BACKGROUND Helicobacter pylori(H.pylori)is a Gram-negative bacterium that relies on flagellar motility to colonize the stomach,damaging the gastric mucosa through various mechanisms and leading to various digestive di...BACKGROUND Helicobacter pylori(H.pylori)is a Gram-negative bacterium that relies on flagellar motility to colonize the stomach,damaging the gastric mucosa through various mechanisms and leading to various digestive disorders.Accurate assessment and precise treatment are essential in initial intensive therapy.AIM To investigate the efficacy and safety of a vonoprazan(VPZ)-based triple regimen for first-line eradication of H.pylori in China.METHODS This multicenter noninferior randomized controlled trial(June 2022 to November 2023)involved 524 H.pyloripositive patients across 19 centers in Shandong,China.Participants were randomized to 14-day esomeprazole/bismuth/amoxicillin/clarithromycin(EBAC),14-day VPZ/amoxicillin/clarithromycin(VACa),or 10-day VPZ/amoxicillin/clarithromycin(VACb)-all administered twice daily.Primary outcomes(eradication rates)were assessed via intention-to-treat(ITT)and per-protocol(PP)analyses.Secondary endpoints included adverse events and adherence.Noninferiority testing andχ^(2)tests were used for statistical comparisons.RESULTS A total of 524 patients participated in this study.In ITT analysis,the eradication rates of the EBAC,VACa,and VACb groups were 72.6%(127/175),88.0%(154/175),and 83.3%(145/174),respectively(P=0.001).The difference in the eradication rate between the EBAC and VPCa groups was 15.4%[95%confidence interval(CI):7.3-23.6,P<0.001],and that between the EBAC and VACb groups was 10.8%(95%CI:2.1-19.4,P=0.018).In PP analysis,the eradication rates of the EBAC,VACa,and VACb groups were 81.4%(127/156),93.9%(154/164),and 90.6%(145/160),respectively(P=0.001).There was no significant difference in the incidence of adverse reactions among the three groups,which were 36.6%,33.8%and 29.6%,respectively(P=0.50).CONCLUSION VPZ-based triple therapies demonstrate noninferiority to 14-day bismuth-containing regimens,with the 10-day regimen showing comparable efficacy and similar adverse event rates.展开更多
Multidrug-resistant Klebsiella pneumoniae(MDR-KP)is characterized by high mortality and risk of nosocomial transmission,and biofilm constitutes the primary challenge in the treatment of its implant-associated and refr...Multidrug-resistant Klebsiella pneumoniae(MDR-KP)is characterized by high mortality and risk of nosocomial transmission,and biofilm constitutes the primary challenge in the treatment of its implant-associated and refractory pulmonary infections.Notably,the hypoxic microenvironment and the physical barrier of biofilm leading to the increased tolerance of the bacteria to antibiotics.Herein,a hypoxia-responsive hybrid nanoparticle(CHLip@FLD/COL)loaded separately with anti-biofilm candidate fingolimod(FLD)and antibiotic colistin(COL)is achieved targeting antibacterial efficacy against MDR-KP in vitro and in vivo.CHLip@FLD/COL is composed of hybridizing hypoxia-responsive lipids(HLipid)and lipid A targeting materials DSPE-mPEG-COL.HLipid is synthesized by hexadecanedioic acid esterified with nitroimidazole,while DSPE-mPEG is coupling with vector COL via amide reaction.The relative level of extracellular polymeric substances and the NIR-IIb sO2 images of the infection site are used as indicators to establish mature biofilm models.CHLip@FLD/COL readily releases FLD and COL in hypoxic conditions,and its MIC against MDR-KP is only one-sixteenth of that when COL is used alone in vitro.The nanoparticle exhibits bacterial targeting ability and antibacterial effect in the pulmonary infection and biofilm infection mice models.Bacterial loads eliminated by 4 Log10 CFU and 2 Log10 CFU,respectively.The strategy provides a valuable reference for the treatment of refractory infections caused by MDR-KP.展开更多
Antibiotic resistance in Helicobacter pylori is reshaping eradication strategies worldwide.Analysis of 1408 treatment-naive isolates collected across Taiwan China between 2019 and 2024 reveals a striking shift in resi...Antibiotic resistance in Helicobacter pylori is reshaping eradication strategies worldwide.Analysis of 1408 treatment-naive isolates collected across Taiwan China between 2019 and 2024 reveals a striking shift in resistance patterns.Tetracycline resistance,once negligible,rose to 3.5%,threatening the durability of bismuthbased quadruple therapy.Conversely,metronidazole resistance declined markedly,while clarithromycin and levofloxacin resistance remained stable at moderate levels,with levofloxacin showing significant regional variation.Emerging dual resistance involving tetracycline underscores the fragility of empiric regimens and highlights the need for culture-guided or molecular approaches.These findings reflect the dual influence of stewardship successes and environmental antibiotic pressures,while also signaling the limits of empiricism in eradication therapy.Potassium-competitive acid blockers provide a promising pharmacologic pivot,capable of enhancing antibiotic efficacy and sustaining eradication outcomes.Taiwan’s China resistance profile thus offers both cautionary lessons and actionable insights for future regional and global treatment strategies.展开更多
Pinewood nematode is a devastating forest pathogen and is considered a quarantine organism worldwide.First identified in China 40 years ago,the disease has been spreading since.In response,Chinese authorities have int...Pinewood nematode is a devastating forest pathogen and is considered a quarantine organism worldwide.First identified in China 40 years ago,the disease has been spreading since.In response,Chinese authorities have introduced new requirements for preventing and controlling the disease.This paper proposes a new and highly effective preventive drug,a trunk injection agent usable at normal temperatures.Its use is suggested for localized epidemic areas to reduce diseased and dead trees and as a preventive measure in adjacent non-epidemic areas to prevent the infection from spreading,particularly protecting important and ancient pine trees.展开更多
