Type I and type II Helicobacter pylori infection status and their impact on gastrin and pepsinogen level in a gastric cancer prevalent area.

BACKGROUND: Type I Helicobacter pylori (H. pylori) infection causes severe gastric inflammation and is a predisposing factor for gastric carcinogenesis. However, its infection status in stepwise gastric disease progression in this gastric cancer prevalent area has not been evaluated; it is also not known its impact on commonly used epidemiological gastric cancer risk markers such as gastrin-17 (G-17) and pepsinogens (PGs) during clinical practice. AIM: To explore the prevalence of type I and type II H. pylori infection status and their impact on G-17 and PG levels in clinical practice. METHODS: Thirty-five hundred and seventy-two hospital admitted patients with upper gastrointestinal symptoms were examined, and 523 patients were enrolled in this study. H. pylori infection was confirmed by both 13C-urea breath test and serological assay. Patients were divided into non-atrophic gastritis (NAG), non-atrophic gastritis with erosion (NAGE), chronic atrophic gastritis (CAG), peptic ulcers (PU) and gastric cancer (GC) groups. Their serological G-17, PG I and PG II values and PG I/PG II ratio were also measured. RESULTS: A total H. pylori infection rate of 3572 examined patients was 75.9%, the infection rate of 523 enrolled patients was 76.9%, among which type I H. pylori infection accounted for 72.4% (291/402) and type II was 27.6%; 88.4% of GC patients were H. pylori positive, and 84.2% of them were type I infection, only 11.6% of GC patients were H. pylori negative. Infection rates of type I H. pylori in NAG, NAGE, CAG, PU and GC groups were 67.9%, 62.7%, 79.7%, 77.6% and 84.2%, respectively. H. pylori infection resulted in significantly higher G-17 and PG II values and decreased PG I/PG II ratio. Both types of H. pylori induced higher G-17 level, but type I strain infection resulted in an increased PG II level and decreased PG I/PG II ratio in NAG, NAGE and CAG groups over uninfected controls. Overall PG I levels showed no difference among all disease groups and in the presence or absence of H. pylori; in stratified analysis, its level was increased in GC and PU patients in H. pylori and type I H. pylori-positive groups. CONCLUSION: Type I H. pylori infection is the major form of infection in this geographic region, and a very low percentage (11.6%) of GC patients are not infected by H. pylori. Both types of H. pylori induce an increase in G-17 level, while type I H. pylori is the major strain that affects PG I and PG IIs level and PG I/PG II ratio in stepwise chronic gastric disease. The data provide insights into H. pylori infection status and indicate the necessity and urgency for bacteria eradication and disease prevention in clinical practice.

[Investigation of Oncomelania hupensis snails in Anhui Province in 2016].

OBJECTIVE: To investigate the status of Oncomelania hupensis snails in Anhui Province in 2016, so as to provide the evidence for formulating the 13th Five-Year Plans for Schistosomiasis Control. METHODS: In 2016, a snail survey was conducted in Anhui Province according to the National Programme of the Oncomelania Snail Survey, covering all snail habitats or historical snail habitats and suspected environments of snail breeding, and the results of the survey were analyzed. RESULTS: In 2016, 22 848 environments were surveyed, and no schistosome-infected snails were found. There were 17 927 historical snail habitats in whole province, among which, the environments without changes, changed partly and changed completely accounted for 71.2%, 19.3% and 9.5%, respectively. The area of historical snail habitats was 1.410 billion m2. There were 4 830 environments with snail habitats covering an area of 0.265 billion m2 in 38 counties of 7 cities, including newly emerging area of 1 287.65 hm2 and reemerging area of 1 375.32 hm2. The density of living snails was 0.392 0 snails/0.1 m2, and the rate of frame with living snails was 12.93%. The type of marshland and lake regions, and the type of hilly and mountainous regions accounted for 22.4% and 77.6% of number of snail habitats, and accounted for 86.7% and 13.3% of areas of snail habitats, respectively. Among the different types of vegetation in snail habitats, grass was superior owe to accounting for 82.2% of the number of snail habitats, 57.3% of the area with snail habitats, and the highest density of living snails (0.413 9 snails/0.1 m2). Among the different types of environments in snail habitats, the ditch was superior owe to accounting for 56.8% of the number of snail habitats, the highest density of living snails (0.570 3 snails/0.1m2) and the highest rate of frame with living snails (18.57%), and the beach was superior owe to accounting for 87.8% of the area with snail habitats. In Anhui Province, the first year of snails and schistosome-infected snails being found was 1950 and 1952, respectively, and the latest year of schistosome-infected snails being found was 2012. The map showed that the most environments with snail habitats were distributed along the Yangtze River in Anhui Province. CONCLUSIONS: For the first time, the investigation has built the database and map of snail spatial distribution, which truly reflect the historic and current status of snail distribution in Anhui Province and can provide the evidence for formulating the 13th Five-Year Plans for Schistosomiasis Control and improving the schistosomiasis prevention and control work in the future.

