This article aims to deepen the understanding of the role of Helicobacter pylori(H.pylori)infection in the development of cholelithiasis,initiated by the article by Yao et al,who investigated the potential link betwee...This article aims to deepen the understanding of the role of Helicobacter pylori(H.pylori)infection in the development of cholelithiasis,initiated by the article by Yao et al,who investigated the potential link between H.pylori infection and the development of cholelithiasis through a multicenter retrospective study on an Asian population of over 70000 participants.They also performed a compre-hensive analysis of previously published studies on H.pylori and cholelithiasis,finding a positive association therein[odds ratio(OR)=1.103,P=0.049].Patients positive for H.pylori also had lower levels of total and direct bilirubin,but higher levels of total cholesterol and low-density lipoprotein cholesterol compared to uninfected patients(P<0.05).Cohort studies have confirmed that H.pylori is a risk factor for cholelithiasis(P<0.0001),and aggregate analyses of case-control and cross-sectional studies have shown a positive association between H.pylori and cholelithiasis in Asia(OR=1.599,P=0.034),but not in Europe(OR=1.277,P=0.246).Moreover,H.pylori appears to be related to a higher ratio of choledocho-lithiasis/cholecystolithiasis(OR=3.321,P=0.033).The authors conclude that H.pylori infection is positively correlated with cholelithiasis,particularly with the choledocholithiasis phenotype,especially in Asia,and it is potentially related to bilirubin and cholesterol metabolism.展开更多
Helicobacter pylori-associated gastritis(HPAG)is a common condition of the gastrointestinal tract.However,extensive and long-term antibiotic use has resulted in numerous adverse effects,including increased resistance,...Helicobacter pylori-associated gastritis(HPAG)is a common condition of the gastrointestinal tract.However,extensive and long-term antibiotic use has resulted in numerous adverse effects,including increased resistance,gastrointestinal dysfunction,and increased recurrence rates.When these concerns develop,traditional Chinese medicine(TCM)may have advantages.TCM is based on the concept of completeness and aims to eliminate pathogens and strengthen the body.It has the potential to prevent this condition while also boosting the rate of Helicobacter pylori eradication.This review elaborates on the mechanism of TCM treatment for HPAG based on cellular signalling pathways,which reflects the flexibility of TCM in treating diseases and the advantages of multi-level,multipathway,and multi-target treatments for HPAG.展开更多
BACKGROUND A dual therapy regimen containing amoxicillin is a common treatment option for the eradication of Helicobacter pylori(H.pylori).While substantial research supports the efficacy and safety of vonoprazan and ...BACKGROUND A dual therapy regimen containing amoxicillin is a common treatment option for the eradication of Helicobacter pylori(H.pylori).While substantial research supports the efficacy and safety of vonoprazan and amoxicillin(VA)dual therapy in the general population,there is still a lack of studies specifically focusing on its safety in elderly patients.AIM To evaluate efficacy and safety of VA dual therapy as first-line or rescue treatment for H.pylori in elderly patients.METHODS As a real-world retrospective study,data were collected from elderly patients aged 60 years and above who accepted VA dual therapy(vonoprazan 20 mg twice daily+amoxicillin 1000 mg thrice daily for 14 days)for H.pylori eradication in the Department of Gastroenterology at Peking University First Hospital between June 2020 and January 2024.H.pylori status was evaluated by^(13)C-urease breath test 6 weeks after treatment.All adverse events(AEs)during treatment were recorded.RESULTS In total,401 cases were screened.Twenty-one cases were excluded due to loss to follow-up,lack of re-examination,or unwillingness to take medication.The total of 380 included cases comprised 250 who received VA dual therapy as first-line treatment and 130 who received VA dual therapy as rescue treatment.H.pylori was successfully eradicated in 239 cases(95.6%)in the first-line treatment group and 116 cases(89.2%)in the rescue treatment group.The overall incidence of AEs was 9.5%for both groups.Specifically,9.2%of patients experienced an AE in the first-line treatment group and 10.0%in the rescue treatment group.Five patients discontinued treatment due to AE,with a discontinuation rate of 1.3%.No serious AE occurred.CONCLUSION The VA dual therapy regimen as a first-line treatment and a rescue therapy was effective and safe for elderly patients aged 60 and older.展开更多
BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in ...BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in military personnel.Current guidelines in China state all patients with evidence of active infection with H.pylori are offered treatment.However,the prevalence of H.pylori infection and its regional distribution in the military population remain unclear,which hinders effective prevention and treatment strategies.Understanding the prevalence of H.pylori infection in the military population will aid in the development of customized strategies to better manage this infectious disease.AIM To investigate the prevalence of H.pylori infection in the Chinese military population in different geographic areas.METHODS This multicenter,retrospective study included 22421 individuals from five tertiary hospitals located in north,east,southwest,and northwest cities of China.H.pylori infection was identified using the urea breath test,which had been performed between January 2020 and December 2021.RESULTS Of the 22421 military service members,7416(33.1%)were urea breath test-positive.The highest prevalence of H.pylori was in the 30-39 years age group for military personnel,with an infection rate of 34.9%.The majority of infected subjects were younger than 40-years-old,accounting for 70.4%of the infected population.The individuals serviced in Lanzhou and Chengdu showed a higher infection prevalence than those in Beijing,Nanjing,and Guangzhou,with prevalence rates of 44.3%,37.9%,29.0%,31.1%,and 32.3%,respectively.CONCLUSION H.pylori infection remains a common infectious disease among military personnel in China and has a relatively high prevalence rate in northwest China.展开更多
Helicobacter pylori(H.pylori)infection plays a critical role in gastric diseases,impacting the microbiota structure in gastric and duodenal ulcers.In their study,Jin et al utilized metagenomic sequencing to analyze mu...Helicobacter pylori(H.pylori)infection plays a critical role in gastric diseases,impacting the microbiota structure in gastric and duodenal ulcers.In their study,Jin et al utilized metagenomic sequencing to analyze mucosal samples from patients with ulcers and healthy controls,revealing significant changes in microbial diversity and composition.This article reviews their findings,emphasizing H.pylori’s role in gastric ulcers and the need for further research on its impact on duodenal ulcers.We evaluate the study’s strengths and limitations,suggesting future research directions to enhance our understanding of H.pylori’s contribution to ulcerative diseases.展开更多