BACKGROUND Effective acid suppression significantly enhances the eradication rate of Helicobacter pylori(H.pylori).AIM To assess the efficacy and safety of high-dose dual therapy(HDDT)utilizing various highly potent a...BACKGROUND Effective acid suppression significantly enhances the eradication rate of Helicobacter pylori(H.pylori).AIM To assess the efficacy and safety of high-dose dual therapy(HDDT)utilizing various highly potent antisecretory medications,thereby providing additional clinical guidance for H.pylori eradication.METHODS The study population comprised untreated H.pylori patients from three medical centers in central China.From February 10,2024 to March 31,2024,439 subjects were randomly allocated to either the esomeprazole-amoxicillin(EA)or esomeprazole-amoxicillin-clarithromycin-bismuth(B-quadruple)group.Subsequently,from April 1,2024 to May 10,2024,367 subjects were randomly assigned to either the vonoprazan-amoxicillin(VA)or vonoprazan-amoxicillin-clarithromycin(VAC)group.The study recorded treatment efficacy,adverse events,compliance,symptom alleviation,and associated costs.RESULTS EA-dual demonstrated non-inferiority to B-quadruple regimen in modified intention-to-treat(mITT)and perprotocol(PP)analyses(P<0.025).However,the eradication rate of EA was lower than that of the B-quadruple group[70.59%vs 83.49%,92.86%vs 98.38%,93.94%vs 98.38%,intention-to-treat(ITT),mITT,PP respectively,P<0.05].In ITT,mITT,and PP analyses,VA-dual was non-inferior to VAC treatment(84.15%vs 83.15%,96.25%vs 92.73%,96.75%vs 93.75%,P<0.025).No significant differences were observed in adverse events,compliance,and symptom relief between groups.VA exhibited the lowest cost.Antibiotic use within 2 years,poor compliance,and suburban residence were associated with reduced eradication efficacy(P<0.05).CONCLUSION The HDDT based on vonoprazan demonstrated non-inferiority to the VAC triple regimen,suggesting its potential as a recommended first-line treatment for H.pylori eradication.While B-quadruple therapy showed better eradication rate than EA therapy,the latter proved non-inferior in mITT and PP analyses.Notably,antibiotic use within the preceding two years,adherence to treatment protocols,and patient residence emerged as critical factors influencing eradication success.展开更多
Nujiang’s success in eliminating poverty sets a good example for the developing countries to follow.Poverty continues to be a major problem in many parts of the world.China’s poverty eradication experience demonstra...Nujiang’s success in eliminating poverty sets a good example for the developing countries to follow.Poverty continues to be a major problem in many parts of the world.China’s poverty eradication experience demonstrates that developing countries can end poverty through perseverance and sustained efforts,noted Irina Bokova,former director general of UNESCO.展开更多
OBJECTIVE:To evaluate the efficacy and safety of 14-day Qingwei Zhitong pellets(清胃止痛微丸,QZ)-containing quadruple therapy(QZQT)compared to bismuth-containing quadruple therapy(BQT)in treatment-naive patients with ...OBJECTIVE:To evaluate the efficacy and safety of 14-day Qingwei Zhitong pellets(清胃止痛微丸,QZ)-containing quadruple therapy(QZQT)compared to bismuth-containing quadruple therapy(BQT)in treatment-naive patients with Helicobacter pylori(H.pylori)infection.METHODS:This single-center,randomized controlled clinical trial enrolled 333 patients,who were divided into either the QZQT group(QZ pellets,3.2 g,three times daily;rabeprazole,10 mg,twice daily;amoxicillin 1000 mg,twice daily;clarithromycin,500 mg,twice daily)or the BQT group(bismuth potassium citrate,1000 mg,three times daily;rabeprazole,10 mg,twice daily;amoxicillin,1000 mg,twice daily;clarithromycin,500 mg,twice daily)for 14 d.The 13C-urea breath test assessed eradication success at least four weeks after treatment.The primary outcome focused on the eradication rate,with secondary outcomes including safety and patient compliance.RESULTS:From August 2022 to June 2023,342 subjects were screened,and 333 were randomized.The QZQT and BQT groups showed eradication rates of 68.9%and 67.8%(P=0.838)by intention-to-treat(ITT)analysis,respectively,and 71.1%and 68.3%(P=0.612)by perprotocol(PP)analysis,respectively.QZQT was non-inferior to BQT in both ITT and PP analyses.QZQT was associated with fewer side effects(57.8%of patients)than BQT(90.4%)(P<0.001).CONCLUSION:The 14 d QZQT treatment demonstrates equal efficacy in eradicating H.pylori infection and improved patient compliance and safety compared to BQT.These results provide evidence supporting 14-day QZQT as an acceptable treatment for H.pylori infection.展开更多
BACKGROUND Helicobacter pylori(H.pylori)is a Gram-negative bacillus classified as a Group I carcinogen by the World Health Organization.However,the efficacy of eradi-cation therapies has declined in recent years,prima...BACKGROUND Helicobacter pylori(H.pylori)is a Gram-negative bacillus classified as a Group I carcinogen by the World Health Organization.However,the efficacy of eradi-cation therapies has declined in recent years,primarily due to the increasing prevalence of antibiotic resistance.The Maastricht VI/Florence Consensus Report highlights the importance of tailoring treatment strategies to local epidemiological data and individual antimicrobial susceptibility patterns.AIM To investigate the efficacy of precision-guided first-line therapy for H.pylori in-fection using genotypic antibiotic susceptibility testing(G-AST).METHODS This single-center randomized controlled trial enrolled 194 H.pylori-positive patients at a tertiary hospital in Qingdao,China(October 2022-August 2024).Participants were randomized to receive either a 14-day bismuth quadruple therapy(BQT:Amoxicillin,clarithromycin,esomeprazole,and bismuth)or a 14-day G-AST-guided regimen with tailored antibiotics(clarithromycin,levofloxacin,or tetracycline).Treatment efficacy and adverse events were compared between groups using intention-to-treat(ITT)and per-protocol(PP)analyses.Primary and secondary outcomes were analyzed with χ^(2) tests.RESULTS Of 194 patients enrolled,180(92.8%)completed the study as planned.In the ITT analysis,the eradication rate was higher in the G-AST group than in the BQT group[92.8%(95%CI:85.8-96.5)vs 79.4%(95%CI:70.3-86.2),P=0.007],with a risk difference of 13.4%(95%CI:3.7-23.2).In the PP analysis,eradication rates were 97.8%(95%CI:92.4-99.4)in the G-AST group and 84.1%(95%CI:75.1-90.3)in the BQT group(P=0.001),with a risk difference of 13.7%(95%CI:5.5-23.0).Adverse event incidence did not differ significantly between groups(30.9%vs 28.9%,P=0.754).CONCLUSION G-AST-guided therapy yielded higher eradication rates than empirical BQT in first-line H.pylori treatment without increasing adverse events,supporting the clinical utility of individualized,resistance-based therapy.展开更多
