Influence of Helicobacter pylori infection on anxiety and depression in patients with chronic gastritis / 中华消化杂志

Objective:To evaluate the influence of Helicobacter pylori ( H. pylori) infection on anxiety and depression in patients with chronic gastritis. Methods:From December 1 2020 to June 30 2021, 387 patients with chronic gastritis who visited the outpatient Department of Gastroenterology, the First Hospital Affiliated to Air Force Medical University were continuously recruited. According to the status of current H. pylori infection, the patients were divided into H. pylori uninfected group and H. pylori infected group. The general demographic information of patients was collected. Hamilton anxiety scale, Hamilton depression rating scale-24, Pittsburgh sleep quality index (PSQI) and gastrointestinal symptom rating scale (GSRS) were filled in. The detection rates of anxiety and depression were compared between the H. pylori uninfected group and the H. pylori infected group according to demographic characteristics. Chi-square test and multiple logistic regression analysis were used for statistical analysis. Results:Finally, 360 patients with chronic gastritis were enrolled, including 200 patients in H. pylori uninfected group and 160 patients in H. pylori infected group. The detection rates of anxiety and depression of the H. pylori infected group were both higher than those of the H. pylori uninfected group (48.1%, 77/160 vs. 30.0%, 60/200; 25.0%, 40/160 vs. 12.5%, 25/200), and the differences were statistically significant ( χ2=12.39 and 9.39, P<0.001 and=0.002). The detection rate of anxiety of male patients in the H. pylori infected group was higher than that in the H. pylori uninfected group (45.1%, 32/71 vs. 24.5%, 27/110); the detection rate of depression of female patients in the H. pylori infected group was higher than that in the H. pylori uninfected group (30.3%, 27/89 vs. 11.1%, 10/90), and the differences were statistically significant ( χ2=8.27 and 10.09, P=0.004 and 0.001). The detection rates of anxiety and depression of patients less than 48 years old in the H. pylori infected group were both higher than those in the H. pylori uninfected group (46.2%, 37/80 vs. 21.9%, 21/96; 20.0%, 16/80 vs. 7.3%, 7/96), and the differences were statistically significant ( χ2=11.73 and 6.20, P=0.001 and 0.013). The detection rates of anxiety and depression of the patients with high school education and below in the H. pylori infected group were higher than those in the H. pylori uninfected group (56.5%, 48/85 vs. 31.7%, 38/120; 32.9%, 28/85 vs. 14.2%, 17/120), and the differences were statistically significant ( χ2=12.57 and 10.24, P<0.001 and =0.001). The results of multivariate analysis showed that H. pylori infection, history of hypertension, PSQI score ≥8, GSRS score ≥7, chronic superficial gastritis and chronic atrophic gastritis were independent risk factors of anxiety in patients with chronic gastritis( P<0.001, =0.013, =0.001, <0.001, =0.036, =0.021), and the risk of anxiety of patients with H. pylori infection was 2.509 times as much as that in uninfected patients (95% confidence interval 1.512 to 4.163). H. pylori infection, PSQI score ≥8, GSRS score≥7, and having overnight dish ≥3 times per week all were independent risk factors of depression in patients with chronic gastritis( P=0.004, =0.002, <0.001, =0.001). The risk of depression in patients with H. pylori infection was 2.563 times as much as that in uninfected patients (95% confidence interval 1.356 to 4.846). Conclusion:H. pylori infection is correlated to anxiety and depression in patients with chronic gastritis, and it is an independent risk factor of anxiety and depression in patients with chronic gastritis.

Analysis of the relation between elevated neutrophil lymphocyte ratio, and erythrocyte sedimentation ratein Helicobacter pyloripositive chronic gastritis patients

Background:Aim of the study was to analyse the relation between elevated neutrophil lymphocyte ratio (NLR), and erythrocyte sedimentation rate (ESR) in Helicobacter pylori(H. pylori)positive chronic gastritis patients, as compared to the control group containing H. pylorinegative chronic gastritis patients.Methods:Chronic gastritis patients were segregated in equal numbers based on H. pyloristatus. NLR was calculated, and ESR noted from the observations, comparison was done between the control and the study groups.Results:A total of 100 patients were included in the study. The 50 each from the control and study group. An observation of elevation in NLR and ESR in H. pyloripositive chronic gastritis patients, as compared to the control group was seen. With an average NLR of 2.43 and 1.43, in the control and study group, respectively.Conclusions:Raise in NLR in H. pyloripositive chronic gastritis patients with an associated raise in ESR suggests, the severity of the infection and the need for eradication and prevent complications

Effect of Lemon Oil Concentrate Cymbopogon citratus ERILIM® towards the Helicobacter pylori Bacteria: A Case Report

This research is based on the effect of the lemon tea concentrate whose polyphenols are powerful antioxidants. Studies have shown that they suppress free radicals in a more effective way than vitamins C or E; in some of cases, specifically in H. pylori, which generally colonizes the human stomach as a single strain with stable characteristics. Authors mention that this colonization can be stable throughout life. This bacterium is related to chronic gastritis, and although H. pylori infection is still the main cause of duodenal and gastric ulcers, the prevalence of ulcers associated with H. pylori is decreasing, while that of related ulcers with non-steroidal anti-inflammatory drugs (NSAIDs) is increasing. Much of what has been published lately about H. pylori and has focused on its important changes in the pattern of the disease and in the potential value of eradication therapy.

