve sepsis-induced lung and liver injuries in mice
  77. Changes of microbiota level in urinary tract infections: A meta-analysis
  78. Identification of key enzalutamide-resistance-related genes in castration-resistant prostate cancer and verification of RAD51 functions
  79. Falls during oxaliplatin-based chemotherapy for gastrointestinal malignancies – (lessons learned from) a prospective study
  80. Outcomes of low-risk birth care during the Covid-19 pandemic: A cohort study from a tertiary care center in Lithuania
  81. Vitamin D protects intestines from liver cirrhosis-induced inflammation and oxidative stress by inhibiting the TLR4/MyD88/NF-κB signaling pathway
  82. Integrated transcriptome analysis identifies APPL1/RPS6KB2/GALK1 as immune-related metastasis factors in breast cancer
  83. Genomic analysis of immunogenic cell death-related subtypes for predicting prognosis and immunotherapy outcomes in glioblastoma multiforme
  84. Circular RNA Circ_0038467 promotes the maturation of miRNA-203 to increase lipopolysaccharide-induced apoptosis of chondrocytes
  85. An economic evaluation of fine-needle cytology as the primary diagnostic tool in the diagnosis of lymphadenopathy
  86. Midazolam impedes lung carcinoma cell proliferation and migration via EGFR/MEK/ERK signaling pathway
  87. Network pharmacology combined with molecular docking and experimental validation to reveal the pharmacological mechanism of naringin against renal fibrosis
  88. PTPN12 down-regulated by miR-146b-3p gene affects the malignant progression of laryngeal squamous cell carcinoma
  89. miR-141-3p accelerates ovarian cancer progression and promotes M2-like macrophage polarization by targeting the Keap1-Nrf2 pathway
  90. lncRNA OIP5-AS1 attenuates the osteoarthritis progression in IL-1β-stimulated chondrocytes
  91. Overexpression of LINC00607 inhibits cell growth and aggressiveness by regulating the miR-1289/EFNA5 axis in non-small-cell lung cancer
  92. Subjective well-being in informal caregivers during the COVID-19 pandemic
  93. Nrf2 protects against myocardial ischemia-reperfusion injury in diabetic rats by inhibiting Drp1-mediated mitochondrial fission
  94. Unfolded protein response inhibits KAT2B/MLKL-mediated necroptosis of hepatocytes by promoting BMI1 level to ubiquitinate KAT2B
  95. Bladder cancer screening: The new selection and prediction model
  96. circNFATC3 facilitated the progression of oral squamous cell carcinoma via the miR-520h/LDHA axis
  97. Prone position effect in intensive care patients with SARS-COV-2 pneumonia
  98. Clinical observation on the efficacy of Tongdu Tuina manipulation in the treatment of primary enuresis in children
  99. Dihydroartemisinin ameliorates cerebral I/R injury in rats via regulating VWF and autophagy-mediated SIRT1/FOXO1 pathway
  100. Knockdown of circ_0113656 assuages oxidized low-density lipoprotein-induced vascular smooth muscle cell injury through the miR-188-3p/IGF2 pathway
  101. Low Ang-(1–7) and high des-Arg9 bradykinin serum levels are correlated with cardiovascular risk factors in patients with COVID-19
  102. Effect of maternal age and body mass index on induction of labor with oral misoprostol for premature rupture of membrane at term: A retrospective cross-sectional study
  103. Potential protective effects of Huanglian Jiedu Decoction against COVID-19-associated acute kidney injury: A network-based pharmacological and molecular docking study
  104. Clinical significance of serum MBD3 detection in girls with central precocious puberty
  105. Clinical features of varicella-zoster virus caused neurological diseases detected by metagenomic next-generation sequencing
  106. Collagen treatment of complex anorectal fistula: 3 years follow-up
  107. LncRNA CASC15 inhibition relieves renal fibrosis in diabetic nephropathy through down-regulating SP-A by sponging to miR-424
  108. Efficacy analysis of empirical bismuth quadruple therapy, high-dose dual therapy, and resistance gene-based triple therapy as a first-line Helicobacter pylori eradication regimen – An open-label, randomized trial
  109. SMOC2 plays a role in heart failure via regulating TGF-β1/Smad3 pathway-mediated autophagy
