Helicobacter pylori-associated chronic atrophic gastritis involving the gastric body and severe disease by Vibrio cholerae

Evidence has associated chronic infection by Helicobacter pylori with chronic gastritis, low gastric acid production and an increased risk of life-threatening cholera. However, the relationship of specific patterns of histological damage in the gastric mucosa associated with H. pylori infection and the occurrence of cholera has not been described. The purpose of this study was to compare the gastric pH and histopathological findings in gastric biopsies taken from patients with severe diarrhoeal disease due to Vibrio cholerae with those taken from a control (cholera-negative) population. Thirty-five H. pylori-positive patients who had severe dehydration from culture-confirmed cholera (cases) and 40 patients with H. pylori but with no history of cholera (controls) were recruited. Gastric pH was measured and multiple biopsies were taken from the gastric antrum and body for histopathological examination. The results revealed that patients with severe cholera had a significantly higher prevalence of hypochlorhydria at endoscopy compared with controls. Furthermore, cases had significantly more chronic atrophic gastritis (45.7% vs. 12.5%; P=0.002) and intestinal metaplasia (37.1% vs. 2.5%; P<0.01) in the gastric body than controls. Our findings suggest that the nature and location of these gastric lesions may predispose a subset of H. pylori-infected individuals to severe disease by V. cholerae.     

荧光胃液分析胃癌癌前病变与胃液中幽门螺杆菌感染的关系

目的利用荧光胃液分析与胃液中Hp相关性的研究，评估对胃癌癌前病变的诊断价值。方法收集980例各种胃内病变患者的胃液，用荧光胃液分析仪进行荧光胃液分析，同时进行胃液Hp检测。结果以受试者工作特征（ROC）曲线为最佳截断点KJF≥0．85作为胃癌判断标准，诊断胃癌的灵敏度为83．3％；重度萎缩性胃炎伴肠上皮化生及不典型增生患者的KJF值接近胃癌患者；在胃癌患者中胃液Hp检出率为45．2％，重度萎缩性胃炎伴肠上皮化生及不典型增生患者Hp检出率为69．3％。结论荧光胃液分析对胃癌的诊断是一种安全、有效的方法，对胃癌癌前病变的诊断特异度较高，且胃癌患者的胃液中Hp感染率较低。     

Effect of ascorbic acid on deterioration of carotenoids and colour in ultrafrozen orange juice

The influence of externally added ascorbic acid (AA) on the deterioration of carotenoid pattern and colour of orange juices has been assessed. Regardless of the enrichment of the samples with ascorbic acid, the changes in their carotenoid profile were analogous and involved mainly the epoxycarotenoids. The decreases in the levels of the two major carotenoids, namely (9Z)-violaxanthin and (9Z)- or (9′Z)-antheraxanthin, due to acid-elicited 5,6-epoxide to 5,8-furanoxide isomerizations, were markedly distinct, with the levels of the former dropping more markedly. It was observed, in any event, that the decreases were higher in the sample spiked with the higher amount of ascorbic. In view of these results it has been hypothesized that the location of (9Z)-violaxanthin in orange cloud particles could be more accessible to the juice acids to that of (9Z)- or (9′Z)-antheraxanthin. In addition, the enrichment of the juices seems to promote the contact of the carotenoids and the acids during their deterioration. In terms of colour, it has been concluded that these changes in the carotenoids led to colour differences that can be discerned visually and that the use of a black background for the measurements yielded a better differentiation among the samples.     

幽门螺杆菌与慢性胃炎

慢性胃炎 (ｃｈｒｏｎｉｃｇａｓｔｒｉｔｉｓ ,ＣＧ)是指不同病因引起的胃黏膜慢性炎性病变。本病非常多见 ,发病率一般随年龄增加 ,其组织学的变异程度较大 ,且与临床表现无密切关系。慢性胃炎的病因尚未完全明了 ,涉及到环境中有害物质对胃黏膜的损伤和机体易感性等诸多方面。常见病因有 :幽门螺杆菌 (Ｈｅｌｉｃｏｂａｃｔｅｒｐｙｌｏｒｉ,Ｈｐ)感染、物理、化学因素损伤、十二指肠胃反流、免疫因素、遗传因素等。慢性胃炎患者胃黏膜活检标本的Ｈｐ检出率可达 6 0 %～ 80 % ,慢性活动性胃炎的检出率几近10 0 %。给蒙古沙土鼠 (ｍｏｎｇ…     

