History of chronic gastritis:How our perceptions have changed

Currently,the diagnostic strategy for chronic gastritis(CG)is aimed not just at fixing the presence of gastric mucosal inflammation,but also at gastric cancer(GC)risk stratification in a particular patient.Modern classification approach with the definition of the stage of gastritis determines the need,activities and frequency of dynamic monitoring of a patient.However,this attitude to the patient suffering from CG was far from always.The present publication is a literature review describing the key milestones in the history of CG research,from the description of the first observations of inflammation of the gastric mucosa,assessment of gastritis as a predominantly functional disease,to the advent of endoscopy of the upper digestive tract and diagnostic gastric biopsy,assessment of the role of Helicobacter pylori infection in progression of inflammatory changes to atrophy,intestinal metaplasia,dysplasia and GC.

Urinary metabolic profiles during Helicobacter pylori eradication in chronic gastritis

BACKGROUND Helicobacter pylori(H.pylori)infection is a major risk factor for chronic gastritis,affecting approximately half of the global population.H.pylori eradication is a popular treatment method for H.pylori-positive chronic gastritis,but its mecha-nism remains unclear.Urinary metabolomics has been used to elucidate the mechanisms of gastric disease treatment.However,no clinical study has been conducted on urinary metabolomics of chronic gastritis.AIM To elucidate the urinary metabolic profiles during H.pylori eradication in patients with chronic gastritis.METHODS We applied LC–MS-based metabolomics and network pharmacology to in-vestigate the relationships between urinary metabolites and H.pylori-positive chronic gastritis via a clinical follow-up study.RESULTS Our study revealed the different urinary metabolic profiles of H.pylori-positive chronic gastritis before and after H.pylori eradication.The metabolites regulated by H.pylori eradication therapy include cis-aconitic acid,isocitric acid,citric acid,L-tyrosine,L-phenylalanine,L-tryptophan,and hippuric acid,which were involved in four metabolic pathways:(1)Phenylalanine metabolism;(2)phenylalanine,tyrosine,and tryptophan biosynthesis;(3)citrate cycle;and(4)glyoxylate and dicarboxylate metabolism.Integrated metabolomics and network pharmacology revealed that MPO,COMT,TPO,TH,EPX,CMA1,DDC,TPH1,and LPO were the key proteins involved in the biological progress of H.pylori eradication in chronic gastritis.CONCLUSION Our research provides a new perspective for exploring the significance of urinary metabolites in evaluating the treatment and prognosis of H.pylori-positive chronic gastritis patients.

Epidemiological and Histopathological Aspects of Chronic Gastritis at the Departmental University Teaching Hospital of Borgou Alibori (CHUD-BA) from 2011 to 2021

Background: Gastritis is better evaluated nowadays since the advent of upper gastrointestinal endoscopy. Despite the availability of this workup in Benin Republic, there is a scarcity of data on chronic gastritis. Objective: This work aimed to study the epidemiological and histopathological aspects of chronic gastritis in the Departmental University Teaching Hospital of Borgou Alibori (CHUD-B/A) from 2011 to 2021. Method: This was a retrospective cross-sectional study with descriptive and analytical purposes, carried out from February 23, 2022 to May 23, 2022, among patients who had undergone gastric biopsy and/or gastrectomy from January 2011 to January 2022 (10 year), and whose specimens were sent into the histopathology section of the CHUD-B/A. Non-probability sampling was performed with exhaustive recruitment. A survey form has been used to collect data from patients’ medical records. Pearson’s chi-square and Fisher’s exact tests have been used as appropriate to determine correlations between variables. Result: A total of 310 cases of chronic gastritis were diagnosed in the histopathology section of the CHUD-B/A from 2011 to 2021. This represented a chronic gastritis frequency of 91.45% for all gastric lesions diagnosed throughout the study period. Erythematous gastropathy was the most frequent (70.35%). Helicobacter pylori was present in 36.77% and dysplasia was observed in 12.26% of cases. Erythematous gastropathy was a predictive factor for the absence of gastric dysplasia in histopathology check up (p-value = 0.042). In contrast, intestinal metaplasia was predictive of the presence of gastric dysplasia in histopathology check up (p-value < 0.001). Conclusion: Chronic gastritis is very common in our setting. Systematic biopsy performance in front of an evocative clinical situation followed by histopathological examination may be encouraged.

