Chronic atrophic gastritis(CAG)is an important stage of precancerous lesions of gastric cancer.Effective treatment and regulation of CAG are essential to prevent its progression to malignancy.Traditional Chinese medic...Chronic atrophic gastritis(CAG)is an important stage of precancerous lesions of gastric cancer.Effective treatment and regulation of CAG are essential to prevent its progression to malignancy.Traditional Chinese medicine(TCM)has shown multi-targeted efficacy in CAG treatment,with advantages in enhancing gastric mucosal barrier defense,improving microcirculation,modulating inflammatory and immune responses,and promoting lesion healing,etc.Clinical studies and meta-analyses indicate that TCM provides significant benefits,with specific Chinese herbal compounds and monomers demonstrating protective effects on the gastric mucosa through mechanisms including anti-inflammation,antioxidation,and regulation of cellular proliferation and apoptosis,etc.Finally,it is pointed out that the efficacy of TCM in the treatment of CAG requires standardized research and unified standards,and constantly clarifies and improves the evaluation criteria of each dimension of gastric mucosal barrier function.展开更多
Current experimental models struggle to simulate the complex process of the transformation from atrophic gastritis to gastric cancer,while gastric organoid technology,especially region-specific modeling,provides a mor...Current experimental models struggle to simulate the complex process of the transformation from atrophic gastritis to gastric cancer,while gastric organoid technology,especially region-specific modeling,provides a more precise in vitro platform for studying this carcinogenic mechanism.Helicobacter pylori activates carcinogenic signaling pathways through virulence factors,inducing DNA damage,epigenetic dysregulation,and immune microenvironment imbalance,driving inflammation-cancer conversion.Intestinal metaplasia and spasmolytic polypeptide-expressing metaplasia serve as critical precursor lesions,gradually developing into dysplasia and adenocarcinoma under the influence of chronic inflammation and genetic instability through intestinal cell transformation and high trefoil factor 2-expressing cell expansion.The immune suppression,metabolic reprogramming,and matrix remodeling within the tumor microenvironment collaboratively create a pro-cancer ecosystem that accelerates inflammationcarcinogenesis transformation.The gastric organoid model successfully simulates the spatiotemporal dynamics of the carcinogenesis process in atrophic gastritis,and its future integration with single-cell omics,real-time imaging technologies,and artificial intelligence technologies could provide a more precise platform for elucidating molecular mechanisms and screening intervention strategies.These advances position gastric organoids as pivotal tools for clinical translation,enabling personalized risk stratification,early intervention targeting precancerous transitions,and ex vivo prediction of patient-specific therapeutic responses to guide precision management of gastric cancer.展开更多
Traditional Chinese medicine(TCM)has been extensively explored with various naturally derived compounds as a potential therapeutic agent for chronic atrophic gastritis(CAG).In addition to the aspects discussed in the ...Traditional Chinese medicine(TCM)has been extensively explored with various naturally derived compounds as a potential therapeutic agent for chronic atrophic gastritis(CAG).In addition to the aspects discussed in the reviewed article,this invited commentary explores the initial available evidence on a fungus from TCM,Hericium erinaceus,in the context of CAG.Initial clinical data suggest the potential of this fungus in inducing clinical and histological improvements in patients with CAG,as well as a marked antimicrobial activity against Helicobacter pylori infection.Preclinical cellular evidence also indicates an antineoplastic role in gastric carcinogenesis,mediated by two components:Erinacine A and S.Further evidence is needed to propose this fungus as a potential complementary thera-peutic approach for CAG.展开更多
Objective:To evaluate the therapeutic effects of Huangqi Sijun Decoction on chronic atrophic gastritis(CAG).Methods:Sixty CAG patients hospitalized between January 2020 and December 2022 were selected and randomly div...Objective:To evaluate the therapeutic effects of Huangqi Sijun Decoction on chronic atrophic gastritis(CAG).Methods:Sixty CAG patients hospitalized between January 2020 and December 2022 were selected and randomly divided into two groups using a random number table.The Traditional Chinese Medicine(TCM)group(n=30)was treated with Huangqi Sijun Decoction,while the Western medicine group(n=30)received omeprazole.The total effective rate,TCM syndrome scores,and serological indicators were compared.Results:The total effective rate in the TCM group was higher than that in the Western medicine group,while the adverse reaction rate was lower(P<0.05).Before treatment,there were no significant differences in TCM syndrome scores or serological indicators between the two groups(P>0.05).After treatment,the TCM group had lower TCM syndrome scores and better serological indicators compared to the Western medicine group(P<0.05).Conclusion:Huangqi Sijun Decoction can enhance the clinical efficacy of CAG patients,prevent adverse reactions,alleviate TCM symptoms,and regulate specific levels of serological indicators,demonstrating significant therapeutic advantages.展开更多
AG(atrophic gastritis)is characterized by precancerous lesions associated with gastric cancer and can cause serious adverse health effects.The high incidence coupled with a low diagnosis rate and the mediocre effectiv...AG(atrophic gastritis)is characterized by precancerous lesions associated with gastric cancer and can cause serious adverse health effects.The high incidence coupled with a low diagnosis rate and the mediocre effectiveness of clinical treatment raises concerns.This article reviews the pathologic features,clinical manifestations,and treatment progress of AG.展开更多
This study summarizes the clinical experience of professor LIAN Jianwei, a nationally renowned traditional Chinese medicine (TCM) practitioner, in treating chronic atrophic gastritis (CAG) with syndrome differentiatio...This study summarizes the clinical experience of professor LIAN Jianwei, a nationally renowned traditional Chinese medicine (TCM) practitioner, in treating chronic atrophic gastritis (CAG) with syndrome differentiation based on pulse-taking. Professor LIAN emphasizes the importance of pulse diagnosis in TCM clinical practice, focusing on the normal and variant aspects of pulse methods, and centers on the dynamic changes of the “Guan pulse” to accurately determine the functional status of the spleen and stomach based on pulse variations, thereby formulating personalized treatment plans. For patients with a slow and moderate pulse, spleen and stomach deficiency and dampness due to spleen deficiency are often identified, and treatment mainly focuses on strengthening the spleen, resolving dampness, and boosting Qi to aid transportation, usually with modifications of Shenling Baizhu San. When the left Guan pulse is string-like and the right Guan pulse is slow and moderate, it indicates liver depression and spleen deficiency, and Xiaoyao San is commonly used to soothe the liver, nourish the blood, and strengthen the spleen, harmonizing the liver and spleen. If the right Guan pulse is large and the left Guan pulse is string-like, it mostly belongs to liver and stomach Qi stagnation, and Bupleurum Liver-soothing powder is often used to soothe the liver, regulate Qi, and harmonize the stomach. A large and empty right Guan pulse suggests insufficiency of Central Qi, and Buzhong Yiqi Tang is commonly used to tonify Qi and soothe the liver. In terms of medication, professor LIAN pays attention to patients’ dietary habits and combines methods of eliminating dampness, promoting digestion, and activating blood circulation to improve symptoms and reverse atrophy.展开更多
