Prevalence of Helicobacter pylori infection in Chinese military personnel:A cross-sectional,multicenter-based study

BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in military personnel.Current guidelines in China state all patients with evidence of active infection with H.pylori are offered treatment.However,the prevalence of H.pylori infection and its regional distribution in the military population remain unclear,which hinders effective prevention and treatment strategies.Understanding the prevalence of H.pylori infection in the military population will aid in the development of customized strategies to better manage this infectious disease.AIM To investigate the prevalence of H.pylori infection in the Chinese military population in different geographic areas.METHODS This multicenter,retrospective study included 22421 individuals from five tertiary hospitals located in north,east,southwest,and northwest cities of China.H.pylori infection was identified using the urea breath test,which had been performed between January 2020 and December 2021.RESULTS Of the 22421 military service members,7416(33.1%)were urea breath test-positive.The highest prevalence of H.pylori was in the 30-39 years age group for military personnel,with an infection rate of 34.9%.The majority of infected subjects were younger than 40-years-old,accounting for 70.4%of the infected population.The individuals serviced in Lanzhou and Chengdu showed a higher infection prevalence than those in Beijing,Nanjing,and Guangzhou,with prevalence rates of 44.3%,37.9%,29.0%,31.1%,and 32.3%,respectively.CONCLUSION H.pylori infection remains a common infectious disease among military personnel in China and has a relatively high prevalence rate in northwest China.

乌贝止溃汤在Hp感染性胃溃疡患者炎症因子水平调节中的作用

探究乌贝止溃汤在Helicobacter pylori (Hp) 感染性胃溃疡患者炎症因子水平调节中的作用。方法 本研究涉及80名胃溃疡患者,均为Hp感染确诊,随机分为研究组与对照组各40例,两组基础数据无显著性差异(P>0.05),具有可比性。研究组采用乌贝止溃汤治疗,对照组给予常规治疗。通过对比两组患者治疗前后血清中炎症因子(IL-32、EGF、TGF-β1)水平、中医症状积分、Hp根除率及溃疡复发率等指标,评估治疗效果。结果 研究组血清IL-32、EGF、TGF-β1水平治疗后均显著优于对照组(P<0.002),乌贝止溃汤能有效降低炎症因子水平。中医症状积分方面,研究组治疗后腹痛、嗳气、腹胀、反酸等症状均较对照组有显著改善(P<0.002)。此外,研究组Hp根除率达95.00%,显著高于对照组的77.50%(P=0.022),溃疡复发率低于对照组(2.50% vs 20.00%,P=0.012)。研究组有效率达97.50%,显著高于对照组的82.50%(P=0.022)。结论 乌贝止溃汤在Hp感染性胃溃疡患者治疗中可显著降低炎症因子水平,改善临床症状,提高Hp根除率,降低溃疡复发率,具有显著的临床应用价值。

Potential mechanisms and therapeutic prospects of the association between Helicobacter pylori infection and metabolic dysfunctionassociated steatohepatitis

Helicobacter pylori(H.pylori)infection is a known inducer of various gastroin-testinal diseases,including gastritis,gastric ulcers,and gastric cancer.However,in recent years,research on the potential association between H.pylori infection and metabolic dysfunction-associated steatohepatitis(MASH)has been scarce.This large-scale multicenter study,covering more than 360 hospitals across 26 medical systems in the United States,systematically evaluated the association between H.pylori infection and MASH.This paper reviews the innovative aspects of this study,discusses its significance in the current research field of H.pylori and liver diseases,analyzes potential molecular mechanisms,and suggests future research directions and therapeutic prospects.

Helicobacter pylori infection as a contributing factor to metabolic dysfunction-associated steatohepatitis: A population-based insight

This letter discusses the research conducted by Abdel-Razeq et al,highlighting a significant association between Helicobacter pylori(H.pylori)infection and me-tabolic dysfunction-associated steatohepatitis(MASH)in individuals with a prior history of H.pylori infection.Using a comprehensive patient database,the study establishes an independent correlation between H.pylori and an elevated risk of MASH,even after adjusting for coexisting conditions such as obesity,type 2 diabetes,and dyslipidemia.Notably,the findings suggest that H.pylori may wo-rsen liver pathology through inflammatory pathways,contributing to hepatic insulin resistance and lipid accumulation.Although the study provides strong evidence for this association,limitations related to diagnostic heterogeneity in-dicate a need for further research to clarify the underlying mechanisms and to explore the potential roles of genetic and microbiome factors in this relationship.

