BIO-CHARACTERISTICS OF INTESTINAL METAPLASIA IN THE STOMACH: HYPERPROLIFERATIVE AND USUAL TYPE

Background： In Padova and Vienna International Classification, the usual intestinal metaplasia （UIM） of the stomach, including complete and incomplete type, is defined as negative for dysplasia, and hyperproliferative intestinal metaplasia （HIM） as indefinite for dysplasia, but the biological characteristics of these two types of intestinal metaplasia （IM）remain to be studied. Objective： To investigate the biological differences between UIM, HIM and intestinal type gastric cancer （IGC）, a panel of biomarkers were detected. Methods： A total of 38 cases of IGC, 41 HIM and 56 UIM adjacent to gastric cancer were studied. Immunohistochemistry was used to detect the expressions of pS2, MUC2, MUC5AC, MUC6, Ki-67, EGFR, p53 and sulfo-Lewisa in UIM, HIM and IGC. Microsatellite instability （MSI） in UIM, HIM and IGC was detected by using Denaturing High Performance Liquid Chromatography （DHPLC）. Results： The pS2 antigen expression in UIM （78.6%） was significantly higher than in HIM and IGC （9.8%, 10.5%）, p〈0.01. The MUC6, sulfo-Lewisa and EGFR protein expressions were significant increased in HIM （24.4%, 82.9%, 48.7%） and IGC （34.2%, 75.0%, 42.1%） than in UIM （3.6%, 25.5%, 17.9%）, p〈0.01. A reversed pattern of expressions of MUC2 and MUC5AC was observed in UIM （96.4%, 50.0%） and HIM （82.9%, 36.6%） compared with IGC （52.6%, 13.2%）, p〈0.05; and the p53 gene expression was increased from UIM （1.8%） to HIM （19.5%） to IGC （57.9%）, p〈0.01. The Ki-67 labeling index was significantiy different among three lesions （UIM： 16%±6%, HIM： 45%±9%, IGC： 63%±10%, p〈0.01）. Conclusion： These findings suggest that there are different bio-characteristics among UIM, HIM and IGC, and HIM may have higher potential to progress to more advanced lesions in comparison with UIM.

Gastrin,somatostatin,and experimental disturbance of the gastrointestinal tract in rats

INTRODUCTIONThe field of gastrointestinal hormones has expanded at a dizzying rate[1-4].Gastrointestinal hormones as regulatory peptides that appear to be major components of bodily integration and have important regulatory actions on physioligical function of the gastrointestinal tract .The successful isolation of some gastrointestinal hormones and the development of sensitive methods for their detection have led to the unexpected finding that they also exist in the brain .

Expression and significance of homeodomain protein Cdx2 in gastric carcinoma and precancerous lesions

AIM： To investigate the expression and significance of caudal-related homeobox transcription factor （Cdx2） in gastric carcinoma （GC） and precancerous lesions. METHODS： The expression of Cdx2 in GC, precancer- ous lesions and normal gastric mucosa were detected using immunohistochemical method. Hematoxylin and eosin staining, alcian blue/periodic acid-schiff and high iron diamine/alcian blue staining were used to classify intestinal metaplasia （IM） and GC. RESULTS： Cdx2 was not detected in normal gas- tric mucosa. Cdx2 expression was detected in 87.1% （101/116） of IM, 50% （36/72） of dysplasia and 48.2% （41/85） of GC. The Cdx2-expressing cells in IM were more prevalent than in dysplasia and carcinoma （P 〈 0.05）. There was no relationship between Cdx2 ex- pression and the classification of IM or the degree of dysplasia. Expression of Cdx2 was significantly higher in intestinal-type carcinoma than in diffuse and mixed- type carcinoma （P 〈 0.05）. Positive expression of Cdx2was mainly found in moderately to well differentiated GC. There was a negative association between nuclear Cdx2 expression and lymph node metastasis and tumor, nodes, metastasis stage of GC （P 〈 0.05）. The patients with Cdx2-positive expression showed a higher survival rate than those with Cdx2-negative expression （P = 0.038）. Multivariate analysis revealed that the expres- sion of Cdx2 and lymph node metastasis were indepen- dent prognostic indicators of GC （P 〈 0.05）.

