ObjectiveTo investigate and analyze the prevalence and influencing factors of Helicobacter pylori (Hp), to provide scientific basis for the development of Hp infection prevention and control program.MethodsThe Hp infection of healthy population who received 13C-urea breath test in Sichuan Science City Hospital from January to December 2018 were retrospectively analyzed. Medical examination reports were collected and sorted out. We compared the gender and age differences of Hp infection, and binary logistic regression analysis was performed to analyze the risk factors of Hp infection.ResultsA total of 8 093 healthy participants were included, including 5 530 males (68.33%) and 2 563 females (31.67%). The infection rate of Hp was 37.80% (3 059/8 093) in all subjects. The infection rate of males [39.48% (2 183/5 530)] was significantly higher than that of females [34.18% (876/2 563)] (χ2=20.899, P<0.001). The infection rate of 50-59 years old group was the highest (43.87%), and that of <30 years old group was the lowest (30.93%). The difference of Hp infection rate among different age groups was statistically significant (χ2=64.577, P<0.001). Logistic regression analysis showed that male [odds ratio (OR) =1.257, P<0.001], 40-49 years old (OR=1.446, P<0.001), 50-59 years old (OR=1.756, P<0.001), 60-69 years old (OR=1.512, P<0.001), high total cholesterol level (OR=1.221, P=0.003) and obesity (OR=1.403, P<0.001) were risk factors for Hp infection.ConclusionsThe prevalence of Hp infection in the general hospital is lower than the national average level, and male, 40-69 years old, high total cholesterol level and obesity are predictors of Hp infection. Effective measures should be taken to prevent and control the infection of Hp.
ObjectiveTo understand the mechanisms of gastric carcinogenesis relevant to Helicobacter pylori (H. pylori)-related cell apoptosis and explore potential causes of gastric cancer development through cell apoptosis. MethodThe literature of recently domestic and international research on the mechanisms of H. pylori-related cell apoptosis in the gastric carcinogenesis was searched and reviewed. ResultsThe H. pylori infection was one of the important risk factors in the occurrence and development of gastric cancer, which was characterized by the imbalance of the interaction between gastric epithelial cells and various cell components in the gastric microenvironment, and which promoted or inhibited the process of apoptosis, and thus interfered with the process of gastric cancer. ConclusionsH. pylori, through the regulation of various cellular components and molecular pathways, increases the sensitivity of gastric epithelial cells to apoptosis, actively participates in the progression of gastric cancer. With the advent of the era of precision medicine, research on the mechanisms of H. pylori-related cell apoptosis in gastric carcinogenesis is transitioning to clinical applications, offering promising new treatment strategies for gastric cancer patients.
【摘要】目的探讨幽门螺杆菌(Hp)感染的根除与治疗糖尿病性胃轻瘫疗效的关系。方法 采用碳14呼气试验测定出67例糖尿病性胃轻瘫并Hp感染患者,经正规抗Hp治疗后进行疗效分析。结果67例中,Hp根除41例,症状明显改善33例,症状无明显改善8例;Hp未根除26例,症状明显改善17例,症状无明显改善9例。结论 糖尿病性胃轻瘫并Hp感染者经有效抗Hp治疗,对提高该病疗效有明显作用
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.
ObjectiveTo summarize the recent advances in the pathogenic mechanism of microorganisms and pancreatic cancer.MethodThrough the retrieval of relevant literatures, the recent progresses in the study of microorganism and pathogenesis of pancreatic cancer were reviewed.ResultsIn recent years, the potential role of intestinal microbiota in the pathogenic mechanism of pancreatic cancer had been studied. The studies found that the microbiome played an important role in the development of pancreatic cancer. Among them, the infections of Helicobacter pylori, oral pathogenic bacteria such as the Porphyromonas ginggivalis, Aggregatibacter actinomycetemcomitans and Phylum fusobacteria, and the changes of composition and diversity of intestinal microflora were closely related to the pancreatic cancer. The microorganisms induced the chronic inflammation and immune response through multiple pathways. The bacterial lipopolysaccharide stimulated the mutations in the KARS gene and mediated the inflammatory response by activating the nuclear factor-κB signaling pathway through Toll like receptor. The oral pathogenic microorganisms and Helicobacter pylori could also promote the cancer progression by secreting toxins that activated cancer-related signaling pathways.ConclusionsBacteria might be important carcinogens. These microorganisms promote development of cancer by causing chronic inflammation, activating cancer-related pathways, activating immune response, oxidative stress, and damaging DNA double strands.