Declining eradication rates of Helicobacter pylori with standard triple therapy in Addis Ababa,Ethiopia

BACKGROUND Standard triple therapy is an effective treatment for eradicating Helicobacter pylori infection,but it is encountered with drug resistance.The stool antigen test is a cost-effective and easy-to-perform test to confirm the eradication of H.pylori,4-8 weeks post-therapy,with 86%sensitivity and 92%specificity.AIM To assess the H.pylori eradication rate of standard triple therapy and factors affecting the eradication rate.METHODS We conducted a prospective,multicenter follow-up study in Addis Ababa,Ethiopia,at selected healthcare facilities among dyspeptic patients with positive stool H.pylori antigen tests from June 1,2023 to October 30,2023 to assess the H.pylori eradication rate.After completing the standard triple therapy,the eradication was confirmed using a stool antigen test 4 weeks later.The data were analyzed using bivariate and multivariate logistic regression methods.RESULTS The H.pylori eradication rate was 85.4%.Patients with a previous diagnosis of H.pylori infection,smokers,and local alcohol consumption were associated with a lower H.pylori eradication rate,with adjusted odds ratio(AORs)of 0.159[95%confidence interval(CI):0.050-0.511],0.206(95%CI:0.052-0.822),and 0.228(95%CI:0.052-0.997),respectively.Patients with complete symptom resolution were 5.383 times more likely to achieve eradication than patients without symptom improvement,AOR=5.383,95%CI:1.74-21.089.CONCLUSION H.pylori eradication rate was lower than expected.Post-treatment testing is crucial to confirm eradication and guide further management,such as susceptibility testing.

Helicobacter pylori infection and gastric microbiota:Insights into gastric and duodenal ulcer development

Helicobacter pylori(H.pylori)infection plays a critical role in gastric diseases,impacting the microbiota structure in gastric and duodenal ulcers.In their study,Jin et al utilized metagenomic sequencing to analyze mucosal samples from patients with ulcers and healthy controls,revealing significant changes in microbial diversity and composition.This article reviews their findings,emphasizing H.pylori’s role in gastric ulcers and the need for further research on its impact on duodenal ulcers.We evaluate the study’s strengths and limitations,suggesting future research directions to enhance our understanding of H.pylori’s contribution to ulcerative diseases.

康复新液联合雷贝拉唑三联疗法治疗Hp相关性消化性溃疡对黏膜愈合效果的影响

目的观察康复新液联合雷贝拉唑三联疗法治疗幽门螺杆菌(Hp)相关性消化性溃疡(PU)对黏膜愈合效果的影响。方法选取2020年2月—2023年8月武夷山市立医院收治的Hp相关性PU患者151例,依据随机数字表法分为康复新液组(n=76)和三联疗法组(n=75)。三联疗法组给予雷贝拉唑三联疗法治疗,康复新液组给予康复新液联合雷贝拉唑三联疗法治疗,2组均连续治疗1个月。比较2组黏膜愈合效果,治疗前后胃肠激素[胃泌素(GAS)、胃动素(MTL)、生长抑素(SS)]、炎性因子[白介素-6(IL-6)、白介素-17(IL-17)、C反应蛋白(CRP)],Hp清除率及不良反应。结果康复新液组总有效率高于三联疗法组(97.37%vs.86.67%,χ^(2)=5.910,P=0.015)。治疗1个月后,2组GAS、MTL、IL-6、IL-17及CRP水平低于治疗前,SS水平高于治疗前,且康复新液组GAS、MTL、IL-6、IL-17及CRP水平更低,SS水平更高(P<0.05或P<0.01)。康复新液组Hp清除率高于三联疗法组(92.11%vs.77.33%,χ^(2)=6.380,P=0.012);康复新液组与三联疗法组不良反应总发生率比较无显著差异(34.21%vs.29.33%,χ^(2)=0.414,P=0.520)。结论康复新液联合雷贝拉唑三联疗法可提升Hp相关性PU的Hp清除率,改善消化功能,减轻炎性反应,促进黏膜愈合,治疗安全有效。

Risks of anti-Helicobacter therapy and long-term therapy with antisecretory drugs

