Expression of mutant type-p53 products in H pylori-associated chronic gastritis

AIM:To investigate the mutation of p 53 immuno-histochemically in non-tumorous gastric mucosa with H pylori infection before and after H pylori eradication therapy.METHODS:53 subjects(36 male,17 female,mean age ± SEM,57.1 ± 12.1)undergoing endoscopic examination were included in this study.42 of 53 patients were H pylori-positive,and 11 were H pylori-negative.All H pylori-positive patients had successful eradication therapy.Biopsy specimens were taken from five points of the stomach,as recommended by the updated Sydney system.Immunohistochemical studies were performed by using primary antibodies against p53(DO-7 and PAb240).RESULTS:p53(DO-7 and PAb240)immunoreactivity was shown in the neck region of the gastric pits,however,quite a few cells were found to be immunopositive for p 53(PAb240)in the H pylori-infected gastric mucosa.The proportion of patients immunopositive for p 53(PAb240)was significantly reduced 6 mo after eradication [28/42(66.7%)to 6/42(14.3%)](P < 0.05),while the biopsies taken from H pylori-negative patients showed no immunoreactivity for p53(PAb240).p53(PAb240)-positive patients were divided into two groups by the number of positive cells detected:one with more than six positive cells per 10 gastric pits(group A,n = 12),and the other with less than five positive cells per 10 gastric pits(group B,n = 30).Atrophy scores in group A were significant higher than those in group B at the greater curvature of the antrum(group A:2.00 ± 0.14 vs group B:1.40 ± 0.15,P = 0.012),the lesser curvature of the corpus(group A:2.00 ± 0.21 vs group B:1.07 ± 0.23,P = 0.017),and the greater curvature of the corpus(group A:1.20 ± 0.30vs group B:0.47 ± 0.21,P = 0.031).Group A showed significant higher intestinal metaplasia scores than group B only at the lesser curvature of the antrum(group A:2.10 ± 0.41 vs group B:1.12 ± 0.29,P = 0.035).CONCLUSION:H pylori-associated chronic gastritis expressed the mutant-type p53,which was significantly associated with more severe atrophic and metaplastic changes.H pylori eradication led to a significant reduction in the expression of the mutant-type p53.It is considered that H pylori-infected chronic gastritis is associated with a genetic instability that leads to gastric carcinogenesis,and H pylori eradication may prevent gastric cancer.

Direct measurement of gastric H^+/K^+-ATPase activities in patients with or without Helicobacter pylori-associated chronic gastritis

AIM: The role of Helicobacter pylori (H pylori) infection in gastric acid secretion of patients with chronic gastritisremains controversial. This study was designed to elucidate the effect of H pylori on H+/K+-ATPase activities in gastric biopsy specimens.METHODS: Eighty-two patients with chronic gastritis who had undergone upper endoscopy were included in this study. H pylori infection was confirmed by rapid urease test and histology. Gastric H+/K+-ATPase activities and serum gastrin concentrations were measured by an enzymatic method and radioimmunoassay, respectively. For those patients who received triple therapy for eradicating H pylori, changes in the activity of gastric H+/K+-ATPase and serum gastrin levels were also measured. RESULTS: The mean gastric H+/K+-ATPase activity in H pyloripositive group (42 patients) was slightly higher than thatin H pylori-negative group (29 patients) (169.65±52.9 and eradication of H pylori, the gastric H+/K+-ATPase activities slightly decreased compared to prior therapy (165.03±59.50 The mean basal gastrin concentration was slightly higher in H pylori-positive patients than in H pylori-negative patients (87.92±39.65 pg/mL vs75.04± 42.57 pg/mL, P= 0.228). The gastrin levels fell significantly after the eradication of Hpylori. (Before treatment 87.00±30.78 pg/mL, aftertreatment 64.73±18.96 pg/mL, P = 0.015).CONCLUSION: Gastric H+/K+-ATPase activities are not associated with H pylori status in patients with chronicgastritis.

