How labile is gastric infection with Hpylori?

It is known that patients infected with H pylori can spontaneously become free from infection, and that the reverse change can occur. The time-scale of these conversions is expressed as percentages per year. Since they have been investigated in terms of serology, the changes are called sero-reversion and sero-conversion respectively. Using serological evidence to investigate these phenomena is open to the criticisms that positive serology can be present in the absence of all other evidence of infection, and that a time-lag of 6-12 mo or longer can occur between eradication of the infection and sero-reversion. Investigations using direct evidence of current infection are sparse. The few that exist suggest that some individuals can seroconvert or sero- revert within six to twelve weeks. If these findings are confirmed, it means that some patients have an ability that is variable in time to resist, or spontaneously recover from, H pylori infection. Evidence suggests that the deciding factor of susceptibility is the level of gastric secretion of acid.

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

AIM： To compare the one-day quadruple therapy with a standard 7-d triple therapy for H pylori eradication in a rural population of China. METHODS： A total of 396 patients with 13C-urea breath test positive for H pylori were assigned into two groups： 239 patients received one-day quadruple therapy （amoxicillin 2000 mg qid; metronidazole 500 mg qid; bismuth citrate 900 mg qid and lansoprazole 60 mg once daily） and 157 patients received 7-d standard triple therapy （amoxicillin 1000 mg bid; clarithromycin 500 mg bid and lansoprazole 30 mg bid）. All the patients underwent a 13C-UBT to assess the eradication of Hpylori infection six weeks after treatment. RESULTS： Two hundred and twenty-nine patients completed the one-day therapy （95.8%） and 148 patients completed the 7-d therapy （94.2%）. The oneday therapy eradicated H pylori infection in 64 patients （27.95%）. In contrast, 103 patients （69.59%） were Hpylori negative after the 7-d therapy （P 〈 0.01）. CONCLUSION： This pilot study suggests there is no beneficial effect of the one-day therapy in treatment ofHpylori infection compared with the 7-d standard therapy.

Non-invasive diagnosis of H pylori infection: Evaluation of serological tests with and without current infection marker CIM

AIM:To evaluate the performance of commercially available immunochromatographic (ICT) and immunoblot tests covering the current infection marker CIM and conventional ELISA for the diagnosis of H pylori infection in adult dyspeptic patients. METHODS:Consecutive non-treated dyspeptic patients undergoing diagnostic endoscopy were tested for H pylori infection by culture, rapid urease test, and histology of gastric biopsy specimens. Serum from 61 H pylori infected and 21 non-infected patients were tested for anti-H pylori IgG antibodies by commercial ELISA (AccuBindTM ELISA, Monobind, USA), ICT (Assure H pylori Rapid Test, Genelabs Diagnostics, Singapore), and immunoblot (Helico Blot 2.1, Genelabs Diagnostics, Singapore) assays. ICT and immunoblot kits cover CIM among other parameters and their performance with and without CIM was evaluated separately. RESULTS:Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of ELISA were 96.7%, 42.8%, 83.1%, 81.8%, and 82.9%, of ICT were 90.1%, 80.9%, 93.2%, 73.9%, and 87.8%, of ICT with CIM were 88.5%, 90.4%, 96.4%, 73.0%, and 89.0%, of immunoblot were 98.3%, 80.9%, 93.7%, 94.4%, and 93.9%, and of immunoblot with CIM were 98.3%, 90.4%, 96.7%, 95.0%, and 96.3%, respectively. CONCLUSION:Immunoblot with CIM had the best performance. ICT with CIM was found to be more specific and accurate than the conventional ELISA and may be useful for non-invasive diagnosis of H pylori infection.

Awareness and attitudes regarding Helicobacter pylori infection among university students:a national cross-sectional survey