Objective Helicobacter pylori(HP)infection is associated with non-alcoholic fatty liver disease(NAFLD)and insulin resistance;however,the correlation between HP eradication and NAFLD remains controversial.This systemat...Objective Helicobacter pylori(HP)infection is associated with non-alcoholic fatty liver disease(NAFLD)and insulin resistance;however,the correlation between HP eradication and NAFLD remains controversial.This systematic review and meta-analysis examined the effect of HP treatment on clinical and laboratory parameters in NAFLD patients.Methods We conducted a literature search of the PubMed,Embase,Scopus,and Web of Science databases through Septem-ber 2023 for randomized controlled trials(RCTs)examining the effect of HP treatment on NAFLD patients versus lifestyle changes alone.The primary outcome was the change in steatosis parameters.The secondary endpoints were changes in anthropometric parameters,inflammatory markers(TNF-α),and metabolic parameters(fasting blood glucose,homeostasis model assessment of insulin resistance,AST/ALT,and lipid profile).The random effects model was used to calculate the standardized mean difference(SMD)with associated 95%confidence intervals(CIs)for our desired outcome.Results Four RCTs met our inclusion criteria.A total of 453 patients were included(mean age 42.8 years,58.5%males),228(50.3%)of whom were in the HP eradication group and 225(49.7%)of whom were in the lifestyle modification group.Compared with lifestyle modification alone,HP eradication had a significant effect on reducing liver steatosis and TNF-αlevels(SMD:-0.9;95%CI-14.67,-3.82,I^(2)=0%and SMD:-6.3;95%CI-9.04,-3.56,I^(2)=0%,respectively).No sig-nificant effect on other metabolic parameters was found.Conclusions HP eradication significantly reduced liver steatosis and TNF-αlevels in NAFLD patients.However,HP eradi-cation did not significantly affect other metabolic indices compared to lifestyle changes alone.展开更多
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
BACKGROUND Gastric cancer(GC)is one of the most common malignancies worldwide,and Helicobacter pylori(HP)infection is a well-established risk factor for its development.Programmed death-ligand 1(PD-L1)expression is a ...BACKGROUND Gastric cancer(GC)is one of the most common malignancies worldwide,and Helicobacter pylori(HP)infection is a well-established risk factor for its development.Programmed death-ligand 1(PD-L1)expression is a crucial biomarker for predicting the efficacy of immune checkpoint inhibitors in cancer treatment.While HP infection and PD-L1 expression in GC may be linked,the relationship between them remains unclear,in part because there have been conflicting results reported from various studies.AIM To perform a meta-analysis to assess the relationship between HP and PD-L1 expression in patients with GC.METHODS A systematic literature review was conducted using PubMed,Embase,Cochrane Library,and Web of Science databases.Observational studies that examined the association between HP infection and PD-L1 expression in patients with GC were included.Odds ratios and 95%confidence intervals were calculated to estimate the association.Heterogeneity was assessed using Cochrane’s Q test and I²statistic.A random-effects model was used due to significant heterogeneity across studies.RESULTS Fourteen studies involving a total of 3069 patients with GC were included.The pooled analysis showed a significant association between HP infection and increased PD-L1 expression in GC tissues(odd ratio=1.69,95%confidence interval:1.24-2.29,P<0.001,I^(2)=59%).Sensitivity analyses confirmed the robustness of these findings.Subgroup analyses did not show significant variation based on geographic region,sample size,or method of PD-L1 assessment.Publication bias was minimal,as shown by funnel plots and Egger’s regression test.CONCLUSION HP infection is associated with increased PD-L1 expression in GC,suggesting that HP status may influence the response to programmed cell death protein 1/PD-L1 blockade therapy.展开更多
BACKGROUND Antibiotic resistance significantly impacts the treatment failure rates of Helicobacter pylori(H.pylori)infections.AIM To investigate the trends in primary antibiotic resistance of H.pylori in Taiwan of Chi...BACKGROUND Antibiotic resistance significantly impacts the treatment failure rates of Helicobacter pylori(H.pylori)infections.AIM To investigate the trends in primary antibiotic resistance of H.pylori in Taiwan of China over the past six years.METHODS We conducted a retrospective analysis of H.pylori isolates from Taiwan residents,China who had not undergone previous treatments(n=1408),collected between January 1,2019 and December 31,2024.Susceptibility of these strains to amoxicillin,clarithromycin,levofloxacin,metronidazole,and tetracycline was tested using the Epsilometer test.We analyzed the trends in single and dual resistance profiles over the study period,and compared antibiotic resistance across different regions(northern,southern and eastern areas)of Taiwan of China.RESULTS The overall resistance rates for H.pylori to amoxicillin,clarithromycin,metronidazole,tetracycline,and levofloxacin in Taiwan of China were 1.3%,18.0%,31.0%,0.8%,and 28.7%,respectively.Tetracycline resistance increased significantly from 0%in 2019 to 3.5%in 2024(P value inχ^(2)test for linear trend:<0.001),while metronidazole resistance declined from 35.5%to 13.0%(P value inχ^(2)test for linear trend:<0.001).No significant changes of amoxicillin,clarithromycin and levofloxacin resistances were observed.The dual resistances to clarithromycin plus tetracycline,and metronidazole plus tetracycline both increased significantly from 0%to 1.7%from 2019 to 2024(P value inχ^(2)test for linear trend:<0.05).Furthermore,no significant regional differences in resistance frequencies except for levofloxacin were detected.CONCLUSION Primary antibiotic resistance to tetracycline in H.pylori has increased in Taiwan of China from 2019 to 2024,while resistance to metronidazole has decreased during the same period.The dual resistance to clarithromycin plus tetracycline and metronidazole plus tetracycline both increased significantly.展开更多
Salvia miltiorrhiza(Danshen)is a traditional Chinese herb that is commonly known for its cardiovascular and hepatoprotective benefits.Recent studies have confirmed that Danshen and its bioactive components can influen...Salvia miltiorrhiza(Danshen)is a traditional Chinese herb that is commonly known for its cardiovascular and hepatoprotective benefits.Recent studies have confirmed that Danshen and its bioactive components can influence gut microbial homeostasis,thereby affecting Helicobacter pylori(HP)colonization in the human stomach.HP is a bacterial pathogen associated with various gastrointestinal diseases.Current HP treatments mainly involve antibiotics and proton pump inhibitors.However,their efficacy is strongly compromised by the rapid emergence of antibiotic resistance in HP and genetic heterogeneity among patients.The interaction between Danshen and gut microbial status provides a novel perspective for HP treatment.Understanding the medical properties of Danshen in altering gut microbiota and eliminating HP,as well as the underlying mechanisms,is important for improving human gastrointestinal healthcare.This review investigates the interaction between Danshen and gut microbiota and its impact on HP infection using databases including Web of Science,PubMed,and Google Scholar.We explored the unconventional intersection between Danshen,gut microbiota,and HP infection,shedding light on their intricate interplay and potential therapeutic implications.A comprehensive understanding of this interaction provides valuable insights into developing novel therapeutic strategies that target the gut microbiota to mitigate HP-associated gastrointestinal disorders.展开更多
