Yiwei Xiaoyu granules for treatment of chronic atrophic gastritis with deficiency syndrome of the spleen and stomach

BACKGROUND The Correa sequence,initiated by Helicobacter pylori(H.pylori),commonly progresses to gastric cancer through the stage of chronic atrophic gastritis(CAG).Although eradication of H.pylori only reduces the risk of gastric cancer,it does not eliminate the risk for neoplastic progression.Yiwei Xiaoyu granules(YWXY)are a commonly used composite preparation in Chinese clinics.However,the pursuit of excellence in clinical trials and the establishment of standardized animal experiments are still needed to contribute to full understanding and application of traditional Chinese medicine in the treatment of CAG.AIM To demonstrate the effectiveness of YWXY in patients with CAG and spleenstomach deficiency syndrome(DSSS),by alleviating histological scores,improving response rates for pathological lesions,and achieving clinical efficacy in relieving DSSS symptoms.METHODS We designed a double-blind,randomized,controlled trial.The study enrolled seventy-two H.pylori-negative patients(mean age,52.3 years;38 men)who were randomly allocated to either the treatment group or control group in a 1:1 ratio,and treated with 15 g YWXY or 0.36 g Weifuchun(WFC)tablet combined with the respective dummy for 24 wk.The pre-randomization phase resulted in the exclusion of 72 patients:50 participants did not meet the inclusion criteria,12 participants declined to participate,and 10 participants were excluded for various other reasons.Seven visits were conducted during the study,and histopathological examination with target endoscopic biopsy of narrow-band imaging was requested before the first and seventh visits.We also evaluated endoscopic performance scores,total symptom scores,serum pepsinogen and gastrin-17.RESULTS Six patients did not complete the trial procedures.Treatment with YWXY improved the Operative Link on Gastric Intestinal Metaplasia Assessment(OLGIM)stage,compared with WFC(P<0.05).YWXY provided better relief from symptoms of DSSS and better improvement in serum gastric function,compared with WFC(P<0.05).CONCLUSION YWXY compared with WFC significantly reduced the risk of mild or moderate atrophic disease,according to OLGIM stage,significantly relieved symptoms of DSSS,and improved serum gastric function.

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.

Chronic active and atrophic gastritis as significant contributing factor to the development of gastric cystica profunda

Gastric cystica profunda(GCP)is an uncommon but underestimated gastric lesion.Its precancerous potential determines its significance.In addition to previous mucosa injury due to operations,biopsy or polypectomy,chronic active and atrophic gastritis may also lead to the development of GCPs.By carefully examining the stomach and taking biopsy samples from the susceptible regions,the stage of atrophy can be determined.Chronic atrophic gastritis is a risk factor for cancer evolvement and it can also contribute to GCPs formation.GCPs frequently occur close to early gastric cancers(EGCs)or EGC can arise from the cystic glands.Endoscopic resection is an effective and minimally invasive treat-ment in GCP.

Incidence and prevalence of gastric neuroendocrine tumors in patients with chronic atrophic autoimmune gastritis

BACKGROUND The incidence of type I gastric neuroendocrine neoplasms(gNENs)has increased significantly over the past 50 years.Although autoimmune gastritis(AIG)increases the likelihood of developing gNENs,the exact incidence and prevalence of this association remain unclear.AIM To evaluate the incidence and prevalence of type I gNENs in a cohort of patients with a histological diagnosis of AIG.METHODS Patients with a histological diagnosis of AIG were enrolled between October 2020 and May 2022.Circulating levels of CgA and gastrin were assessed at enrollment.Included patients underwent regular endoscopic follow-up to detect gastric neoplastic lesions,enterochromaffin-like(ECL)cell hyperplasia,and the development of gNEN.RESULTS We included 176 patients[142 women(80.7%),median age 64 years,interquartile range(IQR)53–71 years]diagnosed with AIG between January 1990 and June 2022.At enrollment.One hundred and sixteen patients(65.9%)had ECL hyperplasia,of whom,29.5%had simple/linear,30.7%had micronodular,and 5.7%had macronodular type.The median follow-up time was 5(3–7.5)years.After 1032 person-years,33 patients developed a total of 50 type I gNENs,with an incidence rate of 0.057 person-years,corresponding to an annual cumulative incidence of 5.7%.Circulating CgA levels did not significantly differ between AIG patients who developed gNENs and those who did not.Conversely,gastrin levels were significantly higher in AIG patients who developed gNENs[median 992 pg/mL IQR=449–1500 vs 688 pg/mL IQR=423–1200,P=0.03].Calculated gastrin sensitivity and specificity were 90.9%and 1.4%,respectively,with an overall diagnostic accuracy of 30%and a calculated area under the gastrin receiver operating characteristic curve(AUROC or AUC)of 0.53.CONCLUSION Type I gNENs are a significant complication in AIG.Gastrin’s low diagnostic accuracy prevents it from serving as a marker for early diagnosis.Effective strategies for early detection and treatment are needed.

