Eradication of H pylori infection in a rural population: One-day quadruple therapy versus 7-day triple therapy

瞄准：比较有标准 7-d 的四倍的治疗增加两倍的一天为在中国的一张农村人口的 H pylori 根除的治疗。方法：396 个病人与的一个总数(13 ) pylori 被分配进二的为 H 阳性的 C 脲呼吸测试组织：239 个病人收到了一天四倍的治疗(amoxicillin 2000 mg qid；灭滴灵 500 mg qid；枸橼酸铋 900 mg qid 和 lansoprazole 60 mg 从前每日) 并且 157 个病人收到了 7-d 标准三元组治疗(amoxicillin 1000 mg 出价；clarithromycin 500 mg 出价和 lansoprazole 30 mg 出价) 。所有病人经历了一(13 ) 六个星期估计 H pylori 感染的根除的 C-UBT 术后疗法。结果：229 个病人完成了一天治疗(95.8%) ， 148 个病人完成了 7-d 治疗(94.2%) 。一天治疗根除了在 64 个病人(27.95%) 的 H pylori 感染。相反， 103 个病人(69.59%) 是在 7-d 治疗以后否定的 H pylori (P 【 0.01 ) 。结论：这个预研项目建议与 7-d 标准治疗相比没有在 H pylori 感染的治疗的一天治疗的有益的效果。

Predictive value of neutrophil infiltration as a marker of Helicobacter pylori infection

AIM:To evaluate the predictive value of neutrophil infiltration as a marker of Helicobacter pylori(H.pylori) infection.METHODS:A total of 315 patients with dyspepsia symptoms who underwent upper gastrointestinal endoscopy were enrolled in this study.Biopsies were evaluated using the updated Sydney system.The medication history of all patients in the preceding 4 wk was recorded.The diagnosis of H.pylori infection was based on 13 C-urea breath test at least 4 wk after withdrawal of antisecretory drugs,antibiotics and related drugs.For the patients with subtotal gastrectomy,the diagnosis of H.pylori infection was based on anti-H.pylori immunoglobulin G(IgG) antibody.Serum anti-H.pylori IgG antibody was measured by enzyme-linked immunosorbent assays(Biohit,Finland).RESULTS:The sensitivity,specificity,positive predictive value and negative predictive value of neutrophil infiltration in the diagnosis of H.pylori infection were 92.3%,83.5%,77.4% and 94.7%,respectively.Neutrophil infiltration of gastric mucosa in the histological analysis was strongly associated with H.pylori infection(77.4% vs 5.3% in the neutrophil infiltration negative group,P = 0.000).Moderate neutrophil infiltration was more frequent in H.pylori infection when compared to mild infiltration(81.8% and 75%,respectively),but did not reach statistical significance.For those patients with negative rapid urease test,H.pylori was detected in 73.2% of patients with positive neutrophil infiltration on histology.In patients with subtotal gastrectomy,the diagnostic accuracy of neutrophil infiltration inH.pylori infection was 50%.CONCLUSION:Neutrophil infiltration is closely associated with H.pylori and may be recognized as a sign of this infection.

A subset of ulcerative colitis with positive proteinase-3 antineutrophil cytoplasmic antibody

A small subset of patients with active ulcerative colitis is non-responsive to major known non-biological therapies. We reported 5 patients with positive serum proteinase-3 antineutrophil cytoplasmic antibody (PR3-ANCA) and tried to (1) identify the common clinical features of these patients; (2) investigate the efficacy of a novel therapy using a Chinese medicine compound; and (3) attract more gastroenterologists to be engaged in further study of this subset of patients. The common manifestations of disease in these 5 patients included recurrent bloody diarrhea and inflammatory lesions involving the entire colorectal mucosa. Initial treatment with intravenous methylprednisolone successfully induced remission. Four of these 5 patients were steroid-dependence, and immunosuppressants, such as azathioprine and cyclophosphamide, were in effective. In 3 patients, only the particular Chinese medicine compound could induce and maintain remission. One patient underwent colectomy. No vascular inflammatory lesions were found by histopathological examination. Although more cases are needed for confirmation, our study indicates thatulcerative colitis with positive PR3-ANCA may belong to a subtype of refractory ulcerative colitis. The particular Chinese medicine compound used in our study is by far the most effective in the management of these patients, with additional advantages of having no noticeable side-effects and less financial burden.