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Gastroesophageal reflux disease (GERD) is a common disease caused by reflux of gastric contents to the esophagus. Proton-pump inhibitors (PPIs) are recommended as a first-line therapy to treat GERD. Recently, the potassium-competitive acid inhibitors have been increasingly in use in clinical practice. We aimed to evaluate the efficacy and safety of P-CABs in GERD. We searched PubMed, the Cochrane Library, EMBASE and Web Of Science for publications regarding randomized controlled trials comparing potassium-competitive acid inhibitors to PPI monotherapy or Placebo with respect to efficacy and safety in GERD (until April 2023). The primary outcome was an absence or global symptom improvement and the incidence of adverse events in GERD. The quality of the included literature was assessed using the bias assessment tool recommended in the Cochrane Systematic Assessor's Handbook 5.1.0. We use RevMan 5.3 software for Meta-analysis, sensitivity analysis and publication bias analysis. Of the 991 screened studies, 14 studies including 4868 participants were analyzed. The ORs for the healing rates of GERD with P-CABs versus PPI/Placebo were 2.10 (95% confidence interval [CI] 1.53–2.88), additionally, 1.09 (95% CI 1.05–1.14), 1.03 (95% CI 1.00–1.06) and 1.03 (95% CI 0.99-1.06) in Weeks 2, 4, and 8, respectively. The effectiveness rate of the experimental group was significantly higher than that of the control group (RR 1.73; 95% CI 1.27–2.36). The overall OR of Incidence of adverse events with P-CABs versus PPI/Placebo was 1.08 (95% CI 0.88–1.12). Overall, the risk of bias was low to some concerns. Furthermore, sensitivity analyses confirmed the robustness of the study's conclusion. Our findings suggest that potassium-competitive acid inhibitors is non-inferior to PPIs as therapy for patients with GERD. The safety outcomes for potassium-competitive acid inhibitors are similar to those for PPIs. [ABSTRACT FROM AUTHOR]

Background: Malnutrition is highly prevalent and associated with complications and mortality in patients with cirrhosis. Methods: This was a prospective observational study. Patients with cirrhosis were screened using the Nutritional Risk Screening 2002, the Royal Free Hospital‐Nutritional Prioritizing Tool and the Skeletal Muscle Index. Then, the sensitivity, specificity, positive and negative predictive values, and consistency with the Global Leadership Initiative on Malnutrition criteria results were calculated. We also analysed the association between nutritional status and short‐term prognosis. Results: We enrolled 125 patients with cirrhosis, of whom 59.20% and 60.00% were malnourished based on the Global Leadership Initiative on Malnutrition criteria and Skeletal Muscle Index. Some 53.60% and 65.60%, respectively, were classified medium‐to‐high nutritional risk by Nutritional Risk Screening 2002 and the Royal Free Hospital‐Nutritional Prioritizing Tool. The Royal Free Hospital‐Nutritional Prioritizing Tool had the best predictive value, and it was more sensitive and had a better negative predictive value than the Nutritional Risk Screening 2002 Tool. The Skeletal Muscle Index also had good sensitivity and predictive value. The Royal Free Hospital‐Nutritional Prioritizing Tool, Skeletal Muscle Index and Global Leadership Initiative on Malnutrition criteria showed high concordance. The 3‐ and 6‐month mortality rates were significantly higher for patients with moderate‐to‐high nutritional risk or malnutrition, regardless of the tool. Conclusions: When assessing cirrhosis with the Global Leadership Initiative on Malnutrition criteria, the Royal Free Hospital‐Nutritional Prioritizing Tool is best for nutritional screening and the Skeletal Muscle Index is also a good nutritional assessment tool. Key points: Diagnosis and treatment of liver diseases were considered.The Royal Free Hospital‐Nutritional Prioritizing Tool score is not affected by the presence of oedema and ascites and is therefore more advantageous than the Nutritional Risk Screening 2002, which is more commonly used in clinical practice in cirrhotic patients.The results of the present study show that the Royal Free Hospital‐Nutritional Prioritizing Tool is more valuable than the Nutritional Risk Screening 2002 for determining the short‐term prognosis of patients with liver cirrhosis.The study found good concordance between the Skeletal Muscle Index (SMI) and Global Leadership Initiative on Malnutrition criteria in patients with cirrhosis. Therefore, lumbar 3‐SMI can be used to assess the nutritional status of these patients.C‐reactive protein, interleukin‐6 and procalcitonin levels significantly increased in patients with moderate‐to‐high nutritional risk or malnutrition compared to their counterparts. [ABSTRACT FROM AUTHOR]

A DBN promoted [4+2] cycloaddition of malononitrile with 2‐(3‐oxo‐3‐arylprop‐1‐en‐1‐yl)phenyl buta‐2,3‐dienoates has been developed. This protocol provides a simple strategy for the construction of 2‐amino‐4‐(2‐oxo‐2‐phenylethyl)‐4H‐chromene‐3‐carbonitriles in moderate to good yields. [ABSTRACT FROM AUTHOR]

