Identification of coccoid forms of Helicobacter pylori and their clinical significance for eradication therapy / 中华传染病杂志

Objective:To investigate the factors associated with the occurrence of coccoid forms in clinical isolates of Helicobacter pylori ( H. pylori) and its relationship with the pathological changes of gastric mucosa. Methods:A total of 66 H. pylori-infected patients admitted to People′s Hospital of Ningxia Hui Autonomous Region from January 2020 to June 2021 were included.The clinical data of the patients were collected. Immunohistochemical staining was performed on gastric mucosal biopsy specimen to observe the occurrence of coccoid forms of H. pylori and pathological changes of gastric mucosa. Chi-square test was used for statistical analysis. Results:After immunohistochemical staining of 66 gastric mucosa biopsy specimens from H. pylori-infected patients, the co-existence of helical and coccoid forms of H. pylori was found in 26(39.39%) specimens, and no simple coccoid H. pylori change was found. Among them, the patients with a history of eradication therapy had a coccoid forms rate of 52.63%(20/38), and those without a history of eradication therapy had a coccoid forms rate of 21.43%(6/28), and the difference was statistically significant ( χ2=6.57, P=0.012). There were no significant differences in the coccoid forms rates between patients with different gender, ethnicity, age and gastric mucosal pathological changes (including atrophy, gastric intestinal metaplasia, inflammation, activity)(all P>0.050). Seventeen (73.9%) of the 23 patients whose endoscopy was more than one to three months from the last eradication therapy developed coccoid forms, while three of 15 patients whose endoscopy was more than three months from the last eradication therapy had coccoid forms, and the difference was statistically significant ( χ2=10.59, P=0.002). Conclusions:The transformation of H. pylori coccoid forms is related to the previous eradication therapy. The coccoid forms of H. pylori is equally pathogenic relative to the helical forms of H. pylori.

Efficacy of helicobacter pylori eradication as an upfront treatment of secondary immune thrombocytopenia: an experience from Pakistan

Background: The effect of Helicobacter-pylori eradication therapy on the platelet counts in patients with immune thrombocytopenia is still debatable. The aim of this study was to assess the response rates of standard triple eradication therapy in secondary immune thrombocytopenia with Helicobacter pylori infection. Methods: From January 2012 to December 2013, 197 patients were diagnosed to have immune thrombocytopenia, out of which 22(11.1%) patients infected with HelicobacterPylorus were enrolled in this study. Helicobacter-Pylori infection was documented by Helicobacter-pylori stool antigen enzyme immunoassay method. All positive patients were put on triple eradication therapy. The responses rates to treatment were defined as per International Working Group on ITP. Results: Mean age of patients was 43.18±12.5 years. There were 10(45.5%) males and 12 (54.5%) females. Of the 22 patients, 7(31.8%) exhibited a complete response (CR) to Hpylori eradication therapy; 10(45.4%) attained a response; and 5(22.7%) had no response. Mean base line platelet counts were 53.36±24.5x109 /l, while platelet counts at 4 week following eradication was 80.86±51.0x109 /l (P=0.003). The predictive factor of response following eradication therapy was baseline platelet counts. Virtually all responders had baseline platelet counts >30x109 /l and all non-responders had <30x109 /l of platelet counts. Conclusions: Though the prevalence of H-pylori is low, this study confirmed the efficacy of eradication in increasing the platelet counts in H-pylori positive patients with ITP. It is an important measure in short time, safe and very cost effective to achieve platelets increment. We endorse the routine detection and eradication treatment of H-pylori infective ITP patients.