[Application of infrared camera technique in investigation of wild animals as infectious source of schistosomiasis].

OBJECTIVE: To investigate the species and activities of wild animals infected with schistosome in hilly and mountain areas by using an infrared camera technique, so as to provide the evidence for the surveillance of schistosomiasis in these areas. METHODS: Six infrared cameras were selected and placed in 6 environments of the risk monitoring points of schistosomiasis in Shitai County in Anhui Province. The species and activities of the wild animals in the 6 environments were observed through the photographs and videos taken by the cameras. RESULTS: Through 5 day's monitoring, 3 wild mammals, such as voles, hares and wild boars, were found in 4 monitoring environments, of which voles were found at 2 environments with snails, and hares, wild boars and voles were found in 2 environments adjacent to environments with snails respectively. The monitoring showed that the vole activity was most frequent in the monitored environment. CONCLUSIONS: The use of infrared camera technique has a good effect in the investigation of wild animal infectious source of schistosomiasis, and it is also suitable for the monitoring work in other types of environments.

[Experimental study of apoptosis and proliferation of gastric mucosal cells in chronic atrophic gastritis].

OBJECTIVE: To study the relationship between long-term high-salt hot diet and chronic atrophic gastritis (CAG). The expression of apoptosis cells, proliferation cells, bcl-2 and Fas proteins were detected in the gastric mucosa of CAG rates induced by high-salt hot water. METHODS: TUNEL technique and immunohistochemical method were used in the experiment. Flow cytometry method was used to detect the DNA content of apoptosis cells. RESULTS: (1) The detection of apoptosis with TUNEL showed that the apoptosis cells in CAG rates induced by high-salt hot water were high. These cells could be seen in all layers of gastric mucosa, apoptosis index of model rates was higher than that of normal rates (P < 0.05). (2) The result of detecting apoptosis gene and proliferating cell nuclear antigen (PCNA) by immunohistochemical method showed that the expression of bcl-2, Fas and PCNA in the CAG rates induced by high-salt hot water was much higher than that of normal gastric mucosa (P < 0.05). The expression rates of bcl-2, Fas proteins were higher with time going on. After being given high-salt hot water intragastrically for 4, 8, 12 weeks, the bcl-2 protein expression rates were 12.5%, 16.7%, 76.5%, the Fas protein expression rates were 18.7%, 22.2% and 64.7%. (3) Flow cytometry technique showed that there was a second G(0)/G(1) peek, which was apoptosis cells peak, but was not seen in the normal gastric mucosa. CONCLUSIONS: Abnormality of proliferation and apoptosis in gastric mucosa could be induced by high-salt hot water. bcl-2, Fas gene played an important role in this course.

Symptom-based tendencies of Helicobacter pylori eradication in patients with functional dyspepsia.