Antimicrobial resistance(AMR)is a growing public health crisis that requires innovative solutions.Emerging multidrug resistant(MDR)Salmonella typhimurium has raised concern for its effect on pathogenic infection and m...Antimicrobial resistance(AMR)is a growing public health crisis that requires innovative solutions.Emerging multidrug resistant(MDR)Salmonella typhimurium has raised concern for its effect on pathogenic infection and mortality in humans caused by enteric diseases.To combat these MDR Salmonella typhimurium pathogens,highly effective and broad-spectrum antibiotics such as flufenicol(FFC)need to be evaluated for their potent antibacterial activity against Salmonella typhimurium.However,the low solubility and low oral bioavailability of flufenicol need to be addressed to better combat AMR.In this work,we develop a novel nano-formulation,flufenicol nano-micelles(FTPPM),which are based on d-α-tocopherol polyethylene glycol 1,000 succinate(TPGS)/poloxamer 188(P188),for the targeted treatment of biofilms formed by drug-resistant Salmonella typhimurium in the intestine.Herein,FTPPM were prepared via a thin film hydration method.The preparation process for the mixed micelles is simple and convenient compared with other existing nanodrug delivery systems,which can further decrease production costs.The optimized FTPPM demonstrated outstanding stability and sustained release.An evaluation of the in vivo anti-drug-resistant Salmonella typhimurium efficacy demonstrated that FTPPM showed a stronger efficacy(68.17%)than did florfenicol-loaded TPGS polymer micelles(FTPM),flufenicol active pharmaceutical ingredients(FFC-API),and flufenicol commercially available medicine(FFC-CAM),and also exhibited outstanding biocompatibility.Notably,FTPPM also inhibited drug-resistant Salmonella typhimurium from forming biofilms.More importantly,FTPPM effectively restored intestinal flora disorders induced by drug-resistant Salmonella typhimurium in mice.In summary,FTPPM significantly improved the solubility and oral bioavailability of florfenicol,enhancing its efficacy against drug-resistant Salmonella typhimurium both in vitro and in vivo.FTPPM represent a promising drug-resistant Salmonella typhimurium treatment for curbing bacterial resistance via oral administration.展开更多
Objective: To compare the eradication rates of Helicobacter pylori (HP) and the incidence of adverse reactions among three treatment methods. Methods: A total of 139 patients with Helicobacter pylori infection diagnos...Objective: To compare the eradication rates of Helicobacter pylori (HP) and the incidence of adverse reactions among three treatment methods. Methods: A total of 139 patients with Helicobacter pylori infection diagnosed at the outpatient clinic or during hospitalization in the Department of Gastroenterology of West Electric Group Hospital from January 2022 to April 2023 were enrolled. Patients were divided into three groups: dual therapy group (46 cases), triple therapy group (62 cases), and quadruple therapy group (31 cases). The dual therapy group received omeprazole and amoxicillin;the triple therapy group received omeprazole, amoxicillin, and probiotics;the quadruple therapy group received omeprazole, colloidal bismuth pectin capsules, amoxicillin, and furazolidone. All treatments lasted for two weeks. The eradication rates and incidence of adverse reactions were compared among the three groups. Results: The eradication rates for the dual, triple, and quadruple therapy groups were 84.8%, 85.5%, and 85%, respectively (P > 0.05). The primary adverse reactions included gastrointestinal symptoms such as bloating, abdominal pain, loss of appetite, and abdominal discomfort, with incidence rates of 1, 2, and 6 cases in the dual, triple, and quadruple therapy groups, respectively (P = 0.574). However, a significant difference was found between the dual and quadruple therapy groups (P = 0.03) and between the triple and quadruple therapy groups (P = 0.026). Neurological side effects, such as dizziness and headache, were rare, with incidences of 0, 1, and 1 cases in the dual, triple, and quadruple therapy groups, respectively (P = 0.611). Conclusion: The efficacy of dual, triple, and quadruple therapy for eradicating Helicobacter pylori showed no significant difference. However, the dual and triple therapy groups had lower adverse reaction rates, making them suitable alternatives to traditional quadruple therapy for reducing patient discomfort. The probiotic group also contributed to the restoration of normal gastrointestinal microbiota.展开更多