CLINICAL OBSERVATION OF TRIPLE THERAPY REGIMEN WITHLANSOPRAZOLE, CLARITHROMYCIN AND METRONIDAZOLE FOR TREATMENT OF HELICOBACTER PYLORI-RELATED ULCER / 现代医院

Objective To investigate therapeutic effects of triple therapy combined Lansoprazole, clarithromycin and metronidazole for eradicating Helicobacter pylori-related ulcer. Methods Fivty-one patients with H. pylori-infected stomach ulcer or duodenal ulcer received the treatment of triple therapy regimen with lansoprazole, clarithromycin and metronidazole.the efficacy of ulcer healing and hp eradication were observed. Results the cure rate of the triple therapy was 90%,and the eradication rate of H. pylori was 88%.Conclusions Triple therapy using combined Lansoprazole, clarithromycin and metronidazole is worthy of clinical application for curing pylori - infected peptic ulcer accompanied by the lower does, the higher hp eradication rate, ulcer healing more rapidly and the shorter course of treatment.

Diagnosis and Treatment Guidelines for Helicobacter pylori Infection in Korea / 대한소화기학회지

Eleven years has passed since the guideline of the Korean College of Helicobacter and Upper Gastrointestinal Research group for H. pyori infection was produced in 1998. During this period the research for H. pyori has much progressed that H. pyori is now regarded as the major cause of gastric cancer. The seroprevalence of H. pyori in Korea was found to be decreased especially below the age of 40's and in the area of Seoul.Gyeonggi province, and annual reinfection rate of H. pyori has decreased up to 2.94%. In the aspect of diagnostic tests of H. pyori the biopsy is recommended in the body instead of antrum in the subjects with atrophic gastritis and/or intestinal metaplasia for the modified Giemsa staining or Warthin Starry silver staining. The urea breath test is the test of choice to confirm eradication when follow-up endoscopy is not necessary. Definite indication for H. pyori eradication is early gastric cancer in addition to the previous indications of peptic ulcer including scar and Marginal zone B cell lymphoma (MALT type). Treatment is also recommended for the relatives of gastric cancer patient, unexplained iron deficiency anemia, and chronic idiopathic thrombocytopenic purpura. One or two week treatment of proton pump inhibitor (PPI) based triple therapy consisting of one PPI and two antibiotics, clarithromycin and amoxicillin, is recommended as the first line treatment regimen. In the case of treatment failure, one or two weeks of quadruple therapy (PPI+metronidazole+tetracycline+bismuth) is recommended. Herein, Korean College of Helicobactor and Upper Gastrointestinal Research proposes a diagnostic and treatment guideline based on currently available evidence.

Epidemiological Survey of Nodular Gastritis and Duodenal Ulcer before and after Eradicative Treatment of Hpylori Infection / 实用儿科临床杂志

Objective To investigate the prevalence of nodular gastritis,duodenal ulcer before and after eradicative treatment of helicobactor pylori(Hp) infection in children with gastroscopy.Methods This was a retrospective analysis of 1 275 children,age ranging 1 to 16 years old,collected from our hospital in recent 10 years,detecting rates of before eradicative treatment and after eradicative treatment were analyzed.Gastroscopes were analyzed with regard to a possible association with the infection.Results The detecting rate(11.89%) of duodenal ulcer after eradicative treatment was lower than that(17%) before eradicative treatment(P

Effect of Esomeprazole,Clarithromycin,Metronidazole Triple Therapy for Helicobactor Pylori Infection in Children / 实用儿科临床杂志

Objective To study the effect of esomeprazole,clarithromycin,metronidazole triple therapy for helicobactor pylori(Hp) infection in children.Methods Ninty-eight cases of children,identified by ~ 13 C-urea breath test(~ 13 C-UBT) Hp infection,deparded into therapy group(66 cases) and control group(32 cases).Therapy group were given Esomeprazole[0.8 mg/(kg?d),1 time/d],clarithromycin[15 mg/(kg?d),2 times/d],metronidazole[30 mg/(kg?d),3 times/d]triple therapy.Control group were given the same treatment except ameprazole.The course was 1 week.They were followed up 4 weeks later after the course and re-tested by ~ 13 C-UBT.Results The recurrent abdominal pain of the two groups recovered in different degrees,and the efficacy rate was 100%.The eradication rate of Hp in therapy group and control group were separately 90.9%(60/66) and 87.5%(28/32).There was no significance difference of the eradication of Hp.Conclusions The trearment of esomeprazole,clarithromycin,metronidazole triple therapy on Hp infection in children is quite effective and safe.The side effect is moderate.