Chronic atrophic gastritis(CAG)is a common type of chronic gastric disease characterized by high incidence and a certain tendency toward cancerization.In recent years,with the deepening of related research,it has been...Chronic atrophic gastritis(CAG)is a common type of chronic gastric disease characterized by high incidence and a certain tendency toward cancerization.In recent years,with the deepening of related research,it has been found that traditional Chinese medicine(TCM)exerts therapeutic effects on CAG through various signaling pathways.This article systematically reviews and summarizes the literature on TCM treatment of CAG,elaborating on the etiology and pathogenesis of CAG,new ideas from different physicians in treating CAG,and the effects of different TCM monomers and compound prescriptions on signaling pathways such as PI3K-AKT and JAK1/STAT3 to provide a reference for subsequent research on CAG.展开更多
Helicobacter pylori(Hp) is a major human pathogen causing chronic, progressive gastric mucosal damage and is linked to gastric atrophy and cancer. Hp-positive individuals constitute the major reservoir for transmissio...Helicobacter pylori(Hp) is a major human pathogen causing chronic, progressive gastric mucosal damage and is linked to gastric atrophy and cancer. Hp-positive individuals constitute the major reservoir for transmission of infection. There is no ideal treatment for Hp. Hp infection is not cured by a single antibiotic, and sometimes, a combined treatment with three or more antibiotics is ineffective. Atrophic gastritis(AG) is a chronic disease whose main features are atrophy and/or intestinal metaplasia of the gastric glands, which arise from long-standing Hp infection. AG is reportedly linked to an increased risk for gastric cancer, particularly when extensive intestinal metaplasia is present. Active or past Hp infection may be detected by conventional methods in about two-thirds of AG patients. By immunoblotting of sera against Hp whole-cell protein lysates, a previous exposure to Hp infection is detected in all AG patients. According to guidelines, AG patients with Hp positivity should receive eradication treatment. The goals of treatment are as follows:(1) Cure of infection, resolution of inflammation and normalization of gastric functions;(2) possible reversal of atrophic and metaplastic changes of the gastric mucosa; and(3) prevention of gastric cancer. An ideal antibiotic regimen for Hp should achieve eradication rates of approximately 90%, and complex multidrug regimens are required to reach this goal. Amongst the factors associated with treatment failure are high bacterial load, high gastric acidity, Hp strain, smoking, low compliance, overweight, and increasing antibiotic resistance. AG, when involving the corporal mucosa, is linked to reduced gastric acid secretion. At a non-acidic intra-gastric p H, the efficacy of the common treatment regimens combining proton pump inhibitors with one or more antibiotics may not be the same as that observed in patients with Hp gastritis in an acid-producing stomach. Although the efficacy of these therapeutic regimens has been thoroughly tested in subjects with Hp infection, there is a paucity of evidence in the subgroupof patients with AG. Bismuth-based therapy may be an attractive treatment in the specific setting of AG, and specific studies on the efficacy of bismuth-based therapies are needed in patients with AG.展开更多
Chronic atrophic gastritis （CAG） is an inflammatory condition characterized by the loss of gastric glandular structures which are replaced by connective tissue （non-metaplastic atrophy） or by glandular structures ...Chronic atrophic gastritis （CAG） is an inflammatory condition characterized by the loss of gastric glandular structures which are replaced by connective tissue （non-metaplastic atrophy） or by glandular structures inappropriate for location （metaplastic atrophy）. Epidemiological data suggest that CAG is associated with two different types of tumors： Intestinal-type gastric cancer （GC） and type I gastric carcinoid （T I GC）. The pathophysiological mechanisms which lead to the development of these gastric tumors are different, It is accepted that a multistep process initiating from Helico- bacterpylori-related chronic inflammation of the gastric mucosa progresses to CAG, intestinal metaplasia, dysplasia and, finally, leads to the development of GC. The T I GC is a gastrin-dependent tumor and the chronic elevation of gastrin, which is associated with CAG, stimulates the growth of enterochromaffin-like cells with their hyperplasia leading to the development of T I GC. Thus, several events occur in the gastric mucosa before the development of intestinatype GC and/ or T I GC and these take several years. Knowledge ofCAG incidence from superficial gastritis, its prevalence in different clinical settings and possible risk factors as- sociated with the progression of this condition to gastric neoplasias are important issues. This editorial intends to provide a brief review of the main studies regarding incidence and prevalence of CAG and risk factors for the development of gastric neoplasias.展开更多
AIM To explore the correlation between serum vitamin B12 level and peripheral neuropathy in patients with chronic atrophic gastritis(CAG).METHODS A total of 593 patients diagnosed with chronic gastritis by gastroscopy...AIM To explore the correlation between serum vitamin B12 level and peripheral neuropathy in patients with chronic atrophic gastritis(CAG).METHODS A total of 593 patients diagnosed with chronic gastritis by gastroscopy and pathological examination fromSeptember 2013 to September 2016 were selected for this study.The age of these patients ranged within 18-to 75-years-old.Blood pressure,height and weight were measured in each patient,and the body mass index value was calculated.Furthermore,gastric acid,serum gastrin,serum vitamin and serum creatinine tests were performed,and peripheral nerve conduction velocity and Helicobacter pylori(H.pylori)were detected.In addition,the type of gastritis was determined by gastroscopy.The above factors were used as independent variables to analyze chronic gastritis with peripheral neuropathy and vitamin B12 deficiency risk factors,and to analyze the relationship between vitamin B12 levels and peripheral nerve conduction velocity.In addition,in the treatment of CAG on the basis of vitamin B12,patients with peripheral neuropathy were observed.RESULTS Age,H.pylori infection,CAG,vitamin B9 and vitamin B12 were risk factors for the occurrence of peripheral nerve degeneration.Furthermore,CAG and H.pylori infection were risk factors for chronic gastritis associated with vitamin B12 deficiency.Serum vitamin B12 level was positively correlated with sensory nerve conduction velocity in the tibial nerve(R=0.463).After vitamin B12 supplementation,patients with peripheral neuropathy improved.CONCLUSION Serum vitamin B12 levels in patients with chronic gastritis significantly decreased,and the occurrence of peripheral neuropathy had a certain correlation.CAG and H.pylori infection are risk factors for vitamin B12 deficiency and peripheral neuropathy.When treating CAG,vitamin B12 supplementation can significantly reduce peripheral nervous system lesions.Therefore,the occurrence of peripheral neuropathy associated with vitamin B12 deficiency may be considered in patients with CAG.Furthermore,the timely supplementation of vitamin B12 during the clinical treatment of CAG can reduce or prevent peripheral nervous system lesions.展开更多