  110. A prospective cohort study of the impact of chronic disease on fall injuries in middle-aged and older adults
  111. circRNA THBS1 silencing inhibits the malignant biological behavior of cervical cancer cells via the regulation of miR-543/HMGB2 axis
  112. hsa_circ_0000285 sponging miR-582-3p promotes neuroblastoma progression by regulating the Wnt/β-catenin signaling pathway
  113. Long non-coding RNA GNAS-AS1 knockdown inhibits proliferation and epithelial–mesenchymal transition of lung adenocarcinoma cells via the microRNA-433-3p/Rab3A axis
  114. lncRNA UCA1 regulates miR-132/Lrrfip1 axis to promote vascular smooth muscle cell proliferation
  115. Twenty-four-color full spectrum flow cytometry panel for minimal residual disease detection in acute myeloid leukemia
  116. Hsa-miR-223-3p participates in the process of anthracycline-induced cardiomyocyte damage by regulating NFIA gene
  117. Anti-inflammatory effect of ApoE23 on Salmonella typhimurium-induced sepsis in mice
  118. Analysis of somatic mutations and key driving factors of cervical cancer progression
  119. Hsa_circ_0028007 regulates the progression of nasopharyngeal carcinoma through the miR-1179/SQLE axis
  120. Variations in sexual function after laparoendoscopic single-site hysterectomy in women with benign gynecologic diseases
  121. Effects of pharmacological delay with roxadustat on multi-territory perforator flap survival in rats
  122. Analysis of heroin effects on calcium channels in rat cardiomyocytes based on transcriptomics and metabolomics
  123. Risk factors of recurrent bacterial vaginosis among women of reproductive age: A cross-sectional study
  124. Alkbh5 plays indispensable roles in maintaining self-renewal of hematopoietic stem cells
  125. Study to compare the effect of casirivimab and imdevimab, remdesivir, and favipiravir on progression and multi-organ function of hospitalized COVID-19 patients
  126. Correlation between microvessel maturity and ISUP grades assessed using contrast-enhanced transrectal ultrasonography in prostate cancer
  127. The protective effect of caffeic acid phenethyl ester in the nephrotoxicity induced by α-cypermethrin
  128. Norepinephrine alleviates cyclosporin A-induced nephrotoxicity by enhancing the expression of SFRP1
  129. Effect of RUNX1/FOXP3 axis on apoptosis of T and B lymphocytes and immunosuppression in sepsis
  130. The function of Foxp1 represses β-adrenergic receptor transcription in the occurrence and development of bladder cancer through STAT3 activity
  131. Risk model and validation of carbapenem-resistant Klebsiella pneumoniae infection in patients with cerebrovascular disease in the ICU
  132. Calycosin protects against chronic prostatitis in rats via inhibition of the p38MAPK/NF-κB pathway
  133. Pan-cancer analysis of the PDE4DIP gene with potential prognostic and immunotherapeutic values in multiple cancers including acute myeloid leukemia
  134. The safety and immunogenicity to inactivated COVID-19 vaccine in patients with hyperlipemia
  135. Circ-UBR4 regulates the proliferation, migration, inflammation, and apoptosis in ox-LDL-induced vascular smooth muscle cells via miR-515-5p/IGF2 axis
  136. Clinical characteristics of current COVID-19 rehabilitation outpatients in China
  137. Luteolin alleviates ulcerative colitis in rats via regulating immune response, oxidative stress, and metabolic profiling
  138. miR-199a-5p inhibits aortic valve calcification by targeting ATF6 and GRP78 in valve interstitial cells
  139. The application of iliac fascia space block combined with esketamine intravenous general anesthesia in PFNA surgery of the elderly: A prospective, single-center, controlled trial
  140. Elevated blood acetoacetate levels reduce major adverse cardiac and cerebrovascular events risk in acute myocardial infarction
  141. The effects of progesterone on the healing of obstetric anal sphincter damage in female rats
  142. Identification of cuproptosis-related genes for predicting the development of prostate cancer
  143. Lumican silencing ameliorates β-glycerophosphate-mediated vascular smooth muscle cell calcification by attenuating the inhibition of APOB on KIF2C activity
  144. Targeting PTBP1 blocks glutamine metabolism to improve the cisplatin sensitivity of hepatocarcinoma cells through modulating the mRNA stability of glutaminase