Helicobacter pylori(H.pylori)infection has a protective effect on gastroesophageal reflux disease(GERD).Both of these diseases have a very high incidence and prevalence.As a result,GERD often recurs after anti-Helicobacter therapy.The problem of effective treatment of H.pylori infection and GERD is that the main groups of drugs[proton pump inhibitors(PPIs)and potassium-competitive acid blockers]have the possibility of side effects with use.Such supposed side effects have no evidence in randomized controlled trials that comply with the principles of evidence-based medicine.Morphological changes in the gastric mucosa after long-term use of antisecretory drugs should be considered as compensatory mechanisms of sanogenesis.The greatest concern for doctors who treat patients with antisecretory drugs is the risk of gastric carcinogenesis.This article presents an analysis of morphological and pathophysiological changes that occur after long-term use of antisecretory drugs(PPIs).Hypertrophy(hyperplasia)of G cells,enterochromaffin-like cells and possible fundic gland polyps(hyperplasia)are compensatory mechanisms of sanogenesis during long-term treatment with PPIs.These mechanisms are of primary importance for rehabilitation and prevention of complications in patients with GERD,non-steroidal anti-inflammatory drugsgastropathy and other diseases during long-term treatment with PPIs.Understanding the pathophysiological and morphological mechanisms of compensation and adaptation,the mechanisms of sanogenesis and carcinogenesis will increase the number of indications for long-term use of PPIs with a high level of efficiency and safety of treatment.In addition,understanding the pathophysiological and morphological mechanisms of compensation and adaptation,the mechanisms of sanogenesis will allow us to forecast the side effects of long-term use of potassium-competitive acid blockers.

肝胃百合汤辅助治疗Hp阳性消化性溃疡(肝郁气滞证)的效果及对溃疡愈合质量、炎症因子水平的影响

目的 探讨肝胃百合汤辅助治疗幽门螺杆菌(Hp)阳性消化性溃疡(肝郁气滞证)的效果。方法 选取2020年5月至2023年3月收治的90例Hp阳性消化性溃疡(肝郁气滞证)患者为研究对象,以随机数字表法将其分为对照组和观察组,每组45例。对照组采用西药四联方案治疗,观察组在对照组基础上增加肝胃百合汤。比较两组的治疗效果。结果 观察组的治疗总有效率高于对照组(P<0.05)。观察组的溃疡愈合优良率高于对照组(P<0.05)。治疗后,观察组的胃泌素(GAS)、胃动素(MTL)水平低于对照组,生长抑素(SS)水平高于对照组(P<0.05)。治疗后,观察组的白细胞介素-1β(IL-1β)、转化生长因子-β1(TGF-β1)及超敏C反应蛋白(hs-CRP)水平低于对照组(P<0.05)。结论 肝胃百合汤辅助治疗Hp阳性消化性溃疡(肝郁气滞证)的效果良好,能提高溃疡愈合质量,调节胃肠激素水平,抑制炎症因子水平,值得推广。

乌梅丸对Hp阳性萎缩性胃炎的临床研究

目的:探讨幽门螺杆菌(Hp)阳性萎缩性胃炎患者采用乌梅丸治疗的应用效果。方法:选取2022年1~12月在佛山市中医院接受治疗的Hp阳性萎缩性胃炎患者100例,以随机数字表法分成治疗组(50例)与对照组(50例)。对照组采用四联根除Hp疗法治疗,治疗组采用乌梅丸联合四联根除Hp疗法治疗,比较两组Hp转阴情况、临床疗效、中医症候积分、胃镜及病理情况、胃蛋白酶原Ⅰ(PGⅠ)及胃蛋白酶原Ⅱ(PGⅡ)水平。结果:治疗组Hp转阴率(96.00%)较对照组(82.00%)更高(P<0.05);治疗组治疗总有效率(92.00%)较对照组(76.00%)更高(P<0.05);两组治疗后中医证候积分降低(P<0.05),且治疗组较对照组更低(P<0.05);两组治疗后胃镜及病理情况评分降低(P<0.05),但两组间比较,差异无统计学意义(P>0.05);两组治疗后PGⅠ、PGⅡ水平提高(P<0.05),且治疗组较对照组更高(P<0.05)。结论:乌梅丸应用于Hp阳性萎缩性胃炎患者中,能够促进Hp转阴情况、临床症状改善,促进临床疗效提高,改善胃黏膜萎缩情况,提高PGⅠ及PGⅡ水平。

