Effect of Helicobacter pylori infection on the apoptotic and cell proliferative processes of the gastric mucosa

The role of the Helicobacter pylori in the induction of gastric carcinogenesis seems to be certain. The exact pathomechanism is not yet known, although the special genetic conditions both of the microbe and the host just as the imbalance of the apoptotic and proliferative processes caused by the chronic inflammation are assumed to be involved. The latter one can be proved by the use of different cell proliferative and apoptotic markers. The results are inconsistent whether the eradication therapy causes the regression of premalignant atrophic gastritis. The regression of the MALT-associated lymphoma after the eradication therapy seems to be more convincing. The need of the eradication to prevent gastric cancer can be judged by the follow-up of some biomarkers (e.g. HLA II genotype, PCNA index, anti HP-IgA titer and the serum pepsinogen level), although their diagnostical application could be hardly introduced in the everyday practise so far.     

Regression of gastric MALT lymphoma after eradication of Helicobacter pylori infection followed by endoscopic ultrasound

The authors report a case of a 42 year-old female patient, who was admitted with epigastric pain and weight loss to our department. Upper gastrointestinal endoscopy two ulcerated lesions revealed in the stomach at the corpus-antrum border. Histologically the lesion proved to be a low grade, malignant B cell MALT lymphoma. Coexistent Helicobacter pylori infection was detected with modified Giemsa staining. Endoscopic ultrasonography was performed to determine the depth of tumorous infiltration of the gastric wall: the tumor was confined to the mucosa and submucosa. No regional lymph node was observed. As a result of successful Helicobacter pylori eradication the regression of MALT lymphoma occurred. The follow-up examinations showed the regression of the tumour and the patient became asymptomatic. A control ultrasonographic examinations demonstrated the normal five layers structure of the gastric wall without any alteration. In our patient Helicobacter pylori eradication was an effective therapy for gastric MALT lymphoma as well. Our results similar as are published in the literature. Endoscopic ultrasonography is very useful in the assessment of the tumours involvement of the gastric wall. In the proper follow-up examinations of the patient endoscopy, histology and endoscopic ultrasound together are the methods to apply including Helicobacter pylori control.     

胃幽门螺杆菌感染与牙周炎的相关性分析

目的分析胃幽门螺杆菌感染(Hp)与牙周炎的相关性,为临床诊治工作提供客观依据。方法选取2015年1月-2016年12月的慢性牙周炎患者100例作为病例组,牙周健康的体检者100例作为对照组,检测及分析所有病例组患者的牙周袋深度、牙周退缩、平均牙周袋深度、平均牙周退缩等牙周损害相关指标,分析两组研究对象的胃内Hp感染情况。结果病例组患者的胃内Hp阳性率及DOB水平均显著高于对照组,两组比较差异有统计学意义(P<0.05);重度慢性牙周炎患者的DOB值及胃内Hp阳性率均高于中度慢性牙周炎患者,中度慢性牙周炎患者的DOB值及胃内Hp阳性率均高于轻度慢性牙周炎患者,差异均有统计学意义(P<0.05);直线相关分析结果显示,慢性牙周炎患者的DOB值与平均牙周袋深度呈正相关(P<0.05),Spearman等级相关分析结果显示,慢性牙周炎患者的DOB值与病情等级呈正相关(P<0.05);Logistic多元回归分析结果显示,重度慢性牙周炎的发生与病程、DOB值、Hp阳性、平均牙周袋深度具有相关性(P<0.05)。结论胃内Hp感染与牙周炎的发生和进展具有密切的关系,其感染程度与牙周炎患者的牙周组织损害程度和疾病严重程度具有相关性,可能在促进牙周炎病情进展方面发挥着重要的作用。     

幽门螺杆菌在胃黏膜中不同形态感染的病理研究

目的探讨胃黏膜中不同形态幽门螺杆菌感染引起的胃部疾病的病理特点,降低胃部幽门螺杆菌感染率。方法选取2011年4月-2014年3月行胃黏膜活检的患者219例,采用不同的染色方法观察幽门螺杆菌的形态,并观察胃黏膜的形影病理学改变;采用SPSS13.0软件进行分析。结果螺旋状伴球形幽门螺杆菌男性患者所占比例明显高于单纯球形幽门螺杆菌患者,两种形态幽门螺杆菌之间差异有统计学意义(P<0.05);两种形态幽门螺杆菌患者黏膜类型、炎症类型以及是否伴有异型增生差异无统计学意义;螺旋状伴球形幽门螺杆菌有炎症活动、重度炎症、有滤泡形成者分别占79.35%、55.43%和50.00%;单纯球形幽门螺杆菌患者分别占43.75%、25.00%和25.00%,螺旋状伴球形幽门螺杆菌明显高于单纯球形螺杆菌,两种形态比较差异有统计学意义(P<0.05)。结论球形幽门螺杆菌与螺旋状幽门螺杆菌均对胃黏膜具有致病性,且螺旋状幽门螺杆菌的致病性更强,而男性存在该形态螺杆菌相对较多,临床应予以注意。     