There has been a rise in the incidence of esophageal adenocarcinoma(EAC)over the past five decades in the United States,and it remains a highly lethal ma-lignancy due to frequent late-stage diagnosis.Barrett’s esopha...There has been a rise in the incidence of esophageal adenocarcinoma(EAC)over the past five decades in the United States,and it remains a highly lethal ma-lignancy due to frequent late-stage diagnosis.Barrett’s esophagus(BE),a well-established precursor to EAC,presents a critical window for early intervention through screening,surveillance,and endoscopic eradication therapy.Despite gastrointestinal society guideline recommendations for screening,the majority of patients with BE or early EAC remain undiagnosed until symptoms of late-stage cancer emerge.This review outlines current challenges and evolving strategies in the United States in BE detection and management,including risk stratification models,non-endoscopic screening tools,high-quality endoscopic techniques,tissue-based biomarkers,and artificial intelligence-enhanced imaging.We high-light best practices for surveillance,emphasizing the importance of thorough inspection of high-risk anatomic zones and the integration of advanced imaging.Endoscopic eradication therapy,including endoscopic mucosal resection and ablation,achieves high rates of complete eradication when performed with meti-culous technique,especially with comprehensive treatment of the gastroeso-phageal junction and gastric cardia.Long-term surveillance remains essential due to the risk of recurrence.As new technologies continue to emerge,integrating precision tools into routine practice will be key to improving outcomes and reducing EAC mortality.展开更多
稻瘟病菌(Magnaporthe oryzae)作为主要的农业病原微生物,其引起的稻瘟病严重威胁着水稻等谷类作物的生产安全。内质网相关蛋白质降解途径(Endoplasmic reticulum-associated protein degradation,ERAD)是生物体应答内质网压力的主要方...稻瘟病菌(Magnaporthe oryzae)作为主要的农业病原微生物,其引起的稻瘟病严重威胁着水稻等谷类作物的生产安全。内质网相关蛋白质降解途径(Endoplasmic reticulum-associated protein degradation,ERAD)是生物体应答内质网压力的主要方式之一,其在机体生长发育过程中具有重要作用。而HRD(HMG-CoA reductase degradation)复合物作为ERAD的关键组分,主要由Hrd1、Hrd3、以及凝集素Yos9等蛋白组成,负责内质网中错误折叠蛋白的识别、转运以及泛素化过程,最终由蛋白酶体降解,从而有效缓解内质网压力,保证细胞的正常生理活动。有研究表明,Hrd3属于单次跨膜蛋白,在内质网腔中与Hrd1、Yos9相结合,负责底物的识别并起着稳定Hrd1的作用。目前Hrd3在稻瘟病菌中的生物学功能尚不清楚。本研究通过基因敲除及互补试验获得了稻瘟病菌的ΔMohrd3突变体和ΔMohrd3-C回补菌株,并以野生型为对照,对突变体的生物学表型进行了分析。结果显示,ΔMohrd3突变体的生长速率、产孢量明显下降;对大麦和水稻的致病力显著减弱。进一步胁迫试验表明,MoHRD3的缺失导致稻瘟病菌对外界盐胁迫、渗透压胁迫的耐受性增强,对内质网胁迫耐受性减弱,而对细胞壁胁迫无明显变化。同时,MoHRD3基因的缺失激活了未折叠蛋白响应途径(Unfolded protein response,UPR)。上述结果表明,MoHRD3参与调控稻瘟病菌的营养生长、无性繁殖、致病及对不同环境胁迫的响应过程。展开更多
AIM： To assess the safety of bismuth used in Helicobacter pylori （H pylorl） eradication therapy regimens. METHODS： We conducted a systematic review and meta-analysis. MEDLINE and EMBASE were searched （up to Octob...AIM： To assess the safety of bismuth used in Helicobacter pylori （H pylorl） eradication therapy regimens. METHODS： We conducted a systematic review and meta-analysis. MEDLINE and EMBASE were searched （up to October 2007） to identify randomised controlled tri- als comparing bismuth with placebo or no treatment, or bismuth salts in combination with antibiotics as part of eradication therapy with the same dose and duration of antibiotics alone or, in combination, with acid suppresion. Total numbers of adverse events were recorded. Data were pooled and expressed as relative risks with 95% confidence intervals （CI）.RESULTS： We identified 35 randomised controlled trials containing 4763 patients. There were no serious adverse events occurring with bismuth therapy. There was no statistically significant difference detected in total adverse events with bismuth rrelative risk （RR） = 1.01; 95% CI： 0.87-1.16], specific individual adverse events, with the exception of dark stools （RR = 5.06; 95% CI： 1.59-16.12）, or adverse events leading to withdrawal of therapy （RR = 0.86; 95% CI： 0.54-1.37）. CONCLUSION： Bismuth for the treatment of H py/ori is safe and well-tolerated. The only adverse event occurring significantly more commonly was dark stools.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
AIM:To evaluate the influence of oral Helicobacter pylori(H.pylori)on the success of eradication therapy against gastric H.pylori.METHODS:A total of 391 patients with dyspepsia were examined for H.pylori using the sal...AIM:To evaluate the influence of oral Helicobacter pylori(H.pylori)on the success of eradication therapy against gastric H.pylori.METHODS:A total of 391 patients with dyspepsia were examined for H.pylori using the saliva H.pylori antigen test(HPS),13C-urea breath test(UBT),gastroscopy,and gastric mucosal histopathological detection.Another 40 volunteers without discomfort were subjected to HPS and13C-UBT,and served as the control group.The 233 patients who were13C-UBT+were enrolled in this study and divided into 4 groups.Patients who were HPS-and13C-UBT+(n=53)received triple therapy alone.Those who were both HPS+and13CUBT+(n=180)were randomly divided into 3 groups:(1)the O+G+t group which received triple therapy alone(n=53);(2)the O+G+tm group which received both triple therapy and mouthrinse treatment(n=65);and(3)the O+G+tmp group which received triple therapy,mouthrinse,and periodontal treatment(n=62).The HPS and13C-UBT were continued for 4 wk after completion of treatment,and the eradication rate of gastric H.pylori and the prevalence of oral H.pylori in the 4 groups were then compared.RESULTS:The eradication rates of gastric H.pylori in the O-G+t group,the O+G+tm group,and the O+G+tmp group were 93.3%,90.0%,and 94.7%respectively;all of these rates were higher than that of the O+G+t group(78.4%)[O-G+t group vs O+G+t group(P=0.039);O+G+tm group vs O+G+t group(P=0.092);O+G+tmp group vs O+G+t group(P=0.012);O+G+tm group vs O-G+t group(P=0.546);O+G+tmp group vs O-G+t group(P=0.765);O+G+tm group vs O+G+tmp group(P=0.924)].The eradication of gastric H.pylori was significantly improved using the combination of triple therapy,mouthrinse,and periodontal treatment.The eradication rates of gastric H.pylori in the peptic ulcer group,chronic atrophic gastritis group and control group were higher than in the duodenitis group and the superficial gastritis group.The prevalence rates of oral H.pylori in the O-G+t group,O+G+t group,O+G+tm group and O+G+tmp group following treatment were 0%,76.5%,53.3%,and 50.9%,respectively[O-G+t group vs O+G+t group(P<0.0001);O+G+tm group vs O+G+t group(P=0.011);O+G+tmp group vs O+G+t group(P=0.006);O+G+tm group vs O-G+t group(P<0.0001);O+G+tmp group vs O-G+t group(P<0.0001);O+G+tm group vs the O+G+tmp group(P=0.790)].Both mouthrinse and periodontal treatment significantly reduced the prevalence of oral H.pylori.CONCLUSION:Mouthrinse treatment alone or combined with periodontal treatment can,to some extent,reduce the prevalence of oral H.pylori and improve the eradication rate of gastric H.pylori.展开更多
