Cdx2蛋白在不同亚型肠上皮化生中的表达及其与H. pylori感染的关系

目的探讨胃黏膜肠上皮化生(intestinal metaplasia,IM)中尾型同源异型盒基因2(caudal type homeobox genes 2,Cdx2)蛋白的表达及其与幽门螺杆菌(helicobacter pylori,H.pylori)感染的关系。方法选取内镜下活检的18例正常胃黏膜和53例IM胃黏膜。采用高铁二铵-爱先蓝-过碘酸雪夫反应(HID-AB-PAS)将胃黏膜IM分为Ⅰ、Ⅱ、Ⅲ型,然后用Cdx2单克隆抗体进行免疫组织化学染色,检测Cdx2在正常胃黏膜及不同亚型IM中的表达。采用一分钟快速尿素酶实验及甲苯胺蓝染色检测H.pylori感染。结果Cdx2蛋白在正常胃黏膜中不表达,IM中Cdx2阳性表达率为83.02%(44/53),其中Ⅰ型IM阳性率为95.45%(21/22),Ⅱ型为83.33%(15/18),Ⅲ型为61.53%(8/13),三者间Cdx2蛋白表达有显著性差异(P=0.036)。IM中H.pylori感染阳性率为47.17%(25/53),其中Ⅰ型IM中H.pylori感染阳性率为27.27%(6/22),Ⅱ型为55.56%(10/18),Ⅲ型为69.23%(9/13),三者间H.pylori感染率亦有显著性差异(P=0.038)。Cdx2蛋白表达主要集中于H.pylori感染阴性者,但H.pylori感染阳性者和阴性者Cdx2表达无统计学差异(P>0.05)。结论Cdx2蛋白异常表达可能参与了胃黏膜IM向胃癌的转变,检测其表达有助于预测胃黏膜IM向胃癌转变的可能性。

Sero-Prevalence of <i>H. pylori</i>Antibodies among Asymptomatic Rural Population in Bauchi State, Nigeria—A Preliminary Study

Helicobacter pylori infection is a major public health problem globally, with high prevalence in developing countries associated with poor sanitation, low standard of living, urban-rural disparity and increased gastrointestinal pathologies. This preliminary study determined the seroprevalence of H. pylori infection among asymptomatic rural population and association of sociodemographic variables on the result outcome. A total of 250 asymptomatic volunteered participants were screened for H. pylori antibodies, using rapid immunochromatographic strips. 44.8% (112/250) were seropositive, and showed increased prevalence with the age group, <15 years (8.0%), 18 - 39 years (23.5%) and 40 - 65 years (12.0%) with no significant difference. High prevalence among males, 88 (35.2) compared to 24 (9.6) females (p < 0.228). Significant association was observed with marital status, high prevalence among married participants 63 (25.0) followed by singles, 41 (16.4) (p < 0.010). Similarly, significant prevalence was observed among participants with non-formal education, 60 (24.0) followed by primary education, 21 (8.4) (p < 0.51). While non-salary earners accounted for 79 (31.6) (p < 0.244). The H. pylori seropositivity of 44.8% is relatively low in region with previous reports of high prevalence and predisposing risk factors. Further studies are needed to evaluate the effect of environmental and occupational risk factors for better epidemiological understanding of H. pylori infection and a template for intervention measures.

Profile of Endoscopic Lesions and Prevalence of <i>H. pylori</i>Infection at the Digestive Endoscopy Unit of Panzi General Reference Hospital in Bukavu

Introduction: Thanks to the opening of the digestive endoscopy unit in the Reference General Hospital of Panzi in Bukavu in the Democratic Republic of the Congo, which inspired our work on the profile of endoscopic lesions observed in a series of 1000 patients correlated with clinical and demographic criteria with the contribution of pathology examinations of the 292 biopsies performed. The aim of our work is to evaluate the prevalence of significant endoscopic lesions as well as that of H. pylori infection. Material and Methods: This is a retrospective, descriptive and analytical study, ranging from the 16th of December 2014 to the 16th of June 2016. It covered 1000 patients who benefited from a high digestive endoscopy and 292 of them had a biopsy with pathological examination. The data obtained were recorded and analyzed using the Epi-info software and chi-square test. Results: fifty-five percent of these patients were women. 66% of the patients were under 50 years of age. Their major symptom was epigastric pain (89.2%), the most observed endoscopic lesion was erythematous gastritis (82%) therefore we have noticed 21.5% of significant lesions. Gastric cancer was present in 3.9% of cases and gastric ulcer in 4.2% of cases. The gastric tumor was correlated with age and sex (P-value at 0.000 and 0.013). The gastroduodenal ulcer was linked to age, NSAID and tobacco use (P-value at 0.0007, 0.001, 0.007). Esophageal mycosis was correlated with HIV status (P-value at 0.000). Helicobacter pylori gastritis was the most frequent (61.30%) and Helicobacter pylori were present in 63% of gastric biopsies. Conclusion: Upper digestive endoscopy is a major tool for the diagnosis of upper gastrointestinal disorders and should always be followed by a biopsy if there is a suspicious lesion for pathologic confirmation and adequate management.