BACKGROUND Since Japanese national insurance coverage was expanded to include Helicobacter pylori(H.pylori)gastritis in 2013,approximately 1.5 million patients have received eradication therapy annually.However,the pr...BACKGROUND Since Japanese national insurance coverage was expanded to include Helicobacter pylori(H.pylori)gastritis in 2013,approximately 1.5 million patients have received eradication therapy annually.However,the prevalence and clinical features of uninvestigated dyspepsia in the post-eradication era remain unclear.AIM To evaluate the prevalence of dyspepsia and related endoscopic findings in the general population.METHODS We analyzed data from a gastric cancer screening program using esophagogastroduodenoscopy in Sendai city between 2019 and 2021.Data regarding endoscopic findings,upper gastrointestinal symptoms,and history of H.pylori eradication were collected.Dyspepsia was defined as the presence of upper abdominal pain,bloating,or both.Multivariate logistic regression was used to identify independent factors associated with dyspepsia.RESULTS Among 23250 participants,overall dyspepsia prevalence was 28.0%.It was 28.7%in the non-infected and post-eradication cohorts,and lower(25.8%,P<0.05)in the currently infected or naturally eradicated cohort.In addition,23.1%of participants reported heartburn.The following were independently associated with dyspepsia:Age<60 years,female sex,gastric ulcers,duodenal ulcers,erosive esophagitis,a history of gastric surgery,and successful H.pylori eradication.Gastric or esophageal cancer showed no association.CONCLUSION Uninvestigated dyspepsia remains common even after successful H.pylori eradication.Dyspepsia was not considered a reliable indicator of gastric or esophageal cancer.展开更多
Although Helicobacter pylori(H.pylori)is implicated in the development of most cases of gastric cancer with autoimmune gastritis,cases of gastric cancer have been reported in patients testing negative for H.pylori.Her...Although Helicobacter pylori(H.pylori)is implicated in the development of most cases of gastric cancer with autoimmune gastritis,cases of gastric cancer have been reported in patients testing negative for H.pylori.Here,we aimed to outline the current research status of the factors involved in the development of gastric cancer in H.pylori-negative autoimmune gastritis.Predictive pathological con-ditions for the development of gastric cancer in H.pylori-negative autoimmune gastritis are postulated to be:(1)Severe atrophy;(2)Hypergastrinemia;(3)Bile reflux;and(4)Low acidity,which are directly related to the pathophysiology of autoimmune gastritis,as well as smoking and family history,which are not re-lated to autoimmune gastritis.In autoimmune gastritis,where there is a possi-bility of spontaneous disappearance of H.pylori in advanced atrophy,it is diffi-cult to assess H.pylori.Since H.pylori infection begins in the antrum and subse-quently progresses to the proximal stomach,it is interpreted as H.pylori-negative autoimmune gastritis if histologically consistent with autoimmune gastritis in the body with spared antrum,and negative for other H.pylori tests.However,it is essential to examine whether the currently prevailing histological interpretation used to evaluate H.pylori infection status is appropriate.展开更多
Objective:The key molecular events signifying the Helicobacter pylori-induced gastric carcinogenesis process are largely unknown.Methods:Bulk tissue-proteomics profiling were leveraged across multi-stage gastric lesio...Objective:The key molecular events signifying the Helicobacter pylori-induced gastric carcinogenesis process are largely unknown.Methods:Bulk tissue-proteomics profiling were leveraged across multi-stage gastric lesions from Linqu(n=166)and Beijing sets(n=99)and single-cell transcriptomic profiling(n=18)to decipher key molecular signatures of H.pylori-related gastric lesion progression and gastric cancer(GC)development.The association of key proteins association with gastric lesion progression and GC development were prospectively studied building on follow-up of the Linqu set and UK Biobank(n=48,529).Results:Concordant proteomics signatures associated with H.pylori infection and gastric carcinogenesis(ρ=0.784,correlation P=1.80×10^(−36))were identified.RNA expression of genes encoding 13 up-and 15 down-regulated key proteins displayed trending alterations in the transition from normal gastric epithelium to intestinal metaplasia,then to malignant cells.A 15-tissue protein panel integrating these signatures demonstrated potential for targeting individuals at high risk for progressing to gastric neoplasia(OR=7.22,95%CI:1.31-39.72 for the high-score group).A 4-circulating protein panel may be used as non-invasive markers predicting the risk of GC development(hazard ratio=3.73,95%confidence interval:1.63-8.54,high-risk vs.low-risk populations,area under the curve=0.75).Conclusions:Concordant proteomics signatures associated with H.pylori infection and gastric carcinogenesis were unveiled with potential as biomarkers for targeted prevention strategies.展开更多
Helicobacter pylori(Hp)is a bacterium present in the pyloric region of the human stomach,which can cause gastrointestinal diseases such as gastritis and peptic ulcers.In addition,studies have found that it may be rela...Helicobacter pylori(Hp)is a bacterium present in the pyloric region of the human stomach,which can cause gastrointestinal diseases such as gastritis and peptic ulcers.In addition,studies have found that it may be related to some extra-gastrointestinal diseases.This article will review the research progress on the mechanism of Helicobacter pylori in extra-gastrointestinal diseases in children.展开更多