Effect of diet and Helicobacter pylori infection to the risk of early gastric cancer

BACKGROUND: The association of dietary habits and Helicobacter pylori infection with early gastric cancer is still unclear. METHODS: A hospital-based case-control study was conducted in Korea. Sixty-nine patients were newly diagnosed as having early gastric cancer at the Division of Gastroenterology, Asan Medical Center, and 199 healthy subjects who visited the Health Promotion Center of the this same hospital for annual health examinations were selected as controls. Helicobacter pylori infection status was assayed by ELISA, and information for dietary habits was obtained by interview using a semi-quantitative food frequency questionnaires. Preference for salty taste was also evaluated using a sensitive test. RESULTS: H. pylori seropositivity was observed in 88% of cases, as compared with 75% of controls (OR = 5.3, 95% confidence interval:1.7-16.5). Adaptive salt concentration was significantly and positively associated with early gastric cancer risk (p < 0.01). Decreased risks of early gastric cancer were observed in association with intakes of clear broth, raw vegetables, fruits, fruit or vegetable juices, and soybean curds. On the other hand, a high intake of salt-fermented fish and kimchi were associated with an elevated risk of early gastric cancer. Subjects with positive H. pylori infection and a high salty preference had a 10-fold higher risk of early gastric cancer than subjects without H. pylori infection and with a low salty preference (p for interaction = 0.047). CONCLUSION: Some dietary factors and H. pylori infection are significantly associated with early gastric cancer. In particular, high-salty diets may enhance the effect of H. pyori infection in gastric carcinogenesis.     

Raynaud syndrome and eradication of Helicobacter pylori

In this work, the effect of eradication of Helicobacter pylori on complaints and symptoms of infected, primary Raynaud's syndrome patients was studied. Altogether 92 Helicobacter pylori positive patients with gastric complaints and with primary Raynaud's syndrome received eradication therapy. In this prospective study, before and after the eradication the severity and frequency of the complaints and symptoms of the patients were recorded. The eradication was performable in 89 patients; in 75 cases the eradication was successful. In the eradicated patients frequency and duration of Raynaud attacks were improved related to those of the not eradicated group. These results might suggest a potential etiopathogenetical role of Helicobacter pylori infection in the pathogenesis of the primary Raynaud's syndrome.     

根除幽门螺杆菌对功能性消化不良的影响

目的探讨根除幽门螺杆菌(Hp)对Hp阳性的功能性消化不良(FD)患者症状的影响。方法191例胃镜检查Hp阳性的FD患者随机分为两组:治疗组予以抗Hp三联(奥美拉唑20mg,阿莫西林1000 mg,克拉霉素500 mg)治疗1周及莫沙必利5 mg,每日3次,治疗2周;对照组予以奥美拉唑20 mg,每日2次治疗1周及莫沙必利5 mg,每日3次,治疗2周。停药4周后行14C-尿素呼气试验检测,同时观察Hp根除与否对患者症状改善的影响。结果治疗组Hp根除率为79.0%,Hp阳性的FD患者在根除Hp后症状积分改善显效率达38.7%,明显高于Hp根除失败亚组的15.0%(P<0.01),亦明显高于对照组的12.5%(P<0.01),但各类型的FD症状积分改善显效率差异无统计学意义。结论部分Hp阳性的FD患者根除Hp后症状可明显改善。     

Effect of vitamins C and E supplementation on Helicobacter pylori eradication: a meta-analysis

Vitamins C and E can act as potent antioxidants to reduce the damage caused by reactive oxygen species in gastric mucosa. Whether vitamin supplements for Helicobacter pylori eradication regimen could improve the rate of eradication remains uncertain. Therefore, we performed a meta-analysis to evaluate the efficacy of vitamins C and E supplementation for the eradication of H. pylori. Searches were conducted in the databases PubMed, EMBASE and Cochrane Library. Randomised controlled trials (RCT) that fulfilled the inclusion criteria and addressed the clinical questions of this analysis were further assessed. Of the six RCT included, five had a low methodological quality. Of the six RCT, three compared the efficacy of the eradication regimen v. eradication regimen plus vitamins C and E. The result of the meta-analysis showed a non-significant difference in the eradication rate of H. pylori between the two groups (risk ratio (RR) 0·93, P = 0·76). Another three RCT compared the eradication regimen v. eradication regimen plus vitamin C only, and there too there was no significant difference in the eradication rate (RR 0·83, P = 0·32). In conclusion, vitamins C and/or E supplements to the H. pylori eradication regimen could not improve the eradication rate. However, currently available data do not draw a definitive conclusion about the effectiveness of antioxidant vitamins on H. pylori eradication, owing to the small sample size and low-to-moderate methodological quality.     