Chronic atrophic autoimmune gastritis (CAAG) is an organ-specific autoimmune disease characterized by an immune response, which is directed towards the parietal cells and intrinsic factor of the gastric body and fundu...Chronic atrophic autoimmune gastritis (CAAG) is an organ-specific autoimmune disease characterized by an immune response, which is directed towards the parietal cells and intrinsic factor of the gastric body and fundus and leads to hypochlorhydria, hypergastrinemia and inadequate production of the intrinsic factor. As a result, the stomach’s secretion of essential substances, such as hydrochloric acid and intrinsic factor, is reduced, leading to digestive impairments. The most common is vitamin B12 deficiency, which results in a megaloblastic anemia and iron malabsorption, leading to iron deficiency anemia. However, in the last years the deficiency of several other vitamins and micronutrients, such as vitamin C, vitamin D, folic acid and calcium, has been increasingly described in patients with CAAG. In addition the occurrence of multiple vitamin deficiencies may lead to severe hematological, neurological and skeletal manifestations in CAAG patients and highlights the importance of an integrated evaluation of these patients. Nevertheless, the nutritional deficiencies in CAAG are largely understudied. We have investigated the frequency and associated features of nutritional deficiencies in CAAG in order to focus on any deficit that may be clinically significant, but relatively easy to correct. This descriptive review updates and summarizes the literature on different nutrient deficiencies in CAAG in order to optimize the treatment and the follow-up of patients affected with CAAG.展开更多
AIM: To investigate the effect of H pylori eradication on atrophic gastritis and intestinal metaplasia (IM).METHODS: Two hundred and fifty-nine patients with atrophic gastritis in the antrum were included in the study...AIM: To investigate the effect of H pylori eradication on atrophic gastritis and intestinal metaplasia (IM).METHODS: Two hundred and fifty-nine patients with atrophic gastritis in the antrum were included in the study, 154 patients were selected for H pylori eradication therapy and the remaining 105 patients served as untreated group. Gastroscopy and biopsies were performed both at the beginning and at the end of a 3-year follow-up study. Gastritis was graded according to the updated Sydney system.RESULTS: One hundred and seventy-nine patients completed the follow-up, 92 of them received H pylori eradication therapy and the remaining 87 H pyloriinfected patients were in the untreated group. Chronic gastritis, active gastritis and the grade of atrophy significantly decreased in H pylori eradication group (P＜0.01). However, the grade of IM increased in H pylori -infected group (P＜0.05).CONCLUSION: H pylori eradication may improve gastric mucosal inflammation, atrophy and prevent the progression of IM.展开更多
BACKGROUND The risk of gastric cancer increases in patients with Helicobacter pylori-associated chronic atrophic gastritis(CAG).X-ray examination can evaluate the condition of the stomach,and it can be used for gastri...BACKGROUND The risk of gastric cancer increases in patients with Helicobacter pylori-associated chronic atrophic gastritis(CAG).X-ray examination can evaluate the condition of the stomach,and it can be used for gastric cancer mass screening.However,skilled doctors for interpretation of X-ray examination are decreasing due to the diverse of inspections.AIM To evaluate the effectiveness of stomach regions that are automatically estimated by a deep learning-based model for CAG detection.METHODS We used 815 gastric X-ray images(GXIs)obtained from 815 subjects.The ground truth of this study was the diagnostic results in X-ray and endoscopic examinations.For a part of GXIs for training,the stomach regions are manually annotated.A model for automatic estimation of the stomach regions is trained with the GXIs.For the rest of them,the stomach regions are automatically estimated.Finally,a model for automatic CAG detection is trained with all GXIs for training.RESULTS In the case that the stomach regions were manually annotated for only 10 GXIs and 30 GXIs,the harmonic mean of sensitivity and specificity of CAG detection were 0.955±0.002 and 0.963±0.004,respectively.CONCLUSION By estimating stomach regions automatically,our method contributes to the reduction of the workload of manual annotation and the accurate detection of the CAG.展开更多
OBJECTIVE:To investigate the effectiveness of Banxia Xiexin decoction(BXD)in a rat model of chronic atrophic gastritis(CAG).METHODS:Sixty 6-week-old healthy Wistar rats(30 males,30 females)were used in the present stu...OBJECTIVE:To investigate the effectiveness of Banxia Xiexin decoction(BXD)in a rat model of chronic atrophic gastritis(CAG).METHODS:Sixty 6-week-old healthy Wistar rats(30 males,30 females)were used in the present study.A rat model of CAG was successfully established using the combined active immunization/ethanol/sodium deoxycholate method.BXD was prepared from a mixture of seven Chinese herbs,and was intragastrically administered to CAG rats at three different doses(6,12,and 24 g·kg^-1·d^-1).Af-ter 24 weeks,the rats were euthanized,and gastric tissue specimens were collected.Gastric mucosal specimens were stained with hematoxylin and eosin for histological examination to evaluate the degree of inflammation and morphological changes.Immunohistochemical staining was performed to examine the mucosal expression of proliferating cell nuclear antigen.Serum gastrin levels were measured using radioimmunoassay.The expression of Notch signaling-associated genes was examined by quantitative polymerase chain reaction and Western blot assay.RESULTS:BXD at all three doses significantly reversed the adverse effects generated by CAG in rats.Compared with control rats,the CAG rats who were administered BXD had an accelerated growth rate,reduced inflammatory cell infiltration,improved gastric mucosal morphology,augmented thickness of the gastric mucosa,increased number of gastric glands,enhanced mucosal expression of proliferating cell nuclear antigen,and elevated serum gastrin levels.展开更多