  145. A single center prospective study: Influences of different hip flexion angles on the measurement of lumbar spine bone mineral density by dual energy X-ray absorptiometry
  146. Clinical analysis of AN69ST membrane continuous venous hemofiltration in the treatment of severe sepsis
  147. Antibiotics therapy combined with probiotics administered intravaginally for the treatment of bacterial vaginosis: A systematic review and meta-analysis
  148. Construction of a ceRNA network to reveal a vascular invasion associated prognostic model in hepatocellular carcinoma
  149. A pan-cancer analysis of STAT3 expression and genetic alterations in human tumors
  150. A prognostic signature based on seven T-cell-related cell clustering genes in bladder urothelial carcinoma
  151. Pepsin concentration in oral lavage fluid of rabbit reflux model constructed by dilating the lower esophageal sphincter
  152. The antihypertensive felodipine shows synergistic activity with immune checkpoint blockade and inhibits tumor growth via NFAT1 in LUSC
  153. Tanshinone IIA attenuates valvular interstitial cells’ calcification induced by oxidized low density lipoprotein via reducing endoplasmic reticulum stress
  154. AS-IV enhances the antitumor effects of propofol in NSCLC cells by inhibiting autophagy
  155. Establishment of two oxaliplatin-resistant gallbladder cancer cell lines and comprehensive analysis of dysregulated genes
  156. Trial protocol: Feasibility of neuromodulation with connectivity-guided intermittent theta-burst stimulation for improving cognition in multiple sclerosis
  157. LncRNA LINC00592 mediates the promoter methylation of WIF1 to promote the development of bladder cancer
  158. Factors associated with gastrointestinal dysmotility in critically ill patients
  159. Mechanisms by which spinal cord stimulation intervenes in atrial fibrillation: The involvement of the endothelin-1 and nerve growth factor/p75NTR pathways
  160. Analysis of two-gene signatures and related drugs in small-cell lung cancer by bioinformatics
  161. Silencing USP19 alleviates cigarette smoke extract-induced mitochondrial dysfunction in BEAS-2B cells by targeting FUNDC1
  162. Menstrual irregularities associated with COVID-19 vaccines among women in Saudi Arabia: A survey during 2022
  163. Ferroptosis involves in Schwann cell death in diabetic peripheral neuropathy
  164. The effect of AQP4 on tau protein aggregation in neurodegeneration and persistent neuroinflammation after cerebral microinfarcts
  165. Activation of UBEC2 by transcription factor MYBL2 affects DNA damage and promotes gastric cancer progression and cisplatin resistance
  166. Analysis of clinical characteristics in proximal and distal reflux monitoring among patients with gastroesophageal reflux disease
  167. Exosomal circ-0020887 and circ-0009590 as novel biomarkers for the diagnosis and prediction of short-term adverse cardiovascular outcomes in STEMI patients
  168. Upregulated microRNA-429 confers endometrial stromal cell dysfunction by targeting HIF1AN and regulating the HIF1A/VEGF pathway
  169. Bibliometrics and knowledge map analysis of ultrasound-guided regional anesthesia
  170. Knockdown of NUPR1 inhibits angiogenesis in lung cancer through IRE1/XBP1 and PERK/eIF2α/ATF4 signaling pathways
  171. D-dimer trends predict COVID-19 patient’s prognosis: A retrospective chart review study
  172. WTAP affects intracranial aneurysm progression by regulating m6A methylation modification
  173. Using of endoscopic polypectomy in patients with diagnosed malignant colorectal polyp – The cross-sectional clinical study
  174. Anti-S100A4 antibody administration alleviates bronchial epithelial–mesenchymal transition in asthmatic mice
  175. Prognostic evaluation of system immune-inflammatory index and prognostic nutritional index in double expressor diffuse large B-cell lymphoma
  176. Prevalence and antibiogram of bacteria causing urinary tract infection among patients with chronic kidney disease
  177. Reactive oxygen species within the vaginal space: An additional promoter of cervical intraepithelial neoplasia and uterine cervical cancer development?