Infections of Helicobacter pylori(H.pylori)affect 42.1%of Chinese and 43.1%of the world population.H.pylori inhabits the mucous sublayer at the pylorus,leading to gastric ulcers,gastritis,and even cancer.Oral antibiot...Infections of Helicobacter pylori(H.pylori)affect 42.1%of Chinese and 43.1%of the world population.H.pylori inhabits the mucous sublayer at the pylorus,leading to gastric ulcers,gastritis,and even cancer.Oral antibiotics are usually used to treat H.pylori infections,whereas traditional quadruple therapy has side effects including headaches,nausea,diarrhea,intestinal dysbacteriosis,antibiotic resistance,and repeat infections.Here,a drug-loaded magnetic microbullet was designed to realize long-term retention in the stomach for one-shot treatment for H.pylori infections.It comprises a hollow cylinder wherein eight microneedles homogenously distribute at the top and several round pores located at the bottom.Itwas three-dimensional(3D)-printed by stereolithography.A clarithromycin(CAM)ground mixture(CGM)was prepared to improve solubility.Enough CGM powders were filled into the cylinder,covered by a small round magnet,and sealed to form a CAM-loaded magnetic microbullet(CMMB).CAM continually released from CMMBs for>24 h.With outside magnetic guidance,an oral CMMB targeted the pylorus site and the microneedles immediately headed into the mucosa followed by long-term local drug release.The in vitro and in vivo safety of CMMBs was confirmed,where their swelling rates were low,and the oral CMMB was finally completely evacuated.An oral CMMB was administered to H.pylori-infected mice and maintained in the stomach for 36 h with magnetic guidance,and the successful eradication of H.pylori was confirmed after single-dose administration.Oral CMMBs are a convenient medication for the eradication of H.pylori.展开更多
Aims:To compare the efficacy and safety of vonoprazan-based bismuth-containing quadruple therapy(VBCQ)versus proton pump inhibitor(PPI)-based bismuth-containing quadruple Therapy(PBCQ)for Helicobacter pylorieradicatio...Aims:To compare the efficacy and safety of vonoprazan-based bismuth-containing quadruple therapy(VBCQ)versus proton pump inhibitor(PPI)-based bismuth-containing quadruple Therapy(PBCQ)for Helicobacter pylorieradication.Methods:We performed a systematic search in PubMed,Embase,Web of Science,Cochrane Library,CNKI,Wanfang databases for relevant randomized controlled trials up to March 2024.Meta-analysis by RevMan 5.4 software.Results:Ten randomized controlled trials were evaluated in this meta-analysis.In intention-to-treat(ITT)analysis and per-protocol(PP)analysis,the eradication rate of VBCQ was signifi cantly higher than PBCQ[ITT overall eradication rate:86.7%vs 82.8%,RR:1.05,95%CI(1.05,1.09),P<0.05;PP overall eradication rate:92.0%vs 88.0%;RR=1.05,95%CI(1.05,1.08),P<0.05].The incidence of adverse events in VBCQ was higher than PBCQ(36.7%vs 36.5%),there was no signifi cant diff erence(P>0.05).Conclusions:VBCQ has a higher eradication rate and comparable safety.展开更多
BACKGROUND This retrospective study aimed to define associations between Helicobacter pylori(H.pylori)in childhood and risk factors for gastric cancer with special emphasis on the role of family history of cancer.AIM ...BACKGROUND This retrospective study aimed to define associations between Helicobacter pylori(H.pylori)in childhood and risk factors for gastric cancer with special emphasis on the role of family history of cancer.AIM To define associations between H.pylori in childhood and risk factors for gastric cancer with special emphasis on the role of family history of cancer.METHODS Details of 600 children who were subjected to upper gastrointestinal endoscopies at our institution are analyzed.Children were classified into positive and negative groups for H.pylori infection based on biopsy and rapid urease tests.The oc-currences of gastric carcinoma,chronic superficial gastritis,glandular atrophy,and intestinal metaplasia among the groups are compared.RESULTS In our study,among the overall population,330 children tested positive for H.pylori,which constituted 55%of the study population.The group denoting H.pylori positivity was found to have strikingly higher frequencies of chronic superficial gastritis(78.8%vs 5.9%),gastric atrophy(39.4%vs 7%),and intestinal metaplasia(0.9%vs 0%),as compared to the H.pylori-negative group.It is interesting to observe that there were a few but statistically significant cases of H.pylori-positive children having a family history of gastric cancer(1.2%),whereas no such cases were reported in children who were H.pylori-negative.CONCLUSION Our study finds that H.pylori infection in childhood is associated with an increased risk of precancerous gastric conditions and that family history might provide an additional risk.These insights recommend the necessity of early H.pylori detection and intervention and management strategies in childhood,especially in those families with histories of gastric cancer.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 The unique survival environment of Helicobacter pylori(H.pylori)presents challenges in establishing appropriate in vitro culture conditions.The fastidious nature of H.pylori and its relatively low growth ra...BACKGROUND The unique survival environment of Helicobacter pylori(H.pylori)presents challenges in establishing appropriate in vitro culture conditions.The fastidious nature of H.pylori and its relatively low growth rate emphasize the need for customized culture conditions,which are essential for both research and clinical applications.AIM To identify the optimal liquid culture medium for H.pylori using both reference and clinical strains.METHODS Nine H.pylori strains were incubated in 10 different broth media commonly used for bacterial cultures under microaerophilic conditions.Bacterial concentrations were estimated using serial dilutions and the pour plate method.A range of H.pylori initial inoculum concentrations was tested for each strain.For growth evaluation,optical density at 600 nm was measured at 24,48,and 72 hours.The growth trends of H.pylori were compared among strains and media.RESULTS All H.pylori strains grew successfully over time,regardless of the initial inoculum concentration.The specific growth trends and the broth that yielded the highest optical density value at each time point varied with strain.The reference strains(H.pylori 26695,ATCC 43504,and J99)consistently exhibited robust growth,whereas the clinical strains displayed distinct media preferences.Overall,bacterial growth was higher in chopped meat carbohydrate broth,Columbia broth,and fastidious anaerobe broth than in Brucella broth after 72 hours.CONCLUSION Chopped meat carbohydrate broth was the most effective for H.pylori liquid culture,and Columbia broth and fastidious anaerobe broth also supported greater growth than Brucella broth.展开更多
BACKGROUND Gastric cancer remains a leading cause of cancer-related mortality worldwide.Both Helicobacter pylori(H.pylori)infection and alterations in serum gastrin levels have been implicated in its pathogenesis.Howe...BACKGROUND Gastric cancer remains a leading cause of cancer-related mortality worldwide.Both Helicobacter pylori(H.pylori)infection and alterations in serum gastrin levels have been implicated in its pathogenesis.However,their associations with tumor characteristics and clinical outcomes require further clarification.AIM To investigate the associations of serum gastrin and H.pylori infection with path-ology and prognosis in gastric cancer.METHODS This hospital-based cohort study included 226 gastric cancer patients undergoing surgery and 100 matched controls from January 2019 to December 2023.Serum gastrin and H.pylori status were assessed and compared.Gastric cancer patients were stratified by biomarker status to analyze associations with tumor-nodes-metastasis(TNM)stage,lymph node metastasis,and tumor differentiation.Kaplan-Meier analysis was used to evaluate disease-free and overall survival(OS).Statistical significance was set at P<0.05.RESULTS Gastric cancer patients exhibited significantly higher serum gastrin levels and H.pylori infection rates than controls(P<0.05).Among gastrin-positive patients,the proportions of advanced TNM stage(III-IV),lymph node metastasis,and poorly differentiated tumors were significantly higher than in gastrin-negative patients(P<0.05).In contrast,H.pylori infection status showed no significant association with TNM stage,lymph node metastasis,or tumor differentiation(P>0.05).Kaplan-Meier analysis indicated no significant difference in disease-free survival between gastrin-positive and negative patients(hazard ratio=1.516,95%confidence interval:0.895-2.550),but gastrin-positive patients had significantly worse OS(hazard ratio=2.717,95%confidence interval:1.311-5.633).CONCLUSION Gastric cancer patients have elevated serum gastrin and higher H.pylori prevalence;elevated gastrin is associated with aggressive tumor features and poorer OS,indicating prognostic value.展开更多