Influence of H pylori on plasma ghrelin in patients without atrophic gastritis

AIM:To determine the association between H pylori infection and serum ghrelin levels in patients without atrophic gastritis.METHODS:Fifty consecutive patients(24 males and 26 females)with either H pylori-positive gastritis(n = 34)or H pylori-negative gastritis(n = 16)with normal gastric acid secretion determined by 24-h pHmetry and without atrophic gastritis in histopathology were enrolled in this study.Thirty-four H pylori-infected patients were treated with triple therapy consisting of a daily regimen of 30 mg lansoprazole bid,1 g amoxicillin bid and 500 mg clarithromycin bid for 14 d,followed by an additional 4 wk of 30 mg lansoprazol treatment.H pylori infection was eradicated in 23 of 34(67.6%)patients.H pylori-positive patients were given eradication therapy.Gastric acidity was determined via intragastric pH catethers.Serum ghrelin was measured by radioimmunoassay(RIA).RESULTS:There was no signifficant difference in plasma ghrelin levels between H pylori-positive and H pylori-negative groups(81.10 ± 162.66 ng/L vs 76.51 ± 122.94 ng/L).In addition,there was no significant difference in plasma ghrelin levels and gastric acidity levels measured before and 3 mo after the eradication therapy.CONCLUSION:H pylori infection does not influence ghrelin secretion in patients with chronic gastritis without atrophic gastritis.

Effects of bile reflux on gastric mucosal lesions in patients with dyspepsia or chronic gastritis

AIM: To investigate the influences of bile reflux on profiles of gastric mucosal lesions in patients with dyspepsia or chronic gastritis.METHODS: A total of 49 patients diagnosed with dyspepsia and chronic gastritis underwent 24-h ambulatory andsimultaneous monitoring of intragastric bilirubin absorbance and pH values, and then they were divided into bile refluxpositive group and bile reflux negative group. Severity of pathological changes in gastric mucosa including activeinflammation, chronic inflammation, intestinal metaplasia, atrophy and dysplasia as well as Helicobacter pylori (H pylori) infection at the corpus, incisura and antrum were determined respectively according to update Sydney system criteria. The profiles of gastric mucosal lesions in the two groups were compared, and correlations between time-percentage of gastric bilirubin absorbance ＞0.14 and severity of gastric mucosal lesions as well as time-percentage of gastric pH ＞4 were analyzed respectively. RESULTS: Thirty-eight patients (21 men and 17 women, mean age 44.2 years, range 25-61 years) were found existing with bile reflux (gastric bilirubin absorbance ＞0.14) and 11 patients (7 men and 4 women, mean age 46.2 years,range 29-54 years) were bile reflux negative. In dyspepsia patients with bile reflux, the mucosal lesions such as active inflammation, chronic inflammation, intestinal metaplasia, atrophy or H pylori infection in the whole stomach, especially in the corpus and incisura, were significantly more severe than those in dyspepsia patients without bile reflux. Moreover, the bile reflux time was well correlated with the severity of pathological changes of gastric mucosa as well as H pylori colonization in the near-end stomach, especially in the corpus region. No relevance was found between the time of bile reflux and pH ＞4 in gastric cavity. CONCLUSION: Bile reflux contributes a lot to mucosal lesions in the whole stomach, may facilitate H pylori colonization in the corpus region, and has no influence on acid-exposing status of gastric mucosa in patients with dyspepsia or chronic gastritis.

Red wine and green tea reduce H pylori- or VacA-induced gastritis in a mouse model

AIM: To investigate whether red wine and green tea could exert anti-H pylori or anti-VacA activity in vivo in a mouse model of experimental infection.METHODS: Ethanol-free red wine and green tea concentrates were administered orally as a mixture of the two beverages to H pylori infected mice, or separately to VacA-treated mice. Gastric colonization and gastric in? ammation were quantifi ed by microbiological, histopathological, and immunohistochemical analyses. RESULTS: In H pylori -infected mice, the red wine and green tea mixture significantly prevented gastritis and limited the localization of bacteria and VacA to the surface of the gastric epithelium. Similarly, both beverages significantly prevented gastric epithelium damage in VacA-treated mice; green tea, but not red wine, also altered the VacA localization in the gastric epithelium. CONCLUSION: Red wine and green tea are able to prevent H pylori -induced gastric epithelium damage, possibly involving VacA inhibition. This observation supports the possible relevance of diet on the pathological outcome of H pylori infection.