Ganhai Weikang capsule in the treatment of functional dyspepsia: a prospective randomized, double-blind, placebo-controlled parallel clinical study / 中华消化杂志

Objective:To explore the efficacy and safety of Ganhai Weikang capsule (GWC) in the treatment of functional dyspepsia (FD).Methods:A randomized, double-blind, placebo-controlled parallel, multi-center, superiority clinical trial was conducted. From March 2018 to April 2020, totally 324 patients with dyspepsia symptoms, who were diagnosed as chronic non-atrophic gastritis by endoscopy and pathology and met the Rome Ⅳ diagnostic criteria for FD from 7 top hospitals were enrolled, including the First Affiliated Hospital of Naval Medical University (Shanghai Changhai Hospital), Heilongjiang Hospital of Traditional Chinese Medicine, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Qilu Hospital of Shandong University, the First Affiliated Hospital of Zhejiang University, Beijing Hospital of Traditional Chinese Medicine of Capital Medical University and the Third Xiangya Hospital of Central South University. The patients were randomly divided into the GWC group and the placebo group according to the ratio of 1∶1. The patients of GWC group were given GWC and the patients of placebo group were given GWC capsule simulant. The patients of both groups orally took capsules before meals, 2.4 g each time and 3 times per day, and the course of treatment was 4 weeks. The main efficacy index was the total clinical effective rate after 4 weeks, and the secondary efficacy index was the changes of clinical symptom scores of upper abdominal pain, upper abdominal burning, postprandial fullness and early satiety. The safety index included laboratory tests and adverse events. Chi-square test and Wilcoxon rank sum test were used for statistical analysis.Results:A total of 320 FD patients were enrolled in the full analysis set (FAS), which included 161 cases in GWC group and 159 cases in placebo group. A total of 298 cases were in the per-protocol set (PPS), 149 cases each in GWC group and placebo group. The results of FAS and PPS both showed that the total clinical effective rates of the GWC group were higher than those of the placebo group (84.5%, 136/161 vs. 44.0%, 70/159 and 83.9%, 125/149 vs. 46.3%, 69/149), and the differences were statistically significant ( χ2=57.07 and 46.32, both P<0.001). In addition, the differences of the total score of main symptoms and each symptom (upper abdominal pain, upper abdominal burning, postprandial fullness and early satiety) before and after treatment of GWC group were all higher than those of the placebo group (FAS: 10 (7, 14) vs. 5 (3, 11); 3 (2, 4) vs. 2 (0, 3); 2 (0, 4) vs. 1 (0, 3); 3 (1, 4) vs. 2 (1, 3); 2 (0, 4) vs. 1 (0, 3). PPS: 10 (7, 13) vs. 5 (3, 11); 3 (2, 4) vs. 2 (0, 3); 2 (0, 4) vs. 1 (0, 2); 3 (1, 4) vs. 2 (1, 3); 2 (0, 4) vs.1 (0, 3)), and the differences were statistically significant (FAS: Z=5.80, 5.91, 3.19, 3.72 and 3.30; PPS: Z=5.14, 5.11, 2.86, 3.21 and 2.84; all P<0.01). The results of FAS and PPS indicated that the improvement rates of main symptoms and each symptom (upper abdominal pain, upper abdominal burning, postprandial fullness and early satiety) of GWC group were all higher than those of the placebo group (FAS: 77.8% (54.6%, 91.3%) vs. 42.9% (28.6%, 61.5%); 100.0% (60.0%, 100.0%) vs. 50.0% (25.0%, 60.0%); 100.0% (50.0%, 100.0%) vs. 50.0% (25.0%, 100.0%); 71.4% (33.3%, 100.0%) vs. 41.4% (25.0%, 66.7%); 100.0% (50.0%, 100.0%) vs. 50.0% (20.0%, 100.0%). PPS: 77.8% (54.2%, 89.5%) vs. 44.0% (28.6%, 65.0%); 100.0% (60.0%, 100.0%) vs. 50.0% (25.0%, 100.0%); 100.0% (50.0%, 100.0%) vs. 50.0% (25.0%, 100.0%); 71.4% (33.3%, 100.0%) vs. 46.4% (25.0%, 66.7%); 100.0% (50.0%, 100.0%) vs. 50.0% (20.0%, 100.0%)), and the differences were statistically significant (FAS: Z=8.60, 7.72, 4.98, 4.24 and 5.61; PPS: Z=7.90, 7.03, 4.49, 3.88 and 4.83; all P<0.001). After 2 weeks of treatment, the differences of the total score of main symptoms and score of each symptom (upper abdominal pain, upper abdominal burning and early satiety) before and after treatment of GWC group were all higher than those of the placebo group (5.0 (3.0, 8.0) vs. 4.0 (2.0, 6.0); 2.0 (1.0, 2.0) vs. 2.0 (0.0, 2.0); 1.5 (0.0, 2.0) vs. 1.0 (0.0, 2.0); 1.5 (0.0, 2.0) vs. 1.0 (0.0, 2.0)), and the differences were statistically significant ( Z=2.95, 3.44, 2.43 and 2.79, all P<0.05). There was no significant difference in the incidence of adverse events between the GWC group and the placebo group (0.6%, 1/163 vs. 0, 0/159). Conclusion:The clinical total effective rate of GWC in the treatment of FD is superior to that of placebo and it has good safety.