文摘This article aims to deepen the understanding of the role of Helicobacter pylori(H.pylori)infection in the development of cholelithiasis,initiated by the article by Yao et al,who investigated the potential link between H.pylori infection and the development of cholelithiasis through a multicenter retrospective study on an Asian population of over 70000 participants.They also performed a compre-hensive analysis of previously published studies on H.pylori and cholelithiasis,finding a positive association therein[odds ratio(OR)=1.103,P=0.049].Patients positive for H.pylori also had lower levels of total and direct bilirubin,but higher levels of total cholesterol and low-density lipoprotein cholesterol compared to uninfected patients(P<0.05).Cohort studies have confirmed that H.pylori is a risk factor for cholelithiasis(P<0.0001),and aggregate analyses of case-control and cross-sectional studies have shown a positive association between H.pylori and cholelithiasis in Asia(OR=1.599,P=0.034),but not in Europe(OR=1.277,P=0.246).Moreover,H.pylori appears to be related to a higher ratio of choledocho-lithiasis/cholecystolithiasis(OR=3.321,P=0.033).The authors conclude that H.pylori infection is positively correlated with cholelithiasis,particularly with the choledocholithiasis phenotype,especially in Asia,and it is potentially related to bilirubin and cholesterol metabolism.
基金Supported by National Natural Science Foundation of China,No.82374323and Hunan Graduate Research Innovation Project,No.2023CX15.
文摘Helicobacter pylori-associated gastritis(HPAG)is a common condition of the gastrointestinal tract.However,extensive and long-term antibiotic use has resulted in numerous adverse effects,including increased resistance,gastrointestinal dysfunction,and increased recurrence rates.When these concerns develop,traditional Chinese medicine(TCM)may have advantages.TCM is based on the concept of completeness and aims to eliminate pathogens and strengthen the body.It has the potential to prevent this condition while also boosting the rate of Helicobacter pylori eradication.This review elaborates on the mechanism of TCM treatment for HPAG based on cellular signalling pathways,which reflects the flexibility of TCM in treating diseases and the advantages of multi-level,multipathway,and multi-target treatments for HPAG.
基金Supported by National High Level Hospital Clinical Research Funding(Youth Clinical Research Project of Peking University First Hospital),No.2023YC27Capital’s Funds for Health Improvement and Research,No.2022-2-40711National High Level Hospital Clinical Research Funding(Interdepartmental Research Project of Peking University First Hospital),No.2024IR20.
文摘BACKGROUND A dual therapy regimen containing amoxicillin is a common treatment option for the eradication of Helicobacter pylori(H.pylori).While substantial research supports the efficacy and safety of vonoprazan and amoxicillin(VA)dual therapy in the general population,there is still a lack of studies specifically focusing on its safety in elderly patients.AIM To evaluate efficacy and safety of VA dual therapy as first-line or rescue treatment for H.pylori in elderly patients.METHODS As a real-world retrospective study,data were collected from elderly patients aged 60 years and above who accepted VA dual therapy(vonoprazan 20 mg twice daily+amoxicillin 1000 mg thrice daily for 14 days)for H.pylori eradication in the Department of Gastroenterology at Peking University First Hospital between June 2020 and January 2024.H.pylori status was evaluated by^(13)C-urease breath test 6 weeks after treatment.All adverse events(AEs)during treatment were recorded.RESULTS In total,401 cases were screened.Twenty-one cases were excluded due to loss to follow-up,lack of re-examination,or unwillingness to take medication.The total of 380 included cases comprised 250 who received VA dual therapy as first-line treatment and 130 who received VA dual therapy as rescue treatment.H.pylori was successfully eradicated in 239 cases(95.6%)in the first-line treatment group and 116 cases(89.2%)in the rescue treatment group.The overall incidence of AEs was 9.5%for both groups.Specifically,9.2%of patients experienced an AE in the first-line treatment group and 10.0%in the rescue treatment group.Five patients discontinued treatment due to AE,with a discontinuation rate of 1.3%.No serious AE occurred.CONCLUSION The VA dual therapy regimen as a first-line treatment and a rescue therapy was effective and safe for elderly patients aged 60 and older.
文摘BACKGROUND Helicobacter pylori(H.pylori)infection is a prevalent disease encountered in military internal medicine and recognized as the main cause of dyspepsia,gastritis,and peptic ulcer,which are common diseases in military personnel.Current guidelines in China state all patients with evidence of active infection with H.pylori are offered treatment.However,the prevalence of H.pylori infection and its regional distribution in the military population remain unclear,which hinders effective prevention and treatment strategies.Understanding the prevalence of H.pylori infection in the military population will aid in the development of customized strategies to better manage this infectious disease.AIM To investigate the prevalence of H.pylori infection in the Chinese military population in different geographic areas.METHODS This multicenter,retrospective study included 22421 individuals from five tertiary hospitals located in north,east,southwest,and northwest cities of China.H.pylori infection was identified using the urea breath test,which had been performed between January 2020 and December 2021.RESULTS Of the 22421 military service members,7416(33.1%)were urea breath test-positive.The highest prevalence of H.pylori was in the 30-39 years age group for military personnel,with an infection rate of 34.9%.The majority of infected subjects were younger than 40-years-old,accounting for 70.4%of the infected population.The individuals serviced in Lanzhou and Chengdu showed a higher infection prevalence than those in Beijing,Nanjing,and Guangzhou,with prevalence rates of 44.3%,37.9%,29.0%,31.1%,and 32.3%,respectively.CONCLUSION H.pylori infection remains a common infectious disease among military personnel in China and has a relatively high prevalence rate in northwest China.