柴芍胃康汤联合四联疗法治疗肝胃气滞证Hp阳性慢性萎缩性胃炎的疗效观察

目的:观察柴芍胃康汤联合四联疗法治疗肝胃气滞证幽门螺杆菌(Hp)阳性慢性萎缩性胃炎(CAG)的疗效及对患者胃泌素-17(G-17)、丙二醛(MDA)、胃蛋白酶原(PG)Ⅰ和PGⅡ水平,胃黏膜组织病理和Hp根除的影响。方法:选取2021年6月至2023年5月该院收治的肝胃气滞证Hp阳性CAG患者140例,按随机数字表法分为联合组和对照组(各70例)。对照组患者给予标准四联疗法,联合组患者在对照组的基础上给予柴芍胃康汤治疗。比较两组患者治疗前后血清G-17、MDA、PGⅠ和PGⅡ水平,胃黏膜组织病理评分、Hp根除率,观察安全性和临床疗效。结果:治疗后,两组患者血清G-17、PGⅠ水平明显升高,MDA、PGⅡ水平和胃黏膜组织病理评分明显降低;且联合组患者血清G-17、PGⅠ水平较对照组升高,MDA、PGⅡ水平和胃黏膜组织病理评分较对照组降低,差异均有统计学意义(P<0.05)。联合组患者的Hp根除率、总有效率分别为92.86%(65/70)、92.86%(65/70),明显高于对照组的81.43%(57/70)、81.43%(57/70),差异均有统计学意义(P<0.05)。结论:柴芍胃康汤联合四联疗法治疗肝胃气滞证Hp阳性CAG的疗效较好,可改善患者胃功能、氧化应激和胃黏膜组织病理损伤,并可有效提高Hp根除率。

基于幽门螺杆菌hp0169基因三维结构的生物信息学分析

目的:克隆幽门螺杆菌(Hp) hp0169基因并进行晶体学研究,分析其二级结构和三维结构。方法:由UniProt数据库中检索Hp NCTC26695菌株hp0169基因及其编码蛋白序列,采用生物信息学方法分析Hp重组胶原蛋白酶(HpPrtC)蛋白理化性质,SOPMA和DNAStrar软件预测HpPrtC蛋白二级结构特征,SWISS-MOPEL软件构建HpPrtC蛋白三维结构,IEDB和ABCpred软件预测HpPrtC蛋白B淋巴细胞抗原表位,SYFPEITHI网站预测T淋巴细胞抗原表位,专家库(EP)算法和随机森林(RF)算法预测HpPrtC蛋白可结晶性。原核表达HpPrtC重组蛋白,经Ni^(2+)亲和层析和分子筛技术纯化蛋白,结晶试剂盒筛选HpPrtC的结晶条件。结果:hp0169基因共包含1 269个碱基配对,编码蛋白全长422个氨基酸,理论等电点为7.64,相对分子质量为47 300。HpPrtC蛋白为亲水性、可溶性蛋白。HpPrtC蛋白α螺旋的氨基酸数量占全部氨基酸数量百分率为35.78%,β片层为18.72%,β转角为6.87%,无规则卷曲为38.63%。抗原表位分析,HpPrtC蛋白含有B淋巴细胞的5个优势线性表位和3个构象表位及多个T淋巴细胞潜在优势抗原表位。同源建模,HpPrtC蛋白呈二聚体,单体由β折叠围成桶状结构,周围被α螺旋和无规则卷曲围绕。HpPrtC蛋白为中等难度结晶,且无信号肽和跨膜螺旋,在0.2 mol·L^(-1)氯化镁、 0.1 mol·L^(-1)三羟甲基氨基甲烷(Tris)、3.4 mol·L^(-1)己二醇和pH 8.5条件下出现细小成簇的针状晶体。结论:HpPrtC是一种亲水型蛋白,呈二聚体构造,在适宜条件下呈细小成簇针状晶体,其具有T淋巴细胞和B淋巴细胞优势抗原表位,可作为Hp疫苗设计的抗原,用于构建多价融合疫苗或多表位疫苗,本研究结果为Hp的防治提供了实验基础。

