Detection of H. pylori from Stool Samples of Patients Attending a Government Hospital in Port-Harcourt Using Antigenic Screening and Culture-Based Techniques

Background: Helicobacter pylori is well-known among other bacteria causing ulcers, stomach cancer and other forms of gastrointestinal infections in developing countries. Aim: This research was designed to investigate the prevalence of H. pylori infection among patients attending a Government Hospital in Port-Harcourt, Rivers State Nigeria. Methodology: One hundred and five (105) stool samples of individuals comprising of 48 males and 57 females were studied. The samples were investigated for H. pylori using H. pylori stool antigen (HpSA) test kit. In addition, culture-based isolation was done using Columbia agar plus 10% horse blood, supplemented with antibiotics (amphotericin B, vancomycin, trimethoprim and ceftazidime). Results: Out of 105 samples screened, 56 (53.3%) tested positive for both antigenic screening and culture-based techniques while 49 (46.7%) tested negative for both. Positive isolates were phenotypically characterized by colony morphology, Gram stain, and biochemical reactions and a total of 19 isolates were suspected to be H. pylori. The result indicated that H. pylori detection was relatively low in male (21.9%) compared to female (31.4%) using antigenic screening. However, the culture-based technique yielded low recovery in male (2.9%) compared to female (4.7%), making the detection of infection high among the female than the male. Age group prevalence increased with age, recording infections within age group ?31 (20.0%) followed by 26-30, (12.3%) and lowest in age group 21-25 (10.5%) and below using antigenic screening. while in culture-based technique, age group 26-30, (3.8%) followed by ?31 (3.8%) yielding low recovery, while age group 21-25 and below had 0 recovery. There was no significant difference (P?0.05) among the different genders and age groups sampled Conclusion: This study revealed a high level of H. pylori infection among the female than the male population sampled. To reduce the detection rates, regular screening, treatment and public health awareness campaign should be developed for the control, elimination and prevention of H. pylori infection.

Comparison of Stool Antigen and PCR-Based Diagnostics for Helicobacter pylori Infection and Associated Gut Dysbiosis in Wad-Medani City, Sudan

Background: The development of stomach illnesses has been linked, in part, to Helicobacter pylori (H. pylori) infection; in clinical practice, accurate identification of Helicobacter pylori infection is crucial, H. pylori infection was associated with a decrease in microbial diversity and an increase in pathogenic taxa, indicating its role in gut dysbiosis. Objectives: We tested a noninvasive method using immunochromatography to detect the presence of the H. pylori antigen in stool specimens. PCR was used to validate the presence of H. pylori by identifying the bacteria's ureC gene in the DNA extracted from stool specimens. Additionally, gut microbiome changes were assessed, understanding the link between H. pylori infection and gut dysbiosis is vital for public health interventions. Method: A total of 100 stool samples obtained from dyspeptic patients (46 men and 54 women, average age 46.1) were assessed using these methods. The results were then compared between the PCR-based technique and the SAT technique. Results: The results showed that 35 (35%) out of 100 samples were positive by the PCR-based technique, compared to 33 (33%) positive by the SAT technique and The PCR method demonstrated a sensitivity of 95% and specificity of 92% in detecting H. pylori. Beta diversity was assessed using Bray-Curtis dissimilarity, revealing significant variations in microbial composition among samples. Conclusion: These data suggest that the techniques used in this study are valuable for studying the molecular epidemiology of H. pylori infection in dyspeptic patients. Stool, as a non-invasive sample, has the potential to be a good replacement for the detection of H. pylori. Additionally, we found that infection with this bacterium contributes to gastric microbial dysbiosis, while no statistically significant differences were observed.