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.

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.

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.

Application of"balancing digestive functions by regulating pivot"in chronic atrophic gastritis and professor Wei Wei's clinical experience

Chronic atrophic gastritis(CAG)has attracted wide attention in clinic due to its high incidence rate and high canceration rate.At present,modern medicine lacks an effective treatment scheme for CAG.Traditional Chinese medicine can improve clinical symptoms,laboratory indexes,pathological examination results and patients'quality of life for patients of CAG.Professor Wei used the method of"Balancing Digestive Functions by Regulating Pivot"to treat CAG in clinical practice.With flexible addition and subtraction on the basic prescription Banxia Xiexin decoction and coordination with various external treatment methods and psychological construction,professor Wei has achieved satisfactory clinical effects with the pungent-opening and bitter-descending method and dispersing liver and promoting blood circulation method.

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.

Clinical Observation on 34 Cases of Chronic Atrophic Gastritis Treated with Shenlian Twelve Flavors

[Objectives]The research aimed to observe the curative effect of Shenlian Twelve Flavors in treating CAG patients with spleen deficiency and blood stasis toxin.[Methods]66 cases of CAG patients with spleen deficiency and blood stasis toxin were selected,32 cases in the control group and 34 cases in the observation group were generated according to the random number table method.The control group was treated with Moluodan;the observation group was treated with Shenlian Twelve Flavors.After treatment,the effective rate,TCM symptom score,gastroscopic score,pathological score,serum gastrin 17(G-17)level,and adverse reactions were compared between the two groups.[Results]The total effective rates of control group and observation group were 84.37%and 91.18%,respectively,and there was no statistical significance between the two groups(P>0.05).For the improvement of TCM symptom score,both groups were improved significantly compared with that before treatment,and observation group was better than control group(P<0.05).For the improvement of gastroscopic score,both groups were improved compared with that before treatment,and observation group was better than control group(P<0.05).For the improvement of pathological scores,both groups were improved compared with that before treatment,but there was no statistical significance between the two groups(P>0.05).[Conclusions]Shenlian Twelve Flavors has definite clinical efficacy in the treatment of CAG with spleen deficiency and blood stasis toxin.It could improve clinical symptoms,delay pathological progress,and regulate the level of G-17.There is no obvious adverse reaction,and it is worthy of clinical reference.

Traditional Chinese herbal medicine plus triple therapy in treating Helicobacter pylori-induced chronic atrophic gastritis: a meta-analysis and cumulative meta-analysis

Objectives:To evaluate the benefits of traditional Chinese herbal medicine(TCHM)plus triple therapy(TT)in the management of Helicobacter pylori(H.pylori)-induced chronic atrophic gastritis(CAG).Methods:A comprehensive access and electronic database search were carried out from inception to June 2020.Prospective randomized trials(TCHM plus TT vs.TT)were selected to assess the eradication rate of H.pylori(ER of H.pylori),clinical symptom relief rate(SRR),treatment-related adverse reactions(TRAR)and 95%confidence intervals(CI)in the meta-analysis and cumulative meta-analysis(CMA).Meta-regression analysis was used to analyze heterogeneity between studies and publication bias.Results:33 studies contained 3,226 participants were included.Compared with the TT group,TCHM plus TT group showed a significantly higher ER of H.pylori(OR=4.14,95%CI:3.21-5.35;P=0.000)and SRR(OR=4.50,95%CI:3.59-5.64).Meanwhile,the TRAR of TCHM plus TT remedy was significantly lower than TT monopoly(RR=0.43,95%CI:0.29-0.64;P=0.000).The results of the CMA,sorted by publication year,duration of treatment,and sample size,confirmed that combined treatment remedy was superior to TT monopoly in respect of ER of H.pylori and SRR.Conclusions:The present study obtained reliable and convincing evidence suggesting that TCHM plus TT remedy was efficacious and safe in treating H.pylori-induced CAG.