胃溃疡及胃炎患者幽门螺杆菌耐药性分析

目的 了解胃溃疡及胃炎患者幽门螺杆菌(Helicobacterpylori,Hp)对甲硝唑等抗生素的耐药情况.方法 采集右江民族医学院附属医院近3年确诊为Hp感染患者的胃窦部黏膜样本进行Hp分离培养和鉴定,经鉴定后选择374株Hp菌株,采用纸片扩散法测定其对甲硝唑、阿莫西林、克拉霉素等抗生素的敏感性.结果 Hp对甲硝唑、阿莫西林、克拉霉素的耐药率从2006年的68.6%,10.2%,15.3%分别上升到2008年的91.7%,21.2%,28.8%;部分Hp同时对多种抗生素耐药,同时对甲硝唑、克拉霉素和阿莫西林耐药的有14株,耐药率为3.74%.结论 胃溃疡及胃炎患者Hp对甲硝唑、阿莫西林、克拉霉素均有一定耐药性,有必要使用其他抗生素替代.     

Use of the refractometer as a tool to monitor dietary formula concentration in gastric juice

BACKGROUND AND AIMS: Critically ill patients do not always tolerate nasogastric tube feeding. Gastric residual volumes are widely used to evaluate feeding tolerance, but controversy exists about what constitutes the residual volume (diet formula or digestive juice). In this paper, we describe the use of the refractometer as a tool to monitor dietary formula concentration in gastric juice and evaluate gastric juice refractometry as a possible clinical application. METHODS: Brix value (an index of the total solutes in solution) readings for polymeric diet at pH 1, 4, 7 and 8, and at 4 degrees C, 25 degrees C and 37 degrees C, and in fasting gastric juice were determined with a refractometer. RESULTS: We found that distilled water, minerals, and vitamins had low Brix values of 0+/-0, 1.2+/-0.1, and 0.4+/-0.1, respectively. On the other hand, because carbohydrate (17 g/100 ml), protein (5.3 g/100 ml), fat (4.1 g/100 ml), and full-strength polymeric diet had high concentrations of dissolved nutrients, they also had high Brix values (12.1+/-0.6, 6.5+/-0.1, 6.0+/-0.1, and 23.5+/-0.1, respectively). The Brix values of polymeric diet had a linear additive relationship with the diet formula concentration at various pHs, temperatures, and in the gastric juice. CONCLUSION: Brix value measurement can be used to monitor stomach dietary formula concentration. Such information can be obtained at the bedside and used to evaluate feeding-intolerant patients receiving enteral feeding.     

胃复春联合叶酸治疗幽门螺旋杆菌阴性慢性萎缩性胃炎的疗效观察

目的 观察胃复春联合叶酸治疗慢性萎缩性胃炎(GAG)的临床疗效.方法 选择经胃镜检查符合CAG诊断的患者100例,随机分为治疗组和对照组,各50例.治疗组给予胃复春4片3次/d,叶酸10mg3次/d口服;对照组给予维酶素1.0g次/d口服,疗程均为12周.观察治疗前后临床症状的变化,并复查胃镜及活检,进行组织病理学改善的评估.结果 观察组总有效率为92％,而对照组仅为30％,二组比较差异有统计学意义(P＜0.01).观察组总有效率为90％,时照组仅为40％,组间比较差异有统计学意义(P＜0.01).结论 胃复春联合叶酸能有效改善慢性萎缩性胃炎患者的临床症状和病理分级.     

Helicobacter pylori infection and gastritis in healthy Nigerians

In a study of forty asymptomatic volunteers from northern Nigeria; 35 (87.5%) had histological gastritis and 32 (80%) were infected byHelicobacter pylori. All but one of the patients infected byHelicobacter Pylori had histological gastritis. This high prevalence ofH. Pylori infection in young, asymptomatic subjects, occurs in an area with a low prevalence of duodenal ulcer. The possible reasons for this are discussed.     