Fecal calprotectin levels used as a noninvasive method for screening for chronic gastritis in pediatric patients. A descriptive study

ABSTRACT BACKGROUND: Gastritis consists of inflammation of the gastric mucosa and is one of the main causes of dyspeptic symptoms in children. OBJECTIVE: To investigate the presence of inflammation by evaluating fecal calprotectin (FC) in children diagnosed with chronic gastritis. DESIGN AND SETTING: Descriptive study in Pediatric Gastroenterology Department of Ondokuz Mayis University Hospital in Turkey. METHODS: Between January 2016 and July 2018, FC levels were compared retrospectively in children with chronic gastritis (histopathology-based diagnosis), patients with inflammatory bowel disease (IBD) and healthy children. RESULTS: A total of 67 chronic gastritis patients (61.2% girls) with a mean age of 13.09 ± 3.5 years were evaluated. The mean FC levels were 153.4 μg/g in the chronic gastritis group, 589.7 μg/g in the IBD group and 43.8 μg/g in the healthy group. These levels were higher in chronic gastritis patients than in healthy individuals (P = 0.001) and higher in IBD patients than in the other two groups (P < 0.001). The FC level in the patients with chronic active gastritis (156.3 μg/g) was higher than in those with chronic inactive gastritis (150.95 μg/g) (P = 0.011). Among the patients with chronic active gastritis, the FC level was significantly higher in Helicobacter pylori-positive individuals than in negative individuals (P = 0.031). CONCLUSION: We confirmed the association between increased FC and chronic gastritis. Elevated FC levels may be seen in patients with chronic active gastritis. In order to be able to use FC as a screening tool for chronic gastritis, further studies in a larger study group are needed.

Mechanism of Banxia Xiexintang on Rats with Chronic Gastritis Based on Quantitative Proteomics / 中国实验方剂学杂志

Objective:To study the biological basis of Banxia Xiexintang against chronic gastritis by using quantitative proteomics. Method:The experimental rats were divided into normal group，chronic gastritis model group，and Banxia Xiexintang group. The chronic gastritis model was established four weeks later by gavage with 56% ethanol. After treatment，the stomach tissues were stained with hematoxylin and eosin （HE） to observe the histopathological damage and improvement of gastric tissue in each group. The protein in gastric tissue was extracted. The differential proteins among different groups were studied by quantitative proteomics using tandem mass spectrometry tag（TMT），and the key differentially expressed proteins（DEPs） were verified by Western blot. Result:A total of 4 452 proteins were identified from rat stomach tissues，of which 318 proteins were different between the model and the normal group. After the intervention of Banxia Xiexintang，compared with the model group，there were a total of 258 differential proteins， which were mainly enriched in cell killing，nucleoid and hijacked molecular function. Kyoto encyclopedia of genes and genomes（KEGG） pathway enrichment included tricarboxylic acid（TCA） cycle，steroid hormone biosyntheis，and Retrograde endocannabinoid signaling，as well as phosphatidylinositol 3-kinase（PI3K）/protein kinase B（Akt），nuclear transcription factor-<italic>κ</italic>B（NF-<italic>κ</italic>B） signal pathways. Western blot verification found that 14-3-3 theta，Tenascin-C，ntercellular adhesion molecule-1（ICAM-1），stem cell factor（SCF），Caspase-3，GTPase of the Immunity-associated protein 4（GIMAP4） and mitochondrial pyruvate carrier 1（Mpc1） might be the crucial proteins for the treatment of chronic gastritis. Conclusion:The mechanism of Banxia Xiexintang in the treatment of chronic gastritis involves energy metabolism，hormone regulation，inflammation and immune processes. The target proteins found by differential proteomics and the signaling pathways may be the biological basis of Banxia Xiexintang in the treatment of chronic gastritis.

Network pharmacology study of Yi medicine Jinweitai Capsules in treating gastrointestinal diseases / 中国中药杂志

The network pharmacology and molecular docking methods were used to explore the mechanism of Jinweitai Capsules in the treatment of acute and chronic gastritis, gastric and duodenal ulcers, and chronic colitis. The chemical components of herbs in Jinweitai Capsules were collected through TCMSP, CNKI and PubMed. Target prediction was performed through PubChem and SwissTargetPrediction databases; genes relating to acute and chronic gastritis, gastric and duodenal ulcers, chronic colitis were collected from OMIM database; potential targets of Jinweitai Capsules for relevant gastrointestinal diseases were obtained by Venny analysis; DAVID database was used to perform GO and KEGG enrichment analysis; protein interactions were obtained by STRING database and visua-lized by Cytoscape; AutoDockVina was used for molecular docking of AKT1, EGFR, PTPN11 and its reverse-selected chemical components. Potential mechanisms of Jinweitai Capsules in treating relevant gastrointestinal diseases were clarified according to the results of the docking. The results showed 86 potential active ingredients of Jinweitai Capsules and 268 potential targets for treatment of acute and chronic gastritis, gastric and duodenal ulcers, and chronic colitis. KEGG pathway enrichment analysis showed that 20 pathways relating to acute and chronic gastritis, gastric and duodenal ulcers, and chronic colitis mainly involved calcium signaling pathway and chemokine signaling pathway. Molecular docking showed a good binding activity between AKT1, EGFR, PTPN11 and its reverse screening chemical components. Jinweitai Capsules may exert an effect in the treatment of acute and chronic gastritis, gastric and duodenal ulcers, and chronic colitis by acting on AKT1, EGFR, PTPN11 and other targets in 15 signal pathways relating to cell inflammation and immunity, cell proliferation and apoptosis, Helicobacter pylori infection, and gastrointestinal tract.