基于胃不和则卧不安探讨Hp相关慢性胃炎对患者睡眠的影响

目的探讨幽门螺杆菌(Hp)相关慢性胃炎对患者睡眠的影响及具体表现形式。方法通过问卷调查,对比分析Hp相关慢性胃炎及非Hp相关慢性胃炎患者睡眠的具体特点。结果Hp相关慢性胃炎男性患者总体睡眠显著优于非Hp相关慢性胃炎男性患者及Hp相关慢性胃炎女性患者,明显较非Hp相关慢性胃炎男性患者睡眠质量好、睡眠时间长、睡眠效率高,明显较Hp相关慢性胃炎女性患者睡眠质量好、入睡时间短、睡眠效率高、睡眠障碍少、催眠药物使用少(P<0.05);Hp相关慢性胃炎男性患者较Hp相关慢性胃炎女性患者明显更少出现夜间易醒或早醒、呼吸不畅、感觉冷、做噩梦及其他影响睡眠的事情,更易咳嗽或鼾声高(P<0.05);Hp相关慢性胃炎女性患者催眠药物使用显著多于非Hp相关慢性胃炎女性患者,咳嗽或鼾声高显著多于非Hp相关慢性胃炎女性患者(P<0.05)。结论Hp相关慢性胃炎患者常有睡眠异常且具有一定的性别差异。

口腔扁平苔藓患者Hp感染状况分析及其与免疫功能的关系

目的分析口腔扁平苔藓(OLP)患者幽门螺杆菌(Hp)感染状况及其与免疫功能相关性。方法回顾性选取2023年1—12月郑州大学第一附属医院收治的215例OLP患者作为OLP组,选取同期182例健康体检正常志愿者作为健康组。比较健康组、OLP组Hp感染情况,根据Hp检验结果将OLP组分为OLP阳性组和OLP阴性组,比较OLP阳性组和OLP阴性组各项免疫指标水平,分析免疫指标与OLP阳性相关性。结果健康组Hp感染率比OLP组更低;OLP阳性组总T淋巴细胞(T)+B淋巴细胞(B)+自然杀伤细胞(NK)、诱导T淋巴细胞(CD4^(+))、免疫球蛋白G(IgG)、补体C3(C3)、补体C4(C4)水平低于OLP阴性组,B淋巴细胞表面抗原(CD19^(+))、免疫球蛋白A(IgA)、免疫球蛋白M(IgM)水平高于OLP阴性组;相关性分析可知,总T+B+NK、CD4^(+)、IgG、C3、C4与OLP阳性呈负相关关系(r=-0.961,-0.754,-0.501,-0.145,-0.669,P<0.05),CD19^(+)、IgA、IgM与OLP阳性呈正相关关系(r=0.443,0.475,0.349,P<0.05)。结论OLP患者有较高Hp感染率,且感染Hp的患者免疫功能较差,其中总T+B+NK、CD4^(+)、IgG、C3、C4与OLP患者Hp阳性呈负相关,CD19^(+)、IgA、IgM与OLP患者Hp阳性呈正相关,临床可将以上免疫功能指标作为评估OLP患者Hp阳性的指标。

抗Hp四联疗法在糖尿病合并Hp感染患者中的应用效果及对血清炎性因子水平的影响

目的分析抗幽门螺杆菌(Hp)四联疗法在糖尿病合并Hp感染患者中的应用效果及对血清炎性因子水平的影响。方法选择2021年4月至2022年5月宝鸡市第二人民医院与宝鸡市中心医院诊治的110例糖尿病合并Hp感染患者作为研究对象,随机将其分为常规组(55例,对症治疗)和观察组(55例,抗Hp四联疗法)。比较两组的治疗效果。结果观察组的治疗总有效率显著高于常规组(P<0.05)。治疗后,观察组的空腹血糖(FPG)、餐后2小时血糖(2 h PG)水平均显著低于常规组(P<0.05)。治疗后,观察组的C-反应蛋白(CRP)、白细胞介素-6(IL-6)、降钙素原(PCT)、白细胞计数(WBC)、胃泌素-17(G-17)、胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)水平低于常规组(P<0.05)。两组治疗期间的不良反应总发生率无显著差异(P>0.05)。结论抗Hp四联疗法治疗糖尿病合并Hp感染患者可获得理想效果,能有效降低血糖与炎性因子水平,调节胃功能,且不会增加药物不良反应。