Helicobacter pylori(H.pylori)infection is one of the most common chronic bacterial infections all over the world.University students are a group with strong comprehensive ability.Their cognition and behavior can exert great impact on society.However,up to now,reports on the awareness and attitudes regarding H.pylori infection among university students are scarce.This study aimed to survey dietary,habits,knowledge,and attitudes towards H.pylori infection.A total of 5794 participants,including undergraduates,postgraduates,and doctoral students,were recruited from the top 100 universities in China.A selfconstructed questionnaire was used to assess the knowledge and attitudes of students toward H.pylori infection and its impact.In our study,most of the population preferred dining in the canteen(69.6%),whereas 20.6% chose restaurants or takeaway.Up to 24.1% of the respondents had at least one lifestyle habit associated with H.pylori colonization.Almost half had at least one digestive symptom related to H.pylori infection.Most students were aware of its association with gastritis(84.4%)and peptic ulcer(86.6%).However,only half of them were aware of its association with gastric cancer(57.9%).Furthermore,only 14.1% of the respondents had been tested for H.pylori,and 25.1% of them tested positive.The H.pylori-detection rate was higher in Hunan province compared with Guangdong and Jilin provinces.Regarding knowledge of H.pylori,65.4% of the respondents had known about it,and 24.3% correctly answered all questions.When comparing the acquisition of H.pylori knowledge between tested and untested students,32.5% of the tested participants answered all questions correctly,which was significantly higher than the untested group(13.1%).There was no significant difference between genders in H.pylori knowledge and detection.University students are highly educated population.If they were fully aware of the harm of H.pylori infection,their parents,friends,and even future families would benefit,thus reducing the incidence of H.pylori infection,as well as gastric cancer and healthcare finances.This survey not only investigated but also spread the awareness of H.pylori among university students,which is of great medical,economic and sociological importance.

煤矿工人胃部有关疾病与Hpylori感染及相关因素的调查

目的:了解煤矿工人胃部有关疾病的患病情况,探讨煤矿工人胃部有关疾病与Hpylori感染及相关因素关系.方法:用分层随机整群抽样方法选取340名煤矿工人进行问卷调查.采用细菌培养法和ELISA法检测Hpylori感染;疾病诊断按胃镜及病理学规定标准进行;资料分析采用X^2检验,Logistic回归分析等.结果:煤矿工人胃部有关疾病的患病率为77.8%,其中井下工人的患病率为80.7%,井上工人的为68.5%;Hpylori感染者的胃部有关疾病的患病率为85.0%,非感染者的患病率为58.6%;饮酒者胃部有关疾病的患病率为79.5%,非饮酒者的患病率为66.7%.结论:煤矿工人胃部有关疾病发病的危险因素主要是饮酒和Hpylori感染,井下工人特有的职业危险因素为粉尘暴露.

The Clinical Observation of ^14C-Urea Breath Test for Diagnosing Helicobacterpylori Infection

The aim of this study is to evaluate the diagnostic value of ^14C-UBT for diagnosis of HP infection. The positive predictive values were above 100 bpm/mmol CO2. 202 of 256 patients with HP-positive infection were detected (sensitivity, 78%), what's more, breath test and RUT corresponded well. 256 patients diagnosed were investigated, aged 17-81 years (average 44.25 years). HP positive rate was 96.5% in 113 patients with peptic ulcer disease (PUD), 91.7% in 60 patients with chronic active gastritis, 73.3% in 15 patients with GERD,

Frequencies of the expression of main protein antigens from Helicobacter pylori isolates and production of specific serum antibodies in infected patients