  178. Identification of disulfidptosis-related genes and immune infiltration in lower-grade glioma
  179. A new technique for uterine-preserving pelvic organ prolapse surgery: Laparoscopic rectus abdominis hysteropexy for uterine prolapse by comparing with traditional techniques
  180. Self-isolation of an Italian long-term care facility during COVID-19 pandemic: A comparison study on care-related infectious episodes
  181. A comparative study on the overlapping effects of clinically applicable therapeutic interventions in patients with central nervous system damage
  182. Low intensity extracorporeal shockwave therapy for chronic pelvic pain syndrome: Long-term follow-up
  183. The diagnostic accuracy of touch imprint cytology for sentinel lymph node metastases of breast cancer: An up-to-date meta-analysis of 4,073 patients
  184. Mortality associated with Sjögren’s syndrome in the United States in the 1999–2020 period: A multiple cause-of-death study
  185. CircMMP11 as a prognostic biomarker mediates miR-361-3p/HMGB1 axis to accelerate malignant progression of hepatocellular carcinoma
  186. Analysis of the clinical characteristics and prognosis of adult de novo acute myeloid leukemia (none APL) with PTPN11 mutations
  187. KMT2A maintains stemness of gastric cancer cells through regulating Wnt/β-catenin signaling-activated transcriptional factor KLF11
  188. Evaluation of placental oxygenation by near-infrared spectroscopy in relation to ultrasound maturation grade in physiological term pregnancies
  189. The role of ultrasonographic findings for PIK3CA-mutated, hormone receptor-positive, human epidermal growth factor receptor-2-negative breast cancer
  190. Construction of immunogenic cell death-related molecular subtypes and prognostic signature in colorectal cancer
  191. Long-term prognostic value of high-sensitivity cardiac troponin-I in patients with idiopathic dilated cardiomyopathy
  192. Establishing a novel Fanconi anemia signaling pathway-associated prognostic model and tumor clustering for pediatric acute myeloid leukemia patients
  193. Integrative bioinformatics analysis reveals STAT2 as a novel biomarker of inflammation-related cardiac dysfunction in atrial fibrillation
  194. Adipose-derived stem cells repair radiation-induced chronic lung injury via inhibiting TGF-β1/Smad 3 signaling pathway
  195. Real-world practice of idiopathic pulmonary fibrosis: Results from a 2000–2016 cohort
  196. lncRNA LENGA sponges miR-378 to promote myocardial fibrosis in atrial fibrillation
  197. Diagnostic value of urinary Tamm-Horsfall protein and 24 h urine osmolality for recurrent calcium oxalate stones of the upper urinary tract: Cross-sectional study
  198. The value of color Doppler ultrasonography combined with serum tumor markers in differential diagnosis of gastric stromal tumor and gastric cancer
  199. The spike protein of SARS-CoV-2 induces inflammation and EMT of lung epithelial cells and fibroblasts through the upregulation of GADD45A
  200. Mycophenolate mofetil versus cyclophosphamide plus in patients with connective tissue disease-associated interstitial lung disease: Efficacy and safety analysis
  201. MiR-1278 targets CALD1 and suppresses the progression of gastric cancer via the MAPK pathway
  202. Metabolomic analysis of serum short-chain fatty acid concentrations in a mouse of MPTP-induced Parkinson’s disease after dietary supplementation with branched-chain amino acids
  203. Cimifugin inhibits adipogenesis and TNF-α-induced insulin resistance in 3T3-L1 cells
  204. Predictors of gastrointestinal complaints in patients on metformin therapy
  205. Prescribing patterns in patients with chronic obstructive pulmonary disease and atrial fibrillation
  206. A retrospective analysis of the effect of latent tuberculosis infection on clinical pregnancy outcomes of in vitro fertilization–fresh embryo transferred in infertile women
  207. Appropriateness and clinical outcomes of short sustained low-efficiency dialysis: A national experience
  208. miR-29 regulates metabolism by inhibiting JNK-1 expression in non-obese patients with type 2 diabetes mellitus and NAFLD
  209. Clinical features and management of lymphoepithelial cyst
  210. Serum VEGF, high-sensitivity CRP, and cystatin-C assist in the diagnosis of type 2 diabetic retinopathy complicated with hyperuricemia
  211. ENPP1 ameliorates vascular calcification via inhibiting the osteogenic transformation of VSMCs and generating PPi
  212. Significance of monitoring the levels of thyroid hormone antibodies and glucose and lipid metabolism antibodies in patients suffer from type 2 diabetes
  213. The causal relationship between immune cells and different kidney diseases: A Mendelian randomization study
  214. Interleukin 33, soluble suppression of tumorigenicity 2, interleukin 27, and galectin 3 as predictors for outcome in patients admitted to intensive care units
  215. Identification of diagnostic immune-related gene biomarkers for predicting heart failure after acute myocardial infarction
  216. Long-term administration of probiotics prevents gastrointestinal mucosal barrier dysfunction in septic mice partly by upregulating the 5-HT degradation pathway
  217. miR-192 inhibits the activation of hepatic stellate cells by targeting Rictor
  218. Diagnostic and prognostic value of MR-pro ADM, procalcitonin, and copeptin in sepsis
  219. Review Articles
  220. Prenatal diagnosis of fetal defects and its implications on the delivery mode
  221. Electromagnetic fields exposure on fetal and childhood abnormalities: Systematic review and meta-analysis
  222. Characteristics of antibiotic resistance mechanisms and genes of Klebsiella pneumoniae
  223. Saddle pulmonary embolism in the setting of COVID-19 infection: A systematic review of case reports and case series
  224. Vitamin C and epigenetics: A short physiological overview
  225. Ebselen: A promising therapy protecting cardiomyocytes from excess iron in iron-overloaded thalassemia patients
  226. Aspirin versus LMWH for VTE prophylaxis after orthopedic surgery
  227. Mechanism of rhubarb in the treatment of hyperlipidemia: A recent review
  228. Surgical management and outcomes of traumatic global brachial plexus injury: A concise review and our center approach