Chinese herbal formula shen-ling-bai-zhu-san to treat chronic gastritis: Clinical evidence and potential mechanisms

BACKGROUND Chronic gastritis(CG) is an inflammatory disease of the gastric mucosa. Shenling-bai-zhu san(SLBZS), a traditional Chinese medicine formula, is widely used for treating CG. Nevertheless, its effects are currently unclear.AIM To determine the clinical evidence and potential mechanisms of SLBZS for the treatment of CG.METHODS We systematically searched 3 English(PubMed, Embase, Medline) and 4 Chinese databases(Cochrane Library Central Register of Controlled Trials, China National Knowledge Infrastructure database, Wanfang Data Knowledge Service Platform,and the VIP information resource integration service platform) without language or publication bias restriction. Qualified studies were selected according to pre-set inclusion and exclusion criteria. RevMan 5.3 software was used for meta-analysis and literature quality assessment, Stata 14.0 software was used for sensitivity analysis, GRADE profiler 3.6 was used to evaluate the quality of evidence. And then, network pharmacology analysis was applied to primary research the mechanisms of action of SLBZS on CG.RESULTS Fourteen studies were finally included, covering 1335 participants. Meta-analysis indicated that:(1) SLBZS was superior to conventional therapies [risk ratio(RR):1.29, 95% confidence interval(CI): 1.21 to 1.37, P < 0.00001];(2) SLBZS was better than conventional therapies [RR: 0.24, 95% confidence interval(95%CI): 0.11 to 0.55, P = 0.0007] in terms of recurrence rate and reversal of Helicobacter pylori positivity(RR: 1.20, 95%CI: 1.11 to 1.30,P < 0.00001);and(3) The safety of SLBZS for CG remains unclear. According to the GRADE method, the quality of evidence was not high. Besides, SNZJS might treat CG by acting on related targets and pathways such as EGFR tyrosine kinase inhibitor resistance, the PI3K-Akt signaling pathway, and others.CONCLUSION SLBZS might be useful in treating CG, but long-term effects and specific clinical mechanisms of it maintain unclear. More samples and high-quality clinical experiments should be assessed and verified in the next step.

Innate immunity–the hallmark of Helicobacter pylori infection in pediatric chronic gastritis

BACKGROUND Innate immunity was found to be associated with both persistence of Helicobacter pylori(H.pylori)infection and increased risk of gastric cancer.AIM To identify the risk factors associated with H.pylori infection and to establish the role of TLR9 rs352140 in suppressing or promoting inflammation related to this infection in children.METHODS We performed a study of 155 children with digestive symptoms,who were divided into two groups according to the histopathological exam:Group 1–48 children with H.pylori-induced chronic gastritis,and Group 2–control group.RESULTS Rural area and poor living conditions were significantly associated with H.pylori chronic gastritis(P=0.0042/P<0.0001).Both positive immunoglobulin A anti H.pylori and the rapid urease test were significantly associated with H.pylori infection(P<0.0001).Significantly higher values of leukocytes and neutrophils within the peripheral blood were found in children with H.pylori chronic gastritis(P=0.111/P=0.284).We found a significant positive correlation between the variant TT genotype of TLR9 rs352140 polymorphism and both leucocytes and neutrophils(P=0.0225/P=0.0292).CONCLUSION Variant TT genotype carriers of the TLR9 rs352140 gene polymorphism might have a more severe degree of inflammation.

Can chronic gastritis cause an increase in fecal calprotectin concentrations?