AIM: To investigate whether there were symptom-based tendencies in the Helicobacter pylori (H. pylori) eradication in functional dyspepsia (FD) patients. METHODS: A randomized, single-blind, placebo-controlled study of H. pylori eradication for FD was conducted. A total of 195 FD patients with H. pylori infection were divided into two groups: 98 patients in the treatment group were treated with rabeprazole 10 mg twice daily for 2 wk, amoxicillin 1.0 g and clarithromycin 0.5 g twice daily for 1 wk; 97 patients in the placebo group were given placebos as control. Symptoms of FD, such as postprandial fullness, early satiety, nausea, belching, epigastric pain and epigastric burning, were assessed 3 mo after H. pylori eradication. RESULTS: By per-protocol analysis in patients with successful H. pylori eradication, higher effective rates of 77.2% and 82% were achieved in the patients with epigastric pain and epigastric burning than those in the placebo group (P < 0.05). The effective rates for postprandial fullness, early satiety, nausea and belching were 46%, 36%, 52.5% and 33.3%, respectively, and there was no significant difference from the placebo group (39.3%, 27.1%, 39.1% and 31.4%) (P > 0.05). In 84 patients who received H. pylori eradication therapy, the effective rates for epigastric pain (73.8%) and epigastric burning (80.7%) were higher than those in the placebo group (P < 0.05). The effective rates for postprandial fullness, early satiety, nausea and belching were 41.4%, 33.3%, 50% and 31.4%, respectively, and did not differ from those in the placebo group (P > 0.05). By intention-to-treat analysis, patients with epigastric pain and epigastric burning in the treatment group achieved higher effective rates of 60.8% and 65.7% than the placebo group (33.3% and 31.8%) (P < 0.05). The effective rates for postprandial fullness, early satiety, nausea and belching were 34.8%, 27.9%, 41.1% and 26.7% respectively in the treatment group, with no significant difference from those in the placebo group (34.8%, 23.9%, 35.3% and 27.1%) (P > 0.05). CONCLUSION: The efficacy of H. pylori eradication has symptom-based tendencies in FD patients. It may be effective in the subgroup of FD patients with epigastric pain syndrome.

[Efficacy of peginterferon alpha-2a in combination with ribavirin in treatment of eldly patients with chronic hepatitis C].

OBJECTIVE: To study the clinical efficacy of PEG-Interferon alpha-2a combined with ribavirin in eldly chronic hepatitis. METHODS: Forty patients with chronic hepatitis C were divided into treatment group and comparative group. The twenty eldly patients of treatment group receive peg-interferon alpha-2a 135-180 microg subcutaneous injection every week combined with ribavirin 600-1000 mg/d for 48 weeks, and twenty adult patients of control group receive peg-interferon 135-180 microg subcutaneous injection every week combined with ribavirin 800-1200 mg/d for 48 weeks. The rapid virological response (RVR) rate, early virological response (EVR) rate, end of treatment virological response (ETVR) rate, sustained virological response (SVR) rate, nonresponder rate, relapse rate and the side reaction was assessed, then to compare the differences between the two groups. RESULTS: The RVR rate, EVR rate, ETVR rate, SVR rate, nonresponder rate, relapse rate was 60%, 70%, 75%, 60%, 10%, 10% respectively, accordingly the rate in control group was 75%, 80%, 85%, 75%, 5%, 10%. The difference between the two group were not statistically significant (P > 0.05). Compared with the control group, the rate of neutropenia was higher in treatment group (P < 0.05). There was no difference between the two groups in influenza-like side effect, anemia, thrombocytopenia and gastrointestinal side reaction. CONCLUSIONS: The eldly patients with Chronic Hepatitis C using general dose peg-IFNalpha-2a combined with lower dose ribavirin can still obtain the similar efficiency and excellent tolerance when the basic diseases such as hypertension, diabetes and side effects were treated successfully.

[A clinical study on combined serum hepatic fibrosis-related markers and ultrasound parameters to diagnose hepatic fibrosis].

OBJECTIVE: This study attempted to explore the value of combining serum hepatic fibrosis-related markers and ultrasound parameters together on diagnosis of hepatic fibrosis. METHODS: Six serum markers and 8 ultrasound parameters were measured from 100 patients with chronic hepatitis B or cirrhosis. The results of the serum hepatic fibrosis-related markers and ultrasound in disease group were analyzed and compared with the findings of hepatic pathology. RESULTS: By filtrating,the group of platelet derived growth factor-BB (PDGF-BB) plus hyaluronic acid (HA) plus echo characteristics of liver parenchyma (LPEC) plus length of spleen (SL) had the highest Se and Spe, which were 90.7% and 85.4% respectively. CONCLUSION: The advantageous combination of serum markers and ultrasound parameters can significantly improve Se and Spe, which is superior to any single serum index or ultrasound parameter. And it was a better non-invasive method for diagnosing hepatic fibrosis.