Objective To evaluate the clinical effectiveness of helicobacter pylori (HP) eradication in treating functional dyspepsia (FD) patients with HP infection. Methods The randomized controlled trials (RCTs) about HP eradication vs. general treatment for FD patients published by April, 2012 were searched in the following databases: CBM, CNKI, WanFang Data, PubMed, Ovid, EMbase and The Cochrane Library (Issue 1, 2012). According to the inclusion and exclusion criteria, two reviewers independently screened studies, extracted data, and evaluated the methodological quality. Then the meta-analysis was conducted using RevMan 5.1 software. Results The total 14 RCTs were included. Among all 2 665 patients involved in, 1 339 were in the treatment group, while the other 1 326 were in the control group. The results of meta-analysis showed that HP eradication was superior to general treatment for FD patients in clinical effects (RR=3.90, 95%CI 3.08 to 4.94, Plt;0.000 01), symptomatic score (WMD=−1.68, 95%CI −1.88 to −1.47, Plt;0.000 01), and improvement of upper abdominal pain (RR=2.84, 95%CI 2.02 to 3.99, Plt;0.000 01). Conclusion With obviously clinical effects, HP eradication can decrease the symptomatic score of dyspepsia, and especially improve upper abdominal pain. For the quality and quantity limitations of the included studies, more well-designed and double blind RCTs are required to further prove this conclusion.
Objective To provide evidence of the role of helicobacter pylori eradication in the treatment of functional dyspepsia. Methods We searched VIP, CBMdisc, MEDLINE and The Cochrane Library for systematic reviews, meta-analysis, randomized controlled trials and clinical guidelines involving helicobacter pylori and functional dyspepsia, so as to provide the best evidence for clinical practice. Results We included two systematic reviews, one meta-analysis and eleven randomized controlled trials. The evidence identified showed that helicobacter pylori infection was more prevalent in functional dyspepsia than in asymptomatic patients, but the effect of H pylori infection in the pathogenesis of functional dyspepsia remained controversial. H pylori eradication therapy had a relatively weak effect in H pylori positive functional dyspepsia. An economic model suggested that this modest benefit may still be cost-effective, but more studies are needed to assess this. Conclusion According to the current evidence, it can be concluded that helicobacter pylori eradication for the treatment of functional dyspepsia should be individualized.
目的 幽门螺杆菌NCTC11637菌株Hp1501基因进行序列测定，并运用生物信息学软件对其进行分析。 方法 用聚合酶链反应方法从幽门螺杆菌 NCTC11637菌株基因组DNA扩增Hp1501基因，T-A克隆，鉴定后测序，将基因序列向GeneBank提交并申请登录号，用生物信息学软件分析其生物学特性。 结果 成功获取幽门螺杆菌 NCTC11637株Hp1501基因序列，获得GeneBank登录号JF820815。软件分析表明，序列全长为1 164 bp，与幽门螺杆菌国际标准株26695和J99的基因序列一致性为96%～97%，氨基酸序列一致性为97%～98%；软件预测其编码的前59个氨基酸为信号肽，其编码的核心肽为幽门螺杆菌外膜蛋白。 结论 成功测定幽门螺杆菌 NCTC11637菌株Hp1501基因序列并预测出其生物学特性，为进一步研究其功能，阐明其致病机制奠定了基础。Objective To determine the sequence of Hp1501 gene from H. pylori NCTC11637 and analyze the sequence with bioinformatics software. Methods Polymerase chain reaction (PCR) was used to amplify the Hp1501 gene from chromosomal DNA of H. pylori NCTC11637. After T-A clone, the amplified DNA sequence was determined and the gene sequence was sent to GeneBank for analysis with bioinformatics software. Results Hp1501 gene from H. pylori NCTC11637 was successfully attained, and the logging number for GeneBank was JF820815. The analysis showed that the gene sequence was 1164 bp in length, 96%-97% identical in DNA sequence and 97%-98% identical in amino acid sequence compared with standard strain 26695 and J99. The forward 59 amino acids were signal peptide and the core peptide was outer membrane protein of H. pylori based on the software prediction. Conclusions The sequence and bionomics of Hp1501 gene from H. pylori NCTC11637 has been determined successfully. It provides a solid base for the further research of the biological function and pathogenicity mechanism of H. pylori.