Prevalence of H pylori associated 'high risk gastritis' for development of gastric cancer in patients with normal endoscopic findings

AIM: To investigate the prevalence of H pylori associated corpus-predominant gastritis (CPG) or pangastritis, severe atrophy, and intestinal metaplasia (IM) in patients without any signifi cant abnormal fi ndings during upper- GI endoscopy. METHODS: Gastric biopsies from 3548 patients were obtained during upper GI-endoscopy in a 4-year period. Two biopsies from antrum and corpus were histologically assessed according to the updated Sydney-System. Eight hundred and forty-fi ve patients (mean age 54.8 ± 2.8 years) with H pylori infection and no peptic ulcer or abnormal gross fi ndings in the stomach were identifi ed and analyzed according to gastritis phenotypes using different scoring systems. RESULTS: The prevalence of severe H pylori associated changes like pangastritis, CPG, IM, and severe atrophy increased with age, reaching a level of 20% in patients of the age group over 45 years. No differences in frequencies between genders were observed. The prevalence of IM had the highest increase, being 4-fold higher at the age of 65 years versus in individuals less than 45 years. CONCLUSION: The prevalence of gastritis featuring at risk for cancer development increases with age. These findings reinforce the necessity for the histological assessment, even in subjects with normal endoscopic appearance. The age-dependent increase in prevalence of severe histopathological changes in gastric mucosa, however, does not allow estimating the individual risk forgastric cancer development-only a proper follow-up can provide this information.

Furazolidone-based triple therapy for H pylori gastritis in children

AIM: To evaluate the furazolidone-based triple therapy in children with symptomatic H pylori gastritis.METHODS: A prospective and consecutive open trial was carried out. The study included 38 patients with upper digestive symptoms suffi ciently severe to warrant endoscopic investigation. H pylori status was defined based both on histology and on positive 13C-urea breath test. Drug regimen was a seven-day course of omeprazole, clarithromycin and furazolidone (100 mg, 200 mg if over 30 kg) twice daily. Eradication of H pylori was assessed two months after treatment by histology and 13C-urea breath test. Further clinical evaluation was performed 7 d, 2 and 6 mo after the treatment. RESULTS: Thirty-eight patients (24 females, 14 males) were included. Their age ranged from 4 to 17.8 (mean 10.9 ± 3.7) years. On intent-to-treat analysis (n = 38), the eradication rate of H pylori was 73.7% (95% CI, 65.2%-82%) whereas in per-protocol analysis (n = 33) it was 84.8% (95% CI, 78.5%-91%). All the patients with duodenal ulcer (n = 7) were successfully treated (100% vs 56.2% with antral nodularity). Side effects were reported in 26 patients (68.4%), mainly vomiting (14/26) and abdominal pain (n = 13). Successfully treated dyspeptic patients showed improvement in 78.9% of H pylori-negative patients after six months and in 50% of H pylori-positive patients after six months of treatment.CONCLUSION: Triple therapy with furazolidone achieves moderate effi cacy in H pylori treatment. The eradicationrate seems to be higher in patients with duodenal ulcer.