Immunohistochemical study of the digestive tract of Oligosarcus hepsetus

AIM: To describe the histology of the digestive tract and to investigate the occurrence of endocrine cells in Oligosarcus hepsetus (O. hepsetus ). METHODS: The digestive tract (DT) of O. hepsetus was divided into esophagus, two stomach regions (glandular and non-glandular) and two intestinal regions (anterior and posterior). These specimens were processed by routine histological techniques and stained with hematoxylin-eosin, Gomori's trichrome, periodic acid Schiff (PAS) and Alcian blue (AB). An immunohistochemical method using avidin-biotin-peroxidase was employed.RESULTS: The esophagus is lined with a non-keratinized stratified squamous epithelium that is reactive to PAS and AB. The stomach has a mucosa lined with a simple columnar epithelium with mucus-secreting cells that are reactive only to PAS. The intestine has a simple columnar epithelium with a brush border and goblet cells that are reactive to PAS and AB. Somatostatin, serotonin and cholecystokinin immunoreactive cells were identified throughout the DT.CONCLUSION: This study revealed adaptations for the species' diet and showed that the distribution and relative frequency of immunoreactive cells are similar to those of other fish.

Gut homeostasis, injury, and healing: New therapeutic targets

The integrity of the gastrointestinal mucosa plays a crucial role in gut homeostasis,which depends upon the balance between mucosal injury by destructive factors and healing via protective factors.The persistence of noxious agents such as acid,pepsin,nonsteroidal anti-inflammatory drugs,or Helicobacter pylori breaks down the mucosal barrier and injury occurs.Depending upon the size and site of the wound,it is healed by complex and overlapping processes involving membrane resealing,cell spreading,purse-string contraction,restitution,differentiation,angiogenesis,and vasculogenesis,each modulated by extracellular regulators.Unfortunately,the gut does not always heal,leading to such pathology as peptic ulcers or inflammatory bowel disease.Currently available therapeutics such as proton pump inhibitors,histamine-2 receptor antagonists,sucralfate,5-aminosalicylate,antibiotics,corticosteroids,and immunosuppressants all attempt to minimize or reduce injury to the gastrointestinal tract.More recent studies have focused on improving mucosal defense or directly promoting mucosal repair.Many investigations have sought to enhance mucosal defense by stimulating mucus secretion,mucosal blood flow,or tight junction function.Conversely,new attempts to directly promote mucosal repair target proteins that modulate cytoskeleton dynamics such as tubulin,talin,Ehm^(2),filamin-a,gelsolin,and flightless I or that proteins regulate focal adhesions dynamics such as focal adhesion kinase.This article summarizes the pathobiology of gastrointestinal mucosal healing and reviews potential new therapeutic targets.

Age-related histomorphologic changes in the canine gastrointestinal tract:A histologic and immunohistologic study

AIM： To examine the of the gastric, jejuna physiological aging. changes in the histomorphology and colonic wall of dogs due to METHODS： Full thickness biopsies were taken from the gastrointestinal tracts of 28 dogs of different ages. The thickness of the different layers of the wall was measured and the numbers of proliferating cells as indicated by immunohistochemical detection of Ki67 were counted. RESULTS： In the three excision sites, the thickness of all subepithelial layers increased with rising age. The strongest correlation between age and thickness of the intestinal wall was found in the first 10 years of life and in the jejunum （r =0.6-0.71 for the deep lamina propria mucosa, the muscularis mucosa, and the circular layer of the tunica muscularis）. The number of proliferating cells decreased during aging, with the strongest correlation in the lamina propria mucosa and lamina muscularis mucosa of the jejunum and in the colonic submucosa （r =-0.61 to -0.71）. Epithelial proliferation was only weakly correlated to the age. CONCLUSION： The morphology of the deeper layers and the proliferation of mesenchymal cells of the intestinal wall of healthy dogs are correlated with age. Gastrointestinal epithelial proliferation is only weakly age-correlated.

Gastric-and-Intestinal Mixed Intestinal Metaplasia Is Irreversible Point with Eradication of Helicobacter pylori