AIM: To study the effects of He-Ne laser irradiation on experimental chronic atrophic gastritis (CAG) in rats.METHODS: Sixty-three male adult Wistar rats were randomly divided into five groups including normal control...AIM: To study the effects of He-Ne laser irradiation on experimental chronic atrophic gastritis (CAG) in rats.METHODS: Sixty-three male adult Wistar rats were randomly divided into five groups including normal control group, model control group and three different dosages He-Ne laser groups. The chronic atrophic gastritis (CAG)model in rats was made by pouring medicine which was a kind of mixed liquor including 2% sodium salicylate and 30% alcohol down the throat for 8 wk to stimulate rat gastric mucosa, combining with irregular fasting and compulsive sporting as pathogenic factors; 3.36, 4.80, and 6.24J/cm2doses of He-Ne laser were used, respectively for three different treatment groups, once a day for 20 d. The pH value of diluted gastric acid was determined by acidimeter,the histopathological changes such as the inflammatory degrees in gastric mucosa, the morphology and structure of parietal cells were observed, and the thickness of mucosa was measured by micrometer under optical microscope.RESULTS: In model control group, the secretion of gastric acid was little, pathologic morphological changes in gastric mucosa such as thinner mucous, atrophic glands, notable inflammatory infiltration were found. After 3.36 J/cm2 dose of He-Ne laser treatment for 20 d, the secretion of gastric acid was increased (P＜0.05), the thickness of gastric mucosa was significantly thicker than that in model control group (P＜0.01), the gastric mucosal inflammation cells were decreased (P＜0.05). Morphology, structure and volume of the parietal cells all recuperated or were closed to normal.CONCLUSION: 3.36J/cm2 dose of He-Ne laser has a significant effect on CAG in rats.展开更多
AIM: To investigate the effects of interleukin-8 (IL-8 ), macrophage migration inhibitory factor (MIF ) gene polymorphisms, Helicobacter pylori (H. pylori ) infection, on the risk of developing severe chronic atrophic...AIM: To investigate the effects of interleukin-8 (IL-8 ), macrophage migration inhibitory factor (MIF ) gene polymorphisms, Helicobacter pylori (H. pylori ) infection, on the risk of developing severe chronic atrophic gastritis (SCAG) and intestinal metaplasia (IM). METHODS: A total of 372 cases were selected from a cohort study in Linqu County, a high risk area for gastric cancer (GC) in northern China. To obtain a sufficient group size, patients with normal or superficial gastritis were included. Based on an average follow-up period of 56 mo, the 372 cases were divided into no progres-sion group (no histological progression from normal or superficial gastritis, n = 137), group Ⅰ (progressed from normal or superficial gastritis to SCAG, n = 134) and group Ⅱ (progressed from normal or superficial gastritis to IM, n = 101). IL-8 , MIF gene polymorphisms were detected by polymerase chain reaction-based denaturing high-performance liquid chromatography analysis and DNA sequencing. RESULTS: An increased risk of SCAG was found in subjects with IL-8-251 AA genotype [odds ratio (OR) = 2.62, 95% CI: 1.23-5.72] or IL-8-251 A allele carriers (AA + AT) (OR = 1.81, 95% CI: 1.06-3.09). An elevated risk of IM was found in subjects with IL-8-251 AT genotype (OR = 2.27, 95% CI: 1.25-4.14) or IL-8-251 A allele carriers (OR = 2.07, 95% CI: 1.16-3.69). An increased risk of SCAG was found in subjects with MIF-173 GC genotype (OR = 2.36, 95% CI: 1.38-4.02) or MIF-173 C allele carriers (GC + CC) (OR = 2.07, 95% CI: 1.21-3.55). An elevated risk of IM was found in subjects with MIF-173 CC genotype (OR = 2.27, 95% CI: 1.16-4.46) or MIF-173 C allele carriers (OR = 3.84, 95% CI: 1.58-9.34). The risk of SCAG and IM was more evident in subjects carrying IL-8-251 A allele (OR = 6.70, 95% CI: 1.29-9.78) or MIF-173 C allele (OR = 6.54, 95% CI: 2.97-14.20) and positive for H. pylori infection. CONCLUSION: IL-8-251 and MIF-173 gene polymorphisms are significantly associated with the risk of SCAG and IM in a population with a high risk of GC in Linqu County, Shandong Province, China.展开更多
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 def...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.展开更多
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.Gastr...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.展开更多
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 p...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.展开更多
Objective： To study the pathologic change and molecular regulation in cell proliferation and apoptosis of gastric mucosa in rats with chronic atrophic gastritis （CAG）, and evaluate the possible mechanisms. Methods...Objective： To study the pathologic change and molecular regulation in cell proliferation and apoptosis of gastric mucosa in rats with chronic atrophic gastritis （CAG）, and evaluate the possible mechanisms. Methods： Rats were administered with 60% alcohol or 2% salicylate sodium, 20 mmol/L deoxycholate sodium and 0.1% ammonia water to establish chronic atrophic gastritis （CAG） models. The gastric specimens were prepared for microscopic view with hematoxylin and eosin （H-E） and alcian blue （A-B） stain. The number of infiltrated inflammatory cells, the thickness of the mucosa gland layer （μm） and the number of gastric glands were calculated. The damage of barrier in mucosa with erosion or ulceration, and the thickness of mucin were examined by scanned electron microscope （SEM）. The levels of PGE2, EGF （epiderminal growth factor） and gastrin in the serum were measured with radioimmunoassay or ELISA method. The immunohistochemistry method was used to observe the number of G cells, the expression of protein of EGFR （EGF receptor）, C-erbB-2, p53, p6 and bcl-2 in gastric tissue. Results： Under SEM observation, the gastric mucosa was diffused erosion or ulceration and the thickness of mucin was decreased. Compared with normal rats, the grade of inflammatory cell infltration in CAG rats was elevated, whereas the thickness and number of gastric gland were significantly lower （P〈0.05）. Compared with normal level of （0.61±0.28） μg/L, EGF in CAG （2.24±0.83） μg/L was significantly higher （P〈0.05）. The levels of PGEz and gastrin in serum were significantly lower in CAG rats than that in normal rats （P〈0.05）. Immunohistochemistry detection showed that the number of G cell in antrum was lower in CAG group （P〈0.05）. Imrauno-stain showed EGFR protein expression in the basal and bilateral membrane, and the cytoplasma in atrophic gastric gland, while negative expression was observed in normal gastric epithelial cells. Positive staining of p53 and p 16 protein was localized in the nucleus of epithelial cells. The former was higher positively expressed in atrophic gland, while the later was higher positively stained in normal gastric tissue, bcl-2 protein was positively stained in the cytoplasma in atrophic gastric gland, while very weakly stained in normal gastric tissue. Conclusion： The pathological findings in gastric gland accorded with the Houston diagnostic criteria of antrum-predominant CAG. CAG in rats was related with the damage of barrier in gastric mucosa and the misbalance of cell proliferation and apoptosis. There was high protein expression of oncogene, while inhibitor of suppressor gene in CAG rats indicated high trend of carcinogenesis.展开更多
基金Supported by the Scientific and Technological Innovation Project of China Academy of Chinese Medical Sciences,No.CI2021A00806High Level Chinese Medical Hospital Promotion Project,No.HLCMHPP2023086the Fundamental Research Funds for the Central Public Welfare Research Institutes,No.ZZ17-XRZ-041.