AIM: To investigate the frequencies of the expression of main protein antigens of Helicobacter pylori (H py/ori) isolates, such as UreB, VacA, CagA1, HpaA, NapA, FlaA and FlaB and the production of specific antibodies in sera from H pylori-infected patients, and to understand the correlations among the different clinical types of chronic gastritis and peptic ulcer and the infection and virulence of H pylori. METHODS: H pylori strains in biopsy specimens from 157 patients with chronic gastritis and peptic ulcer were isolated and serum samples from the patients were also collected. The target recombinant proteins rUreB, rVacA, rCagAl, rHpaA, rNapA, rFlaA and rFlaB expressed by the prokaryotic expression systems constructed in our previous studies were collected through Ni-NTA affinity chromatography. Rabbit antisera against rUreB, rVacA, rCagAl, rHpaA, rNapA, rFlaA and rFlaB were prepared by using routine subcutaneous immunization. By using ultrasonic lysates of the isolates as coated antigens, and the self-prepared rabbit antisera as the first antibodies and commercial HRP-labeling sheep anti-rabbit IgG as the second antibody, expression frequencies of the seven antigens in the isolates were detected by ELISA. Another ELISA was established to detect antibodies against the seven antigens in sera of the patients by using the corresponding recombinant proteins as coated antigens, and the sera as the first antibody and HRP-labeling sheep anti-human IgG as the second antibody respectively. Correlations among the different clinical types of chronic gastritis and peptic ulcer and the infection and virulence of H pylori were statistically analysed. RESULTS: In the 125 isolates of H pylori, the positive rates of UreB, VacA, CagAl, HpaA, NapA, FlaA and FlaB were 100%, 65.6%, 92.8%, 100%, 93.6%, 100% and 99.2% respectively. In the 125 serum samples from the H pylori infected patients, the positive rates of antibodies against recombinant UreB, VacA, CagA1, HpaA, NapA, FIaA and FlaB were 100%, 42.4%, 89.6%, 81.6%, 93.6%, 98.4% and 92.8% respectively. H pylori strains were isolated from 79.6% (125/157) of the biopsy specimens, but no close correlations among the H pylori infection frequencies and different types of chronic gastritis and peptic ulcer could be found (P>0.05, x2 = 0.01-0.87). The VacA positive rate (82.40%) in the strains isolated from the specimens of patients with peptic ulcer and the anti-VacA positive rate (54.3%) in the sera from the patients were significantly higher than those (51.5%, 32.3%) from the patients with chronic gastritis (P<0.01, x2= 13.19; P<0.05, x2= 6.13). When analysis was performed in the different types of chronic gastritis, the VacA in the strains isolated from the specimems of patients with active gastritis showed a higher expression frequency (90.0%) than those from superficial (47.9%) and atrophic gastritis (30.0%) (P<0.05, x2 = 5.93; P<0.01,x2 = 7.50). While analysis was carried out in the strains isolated from the specimens with superficial (93.8%) and active gastritis (100%), NapA showed a higher expression frequency compared to that from atrophic gastritis (60.0%) (P<0.01, x2 = 8.88; P<0.05, X2=5.00). CONCLUSION: The types of chronic gastritis and peptic ulcer and their severity are not associated with H pylori infection frequency but closely related to the infection frequency of different virulent H pylori strains. The optimal antigens for developing vaccine and diagnostic kit are UreB, FlaA, HpaA, FlaB, NapA and CagAl, but not VacA.

胃复春联合铋剂四联疗法治疗萎缩性胃炎并Hp感染临床研究

目的:观察胃复春联合铋剂四联疗法治疗萎缩性胃炎并幽门螺杆菌(Hp)感染的临床疗效及对Hp的根除效果。方法:选取80例萎缩性胃炎并Hp感染患者为研究对象,按随机数字表法分为观察组和对照组各40例。对照组采用铋剂四联疗法治疗,观察组采用胃复春联合铋剂四联疗法治疗。比较2组临床疗效、Hp根除率、中医证候评分、炎症因子[肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)、白细胞介素-33(IL-33)]水平、生长因子[表皮细胞生长因子(EGF)、血管内皮细胞生长因子(VEGF)]水平及不良反应发生情况。结果:观察组总有效率为92.50%,对照组为75.00%,2组比较,差异有统计学意义(P<0.05)。随访1个月,观察组Hp根除率为95.00%,对照组为80.00%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组中医证候评分均较治疗前降低(P<0.05),且观察组中医证候评分低于对照组(P<0.05)。治疗后,2组TNF-α、IL-4、IL-33水平均较治疗前降低(P<0.05),且观察组3项指标均低于对照组(P<0.05)。治疗后,2组EGF水平均较治疗前降低(P<0.05),VEGF水平均较治疗前升高(P<0.05);且观察组EGF水平低于对照组(P<0.05),VEGF水平高于对照组(P<0.05)。治疗期间,2组患者均未出现严重不良反应。结论:胃复春联合铋剂四联疗法可改善萎缩性胃炎并Hp感染患者的临床症状,降低机体炎症反应水平,恢复内皮功能,Hp根除效果良好。

Secreted Protein HP1286 of Helicobacter pylori Strain 26695 Induces Apoptosis of AGS Cells

Objective Secreted proteins of Helicobacter pylori （H. pylori） interact with gastric epithelium cells and may contribute to cell damage. Considering the fact that HPO17S and hypothetical conserved protein HP1286 are included in the group and that HP0175 is a well-known apoptosis-induced factor, the present study aims to clarify whether HP1286 plays a role in bacterial pathogenicity or even functions as an apoptosis-induced factor in human stomach. Methods Two genes encoding HP1286 and HPO175 were cloned into pET32a vector and expressed as recombinant proteins in Escherichia coil （E. coil） BL21. Signal peptide sequences were not included. The recombinant proteins were purified with His SpinTrap and desalted by using HiTrap Desalting. Immunoreactivity of the proteins was determined by Western blot. Human gastric epithelial cell AGS was challenged with these endotoxin-free proteins; and apoptosis of cells was assayed with the Cell Death ELISA kit. Results Recombinant proteins and their respective products whose N-terminal his-tag were removed with thrombin were recognized by serum from the patient infected with H. pylori. Apoptotic AGS cells challenged by HP1286 of H. pylori 26695 were four times more than untreated cells. In addition, apoptosis-induced ability of HP1286 of SS1 was not as strong as that of H. pylori 26695 strain. Conclusion HP1286 of H. pylori 26695 induces apoptosis of AGS cells in a time-dependent manner, however the apoptosis-induced ability of HP1286 may differ due to variations between different strains.