Helicobacter pylori (H. pylori) represents an important factor in the development of atrophic gastritis, intestinal metaplasia (IM), and gastric cancer. Eradication of H. pylori has been reported to prevent gastric cancer only in cases without atrophy or IM. However, histological changes with eradication have yet to be fully clarified. We evaluated 38 H. pylori-positive cases before and after eradication at the gland level;pyloric glands were classified as showing gastric proper (G) and IM gland types, with the latter including gastric-and-intestinal mixed IM (GI-IM) and solely intestinal IM (I-IM), depending on the remaining gastric phenotypes. On eradication, acute and chronic inflammation attenuated rapidly and gradually, respectively, whereas levels of MUC5AC and MUC6 expression were not markedly altered. Gland width, size of nuclei and cytoplasm and their ratio in surface foveolar epithelium, the number of Ki-67-positive cells and the length of the proliferating zone in each gland were significantly decreased in G glands after eradication compared with those in GI-IM and I-IM. The number of mitotic phase cells, positive for phosphorylated histone H3 at serine 28, was increased in both types of IM compared to that in G glands in the H. pylori-infected state, but unexpectedly remained unchanged with eradication. These results suggest that GI-IM, as the beginning of IM, could represent a histological irreversible point with eradication and be considered as a “histological point of no return”.

75 CASES OF SIMPLE OBESITY TREATED WITH AURICULAR AND BODY ACUPUNCTURE

The author adopted auricular and body acupuncture in the treatment of obesity with satisfactory results as reported in the following: Clinical Data The series of 75 cases were diagnosed simple obesity for lack of evidence of any primary disease; age range was 17-65 years,

75 CASES OF SIMPLE OBESITY TREATED WITH AURICULAR AND BODY ACUPUNCTURE

The author adopted auricular and bodyacupuncture in the treatment of obesity withsatisfactory results as reported in the follow-ing:Clinical DataThe series of 75 cases were

AN EXPERIMENTAL STUDY BY SINGLE BLIND METHOD ON THE ANTIOBESITY EFFECT OF XIAOPANGMEI

To evaluate the anti-obesity effect of Xiaopang-mei,an experimental study by single method in threegroups of rats was done.The first group were fedwith Xiaopangmei-01,the second group with aplacebo,and the third group were controls.Ascompared with the control and the placebo groups,the rata that had been fed Xiaopangmei for six weeksshowed body weight,food intake,weight of epididy-mis fat pad and the intestinal absorption of glucoseall significantly decreased.The swimming tolerancetest showed they swam longer than the other twogroups.No significant difference was found betweenthe three groups in the growth and developmentindices such as body length,length of femur and tibia,weight of heart,lungs,spleen,kidneys,stomach,smallintestines,gastrocnemius muscle,and adrenal glands.No side effects were found on the liver and kidney.The secretion of insulin was inhibited after the swim-ming tolerance test and the gestrocnemius muscletest was similar for all three groups of rats.Weconcluded that Xiaopangmei is an effective anti-obesity drug.

Value of enhanced computed tomography in differentiating small mesenchymal tumours of the gastrointestinal from smooth muscle tumours

BACKGROUND Computed tomography(CT)technology has been gradually used in the differen-tiation of small mesenchymal tumors of the stomach and intestines from smooth muscle tumours.AIM To explore the value of enhanced CT in the differentiation of small mesenchymal tumors of the stomach and intestines from smooth muscle tumours.METHODS Clinical data of patients with gastric mesenchymal or gastric smooth muscle tu-mours who were treated in our hospital from May 2018 to April 2023 were retrospectively analysed.Patients were divided into the gastric mesenchymal tumor group and the gastric smooth muscle tumor group respectively(n=50 cases per group).Clinical data of 50 healthy volunteers who received physical examinations in our hospital during the same period were selected and included in the control group.Serum levels of carcinoembryonic antigen(CEA),alpha-fetoprotein(AFP),carbohydrate antigen 19-9(CA19-9),CA-125 and cytokeratin 19 fragment antigen 21-1 were compared among the three groups.The value of CEA and CA19-9 in the identification of gastric mesenchymal tumours was analysed using the receiver operating characteristic(ROC)curve.The Kappa statistic was used to analyse the consistency of the combined CEA and CA19-9 test in identi-fying gastric mesenchymal tumours.RESULTS CEA levels varied among the three groups in the following order:The gastric mesenchymal tumour group>the control group>the gastric smooth muscle tumour group.CA19-9 levels varied among the three groups in the following order:The gastric mesenchymal group>the gastric smooth muscle group>the control group,the difference was statistically significant(P<0.05).ROC analysis showed that the area under the curve of CEA and CA19-9 was 0.879 and 0.782,respectively.CONCLUSION Enhanced CT has shown value in differentiating small mesenchymal tumors of the stomach and intestines from smooth muscle tumors.