Gastritis: Sociodemographic, Clinical, Endoscopic and Histological Aspects, about 593 Cases at the Digestive Endoscopy Unit of the General Hospital Idrissa Pouye

Introduction: Gastritis is a very common and widely distributed condition worldwide. It represents one of the most common pathological entities in gastroenterology and digestive endoscopy. Our objective was to determine the sociodemographic, clinical, endoscopic, and histological aspects of gastritis in the digestive endoscopy unit of the General Hospital Idrissa Pouye (GHIP). Materials and Method: This was a retrospective study over a period of 4 years (from 1 January 2014 to 31 December 2017) at the digestive endoscopy unit of GHIP. We had collated oesogastroduodenal endoscopy (EGDE) reports with gastritis appearance with gastric biopsies and reports with normal stomach appearance with gastric biopsies and their histological reports. We collected and analyzed data on age, gender, indications for endoscopy, endoscopic findings and histological results. Results: The reports of 593 patients were analyzed. The mean age was 45 years old (range 8 - 88 years old) and the sex ratio was 0.63 (230 men). The indications for endoscopy were epigastralgia in (91%) of cases, dyspepsia in (22%) of cases, pyrosis in (12%) of cases. The endoscopic appearance was normal in 229 patients (39%). The endoscopic location of the gastritis was antral in 76%, fundic in 22% and pangastric in 2%. The gastritis was erythematous in 327 patients (90%), erosive in 126 patients (35%), congestive in 53 patients (15%), pseudonodular in 14 patients (4%) and atrophic in 10 patients (3%). Histology was normal in 8 patients (1.3%) and showed gastritis in 585 patients (98.7%). Gastritis was chronic in 575 patients (98.2%), acute in 10 patients (1.7%). Gastritis activity was moderate in (52.7%) and mild in (42.9%). Atrophy was absent in 521 patients (88.6%) and mild in 46 patients (8.2%). Intestinal metaplasia was found in 66 patients (11%). Dysplasia was present in 1.7% of cases. This dysplasia was intermediate grade (60%) in 6 patients, low grade (20%) in 2 patients and severe grade (20%). H. pylori was present in 404 patients (68%). Conclusion: Gastritis is usually found in the digestive endoscopy unit of the GHIP. The indications for endoscopy are dominated by epigastralgia and histology is necessary for its diagnosis.

Effects of Chaihu Guizhi Ganjiang Decoction Combined with Standard Triple Therapy on Reducing Serum CagA and Hp-NAP in Patients with H.pylori-Related Gastritis

OBJECTIVE: To explore the effects of Chaihu Guizhi Ganjiang Decoction combined with standard triple therapy on treating H.pylori-related gastritis. METHODS: Eighty-two patients with H. pylori-related gastritis treated in our hospital from January 2016 to December 2017 were selected according to the random number table method and divided into experimental group and control group, with 41 patients in each group. The control group was treated with standard triple therapy, while the experimental group was additionally treated with modified Chaihu Guizhi Ganjiang Decoction. The venous blood of one elbow was taken before and after treatment. The concentrations of serum CagA and Hp-NAP were detected by enzyme-linked immunosorbent assay(ELISA). The symptoms were evaluated according to the change of symptom scores before and after the intervention. The H.pylori eradication rate was calculated. RESULTS: There was no significant difference in CagA and Hp-NAP concentrations between the 2 groups before intervention(P > 0.05). After intervention, CagA and Hp-NAP concentrations in experimental group were(19.21±6.27) ng/L and(24.37±6.10) ng/L respectively which were lower than(25.81±7.14) ng/L and(32.09±5.73) ng/L of control group. The differences were statistically significant(P < 0.05). The total effective rate of major symptoms in experimental group was 39 cases(95.12%), which was significantly higher than that of the control group(31 cases, 75.61%). There was statistically significant difference between the 2 groups(P < 0.05). The eradication rate of H.pylori was 38 cases(92.68%) in the experimental group, which was significantly higher than 31 cases(75.61%) of the control group. The difference between the 2 groups was statistically significant(P < 0.05). CONCLUSION: Chaihu Guizhi Ganjiang Decoction combined with standard triple therapy can effectively reduce CagA, Hp-NAP of serum level in patients with H.pylori-related gastritis, improve efficacy of symptoms and eradication rate of H.pylori, and is worthy of clinical promotion.