Effect of nutrient intake and Helicobacter pylori infection on gastric cancer in Korea: a case-control study

To examine the effects of dietary factor and Helicobacter pylori (H. pylori) infection with emphasis on vitamin intake on the risk of gastric cancer (GC), we conducted a case-control study in South Korea, a high-risk area for GC. Trained dietitians interviewed 136 cases histologically diagnosed with GC. An equal number of hospital controls was selected by matching sex and age. High dietary intakes of vegetable fat [odds ratio (OR) = 0.35; 95% confidence interval (CI) = 0.15-0.83], folate (OR = 0.35; 95% CI = 0.13-0.96), and antioxidants, such as vitamin A (OR = 0.34; 95% CI = 0.13-0.83), beta-carotene (OR = 0.33; 95% CI = 0.13-0.82), vitamin C (OR = 0.26; 95% CI = 0.09-0.72), and vitamin E (OR = 0.41; 95% CI = 0.17-1.01), were shown to have a protective effect on GC risk using a multivariate model adjusting for foods significantly related to GC in our previous study (charcoal grilled beef, spinach, garlic, mushroom, and a number of types of kimchi) and supplement use. When stratified according to H. pylori infection, high intakes of vitamin C (OR = 0.10; 95% CI = 0.02-0.63) and vitamin E (OR = 0.16; 95% CI = 0.03-0.83) exhibited highly significant inverse associations with GC among the H. pylori-infected subjects compared with noninfected individuals. GC risk was significantly decreased only when consumption levels for two of these vitamins were high. Our findings suggest that high intake of antioxidant vitamins contribute to the reduction of GC risk and that GC risk in Korea may be decreased by encouraging those with H. pylori infection to increase their intake of antioxidant vitamins.     

幽门螺杆菌感染与胃癌中信号通路中效应蛋白及反式激活活性蛋白表达的关系

目的 探讨幽门螺杆菌(Hp)感染与胃癌中信号通路中效应蛋白(Shh)和反式激活活性蛋白(C-myc)表达的关系,可作为胃上皮组织发生肿瘤化的重要指示基因.方法 采用免疫组化法对100例胃癌组织及46例正常胃上皮组织中的Shh及C-myc进行检测,然后采用快速尿素酶试验及组织病理学检测两种临床检测方法对Hp进行检测,以了解Shh与C-myc在胃癌组织中的表达及其与Hp感染之间的关系.结果 胃癌组织中Shh的平均染色得分为(4.02±2.31)分,明显高于正常胃上皮的染色总得分(1.19±0.87)分(P＜0.05);胃癌组织中C-myc的平均染色得分为(4.59±2.58)分,明显高于正常胃上皮的染色总得分(2.11±1.77)分(P＜0.05);Hp感染呈阳性与阴性胃癌中,Shh表达的阳性率分别为23.68％与69.35％,差异有统计学意义(P＜0.05);在Hp感染呈阳性与阴性胃癌中,C-myc表达的阳性率分别为54.76％、74.14％,差异无统计学意义.结论 胃癌组织中的Shh及C-myc两种基因的表达与Hp感染存在着一定的关系,可作为胃上皮组织发生肿瘤化的重要指示基因.     

幽门螺杆菌感染调查与耐药性分析

目的探讨幽门螺杆菌(Helicobacter pylori,Hp)的培养结果及对抗菌药物的耐药性,为临床治疗提供参考依据。方法收集2014年1-9月因上消化道疾病胃镜检查中获取的胃黏膜组织对其分离并培养,并将所得Hp进行药敏试验,数据采用SPSS21.0进行统计分析。结果共收集2 991例,Hp培养阳性1 184例,阳性率为39.59%;Hp对各种抗菌药物的耐药率由高到低依次为甲硝唑97.89%、左氧氟沙星17.91%、克拉霉素15.20%、阿莫西林、庆大霉素、痢特灵均为0。结论 Hp培养阳性率与性别、年龄、上消化道疾病相关,对甲硝唑几乎全耐药,随着年龄增大,耐药性也升高。     

Effect of a probiotic food as an adjuvant to triple therapy for eradication of Helicobacter pylori infection in children