目的 分析幽门螺杆菌(Helicobacter pylori, HP)根除治疗失败相关因素，为有效根除Hp提供建议和决策。 方法 对2005年5月-2008年12月经胃镜检查确诊的慢性胃炎或消化性溃疡，且Hp检测阳性并行含质子泵抑制剂三联或四联治疗的患者103例进行研究。治疗结束至少4周后，用14C呼气试验评估Hp是否成功根除，根据测试结果分为治疗失败组33例及治疗成功组70例。运用统一标准的调查表对每位患者进行相关因素调查，就调查表所涉及的因素在根除失败组与成功组间采用单因素及多因素Logistic回归进行分析。 结果 通过单因素分析依从性和饮酒在两组之间有统计学意义(P＜0.05)。Logistic多因素分析发现，依从性差是根除失败的独立危险因素。 结论 依从性差是治疗失败十分重要的影响因素。
To explain how to treat common gastric diseases like chronic gastritis, peptic ulcer, functional dyspepsia and gastric oesophageal reflux disease (GORD) based on evidence-based medicine. Through this paper, we try to help readers find and use clinical evidence to solve clinical problems.
Objective To explore the interference of recent use of antibiotics in the sensitivities of different methods for the detection of Helicobacter pylori (Hp) in children. Methods From June 2015 to December 2017, children who were highly suspected of Hp infection and required gastroscopy were divided into the antibiotic group and the control group according to the recent use of antibiotics, with 200 cases in each group. The use of antibiotics of children in the antibiotic group was analyzed. The children in the two groups completed five methods of Hp detection, including rapid urease test (RUT), 13C-urea breath test (13C-UBT), pathological Warthin-Starry staining, colloidal gold method for measuring Hp immunoglobulin M (IgM) antibody, and enzyme linked immunosorbent assay method for measuring Hp stool antigen (HpSA). Comparative analyses of data were done. Results The positive rate of RUT was 36.5% in the antibiotic group and 75.0% in the control group (P<0.05). The positive rate and value of13C-UBT were 59.0% and 13.6±4.7 in the antibiotic group, and 78.0% and 41.7±6.6 in the control group (P<0.05). The positive rate of pathological biopsy was 48.0% in the antibiotic group and 68.0% in the control group (P<0.05), and L-forms were found in 80.9% of the Hp-positive specimens in the antibiotic group. The positive rate of IgM antibody was 54.5% in the antibiotic group and 65.5% in the control group (P<0.05). The positive rate of HpSA was 38.0% in the antibiotic group and 69.0% in the control group (P<0.05). In the antibiotic group, only 12.5% of the children used antibiotics for eradication of Hp and 87.5% for non Hp eradication. Conclusions Under the interference of antibiotics use, the sensitivity of 13C-UBT is the highest among the five methods for Hp detection, and the sensitivities of RUT and HpSA are very low. For children who could not cooperate with 13C-UBT, the sensitivity of IgM detection is relatively high. For children who need gastroscopy, prolonged chromogenic time for RUT and multi-point pathological biopsy can reduce misdiagnosis.
ObjectiveTo systematically review the quality of guidelines concerning management of helicobacter pylori (H. pylori) infection, so as to improve the guidelines of low quality and promote the clinical practice of high quality guidelines. MethodDatabases including PubMed, CNKI, Guidelines International Network (GIN), National Guideline Clearinghouse (NGC), National Institute for Health and Clinical Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), American Society of Health-System Pharmacists (ASHP) and Google search engine were searched from January 2005 to April 2015 to collect guidelines concerning H. pylori management about recent ten years. The methodological quality of included guidelines was evaluated according to the AGREE Ⅱ instrument, and the difference in indications and recommended first-line therapy of H. pylori eradication among different guidelines were compared. ResultsA total of 13 guidelines were included. According to the AGREE Ⅱ instrument, the highest scores were for clarity and presentation 92.6% (78%-100%) and the lowest were for editorial independence 35.7% (0%-92%). The mean scores for rest domains were: scope and purpose 70.2% (39%-100%), stakeholder involvement 41.4% (22%-75%), rigor of development 41.7% (11%-82%), applicability 58.1% (35%-85%). ConclusionThe quality of guidelines for management of H. pylori infection is not high. Great efforts are needed to provide reliable and high quality guidelines, especially for the domains of stakeholder involvement, rigor of development, and editorial independence.