Comparative Analysis of the Elementary and Amino Acid Composition of Nepeta olgae Regel L. Plants Growing in Uzbekistan

This article for the first time presents the results of the study of qualitative and quantitative elemental and amino acid composition of the aboveground part of the plant Nepeta olgae Regel (L.) taken in the territory of Chust and Kosonsai districts (from the slopes of Gova and Kosonsai mountains) of Namangan region during the period before and during flowering (May-June, 2021-2022). The use of instrumental analysis of high-throughput energy dispersive X-ray fluorescence spectrometry, allowed to establish 20 mineral elements in the plant Nepeta olgae Regel (L.), among which to vital 9 elements and 3 to conditionally necessary. The amino acid composition of the plant Nepeta olgae Regel (L.) was studied by high performance liquid chromatography (HPLC) and 17 compounds were identified. Of these, 8 were substitutable and 9 essential amino acids.

Prevalencia y localización gástrica del Helicobacter pylori en pacientes con atrofia y metaplasia intestinal en una institución de alta complejidad en Colombia / Prevalence and Gastric Location of Helicobacter pylori in Patients with Intestinal Atrophy and Metaplasia in a Tertiary Care Institution in Colombia

Resumen Introducción: Helicobacter pylori juega un papel fundamental en la cascada de carcinogénesis del cáncer gástrico tipo intestinal; sin embargo, no existe claridad respecto a su prevalencia en condiciones preneoplásicas que generan cambio en el microambiente de la mucosa. Actualmente se recomienda la vigilancia endoscópica por protocolo de Sydney cada 2 a 3 años, pero no es clara la presencia de H. pylori en la región subcardial y el fondo gástrico. Objetivo: determinar la prevalencia y localización gástrica del H. pylori en pacientes con condiciones preneoplásicas. Materiales y métodos: estudio de corte transversal en adultos con diagnóstico previo de atrofia o metaplasia intestinal que ingresaron a endoscopia de control, a quienes se les tomaron biopsias del antro, cuerpo, incisura angularis, región subcardial y fondo gástrico. Se realizó un análisis descriptivo de los resultados por regiones gástricas. Resultados: se recolectó la información de 160 pacientes con una prevalencia de H. pylori del 37,5 %, la cual fue en aumento de proximal a distal iniciando con una prevalencia de 12,5 % en la región subcardial hasta una prevalencia de 30,6 % en el antro; hubo un patrón similar en la prevalencia de lesiones preneoplásicas. Se observó una mayor presencia de lesiones avanzadas (displasia, carcinoma) en la incisura. Conclusiones: la prevalencia de H. pylori en condiciones premalignas evidenció una mayor presencia en las regiones distales en comparación con las proximales, y es más frecuente en la región antral y menor en la región subcardial. En cuanto a la distribución gástrica de atrofia y metaplasia, se encontró mayor compromiso en el antro y la incisura, y es baja en la región subcardial y el fondo.

Abstract Introduction: Helicobacter pylori infection plays a critical role in the carcinogenesis cascade of intestinal gastric cancer. However, its prevalence in preneoplastic conditions generating changes in the gastric mucosa is unclear. Currently, endoscopic surveillance using the Sydney protocol is suggested every 2 to 3 years, but the presence of H. pylori infection in the subcardial region and gastric fundus is ill-defined. Objective: to determine the prevalence and gastric location of H. pylori infection in patients with preneoplastic conditions. Materials and methods: a cross-sectional study in adults with a previous diagnosis of atrophy or intestinal metaplasia who entered control endoscopy and were antrum, body, incisura angularis, subcardial region, and gastric fundus biopsied. A descriptive analysis of the results by gastric regions was performed. Results: data from 160 patients with a prevalence of H. pylori of 37.5% were collected. It increased from proximal to distal, starting with a 12.5% prevalence in the subcardial region to a 30.6% prevalence in the antrum. In addition, there was a similar pattern in the prevalence of preneoplastic lesions. Furthermore, advanced lesions (dysplasia, carcinoma) were observed in the incisura. Conclusions: the prevalence of H. pylori in precancerous conditions showed a high presence in the distal regions compared to the proximal ones, and it is more frequent in the antrum and lower in the subcardial region. As for the gastric distribution of atrophy and metaplasia, more involvement was found in the antrum and angular notch and lower in the subcardial region and fundus.