Which Gastric Microbiota Associated with <i>H. pylori</i>in Dyspeptic Patients with Gastritis

Introduction: H. pylori is the comment infection worldwide. Its relation to dyspepsia has long been investigated. However, the association between H. pylori and other microbiota in the context of dyspepsia is less understood. The aim of this study was to determine different bacterial species isolated from the stomachs of patients with H. pylori infection and dyspepsia. Methods: A total of 81 patients were included and divided into: group I (N = 50) patients complaining of chronic dyspepsia and group II (N = 31) are patients with non-dyspeptic symptoms endoscoped for reasons other than dyspepsia. All patients were endoscoped and 4 gastric biopsies were obtained from each patient. All patients were examined initially by rapid urease test then histopathology to confirm H. pylori infection and determine the degree of gastric inflammation and finally tissue cultures for H. pylori and other bacterial species using matrix-assisted laser desorption ionization-time-of-flight mass spectroscopy (MALDI-TOF MS). Results: Regarding the demographics;patients of dyspepsia in group I were more consumers of spicy food and smoking than non-dyspeptic patients. Almost, all dyspeptic patients (98%) who had underlying gastric pathology with active gastritis and erosions were the most frequent reported pathological findings. Culture results showed significant association of Staphyloccus and Lactobacillus with dyspepsia while Streptoccous and Klebsilla were more frequent among non-dyspeptic patients. Conclusion: Dyspeptic patients in this study had different grades of gastric pathology and different species of microbiota were isolated, which seems to have concomitant interaction with H. pylori in pathogenicity of gastric mucosa and cause symptoms of chronic dyspepsia.

Predictors of <i>H. pylori</i>infection in a safety-net hospital in Arizona

Objective: The purpose of this study was to determine the risk factors associated with having H. pylori infection as proven by endoscopic biopsy at Maricopa Medical Center (MMC), a safety-net hospital in phoenix, Arizona which serves primarily patients with limited financial and insurance resources. Methods: A total of 1116 biopsies were identified in a Department of Pathology database searched from November 2004 to March 2013. To be included, the subjects had to have an endoscopy with gastric biopsy. After the inclusion criteria were applied, 282 control subjects without histological evidence of H. pylori infection and 256 cases with histological evidence of H. pylori infection were identified. Patient charts were reviewed to extract information on variables collected for this study. Results: The mean age of cases and controls was 50.5 and 52.3 years respectively. The BMI of the cases and controls was 28.1 and 28.0 respectively. The mean number of upper endoscopic exams performed was 1.3 in cases and 1.4 in controls respectively. Potential predictors examined were gender, history of drug abuse, history of alcohol abuse, chronic pain medication use, smoking, employment status, outpatient vs. inpatient upper endoscopy exam, language spoken (English, Spanish, or bilingual), race/ ethnicity, type of insurance, heart burn, dysphagia, abdominal pain, gastroduodenal ulcers, intestinal metaplasia, and having vs. not having a primary care physician. Based on univariate analyses, having a gastroduodenal ulcer, having a history of abdominal pain, Hispanic race, government insurance status, self-pay insurance status, and speaking Spanish only were found to be significantly related to having H. pylori infection. These variables were next entered into a multivariate analysis. The multivariate analysis revealed that gastroduodenal ulcer, abdominal pain, Hispanic race and self-pay insurance status remained significant predictors of H. pylori infection. For the last 119 subjects, information regarding the country of their birth was available. These 119 subjects were separately analyzed. Country of birth, age, sex, Hispanic race, self-pay insurance status, Spanish speaker, and having government insurance were included in a multivariate analysis. Twenty seven percent of patients without H. pylori were born in the US, compared to fifty eight percent H. pylori positive patients who were born outside of the US. Conclusion: Hispanics are at high risk for H. pylori infection. In a multivariate model, patients with H. pylori were found to have a higher risk of ulcers, Hispanic race, abdominal pain and self-insurance status. When self-insurance and Hispanic race were included in another analysis with place of birth, only birth outside US remained significant.