小剂量奥美拉唑联合瑞巴派特治疗Helicobecter pylori相关慢性浅表性胃炎临床研究

目的评价小剂量奥美拉唑（0）联用瑞巴派特（R）对H．pylori相关性慢性浅表性胃炎的临床症状、内镜下黏膜变化及组织学炎症改善作用。方法采用随机平行对照临床研究。将96例H．pylori感染的慢性浅表性胃炎患者，随机分为OR组（32例）、0组（32例）、R组（32例）。治疗第1周，3组均予H．pylori根除三联方案。第2～6周，0组予洛赛克MUPS10mg每日1次13服；R组予膜固思达100mg每日3次口服；OR组予MUPS10mg每日1次口服，联合膜固思达100mg每日3次口服。结果治疗结束，3组临床症状改善均有显著性变化。OR组、0组临床症状改善均比R组显著。第6周末复查胃镜，镜下黏膜情况3组差异无统计学意义；OR组、R组组织学炎症消退均比0组明显。结论治疗H．pylori相关性慢性浅表性胃炎，小剂量奥美拉唑联合瑞巴派特，比两药单用能够更好缓解临床症状。促进炎症消退。

SD大鼠H.pylori感染胃炎模型的建立

目的尝试在SPF级SD大鼠胃内定植H.pylori,以建立大鼠H.pylori感染胃炎模型。方法选用SD大鼠30只,随机分为5组,即对照组及4个模型组,模型组分别予NaHCO3溶液、56%酒精、消炎痛溶液、NaHCO3+消炎痛溶液联合H.pylori菌液灌胃造模,灌胃隔天1次,连续5次,并于最后一次灌胃结束后第2、4、6周处死大鼠,取胃黏膜组织分别记录损伤指数、进行快速尿素酶试验、胃黏膜涂片及病理切片。结果每组大鼠数、快速尿素酶试验及革兰染色阳性数:NaHCO3溶液+H.pylori组分别为6、4、4,56%酒精+H.pylori组分别为6、6、1,消炎痛溶液+H.pylori组分别为5、4、4,NaHCO3+消炎痛溶液+H.pylori组分别为4、4、4。损伤指数及病理切片:对照组胃黏膜形态正常,无损伤,各模型组胃黏膜肉眼观察均有不同程度的损伤,病理切片观察第2周有少量淋巴细胞浸润,第4周大量淋巴细胞及中性粒细胞浸润,腺体破坏,为活动性胃炎,第6周有大量淋巴细胞及中性粒细胞浸润,但损伤无进行性加重。结论 4种造模方式均可使H.pylori在SPF级大鼠胃内定植,定植时间至少长达6周,并能导致胃黏膜炎性损伤,损伤在第4周时最为严重,但以NaHCO3+消炎痛溶液+H.pylori造模最为成功,值得推广。

成都地区儿童消化道疾病及HLA-DQB1多态性分析

目的:对行胃镜检出的慢性胃炎患儿行H.pylori检查,分析其检查阳性和阴性患儿的HLA-DQB1等位基因的遗传多态性。方法:病例对照法研究H.pylori阳性和阴性患儿,采用PCR-SSO杂交方法确定HLA-DQB1等位基因型别,病例对照为健康儿童。结果:胃镜检查242例,有上消化道疾病患儿222例,占91.74%。对86例慢性胃炎者行H.pylori检查,阳性57例,占66.28%;阳性患儿DQB1*0602等位基因阳性率低于阴性患儿(χ2=6.97,P<0.01),阳性健康儿DQB1*03032阳性率低于阴性健康儿(χ2=6.97,P<0.01)。结论:胃镜检查儿童上消化道疾病以慢性胃炎为主,H.pylori感染率超过2/3。DQB1*03032和DQB1*0602可能是抵抗H.pylori感染和相关性胃炎的遗传保护因素。