Detection of CagA protein in strains of Helicobacter pylori isolated from patients with gastritis and gastric ulcer disease

A total of 156 Helicobacter pylori strains isolated from adult patients (81 men, 75 women) with diagnosis of gastritis (43 strains GAS) and gastric ulcer (113 strains GU) were analyzed for the production of CagA protein by quantitative and qualitative immunoblot methods. 80% of gastric ulcer group strains (84% in men, 73% in women) produced CagA protein, while in the gastritis patients group only 63% of strains were CagA protein positive (59% in men, 65% in women). Quantitative production was estimated by CagA index (mean production of CagA protein in CagA positive strains) in both groups of strains GAS and GU in men and women. Strains of GU group were shown to be higher producers (index CagA 2.42) as compared to GAS group (2.09). Index CagA was higher in strains isolated from men (index CagA 2.54) than is strains from women (index CagA 2.13). CONCLUSION: CagA production has been proved in 75% of analysed Helicobacter pylori strains. CagA positive strains were more frequent in gastric ulcer disease patients, slightly higher in the male than in the female patients. Strains isolated from men, irrespective of diagnosis (GAS and GU), are higher producers of CagA protein.     

自拟中药汤剂对幽门螺杆菌相关性胃癌前病变患者胃黏膜Ki-67蛋白表达的影响

目的 分析自拟中药汤剂对幽门螺杆菌(Hp)相关性胃癌前病变患者胃黏膜Ki-67蛋白表达的影响,为感染相关性疾病的治疗和控制提供研究依据。方法 选取医院2015年1月-2018年1月收治的268例Hp相关性胃癌前病变患者作为研究对象,应用随机数字表法将其分为研究组和对照组,每组各134例。对照组患者在三联Hp根除治疗基础上给予胃康灵胶囊进行治疗,研究组患者在三联Hp根除治疗基础上给予自拟中药汤剂进行治疗。对两组患者治疗前、后胃黏膜病理评分、Ki-67蛋白表达阳性率进行检测和比较。观察两组患者临床疗效和Hp根除率。结果 治疗后,研究组患者胃黏膜不完全型肠化、异型增生的病理评分降低值大于对照组(P<0.05)。研究组疗效优于对照组(P=0.023)。研究组患者Hp根除率为87.31%(117/134)高于对照组的69.40%(93/134)(P<0.001)。两组患者的胃黏膜Ki-67蛋白表达阳性率均较治疗前下降,研究组患者治疗后的胃黏膜Ki-67蛋白表达阳性率低于对照组,差异有统计学意义(P<0.001)。结论 在三联Hp根除治疗的基础上应用自拟中药汤剂进行辅助治疗,能够显著改善患者的临床症状和胃黏膜病理变化程度、提高Hp根除率、降低Ki-67蛋白表达阳性率,对于抑制胃黏膜病变进展、降低胃癌发生率具有积极的意义。     

Ascorbic acid supplementation and regular consumption of fresh orange juice increase the ascorbic acid content of human milk: studies in European and African lactating women

BACKGROUND: Little is known about the influence of an increased intake of ascorbic acid (AA) on human milk AA output. OBJECTIVE: We aimed to compare human milk AA content in European and African women and to evaluate the influence of increased AA intake on human milk AA output. DESIGN: Apparently healthy lactating women were recruited. AA was analyzed by titration with 2,6-dichlorophenol-indophenol. RESULTS: Mean human milk AA was approximately 50% lower (P < 0.001) in the African women (31 mg/kg; n = 171) than in the European women (63 mg/kg; n = 142). AA supplementation (1000 mg/d for 10 d) increased mean human milk AA from 19 to 60 mg/kg (P < 0.001) and from 60 to 70 mg/kg (P = 0.03) in 18 African and 10 European women, respectively. In 11 African women, mean human milk AA increased from 17 to 36 mg/kg (P < 0.001) after intake of 100 mg AA/d for 10 d. In African women, intake of 1 serving of orange juice per week had no significant effect, whereas 3 or 5 servings/wk ( approximately 100 mg AA/serving) for 6 wk increased mean human milk AA from 16 to 32 mg/kg (n = 13) and from 21 to 46 mg/kg (n = 13), respectively (P < 0.001). CONCLUSIONS: Human milk AA can be doubled or tripled by increased intake of AA in women with low human milk AA content at baseline. The response to a relatively high dose of AA was modest in European women in contrast with the 3-fold increase in mean human milk AA content in African women. These data indicate that human milk AA content is regulated.     