Research Progress of Treating Chronic Atrophic Gastritis by Non-Drug Therapy

Modern medicine believes that the incidence and detection rate of chronic atrophic gastritis(CAG)are positively correlated with age.Early detection,monitoring and intervention are helpful to reduce the incidence and mortality of gastric cancer.Non-drug therapy has many unique methods,wide range of application,simple operation,easy to popularize characteristics.In the process of using non-drug therapy to treat CAG syndrome differentiation,the principle of"treating the same disease with different methods"and"treating different diseases with the same method"must be followed.In recent years,in order to improve the quality of life of CAG patients and optimize treatment methods,some research progress has been made in the treatment of chronic atrophic gastritis with non-drug therapy.This paper summarized mainly from the basic function principle and the characteristic of Chinese medicine non-drug therapy,the mechanism of various kinds of non-drug therapy treatment of chronic atrophic gastritis and its respective application.

A cross-sectional study on traditional Chinese medicine syndromes distribution for chronic atrophic gastritis based on data mining

Background:Chronic atrophic gastritis(CAG)is a common digestive system disease characterized by reduced gastric mucosa inherent glands and often accompanied by intestinal metaplasia and dysplasia.Traditional Chinese medicine believes that syndrome elements dampness and blood stasis are closely related to the occurrence and development of CAG and promote the occurrence of precancerous lesions of gastric cancer.However,there is a lacking of more in-depth and detailed study on the above syndrome elements.This study aimed to made a quantitative description by cross-sectional study on the frequency of key syndrome elements dampness and blood stasis of CAG.Methods:201 CAG patients who met with inclusion criteria were divided into 4 groups including:only dampness group,only blood stasis group,none of dampness and blood stasis group,dampness and blood stasis group according to their four diagnostic information.The severities and levels of patients’clinical symptoms,pathological signs and patient-reported outcome scale used as evaluation indexes were collected.Data mining method of exploratory factor analysis was used for statistics.Results:The results suggested that the frequencies of dampness and blood stasis were reflected in the severity and levels of gastric symptoms,helicobacter pylori infection and the distribution and severity of dysplasia.And blood stasis played a more prominent role in promoting the progression of the CAG to cancer.Conclusion:Our results might provide a quantitative syndrome description for the traditional Chinese medicine differentiation in treating precancerous lesions of gastric cancer and preventing gastric cancer.

Improved method for inducing chronic atrophic gastritis in mice

BACKGROUND Chronic atrophic gastritis(CAG)is a common disease of the digestive system with pathological characteristics of a decreasing number,or disappearance,of inherent glands of the gastric mucosa.CAG has been defined as a precancerous condition of gastric cancer.Intestinal metaplasia or intraepithelial neoplasia accompanying atrophied glands of the stomach is regarded as one of the most important precancerous lesions of gastric cancer.As a common malignant tumour,gastric cancer remains without a satisfactory therapy and its pathogenesis remains unclear,seriously threatening human life.Therefore,some scholars have proposed to prevent the incidence of gastric cancer by avoiding precancerous lesions.If CAG can be reversed,the incidence of gastric cancer can be substantially reduced.To reverse and prevent CAG and study its pathogenesis and therapy,it is necessary to develop an ideal,safe,stable,animal model.AIM To study a rapid,stable,and safe method of establishing a mouse model of human CAG.METHODS Six-week-old Kunming mice were divided into a phosphate buffered solution control group,a Helicobacter pylori(H.pylori)group,an N-methyl-N'-nitroguanidine(MNNG)group,an ammonia water group,and a group combining H.pylori,MNNG,and ammonia water(hereinafter referred to as the combined group).The mice were administrated with drinking water containing ammonia or infected with H.pylori through gavage.At the 30th,60th,90th,and 120th day after the last H.pylori infection,mice were selected randomly to collect their gastric mucosa for hematoxylin eosin staining,terminal nick-end labelling staining detection,and immunohistochemical staining for Bax and Bcl-2.In addition,H.pylori was isolated,cultured,and identified,and its extent of colonisation calculated.Blood was collected to detect inflammatory factors interleukin(IL)-1β,IL-8,and tumor necrosis factor(TNF)-αand immune function markers CD4 and CD8 to confirm successful establishment of the CAG model.RESULTS The combined group showed slight CAG at the 90th day and moderate CAG at the 120th day,while other groups did not show CAG at that time.CONCLUSION The combination of H.pylori,MNNG,and ammonia is an effective method of developing a mouse model of human CAG.