Pathological Changes and Influencing Factors of Lamb's Tripe Extract and Vitamin B12 Capsule in Treatment of Chronic Atrophic Gastritis With Intestinal Metaplasia / 胃肠病学

Background: Chronic atrophic gastritis with intestinal metaplasia is closely related to the development of gastric cancer. Studies have showed that Lamb's Tripe Extract and Vitamin B12 capsule (LTEVB12) may reverse atrophy and intestinal metaplasia by promoting gastric mucosal gland proliferation, inhibiting gland apoptosis and inhibiting oxidative stress response in rats.Aims: To explore the pathological changes and influencing factors of LTEVB12 in treatment of chronic atrophic gastritis with intestinal metaplasia. Methods: A total of 173 patients with chronic atrophic gastritis with intestinal metathesis from June 2018 to June 2019 at Xijing Hospital were enrolled. All patients were treated with LTEVB12 (2 capsules tid). Gastroscopy and gastric mucosal biopsies were performed at 6 months and 12 months after treatment. The therapeutic effect of the drug was evaluated according to the changes of OLGA staging and OLGIM staging before and after treatment. The influencing factors were analyzed by univariate analysis and multivariate analysis. Results: After 6 months of treatment, the effective rates on OLGA staging and OLGIM staging were 49.7% and 32.9%, respectively. After 12 months of treatment, the effective rates on OLGA staging and OLGIM staging were 56.4% and 41.8%, respectively. The total effective rates of 6 months and 12 months treatment were 64.7% and 70.9%, respectively. Univariate analysis showed that education, fried food, statins and antibiotics were correlated with OLGA staging, while age was correlated with OLGIM staging. Multivariate analysis showed that education, fried food and antibiotics were independent factors of OLGA staging. Conclusions: LTEVB12 can significantly reduce the OLGA staging and OLGIM staging in patients with chronic atrophic gastritis with intestinal metaplasia, which suggests that LTEVB12 has the potential to reduce risk of gastric cancer and has the prospects of clinical application in prevention of gastric cancer.

Comparison of the accuracy of staging in the combination of different endoscopic biopsy sites, operative link for gastritis assessment and operative link for gastric intestinal metaplasia assessment / 中华消化杂志