文摘Chronic atrophic gastritis(CAG)is an important stage of precancerous lesions of gastric cancer.Effective treatment and regulation of CAG are essential to prevent its progression to malignancy.Traditional Chinese medicine(TCM)has shown multi-targeted efficacy in CAG treatment,with advantages in enhancing gastric mucosal barrier defense,improving microcirculation,modulating inflammatory and immune responses,and promoting lesion healing,etc.Clinical studies and meta-analyses indicate that TCM provides significant benefits,with specific Chinese herbal compounds and monomers demonstrating protective effects on the gastric mucosa through mechanisms including anti-inflammation,antioxidation,and regulation of cellular proliferation and apoptosis,etc.Finally,it is pointed out that the efficacy of TCM in the treatment of CAG requires standardized research and unified standards,and constantly clarifies and improves the evaluation criteria of each dimension of gastric mucosal barrier function.
基金Supported by National Traditional Chinese Medicine Advantageous Specialty Project of National Administration of Traditional Chinese MedicineShuguang Hospital Siming Foundation Research Special Project,No.SGKJ-202304.
文摘Current experimental models struggle to simulate the complex process of the transformation from atrophic gastritis to gastric cancer,while gastric organoid technology,especially region-specific modeling,provides a more precise in vitro platform for studying this carcinogenic mechanism.Helicobacter pylori activates carcinogenic signaling pathways through virulence factors,inducing DNA damage,epigenetic dysregulation,and immune microenvironment imbalance,driving inflammation-cancer conversion.Intestinal metaplasia and spasmolytic polypeptide-expressing metaplasia serve as critical precursor lesions,gradually developing into dysplasia and adenocarcinoma under the influence of chronic inflammation and genetic instability through intestinal cell transformation and high trefoil factor 2-expressing cell expansion.The immune suppression,metabolic reprogramming,and matrix remodeling within the tumor microenvironment collaboratively create a pro-cancer ecosystem that accelerates inflammationcarcinogenesis transformation.The gastric organoid model successfully simulates the spatiotemporal dynamics of the carcinogenesis process in atrophic gastritis,and its future integration with single-cell omics,real-time imaging technologies,and artificial intelligence technologies could provide a more precise platform for elucidating molecular mechanisms and screening intervention strategies.These advances position gastric organoids as pivotal tools for clinical translation,enabling personalized risk stratification,early intervention targeting precancerous transitions,and ex vivo prediction of patient-specific therapeutic responses to guide precision management of gastric cancer.
文摘Traditional Chinese medicine(TCM)has been extensively explored with various naturally derived compounds as a potential therapeutic agent for chronic atrophic gastritis(CAG).In addition to the aspects discussed in the reviewed article,this invited commentary explores the initial available evidence on a fungus from TCM,Hericium erinaceus,in the context of CAG.Initial clinical data suggest the potential of this fungus in inducing clinical and histological improvements in patients with CAG,as well as a marked antimicrobial activity against Helicobacter pylori infection.Preclinical cellular evidence also indicates an antineoplastic role in gastric carcinogenesis,mediated by two components:Erinacine A and S.Further evidence is needed to propose this fungus as a potential complementary thera-peutic approach for CAG.
基金Inner Mongolia Autonomous Region Education Science“14th Five-Year Plan”Project(Project No.NGJGH2023467)Inner Mongolia Medical University Higher Education Teaching Reform Research Project(Project No.NYJXGG2022054)。
文摘Objective:To evaluate the therapeutic effects of Huangqi Sijun Decoction on chronic atrophic gastritis(CAG).Methods:Sixty CAG patients hospitalized between January 2020 and December 2022 were selected and randomly divided into two groups using a random number table.The Traditional Chinese Medicine(TCM)group(n=30)was treated with Huangqi Sijun Decoction,while the Western medicine group(n=30)received omeprazole.The total effective rate,TCM syndrome scores,and serological indicators were compared.Results:The total effective rate in the TCM group was higher than that in the Western medicine group,while the adverse reaction rate was lower(P<0.05).Before treatment,there were no significant differences in TCM syndrome scores or serological indicators between the two groups(P>0.05).After treatment,the TCM group had lower TCM syndrome scores and better serological indicators compared to the Western medicine group(P<0.05).Conclusion:Huangqi Sijun Decoction can enhance the clinical efficacy of CAG patients,prevent adverse reactions,alleviate TCM symptoms,and regulate specific levels of serological indicators,demonstrating significant therapeutic advantages.
文摘AG(atrophic gastritis)is characterized by precancerous lesions associated with gastric cancer and can cause serious adverse health effects.The high incidence coupled with a low diagnosis rate and the mediocre effectiveness of clinical treatment raises concerns.This article reviews the pathologic features,clinical manifestations,and treatment progress of AG.
基金supported by the Zhejiang Science and Technology Program of TCM(No.2025ZF017)the Clinical Young-Talent Trainning Project in TCM under the Young Eagle Program of the China Association of Chinese Medicine(No.CYJH2024048).