A bioinformatics approach revealed the transcription factors of Helicobacter pylori pathogenic genes and their regulatory network nodes

BACKGROUND: Helicobacter pylori is a chronic pathogenic bacteria that causes gastric mucosal damage through various host-related and pathogen-related factors. Thus, a single gene research cannot fully explain its pathogenicity. PURPOSE OF STUDY: It is necessary to establish a Helicobacter pylori pathogenic gene transcription factor regulatory network (TFRN) and study its central nodes. RESULTS: The expression data of Helicobacter pylori pathogenic genes were obtained through GEO Datasets of NCBI. The genes were screened using linear model-empirical Bayesian statistics in R language Limma package combined with the conventional t-test; the results identified 1231 differentially expressed genes. The functional analysis (gene ontology-analysis) and signal pathway analysis (pathway-analysis) of differentially expressed genes were performed using the DAVID and KEGG databases, respectively. The pathogenic gene regulatory network was constructed by integrating transcriptional regulatory element database (TRED); the disease-related analysis of the pathogenic genes was conducted using the DAVID annotation tool. Five pathogenic genes (Nos2, Il5, Colla1, Tnf, and Nfkb1) and their transcription factors (Jun, Cebpa, Egrl, Ppara, and Il6) were found to suppress the host immune function and enhance the pathogenicity of Helicobacter pylori by regulating the host immune system. CONCLUSIONS: This effect was largely mediated via three signaling pathways: Tnf pathway, PI3K Akt pathway, and Jak­STAT pathway. The pathogenicity of Helicobacter pylori is closely related to the body's immune and inflammatory system. A better understanding of the correlation of the pathogenic factors with the host immune and inflammatory factors may help to determine the precise pathogenic mechanism of H. pylori infection.

Systematic review and Meta-analysis of efficacy and safety of Xiangsha Yangwei Pills in treatment of chronic gastritis / 中国中药杂志

To systematically evaluate the efficacy and safety of Xiangsha Yangwei Pills in the treatment of chronic gastritis. Compu-ter retrieval was performed for Cochrane Library, Medline, EMbase, China Knowledge Network Database(CNKI), China Biomedical Literature Service System(SinoMed), Chongqing Weipu Chinese Science and Technology Journal Database(VIP) and WanFang Database(WanFang) randomized controlled trials about Xiangsha Yangwei Pills combined with Western medicine in the treatment of chro-nic gastritis. The retrieval time ranged from the establishment of the library to April 26, 2019. Meta-analysis was performed by RevMan 5.3 software after two independent researchers conducted literature screening, data extraction and quality evaluation according to inclusion and exclusion criteria. A total of 1 720 patients were enrolled in 18 RCT. According to the classification of chronic gastritis, they were divided into three subgroups: chronic gastritis, chronic atrophic gastritis and chronic superficial gastritis. The results of Meta-ana-lysis showed that the efficacy of Xiangsha Yangwei Pills combined with Western medicine in treating chronic gastritis was higher than that of Western medicine. As for the recurrence rate, Xiangsha Yangwei Pills combined with Western medicine was lower than Western medicine. And there was no statistical difference about helicobacter pylori(Hp) eradication rate between Xiangsha Yangwei Pills combined with Western medicine as well as Western medicine. In terms of the incidence of adverse reactions, Xiangsha Yangwei Pills combined with Western medicine was lower than Western medicine, and no serious adverse reaction was reported. The results of this systematic review showed that compared with the conventional Western medicine group, Xiangsha Yangwei Pills combined with Western medicine can significantly alleviate clinical symptoms of chronic gastritis, with fewer adverse reactions. However, due to the low methodological quality of the included studies and the reliability of the impact conclusions, high-quality multi-center, large-sample, randomized, double-blind controlled trials are needed for validation.

Identificación de Helicobacter pylori por medio de la coloración especial de Warthin-Starry en biopsias de pacientes con gastritis crónica folicular, previamente negativas en la tinción de hematoxilina-eosina / Warthin-Starry stain identification of Helicobacter pylori in biopsies of patients who previously tested negative in hematoxylin-eosin staining for follicular gastritis

Resumen Las técnicas empleadas para la detección del Helicobacter pylori (H. pylori) son no invasivas e invasivas. En estas últimas, la presencia del H. pylori se determina a partir de la tinción de hematoxilina-eosina (HE), prueba rutinaria, mientras que en pocas ocasiones se aplica la tinción de Warthin-Starry (WS) como coloración especial. Objetivo: identificar la presencia de H. pylori por medio de la coloración especial de la WS en biopsias de pacientes con gastritis crónica folicular, previamente negativas en la tinción HE. Materiales y métodos: se desarrolló un estudio de tipo descriptivo transversal, en un período de 12 meses. Se tomaron los bloques de parafina de las muestras de la mucosa gástrica de pacientes con diagnóstico de gastritis crónica e hiperplasia folicular. Además, se extrajo un corte histológico del mismo bloque, al cual se le aplicó HE y se determinó la presencia o ausencia de H. pylori. Así, de estar ausente, se tomó del mismo bloque un corte adicional y se aplicó WS. Esto se evaluó con el fin de identificar la existencia o no del bacilo. Resultados: se recolectaron 314 muestras; 209 fueron negativas y 105 fueron positivas para HE. El 45 % (94) de estas muestras fueron positivas respecto a la presencia del bacilo, al aplicar la segunda coloración, y el 55 % (115) de las muestras persistieron negativas. Conclusión: el hallazgo de H. pylori es significativamente alto al aplicar la coloración de WS a muestras cuyo estudio histológico evidenció la ausencia del bacilo en biopsias de la mucosa gástrica, especialmente en muestras con escasa cantidad de bacterias.