Localization and Dynamic Expression of a 27.8kDa Receptor Protein for Lymphocystis Disease Virus Infection in Sea Bass(Lateolabrax japonicus) Tissues

Lymphocystis disease virus(LCDV) infects target cells by attaching to a 27.8 k Da receptor(27.8R) protein in flounder Paralichthys olivaceus, and anti-27.8R monoclonal antibodies(MAbs) have been developed. However, the 27.8R existence in tissues of sea bass(Lateolabrax japonicus) and its role in LCDV infection have remained unclear. In this study, the results of western blotting demonstrated that the same 27.8R was shared by flounder and sea bass. LCDV-free sea bass individuals were intramuscularly injected with LCDV, and viral copies were detected in tissues from 3 h post infection and showed a time-dependent increase during 9 days infection. Distribution and synthesis of 27.8R in sea bass tissues were investigated by using anti-27.8R MAbs as probes. It was found that 27.8R was distributed in all the tested tissues. The levels of 27.8R protein were highest in gill and skin, then a bit lowly in stomach, head kidney and heart, followed by spleen, intestine, blood cells, gonad and liver, and least in kidney and brain in healthy sea bass. Upon LCDV infection, 27.8R synthesis was up-regulated in each tissue, and higher in the tissues with higher LCDV copies. The 27.8R and LCDV were detected in some peripheral blood leukocytes but not in red blood cells. These results suggested that 27.8R was widely distributed in sea bass tissues, and it served as a receptor and correlated with tissue tropism of LCDV infection. Furthermore, leukocytes had the potential of being a LCDV carrier and were responsible for a systemic infection of LCDV in sea bass.

Exploration of the immunologic characteristics of KIT/PDGFRA wild-type gastrointestinal stromal tumor and potential application of neoantigen vaccination

To the Editor:Gastrointestinal stromal tumors(GISTs)are the most common mesenchymal tumors of the gastrointestinal tract.GISTs mostly occur in the stomach or small intestine among patients around 40-60 years of age,and are insensitive to chemotherapy or radiotherapy.

基于“从脾治痹”探讨热敏灸合募配穴治疗膝骨关节炎作用机制

膝骨关节炎(knee osteoarthritis,KOA)是一种发病机制复杂的骨关节疾病,其发病率有逐年增高的趋势。中医理论认为人体气血亏虚是KOA发病的根本原因,脾胃功能衰弱导致气血化生不足,水液运化失常,内生湿邪,膝关节在感受外邪后,内湿引动外邪合而发病。热敏灸是陈日新教授创立的一种特殊的灸疗法,可以通过对人体穴位施以饱和灸量,增加对穴位刺激量来治疗疾病。近年来,热敏灸治疗KOA的研究多集中在局部取穴,缺少对新的配穴方式及其作用机制的探讨。笔者从脾胃角度思考热敏灸合募配穴疗法治疗KOA的可行性,研究其潜在机制,为中医外治法治疗KOA提供新的理论支撑。

Risk of gastric cancer development after eradication of Helicobacter pylori

Helicobacter pylori(H. pylori) infection is the most important risk factor for gastric cancer(gc) development through the correa's gastric carcinogenesis cascade. However, H. pylori eradication alone does not eliminate gc, as pre-neoplastic lesions(atrophic gastritis, intestinal metaplasia and dysplasia) may have already developed in some patients. It is therefore necessary to identify patients at high-risk for gastric cancer after H. pylori eradication to streamline the management plan. If the patients have not undergone endoscopy with histologic assessment, the identification of certain clinical risk factors and non-invasive testing(serum pepsinogen) can predict the risk of atrophic gastritis. For those with suspected atrophic gastritis, further risk stratification by endoscopy with histologic assessment according to validated histologic staging systems would be advisable. Patients with higher stages may require long-term endoscopic surveillance. Apart from secondary prevention to reduce deaths by diagnosing gc at an early stage, identifying medications that could potentially modify the gc risk would be desirable. The potential roles of a number of medications have been suggested by various studies, including proton pump inhibitors(PPIs), aspirin, statins and metformin. However, there are currently no randomized clinical trials to address the impact of these medications on gc risk after H. pylori eradication. In addition, most of these studies failed to adjust for the effect of concurrent medications on gc risk. Recently, large population-based retrospective cohort studies have shown that PPIs were associated with an increased gc risk after H. pylori eradication, while aspirin was associated with a lower risk. The roles of other agents in reducing gc risk after H. pylori eradication remain to be determined.