灭幽汤对Hp相关性胃炎“脾胃湿热证”模型小鼠HSP70表达的影响

目的观察灭幽汤对Hp相关性胃炎"脾胃湿热证"模型小鼠热休克蛋白70(HSP70)蛋白及其mRNA的影响。方法采用复合因素(肥甘食物+湿热环境+幽门螺杆菌)建立BALB/c小鼠Hp相关性胃炎"脾胃湿热证"模型,造模成功后将小鼠随机分为5组:高浓度灭幽汤组、低浓度灭幽汤组、胃三联组(替硝唑+克拉霉素+枸橼酸铋钾颗粒)、模型组、对照组。连续给药14 d后,分别采用Western Blot和qPCR检测HSP70蛋白、HSP70 mRNA的表达情况。结果 HSP70蛋白及其mRNA的表达:BALB/c小鼠模型组与对照组比较,HSP70蛋白、HSP70 mRNA表达均增加(P<0.01);与模型组比较,高、低浓度灭幽汤组,胃三联组小鼠HSP70蛋白、HSP70 mRNA表达均增加(P<0.01);胃三联组与高、低浓度灭幽汤组中HSP70蛋白HSP70 mRNA表达均增加(P<0.05)。结论灭幽汤可能通过上调HSP70蛋白及其mRNA表达而发挥治疗Hp相关性胃炎的作用。

天麻钩藤饮治疗老年慢性萎缩性胃炎合并H型高血压60例

目的探讨天麻钩藤饮治疗慢性萎缩性胃炎合并H型高血压老年患者的临床疗效。方法选取医院收治的慢性萎缩性胃炎合并H型高血压老年患者120例,按随机数字表法分为对照组和试验组,各60例。对照组患者给予奥美拉唑、果胶铋、依那普利叶酸片治疗,试验组患者在对照组基础上,给予天麻钩藤饮,4周为1个疗程,两组患者均治疗1个疗程。结果治疗后,试验组24 h平均舒张压、24 h平均收缩压均较对照组明显降低(P<0.05);试验组降压总有效率为83.33%,明显高于对照组的68.33%(P<0.05);两组同型半胱氨酸治疗后较治疗前均有所下降,且试验组下降更明显(P<0.05);试验组治疗胃炎总有效率为75.00%,明显高于对照组的60.00%(P<0.05)。结论天麻钩藤饮治疗慢性萎缩性胃炎合并H型高血压老年患者疗效确切,值得临床推广。

大剂量细小病毒H-1静脉接种后导致猕猴出血性胃窦炎、结肠炎

目的：观察股静脉接种细小病毒Ｈ－１对猕猴的毒副作用，为今后作为抗肿瘤制剂使用提供依据。方法：采用３只健康猕猴（简称Ｍ１、Ｍ２、Ｍ３）经股静脉接种ＰＶＨ－１ １×１０~9ｐｆｕ， Ｍ２在第一次给病毒１４天后重复给一次，Ｍ１和Ｍ３只接种一次。动态观察动物一般状况、肝肾功能，并在２个多月时作有关脏器的病理检查。结果表明：动物接种ＰＶＨ－１后两个月内一般状况如常，未见有明显病毒血症样症状。Ｍ１、Ｍ２于病毒接种后第５７天和６５天分别出现消化道出血，其中ＭＩ给予抗生素治疗后很快得到了控制，Ｍ３在所观察的时间内看上去健康，未见有明显异常症状。解剖动物发现：Ｍ１胃肠道粘膜完全正常；Ｍ２、Ｍ３经病毒接种后消化道粘膜充血糜烂集中分布于胃窦和结肠，而且Ｍ２病变重于Ｍ３。血清ＡＬＴ在动物病毒接种后６０天时呈上升趋势。光镜下心、肺、肾、脑、小肠、牌和胰腺未见有明显形态上改变，部分肝细胞肿胀，胞浆疏松，少数呈气球样变性。结论：大剂量ＰＶＨ－１静脉接种后可导致猕猴出血性胃炎、结肠炎。