Requirement for ascorbic acid in a rat mutant unable to synthesize ascorbic acid

The activities of several enzymes involved in hepatic ascorbic acid synthesis and the requirement of dietary ascorbic acid were investigated in the OD (osteogenic disorder) rat, which has a hereditary defect in ascorbic acid-synthesizing ability. No activity of hepatic L-gulonolactone oxidase was detected in OD rats. However, OD rats maintained the normal activities of hepatic UDPglucose dehydrogenase, UDPglucuronyl transferase and beta-glucuronidase. Hemorrhage in muscle and leg joints, lower hepatic content of cytochrome P-450 and lower activities of hepatic drug-metabolizing enzymes, higher serum and adrenal levels of corticosterone and lower urinary excretion of hydroxyproline were observed in ascorbic acid-deficient OD rats than in OD rats fed 300 mg ascorbic acid/kilogram diet. Consequently, we conclude that OD rats cannot synthesize ascorbic acid because of the lack of activity of hepatic L-gulonolactone oxidase and that the dietary addition of about 300 mg ascorbic acid (per kilogram diet) is enough to prevent signs of vitamin C deficiency and to achieve maximum growth, and that more than 300 mg ascorbic acid per kilogram diet may be required for the maximum activity of hepatic drug-metabolizing enzymes.     

Urinary ascorbic acid levels following the withdrawal of large doses of ascorbic acid in guinea pigs

Male guinea pigs received sodium ascorbate solution [equivalent to 1 g ascorbic acid/(kg body weight.d)] by intraperitoneal injection for 4 wk. During the ascorbic acid treatment period, plasma and urinary ascorbic acid levels rose markedly. Three weeks after the ascorbic acid treatment was withdrawn, mean urinary ascorbic acid levels were significantly lower than their corresponding basal levels. At both 2 and 5 wk after withdrawal of ascorbic acid treatment, mean plasma ascorbic acid levels were below normal. The results indicate that these animals had experienced a transient withdrawal effect after administration of large doses of ascorbic acid that lasted about 1 wk. This, in turn, indicates that the rate of ascorbic acid turnover was probably increased during treatment, and this effect persisted even after the ascorbic acid was withdrawn. Examination of data from each individual experimental animal revealed that the pattern of urinary ascorbic acid excretion after the withdrawal of large doses of ascorbic acid varied from animal to animal. Among the twelve experimental guinea pigs, seven had abnormally low urinary ascorbic acid levels 2-4 wk after the withdrawal of the large doses of ascorbic acid.     

消化性溃疡出血患者血清及胃液中白细胞介素的表达与幽门螺杆菌感染关系

目的探讨消化性溃疡出血患者血清、胃液中白细胞介素6(IL-6)、白细胞介素8(IL-8)的表达及与幽门螺杆菌(Hp)感染的关系,为降低Hp的感染率提供依据。方法选择2010年1月-2013年12月80例消化性溃疡患者为研究对象,分为溃疡出血组50例和溃疡组30例,选择36例慢性浅表性胃炎患者为对照组,检测受试者血清和胃液中IL-6、IL-8含量,并对各指标与年龄、病程、临床症状、Hp感染、体质量指数的关系进行相关性分析。结果溃疡出血组患者血清及胃液中IL-6、IL-8含量均明显高于溃疡组和对照组(P<0.01),且溃疡组IL-6、IL-8含量高于对照组(P<0.05);50例消化性溃疡出血患者检测Hp阳性22例,阳性率44.0%;Hp阳性患者血清及胃液IL-6、IL-8含量均高于Hp阴性患者(P<0.05)。结论 IL-6、IL-8在消化性溃疡出血患者血清、胃液中呈高表达;IL-6、IL-8在消化性溃疡出血中的表达与患者Hp感染有关;IL-6、IL-8与消化性溃疡出血的发病及是否合并Hp感染密切相关。     

Leucocyte ascorbic acid and pregnancy

1. Leucocyte ascorbic acid concentrations have been measured in 1147 females during early pregnancy and in smaller numbers of women before conception, throughout pregnancy and at 6 months post partum. 2. The leucocyte concentration in the 1st trimester was found to be affected by season, social class and smoking. Selecting individuals by extremes of social class, season and smoking produced two small populations with almost separate ascorbic acid distributions and mean concentrations of 21.7 and 45.1 microgram/10(8) leucocytes. 3. Early pregnancy had little effect on leucocyte ascorbic acid concentrations but values decreased in the second trimester. However, this was associated with a leucocytosis so that the total leucocyte ascorbic acid content of blood was unchanged. 4. Low ascorbic acid concentrations during the 1st trimester were not associated with subsequent spontaneous abortions, still-births or neonatal deaths, but there was an increased frequency of low values in women who gave birth to infants smaller than 3250 g. 5. The adequacy of ascorbic acid reserves in early pregnancy is discussed.