Oily particulate matter pollution and bacteria pose a serious threat to human health and have drawn widespread attention. Herein, an Ag‐doped nylon 6 multi‐stage structured antibacterial nanofiber membrane (PA6&Ag MSNM) for effective air filtration of fine oily particulate matters was fabricated by adding a certain amount of tetrabutylammonium hexafluorophosphate (TBAHP) and silver nitrate (AgNO3) into PA6 solution via one‐step electrospinning. The fabricated PA6&Ag MSNM is composed of coarse trunk fibers and fine branching fibers, which exhibits high filtration efficiency for oily particulate matters and low pressure drop, with an average filtration efficiency of 99.92% for oily particles of 0.20 ~ 4.59 μm and a low pressure drop of 386 Pa. In addition, the fiber membranes possesses excellent antibacterial properties due to the doping of Ag. The prepared multi‐stage electrospun nanofiber membrane may provide a versatile strategy for designing new antibacterial air filtration materials, which would have broad application prospects. [ABSTRACT FROM AUTHOR]

In this paper, we study the averaging principle for a class of slow-fast stochastic differential equations with Markovian switching, where the slow component is the solution of a stochastic differential equation and the fast component is a Markov chain. Using the technique of Poisson equation and mollifying approximation, the optimal strong convergence order $ 1/2 $ is obtained under the Lipschitz continuous condition. [ABSTRACT FROM AUTHOR]

Gastric adenocarcinoma of the fundic gland type is a new subtype of gastric adenocarcinoma. In 2019, the World Health Organization (WHO) listed gastric adenocarcinoma of the fundic gland type (GA-FG) as a new and rare gastric tumour with a low incidence due to the small number of cumulative cases worldwide. Twenty cases of GA-FG found in our centre were retrospectively analysed to improve the diagnostic ability of endoscopy and pathology in this disease. To investigate the clinicopathological features of fundus-derived gastric tumours and to improve the understanding of and diagnostic accuracy of endoscopy for this disease. The clinicopathological characteristics of 20 GA-FG cases between 2018 and 2022 were analysed using clinical and follow-up data and endoscopic, immunohistochemical, and pathological morphology characteristics. In all cases, GA-FG was found in the fundus and the body of the stomach. In total, there were 19 patients with 20 lesions, with most of the patients having a single lesion. One patient had multiple lesions, and another patient had complications from signet ring cell carcinoma (SRCC). All lesions occurred in non-atrophic areas, and 10 patients had gastric fundic gland polyps simultaneously. There were 14 cases of gastric fundus adenocarcinoma and 6 cases of acid-secreting adenoma. Fourteen lesions were treated with endoscopic submucosal dissection (ESD), without recurrence or metastasis during the follow up; 6 patients were followed up for observation, 2 of whom showed no lesions after the first biopsy by gastric endoscopy, and 4 of whom showed no significant changes. The incidence rate for GA-FG lesions may be underestimated due to their benign course. ESD seems to be an adequate treatment for GA-FG. Gastric adenocarcinoma of the fundic gland type (GA-FG) is located in the fundus and body of the stomach. All lesions occur in non-atrophic areas, and almost one-half involve gastric fundus polyps simultaneously. GA-FG lesions typically follow a benign disease course. ESD seems to be an adequate treatment for GA-FG. [ABSTRACT FROM AUTHOR]

Gastrointestinal stromal tumors (GISTs) are the most common mesenchymal tumors in the gastrointestinal (GI) tract that require different therapeutic interventions according to the malignancy. We aim to develop and validate a EUS (endoscopic ultrasonography)-based nomogram to predict malignant potential in patients with GIST. 258 patients with pathological diagnosis of gastric GISTs were enrolled retrospectively in our hospital from June 2015 to October 2020. Patients were randomly divided into the development cohort (DC, n = 179) and the validation cohort (VC, n = 79). We established a nomogram using lasso regression based on DC data. The predictive effectiveness of the nomogram was evaluated by the area under the receiver operating characteristic curve (AUC). Through bootstrapping, a consistency index (C-index) and calibration chart are developed to evaluate the reliability and accuracy of the nomogram. A total of 192 patients with low-malignant potential (very low and low-risk) GISTs and 66 patients with high-malignant potential (intermediate and high-risk) GISTs were included in this study. The nomogram was constructed with the following 6 EUS indicators: ulceration, hemorrhage, tumor shape, irregular border, transverse diameter, and necrosis. Internal and external validation showed that the nomogram had a good ability to predict the malignant potential of GISTs (AUC = 0.881 and 0.908, respectively). The calibration curve shows that the nomogram has a good agreement between predicted and actual probabilities for differentiating GISTs malignancy (C-index = 0.868 and 0.907, respectively). This study developed and verified a EUS-based nomogram, which can effectively predict the malignant potential of patients with gastric GISTs. [ABSTRACT FROM AUTHOR]

In this paper, we first study the well-posedness of a class of McKean-Vlasov stochastic partial differential equations driven by cylindrical α-stable process, where α ∈ (1 , 2). Then by the method of the Khasminskii's time discretization, we prove the averaging principle of a class of multiscale McKean-Vlasov stochastic partial differential equations driven by cylindrical α-stable processes. Meanwhile, we obtain a specific strong convergence rate. [ABSTRACT FROM AUTHOR]