文摘This study summarizes the clinical experience of professor LIAN Jianwei, a nationally renowned traditional Chinese medicine (TCM) practitioner, in treating chronic atrophic gastritis (CAG) with syndrome differentiation based on pulse-taking. Professor LIAN emphasizes the importance of pulse diagnosis in TCM clinical practice, focusing on the normal and variant aspects of pulse methods, and centers on the dynamic changes of the “Guan pulse” to accurately determine the functional status of the spleen and stomach based on pulse variations, thereby formulating personalized treatment plans. For patients with a slow and moderate pulse, spleen and stomach deficiency and dampness due to spleen deficiency are often identified, and treatment mainly focuses on strengthening the spleen, resolving dampness, and boosting Qi to aid transportation, usually with modifications of Shenling Baizhu San. When the left Guan pulse is string-like and the right Guan pulse is slow and moderate, it indicates liver depression and spleen deficiency, and Xiaoyao San is commonly used to soothe the liver, nourish the blood, and strengthen the spleen, harmonizing the liver and spleen. If the right Guan pulse is large and the left Guan pulse is string-like, it mostly belongs to liver and stomach Qi stagnation, and Bupleurum Liver-soothing powder is often used to soothe the liver, regulate Qi, and harmonize the stomach. A large and empty right Guan pulse suggests insufficiency of Central Qi, and Buzhong Yiqi Tang is commonly used to tonify Qi and soothe the liver. In terms of medication, professor LIAN pays attention to patients’ dietary habits and combines methods of eliminating dampness, promoting digestion, and activating blood circulation to improve symptoms and reverse atrophy.
基金supported by the Youth Medical Science and Technology Talent Special Research Project of Xinjiang Uygur Autonomous Region Health Commission(WJWY-202440).
文摘Chronic atrophic gastritis(CAG)is a common type of chronic gastric disease characterized by high incidence and a certain tendency toward cancerization.In recent years,with the deepening of related research,it has been found that traditional Chinese medicine(TCM)exerts therapeutic effects on CAG through various signaling pathways.This article systematically reviews and summarizes the literature on TCM treatment of CAG,elaborating on the etiology and pathogenesis of CAG,new ideas from different physicians in treating CAG,and the effects of different TCM monomers and compound prescriptions on signaling pathways such as PI3K-AKT and JAK1/STAT3 to provide a reference for subsequent research on CAG.
文摘Helicobacter pylori(Hp) is a major human pathogen causing chronic, progressive gastric mucosal damage and is linked to gastric atrophy and cancer. Hp-positive individuals constitute the major reservoir for transmission of infection. There is no ideal treatment for Hp. Hp infection is not cured by a single antibiotic, and sometimes, a combined treatment with three or more antibiotics is ineffective. Atrophic gastritis(AG) is a chronic disease whose main features are atrophy and/or intestinal metaplasia of the gastric glands, which arise from long-standing Hp infection. AG is reportedly linked to an increased risk for gastric cancer, particularly when extensive intestinal metaplasia is present. Active or past Hp infection may be detected by conventional methods in about two-thirds of AG patients. By immunoblotting of sera against Hp whole-cell protein lysates, a previous exposure to Hp infection is detected in all AG patients. According to guidelines, AG patients with Hp positivity should receive eradication treatment. The goals of treatment are as follows:(1) Cure of infection, resolution of inflammation and normalization of gastric functions;(2) possible reversal of atrophic and metaplastic changes of the gastric mucosa; and(3) prevention of gastric cancer. An ideal antibiotic regimen for Hp should achieve eradication rates of approximately 90%, and complex multidrug regimens are required to reach this goal. Amongst the factors associated with treatment failure are high bacterial load, high gastric acidity, Hp strain, smoking, low compliance, overweight, and increasing antibiotic resistance. AG, when involving the corporal mucosa, is linked to reduced gastric acid secretion. At a non-acidic intra-gastric p H, the efficacy of the common treatment regimens combining proton pump inhibitors with one or more antibiotics may not be the same as that observed in patients with Hp gastritis in an acid-producing stomach. Although the efficacy of these therapeutic regimens has been thoroughly tested in subjects with Hp infection, there is a paucity of evidence in the subgroupof patients with AG. Bismuth-based therapy may be an attractive treatment in the specific setting of AG, and specific studies on the efficacy of bismuth-based therapies are needed in patients with AG.
文摘Chronic atrophic gastritis （CAG） is an inflammatory condition characterized by the loss of gastric glandular structures which are replaced by connective tissue （non-metaplastic atrophy） or by glandular structures inappropriate for location （metaplastic atrophy）. Epidemiological data suggest that CAG is associated with two different types of tumors： Intestinal-type gastric cancer （GC） and type I gastric carcinoid （T I GC）. The pathophysiological mechanisms which lead to the development of these gastric tumors are different, It is accepted that a multistep process initiating from Helico- bacterpylori-related chronic inflammation of the gastric mucosa progresses to CAG, intestinal metaplasia, dysplasia and, finally, leads to the development of GC. The T I GC is a gastrin-dependent tumor and the chronic elevation of gastrin, which is associated with CAG, stimulates the growth of enterochromaffin-like cells with their hyperplasia leading to the development of T I GC. Thus, several events occur in the gastric mucosa before the development of intestinatype GC and/ or T I GC and these take several years. Knowledge ofCAG incidence from superficial gastritis, its prevalence in different clinical settings and possible risk factors as- sociated with the progression of this condition to gastric neoplasias are important issues. This editorial intends to provide a brief review of the main studies regarding incidence and prevalence of CAG and risk factors for the development of gastric neoplasias.
基金Cangzhou City Science and Technology Plan Projects,No.151302138
文摘AIM To explore the correlation between serum vitamin B12 level and peripheral neuropathy in patients with chronic atrophic gastritis(CAG).METHODS A total of 593 patients diagnosed with chronic gastritis by gastroscopy and pathological examination fromSeptember 2013 to September 2016 were selected for this study.The age of these patients ranged within 18-to 75-years-old.Blood pressure,height and weight were measured in each patient,and the body mass index value was calculated.Furthermore,gastric acid,serum gastrin,serum vitamin and serum creatinine tests were performed,and peripheral nerve conduction velocity and Helicobacter pylori(H.pylori)were detected.In addition,the type of gastritis was determined by gastroscopy.The above factors were used as independent variables to analyze chronic gastritis with peripheral neuropathy and vitamin B12 deficiency risk factors,and to analyze the relationship between vitamin B12 levels and peripheral nerve conduction velocity.In addition,in the treatment of CAG on the basis of vitamin B12,patients with peripheral neuropathy were observed.RESULTS Age,H.pylori infection,CAG,vitamin B9 and vitamin B12 were risk factors for the occurrence of peripheral nerve degeneration.Furthermore,CAG and H.pylori infection were risk factors for chronic gastritis associated with vitamin B12 deficiency.Serum vitamin B12 level was positively correlated with sensory nerve conduction velocity in the tibial nerve(R=0.463).After vitamin B12 supplementation,patients with peripheral neuropathy improved.CONCLUSION Serum vitamin B12 levels in patients with chronic gastritis significantly decreased,and the occurrence of peripheral neuropathy had a certain correlation.CAG and H.pylori infection are risk factors for vitamin B12 deficiency and peripheral neuropathy.When treating CAG,vitamin B12 supplementation can significantly reduce peripheral nervous system lesions.Therefore,the occurrence of peripheral neuropathy associated with vitamin B12 deficiency may be considered in patients with CAG.Furthermore,the timely supplementation of vitamin B12 during the clinical treatment of CAG can reduce or prevent peripheral nervous system lesions.