Abstract Non-invasive and invasive techniques can be used for detection of Helicobacter pylori. An invasive technique identifies the bacteria through routine hematoxylin-eosin staining. Warthin-Starry stain is rarely used. Objective: Our objective was to identify H. pylori by Warthin-Starry staining of patient's biopsies with chronic follicular gastritis who had previously tested negative in hematoxylin-eosin staining. Materials and methods: This is a descriptive, cross-sectional descriptive study that was carried out over a period of 12 months. The study examined paraffin blocks of samples taken from the gastric mucosa of patients diagnosed with chronic gastritis and follicular hyperplasia. A histological section was extracted from a block and tested with hematoxylin-eosin staining for the presence or absence of H. pylori. If absent, an additional cut was taken from the same block and Warthin-Starry staining was used to retest for the presence of the bacteria. Results: Of the 314 samples collected, 209 tested negative, and 105 tested positive for H. pylori when hematoxylin-eosin staining was used. Of the 209 negative samples, 45% (94) tested positive when Warthin Starry stain was used, and 55% (115) still tested negative. Conclusion: Findings of H. pylori are significantly higher when Warthin Starry stain was used to test samples whose previous histological study had evidenced an absence of the bacillus, especially in samples with a small amount of bacteria.

Clinical Observation of Zhiwei Pills for Gastritis Caused by Helicobacter Pylori with Syndrome of Stagnation in Liver and Stomach Qi / 中国实验方剂学杂志

Objective::To evaluate theclinical efficacy of Zhiwei pills combined with Hperadication programme for gastritis with liver and stomach Qi stagnation syndrome caused by helicobacter pylori (Hp) and to investigate its effect on antioxidant stress. Method::One hundred and sixty patients were randomly divided into control group (80 cases) and observation group (80 cases) by random number table. Patients in control group gotHperadication programme, and esomeprazole magnesium enteric-coated tablets, 20 mg/time, 1 time/day. Bismuth potassium citrate tablets, 0.3 g/time, 2 times/days. Amoxicillin capsules, 1.0 g/time, 2 times/days. Furazolidone tablets, 0.1 g/time, 2 times/days, all for 14 days. Based on the treatment in control group, the patients in observation group additionally got Zhiwei pills, 6 g/time, 3 times/day. The course of treatment was 8 weeks in both groups. After treatment, eradication of Hp was detected. Before and after treatment, scores of liver and stomach Qi stagnation syndrome were graded. After treatment, patients received gastroscopy and pathological review, and patient report outcome indicators (PRO) both before and after treatment were discussed. The levels of tumor necrosis factor-α (TNF-α), interleukin-1β (IL-1β), IL-8, oxidative dismutase (SOD), glutathione peroxidase (GSH-Px) and malondialdehyde (MDA) were detected both before and after treatment. Result::Negative conversion rate of Hp was(70/75) 93.33% in observation group, higher than(58/71) 81.69% in control group (P<0.05). In the analysis of rank sum test, effect of traditional Chinese medical(TCM) syndrome in observation group was better than that in control group (Z=2.183, P<0.05), and clinical efficacy was also better than that in control group (Z=2.175, P<0.05). Scores of liver and stomach Qi stagnation syndrome and total PRO score in observation group were all lower than those in control group (P<0.01). Levels of TNF-α, IL-1β, IL-8 and MDA were lower than those in control group (P<0.01), while levels of SOD and GSH-Px were higher than those in control group (P<0.01). Conclusion::Zhiwei pills combined with Hperadication programme can improve the eradication rate of Hp, alleviate clinical symptoms, improve the quality of life of patients, inhibit inflammatory reaction and anti-oxidative stress, and improve the curative effect and clinical efficacy of TCM syndromes in the treatment of gastritis with liver and stomach Qi stagnation syndrome, so it is worth for further study and use.

Clinical Effect of Kangfuxin Solution Combined with Almagate Suspension on Complication of Gastroscope Biopsy / 中国实验方剂学杂志

Objective:To observe the clinical effect of Kangfuxin solution combined with Almagate suspension on the complication of gastroscope biopsy. Method:Totally 276 cases of chronic superficial gastritis gastroscope biopsy were divided into treatment group and control group randomly. Treatment group was treated by Kangfuxin solution combined with Almagate suspension，while the control group was given no precautionary measures as usual. Then the patients received the abdominal symptom score and fecal occult blood test（FOBT）after 1 week. Result:The cases with abdominal pain，burning sensation and stool occult blood in the control group were more than the treatment group significantly（P<0.05）. The patients' abdominal symptom score in control group was higher than that before the gastroscope biopsy，and that was lower in treatment group（P<0.05）. And the patients' abdominal symptom score of the control group was significantly higher than that of the treatment group after the gastroscope biopsy（P<0.05）. Compared with the Helicobacter pylori（HP）-infected subgroup，the incidences of early satiety and ventosity in the control group were higher than those of the treatment group（P<0.05）. The abdominal symptom score of the patients infected with helicobacter pylori（HP）in control group was significantly higher than that before the gastroscope biopsy and in the treatment group（P<0.05）. Conclusion:Kangfuxin solution combined with Almagate suspension is safe and effective in preventing complications of gastroscope biopsy，especially for patients infected with HP. The method could avoid exacerbating clinical symptoms.