Research Progress of Radical Treatment of Helicobacter Pylori Based on Drug Sensitivity Test as First-Line Treatment

Helicobacter pylori (HP) infection is a global problem that affects about half of the world’s population and requires sufficient attention in clinical and scientific work. Due to differences in economic and medical conditions among countries around the world, there is currently no unified treatment plan for anti-HP. In China, empirical quadruple therapy is mainly used. With the abuse of antibiotics, many patients face the problem of secondary eradication after failure, and the resistance rate of HP is gradually increasing. After eradication failure, drug sensitivity cultivation is carried out to choose sensitive antibiotics for treatment. A new strategy is currently needed to address how to improve the eradication rate of HP during the first eradication. This article aims to discuss the first-line treatment plans and research progress for eradicating HP based on drug sensitivity testing before eradication. Compared with traditional empirical therapies, treatment based on drug sensitivity results can effectively improve the eradication rate of HP, and reduce drug resistance rates, and adverse reactions, among other benefits. .

HpSA试验监测幽门螺杆菌感染根除效果的价值

目的检测粪便幽门螺杆菌抗原(HpSA)水平在根除治疗期间及以后的变化,并评估根除治疗疗效检测的最佳时间。方法受试者为57例Hp阳性的病人,均接受了一周的三联疗法。根除治疗的结果由尿素呼气试验、细菌培养以及治疗结束后6周时的组织检查来判定。HpSA的水平则从治疗前到治疗后的12周,先后共检测9次。结果根除治疗获得成功组病人的HpSA在治疗结束后立即转阴并保持阴性。而治疗失败组的病人HpSA也在治疗结束后立即转阴,但在治疗结束后2周时又转为阳性。治疗失败组在根除治疗开始后第4天HpSA试验的平均吸收值显著高于根治成功组。HpSA试验诊断(根除成功与否)的准确率在治疗2周以后增长到>90%。治疗结束后第2、6、8、12周HpSA的诊断准确率与治疗结束后第4周相比无显著差异。结论根除成功组病人的HpSA水平在治疗后的变化情况同失败组显著不同。HpSA的检测对于评估根治疗效是非常有意义的,且评估治疗效果的适当时机是在根除治疗后2周以后。

莫沙必利联合抗Hp感染疗法对T2DM伴Hp阳性胃轻瘫患者血糖水平、胃肠功能和血清炎症因子的影响

目的:探讨莫沙必利联合抗幽门螺杆菌(Helieobacter pylori,Hp)感染疗法对2型糖尿病(type 2 diabetes mellitus,T2DM)伴Hp阳性胃轻瘫患者血糖水平、胃肠功能以及血清炎症因子的影响。方法:选取2017年5月至2019年6月期间在如皋市人民医院门诊诊治的120例T2DM伴Hp阳性胃轻瘫患者,根据Excel生成的随机数分为对照组(n=60)和研究组(n=60),所有患者均严格控制血糖,对照组口服枸橼酸莫沙必利治疗,5 mg/次,每天3次;研究组在控制血糖和口服莫沙必利治疗基础上给予抗Hp感染疗法。治疗期间通过电话和门诊复查等保持随访,观察两组Hp根除率,并比较治疗前后空腹血糖(fasting blood glucose,FBG)、餐后2 h血糖(2 hours postprandial blood glucose,2h PBG)、胃排空时间、胃泌素(gastrin,GAS)以及血清超敏C-反应蛋白(hypersensitive C-reactive protein,hs-CRP)、白介素-6(interleukin-6,IL-6)水平,评估两组胃轻瘫缓解疗效。结果:研究组Hp转阴率85.00%,高于对照组的13.33%(P<0.05);两组治疗后FBG,2h PBG,胃排空时间,GAS水平均有明显下降(P<0.05),且研究组治疗后上述指标均明显低于对照组,差异有统计学意义(P<0.05);对照组治疗前后血清hs-CRP,IL-6水平比较无显著差异(P>0.05),研究组hs-CRP,IL-6水平较治疗前均有明显下降(P<0.05),组间治疗后hs-CRP,IL-6水平比较,差异亦有统计学意义(P<0.05)。研究组胃轻瘫缓解总有效率96.67%,高于对照组的80.00%(P<0.05)。结论:莫沙必利联合抗Hp感染疗法能有效控制T2DM伴Hp阳性胃轻瘫患者血糖水平,改善胃肠功能和减轻血清炎症因子水平,提高胃轻瘫临床疗效。

