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.
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.
ObjectiveTo summary the study results of the Sichuan Gastric Cancer Early Detection and Screening Research Program (SIGES). MethodsIn the past 10 years, SIGES program conducted a series of clinical and clinical epidemiological studies on the current situation and strategies of gastric cancer prevention and control in China, which provided evidence for supply-side structural reform to improve the gastric cancer prevention and control. We collected related studies and made a review. ResultsSIGES program systematically and specifically studied carcinogenic pathogens, risk factors, screening strategies, as well as critical technique and system construction of tertiary prevention for gastric cancer. The main results supported that Helicobacter pylori was highly correlated with precancerous atrophic gastritis and gastric cancer. Oncoviruses, such as Epstein-Barr virus, hepatitis B virus, human cytomegalovirus, human papillomavirus, John Cunningham virus were correlated with the risk of gastric cancer, and should be paid further attention in the prevention and screening strategy of gastric cancer. Ethnicity, domicile, and family history of gastric cancer were also correlated with gastric cancer and gastric cancer-related risk factors, so it was suggested to include in the personalized evaluation criteria system of high-risk groups for gastric cancer. ConclusionsAt present, the prevention and control of gastric cancer in China has achieved substantial achievements, but the burden of gastric cancer keeps heavy. It is still necessary to conduct further scientific research on critical technique or issues in designing prevention and control strategies.
ObjectiveTo investigate the relation between colonic adenomatous polyps and Helicobacter pylori infection. MethodsA case-control study was conducted to collect clinical data of patients with colonic adenomatous polyps in People's Hospital of Zhongjiang County from February 2014 to September 2015. Patients with healthy colon of the corresponding period of the hospital were collected as a control group. The difference of positive rate of Hp infection was compared between the colonic adenomatous polyps group and the control group. According to the age, gender, living condition, location, type of pedicle, pathological type and number, the colonic adenomatous polyps group was divided into subgroups and the differences of positive rate of Hp infection were compared among the subgroups. ResultsA total of 219 patients involving 119 cases and 100 controls were included. The positive rate of Hp infection in the colonic adenomatous polyps group was significantly higher than that in the control group (69.7% vs. 52.0%) with a significant difference (χ2=7.239, P=0.007). Among 119 patients with colonic adenomatous polyps, no statistical differences were found in the positive rate of Hp infection among subgroups of different age, gender, living condition, location, type of pedicle, pathological type and number (all P values>0.05). ConclusionHp infection may increase the risk of developing colonic adenomatous polyps.
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.
Objective To investigate the expressions of monocyte chemoattractant protein-1 (MCP-1) and vascular endothelial growth factor (VEGF) in gastric cancer tissues and normal gastirc mucosa tissues and the situation of helicobacter pylori (HP) infection, and detect their relationships and clinicopathologic significances. Methods Expressions of MCP-1 and VEGF were detected by immunohistochemistry in gastric cancer tissues and normal gastric mucosa tissues (5-10 cm from the mass), and HP was detected in specimen from gastric antrum by Giemsa dyeing method. Results MCP-1 and VEGF expressions in gastric cancer tissues were significantly higher than those in normal gastric mucosa tissues (P＜0.05), but there was no difference in HP positive and negative tissues included the cancer and the normal tissues （P＞0.05）. The expressions of MCP-1 and VEGF in carcinoma with tumordiameter ＞5 cm, poorly differentiated， lymph node metastasis， distant metastasis and Ⅲ+Ⅳ stage of TNM were significantly higher than those with tumor diameter ≤5 cm, well and moderately differentiated， non-lymph node metastasis， non-distant metastasis and Ⅰ+Ⅱ stage of TNM (P＜0.05). Conclusion The high expressions of MCP-1 and VEGF in gastric cancer may relate to tumor angiogenesis and metastasis, but HP infection may be irrelevant.