Application of special acupoints for chronic gastritis in ancient literature of acupuncture and moxibustion / 中国针灸

The application of special acupoints for different primary symptoms of chronic gastritis in ancient literature of acupuncture and moxibustion was analyzed and summarized. With keywords, electronic and manual retrieval of ancient literature being performed to establish a database, the association rules were performed with SPSS Modeler 18. As a result, ① among all the 2243 items included, 109 items mentioned special acupoints (excluding those only mentioned crossing acupoint). The frequency of special acupoints was 2554 (71.7%), and the special acupoints on the spleen meridian, the stomach meridian, the conception vessel were frequently used. The frequency of five- point was highest, followed by front- points. ② The special acupoints for four main primary symptoms of chronic gastritis, "stomachache" "vomiting and regurgitation" "belching and acid regurgitation" and "epigastric fullness", included Zusanli (ST 36), Neiguan (PC 6), Zhongwan (CV 12), Gongsun (SP 4), Taibai (SP 3). In addition, the back- points were also selected to treat the primary symptoms other than "epigastric fullness". Zhangmen (LR 13) was added to treat "belching and acid regurgitation". The combination of Neiguan (PC 6) and Gongsun (SP 4) showed the strongest correlation; due to different primary symptoms, the combination had different emphasis.

Nuevos retos en el tratamiento de la infección por helicobacter pylori / New challenges in the treatment of the infection for helicobacter pylori

RESUMEN La infección por helicobacter pylori afecta aproximadamente al 50% de la población mundial, es causante de gastritis crónica, úlcera péptica, cáncer gástrico y linfoma del tejido linfoide asociado a la mucosa. Desde su descubrimiento, la erradicación ha sido uno de los más importantes retos en Gastroenterología. En muchos países se desconoce la prevalencia de resistencia primaria del microorganismo a los diferentes antibióticos que empíricamente se utilizan, y por no realizar pruebas de rutina que verifican su erradicación en la práctica diaria, se ignora la efectividad de los esquemas prescritos. El incremento progresivo de la resistencia a la claritromicina y metronidazol, unido a una ausencia de antibioticoterapia alternativa, desafía la capacidad para eliminar de manera efectiva a ésta bacteria. El subcitrato de bismuto ha resurgido y su adición en la terapia ha permitido aumentar las tasas de curación por encima del 90%. Actualmente se invoca que para mejorar la eficacia en el tratamiento se debe combinar una supresión potente del ácido gástrico en tratamientos combinados cuádruples con una duración de 14 días, para la mayoría de los casos. La adherencia al tratamiento es crucial para obtener buenos resultados terapéuticos.

ABSTRACT The infection for helicobacter pylori affects approximately to the world population's 50%, it is causing of chronic gastritis, peptic ulcer, gastric cancer and linfoma associated to the mucous one. From their discovery, the eradication has been one of the most important challenges in Gastroenterología. In many countries the prevalencia of primary resistance is ignored from the microorganism to the different antibiotics that empirically they are used, and for not carrying out routine tests that verify its eradication in the daily practice, the effectiveness of the prescribed outlines it is ignored. The progressive increment of the resistance to the claritromicina and metronidazol, together to an absence of alternative antibioticotherapy, challenges the capacity to eliminate from an effective way to this bacteria. The bismuth subcitrato has resurged and its addition in the therapy has allowed to increase the cure rates above 90%. At the moment it is invoked that to improve the effectiveness in the treatment, that is should combine a potent suppression of the gastric acid in combined quadruple treatments with a duration of 14 days, for most of the cases. The adherence to the treatment is crucial to obtain therapeutic good results.

Analysis on Medication Rules of National Medical Masters in Treatment of Stomachache / 中国实验方剂学杂志

Objective: To analyze medication rules of national medical masters in the treatment of stomachache by data mining. Method: Prescriptions were collected from 9 works as well as the first batch of national medical masters' medical cases and prescriptions for stomachache recorded in CNKI. Then, Microsoft Excel 2016 was adopted for analyzing the frequencies, properties, flavors and meridian tropisms of herbs, the Apriori algorithm provided by SPSS Clementine 12.0 software was used to analyze association rules of the herbs, and factor analysis was conducted by SPSS 19.0 software. Result: A total of 175 prescriptions containing 230 herbs were selected. The top five herbs used in frequency ranking were Glycyrrhizae Radix et Rhizoma, Paeoniae Radix Alba, Pinelliae Rhizoma, Atractylodis Macrocephalae Rhizoma, Poria. The medical properties with high usage frequency were warm, mild and slight cold. The flavors were sweet, bitter and pungent. Meridian tropisms were spleen, stomach and lung. Herbs for regulating Qi, tonifying Qi and promoting digestion ranked top three according to the classification of efficacy. The association rules analysis showed that the highest confidence and support of the related drugs was Atractylodis Macrocephalae Rhizoma→Codonopsis Radix-Poria, which reflected treatment characteristics of national medical masters with Sijunzitang as the basic prescription for tonifying Qi. A total of 12 strongly association rules of 2-drug pairs were obtained by association rules, and the most commonly used of which was Paeoniae Radix Alba-Glycyrrhizae Radix et Rhizoma. Nine common factors were respectively extracted by factor analysis. Conclusion: Herbs used in the prescriptions of national medical masters for treatment of stomachache are often with the actions of regulating Qi, invigorating deficiency and benefiting Qi, in addition, Shaoyao Gancaotang is often used to generate Yin and relieve pain.