Rare gastrointestinal lymphomas: the endoscopic investigation

Gastrointestinal lymphomas represent up to 10%of gastrointestinal malignancies and about one third of nonHodgkin lymphomas.The most prominent histologies are mucosa-associated lymphoid tissue lymphoma and diffuse large B-cell lymphoma.However,the gastrointestinal tract can be the site of rarer lymphoma subtypes as a primary or secondary localization.Due to their rarity and the multifaceted histology,an endoscopic classification has not been validated yet.This review aims to analyze the endoscopic presentation of rare gastrointestinal lymphomas from disease diagnosis to follow-up,according to the involved site and lymphoma subtype.Existing,new and emerging endoscopic technologies have been examined.In particular,we investigated the diagnostic,prognostic and follow-up endoscopic features of T-cell and natural killer lymphomas,lymphomatous polyposis and mantle cell lymphoma,follicular lymphoma,plasma cell related disease,gastrointestinal lymphomas in immunodeficiency and Hodgkin’s lymphoma of the gastrointestinal tract.Contrarily to more frequent gastrointestinal lymphomas,data about rare lymphomas are mostly extracted from case series and case reports.Due to the data paucity,a synergism between gastroenterologists and hematologists is required inorder to better manage the disease.Indeed,clinical and prognostic features are different from nodal and extranodal or the bone marrow(in case of plasma cell disease)counterpart.Therefore,the approach should be based on the knowledge of the peculiar behavior and natural history of disease.

Microsatellite instability in gastric cancer and pre-cancerous lesions

AIM: To investigate the microsatellite instability (MSI) in cancer and pre-cancerous lesions of the stomach and its mechanisms underlying the development of gastric cancer.METHODS: Thirty-six gastric cancer samples were obtained from patients undergoing surgery. Forty-one gastric mucosa samples with dysplasia and 51 with intestinal metaplasia (IM) were obtained from patients with chronic gastritis undergoing gastro-endoscopy. Genomic DNA was extracted from the samples. Silver staining single strand conformation polymorphis-polymerize chain reaction (SSCP-PCR) was used to screen MSI markers at 5 loci (Bat-25, Bat-26, D5S346, D17S250, and D2S123)in fresh tissues and formalin-fixed, paraffin-embedded samples and their corresponding normal gastric mucosa.RESULTS: The abnormal shifting of the single-strand DNA (MSI) was identified in 21 out of 36 (58.3%) gastric cancers.Seven cases showed high-level MSI (two or more loci altered) and 14 showed low-level MSI (one locus altered).Gastric cancer with MSI had a tendency to be located in the distal stomach. MSI was also detected in 11 out of 41(26.8%) dysplasia samples and in 9 of 51 (17.6%) IM samples respectively. Three cases of dysplasia and one case of IM showed high-level MSI. Eight cases of dysplasia and 8 cases of IM displayed low-level MSI. MIS in IM was found only in moderate or severe-grade IM. No association was detected between MSI and dysplasia grade.CONCLUSION: Accumulation of MSI in dysplasia and intestinal metaplasia of gastric mucosa may be an early molecular event during gastric carcinogenesis and may contribute to the acquisition of transformed cell phenotype and the development of gastric cancer.

Lamb’s tripe extract and vitamin B12 capsule plus celecoxib reverses intestinal metaplasia and atrophy:A retrospective cohort study

BACKGROUND Chronic atrophic gastritis(AG)with intestinal metaplasia(IM)significantly increases the risk of gastric cancer.Some medicines have showed definite therapeutic effects in AG and IM regression.AIM To validate the efficacy of Lamb’s tripe extract and vitamin B12 capsule(LTEVB12)initial therapy and celecoxib rescue therapy for IM and AG.METHODS A total of 255 patients were included to receive LTEVB12 initial therapy(2 capsules each time,three times daily for 6 mo)in hospital in this study.The patients with failure of IM regression continued to receive celecoxib rescue therapy(200 mg,once daily for 6 mo).After each therapy finished,the patients underwent endoscopy and biopsy examination.The regression efficiency was assessed by the operative link on gastritis assessment(OLGA)and the operative link on the gastric intestinal metaplasia assessment(OLGIM)staging system.Logistic regression analysis was applied to identify factors associated with the curative effect.RESULTS For LTEVB12 initial therapy,the reversal rates of IM and AG were 52.95%and 48.24%,respectively.Analogously,for celecoxib rescue therapy,the effective rates for IM and AG were 56.25%and 51.56%,respectively.The IM regression rate of complete therapy was up to 85.03%.In different OLGA and OLGIM stages of IM patients,therapeutic efficiency showed a significant difference in each group(P<0.05).For both therapies,patients with high stages(III or IV)of both the OLGA and OLGIM evaluation systems showed a higher IM or AG regression rate than those with low stages(I or II).Among patients with high stages(OLGIM III and IV),the IM regression rate was above 70%for each therapy.Eating habits,fresh vegetable intake,and high-salt diet were identified as independent factors for the IM reversal effect of LTEVB12 therapy,especially high-salt diet(odds ratio=1.852,P<0.05).CONCLUSION Monotherapy could reverse IM and AG.LTEVB12 initial therapy and celecoxib rescue therapy significantly increase the regression effect.IM may not be the point of no return among gastric precancerous lesions.