AIM:To evaluate fecal calprotectin concentrations(FCCs) in subjects with chronic gastritis and the correlation between FCCs and gastritis activity score.METHODS:FCCs were measured in 61 patients with histological diagnosis of gastritis and in 74 healthy volunteers.Histological grading of gastritis was performed according to the updated Sydney gastritis classification.Patients were subdivided into 2 groups according to the presence/absence of an active gastritis.Patients with chronic active gastritis were divided into 3 subgroups on the basis of the activity score(mild,moderate,marked).FFCs in relation to Helicobacter pylori(H.pylori) infection and proton pump inhibitor(PPI) use were also evaluated.RESULTS:FCCs in patients with chronic active gastritis were not significantly different to FCCs either in subjects with non active gastritis or in healthy controls.Among patients with chronic active gastritis(even marked),FCCs did not significantly differ according to activity score.No significant differences in FCCs were found when considering H.pylori,as well as when considering PPI chronic use.CONCLUSION:FCCs were not significantly increased in subjects with chronic gastritis,even in those patients with a marked neutrophil infiltration.

Dynamic observation of the progression of chronic gastritis to gastric cancer in a diseasee-TCM pattern rat model

Objective:To dynamically observe the progression of chronic gastritis to gastric cancer(GC)in diseasetraditional Chinese medicine(TCM)pattern rats to provide data for understanding the disease progression and effective approaches for drug screening and mechanism exploration.Methods:Wistar rats were randomly divided into control(n=96,half female and half male)and model(n=336,half female and half male)groups.Model rats received free access to N-methyl-N0-nitro-Nnitrosoguanidine(120 mg/mL),sodium deoxycholate(20 mmol/L),and alcohol(45%),and were subjected to intermittent fasting.Mortality rate,body weight,water consumption,food intake,gastric pathology,blood content analysis,and liver and kidney function of model rats were dynamically monitored over 30 weeks.In the 30th week,pattern characteristics were assessed.Gastric pathology and pattern characteristics were observed for an additional 8 weeks to evaluate stability.Results:The overall mortality of the model group was 34.82%(33.10%for females and 36.55%for males)at 30 weeks post-intervention.Inflammatory cell infiltration,glandular atrophy,atypical hyperplasia,and GC manifested successively in the gastric mucosa of rats.In model rats,N-methyl-N0-nitro-N-nitrosoguanidine intake was lower in males than in females,whereas pathological changes in the gastric mucosa occurred earlier in females than in males.Notably,gastric mucosal lesions were more severe in males than in females.Our modeling methods maintained stable gastric mucosal lesions for at least 8 weeks after final intervention.The pattern characteristics observed in model rats at the 30th and 38th week were consistent with those of spleen deficiency,blood stasis,and yin deficiency pattern.Blood content and indexes of liver and kidney function in the model group were normal.Conclusion:Our findings provide evidence for the pathological stages underscoring the progression of chronic gastritis to GC in disease-TCM pattern rats,which may facilitate development of relevant pharmacotherapies.

Xinli Wen's Experience in Treating Chronic Gastritis with Insomnia

Through reviews of chronic gastritis treatment literatures in the past 10 years,it has been found that most patients with chronic gastritis also have insomnia and other symptoms in addition to the manifestations of gastritis,in which modem medicine has found clear correlations between the two.In Professor Xinli Wen's practice,the professor believes that the pathogenesis of this disease is a mixture of cold and heat.In regard to treating the disease,the characteristic of"the desire to solve Jueyin disease"is well-grasped.Professor Wen emphasizes on the harmonization of the liver and spleen as well as the restrain from following the original prescription and application of its medicine.Therefore,she used Mume pill to increase and decrease the upper temperature and lower temperature in regulating cold and heat.