ObjectiveTo study the relationship between cholecystectomy and Helicobacter pylori （Hp） infection. MethodsOne hundred and eleven patients with cholecystolithiasis were chosen as the investigation group, while 577 patients with upper digestive tract symptoms without cholecystolithiasis as the control group. All the patients took the 13C breath test to determine whether they were infected by Hp. All the patients with Hp infection continued eradical therapy for Hp infection for one course after cholecystectomy and were followed up on outpatient basis. ResultsThe infection rate in the investigation group was 45.9%, while 27.4% in the control group. During the 3 to 6 months of followup for the patients undergoing eradical therapy for Hp infection, we found no patient complaining of epigastric pain, malaise, belching and nausea. ConclusionThe infection rate of Hp in patients with cholecystolithiasis is high, Hp may be one of the factors causing “postcholecystectomy syndrome”. Eradical therapy for Hp after cholecystectomy will help improve the effects of operation.
ObjectiveTo study the expression of cyclooxygenase2 (COX2) and its clinical significance in gastric carcinoma. MethodsThe expression of COX2 in 47 cases of gastric carcinoma and 16 cases of normal gastric tissue were detected by SP immunohistochemical technique. Helicobacter pylori (H.pylori) infection was diagnosed by urease experiment and Giemsa staining.ResultsThere was no positive signal of COX2 detected in normal gastric tissue. The positive expression rate of COX2 was 63.8%(30/47) in gastric carcinoma.The expression of COX2 was correlated with TNM stage, lymph node metastasis and H.pylori infection（P＜0.01）. Positive COX2 expression rate in H.pylori infection group was 72.4%(21/29), significantly higher than that in the group without H.pylori infection.Conclusion COX2 expression is involved in the carcinogenesis and malignant progression of gastric carcinoma.The examination of COX2 may be helpful to judge biological behavior of gastric carcinoma.
Objective To make an individualized treatment plan for one first-visit gastro-esophageal reflux disease patient via evidence-based medicine methods. Methods The condition of the patient was evaluated comprehensively, then clinical problems were put forward according to PICO principle, and high-quality evidence was collected from The Cochrane Library (1990 to 2010), PubMed (1990 to 2010), and EMbase (1990 to 2010). The treatment plan was designed based on the evaluation of evidence, doctor’s experience, and patient’s preferences. Results A total of 17 RCTs and 10 meta-analyses/ systematic reviews were included. The evidence showed that the therapeutic effect of PPI was better than that of H2RA, and meanwhile prokinetic drugs should be used. When PPI needed to be use for a long time, HP eradication operation was required for the combination of HP inflammation. Laparoscopic fundoplication surgery was a better choice if the operation was required. Based on the above evidence combined with the patient’s preferences, the combination of general treatment, esomeprazole and cisaPride were adopted to treat. Meanwhile, anti-HP medicine was used to control the HP inflammation caused by the long-term maintenance therapy. The gastro-esophageal reflux symptoms were remarkably relieved six months after the treatment. Conclusion PPI plus prokinetic drugs, combined with HP eradication of gastroesophageal reflux surgery, can improve the clinical outcomes and patient’s quality of life. However, long-term prognostic benefits need to be confirmed by further follow-up.