Dyslipidemia and H pylori in gastric xanthomatosis

AIM: To investigate the relationship among gastric xanthomatosis (GX), H pylori, dyslipidemia, and gastritis in Korea, a well-known H pylori endemic area. METHODS: A total of 771 patients who had undergone gastroduodenoscopy by one endoscopist were included in this study. Among them, 54 patients with GX were assessed for H pylori infection and their endoscopic characteristics and serum lipid profiles. The findings were compared with 54 age-and sex-matched control subjects without GX. RESULTS: The prevalence of GX was 7% (54/771) with no sex difference. GX was mainly single (64.8%) and located in the antrum (53.7%). The mean diameter was 7 ± 3 mm. Mean body mass index (BMI) of patients with GX was 23.1 ± 2.8 and no one was above 30. Compared with the controls, lipid profiles of GX group showed significantly lower HDL-cholesterol (48.8 ± 12.3 vs 62.9 ± 40.5, P = 0.028) and higher LDL-cholesterol (112.9 ± 29.9 vs 95.9 ± 22.4, P = 0.032). The level of total serum cholesterol, triglyceride and the existence of dyslipoproteinemia were not related to the presence of GX. However, GX showed a close relationship with endoscopically determined atrophic gastritis and histologic severity (24/53, 44.4% vs 8/54, 14.8%, P = 0.0082). H pylori infection and bile reflux gastritis were not significantly related with GX. CONCLUSION: The prevalence of GX is 7% and it may be an increasing entity in Korea. Moreover, dyslipidemia and atrophic gastritis are found to be related to GX, but H pylori infection is not.

慢性萎缩性胃炎胃黏膜癌前病变病理变化与中医证型及Hp的相关性研究

目的:观察慢性萎缩性胃炎(CAG)癌前病变的病理变化与中医证型及幽门螺杆菌(Hp)的相关性。方法选取内镜确诊为慢性萎缩性胃炎及病理确诊为慢性萎缩性胃炎伴异型增生或肠上皮化生患者317例,并进行Hp检测及中医证型辨证,分析CAG的病理变化与中医证型及Hp的相关性。结果:1.萎缩性胃炎癌前病变中医证型按照所占比率排序为脾胃虚气滞型>脾胃湿热>脾胃虚弱>肝胃不和>胃阴不足>胃络瘀阻。2.中医各证型与Hp感染的相关性分析研究结果显示:6种证型在Hp的阳性感染方面差异有显著性。以胃阴不足及胃络瘀阻型为最低与其它各型间差异有显著性(P<0.05)。Hp在本次研究中的阳性感染率为45.1%。3.中医辨证各型与胃黏膜病理改变的相关性分析表明:①同一证型在不同程度肠上皮化生分布上具有非常显著性差异(P<0.01),不同证型在同一程度肠上皮化生差异有显著性(P<0.05)。②各证型在轻度异型增生分布上无显著性差异,在中重度分布上差异有显著性(P<0.05),且以脾胃虚弱、胃阴不足及胃络瘀阻3型在重度异型增生时较高。③各证型在轻、中、重度萎缩程度分布上具有显著性差异;轻度萎缩时排序为肝胃不和、脾虚气滞、、脾胃湿热、胃阴不足、胃络瘀阻,各证型间有显著性差异(P<0.05);中度萎缩在脾胃湿热和胃络瘀阻、脾胃虚弱较高,与其他证型间有显著性差异;重度以胃阴不足及胃络瘀阻较高,与其他证型之间有非常显著性差异(P<0.01)。结论:萎缩性胃炎癌前病变与中医证型之间及Hp之间存在一定相关性,轻度时以实证为主,中度时以虚实夹杂为主,重度时以虚及瘀为主。本研究为该病发病机理及治疗提供理论依据。