探讨护理干预措施在根治消化性溃疡患者幽门螺旋杆菌(Hp)感染中应用的效果

目的探讨护理干预措施在根治消化性溃疡患者幽门螺旋杆菌（Hp）感染中应用的效果。方法将2015年4月~2016年4月来我院就诊的消化性溃疡且幽门螺旋杆菌（Hp）感染的180例患者,作为本次的研究对象,并且按进入医院的编号分为观察组和对照组,每组90例。对照组进行普通护理治疗,观察组在常规护理治疗的基础上进行护理干预治疗,比较两组患者的治疗效果。结果观察组总有效率92.22%,对照组有效率71.11%,差异具有统计学意义（P〈0.05）。结论在进行消化性溃疡的治疗过程中,运用干预护理措施能够增强治疗效果。

益生菌联合三联疗法治疗小儿幽门螺杆菌感染对临床效果、Hp根除率及复发的影响

目的:研究幽门螺杆菌(Hp)感染患儿采用益生菌联合三联疗法治疗的临床效果、Hp根除率、复发情况以及不良反应等。方法:临床纳入2014年8月-2016年8月本院收治的98例Hp感染患儿作为研究对象,按照随机数字表法分为两组,各49例。其中49例患儿采用标准三联疗法治疗(奥美拉唑+阿莫西林+克拉霉素)作为对照组,另49例患儿在上述基础上联合益生菌治疗作为观察组。观察两组患儿的治疗效果、Hp根除率、临床症状、生活质量、复发及不良反应等。结果:观察组、对照组患儿治疗总有效率分别为97.96%、83.67%,观察组明显较高(P<0.05)。观察组、对照组患儿Hp根除率分别为95.92%、77.55%,观察组明显高于对照组(P<0.05)。治疗前两组患儿上腹胀、上腹痛、反酸以及嗳气等临床症状评分对比,差异均无统计学意义(P>0.05);治疗后观察组患儿上述症状评分均明显低于对照组(P<0.05)。治疗前两组患儿ADL、QOL评分对比,差异均无统计学意义(P>0.05);治疗后观察组患儿ADL、QOL评分均明显高于对照组(P<0.05)。观察组不良反应发生率及复发率分别为6.12%、8.16%,均明显低于对照组的16.33%、38.78%(P<0.05)。结论:益生菌联合三联疗法对治疗Hp感染患儿效果更佳,明显改善患儿临床症状,Hp根除率更高,提高患儿生活质量,降低不良反应及复发率,值得临床应用及推广。

H pylori:Treatment for the patient only or the whole family?

AIM： To compare the effects of treatment of H pyloriinfected individuals with the effects of treatment of individuals as well as all Hpylori-infected family members.METHODS： H pylori-positive patients with similar demographic specifications were prospectively randomized with respect to treatment, with a triple regimen of either patients and all Hpylori-positive family members living together （group Ⅰ ） or patients only （group Ⅱ）. Nine months after treatment, all patients were assessed for H pylori positivity.RESULTS： There were 70 H pylori-positive patients in each group; patients in groups Ⅰ and Ⅱ lived with 175 and 190 Hpylori-positive relatives, respectively. Age, sex and Hpylori positivity rate were similar in both groups of relatives. Nine months after 14 d standard triple therapy, Hpylori positivity was 7.1% in group I patients and 38.6% in group 11 patients [P 〈 0.01, OR = 8.61 95% confidence interval （CI）： 2.91-22.84].CONCLUSION： The present results indicate bad environmental hygienic conditions and close intra-familial relationships are important in H pylori contamination. These findings indicate all family members of H pyloripositive individuals should be assessed for H pylori positivity, particularly in developing countries where H pylori prevalence is high; they also suggest patients, their spouses and all H pyloN-positive family members of H pylori-positive individuals should be treated for H pylori infection.