Effect of modified Zhengqi Powder in treating chronic gastritis and on patients' life quality and inflammatory factors / 中国中药杂志

Chronic gastritis is a kind of chronic gastric mucosal inflammation caused by many factors.Intestinal metaplasia refers to the transformation of gastric mucosal epithelial cells into small/large intestinal mucosal epithelium containing Panette or goblet cells.Chronic gastritis has the highest incidence among stomach diseases,while intestinal metaplasia is the serious manifestation of chronic gastritis.In this experiment,the therapeutic effect of modified Zhengqi Powder on mild intestinal metaplasia in chronic gastritis and on patients' quality of life and inflammatory reaction was investigated to analyze the efficacy and mechanism of traditional Chinese medicine prescription.From April 2016 to April 2017,120 patients of chronic gastritis with mild intestinal metaplasia were selected and divided into two groups according to the envelope method.The control group(60 cases) was treated with famoxetine.After one month of continuous treatment,the total effective rate of treatment in the observation group was 93.3%,which was much higher than 80.0% in the control group.Health questionnaire(SF-36),serum C-reactive protein(CRP),interleukin-8(IL-8) and tumor necrosis factor-α(TNF-α) levels were significantly higher than those in the control group(P<0.05).The results showed that modified Zhengqi Powder has a significant efficacy in treat chronic gastritis with mild intestinal metaplasia,and can obviously alleviate clinical symptoms and intestinal metaplasia,remove inflammatory factors and improve the quality of life of patients,and is worth promotion.

Clinical Significance of OLGA/OLGIM Staging Systems for Chronic Gastritis / 胃肠病学

The OLGA (Operative Link for Gastritis Assessment) grading and staging system is a semi-quantitative scoring of inflammation and atrophy based on updated Sydney system, the staging represents the topography, extension and severity of gastric atrophy, while the alternative staging system OLGIM (Operative Link on Gastric Intestinal Metaplasia Assessment) replaces the atrophy score with an assessment of intestinal metaplasia alone. The OLGA/OLGIM staging systems correlate the histopathological change of chronic gastritis with the risk of gastric cancer. Stages III and are associated with an increased risk of gastric cancer. Therefore, these staging systems can be used for gastric cancer screening, precancerous lesion monitoring and establishing individualized strategy for endoscopic surveillance.

Analysis on the specificity of the relevant points along the governor vessel in chronic gastritis based on tenderness reaction and tenderness threshold / 中国针灸

OBJECTIVE@#To explore the specificity of the relevant points along the governor vessel in chronic gastritis through the synchronous observation of the tenderness reaction and tenderness threshold on the back along the governor vessel in the volunteers with chronic gastritis and make the comparison with healthy volunteers.@*METHODS@#A chronic gastritis group and a healthy volunteer group were prepared, 30 cases in each one. Using synchronous comparison, the tenderness reaction at the point inferior to each of the spinous processes from T to L along the governor vessel was observed. The mechanical pressure pain threshold was determined.@*RESULTS@#Regarding the tenderness reaction at the point inferior to each spinous process on the back along the governor vessel, the occurrence rate was different significantly between the chronic gastritis group and the healthy volunteer group (0.05).@*CONCLUSION@#The point inferior to the spoinous process of T on the governor vessel, Shendao (GV 11, T) and Lingtai (GV 10, T) are the points with the high specificity in chronic gastritis, which provides the reference to clinical treatment with acupuncture and moxibustion. The occurrence rate of high tenderness reaction and the low tenderness threshold may be the important manifestation of the point specificity on the back along the governor vessel in chronic gastritis.

Caracterización de la infección por Helicobacter pylori en niños y adolescentes en un servicio ambulatorio / Characterization of Helicobacter pylori infection in children and adolescents in an ambulatory service