Effect of electroacupunture on gastric mucosal intestinal trefoil factor gene expression of stress-induced gastric mucosal injury in rats

AIM： To investigate electroacupunture（EA） at the acupoints of Stomach Meridian of Foot-Yangming（SMFY）, Gallbladder Meridian of Foot-Yangming（SMFY） on gastric mucosal intestinal trefoil factor （ITF） gene expression detection in stress-induced rats with gastric mucosal lesion, and to explore the regulatory mechanism and significance of EA-related gastric mucosal protective effect. METHODS： Forty rats were randomly divided into 4 groups： Blank group, Model group, Model group＋EA at acupoints of SMFY group（＂SMFY group＂）, and Model group＋EA at acupoints of GMFY group（GMFY group）. All rats （except blank group） were made model by water immersion and restraint stress （WRS）. Then the gastric mucosa tissue in each rat was taken off alter assessment of gastric mucosal lesion index（GUI）, and the expression of ITF mRNA of the tissues was detected by reverse transcdption-polymerase chain reaction（RT-PCR） method. RESULTS： Compared with Model group（S4.3± 1.34）, the GUI value in SMFY group （31±2.211 decreased significantly（P〈0.01）, so did that in GMFY group （39.8± 1.62, P〈0.05）, meanwhile GUI value in SMFY group was significantly lower than in GMFY group（P〈0.01）. Compared with Model group （0.65±0.01）, EA had a tendency to improve the expression of gastric mucosal ITFmRNA gene： such tendency existed in GMFY group （0.66±0.01） but with no signficant difference（P〉 0.05）, in SMFY group（0.76±0.01） with an extremely obvious difference （P〈0.01）, furthermore the expression in SMFY group was significantly higher than in GMFY group （P〈 0.01）.CONCLUSION： The gastric mucosal protective effect by EA at the acupoints of SMFY and GMFY was related to the expression variance of ITF, indicating certain meridian specificity exists, It could be one proof for the TCM theory ＂Relative pardcularity between SMFY and stomach＂.

Histopathological profile of gastritis in adult patients seen at a referral hospital in Kenya

AIM： To conduct a detailed histological study of gastritis in adult patients attending an endoscopy clinic at a Kenyan teaching and referral hospital.METHODS： Biopsy specimens from consecutive patients were examined and graded according to the Updated Sydney System for H pylori infection, chronic inflammation, neutrophil activity, glandular atrophy and intestinal metaplasia. Also documented were gastric tissue eosinophil counts and presence of lymphoid follicles.RESULTS： The rate of the graded variables, in the antrum and corpus respectively, were as follows： H pylori infection （91%, 86%）, chronic inflammation （98%, 93%）, neutrophil activity （91%, 86%）, glandular atrophy （57%, 15%） and intestinal metaplasia （11%, 2%）. Lymphoid follicles were noted in 11% of cases. Duodenal and gastric ulcers were documented in 32% and 2% respectively. The mean eosinophil count was 5.9 ±0.74 eosinophils/ HPF and 9.58 ± 0.93 eosinophils/HPF in the corpus and antrum respectively. Significant association was found between the degree of H pylori colonisation with chronic inflammation, neutrophil activity and antral glandular atrophy. Biopsies from the antrum and corpus showed significant histopathological discordance for all the graded variables. H pylori negative cases were associated with recent antibiotic use.CONCLUSION： The study the chief cause of gastritis reaffirms that H pylori is in this environment. The majority of patients show a moderate to high degree of inflammation but a low degree of glandular atrophy and intestinal metaplasia. The study shows that interrelationships between the histological variables in this African population are similar to those found in other populations worldwide including non-African populations.