Effects of Anwei decoction on the protein expression of TFF in rats with chronic atrophic gastritis

Objective: To explore the effects of Anwei decoction (AD) on the protein expression of TFF in rats with chronic atrophic gastritis(CAG). Methods: Forty-eight healthy rats were randomly divided into 4 groups: normal control group, pathologic model group, Anwei Decoction group, and Weifuchun group. CAG was induced in rats with N-methy-N-nitro-N-nitrogua-nidine (MNNG). The protein expression of TFF in rats’ gastric mucosa was determined by immunohistochemistry. Results: Compared with that in the normal control group, the protein expression of TFF1 was significantly enhanced in the pathologic model, Anwei Decoction and Weifuchun groups (both P TFF1 was significantly higher in the Anwei Decoction group than in the Weifuchun group (P < 0.01). Compared with the normal control group, the protein expression of TFF2 was significantly enhanced in the pathologic model, Anwei Decoction and Weifuchun groups (both P < 0.01). The protein expression level of TFF2 was significantly higher in the Anwei Decoction group than in the Weifuchun group (P < 0.01). In comparison with the pathologic model group, the protein expression of TFF3 was remarkably reduced in Anwei Decoction and Weifuchun groups (both P < 0.01). but there was no difference between the group of Anwei decoction and the group of Weifuchun (P > 0.05). Conclusion: Anwei decoction may be effective in the treatment of CAG by enhancing the protein expression of TFF1, TFF2 while reducing that of TFF3 in gastric mucosas.

Koumiss Consumption Alleviates Symptoms of Patients with Chronic Atrophic Gastritis:A Possible Link to Modulation of Gut Microbiota

Intestinal dysbiosis is closely related to a variety of medical conditions,especially gastrointestinal diseases.The present study aimed to investigate the effects of koumiss on chronic atrophic gastritis(CAG)in an outpatient clinical trial(n=10;all female subjects aged 41-55;body mass index ranging from 19.5 to 25.8).Each patient consumed three servings of koumiss per day(i.e.250 ml daily before each of 3 meals)for a 60-day period.The improvement of patients'symptoms was monitored by comparing the total scores of symptoms before and after the treatment.Meanwhile,the changes in the patients’fecal microbiota composition and specific blood parameters were determined.After the 60-day koumiss administration,significant symptom improvements were observed,as evidenced by the reduction of the total symptoms score,and changes in blood platelet and cholesterol levels.The changes in patients’fecal microbiota composition were found.The patients’fecal microbiota fell into two distinct enterotypes,Bacteroides dorei/Bacteroides uniformis(BB-enterotype)and Prevotella copri(P-enterotype).Significant less Bacteroides uniformis was found in the BB-enterotype patient group,while significant more butyrate-producing bacteria(e.g.Eubacterium rectale and Faecalibacterium prausnitzii)were found in the P-enterotype patient group,following koumiss administration.After stopping koumiss consumption,the relative abundance of some biomarker taxa returned to the original level,suggesting that the gut microbiota modulatory effect was not permanent and that continuous koumiss administration was required to maintain the therapeutic effect.In conclusion,koumiss consumption could alleviate the symptoms of CAG patients.Our results may help understand the mechanism of koumiss in alleviating CAG disease symptoms,facilitating the development of such products with desired therapeutic functions.

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.

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.