基金Supported by Qilu Health Outstanding Young Talent Cultivation Project,No.QDFY-3839。
文摘BACKGROUND Helicobacter pylori(H.pylori)is a Gram-negative bacterium that relies on flagellar motility to colonize the stomach,damaging the gastric mucosa through various mechanisms and leading to various digestive disorders.Accurate assessment and precise treatment are essential in initial intensive therapy.AIM To investigate the efficacy and safety of a vonoprazan(VPZ)-based triple regimen for first-line eradication of H.pylori in China.METHODS This multicenter noninferior randomized controlled trial(June 2022 to November 2023)involved 524 H.pyloripositive patients across 19 centers in Shandong,China.Participants were randomized to 14-day esomeprazole/bismuth/amoxicillin/clarithromycin(EBAC),14-day VPZ/amoxicillin/clarithromycin(VACa),or 10-day VPZ/amoxicillin/clarithromycin(VACb)-all administered twice daily.Primary outcomes(eradication rates)were assessed via intention-to-treat(ITT)and per-protocol(PP)analyses.Secondary endpoints included adverse events and adherence.Noninferiority testing andχ^(2)tests were used for statistical comparisons.RESULTS A total of 524 patients participated in this study.In ITT analysis,the eradication rates of the EBAC,VACa,and VACb groups were 72.6%(127/175),88.0%(154/175),and 83.3%(145/174),respectively(P=0.001).The difference in the eradication rate between the EBAC and VPCa groups was 15.4%[95%confidence interval(CI):7.3-23.6,P<0.001],and that between the EBAC and VACb groups was 10.8%(95%CI:2.1-19.4,P=0.018).In PP analysis,the eradication rates of the EBAC,VACa,and VACb groups were 81.4%(127/156),93.9%(154/164),and 90.6%(145/160),respectively(P=0.001).There was no significant difference in the incidence of adverse reactions among the three groups,which were 36.6%,33.8%and 29.6%,respectively(P=0.50).CONCLUSION VPZ-based triple therapies demonstrate noninferiority to 14-day bismuth-containing regimens,with the 10-day regimen showing comparable efficacy and similar adverse event rates.
基金granted by National Key Research and Development Program of China(2021YFD1800900)Science and Technology Innovation Key R&D Program of Chongqing(CSTB2024TIAD-STX0038)+3 种基金National Natural Science Foundation of China(82574334,32501226)Chongqing Science and Technology Commission(CSTB2023NSCQ-JQX0002)Special Fund for Youth Team of Southwest University(SWU-XJLJ202306)Chongqing Natural Science Foundation(CSTB2024NSCQ-MSX0547).
文摘Multidrug-resistant Klebsiella pneumoniae(MDR-KP)is characterized by high mortality and risk of nosocomial transmission,and biofilm constitutes the primary challenge in the treatment of its implant-associated and refractory pulmonary infections.Notably,the hypoxic microenvironment and the physical barrier of biofilm leading to the increased tolerance of the bacteria to antibiotics.Herein,a hypoxia-responsive hybrid nanoparticle(CHLip@FLD/COL)loaded separately with anti-biofilm candidate fingolimod(FLD)and antibiotic colistin(COL)is achieved targeting antibacterial efficacy against MDR-KP in vitro and in vivo.CHLip@FLD/COL is composed of hybridizing hypoxia-responsive lipids(HLipid)and lipid A targeting materials DSPE-mPEG-COL.HLipid is synthesized by hexadecanedioic acid esterified with nitroimidazole,while DSPE-mPEG is coupling with vector COL via amide reaction.The relative level of extracellular polymeric substances and the NIR-IIb sO2 images of the infection site are used as indicators to establish mature biofilm models.CHLip@FLD/COL readily releases FLD and COL in hypoxic conditions,and its MIC against MDR-KP is only one-sixteenth of that when COL is used alone in vitro.The nanoparticle exhibits bacterial targeting ability and antibacterial effect in the pulmonary infection and biofilm infection mice models.Bacterial loads eliminated by 4 Log10 CFU and 2 Log10 CFU,respectively.The strategy provides a valuable reference for the treatment of refractory infections caused by MDR-KP.
文摘Antibiotic resistance in Helicobacter pylori is reshaping eradication strategies worldwide.Analysis of 1408 treatment-naive isolates collected across Taiwan China between 2019 and 2024 reveals a striking shift in resistance patterns.Tetracycline resistance,once negligible,rose to 3.5%,threatening the durability of bismuthbased quadruple therapy.Conversely,metronidazole resistance declined markedly,while clarithromycin and levofloxacin resistance remained stable at moderate levels,with levofloxacin showing significant regional variation.Emerging dual resistance involving tetracycline underscores the fragility of empiric regimens and highlights the need for culture-guided or molecular approaches.These findings reflect the dual influence of stewardship successes and environmental antibiotic pressures,while also signaling the limits of empiricism in eradication therapy.Potassium-competitive acid blockers provide a promising pharmacologic pivot,capable of enhancing antibiotic efficacy and sustaining eradication outcomes.Taiwan’s China resistance profile thus offers both cautionary lessons and actionable insights for future regional and global treatment strategies.
基金supported by the National Key Research and Development Program of China(Grant Number:2021YFD1400903).
文摘Pinewood nematode is a devastating forest pathogen and is considered a quarantine organism worldwide.First identified in China 40 years ago,the disease has been spreading since.In response,Chinese authorities have introduced new requirements for preventing and controlling the disease.This paper proposes a new and highly effective preventive drug,a trunk injection agent usable at normal temperatures.Its use is suggested for localized epidemic areas to reduce diseased and dead trees and as a preventive measure in adjacent non-epidemic areas to prevent the infection from spreading,particularly protecting important and ancient pine trees.