Introducción: la infección por Helicobacter pylori es muy común, particularmente en los países en vías de desarrollo, y juega un rol importante en la enfermedad ácido péptica. Objetivos: conocer la prevalencia y algunos datos clínico epidemiológicos, describir los hallazgos endoscópicos (gastritis eritematosa, nodular y úlcera duodenal), y relacionarlos con los hallazgos histológicos; describir la asociación entre los grados histológicos de la gastritis crónica y la positividad de la prueba de ureasa rápida y la presencia de Helicobacter pylori según histología, así como identificar la relación de los pacientes con gastritis crónica antral y úlcera duodenal por Hp, con la edad. Métodos: se realizó un estudio tipo descriptivo prospectivo durante 3 años se hizo una encuesta de síntomas a pacientes y/o padres y examen físico. Se realizó panendoscopia, previo consentimiento informado, y 2 biopsias de mucosa antral para prueba de ureasa rápida, así como estudio histopatológico (hematoxilina-eosina y Giemsa) para determinar el grado de gastritis y presencia de Helicobacter pylori según sistema Sydney. Se demostró la infección por uno de los métodos. Resultados: se seleccionaron 196 pacientes entre 7-18 años (media 14,6) de 471 (41,6 por ciento). El 53 por ciento era del sexo femenino, y el 59,7 por ciento tenía entre 10 y 14 años. Por endoscopia, el 49,5 por ciento tenía gastritis eritematosa antral, el 36,8 por ciento gastritis nodular astral, y el 13,7 por ciento úlcera duodenal con gastritis asociada. Con antecedentes familiares de úlcera péptica estuvo el 29,6 por ciento, con epigastralgia el 85,2 por ciento, con acidez el 46,4 por ciento con vómitos el 21 por ciento y con náuseas el 16,3 por ciento. En relación con el tiempo de evolución al diagnóstico, predominó el grupo de más de un año (24,5 por ciento), seguido del de 4-6 meses (22,4 por ciento). Todos presentaron gastritis crónica de diferentes grados: ligera (34,7 por ciento), moderada (37,2 por ciento) y severa (28,1 por ciento), con Helicobacter pylori por ureasa rápida 83,2 por ciento y 93,4 por ciento por histología, con coincidencia de ambos métodos en 150 (76,5 por ciento). Se observó presencia de nódulos linfoides en 41,8 por ciento. Conclusiones: la infección por Helicobacter pylori es frecuente en niños y adolescentes, causa lesiones inflamatorias gastroduodenales, en particular, gastritis nodular antral. Se encuentra una asociación importante del Helicobacter pylori por ambos métodos diagnósticos. Se recomienda seguimiento por biopsia, en especial, a los que continúan con infección crónica y presenten nódulos linfoides, por el riesgo de presentar linfoma gástrico de células B del tejido linfoide asociado a mucosa (linfoma MALT), si no se consigue la erradicación del Helicobacter pylori(AU)

Introduction: Helicobacter pylori infection is very common, particularly in developing countries, and plays an important role in acid peptic disease. Objectives: to know the prevalence and some clinical epidemiological data for describing the endoscopic findings (erythematous gastritis, nodular and duodenal ulcer), and to relate them with the histological findings; to describe the association among the histological degrees of chronic gastritis and the positivity of the rapid urease test, and the presence of Helicobacter pylori according to histology, as well as identifying by Hp with age the number of patients with chronic antral gastritis and duodenal ulcer. Methods: a prospective, descriptive study was carried out during 3 years, and a survey of symptoms was made to patients and / or parents and also physical examination. Panendoscopy was performed with prior informed consent, and also 2 antral mucosa biopsies for rapid urease test, as well as histopathological study (hematoxylin-eosin and Giemsa) to determine the degree of gastritis and the presence of Helicobacter pylori according to the Sydney system. Infection was demonstrated by one of the methods. Results: 196 patients among 7-18 years (mean 14.6) were selected of 471 (41.6 percent). 53 percent were female, and 59.7 percent were among 10 and 14 years old. By endoscopy, 49.5 percent had antral erythematous gastritis, 36.8 percent astral nodular gastritis, and 13.7 percent duodenal ulcer with associated gastritis. 29.6 percent had a family history of peptic ulcer, 85.2 percent of epigastralgia, 46.4 percent with acidity, 21 percent with vomiting, and 16.3 percent with nausea. In relation to the time of evolution to the diagnosis, the group of more than one year prevailed (24.5 percent followed by the one of 4-6 months (22.4 percent). All presented chronic gastritis of different degrees: light (34.7 percent), moderate (37.2 percent) and severe (28.1 percent), with Helicobacter pylori by rapid urease 83.2 percent, and 93.4 percent by histology with coincidence of both methods in 150 (76.5 percent). The presence of lymphoid nodules was observed in 41.8 percent. Conclusions: Helicobacter pylori infection is frequent in children and adolescents causing gastroduodenal inflammatory lesions, in particular antral nodular gastritis. An important association of Helicobacter pylori is found by both diagnostic methods. Follow-up by biopsy is recommended, especially those who continue with chronic infection and have lymphoid nodules due to the risk of presenting B-cell gastric lymphoma of the lymphoid tissue associated to the mucosa (MALT lymphoma), if Helicobacter pylori eradication is not achieved(AU)

Study on Syndrome Elements of Chronic Gastritis Based on Factor Analysis / 中国中医药信息杂志

Objective To investigate the syndrome elements of chronic gastritis; To provide references for syndrome differentiation and treatment of chronic gastritis. Methods Totally 300 patients of chronic gastritis were investigated through a pre-designed scale. Syndrome elements were summarized with factor analysis. Results There were 6 common factors (syndrome elements) picked up by factor analysis. Syndrome elements of disease locations were stomach, spleen, liver, and syndrome elements of disease characteristics were qi deficiency, qi stagnation, blood stasis, stagnated heat, damp obstruction, and dampness-heat, which were consistent with clinical observation. Conclusion It is feasible to apply factor analysis to syndrome elements of chronic gastritis, which can provide references for syndrome differentiation and treatment.