Clinical manifestation,lifestyle,and treatment patterns of chronic erosive gastritis:A multicenter real-world study in China

BACKGROUND Although chronic erosive gastritis(CEG)is common,its clinical characteristics have not been fully elucidated.The lack of consensus regarding its treatment has resulted in varied treatment regimens.AIM To explore the clinical characteristics,treatment patterns,and short-term outcomes in CEG patients in China.METHODS We recruited patients with chronic non-atrophic or mild-to-moderate atrophic gastritis with erosion based on endoscopy and pathology.Patients and treating physicians completed a questionnaire regarding history,endoscopic findings,and treatment plans as well as a follow-up questionnaire to investigate changes in symptoms after 4 wk of treatment.RESULTS Three thousand five hundred sixty-three patients from 42 centers across 24 cities in China were included.Epigastric pain(68.0%),abdominal distension(62.6%),and postprandial fullness(47.5%)were the most common presenting symptoms.Gastritis was classified as chronic non-atrophic in 69.9%of patients.Among those with erosive lesions,72.1%of patients had lesions in the antrum,51.0%had multiple lesions,and 67.3%had superficial flat lesions.In patients with epigastric pain,the combination of a mucosal protective agent(MPA)and proton pump inhibitor was more effective.For those with postprandial fullness,acid regurgitation,early satiety,or nausea,a MPA appeared more promising.CONCLUSION CEG is a multifactorial disease which is common in Asian patients and has non-specific symptoms.Gastroscopy may play a major role in its detection and diagnosis.Treatment should be individualized based on symptom profile.

Metabolic dynamics in chronic gastritis:Examining urinary profiles post Helicobacter pylori eradication

Chronic gastritis is the persistent and insidious inflammation of the gastric lining.Helicobacter pylori(H.pylori)has been identified as the most common cause of chronic gastritis and consequently elimination of H.pylori can lead to its cure.This editorial explores the use of urinary metabolic profiles before and after eradication to identify biomarkers that can aid in prognosis and treatment.Despite providing promising insights,there are limitations such as a small sample size(17 patients),a narrow treatment period of 2 wk,and treatment heterogeneity,which raise concerns.Nevertheless,these findings have opened a gateway to enhancing the treatment and prognosis of chronic gastritis through urinary metabolomics.

Prevalence and Factors Associated with Intestinal Metaplasia in Chronic Helicobacter pylori Gastritis in a Country with High Endemicity: Ivory Coast Case

Context/Objective: Few studies have been carried out in a country with high endemicity for Helicobacter pylori (H. pylori) infection in Sub-Saharan Africa looking for the association of intestinal metaplasia (IM) with chronic gastritis. We hypothesize that IM is correlated with the intensity of H. pylori infection in a country with high endemicity, Ivory Coast. The objective of this study was to determine the prevalence of intestinal metaplasia in chronic H. pylori gastritis in Ivory Coast. Methods: This was a prospective, cross-sectional, multicenter study, carried out over a period of 5 months, in the reference hospital centers of Abidjan, specialized in Gastroenterology. All patients who had undergone Gastroscopy with biopsies according to the criteria of the Sydney System for the anatomopathological study, those with chronic gastritis and/or H. pylori intestinal metaplasia on histology and in whom all the parameters of the Sydney system classification had been well informed. The quantitative variables were expressed by their means accompanied by their standard deviations and the qualitative variables by their numbers and percentages. Chi-square and Fischer tests were used to look for associations between variables. The significance level was set at 5%. Results: 152 patients were retained. The mean age was 44.9 ± 12.9 years. The prevalence of intestinal metaplasia was 11.8%. In univariate analysis, no significant association was found between clinical and pathological sociodemographic factors (age, sex, ethnicity, educational level, profession) and intestinal metaplasia in chronic Helicobacter pylori gastric cases. In multivariate analysis we found that prolonged use of Proton Pump Inhibitors (PPIs) and a history of Gastroesophageal Reflux Disease (GERD) were significantly associated with the absence of IM. Conclusion: Chronic H. pylori gastritis is the main risk factor for intestinal metaplasia. Prolonged use of PPIs and a history of GERD were significantly identified as factors that would protect against intestinal metaplasia.