基金Supported by the National Natural Science Foundation of China,No.82270594the National Natural Science Foundation for Youths of China,No.82103151+1 种基金the Outstanding Youth Foundation of Hunan Province,No.2022JJ20092the Wisdom Accumulation and Talent Cultivation Project of Third Xiangya Hospital of Central South University,No.YX202103.
文摘BACKGROUND Effective acid suppression significantly enhances the eradication rate of Helicobacter pylori(H.pylori).AIM To assess the efficacy and safety of high-dose dual therapy(HDDT)utilizing various highly potent antisecretory medications,thereby providing additional clinical guidance for H.pylori eradication.METHODS The study population comprised untreated H.pylori patients from three medical centers in central China.From February 10,2024 to March 31,2024,439 subjects were randomly allocated to either the esomeprazole-amoxicillin(EA)or esomeprazole-amoxicillin-clarithromycin-bismuth(B-quadruple)group.Subsequently,from April 1,2024 to May 10,2024,367 subjects were randomly assigned to either the vonoprazan-amoxicillin(VA)or vonoprazan-amoxicillin-clarithromycin(VAC)group.The study recorded treatment efficacy,adverse events,compliance,symptom alleviation,and associated costs.RESULTS EA-dual demonstrated non-inferiority to B-quadruple regimen in modified intention-to-treat(mITT)and perprotocol(PP)analyses(P<0.025).However,the eradication rate of EA was lower than that of the B-quadruple group[70.59%vs 83.49%,92.86%vs 98.38%,93.94%vs 98.38%,intention-to-treat(ITT),mITT,PP respectively,P<0.05].In ITT,mITT,and PP analyses,VA-dual was non-inferior to VAC treatment(84.15%vs 83.15%,96.25%vs 92.73%,96.75%vs 93.75%,P<0.025).No significant differences were observed in adverse events,compliance,and symptom relief between groups.VA exhibited the lowest cost.Antibiotic use within 2 years,poor compliance,and suburban residence were associated with reduced eradication efficacy(P<0.05).CONCLUSION The HDDT based on vonoprazan demonstrated non-inferiority to the VAC triple regimen,suggesting its potential as a recommended first-line treatment for H.pylori eradication.While B-quadruple therapy showed better eradication rate than EA therapy,the latter proved non-inferior in mITT and PP analyses.Notably,antibiotic use within the preceding two years,adherence to treatment protocols,and patient residence emerged as critical factors influencing eradication success.
文摘Nujiang’s success in eliminating poverty sets a good example for the developing countries to follow.Poverty continues to be a major problem in many parts of the world.China’s poverty eradication experience demonstrates that developing countries can end poverty through perseverance and sustained efforts,noted Irina Bokova,former director general of UNESCO.
基金the China Zhongguancun Precision Medicine Science and Technology Foundation:Study on the Evaluation of Eradication Rate and Safety of Helicobacter Pylori in a Quadruple Therapy using Qingwei Zhitong Pellets as a Substitute for Bismuth Agent(320.6799.2022.09.24)。
文摘OBJECTIVE:To evaluate the efficacy and safety of 14-day Qingwei Zhitong pellets(清胃止痛微丸,QZ)-containing quadruple therapy(QZQT)compared to bismuth-containing quadruple therapy(BQT)in treatment-naive patients with Helicobacter pylori(H.pylori)infection.METHODS:This single-center,randomized controlled clinical trial enrolled 333 patients,who were divided into either the QZQT group(QZ pellets,3.2 g,three times daily;rabeprazole,10 mg,twice daily;amoxicillin 1000 mg,twice daily;clarithromycin,500 mg,twice daily)or the BQT group(bismuth potassium citrate,1000 mg,three times daily;rabeprazole,10 mg,twice daily;amoxicillin,1000 mg,twice daily;clarithromycin,500 mg,twice daily)for 14 d.The 13C-urea breath test assessed eradication success at least four weeks after treatment.The primary outcome focused on the eradication rate,with secondary outcomes including safety and patient compliance.RESULTS:From August 2022 to June 2023,342 subjects were screened,and 333 were randomized.The QZQT and BQT groups showed eradication rates of 68.9%and 67.8%(P=0.838)by intention-to-treat(ITT)analysis,respectively,and 71.1%and 68.3%(P=0.612)by perprotocol(PP)analysis,respectively.QZQT was non-inferior to BQT in both ITT and PP analyses.QZQT was associated with fewer side effects(57.8%of patients)than BQT(90.4%)(P<0.001).CONCLUSION:The 14 d QZQT treatment demonstrates equal efficacy in eradicating H.pylori infection and improved patient compliance and safety compared to BQT.These results provide evidence supporting 14-day QZQT as an acceptable treatment for H.pylori infection.
基金Supported by Qilu Health Outstanding Young Talent Cultivation Project,No.QDFY-3839.
文摘BACKGROUND Helicobacter pylori(H.pylori)is a Gram-negative bacillus classified as a Group I carcinogen by the World Health Organization.However,the efficacy of eradi-cation therapies has declined in recent years,primarily due to the increasing prevalence of antibiotic resistance.The Maastricht VI/Florence Consensus Report highlights the importance of tailoring treatment strategies to local epidemiological data and individual antimicrobial susceptibility patterns.AIM To investigate the efficacy of precision-guided first-line therapy for H.pylori in-fection using genotypic antibiotic susceptibility testing(G-AST).METHODS This single-center randomized controlled trial enrolled 194 H.pylori-positive patients at a tertiary hospital in Qingdao,China(October 2022-August 2024).Participants were randomized to receive either a 14-day bismuth quadruple therapy(BQT:Amoxicillin,clarithromycin,esomeprazole,and bismuth)or a 14-day G-AST-guided regimen with tailored antibiotics(clarithromycin,levofloxacin,or tetracycline).Treatment efficacy and adverse events were compared between groups using intention-to-treat(ITT)and per-protocol(PP)analyses.Primary and secondary outcomes were analyzed with χ^(2) tests.RESULTS Of 194 patients enrolled,180(92.8%)completed the study as planned.In the ITT analysis,the eradication rate was higher in the G-AST group than in the BQT group[92.8%(95%CI:85.8-96.5)vs 79.4%(95%CI:70.3-86.2),P=0.007],with a risk difference of 13.4%(95%CI:3.7-23.2).In the PP analysis,eradication rates were 97.8%(95%CI:92.4-99.4)in the G-AST group and 84.1%(95%CI:75.1-90.3)in the BQT group(P=0.001),with a risk difference of 13.7%(95%CI:5.5-23.0).Adverse event incidence did not differ significantly between groups(30.9%vs 28.9%,P=0.754).CONCLUSION G-AST-guided therapy yielded higher eradication rates than empirical BQT in first-line H.pylori treatment without increasing adverse events,supporting the clinical utility of individualized,resistance-based therapy.