The Transitional Zone - The Key to Understanding H. pylori-associated Disease

Long before the discovery of Helicobacter pylori, there were many excellent observational studies that documented differences in the patterns of gastroduodenal disease. It was clear that in the developing world, gastric ulcer and gastric cancer were more common than in the developed world where duodenal ulcer predominated. This correlated with the distribution of gastritis in duodenal ulcer patients where the inflammation was antral predominant while in gastric ulcer patients the gastritis was more evenly distributed through the stomach. Gastric ulcers usually appeared in a fairly restricted distribution in the stomach near the angulus and close to the transitional zone between antrum and body mucosa. As a so ciety developed sothese patterns of disease changed.

H. pylori Infection - Basic and Clinical Outcomes

H. pylori infection causes invariably chronic inflammation of the gastric mucosa and predisposes for peptic ulcerations in the stomach and duodenum as well as for gastric neoplasias. A subset of patients with chronic gastritis and without additional lesions will develop dyspeptic symptoms, whereas around 80% of all infected may never experience any clinical manifestation. The determinants of different diseases conditions associated with the H. pylori infection are related to the variability of bacterial strains, host genetic factors, and ambiental conditions.

H. pylori Infection - An Overview

Comparison of the two recently identified genome sequences has revealed that, of the～1500 genes, some 60 % can be assigned a predicted function, while another 20 % have homologues of unknown identity. The remainder has no currently identified homologues. Of singular importance is the 'pathogenicity island' of which the cagA-gene is a marker. The vacA-gene is outside the pathogenicity island and is a true cytotoxin. The cag pathogenicity island encodes proteins associated with cell signaling and secretion systems for delivery of virulence factors to target cells. Certaingenotypes, particularly the cag-A positive,

Racial Differences in H. pylori Infection and Disease Outcomes in a Mutiracial Asian Country

Malaysia epitomizes the multiraciality of a South East Asian country where three major Asian races: Malay, Chinese and Indians live together. The distribution of Hp infection amongst the differences in Malaysia show an interesting pattern with the Malays having a consistently low prevalence compared to the Chinese and Indians. In our seroepidemiological studies and in a large endoscopic survey, Chinese and Indian race remained as independent predictive factors for H.pylori infection, after adjusting for possible confounding factors such as social class and age.

Protective Effect of Decoction of Liao-wei on Gastric Mucosa of H. pylori Associated Chronic Atrophic Gastritis in Rats

To investigate the protective effect of decoction of liaowei on gastric mucosa of H. pylori associated chronic atrophic gastritis in rats. The H. pylori associated chronic atrophic gastritis models were induced with sodium deoxycholate, sodium salicylate, ethanol, and culture broth of H. pylori. Protective effect of decoction of liaowei on gastric mucosa of H. pylori associated chronic atrophic gastritis was observed quantitatively.

H. pylori, Cydooxygenase and Gastro-duodenal Diseases

The studies on H. pylori infection and its effects on the development of peptic ulcer disease and gastric cancer have led to a new area of exploration, namely the role of cyclooxygenase in these pathogenic mechanisms. Cyclooxygenase is the most important enzyme in the local production of prostagladins in the stomach. What are the effects of H. pylori infection on expression of cyclooxygenase I/II (COX-I and COX-H)? How would COX expression affect of healing of ulcers when NSIAD or COX-II inhibitors are to be used? Is there a role of COX expression in the development of gastric cancers?

Molecular Diagnosis and Analysis of Virulent Strain of H. pylori

The infection of H. pylori was conventionally diagnosed by microscope identification and isolation ofthe pathogen by culture. However, these procedures are fairly time consuming and not sensitive enough. We have developed highly sensitive and specific method to detect the infection by PCR based amplification of nucleicacid. Using this procedure, we are studying the molecular aspect of this particular pathogen. The genetic analysis of clarithromycin resistant strain revealed that the appearance of resistant strain is not due to the conversion from sensitive strain to resistant,