幽门螺杆菌对胎儿胃粘膜上皮细胞的粘附用研究

实验选用６至７个月龄的脑儿胃粘膜组织进行有关幽门螺杆菌（Ｈｐ）的粘附部位及菌株间粘附能力差异的研究，发现ＣＡＰＭＤ３２株与ＮＣＴＣ１１６３７株的粘附部位相似，Ｈｐ对胃窦及胃体下部粘膜组织具有很强的粘附能力，而对胃体上部及胃底部粘膜组织的粘附能力很差或不能粘附；而ＣＡＰＭ Ｚ－４株则对胃体、胃窦及胃底部粘膜上皮组织均表现出很强的粘附能力；表明Ｈｐ的粘附存在明显的部位特异性，不同Ｈｐ菌株间在粘附同一胎儿胃粘膜组织时表现出明显的差异，Ｈｐ与胃粘膜上皮细胞间的粘附过程比较复杂，至少包括两种类型，参与Ｈｐ粘附的粘附素和相应受体不止一种。结果提示Ｈｐ相关性慢性胃炎的好发部位及严重程度除与人胃粘膜组织不同部位细菌粘附受体的表达存在明显的差异外，还决定于Ｈｐ的粘附素的种类和粘附特性。不但首次在机体和细菌两个方面揭示了Ｈｐ相关性慢性胃炎的发病规律，也为进一步开展该菌疫苗的研制、开展对Ｈｐ感染及其相关疾病的防治提供了重要线索。     

幽门螺杆菌疫苗免疫机制的研究进展

幽门螺杆菌(H.pylori)是定植于人体胃粘膜的重要致病菌,而粘膜疫苗以其有效的保护性免疫成为防治H.pyiori的热点,但对相应的免疫机制的认识目前尚不明确.故本文对H.pyiori疫苗的保护性免疫机制中的抗原递呈机制,抗体的作用以及TH细胞反应的作用等研究进展做一概要介绍.     

In vitro biosynthesis of plasma proteins under ischemic conditions of closed-circuit perfusion of healthy and intoxicated rabbit liver

We are elaborating on the kinetics and mechanisms of septic rabbit liver to de novo biosynthesize acute-phase response (APR) proteins under in vitro conditions of deepening ischemia in reference to their in vivo prevalence in serum and cerebrospinal fluids (CSF) collected at predetermined times. The significance of the data is interpreted as relevant to grafting cadaveric liver into end-stage liver diseased patients and APR-induced ischemic heart diseases (IHD). Hepatic APR was induced by CCl(4)-intubation, and the administration of cholera toxin (CT) or scorpion venom (SV), or both, to rabbits. Hepatic functional efficiency, in terms of biosynthesis of APR proteins in closed circuit perfusion of the isolated intoxicated liver with oxygenated saline or L-15 media paralleled the two-dimensional immunoelectrophoresis (2D-IEP) spectrum of APR serum proteins at time of liver isolation. We are suggesting: (a) in vitro biosynthesis of plasma proteins by isolated perfused liver is the result of in vivo decoded and retained APR inflammatory signals; and (b) decoded inflammatory signals are expressed not withstanding the perfusate's organic composition. Furthermore, 90 min of ischemic perfusion in saline or L-15 medium precipitated mitochondrial aberrations which resulted in further deterioration of de novo biosynthesis of APR plasma proteins. Regardless of the nature of the inflammatory stimuli, mitochondrial aberrations rendered the perfused organ a biologically inert tissue mass that was incapable of resuming biological function upon perfusion with oxygenated L-15 medium. This is most likely due to ischemia-induced irreversible hepatic necrosis. Thus, in vitro aberrations of mitochondrial function(s) critically limit the capability of the isolated liver to resume its organic function to sustain biosynthesis of de novo plasma proteins. Extrapolation of these results to the surgical management of end-stage liver diseases points to the importance of the status and the handling protocol(s) of the cadaver donor liver prior to successful grafting. We conclude that although histology of a cadaver liver may reveal well-preserved hepatic cellular organelles with at least minimal intra- and intercellular communication required for viable hepatic function, we deem it essential to further define acceptable minimal capabilities to de novo biosynthesize plasma proteins by a cadaver liver as a measure of its functional viability and suitability for transplantation. Ultimately, this measure may improve the success of liver transplants with minimal surgical and drug interventions.     

Does infection with Chlamydia pneumoniae and/or Helicobacter pylori increase the expression of endothelial cell adhesion molecules in humans?