基金supported by the grants from the National Key Research and Development Program of China(Grant No.:2024YFE0106300)the Key Projects of Natural Science Foundation of Anhui Provincial Department of Education,China(Grant No.:2023AH051017)+2 种基金the Outstanding Youth Scientific Research Foundation of the Anhui Education Department,China(Grant No.:2024AH030019)the National Natural Science Foundation of China(Grant No.:32302923)Natural Science Foundation of Anhui Province,China(Grant No.:2208085MC79).
文摘Antimicrobial resistance(AMR)is a growing public health crisis that requires innovative solutions.Emerging multidrug resistant(MDR)Salmonella typhimurium has raised concern for its effect on pathogenic infection and mortality in humans caused by enteric diseases.To combat these MDR Salmonella typhimurium pathogens,highly effective and broad-spectrum antibiotics such as flufenicol(FFC)need to be evaluated for their potent antibacterial activity against Salmonella typhimurium.However,the low solubility and low oral bioavailability of flufenicol need to be addressed to better combat AMR.In this work,we develop a novel nano-formulation,flufenicol nano-micelles(FTPPM),which are based on d-α-tocopherol polyethylene glycol 1,000 succinate(TPGS)/poloxamer 188(P188),for the targeted treatment of biofilms formed by drug-resistant Salmonella typhimurium in the intestine.Herein,FTPPM were prepared via a thin film hydration method.The preparation process for the mixed micelles is simple and convenient compared with other existing nanodrug delivery systems,which can further decrease production costs.The optimized FTPPM demonstrated outstanding stability and sustained release.An evaluation of the in vivo anti-drug-resistant Salmonella typhimurium efficacy demonstrated that FTPPM showed a stronger efficacy(68.17%)than did florfenicol-loaded TPGS polymer micelles(FTPM),flufenicol active pharmaceutical ingredients(FFC-API),and flufenicol commercially available medicine(FFC-CAM),and also exhibited outstanding biocompatibility.Notably,FTPPM also inhibited drug-resistant Salmonella typhimurium from forming biofilms.More importantly,FTPPM effectively restored intestinal flora disorders induced by drug-resistant Salmonella typhimurium in mice.In summary,FTPPM significantly improved the solubility and oral bioavailability of florfenicol,enhancing its efficacy against drug-resistant Salmonella typhimurium both in vitro and in vivo.FTPPM represent a promising drug-resistant Salmonella typhimurium treatment for curbing bacterial resistance via oral administration.
文摘Objective: To compare the eradication rates of Helicobacter pylori (HP) and the incidence of adverse reactions among three treatment methods. Methods: A total of 139 patients with Helicobacter pylori infection diagnosed at the outpatient clinic or during hospitalization in the Department of Gastroenterology of West Electric Group Hospital from January 2022 to April 2023 were enrolled. Patients were divided into three groups: dual therapy group (46 cases), triple therapy group (62 cases), and quadruple therapy group (31 cases). The dual therapy group received omeprazole and amoxicillin;the triple therapy group received omeprazole, amoxicillin, and probiotics;the quadruple therapy group received omeprazole, colloidal bismuth pectin capsules, amoxicillin, and furazolidone. All treatments lasted for two weeks. The eradication rates and incidence of adverse reactions were compared among the three groups. Results: The eradication rates for the dual, triple, and quadruple therapy groups were 84.8%, 85.5%, and 85%, respectively (P > 0.05). The primary adverse reactions included gastrointestinal symptoms such as bloating, abdominal pain, loss of appetite, and abdominal discomfort, with incidence rates of 1, 2, and 6 cases in the dual, triple, and quadruple therapy groups, respectively (P = 0.574). However, a significant difference was found between the dual and quadruple therapy groups (P = 0.03) and between the triple and quadruple therapy groups (P = 0.026). Neurological side effects, such as dizziness and headache, were rare, with incidences of 0, 1, and 1 cases in the dual, triple, and quadruple therapy groups, respectively (P = 0.611). Conclusion: The efficacy of dual, triple, and quadruple therapy for eradicating Helicobacter pylori showed no significant difference. However, the dual and triple therapy groups had lower adverse reaction rates, making them suitable alternatives to traditional quadruple therapy for reducing patient discomfort. The probiotic group also contributed to the restoration of normal gastrointestinal microbiota.
文摘There has been a rise in the incidence of esophageal adenocarcinoma(EAC)over the past five decades in the United States,and it remains a highly lethal ma-lignancy due to frequent late-stage diagnosis.Barrett’s esophagus(BE),a well-established precursor to EAC,presents a critical window for early intervention through screening,surveillance,and endoscopic eradication therapy.Despite gastrointestinal society guideline recommendations for screening,the majority of patients with BE or early EAC remain undiagnosed until symptoms of late-stage cancer emerge.This review outlines current challenges and evolving strategies in the United States in BE detection and management,including risk stratification models,non-endoscopic screening tools,high-quality endoscopic techniques,tissue-based biomarkers,and artificial intelligence-enhanced imaging.We high-light best practices for surveillance,emphasizing the importance of thorough inspection of high-risk anatomic zones and the integration of advanced imaging.Endoscopic eradication therapy,including endoscopic mucosal resection and ablation,achieves high rates of complete eradication when performed with meti-culous technique,especially with comprehensive treatment of the gastroeso-phageal junction and gastric cardia.Long-term surveillance remains essential due to the risk of recurrence.As new technologies continue to emerge,integrating precision tools into routine practice will be key to improving outcomes and reducing EAC mortality.