联合检测血清胃蛋白酶原、Hp抗体、CEA、CA724在胃癌筛查的临床研究

目的探讨血清胃蛋白酶原Ⅰ(PGⅠ)、胃蛋白酶原Ⅱ(PGⅡ)、PGⅠ/PGⅡ比值、幽门螺杆菌(Hp)抗体、糖类抗原724(CA724)、癌胚抗原(CEA)联合检测在胃癌筛查的临床价值研究。方法选取2021年7月至2023年11月在玉林市第一人民医院就诊的100例胃癌患者为胃癌组、80例萎缩性胃炎患者为萎缩性胃炎组及同期80例非萎缩性胃炎为对照组。检测并比较三组研究对象血清中PGⅠ、PGⅡ、PGⅠ/PGⅡ比值、Hp抗体、CEA、CA724水平,用受试者工作特征(ROC)曲线评估以上指标在胃癌中的诊断价值。结果胃癌组、萎缩性胃炎组的PGⅠ、PGⅠ/PGⅡ比值水平均低于对照组,差异有统计学意义(P<0.05)。胃癌组的PGⅡ及Hp抗体水平均高于对照组,但胃癌组Hp抗体水平低于萎缩性胃炎组,差异有统计学意义(P<0.05)。胃癌组的CEA、CA724水平均高于其余两组,差异有统计学意义(P<0.05)。采用Spearman相关分析,结果显示PGⅠ/PGⅡ比值与PGⅠ呈正相关(r=0.229,P<0.05),与PGⅡ、Hp抗体、CA724呈负相关(r=-0.560,P<0.05;r=-0.236,P<0.05;r=-0.223,P<0.05)。联合检测血清PGⅠ、PGⅡ、Hp抗体、CEA、CA724诊断胃癌的曲线下面积(AUC=0.844)均大于各单项诊断AUC。结论联合检测血清PGⅠ、PGⅡ、PGⅠ/PGⅡ比值、Hp抗体、CEA、CA724可提高胃癌的诊断价值。

健脾化湿养胃方治疗脾虚湿阻型慢性萎缩性胃炎伴肠上皮化生Hp阳性患者的疗效及作用机制分析

目的探讨健脾化湿养胃方治疗慢性萎缩性胃炎伴肠上皮化生(脾虚湿阻型)的疗效并分析其作用机制。方法选取2021年1月-2023年1月在该院(门诊诊治)收治的幽门螺杆菌(Helicobacter pylori,Hp)阳性慢性萎缩性胃炎伴肠上皮化生(脾虚湿阻型)”患者120例,据简单随机法将其分为中药联合组与对照组,各60例。对照组予以常规西药治疗(15 d),中药联合组在对照组基础上予以健脾化湿养胃方治疗(28 d)。治疗后,评估病患临床疗效,比较两组病患治疗前和治疗后的中医证候积分、Hp转阴率和血清胃肠激素[胃蛋白酶原Ⅰ(pepsinogen-Ⅰ,PGI),胃蛋白酶原Ⅱ(pepsinogen-Ⅱ,PG-Ⅱ),胃泌素-17(gastrin-17,GAS-17),内皮素-1(endothelin-1,ET-1)]、炎症因子[白细胞介素8(interleukin-8,IL-8),肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α),白细胞介素23(interleukin-23,IL-23)]变化情况;记录不良反应发生情况。结果中药联合组治疗和有效率和Hp转阴率与对照组比较,差异具有统计学意义(P<0.05);治疗后两组PGⅠ、GAS-17值均升高,中医证候积分、PGⅡ、ET-1、IL-8、TNF-α、IL-23值均降低;且中药联合组PGⅠ、GAS-17值高于对照组;中医证候积分、PGⅡ、ET-1、IL-8、TNF-α、IL-23值低于对照组,差异有统计学意义(P<0.05)。两组病患不良反应发生率比较,差异无统计学意义(P>0.05)。结论健脾化湿养胃方可以促进Hp转阴,改善胃功能和胃黏膜病理情况,进而有效治疗慢性萎缩性胃炎伴肠上皮化生(脾虚湿阻型)。