Objective   To investigate if Chlamydia pneumoniae and/or Helicobacter pylori seropositivity is associated with elevated levels of soluble endothelial cell adhesion molecules (sCAMs) as markers of atherosclerotic activity.
Methods   Immunoglobulin A (IgA) and IgG antibodies to the two bacteria, soluble intercellular cell adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1) and E-selectin were measured in coronary heart disease (CHD) patients ( n  = 193) and age- and sex-matched controls ( n  = 193). Two different serological methods were used for the detection of Chlamydia antibodies: Labsystems microimmunofluorescence to detect species-specific C. pneumoniae antibodies and Medac's recombinant enzyme-linked immunosorbent assay to detect genus-specific lipopolysaccharide antibodies.
Results   The concentrations of sICAM-1 and E-selectin were higher in CHD patients with positive vs. negative Chlamydia lipopolysaccharide IgA ( P  = 0.044 for both). H. pylori antibodies alone did not predict raised levels of sCAMs, but in CHD patients sICAM-1 was increased with IgA seropositivity to both bacteria compared to double seronegativity ( P  = 0.034). Concentrations of sVCAM-1 were elevated in CHD patients with double IgA seropositivity compared to those with Chlamydia lipopolysaccharide IgA seropositivity alone ( P  = 0.018).
Conclusion   Our results may indicate that C. pneumoniae contributes to increased inflammation in CHD, and that this contribution is even more pronounced when present in combination with H. pylori IgA antibodies.     

The chemokine receptor CCR7 is expressed on epithelium of non-inflamed gastric mucosa, Helicobacter pylori gastritis, gastric carcinoma and its precursor lesions and up-regulated by H. pylori

CCR7 chemokine-receptor expression on tumour cells of gastric carcinoma has been associated with lymph-node metastasis and is thought to play an important role in metastasis. However, so far it is unknown whether CCR7 is newly up-regulated on gastric carcinoma or already expressed in non-neoplastic gastric epithelium. Therefore, epithelial CCR7 expression was investigated in the process of gastric carcinogenesis: non-inflamed mucosa --Helicobacter pylori gastritis -- intestinal metaplasia/dysplasia -- gastric carcinoma. CCR7 was expressed by gastric epithelium in non-inflamed gastric mucosa (n = 5), H. pylori gastritis (n = 17), intestinal metaplasia (n = 10), dysplasia (n = 3) and on tumour cells in 20 of 24 patients with gastric carcinoma (13/14 intestinal-type; 7/10 diffuse-type) as tested by immunohistochemistry. As CCR7 expression by gastric epithelium was significantly stronger in H. pylori gastritis than in non-infected mucosa, the influence of H. pylori on CCR7 receptor expression of gastric epithelial cells was investigated by fluorescence activated cell sorter analysis. H. pylori strains up-regulated the CCR7 chemokine-receptor in CCR7-positive cell lines. No difference in CCR7 up-regulation between cag(+) and cag(-)H. pylori strains was found. Epithelial CCR7 up-regulation by H. pylori may alter the metastatic fate of gastric carcinoma. Additionally, CCR7 expression not only on gastric carcinoma, but also on non-neoplastic gastric epithelium, suggests a novel biological function.     

Assessment of different methods for staining Helicobacter pylori in endoscopic gastric biopsies

The recent implication of Helicobacter pylori in the pathogenesis of gastritis-peptic ulcer syndrome and its relevance for the development of upper gastrointestinal malignancy warrant efficient methods for the detection and demonstration of the organism in biopsy specimens. We have compared 5 staining methods, namely, haematoxylin and eosin (H & E), immunohistochemistry (IHC), the silver staining HpSS, the alcian yellow-toluidine blue (Leung) method (A-Y) and Genta staining, for the demonstration of the organism in gastric biopsies taken from antrum, body and fundus of 118 patients who presented to our hospital with upper gastrointestinal symptoms. We found no significant differences in the efficacy of H & E, IHC, HpSS and A-Y in the demonstration of H. pylori in all 3 gastric sites. The least reproducible stain in our hands was the Genta stain. We conclude that H & E is adequate for the initial assessment of gastric biopsies in symptomatic upper gastrointestinal patients. This is because it is a well-tested, cheap and easy staining method, requiring a relatively short period of time to perform, with highly reproducible results. It has an added advantage of enabling simultaneous assessment of morphological changes accompanying H. pylori infection. When the density of the organism is expected to be low, we recommend addition of HpSS staining because of its high sensitivity and low cost. The disadvantages of the other staining methods (IHC, A-Y and Genta) are discussed.     