H pylori infection causes chronic pancreatitis in Mongolian gerbils

AIM: To investigate whether chronic H pylori infection has the potential to induce pancreatitis in the Mongolian gerbil model, and whether it is dependent on an intact type Ⅳ secretion system. METHODS: Mongolian gerbils were infected with wild type (WT) H pylori typeⅠstrain B128 or its isogenic mutant B128 ?cagY (defective type Ⅳ secretion). After seven months of infection, H pylori was reisolated from antrum and corpus and H pylori DNA was analyzed by semi- nested polymerase chain reaction (PCR). Inflammation and histological changes were documented in the gastric antrum, corpus, and pancreas by immunohistochemistry. Cytokine mRNA, gastric pH, plasma gastrin, amylase, lipase, and glucose levels were determined. RESULTS: The H pylori infection rate was 95%. Eight infected animals, but none of the uninfected group, developed transmural inflammation and chronic pancreatitis. Extensive interstitial fibrosis and inflammation of the pancreatic lobe adjacent to the antrum was confirmed by trichrome stain, and immuno- histochemically. Pro-inflammatory cytokine mRNA was significantly increased in the antral mucosa of all infected gerbils. In the corpus, only cytokine levels of WT-infected animals and those developing transmural inflammation and pancreatitis were significantly increased. Levels of lipase, but not glucose or amylase levels, were significantly reduced in the pancreatitis group. H pylori DNA was detected in infected antral and corpus tissue,but not in the pancreas. CONCLUSION: H pylori infection is able to induce chronic pancreatitis in Mongolian gerbils independently of the type Ⅳ secretion system, probably by an indirect mechanism associated with a penetrating ulcer.

Causal role of Helicobacter pylori infection and eradication therapy in gastric carcinogenesis

许多流行病学的报告显示感染玩的那 Helicobacter pylori (H pylori ) 在胃的致癌作用的一个重要角色。几基因、渐成说的改变以一种多步方式贡献癌症房间的开始，提升，和前进。H pylori 被知道在胃粘膜导致慢性炎。包括超级氧化物，它的产品参予开始跟随的 DNA 损坏，并且导出发炎的 cytokines 和生长因素贡献胃的致癌作用的提升。由根除 H pylori，胃的发炎能被治好；治疗减少不仅煽动性的房间渗入，而且 atrophy/intestinal 组织变形的层次部分地。使随机化的控制试用表明根除治疗减少了在没有癌症前期的条件的情况中的胃的癌症流行。另外，从日本组的最近的流行病学的研究证明特别肠的类型，胃的癌症的发展被成功的根除治疗减少，尽管这些以一种非使随机化的方式被设计。然而，内视镜的察觉是评估胃的致癌作用的度的唯一的方法，这应该被提及。我们报导了内视镜、组织学的形态学能被根除治疗修改，它可能贡献胃的癌症开发的流行。就癌症房间增长的生物性质而言，足够地长期的后续将是必要的讨论根除治疗的反癌症效果，这被考虑。

Effects of the myeloperoxidase 463 gene polymorphisms on development of atrophy in H pylori infected or noninfected gastroduodenal disease

AIM: To investigate the relationship between myelo- peroxidase polymorphisms as a host-related factor and atrophy caused by H pylori. METHODS: Our study enrolled 77 patients. Biopsy materials obtained during gastrointestinal endoscopies were evaluated for the presence of H pylori. Polymerase chain reaction-restriction fragment length polymorphism assay was used to characterize myeloperoxidase genotypes. RESULTS: Forty four patients (57.1%) were Hp (+) and 33 (42.9%) were Hp (-). Sixty six (85.7%) had GG genotype, 10 (12.9%) had GA genotype and 1 (1.29%) had AA genotype. The change in atrophy in relation to neutrophil infiltration was significant in Hp (+) patients (P = 0.0001). The change in atrophy in relation to neutrophil infiltration in patients with GG genotype was significant (P = 0.002). However, the change in atrophy in relation to neutrophil infiltration was not significiant in patients with Hp (+) GG genotype (r = 0.066, P = 0.63). CONCLUSION: Myeloperoxidase genotype is critical for development of atrophy in relation to the severity of inflammation. However, it is interesting to note that, H pylori does not show any additive effect on development of atrophy.