Objective To analyze the accuracy of staging among the combination of endoscopic biopsy sites,operative link for gastritis assessment (OLGA) and operative link for gastric intestinal metaplasia assessment (OLGIM) with five different biopsy sites.Methods From January 2014 to September 2015,patients with functional dyspepsia and undergoing gastroendoscopy examination were enrolled.According to update Sydney system,a total of five biopsy pieces were obtained from lesser curvature of gastric body,larger curvature of gastric body,gastric angle,larger curvature of antrum and lesser curvature of antrum.The degrees of atrophy and intestinal metaplasia were determined and staged according to OLGA and OLGIM.Kappa test and chi-square test were performed for the statistical analysis.Results A total of 268 patients were enrolled.The incidences of atrophy and intestinal metaplasia in different sites were as follow:30.4％ (113/372) and 31.0％ (111/358) in lesser curvature of antrum;26.1％(97/372) and 25.1％(90/358) in gastric angle;20.2％(75/372) and 15.4％(56/358) in larger curvature of antrum;14.8％(55/372) and 15.4％(55/358) in lesser curvature of gastric body;8.6％(32/372) and 8.1％(29/358) in larger curvature of gastric body.The incidences of atrophy and intestinal metaplasia of lesser curvature of antrum were significantly higher than those of larger curvature of gastric body,lesser curvature of gastric body and larger curvature of antrum (x2 =45.248,48.029,20.024,18.892,7.681 and 7.848;all P＜＜0.05).The incidences of atrophy and intestinal metaplasia of gastric angle were significantly higher than those of lesser curvature and larger curvature of gastric body(x2 =32.752,31.269,11.605 and 8.448;all P＜0.05).The incidences of atrophy and intestinal metaplasia of the lesser curvature of gastric body and larger curvature of antrum were higher than those of larger curvature of gastric body,and the differences were statistically significant (x2 =6.080,8.048,17.280,18.980,all P＜0.05).The incidences of mild atrophy and intestinal metaplasia of the lesser curvature of antrum were 20.2 ％ (75/ 372) and 21.2％ (76/358),respectively,which were higher than those of larger curvature of antrum (12.9％,48/372 and 12.8％,46/358),and the differences were statistically significant (x2 =5.927 and 7.377,both P＜0.05).The incidence of severe atrophy of lesser curvature of antrum was 2.4％ (9/372),respectively,which was higher than that of larger curvature of antrum (0.8％,3/372),and the difference was statistically significant (x2 =3.000,P =0.015).The incidences of mild atrophy and intestinal metaplasia of the lesser curvature of gastric body were 10.5％ (39/372) and 11.2％ (40/358),respectively,which were higher than those of larger curvature of gastric body (5.4 ％,20/372 and 5.9 ％,21/358),and the differences were statistically significant (x2 =6.119 and 5.918,both P＜0.05).The consistency of staging by three biopsy sites (lesser curvature of gastric body,gastric angle and lesser curvature of antrum) and five biopsy sites with OLGA and OLGIM was 94.0 ％ (95 ％ confidence interval (CI) =91.2％ to 96.9％,Kappa value=0.912,P＜0.01) and 92.9％ (95％CI:89.8％ to 96.0％,Kappa value=0.893,P＜0.01).Conclusion Three biopsy sites (lesser curvature of gastric body,gastric angle and lesser curvature of antrum) could accurately reflect gastric mucosa lesions with less biopsy tissues and it is worthy of clinical popularization and application.

Impacto del sistema OLGA en la detección de gastritis crónica atrófica en Colombia: un estudio de casos y controles / A Case and Control Study of the OLGA System’s Impact on Detection of Chronic Atrophic Gastritis in Colombia

Introducción: la gastritis crónica atrófica (GCA) es una entidad clinicopatológica relacionada con cáncer gástrico (CG) de tipo intestinal. Su principal causa es Helicobacter pylori. Actualmente, además del diagnóstico, se recomienda evaluar la extensión de la atrofia o de la metaplasia intestinal, para estadificar el riesgo de CG. El método más preciso para la atrofia es el OLGA, que exige 5 biopsias: 2 del cuerpo, 2 del antro y 1 de la incisura angularis, marcadas y enviadas en frascos separados. En Colombia, no se ha evaluado el rendimiento de OLGA en el estudio de la atrofia gástrica. Materiales y métodos: estudio de casos y controles. Los casos son pacientes en quienes se hizo el muestreo de biopsias para el OLGA. Los controles pacientes con menos de 5 biopsias gástricas, sin el muestreo del OLGA. Resultados: 1599 casos y 4191 controles. Edad promedio de los casos: 49±12 años versus controles 54±10 años (p: NS). H. pylori: 60% versus 57%. GCA en casos: 42% versus 26%. El 12,3% tenía OLGA III/IV y el 88%, OLGA 0, I o II, los cuales no ameritarían vigilancia endoscópica. Conclusión: el sistema OLGA permite detectar un 61,8% más de atrofia que la detectada con un muestreo insuficiente de biopsias gástricas. La mayoría de los casos (88%) tuvo bajo riesgo de CG (estado 0-II) y no se justificaría vigilancia endoscópica.