Paradoxical association between dyspepsia and autoimmune chronic atrophic gastritis:Insights into mechanisms,pathophysiology,and treatment options

BACKGROUND Autoimmune gastritis(AIG)is a progressive,chronic,immune-mediated inflammatory disease characterized by the destruction of gastric parietal cells leading to hypo/anacidity and loss of intrinsic factor.Gastrointestinal symptoms such as dyspepsia and early satiety are very common,being second in terms of frequency only to anemia,which is the most typical feature of AIG.AIM To address both well-established and more innovative information and knowledge about this challenging disorder.METHODS An extensive bibliographical search was performed in PubMed to identify guidelines and primary literature(retrospective and prospective studies,systematic reviews,case series)published in the last 10 years.RESULTS A total of 125 records were reviewed and 80 were defined as fulfilling the criteria.CONCLUSION AIG can cause a range of clinical manifestations,including dyspepsia.The pathophysiology of dyspepsia in AIG is complex and involves changes in acid secretion,gastric motility,hormone signaling,and gut microbiota,among other factors.Managing dyspeptic symptoms of AIG is challenging and there are no specific therapies targeting dyspepsia in AIG.While proton pump inhibitors are commonly used to treat dyspepsia and gastroesophageal reflux disease,they may not be appropriate for AIG.Prokinetic agents,antidepressant drugs,and non-pharmacological treatments may be of help,even if not adequately evidence-based supported.A multidisciplinary approach for the management of dyspepsia in AIG is recommended,and further research is needed to develop and validate more effective therapies for dyspepsia.

Efficacy and safety of Huangqi Jianzhong decoction in the treatment of chronic atrophic gastritis:A meta-analysis

BACKGROUND Chronic atrophic gastritis is a persistent disorder of the digestive system where the gastric mucosa epithelium and glands undergo atrophy,leading to a decrease in their number and thinning of the gastric mucosa.It is worth noting that the prevalence of chronic atrophic gastritis is higher in China compared to the global average,and it is also considered a precancerous condition for gastric cancer.AIM To evaluate the efficacy of Huangqi Jianzhong decoction in treating chronic atrophic gastritis.Chronic atrophic gastritis is a persistent illness characterized by the progressive disappearance of healthy gastric glands due to repeated injury.Huangqi Jianzhong decoctions are widely used in China to treat chronic atrophic gastritis.However,there is limited scientific evidence regarding their efficacy in treating this illness.METHODS The present meta-analysis adhered to the PRISMA guidelines and used the Cochrane Collaboration methodology.We performed a comprehensive search for clinical trials investigating the use of Huangqi Jianzhong decoction in treating chronic atrophic gastritis published until January 2023.The risk of bias and the quality of the included studies were evaluated using the Cochrane Handbook guidelines.Finally,a meta-analysis was conducted using the RevMan 5.4 softRESULTS This study included a total of 13 articles,comprising 1269 samples.The meta-analysis was conducted on these 13 articles,yielding the following results:I2=0%,P=0.60,[RR=1.24,95%CI:1.18 to 1.30,P<0.00001].The forest plot analysis of the Helicobacter pylori clearance rate revealed I2=0%,P=0.36,[RR=1.20,95%CI:1.05 to 1.38,P=0.009].The forest plot of PG-I level showed I2=99%,P<0.00001,[MD=4.99,95%CI:-1.59 to 11.58,P=0.14].The forest plot of stomach pain demonstrated I2=54%,P=0.04,[MD=-0.63,95%CI:-0.68 to-0.58,P<0.00001].The forest plot of reflux indicated I2=82%,P=0.0009,[MD=-0.48,95%CI:-0.63 to-0.33,P<0.00001].The forest plot of recurrence rate exhibited I2=0%,P=0.92,[RR=0.15,95%CI:0.04 to 0.66,P=0.01].The forest plot of adverse reactions showed no heterogeneity in outcome data,[RR=1.07,95%CI:0.53 to 2.17,P=0.86].CONCLUSION This study demonstrated that Huangqi Jianzhong decoction improved various factors in adults with chronic atrophic gastritis.These factors included the total effective rate,Helicobacter pylori clearance rate,symptoms such as stomachache and acid reflux alleviation,and recurrence rates.