  229. The progress of autoimmune hepatitis research and future challenges
  230. METTL16 in human diseases: What should we do next?
  231. New insights into the prevention of ureteral stents encrustation
  232. VISTA as a prospective immune checkpoint in gynecological malignant tumors: A review of the literature
  233. Case Reports
  234. Mycobacterium xenopi infection of the kidney and lymph nodes: A case report
  235. Genetic mutation of SLC6A20 (c.1072T > C) in a family with nephrolithiasis: A case report
  236. Chronic hepatitis B complicated with secondary hemochromatosis was cured clinically: A case report
  237. Liver abscess complicated with multiple organ invasive infection caused by hematogenous disseminated hypervirulent Klebsiella pneumoniae: A case report
  238. Urokinase-based lock solutions for catheter salvage: A case of an upcoming kidney transplant recipient
  239. Two case reports of maturity-onset diabetes of the young type 3 caused by the hepatocyte nuclear factor 1α gene mutation
  240. Immune checkpoint inhibitor-related pancreatitis: What is known and what is not
  241. Does total hip arthroplasty result in intercostal nerve injury? A case report and literature review
  242. Clinicopathological characteristics and diagnosis of hepatic sinusoidal obstruction syndrome caused by Tusanqi – Case report and literature review
  243. Synchronous triple primary gastrointestinal malignant tumors treated with laparoscopic surgery: A case report
  244. CT-guided percutaneous microwave ablation combined with bone cement injection for the treatment of transverse metastases: A case report
  245. Malignant hyperthermia: Report on a successful rescue of a case with the highest temperature of 44.2°C
  246. Anesthetic management of fetal pulmonary valvuloplasty: A case report
  247. Rapid Communication
  248. Impact of COVID-19 lockdown on glycemic levels during pregnancy: A retrospective analysis
  249. Erratum
  250. Erratum to “Inhibition of miR-21 improves pulmonary vascular responses in bronchopulmonary dysplasia by targeting the DDAH1/ADMA/NO pathway”
  251. Erratum to: “Fer exacerbates renal fibrosis and can be targeted by miR-29c-3p”
  252. Retraction
  253. Retraction of “Study to compare the effect of casirivimab and imdevimab, remdesivir, and favipiravir on progression and multi-organ function of hospitalized COVID-19 patients”
  254. Retraction of “circ_0062491 alleviates periodontitis via the miR-142-5p/IGF1 axis”
  255. Retraction of “miR-223-3p alleviates TGF-β-induced epithelial-mesenchymal transition and extracellular matrix deposition by targeting SP3 in endometrial epithelial cells”
  256. Retraction of “SLCO4A1-AS1 mediates pancreatic cancer development via miR-4673/KIF21B axis”
  257. Retraction of “circRNA_0001679/miR-338-3p/DUSP16 axis aggravates acute lung injury”
  258. Retraction of “lncRNA ACTA2-AS1 inhibits malignant phenotypes of gastric cancer cells”
  259. Special issue Linking Pathobiological Mechanisms to Clinical Application for cardiovascular diseases
  260. Effect of cardiac rehabilitation therapy on depressed patients with cardiac insufficiency after cardiac surgery
  261. Special issue The evolving saga of RNAs from bench to bedside - Part I
  262. FBLIM1 mRNA is a novel prognostic biomarker and is associated with immune infiltrates in glioma
  263. Special Issue Computational Intelligence Methodologies Meets Recurrent Cancers - Part III
  264. Development of a machine learning-based signature utilizing inflammatory response genes for predicting prognosis and immune microenvironment in ovarian cancer
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Heruntergeladen am 14.9.2025 von https://www.degruyterbrill.com/document/doi/10.1515/med-2023-0722/html
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