文摘Helicobacter pylori(H.pylori)infection plays a critical role in gastric diseases,impacting the microbiota structure in gastric and duodenal ulcers.In their study,Jin et al utilized metagenomic sequencing to analyze mucosal samples from patients with ulcers and healthy controls,revealing significant changes in microbial diversity and composition.This article reviews their findings,emphasizing H.pylori’s role in gastric ulcers and the need for further research on its impact on duodenal ulcers.We evaluate the study’s strengths and limitations,suggesting future research directions to enhance our understanding of H.pylori’s contribution to ulcerative diseases.
文摘Objective Helicobacter pylori(HP)infection is associated with non-alcoholic fatty liver disease(NAFLD)and insulin resistance;however,the correlation between HP eradication and NAFLD remains controversial.This systematic review and meta-analysis examined the effect of HP treatment on clinical and laboratory parameters in NAFLD patients.Methods We conducted a literature search of the PubMed,Embase,Scopus,and Web of Science databases through Septem-ber 2023 for randomized controlled trials(RCTs)examining the effect of HP treatment on NAFLD patients versus lifestyle changes alone.The primary outcome was the change in steatosis parameters.The secondary endpoints were changes in anthropometric parameters,inflammatory markers(TNF-α),and metabolic parameters(fasting blood glucose,homeostasis model assessment of insulin resistance,AST/ALT,and lipid profile).The random effects model was used to calculate the standardized mean difference(SMD)with associated 95%confidence intervals(CIs)for our desired outcome.Results Four RCTs met our inclusion criteria.A total of 453 patients were included(mean age 42.8 years,58.5%males),228(50.3%)of whom were in the HP eradication group and 225(49.7%)of whom were in the lifestyle modification group.Compared with lifestyle modification alone,HP eradication had a significant effect on reducing liver steatosis and TNF-αlevels(SMD:-0.9;95%CI-14.67,-3.82,I^(2)=0%and SMD:-6.3;95%CI-9.04,-3.56,I^(2)=0%,respectively).No sig-nificant effect on other metabolic parameters was found.Conclusions HP eradication significantly reduced liver steatosis and TNF-αlevels in NAFLD patients.However,HP eradi-cation did not significantly affect other metabolic indices compared to lifestyle changes alone.
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.
文摘BACKGROUND Gastric cancer(GC)is one of the most common malignancies worldwide,and Helicobacter pylori(HP)infection is a well-established risk factor for its development.Programmed death-ligand 1(PD-L1)expression is a crucial biomarker for predicting the efficacy of immune checkpoint inhibitors in cancer treatment.While HP infection and PD-L1 expression in GC may be linked,the relationship between them remains unclear,in part because there have been conflicting results reported from various studies.AIM To perform a meta-analysis to assess the relationship between HP and PD-L1 expression in patients with GC.METHODS A systematic literature review was conducted using PubMed,Embase,Cochrane Library,and Web of Science databases.Observational studies that examined the association between HP infection and PD-L1 expression in patients with GC were included.Odds ratios and 95%confidence intervals were calculated to estimate the association.Heterogeneity was assessed using Cochrane’s Q test and I²statistic.A random-effects model was used due to significant heterogeneity across studies.RESULTS Fourteen studies involving a total of 3069 patients with GC were included.The pooled analysis showed a significant association between HP infection and increased PD-L1 expression in GC tissues(odd ratio=1.69,95%confidence interval:1.24-2.29,P<0.001,I^(2)=59%).Sensitivity analyses confirmed the robustness of these findings.Subgroup analyses did not show significant variation based on geographic region,sample size,or method of PD-L1 assessment.Publication bias was minimal,as shown by funnel plots and Egger’s regression test.CONCLUSION HP infection is associated with increased PD-L1 expression in GC,suggesting that HP status may influence the response to programmed cell death protein 1/PD-L1 blockade therapy.
基金Supported by the An Nan Hospital,China Medical University,No.ANHRF114-20 and No.ANHRF114-21.
文摘BACKGROUND Antibiotic resistance significantly impacts the treatment failure rates of Helicobacter pylori(H.pylori)infections.AIM To investigate the trends in primary antibiotic resistance of H.pylori in Taiwan of China over the past six years.METHODS We conducted a retrospective analysis of H.pylori isolates from Taiwan residents,China who had not undergone previous treatments(n=1408),collected between January 1,2019 and December 31,2024.Susceptibility of these strains to amoxicillin,clarithromycin,levofloxacin,metronidazole,and tetracycline was tested using the Epsilometer test.We analyzed the trends in single and dual resistance profiles over the study period,and compared antibiotic resistance across different regions(northern,southern and eastern areas)of Taiwan of China.RESULTS The overall resistance rates for H.pylori to amoxicillin,clarithromycin,metronidazole,tetracycline,and levofloxacin in Taiwan of China were 1.3%,18.0%,31.0%,0.8%,and 28.7%,respectively.Tetracycline resistance increased significantly from 0%in 2019 to 3.5%in 2024(P value inχ^(2)test for linear trend:<0.001),while metronidazole resistance declined from 35.5%to 13.0%(P value inχ^(2)test for linear trend:<0.001).No significant changes of amoxicillin,clarithromycin and levofloxacin resistances were observed.The dual resistances to clarithromycin plus tetracycline,and metronidazole plus tetracycline both increased significantly from 0%to 1.7%from 2019 to 2024(P value inχ^(2)test for linear trend:<0.05).Furthermore,no significant regional differences in resistance frequencies except for levofloxacin were detected.CONCLUSION Primary antibiotic resistance to tetracycline in H.pylori has increased in Taiwan of China from 2019 to 2024,while resistance to metronidazole has decreased during the same period.The dual resistance to clarithromycin plus tetracycline and metronidazole plus tetracycline both increased significantly.
基金supported by Henan Province Science and Technology Research and Development(No.242102311176)China Agriculture Research System of MOF and MARA(No.CARS-21)+2 种基金Henan Modern Industrial Technology System of Chinese Herbal Medicine(No.HARS-22-11-Z1)Program for Science&Technology Innovation Talents in Universities of Henan Province(No.23HASTIT045)Henan Province Scientific and Technological Project(No.232102311059)。
文摘Salvia miltiorrhiza(Danshen)is a traditional Chinese herb that is commonly known for its cardiovascular and hepatoprotective benefits.Recent studies have confirmed that Danshen and its bioactive components can influence gut microbial homeostasis,thereby affecting Helicobacter pylori(HP)colonization in the human stomach.HP is a bacterial pathogen associated with various gastrointestinal diseases.Current HP treatments mainly involve antibiotics and proton pump inhibitors.However,their efficacy is strongly compromised by the rapid emergence of antibiotic resistance in HP and genetic heterogeneity among patients.The interaction between Danshen and gut microbial status provides a novel perspective for HP treatment.Understanding the medical properties of Danshen in altering gut microbiota and eliminating HP,as well as the underlying mechanisms,is important for improving human gastrointestinal healthcare.This review investigates the interaction between Danshen and gut microbiota and its impact on HP infection using databases including Web of Science,PubMed,and Google Scholar.We explored the unconventional intersection between Danshen,gut microbiota,and HP infection,shedding light on their intricate interplay and potential therapeutic implications.A comprehensive understanding of this interaction provides valuable insights into developing novel therapeutic strategies that target the gut microbiota to mitigate HP-associated gastrointestinal disorders.