文摘稻瘟病菌(Magnaporthe oryzae)作为主要的农业病原微生物,其引起的稻瘟病严重威胁着水稻等谷类作物的生产安全。内质网相关蛋白质降解途径(Endoplasmic reticulum-associated protein degradation,ERAD)是生物体应答内质网压力的主要方式之一,其在机体生长发育过程中具有重要作用。而HRD(HMG-CoA reductase degradation)复合物作为ERAD的关键组分,主要由Hrd1、Hrd3、以及凝集素Yos9等蛋白组成,负责内质网中错误折叠蛋白的识别、转运以及泛素化过程,最终由蛋白酶体降解,从而有效缓解内质网压力,保证细胞的正常生理活动。有研究表明,Hrd3属于单次跨膜蛋白,在内质网腔中与Hrd1、Yos9相结合,负责底物的识别并起着稳定Hrd1的作用。目前Hrd3在稻瘟病菌中的生物学功能尚不清楚。本研究通过基因敲除及互补试验获得了稻瘟病菌的ΔMohrd3突变体和ΔMohrd3-C回补菌株,并以野生型为对照,对突变体的生物学表型进行了分析。结果显示,ΔMohrd3突变体的生长速率、产孢量明显下降;对大麦和水稻的致病力显著减弱。进一步胁迫试验表明,MoHRD3的缺失导致稻瘟病菌对外界盐胁迫、渗透压胁迫的耐受性增强,对内质网胁迫耐受性减弱,而对细胞壁胁迫无明显变化。同时,MoHRD3基因的缺失激活了未折叠蛋白响应途径(Unfolded protein response,UPR)。上述结果表明,MoHRD3参与调控稻瘟病菌的营养生长、无性繁殖、致病及对不同环境胁迫的响应过程。
文摘AIM： To assess the safety of bismuth used in Helicobacter pylori （H pylorl） eradication therapy regimens. METHODS： We conducted a systematic review and meta-analysis. MEDLINE and EMBASE were searched （up to October 2007） to identify randomised controlled tri- als comparing bismuth with placebo or no treatment, or bismuth salts in combination with antibiotics as part of eradication therapy with the same dose and duration of antibiotics alone or, in combination, with acid suppresion. Total numbers of adverse events were recorded. Data were pooled and expressed as relative risks with 95% confidence intervals （CI）.RESULTS： We identified 35 randomised controlled trials containing 4763 patients. There were no serious adverse events occurring with bismuth therapy. There was no statistically significant difference detected in total adverse events with bismuth rrelative risk （RR） = 1.01; 95% CI： 0.87-1.16], specific individual adverse events, with the exception of dark stools （RR = 5.06; 95% CI： 1.59-16.12）, or adverse events leading to withdrawal of therapy （RR = 0.86; 95% CI： 0.54-1.37）. CONCLUSION： Bismuth for the treatment of H py/ori is safe and well-tolerated. The only adverse event occurring significantly more commonly was dark stools.
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AIM:To evaluate the influence of oral Helicobacter pylori(H.pylori)on the success of eradication therapy against gastric H.pylori.METHODS:A total of 391 patients with dyspepsia were examined for H.pylori using the saliva H.pylori antigen test(HPS),13C-urea breath test(UBT),gastroscopy,and gastric mucosal histopathological detection.Another 40 volunteers without discomfort were subjected to HPS and13C-UBT,and served as the control group.The 233 patients who were13C-UBT+were enrolled in this study and divided into 4 groups.Patients who were HPS-and13C-UBT+(n=53)received triple therapy alone.Those who were both HPS+and13CUBT+(n=180)were randomly divided into 3 groups:(1)the O+G+t group which received triple therapy alone(n=53);(2)the O+G+tm group which received both triple therapy and mouthrinse treatment(n=65);and(3)the O+G+tmp group which received triple therapy,mouthrinse,and periodontal treatment(n=62).The HPS and13C-UBT were continued for 4 wk after completion of treatment,and the eradication rate of gastric H.pylori and the prevalence of oral H.pylori in the 4 groups were then compared.RESULTS:The eradication rates of gastric H.pylori in the O-G+t group,the O+G+tm group,and the O+G+tmp group were 93.3%,90.0%,and 94.7%respectively;all of these rates were higher than that of the O+G+t group(78.4%)[O-G+t group vs O+G+t group(P=0.039);O+G+tm group vs O+G+t group(P=0.092);O+G+tmp group vs O+G+t group(P=0.012);O+G+tm group vs O-G+t group(P=0.546);O+G+tmp group vs O-G+t group(P=0.765);O+G+tm group vs O+G+tmp group(P=0.924)].The eradication of gastric H.pylori was significantly improved using the combination of triple therapy,mouthrinse,and periodontal treatment.The eradication rates of gastric H.pylori in the peptic ulcer group,chronic atrophic gastritis group and control group were higher than in the duodenitis group and the superficial gastritis group.The prevalence rates of oral H.pylori in the O-G+t group,O+G+t group,O+G+tm group and O+G+tmp group following treatment were 0%,76.5%,53.3%,and 50.9%,respectively[O-G+t group vs O+G+t group(P<0.0001);O+G+tm group vs O+G+t group(P=0.011);O+G+tmp group vs O+G+t group(P=0.006);O+G+tm group vs O-G+t group(P<0.0001);O+G+tmp group vs O-G+t group(P<0.0001);O+G+tm group vs the O+G+tmp group(P=0.790)].Both mouthrinse and periodontal treatment significantly reduced the prevalence of oral H.pylori.CONCLUSION:Mouthrinse treatment alone or combined with periodontal treatment can,to some extent,reduce the prevalence of oral H.pylori and improve the eradication rate of gastric H.pylori.