The Role of Interleukin-1beta Gene Polymorphism in the Gastric Carcinogenesis / 대한소화기학회지

BACKGROUND/AIMS: This study was aimed to investigate the polymorphism of interleukin-1beta(IL-1B) and IL-1 receptor antagonist (IL-1RN) gene and the relationship between genotypes and development of gastric adenocarcinoma in Korean, and to investigate the role of Helicobactor pylori (H. pylori) infection. METHODS: The study population comprised of 258 patients with gastric adenocarcinoma. They were classified according to Lauren's classification and the status of H. pylori infection. Genomic DNA was extracted from the gastric tissue. As a control, genomic DNA from peripheral lymphocyte of 100 healthy individuals was used. The amplified products of -511 bp and -31 bp fragments in the IL-1B by PCR were digested by restriction enzyme and separated for RFLP. Variable number tandem repeats were amplified and subjected to RFLP of IL-1RN. RESULTS: There was no significant difference in the genotype of IL-1B-511T and IL-1B-31C between the adenocarcinoma group and the control group. IL-1RN allele 1 homozygote in the intestinal type showed high frequency of 91.7% (p=0.007). In the H. pylori-positive group of the adenocarcinoma, the frequency of IL-1B-31C was significantly higher than that of H. pylori-negative group (p=0.045). CONCLUSIONS: The single nucleotide polymorphism of IL-1B-31C may contribute to the development of the gastric adenocarcinoma in the H. pylori-positive population.

CpG-Oligodeoxynucleotide is the ideal adjuvant for development of a Helicobacter pylori vaccine / 中华消化杂志

Objective To investigate whether a novel mucosal adjuvant (DNA containing six base pair motifs consisting of an unmethylated CpG dinucleotide flanked by two 5′ purines and two 3′ pyrimidines, CpG Oligodeoxynucleotide, CpG ODN),which has not been shown to have significant toxicity,could be an ideal mucosal adjuvant for the development of a H. pylori vaccine in mice model. Methods C57BL/6 mice were orally or intranasally immunized with H. pylori whole cell sonicate(WCS) / cholera toxin (CT) or WCS /CpG ODN, and the corresponding control groups were set. Mice were dosed once a week for four weeks. One week after the last immunization, all animals were challenged by live H. pylori (5?10 8) three times in a five day duration. Two and 8 weeks after the last challenge, all animals were sacrificed to examine infection of H. pylori. Sera, saliva, gastric juice were collected to measure the concentrations of IgG, IgG1, IgG2a and IgA by ELISA. Results The protecting rates against H. pylori infection were 75%(9/12), 70% (7/10) and 0 (0/10) in the group of WCS/CT orally, WCS/CpG ODN intranasally and WCS/CpG ODN orally, respectively. Significantly higher levels of serum IgG2a antibody was found in the group immunized with WCS plus CpG ODN than those found in the sham immunized controls ( P

The influence of protein-tyrosine phosphatase inhibitor on the vacuolating activity of VacA / 中华消化杂志

Objective It has been reported that VacA receptor of H pylori on gastric cell membrane is belong to the receptors of protein tyrosine phosphatase(RPTP) family, which are associated with signal transduction of cells. However the mechanism of vacuolation is still unknown. There may be a new way to reduce the toxicity of H.pylori by interfering the signal transduction. Methods The concentrates of supernatants from H.pylori liquid culture was used as rough VacA. Protein tyrosine phosphatase inhibitor (PTPI) and protein tyrosine kinase inhibit or(PTKI) which were diluted and combined with rough VacA were incubated with SGC 7901 cells for 24 hours. Results PTPI could inhibit the vacuolating activity with a minimal concentration of 2.7 ?mol/L( A 550 =0.46?0.06 vs 0.59?0.04, P

The Significance of Erosive Prepyloric Change or Helicobacter pylori Infection in Patients with Functional Dyspepsia / 대한소화기내시경학회지