Chronic atrophic gastritis detection with a convolutional neural network considering stomach regions

BACKGROUND The risk of gastric cancer increases in patients with Helicobacter pylori-associated chronic atrophic gastritis(CAG).X-ray examination can evaluate the condition of the stomach,and it can be used for gastric cancer mass screening.However,skilled doctors for interpretation of X-ray examination are decreasing due to the diverse of inspections.AIM To evaluate the effectiveness of stomach regions that are automatically estimated by a deep learning-based model for CAG detection.METHODS We used 815 gastric X-ray images(GXIs)obtained from 815 subjects.The ground truth of this study was the diagnostic results in X-ray and endoscopic examinations.For a part of GXIs for training,the stomach regions are manually annotated.A model for automatic estimation of the stomach regions is trained with the GXIs.For the rest of them,the stomach regions are automatically estimated.Finally,a model for automatic CAG detection is trained with all GXIs for training.RESULTS In the case that the stomach regions were manually annotated for only 10 GXIs and 30 GXIs,the harmonic mean of sensitivity and specificity of CAG detection were 0.955±0.002 and 0.963±0.004,respectively.CONCLUSION By estimating stomach regions automatically,our method contributes to the reduction of the workload of manual annotation and the accurate detection of the CAG.

Histopathological classification and follow-up analysis of chronic atrophic gastritis

BACKGROUND The pathological diagnosis and follow-up analysis of gastric mucosal biopsy have been paid much attention,and some scholars have proposed the pathological diagnosis of 12 kinds of lesions and accompanying pathological diagnosis,which is of great significance for the treatment of precision gastric diseases,the improvement of the early diagnosis rate of gastric cancer,and the reduction of missed diagnosis rate and misdiagnosis rate.AIM To perform a histopathological classification and follow-up analysis of chronic atrophic gastritis(CAG).METHODS A total of 2248 CAG tissue samples were collected,and data of their clinical characteristics were also gathered.Based on these samples,the expression levels of Mucin 1(MUC1),MUC2,MUC5AC,and MUC6 in CAG tissue were tested by immunohistochemical assay.Moreover,we followed these patients for up to four years.The difference between different stages of gastroscopic biopsy was observed.RESULTS Through observation,it is believed that CAG should be divided into four types,simple type,hyperplasia type,intestinal metaplasia(IM)type,and intraepithelial neoplasia(IEN)type.Simple CAG accounted for 9.1%(205/2248),which was more common in elderly people over 60 years old.The main change was that the lamina propria glands were reduced in size and number.Hyperplastic CAG accounted for 29.1%(654/2248),mostly occurring between 40 and 60 years old.The main change was that the lamina propria glands were atrophy accompanied by glandular hyperplasia and slight expansion of the glands.IM CAG accounted for 50.4%(1132/2248),most of which increased with age,and were more common in those over 50 years.The atrophy of the lamina propria glands was accompanied by significant IM,and the mucus containing sialic acid or sulfate was distinguished according to the nature of the mucus.The IEN type CAG accounted for 11.4%(257/2248),which developed from the previous types,with severe gland atrophy and reduced mucus secretion,and is an important precancerous lesion.CONCLUSION The histological typing of CAG is convenient to understand the property of lesion,determine the follow-up time,and guide the clinical treatment.

Identifying the molecular basis of Jinhong tablets against chronic superficial gastritis via chemical profile identification and symptom-guided network pharmacology analysis

Chronic superficial gastritis(CSG)is a common disease of the digestive system that possesses a serious pathogenesis.Jinhong tablet(JHT),a traditional Chinese medicine(TCM)prescription,exerts therapeutic effects against CSG.However,the molecular basis of its therapeutic effect has not been clarified.Herein,we employed ultra-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry(UPLC-Q/TOF-MS)based chemical profile identification to determine the chemical components in JHT.Further,we applied network pharmacology to illustrate its molecular mechanisms.A total of 96 chemical constituents were identified in JHT,31 of which were confirmed using reference standards.Based on the bioinformatics analysis using the symptom-guided pharmacological networks of“chi,”“blood,”“pain,”and“inflammation,”and target screening through the interaction probabilities between compounds and targets,matrix metalloproteinase 2(MMP2),dopamine d2 receptor(DRD2),and Aldo-keto reductase family 1 member B1(AKR1B1)were identified as key targets in the therapeutic effect exhibited by JHT against CSG.Moreover,according to the inhibitory activities presented in the literature and binding mode analysis,the structural types of alkaloids,flavonoids,organic acids,including chlorogenic acid(10),caffeic acid(13),(-)-corydalmine(33),(-)-isocorypalmine(36),isochlorogenic acid C(38),isochlorogenic acid A(41),quercetin-3-O-a-L-rhamnoside(42),isochlorogenic acid B(47),quercetin(63),and kaempferol(70)tended to show remarkable activities against CSG.Owing to the above findings,we systematically identified the chemical components of JHT and revealed its molecular mechanisms based on the symptoms associated with CSG.