急性脑梗死患者发生Hp感染的危险因素

目的 探讨急性脑梗死(ACI)患者幽门螺杆菌(Hp)发生的危险因素,为临床干预提供依据。方法 回顾性分析2021年1月至2022年5月南阳市中心医院收治的156例ACI患者临床资料,依据是否发生Hp感染,分为发生组73例、未发生组83例。采用多因素logistic回归分析Hp感染发生的影响因素。结果 年龄、NIHSS评分、动态动脉硬化指数、脑白质疏松程度评分、房颤、白细胞计数、白细胞介素-6、C反应蛋白、低密度脂蛋白胆固醇、丙二醛、同型半胱氨酸为Hp感染发生的独立危险因素,血清血管内皮生长因子水平为Hp感染发生的独立保护因素(P<0.05)。结论 ACI患者Hp感染发生的危险因素较多,临床应提前进行筛查,并采取相应干预措施,以降低Hp感染发生率。

穴位埋线辅助四联疗法治疗脾胃虚弱型慢性萎缩性胃炎伴Hp感染临床研究

目的:观察穴位埋线辅助四联疗法治疗脾胃虚弱型慢性萎缩性胃炎(CAG)伴幽门螺杆菌(Hp)感染的临床疗效。方法:选取112例脾胃虚弱型CAG伴Hp感染患者,采用随机数字表法分为对照组(予四联疗法治疗)和观察组(予穴位埋线辅助四联疗法治疗)各56例。治疗结束后,2组均随访5个月。比较2组临床疗效、胃黏膜功能指标[胃泌素17(G-17)、胃蛋白酶原Ⅰ(PGⅠ)]、健康调查简表(SF-36)评分、中医证候积分、病理评分、不良反应发生率及复发率。结果:总有效率观察组96.43%,高于对照组80.36%(P<0.05)。治疗后3个月,2组血清G-17、PGⅠ水平均较治疗前升高(P<0.05),观察组上述2项指标水平均高于对照组(P<0.05)。治疗后1个月、3个月,2组SF-36评分均较治疗前升高(P<0.05),观察组SF-36评分均高于同期对照组(P<0.05)。治疗后3个月,2组中医证候积分均较治疗前降低(P<0.05),观察组中医证候积分低于对照组(P<0.05)。治疗后5个月,2组病理评分均较治疗前下降(P<0.05),观察组病理评分低于对照组(P<0.05)。不良反应发生率观察组8.93%,与对照组3.57%比较,差异无统计学意义(P>0.05)。治疗后5个月,复发率观察组1.85%,低于对照组15.56%(P<0.05)。结论:穴位埋线辅助四联疗法治疗脾胃虚弱型CAG伴Hp感染,可减轻患者的临床症状,改善胃黏膜功能,提高生活质量,降低复发率,且安全性好。

Increased expression of tyrosine phosphatase SHP-2 in Helicobacter pylori-infected gastric cancer

AIM:To explore the alteration of tyrosine phosphatase SHP-2 protein expression in gastric cancer and to assess its prognostic values.METHODS:Three hundred and five consecutive cases of gastric cancer were enrolled into this study.SHP-2 expression was carried out in 305 gastric cancer specimens,of which 83 were paired adjacent normal gastric mucus samples,using a tissue microarray immunohistochemical method.Correlations were analyzed between expression levels of SHP-2 protein and tumor parameters or clinical outcomes.Serum anti-Helicobacter pylori(H.pylori) immunoglobulin G was detected with enzyme-linked immunosorbent assay.Cox proportional hazards model was used to evaluate prognostic values by compassion of the expression levels of SHP-2 and disease-specific survivals in patients.RESULTS:SHP-2 staining was found diffuse mainly in the cytoplasm and the weak staining was also observed in the nucleus in gastric mucosa cells.Thirty-two point five percent of normal epithelial specimen and 62.6% of gastric cancer specimen were identified to stain with SHP-2 antibody positively(P < 0.001).Though SHP-2 staining intensities were stronger in the H.pylori(+) group than in the H.pylori(-) group,no statistically significant difference was found in the expression levels of SHP-2 between H.pylori(+) and H.pylori(-) gastric cancer(P = 0.40).The SHP-2 expression in gastric cancer was not significantly associated with cancer stages,lymph node metastases,and distant metastasis of the tumors(P = 0.34,P = 0.17,P = 0.52).Multivariate analysis demonstrated no correlation between SHP-2 expression and disease-free survival(P = 0.86).CONCLUSION:Increased expression of SHP-2 protein in gastric cancer specimen suggesting the aberrant upregulation of SHP-2 protein might play an important role in the gastric carcinogenesis.