幽门螺杆菌感染与缺血性脑卒中发病风险相关性的Meta分析

目的 系统评价幽门螺杆菌（Hp）感染与缺血性脑卒中（IS）发病风险的相关性。方法 计算机检索PubMed、EMBASE、The Cochrane Library、CBM、CNKI、WanFang、VIP等数据库。搜集Hp感染与IS发病风险相关性的观察性研究,检索时限从建库至2020年12月。由2名研究者独立筛选文献、提取信息并评价纳入研究的质量及偏倚风险,采用Stata软件进行meta分析。结果 共纳入26项比较,发表在24篇文献中,涉及111 059例患者,包括19项病例对照研究,7项队列研究。文献质量均评价为中高水平。meta分析结果显示:Hp感染可增加IS的发病风险 [OR（95%CI） = 1.52（1.31～1.77）,P＜0.01]。以研究类型[病例对照研究（OR = 1.69）]、Hp感染检测指标[Hp - IgG（OR = 1.42）、CagA - IgG（OR = 2.09）、C - 14（OR = 3.30）]、卒中病因分型[大动脉粥样硬化型（OR = 2.69）]为分类依据进行亚组分析,发现Hp感染可以增加IS的发病风险。结论 Hp感染与IS发病风险具有一定的相关性,但该结论尚需更多高质量病因学研究进一步证实。     

抗幽门螺杆菌感染二种三联疗法的临床比较

目的　选择高效安全价廉适宜基层医院应用推广的根除幽门螺杆菌 (Hp)的方案。观察二种三联疗法(洛赛克、克拉霉素、阿莫西林、简称LCA ;善胃得、替硝唑、阿莫西林、简称ZTA)抗Hp感染的疗效 ,并与对照组 (泰胃美、简称Tag;普瑞博思、简称Pre)作比较。方法 :对 165例确诊为Hp感染的胃炎及溃疡病者 ,随机分治疗组 83例 (A组 42例、B组 41例 )和对照组 82例 (A1 组 41例均为溃疡、B1 组 41例均为胃炎 )。A组用LCA方案共一周 ,B组用ZTA方案二周 ;A1 组用Tag四周 ,B1 组用Pre十天。除A1 组 1例B1 组 2例失访外 162例治疗后 6周作呼吸试验 ( 1 3C-UBT、部分1 4C -UBT)等以观察近期疗效 ;14 6例 (A组 40例B组 37例 ,A1 组 36例B1 年组 33例 )一年后作胃镜等复查 ,确定Hp根除率及评价远期疗效。结果 :近期Hp根除率治疗组 91.6% (A组 95 .2 %、B组 87.8% )比对照组 35 .4% (A1 组 40 .4%、B1 组 30 .8% )高 (P <0 .0 1) ;远期Hp根除率治疗组 81.8% (A组 85 .0 %、B组 78.4% )明显高于对照组 30 .4% (A1 组 33.3%、B1 组 2 7.3% ) (P <0 .0 1) ;溃疡组 ,治疗A组Hp根除率 82 .6% ,B组 76.5 %均明显高于A1组 33.3% (P <0 .0 1) ;溃疡愈合率治疗组 87.5 % (A组 91.3%、B组 82 .4% )明显高于对照组 5 2 .8% (P <0 .0 1)     

健脾清热中药治疗Ⅰ型幽门螺杆菌相关性胃炎的研究

目的　研究健脾清热中药对Ⅰ型幽门螺杆菌相关性胃炎的疗效。方法　 10 0例Ⅰ型幽门螺杆菌感染的慢性胃炎患者随机分成 2组。研究组 (A组 ) 5 0例 ,服用健脾清热中药 (汤剂 ) 5 0ml 3 日 ,雷尼替丁 15 0mg 2 日 ;对照组(B组 ) 5 0例 ,口服甲硝唑 40 0mg 2 日 ,阿莫西林 10 0 0mg 2 日 ,雷尼替丁 15 0mg2 日 ,疗程均为 2周。停药 4周后给予1 4　C -UBT试验。结果　临床症状缓解率A组高于B组 (P <0 .0 5 ) ,HP的根除率两组间不存在显著差异 (P >0 .0 5 ) ,而A组产生的治疗副作用少。结论　健脾清热中药外加雷尼替丁是一种根除Ⅰ型幽门螺杆菌和缓解慢性胃炎症状的有效组合。     

幽门螺杆菌感染与缺血性心脑病的关系探讨

目的：探讨幽门螺杆菌（HP）感染与缺血性心脏病（IHD）的关系以及可能的发病机理。方法：应用酶联免疫法测定IHD组（142例）和对照组（50例）血清特异性HP抗体（HPIgG),用全自动生化仪测定血清TC,TG＜ApoA1,ApoB,Lp(a),HDL-c,LDL-c含量,应用全自动凝血仪测定血中纤维蛋白原浓度（Fbg),化学比色法测定血清中NO和NOS含量。结果：IHD组血清HPIgG阳性率明显高于对照组（65．49％VS28．00％,P＜0．0001）,经多元回归分析显示HP感染与IHD发病呈明显的正相关（P＝0．0004）,HPIgG阳性者的TG,ApoB,NO,NOS含量明显增高（P＜0．05）,TC,Lp(a),LDL-c,Fbg含量有增高趋势。结论：HP感染与IHD的发生有明显的相关性,其可能的发病机理为HP感染改变了脂质代谢和血管的内皮功能来增加发生IHD的危险。