OBJECTIVE: Current recommendations for treatment of Helicobacter pylori infection include a proton pump inhibitor in combination with two antibiotics. We evaluated the potential activity of a probiotic food as an adjuvant to antibiotic triple therapy for eradication of H. pylori infection in children from Buenos Aires, Argentina. METHODS: Sixty-five children who tested positive for H. pylori, as diagnosed by (13)C-urea breath test and endoscopy, were included in this study. Patients were randomized to receive 1-wk triple therapy plus probiotic food (treated group) or milk placebo (control) that was administered for 3 mo. Probiotic food consisted of 250 mL of a commercial yogurt containing Bifidobacterium animalis and Lactobacillus casei (10(7) colony-forming units/mL). Post-treatment urea breath test controls were performed 1 and 3 mo after the end of triple therapy. RESULTS: We found no significant differences in H. pylori eradication rates (ERs) at 1 and 3 mo between the treated group (ER = 45.5% and 42.4%) and the control group (ER = 37.5% and 40.6%). Relative risks between groups were 0.87 (95% confidence interval 0.58-1.32, P = 0.345) in the first month and 0.97 (95% confidence interval 0.64-1.46, P = 0.542) in the third month. CONCLUSIONS: We could not demonstrate an adjuvant effect of the studied probiotic food to triple therapy in the eradication of H. pylori infection in children in Buenos Aires, Argentina. However, we found lower ERs than those reported for the same therapeutic scheme in developed countries, indicating that bacterial resistance and alternative therapeutic strategies should be studied.     

含呋喃唑酮方案对十二指肠溃疡患者幽门螺杆菌根除效果研究

目的探讨含呋喃唑酮方案对幽门螺杆菌(Hp)感染的十二指肠溃疡患者Hp根除效果,以降低Hp感染率。方法选取2010年3月-2014年3月Hp阳性十二指肠溃疡患者252例为研究对象,将患者按照不同治疗方案分为观察组和对照组,观察组给予含呋喃唑酮方案治疗,对照组给予不含呋喃唑酮的方案治疗,对比两组患者的Hp根除率、临床缓解情况、不良反应。结果观察组Hp根除率89.88%,高于对照组的77.38%,两组差异有统计学意义(P<0.01);观察组临床症状缓解效果优于对照组,差异有统计学意义(P<0.05);两组均未出现严重不良反应,观察组和对照组不良反应发生率差异无统计学意义。结论含呋喃唑酮方案可以提高Hp阳性十二指肠溃疡的Hp根除率,增强患者临床症状缓解效果,且安全性较高。     

919例幽门螺旋杆菌感染检测及干预治疗效果分析

目的为全面了解衡水某院幽门螺杆菌的感染状况及流行病学特征,探讨三联疗法的干预治疗效果,为幽门螺杆菌的防治和治疗提供科学依据。方法对2010年7月~2014年6月在衡水市第三人民医院做幽门螺杆菌检测的919例(健康体检者487例和胃部疾病患者432例)采集血液标本,检测其血清中尿素酶抗体(HP),对于测定结果阳性的给予三联疗法干预治疗,5周后进行复查。结果男性幽门螺杆菌感染率要高于女性(X~2=23.64,P0.05),幽门感染率随着年龄的增加而增加,经过三联疗法治疗后,健康体检组和胃部疾病组有很好的效果,HP阳性率有明显的下降,分别为X~2=36.72,P0.05,X~2=43.75,P0.05。结论应重视HP的阳性感染,加强预防和及早治疗。     

血清炎性因子对Hp感染胃溃疡患者免疫功能的评估效果

目的探索血清炎性因子对幽门螺杆菌(Hp)感染胃溃疡患者免疫功能与病情进展的评估效果。方法选取2015年7月-2018年7月在郑州大学第一附属医院治疗的104例胃溃疡患者为研究对象,按照患者Hp检测结果分为Hp阳性组(n=56)和Hp阴性组(n=48)。对比两组患者治疗前后的血清白介素-2(IL-2)、白介素-6(IL-6)、白介素-8(IL-8)、高敏-C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平。结果治疗前Hp阳性组IL-2指标水平低于Hp阴性组,Hp阳性组的IL-6、IL-8、hs-CRP、TNF-α指标水平高于Hp阴性组(均P<0.05)。治疗后两组患者的IL-2、IL-6、IL-8、hs-CRP、TNF-α指标水平无统计学差异。Hp阳性组患者治疗前的IL-2水平低于治疗后,Hp阳性组治疗前的IL-6、IL-8、hs-CRP、TNF-α水平均高于治疗后(P<0.05)。结论血清IL-2、IL-6、IL-8、hs-CRP、TNF-α指标在胃溃疡患者发生Hp感染后变化明显,对胃溃疡患者的病情进展判断具有重要的参考意义。