Introduction: Chronic atrophic gastritis (GCA) is a clinicopathological entity related to intestinal type gastric cancer (GC) whose main cause is helicobacter pylori. Currently, in addition to the diagnosis, it is recommended that the extent of atrophy or intestinal metaplasia be evaluated in order to stage the GC risk. The most accurate method for atrophy is OLGA which requires five biopsies: two from the corpus, two from the antrum and one from the angular incisure. Each biopsy is marked placed in a separate tube and marked. In Colombia, the use of OLGA to study gastric atrophy had not been evaluated previously. Materials and methods: This is a case and control study whose cases are patients who had biopsies taken to be studied with OLGA. Control patients had less than five gastric biopsies, without OLGA sampling. Results: This study includes 1,599 cases and 4,191 controls. The average age of cases was 49 +/- 12 years, and the average age of controls was 54 +/- 10 years (p: NS). H. pylori infections were found in 60% of the cases and in 57% of the controls while 42% of the cases were found to have gastric cancer and 26% of the cases were found to have GC. 12.3% had OLGA III or IV and 88% had OLGA 0, I or II and did not merit endoscopic monitoring. Conclusion: The OLGA system detects 61.8% more atrophy than is detected with less sampling of gastric biopsies. Most of the cases (88%) had low risk of GC (stages 0-II) and did not require endoscopic monitoring

Pathological assessment of gastric mucosa using OLGA system / 中华消化内镜杂志

Objective To evaluate the clinical value of OLGA (Operative Link on Gastritis Assessment) system in pathological assessment of gastric mucosa from Chinese patients.Methods Endoscopic and pathological data of patients,who underwent the endoscopic examination of upper gastrointestinal tract from 2007 to 2012,were analyzed.Using the Sydney protocol,we graded atrophy and staged the Helicobacter pylori infection status in gastric biopsies from 108 patients with dyspepsia.We applied the OLGA system to assess the relationship between OLGA staging and grading and dysplasia/cancer,and the relationship between OLGA grading and Helicobacter pylori infection.Results Two cases of early gastric adenocarcinoma were detected at stage Ⅱ and Ⅳ,respectively.The detection rates of precancerous lesions (including intestinal metaplasia and dysplasia) in cases clustered in stages Ⅲ-Ⅳ were significantly higher than those in stages 0-Ⅱ (intestinal metaplasia:100.0％ VS 65.3％,P ＜0.001 ;dysplasia:77.8％ VS 13.9％,P ＜0.001,respectively),and there were significant differences between OLGA staging and the degree of dysplasia (r =0.671,P ＜0.001).In the subjects at stage 0-Ⅱ,we observed only 10 cases (13.9％) of mild dysplasia.The difference in rate of Helicobacter pylori infection was significant at different OLGA grade (P ＜ 0.001),and the correlation between OLGA grading and infection degree of Helicobacter pylori was significant (r =0.586,P ＜ 0.001).Conclusion Precancerous lesions and gastric adenocarcinoma tend to be discovered in patients clustered at high-risk (Ⅲ-Ⅳ) OLGA stages.OLGA staging of dysplasia can effectively differentiate the risks of gastric cancer.The OLGA grading system is consistently associated with the Helicobacter pylori infection.

El gastroenterólogo y la gastritis crónica en la práctica clínica diaria: [revisión] / The gastroenterologist and chronic gastritis in daily clinical practice: [review]

La gastritis crónica con atrofia y metaplasia intestinal, producida fundamentalmente por H. pylori es el principal factor de riesgo para cáncer gástrico (CG). Sin embargo, no es vigilada de manera sistemática por el gastroenterólogo. Recientemente, se ha propuesto el sistema OLGA para el estadiaje de la atrofia y estratificación del riesgo para CG en grupos 0-IV, siendo el III/IV los que tienen mayor riesgo y ameritan vigilancia. Se revisa la evidencia sobre la utilidad de implementar en la práctica diaria este sistema de puntaje y con base en los resultados discutidos, se dan recomendaciones sobre cómo seguir a los pacientes con gastritis crónica.

Chronic gastritis with atrophy and intestinal metaplasia, produced fundamentally by H. pylori, is the principal risk factor for gastric cancer (GC). Despite this, gastroenterologists do not systematically screen patients for GC. Recently a staging system for atrophy and GC has been proposed by the Operative Link for Gastritis Assessment (OLGA). It categorizes stages from 0 to IV. Stages III and IV have the highest levels of risk and merit close attention by physicians. This article reviews the evidence regarding the usefulness of integrating this staging system into daily practice. Based on the results discussed recommendations are made about how to follow up on patients with chronic gastritis.