Objective To evaluate the efficacy and safety of furazolidone-based first-line therapy for Helicobacter pylori infection. Methods The randomized controlled trials (RCTs) of furazolidone-based first-line therapy for Helicobacter pylori infection were identified from Cochrane Library (Issue 1, 2009), PubMed (1992 to January 2009), OVID (1994 to January 2009), Wanfang Data (1994 to January 2009), CNKI (1994 to January 2009), and VIP Data (1994 to January 2009). The quality of included RCTs was assessed, and the meta-analysis was conducted with RevMan5.0 software. Results Among five included RCTs involving 499 patients, four were graded as B in methodology quality and the left one was graded as C. As to the intention-to-treat (ITT) analysis, the Helicobacter pylori eradication rate was 78.3% in furazolidone group and 66.8% in control group (RR=1.18, 95%CI 0.86 to 1.62), while the Per Protocol (PP) analysis, the eradication rate of furazolidone group and control group was 83.1% and 70.9% respectively (RR=1.17, 95%CI 0.88 to 1.57). The incidence rate of mild side-effects was 40.8% in furazolidone group and 39.4% in control group (RR=1.03, 95%CI 0.79 to 1.36), and while that of severe side-effects in furazolidone group and control group was 7.8% and 3.7% respectively (RR=1.86, 95%CI 0.84 to 4.09). Conclusions With similar efficacy and safety as control group has, the furazolidone-based therapy could be recommended as a first-line therapy for Helicobacter pylori infection. The high-quality RCTs with large sample are required to prove the above conclusion for the limitation of quantity and quality of included studies.
Objective To systematically review the relationship between helicobacter pyloric (HP) infection and ischemia stroke. Methods We searched MEDLINE, BIOSIS, VIP, and China Full Text Journal databases to identify the studies that studied the relationship between HP infection and ischemia stroke. All the studies were strictly screened according to the inclusion criteria, and meta-analyses were performed for the included studies using RevMan 4.2 software.Results Eleven case-control studies involving 1 530 patients with ischemia stroke and 1 451 health controls were included. The results of meta-analyses showed that there was a significant difference in the infection ratio of HP between the patients with ischemia stroke and health controls (OR=1.77, 95%CI 1.38 to 2.28, Plt;0.0001), but this difference was not been found after adjusting some related risk factors (1.22, 95%CI 0.93 to 1.59, P=0.15). The results of subgroup meta-analyses showed these differences were only found in the LAA (large-artery atherosclerosis) subgroup (OR=3.65, 95%CI 2.58 to 5.17) and the SAA (small-artery atherosclerosis) subgroup (OR=1.74, 95%CI 1.30 to 2.34), but was not found in the CE (cardiogenic cerebral embolism) subgroup (OR=1.08, 95%CI 0.58 to 2.02). Conclusion HP infection is associated with ischemia stroke, but the relationships between HP infection and the subtypes of ischemia stroke are different. The association between HP and LAA is ber than that between HP and the other subtypes. More evidence is needed to prove whether Helicobacter pyloric infection is an independent risk factor of ischemia stroke.
Objective To analyze the relationship between helicobacter pylori (HP) and gastric cancer. Methods We searched CNKI (Jan.1995-Dec.2005) and Wangfandatabase (Jan.1995-Dec.2005). Case-control studies on relationship of helicobacter pylori infection and gastric cancer were collected. Meta-analysis method was used to sum up the odds ratio (OR) and 95%CI of these studies.Results We identified 14 case-control studies with 11 studies of healthy adults versus gastric cancer patients and 4 studies of gastritis versus gastric cancer patients. The results of subgroup analyses based on patients resource showed: statistical difference was founded between healthy adults and gastric cancer patients with pooled OR 2.00 and 95%CI 1.25 to 3.20; no statistical difference was founded between gastritis patients and gastric cancer patients with pooled OR 1.54 and 95%CI 0.68 to 3.50. The results of subgroup analyses based on locations of gastric cancer showed: statistical difference was founded between the non-cardiac gastric cancer patients and the control with pooled OR 3.60 and 95%CI 1.25 to 10.36; no statistical difference was found between cardiac gastric cancer patients and control with pooled OR 0.88 and 95%CI 0.56 to 1.39.Conclusion HP infection can be associated with gastric cancer, and the different conclusions of the 14 reports may be attributed to the locations of gastric cancer and the selection of controls.