文摘Chronic atrophic autoimmune gastritis (CAAG) is an organ-specific autoimmune disease characterized by an immune response, which is directed towards the parietal cells and intrinsic factor of the gastric body and fundus and leads to hypochlorhydria, hypergastrinemia and inadequate production of the intrinsic factor. As a result, the stomach’s secretion of essential substances, such as hydrochloric acid and intrinsic factor, is reduced, leading to digestive impairments. The most common is vitamin B12 deficiency, which results in a megaloblastic anemia and iron malabsorption, leading to iron deficiency anemia. However, in the last years the deficiency of several other vitamins and micronutrients, such as vitamin C, vitamin D, folic acid and calcium, has been increasingly described in patients with CAAG. In addition the occurrence of multiple vitamin deficiencies may lead to severe hematological, neurological and skeletal manifestations in CAAG patients and highlights the importance of an integrated evaluation of these patients. Nevertheless, the nutritional deficiencies in CAAG are largely understudied. We have investigated the frequency and associated features of nutritional deficiencies in CAAG in order to focus on any deficit that may be clinically significant, but relatively easy to correct. This descriptive review updates and summarizes the literature on different nutrient deficiencies in CAAG in order to optimize the treatment and the follow-up of patients affected with CAAG.
基金Supported by the Scientific Research Fund of the Health Bureau of Zhejiang Province, No. 2001QN012
文摘AIM: To investigate the effect of H pylori eradication on atrophic gastritis and intestinal metaplasia (IM).METHODS: Two hundred and fifty-nine patients with atrophic gastritis in the antrum were included in the study, 154 patients were selected for H pylori eradication therapy and the remaining 105 patients served as untreated group. Gastroscopy and biopsies were performed both at the beginning and at the end of a 3-year follow-up study. Gastritis was graded according to the updated Sydney system.RESULTS: One hundred and seventy-nine patients completed the follow-up, 92 of them received H pylori eradication therapy and the remaining 87 H pyloriinfected patients were in the untreated group. Chronic gastritis, active gastritis and the grade of atrophy significantly decreased in H pylori eradication group (P＜0.01). However, the grade of IM increased in H pylori -infected group (P＜0.05).CONCLUSION: H pylori eradication may improve gastric mucosal inflammation, atrophy and prevent the progression of IM.
文摘BACKGROUND The risk of gastric cancer increases in patients with Helicobacter pylori-associated chronic atrophic gastritis(CAG).X-ray examination can evaluate the condition of the stomach,and it can be used for gastric cancer mass screening.However,skilled doctors for interpretation of X-ray examination are decreasing due to the diverse of inspections.AIM To evaluate the effectiveness of stomach regions that are automatically estimated by a deep learning-based model for CAG detection.METHODS We used 815 gastric X-ray images(GXIs)obtained from 815 subjects.The ground truth of this study was the diagnostic results in X-ray and endoscopic examinations.For a part of GXIs for training,the stomach regions are manually annotated.A model for automatic estimation of the stomach regions is trained with the GXIs.For the rest of them,the stomach regions are automatically estimated.Finally,a model for automatic CAG detection is trained with all GXIs for training.RESULTS In the case that the stomach regions were manually annotated for only 10 GXIs and 30 GXIs,the harmonic mean of sensitivity and specificity of CAG detection were 0.955±0.002 and 0.963±0.004,respectively.CONCLUSION By estimating stomach regions automatically,our method contributes to the reduction of the workload of manual annotation and the accurate detection of the CAG.
基金Supported by the Natural Science Foundation of Zhejiang Province(Notch signaling-based Mechanistic Studies on the Therapeutic Role of Banxia Xiexin Decoction in Chronic Atrophic Gastritis,No.LY15H270013)
文摘OBJECTIVE:To investigate the effectiveness of Banxia Xiexin decoction(BXD)in a rat model of chronic atrophic gastritis(CAG).METHODS:Sixty 6-week-old healthy Wistar rats(30 males,30 females)were used in the present study.A rat model of CAG was successfully established using the combined active immunization/ethanol/sodium deoxycholate method.BXD was prepared from a mixture of seven Chinese herbs,and was intragastrically administered to CAG rats at three different doses(6,12,and 24 g·kg^-1·d^-1).Af-ter 24 weeks,the rats were euthanized,and gastric tissue specimens were collected.Gastric mucosal specimens were stained with hematoxylin and eosin for histological examination to evaluate the degree of inflammation and morphological changes.Immunohistochemical staining was performed to examine the mucosal expression of proliferating cell nuclear antigen.Serum gastrin levels were measured using radioimmunoassay.The expression of Notch signaling-associated genes was examined by quantitative polymerase chain reaction and Western blot assay.RESULTS:BXD at all three doses significantly reversed the adverse effects generated by CAG in rats.Compared with control rats,the CAG rats who were administered BXD had an accelerated growth rate,reduced inflammatory cell infiltration,improved gastric mucosal morphology,augmented thickness of the gastric mucosa,increased number of gastric glands,enhanced mucosal expression of proliferating cell nuclear antigen,and elevated serum gastrin levels.
