Anti-Helicobacter pylori therapy followed by celecoxib on progression of gastric precancerous lesions

AIM： To evaluate whether celecoxib, a selective cyclooxygenase 2 （COX-2） inhibitor, could reduce the severity of gastric precancerous lesions following Hel/cobacter pylori （H pylorl） eradication. METHODS： H pylori-eradicated patients with gastric precancerous lesions randomly received either celecoxib （n = 30） or placebo （n = 30） for up to 3 mo. COX-2 expression and activity was determined by immunostaining and prostaglandin E2 （PGE2） assay, cell proliferation by Ki-67 immunostaining, apoptosis by TUNEL staining and angiogenesis by microvascular density （MVD） assay using CD31 staining.RESULTS： COX-2 protein expression was significantly increased in gastric precancerous lesions （atrophy, intestinal metaplasia and dysplasia, respectively） compared with chronic gastritis, and was concomitant with an increase in cell proliferation and angiogenesis. A significant improvement in precancerous lesions was observed in patients who received celecoxib compared with those who received placebo （P 〈 0.001）. Of these three changes, 84.6% of sites with dysplasia regressed in patients treated with celecoxib （P = 0.002） compared with 60% in the placebo group, suggesting that celecoxib was effective on the regression of dysplasia. COX-2 protein expression （P 〈 0.001） and COX-2 activity （P 〈 0.001） in the gastric tissues were consistently lower in celecoxib-treated patients compared with the placebo-treated subjects. Moreover, it was also shown that celecoxib suppressed cell proliferation （P 〈 0.01）, induced cell apoptosis （P 〈 0.01） and inhibited angiogenesis with decreased MVD （P 〈 0.001）. However, all of these effects were not seen in placebo-treated subjects. Furthermore, COX-2 inhibition resulted in the up-regulation of PPARy expression, a protective molecule with anti-neoplastic effects. CONCLUSION： H pylori eradication therapy followed by celecoxib treatment improves gastric precancerous lesions by inhibiting COX-2 activity, inducing apoptosis, and suppressing cell proliferation and angiogenesis.

Efficacy of one-day quadruple therapy for H pylori infection in Chinese patients

AIM： TO compare the efficacies of one-day quadruple therapy and seven-day triple therapy in Chinese patients. METHODS： Sixty consecutive patients with nonulcer dyspepsia and confirmed H pylori infection were randomized to receive either omeprazole 40 mg, amoxycillin 1 g, and furazolidone 100 mg, all twice a day for 7 d or omeprazole 20 mg （at breakfast and dinner）, amoxicillin 1 g, furazolidone 200 mg, and colloidal bismuth subcitrate 220 mg four times for only one day. H pylori status was determined before and at least 5 weeks after therapy by endoscopy with antral and corpus biopsies for rapid urease test and histology. RESULTS： Hpyloi eradication was successful in 66.67% （20/30） patients in the 7-d group and in 36.67% （11/30） patients in the 1-day group （P = 0.037）. Side effects were induced by the treatment in 13.3% （4/30） patients of each group, but these were all self-limiting, shortlasting, and did not require any specific treatment. CONCLUSION： The one-day quadruple therapy is less effective than the one-week regimen in curing H pylori infection in Chinese patients.

Acupuncture for 14 cases of Meige’s syndrome Ⅱ

Objective:To observe the clinical efficacy of acupuncture for Meige’s syndrome Ⅱ.Methods:Fourteen patients of Meige’s syndrome Ⅱ were treated with acupuncture.The acupoints included bilateral Tāichōng(太冲LR3),Sānyīnjiāo(三阴交SP6),Tāixī(太溪KI3),dance tremor control area of scalp acupuncture(舞蹈震颤控制区),Yángbái(阳白GB14),Sīzhúkōng(丝竹空TE23),Yíngxiāng(迎香LI20),Dìcāng(地仓ST4),Jiāchē(颊车ST6) and Xiàguān(下关ST7),and the needle retention continued for 40 min.The treatment was applied once a day,and there was a 5-day treatment and a 2-day rest every week.One course of treatment included a week,and there were 4 courses of treatment in total.After treatment,the clinical efficacy of the patients was evaluated.Results:4 cases were cured,9 cases were effective,1 case was ineffective,and the effective rate was 92.9%.Conclusions:Acupuncture had a satisfactory clinical therapeutic effect on patients of Meige’s syndrome Ⅱ.