文摘BACKGROUND Since Japanese national insurance coverage was expanded to include Helicobacter pylori(H.pylori)gastritis in 2013,approximately 1.5 million patients have received eradication therapy annually.However,the prevalence and clinical features of uninvestigated dyspepsia in the post-eradication era remain unclear.AIM To evaluate the prevalence of dyspepsia and related endoscopic findings in the general population.METHODS We analyzed data from a gastric cancer screening program using esophagogastroduodenoscopy in Sendai city between 2019 and 2021.Data regarding endoscopic findings,upper gastrointestinal symptoms,and history of H.pylori eradication were collected.Dyspepsia was defined as the presence of upper abdominal pain,bloating,or both.Multivariate logistic regression was used to identify independent factors associated with dyspepsia.RESULTS Among 23250 participants,overall dyspepsia prevalence was 28.0%.It was 28.7%in the non-infected and post-eradication cohorts,and lower(25.8%,P<0.05)in the currently infected or naturally eradicated cohort.In addition,23.1%of participants reported heartburn.The following were independently associated with dyspepsia:Age<60 years,female sex,gastric ulcers,duodenal ulcers,erosive esophagitis,a history of gastric surgery,and successful H.pylori eradication.Gastric or esophageal cancer showed no association.CONCLUSION Uninvestigated dyspepsia remains common even after successful H.pylori eradication.Dyspepsia was not considered a reliable indicator of gastric or esophageal cancer.
文摘Although Helicobacter pylori(H.pylori)is implicated in the development of most cases of gastric cancer with autoimmune gastritis,cases of gastric cancer have been reported in patients testing negative for H.pylori.Here,we aimed to outline the current research status of the factors involved in the development of gastric cancer in H.pylori-negative autoimmune gastritis.Predictive pathological con-ditions for the development of gastric cancer in H.pylori-negative autoimmune gastritis are postulated to be:(1)Severe atrophy;(2)Hypergastrinemia;(3)Bile reflux;and(4)Low acidity,which are directly related to the pathophysiology of autoimmune gastritis,as well as smoking and family history,which are not re-lated to autoimmune gastritis.In autoimmune gastritis,where there is a possi-bility of spontaneous disappearance of H.pylori in advanced atrophy,it is diffi-cult to assess H.pylori.Since H.pylori infection begins in the antrum and subse-quently progresses to the proximal stomach,it is interpreted as H.pylori-negative autoimmune gastritis if histologically consistent with autoimmune gastritis in the body with spared antrum,and negative for other H.pylori tests.However,it is essential to examine whether the currently prevailing histological interpretation used to evaluate H.pylori infection status is appropriate.
基金funded by the National Natural Science Foundation of China(Grant No.82273704)Noncommunicable Chronic Diseases-National Science and Technology Major Project(Grant Nos.2023ZD0501400-2023ZD0501402)+3 种基金Beijing Hospitals Authority’s Ascent Plan(Grant No.DFL20241102)Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support(Grant No.ZLRK202325)Peking University Medicine Fund for World’s Leading Discipline or Discipline Cluster Development(Grant No.BMU2022XKQ004)the Science Foundation of Peking University Cancer Hospital(Grant Nos.BJCH2024BJ02,XKFZ2410,and 2022-27).
文摘Objective:The key molecular events signifying the Helicobacter pylori-induced gastric carcinogenesis process are largely unknown.Methods:Bulk tissue-proteomics profiling were leveraged across multi-stage gastric lesions from Linqu(n=166)and Beijing sets(n=99)and single-cell transcriptomic profiling(n=18)to decipher key molecular signatures of H.pylori-related gastric lesion progression and gastric cancer(GC)development.The association of key proteins association with gastric lesion progression and GC development were prospectively studied building on follow-up of the Linqu set and UK Biobank(n=48,529).Results:Concordant proteomics signatures associated with H.pylori infection and gastric carcinogenesis(ρ=0.784,correlation P=1.80×10^(−36))were identified.RNA expression of genes encoding 13 up-and 15 down-regulated key proteins displayed trending alterations in the transition from normal gastric epithelium to intestinal metaplasia,then to malignant cells.A 15-tissue protein panel integrating these signatures demonstrated potential for targeting individuals at high risk for progressing to gastric neoplasia(OR=7.22,95%CI:1.31-39.72 for the high-score group).A 4-circulating protein panel may be used as non-invasive markers predicting the risk of GC development(hazard ratio=3.73,95%confidence interval:1.63-8.54,high-risk vs.low-risk populations,area under the curve=0.75).Conclusions:Concordant proteomics signatures associated with H.pylori infection and gastric carcinogenesis were unveiled with potential as biomarkers for targeted prevention strategies.
文摘Helicobacter pylori(Hp)is a bacterium present in the pyloric region of the human stomach,which can cause gastrointestinal diseases such as gastritis and peptic ulcers.In addition,studies have found that it may be related to some extra-gastrointestinal diseases.This article will review the research progress on the mechanism of Helicobacter pylori in extra-gastrointestinal diseases in children.
基金supported by the National Natural Science Foundation of China(82073791).
文摘Infections of Helicobacter pylori(H.pylori)affect 42.1%of Chinese and 43.1%of the world population.H.pylori inhabits the mucous sublayer at the pylorus,leading to gastric ulcers,gastritis,and even cancer.Oral antibiotics are usually used to treat H.pylori infections,whereas traditional quadruple therapy has side effects including headaches,nausea,diarrhea,intestinal dysbacteriosis,antibiotic resistance,and repeat infections.Here,a drug-loaded magnetic microbullet was designed to realize long-term retention in the stomach for one-shot treatment for H.pylori infections.It comprises a hollow cylinder wherein eight microneedles homogenously distribute at the top and several round pores located at the bottom.Itwas three-dimensional(3D)-printed by stereolithography.A clarithromycin(CAM)ground mixture(CGM)was prepared to improve solubility.Enough CGM powders were filled into the cylinder,covered by a small round magnet,and sealed to form a CAM-loaded magnetic microbullet(CMMB).CAM continually released from CMMBs for>24 h.With outside magnetic guidance,an oral CMMB targeted the pylorus site and the microneedles immediately headed into the mucosa followed by long-term local drug release.The in vitro and in vivo safety of CMMBs was confirmed,where their swelling rates were low,and the oral CMMB was finally completely evacuated.An oral CMMB was administered to H.pylori-infected mice and maintained in the stomach for 36 h with magnetic guidance,and the successful eradication of H.pylori was confirmed after single-dose administration.Oral CMMBs are a convenient medication for the eradication of H.pylori.