基金Supported by the Natural Science Foundation of Hebei Province, No. 301427
文摘AIM: To study the effects of He-Ne laser irradiation on experimental chronic atrophic gastritis (CAG) in rats.METHODS: Sixty-three male adult Wistar rats were randomly divided into five groups including normal control group, model control group and three different dosages He-Ne laser groups. The chronic atrophic gastritis (CAG)model in rats was made by pouring medicine which was a kind of mixed liquor including 2% sodium salicylate and 30% alcohol down the throat for 8 wk to stimulate rat gastric mucosa, combining with irregular fasting and compulsive sporting as pathogenic factors; 3.36, 4.80, and 6.24J/cm2doses of He-Ne laser were used, respectively for three different treatment groups, once a day for 20 d. The pH value of diluted gastric acid was determined by acidimeter,the histopathological changes such as the inflammatory degrees in gastric mucosa, the morphology and structure of parietal cells were observed, and the thickness of mucosa was measured by micrometer under optical microscope.RESULTS: In model control group, the secretion of gastric acid was little, pathologic morphological changes in gastric mucosa such as thinner mucous, atrophic glands, notable inflammatory infiltration were found. After 3.36 J/cm2 dose of He-Ne laser treatment for 20 d, the secretion of gastric acid was increased (P＜0.05), the thickness of gastric mucosa was significantly thicker than that in model control group (P＜0.01), the gastric mucosal inflammation cells were decreased (P＜0.05). Morphology, structure and volume of the parietal cells all recuperated or were closed to normal.CONCLUSION: 3.36J/cm2 dose of He-Ne laser has a significant effect on CAG in rats.
基金Supported by The Grants from Beijing Municipal Science Foundationthe Key Technology Research and Development Program, No. 2002BA711A06+1 种基金the National 973 Project, No.1998051203863 Project, No. 2006A402
文摘AIM: To investigate the effects of interleukin-8 (IL-8 ), macrophage migration inhibitory factor (MIF ) gene polymorphisms, Helicobacter pylori (H. pylori ) infection, on the risk of developing severe chronic atrophic gastritis (SCAG) and intestinal metaplasia (IM). METHODS: A total of 372 cases were selected from a cohort study in Linqu County, a high risk area for gastric cancer (GC) in northern China. To obtain a sufficient group size, patients with normal or superficial gastritis were included. Based on an average follow-up period of 56 mo, the 372 cases were divided into no progres-sion group (no histological progression from normal or superficial gastritis, n = 137), group Ⅰ (progressed from normal or superficial gastritis to SCAG, n = 134) and group Ⅱ (progressed from normal or superficial gastritis to IM, n = 101). IL-8 , MIF gene polymorphisms were detected by polymerase chain reaction-based denaturing high-performance liquid chromatography analysis and DNA sequencing. RESULTS: An increased risk of SCAG was found in subjects with IL-8-251 AA genotype [odds ratio (OR) = 2.62, 95% CI: 1.23-5.72] or IL-8-251 A allele carriers (AA + AT) (OR = 1.81, 95% CI: 1.06-3.09). An elevated risk of IM was found in subjects with IL-8-251 AT genotype (OR = 2.27, 95% CI: 1.25-4.14) or IL-8-251 A allele carriers (OR = 2.07, 95% CI: 1.16-3.69). An increased risk of SCAG was found in subjects with MIF-173 GC genotype (OR = 2.36, 95% CI: 1.38-4.02) or MIF-173 C allele carriers (GC + CC) (OR = 2.07, 95% CI: 1.21-3.55). An elevated risk of IM was found in subjects with MIF-173 CC genotype (OR = 2.27, 95% CI: 1.16-4.46) or MIF-173 C allele carriers (OR = 3.84, 95% CI: 1.58-9.34). The risk of SCAG and IM was more evident in subjects carrying IL-8-251 A allele (OR = 6.70, 95% CI: 1.29-9.78) or MIF-173 C allele (OR = 6.54, 95% CI: 2.97-14.20) and positive for H. pylori infection. CONCLUSION: IL-8-251 and MIF-173 gene polymorphisms are significantly associated with the risk of SCAG and IM in a population with a high risk of GC in Linqu County, Shandong Province, China.
基金Supported by National Natural Science Foundation of China,No.31460023Science Research and Technology Development Project of Guangxi,No.1598025-33
文摘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.
文摘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.
文摘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.
基金Project (No. 011103018) supported by the Science and TechnologyPlan of Zhejiang Province, China
文摘Objective： To study the pathologic change and molecular regulation in cell proliferation and apoptosis of gastric mucosa in rats with chronic atrophic gastritis （CAG）, and evaluate the possible mechanisms. Methods： Rats were administered with 60% alcohol or 2% salicylate sodium, 20 mmol/L deoxycholate sodium and 0.1% ammonia water to establish chronic atrophic gastritis （CAG） models. The gastric specimens were prepared for microscopic view with hematoxylin and eosin （H-E） and alcian blue （A-B） stain. The number of infiltrated inflammatory cells, the thickness of the mucosa gland layer （μm） and the number of gastric glands were calculated. The damage of barrier in mucosa with erosion or ulceration, and the thickness of mucin were examined by scanned electron microscope （SEM）. The levels of PGE2, EGF （epiderminal growth factor） and gastrin in the serum were measured with radioimmunoassay or ELISA method. The immunohistochemistry method was used to observe the number of G cells, the expression of protein of EGFR （EGF receptor）, C-erbB-2, p53, p6 and bcl-2 in gastric tissue. Results： Under SEM observation, the gastric mucosa was diffused erosion or ulceration and the thickness of mucin was decreased. Compared with normal rats, the grade of inflammatory cell infltration in CAG rats was elevated, whereas the thickness and number of gastric gland were significantly lower （P〈0.05）. Compared with normal level of （0.61±0.28） μg/L, EGF in CAG （2.24±0.83） μg/L was significantly higher （P〈0.05）. The levels of PGEz and gastrin in serum were significantly lower in CAG rats than that in normal rats （P〈0.05）. Immunohistochemistry detection showed that the number of G cell in antrum was lower in CAG group （P〈0.05）. Imrauno-stain showed EGFR protein expression in the basal and bilateral membrane, and the cytoplasma in atrophic gastric gland, while negative expression was observed in normal gastric epithelial cells. Positive staining of p53 and p 16 protein was localized in the nucleus of epithelial cells. The former was higher positively expressed in atrophic gland, while the later was higher positively stained in normal gastric tissue, bcl-2 protein was positively stained in the cytoplasma in atrophic gastric gland, while very weakly stained in normal gastric tissue. Conclusion： The pathological findings in gastric gland accorded with the Houston diagnostic criteria of antrum-predominant CAG. CAG in rats was related with the damage of barrier in gastric mucosa and the misbalance of cell proliferation and apoptosis. There was high protein expression of oncogene, while inhibitor of suppressor gene in CAG rats indicated high trend of carcinogenesis.