BACKGROUND/AIMS: The etiology of funetional dyspepsia remains unknown, with inconclusive evidence for several factors, including abnormal gastroduodenal motility, personal traits, infection of Helicobactor pylori (H. pylori) and erosive prepyloric change (EPC). Therefore, we evaluated the relation between H. pylori or EPC and gastric emptying in patients with functional dyspepsia. METHODS: We performed an ultrasonographic gastric emptying test in 18 patients with functional dyspepsia comparing 6 healthy volunteers as the control. The presence of BPC in the stomah was diagnosed by esophogogastroduodenoscopy, and the Helicobacter pylori infection was evaluated using a rapid urease test. RESULTS: The erosive prepyloric change in the antrum was revealed in five patients with dyspepsia. Amang the EPC (+), EPC (-) with dyspepsia, and healthy volunteers, the parameters of the ultrasonographic gastric emptying test and subjective symptom scores did not reveal significant differences. Among the H. pylori (+), H. pylori (-) patients with dyspepsia and healthy volunteers, the parameters of the ultrasonographic gastric emptying test and subjective symptom scores did not reveal significant differences. CONCLUSIONS: No association was found between dyspeptic symtoms and the presence of H. pylori infection or EPC. The two factors, Helicobacter pylori infection and erosive prepyloric change, did not affect the gastric motility in functional dyspepsia.

Relationship between gastric acid output＆ H.pylori colonization in atrophic gastritis / 中华消化内镜杂志

Objective The effect of acidity and severity of gastric atrophy on Helicobactor pylori (H.pylori) colonization was studied. Methods 95 patients with chronic atrophic gastritis (CAG) and positive H.pylori test were categorized into groups.Group 1,48 cases having moderate atrophic antritis with various degrees of fundic atrophy.Group 2,47 cases having mild fundic atrophy with various degrees of antritis. Assessment was made of basic and maximum acid output (BAO, MAO ) as well as of gastrin. H.pylori was tested with Warthin-Starry staining. Results In group 1, H.pylori colonization reduced significantly (P0.05) was found between patients with severe and moderate atrophy in fundus, while H.pylori colonization declined more markedly (P0.05) between cases with moderate and severe antritis,whereas H.pylori colonization reduced more significantly in the latter than the former (P

The Effects of Shosaiko-to on Chronic Gastritis / 日本東洋医学雑誌

Twenty-one cases of patients with chronic gastritis were treated with the Kampo (Japanese herbal medicine) formula Shosaiko-to, for a minimum of six months. The results were that the chief complaints associated with chronic gastritis such as nausea, vomiting, epigastralgia, abdominal discomfort and heartburn were entirely alleviated. Eructaion and fatigue were also almost entirely relieved. However, there was one case where loss of appetite, feeling of abdominal distention and a sloshing sound in the gastric area were exacerbated<br>Concerning the level of anti-Helicobactor pylori IgG antibody, the level was greatly decreased in 6 out of 17 cases (35.5%). However, among the patients with gastritis superficialis, the level of the antibody against Helicobactor pylori decreased in 4 out of 8 cases (50%).<br>The endoscopic findings of the stomach showed improvement in all 10 cases of gastritis superficialis. Gastritis atrophicans, however, did not improve with treatment with Shosaiko-to.<br>These results strongly suggest that Shosaiko-to can be an effective tool in the treatment of chronic gastritis.

Study on clinical and pathology of children with gastrointestinal bleeding / 实用儿科临床杂志

Objective To evaluate the etiologies of children with gastrointestinal bleeding(GIB), and the relationship between the pathological findings and clinical.Methods Gastroscopy or proctoscope was performed in 153 children with GIB. Pathological studies and tests as for helicobactor pylori (Hp) were undertaken.Results Among 153 children,140 cases(91.5 %) had definite diagnosis,including 74 children with upper gastrointestinal bleeding(UGIB) and 66 cases with lower gastrointestinal bleeding(LGIB). Gastric pathologic study was conducted in 56 cases. All patients had chronic superficial gastritis(CSFG). Hp test was positive in 33 patients. There was significant difference in the positive rate of Hp test between patients with gastritis or duodenitis and those with ulcers (P