文摘Aims:To compare the efficacy and safety of vonoprazan-based bismuth-containing quadruple therapy(VBCQ)versus proton pump inhibitor(PPI)-based bismuth-containing quadruple Therapy(PBCQ)for Helicobacter pylorieradication.Methods:We performed a systematic search in PubMed,Embase,Web of Science,Cochrane Library,CNKI,Wanfang databases for relevant randomized controlled trials up to March 2024.Meta-analysis by RevMan 5.4 software.Results:Ten randomized controlled trials were evaluated in this meta-analysis.In intention-to-treat(ITT)analysis and per-protocol(PP)analysis,the eradication rate of VBCQ was signifi cantly higher than PBCQ[ITT overall eradication rate:86.7%vs 82.8%,RR:1.05,95%CI(1.05,1.09),P<0.05;PP overall eradication rate:92.0%vs 88.0%;RR=1.05,95%CI(1.05,1.08),P<0.05].The incidence of adverse events in VBCQ was higher than PBCQ(36.7%vs 36.5%),there was no signifi cant diff erence(P>0.05).Conclusions:VBCQ has a higher eradication rate and comparable safety.
文摘BACKGROUND This retrospective study aimed to define associations between Helicobacter pylori(H.pylori)in childhood and risk factors for gastric cancer with special emphasis on the role of family history of cancer.AIM To define associations between H.pylori in childhood and risk factors for gastric cancer with special emphasis on the role of family history of cancer.METHODS Details of 600 children who were subjected to upper gastrointestinal endoscopies at our institution are analyzed.Children were classified into positive and negative groups for H.pylori infection based on biopsy and rapid urease tests.The oc-currences of gastric carcinoma,chronic superficial gastritis,glandular atrophy,and intestinal metaplasia among the groups are compared.RESULTS In our study,among the overall population,330 children tested positive for H.pylori,which constituted 55%of the study population.The group denoting H.pylori positivity was found to have strikingly higher frequencies of chronic superficial gastritis(78.8%vs 5.9%),gastric atrophy(39.4%vs 7%),and intestinal metaplasia(0.9%vs 0%),as compared to the H.pylori-negative group.It is interesting to observe that there were a few but statistically significant cases of H.pylori-positive children having a family history of gastric cancer(1.2%),whereas no such cases were reported in children who were H.pylori-negative.CONCLUSION Our study finds that H.pylori infection in childhood is associated with an increased risk of precancerous gastric conditions and that family history might provide an additional risk.These insights recommend the necessity of early H.pylori detection and intervention and management strategies in childhood,especially in those families with histories of gastric cancer.
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 the Bio&Medical Technology Development Program of the National Research Foundation Funded by the Korean Government(MSIT),No.RS-2023-00223501Hallym University Research Fund.
文摘BACKGROUND The unique survival environment of Helicobacter pylori(H.pylori)presents challenges in establishing appropriate in vitro culture conditions.The fastidious nature of H.pylori and its relatively low growth rate emphasize the need for customized culture conditions,which are essential for both research and clinical applications.AIM To identify the optimal liquid culture medium for H.pylori using both reference and clinical strains.METHODS Nine H.pylori strains were incubated in 10 different broth media commonly used for bacterial cultures under microaerophilic conditions.Bacterial concentrations were estimated using serial dilutions and the pour plate method.A range of H.pylori initial inoculum concentrations was tested for each strain.For growth evaluation,optical density at 600 nm was measured at 24,48,and 72 hours.The growth trends of H.pylori were compared among strains and media.RESULTS All H.pylori strains grew successfully over time,regardless of the initial inoculum concentration.The specific growth trends and the broth that yielded the highest optical density value at each time point varied with strain.The reference strains(H.pylori 26695,ATCC 43504,and J99)consistently exhibited robust growth,whereas the clinical strains displayed distinct media preferences.Overall,bacterial growth was higher in chopped meat carbohydrate broth,Columbia broth,and fastidious anaerobe broth than in Brucella broth after 72 hours.CONCLUSION Chopped meat carbohydrate broth was the most effective for H.pylori liquid culture,and Columbia broth and fastidious anaerobe broth also supported greater growth than Brucella broth.
文摘BACKGROUND Gastric cancer remains a leading cause of cancer-related mortality worldwide.Both Helicobacter pylori(H.pylori)infection and alterations in serum gastrin levels have been implicated in its pathogenesis.However,their associations with tumor characteristics and clinical outcomes require further clarification.AIM To investigate the associations of serum gastrin and H.pylori infection with path-ology and prognosis in gastric cancer.METHODS This hospital-based cohort study included 226 gastric cancer patients undergoing surgery and 100 matched controls from January 2019 to December 2023.Serum gastrin and H.pylori status were assessed and compared.Gastric cancer patients were stratified by biomarker status to analyze associations with tumor-nodes-metastasis(TNM)stage,lymph node metastasis,and tumor differentiation.Kaplan-Meier analysis was used to evaluate disease-free and overall survival(OS).Statistical significance was set at P<0.05.RESULTS Gastric cancer patients exhibited significantly higher serum gastrin levels and H.pylori infection rates than controls(P<0.05).Among gastrin-positive patients,the proportions of advanced TNM stage(III-IV),lymph node metastasis,and poorly differentiated tumors were significantly higher than in gastrin-negative patients(P<0.05).In contrast,H.pylori infection status showed no significant association with TNM stage,lymph node metastasis,or tumor differentiation(P>0.05).Kaplan-Meier analysis indicated no significant difference in disease-free survival between gastrin-positive and negative patients(hazard ratio=1.516,95%confidence interval:0.895-2.550),but gastrin-positive patients had significantly worse OS(hazard ratio=2.717,95%confidence interval:1.311-5.633).CONCLUSION Gastric cancer patients have elevated serum gastrin and higher H.pylori prevalence;elevated gastrin is associated with aggressive tumor features and poorer OS,indicating prognostic value.