Evaluation of the Gastric Microbiome in Patients with Chronic Superficial Gastritis and Intestinal Metaplasia

Objective To evaluate the gastric microbiome in patients with chronic superficial gastritis(CSG)and intestinal metaplasia(IM)and investigate the influence of Helicobacter pylori(H.pylori)on the gastric microbiome.Methods Gastric mucosa tissue samples were collected from 54 patients with CSG and IM,and the patients were classified into the following four groups based on the state of H.pylori infection and histology:H.pylori-negative CSG(n=24),H.pylori-positive CSG(n=14),H.pylori-negative IM(n=11),and H.pylori-positive IM(n=5).The gastric microbiome was analyzed by 16S rRNA gene sequencing.Results H.pylori strongly influenced the bacterial abundance and diversity regardless of CSG and IM.In H.pylori-positive subjects,the bacterial abundance and diversity were significantly lower than in H.pylori-negative subjects.The H.pylori-negative groups had similar bacterial composition and bacterial abundance.The H.pylori-positive groups also had similar bacterial composition but different bacterial relative abundance.The relative abundance of Neisseria,Streptococcus,Rothia,and Veillonella were richer in the I-HP group than in G-HP group,especially Neisseria(t=175.1,P<0.001).Conclusions The gastric microbial abundance and diversity are lower in H.pylori-infected patients regardless of CSG and IM.Compared to H.pylori-positive CSG group and H.pylori-positive IM,the relative abundance of Neisseria,Streptococcus,Rothia,and Veillonella is higher in H.pylori-positive patients with IM than in H.pylori-positive patients with CSG,especially Neisseria.

Effects of Granule Dendrobii on chronic atrophic gastritis induced by N-methyl-N'-nitro-N-nitrosoguanidine in rats

BACKGROUND Dendrobium officinale is an herb of Traditional Chinese Medicine(TCM)commonly used for treating stomach diseases.One formula of Granule Dendrobii(GD)consists of Dendrobium officinale and American Ginseng(Radix Panacis quinquefolii),and is a potent TCM product in China.Whether treatment with GD can promote gastric acid secretion and alleviate gastric gland atrophy in chronic atrophic gastritis(CAG)requires verification.AIM To determine the effect of GD treatment on CAG and its potential cellular mechanism.METHODS A CAG model was induced by feeding rats N-methyl-N'-nitro-N-nitrosoguanidine(MNNG)for 12 wk.After oral administration of low,moderate,and high doses of GD in CAG rats for 8 wk,its effects on body weight,gastric mucosa histology,mucosal atrophy,intestinal metaplasia,immunohistochemical staining of proliferating cell nuclear antigen(PCNA)and B-cell lymphoma-2,and hemoglobin and red blood cells were examined.RESULTS The body weights of MNNG-induced CAG model rats before treatment(143.5±14.26 g)were significantly lower than that of healthy rats(220.2±31.20 g,P<0.01).At the 8th week of treatment,the body weights of rats in the low-,moderate-,and high-dose groups of GD(220.1±36.62 g)were significantly higher than those in the untreated group(173.3±28.09 g,all P<0.01).The level of inflammation in gastric tissue of the high-dose group(1.68±0.54)was significantly reduced(P<0.01)compared with that of the untreated group(3.00±0.00,P<0.05).The number and thickness of gastric glands in the high-dose group(31.50±6.07/mm,306.4±49.32μm)were significantly higher than those in the untreated group(26.86±6.41/mm,244.3±51.82μm,respectively,P<0.01 and P<0.05),indicating improved atrophy of gastric mucosa.The areas of intestinal metaplasia were significantly lower in the high-dose group(1.74%±1.13%),medium-dose group(1.81%±0.66%)and low-dose group(2.36%±1.08%)than in the untreated group(3.91%±0.96%,all P<0.01).The expression of PCNA in high-dose group was significantly reduced compared with that in untreated group(P<0.01).Hemoglobin level in the high-dose group(145.3±5.90 g/L),medium-dose group(139.3±5.71 g/L)and low-dose group(137.5±7.56 g/L)was markedly increased compared with the untreated group(132.1±7.76 g/L;P<0.01 or P<0.05).CONCLUSION Treatment with GD for 8 wk demonstrate that GD is effective in the treatment of CAG in the MNNG model by improving the histopathology of gastric mucosa,reversing gastric atrophy and intestinal metaplasia,and alleviating gastric inflammation.

Risk assessment models of integrative medicine indicators for malignant transformation of chronic atrophic gastritis:A registry study protocol

Objective:Traditional Chinese medicine(TCM)and modern medicine have both been used in arresting malignant transformation of chronic atrophic gastritis(CAG)in China with good therapeutic effect.However,no studies have been undertaken to assess the risk of malignant transformation in CAG patients using both modern medicine and TCM features.Our study aimed to develop risk assessment models for malignant transformation of CAG combining indicators of both TCM and modern medicine.These models will facilitate early warning and control of malignant transformation of CAG from the perspective of evidence-based integrative medicine.Methods:In the proposed registry study,a total of 1000 eligible CAG patients will be recruited from four hospitals in China.A 10-year follow-up study will be conducted both on-site and off-site to track the events of malignant transformation.Frequency analysis and chi-squared tests will be used to perform the comparative analysis on the prevalence of malignant transformation events and indicators in TCM or modern medicine in different groups.A multivariate Cox proportional hazard model will be used to perform correlation analyses of malignant transformation events and factors of TCM or modern medicine.Conclusion:The proposed study has been designed with a large sample size and long follow-up period,in which wide-ranging modern medicine and TCM indicators can be gathered over the whole process of malignant transformation of CAG.Based on this study,risk assessment models for malignant transformation ofCAGmaybe constructed fromthe perspective of integrative medicine.This may provide clinicians and patients with an optimized early warning system as well as prevention strategies for malignant transformation of CAG.

Efficacy of Shugan Hewei Therapy for Chronic Atrophic Gastritis:A Systematic Review and Meta-Analysis

Objective:Shugan Hewei therapy(SHT)acts to soothe the liver and harmonize the stomach.It is a classical traditional Chinese medicine method widely used in China to treat chronic atrophic gastritis(CAG)due to liver qi invading the stomach.However,the clinical effects of SHT remain unclear.We aimed to evaluate the overall clinical effective rate and safety of SHT in treating CAG.Methods:We used the Jadad scale and Cochrane Collaboration risk of bias tool to evaluate the methodological quality of studies investigating SHT.Eight medical databases were searched to identify relevant studies.After data extraction and quality evaluation,27 randomized controlled trials,including 2,441 patients,were considered eligible for analysis.No serious heterogeneity or publication bias was observed across the included studies.We used Revman 5.3 statistical software to evaluate the general clinical effective rate and safety of SHT.Results:The results showed that SHT was more effective(RR=1.25;95%CI[1.20,1.29];P<0.01)and safer(MD=0.24,95%CI[0.08,0.75];P<0.01)than control interventions comprising western medicine,Chinese patent medicine,and/or western medicine+Chinese patent medicine.Compared with the control interventions,SHT resulted in greater improvements in the symptom scores for stomach distension and stomachache,serum gastrin level,histopathologic changes,Helicobacter pylori(HP)inhibition rate,and gastric mucosal inflammation.Conclusion:SHT was more effective and safer than control interventions for CAG.