Registro argentino para el manejo de la infección por Helicobacter pylori: efectividad y seguridad de los esquemas de primera línea de tratamiento / Argentinean registry on the management of Helicobacter pylori infection: effectiveness and safety of first line treatment

Resumen Introducción : El óptimo manejo de la infección por Helicobacter pylori (H. pylori) es objeto de debate. Contar con datos locales ayudaría a lograr altas tasas de erra dicación. El Registro Argentino H. pylori (RegArg-Hp) se estableció con el objetivo de monitorear el manejo local de la infección. El objetivo fue describir la efectividad y seguridad de las terapias empíricas de primera línea para la erradicación del H. pylori utilizadas en Argentina. Materiales y métodos : Registro prospectivo, multi céntrico, de la práctica clínica de los gastroenterólogos argentinos. Se incluyeron datos demográficos de pa cientes con infección por H. pylori, intentos previos de erradicación, tratamiento indicado, eventos adversos, cumplimiento y erradicación. Resultados : De 800 pacientes incluidos, 727 recibieron un tratamiento empírico de primera línea. Las indica ciones de tratamiento más frecuentes fueron dispepsia (78%) y úlcera gastroduodenal (12%). Entre los trata mientos de primera línea, las terapias cuádruples (con o sin bismuto) lograron tasas de erradicación del 94.9% mientras las terapias triples tasas de erradicación del 78.9%. Las terapias cuádruples fueron significativamente más efectivas que las triples (P < 0.01, OR 5, IC 2.95-8.6). La terapia secuencial con zinc mostró una efectividad del 95.6%. Se reportaron eventos adversos en el 29% de los pacientes, generalmente leves y con una tolerancia similar entre las diferentes terapias. Conclusiones : En Argentina, las terapias cuádruples con o sin bismuto y la secuencial con zinc presentaron una efectividad de erradicación de H. pylori superior al 90%. La implementación de registros locales podría contribuir al control de la resistencia a los antibióticos.

Abstract Introduction : The optimal management of Helicobacter pylori (H pylori) infection remains unclear. Updated in formation concerning local data is needed to design the best strategy to treat H. pylori infection to reach high eradication rates. The Argentinean Registry (Hp-ArgReg) on H. pylori management was launched to monitor the eradication practices of gastroenterologists. The objec tive was to assess the effectiveness and safety of first-line H. pylori treatment in Argentina. Materials and methods : A multicenter prospective registry of the clinical practice of the Argentinean gastro enterologists concerning H. pylori infection (Hp-ArgReg) was developed. Variables included: patient demographic information, previous eradication attempts, prescribed treatment, adverse events, compliance and outcome. Results : Overall, 800 patients were included and 727 patients received first-line empirical treatment. The most frequent treatment indications were dyspepsia (78%) and gastroduodenal ulcer (12%). Among first-line treatments, quadruple therapies (with or without bis muth) achieved eradication rates of 94.9%, while triple therapies achieved eradication rates of 78.9%. Quadruple therapies were significantly more effective than triple therapies (P < 0.01, OR 5, CI 2.95-8.6). Sequential therapy with zinc showed an effectiveness of 95.6%. Adverse events were reported in 29% of the cases (mainly mild) and tolerance was quite similar among therapies. Conclusion : in Argentina, Quadruple therapies with or without bismuth and sequential therapy with zinc showed an H. pylori eradication effectiveness of over 90% in real clinical practice. Local Registries for H py lori management could help to control the spread of antibiotic resistance.

Helicobacter Pylori and Metaplastic Changes in Chronic Cholecystitis: A Correlation Study

Introduction: Various types of metaplastic changes, such as gastric metaplasia (foveolar type or antral type) and intestinal metaplasia, are observed in chronic cholecystitis but not in normal mucosa. Helicobacter species can be detected in the bile and gallbladder tissue of patients with benign gallbladder disease. Objective: The present study aimed to observe the correlation between chronic cholecystitis and the presence of Helicobacter pylori as well as the different types of metaplastic changes in gallbladder mucosa. Materials and Methods: This descriptive, observational study was conducted at the Departments of Pathology and Surgery at a tertiary care medical college and hospital from April 2021 to March 2022, using a cross-sectional design. All confirmed cases of chronic cholecystitis, with or without cholelithiasis, were included in the study. Results: Intestinal metaplasia was the most common type of metaplastic change in the gallbladder epithelium in chronic cholecystitis in this region. PAS and Alcian Blue positivity were significantly higher in cases with metaplasia compared to those without metaplasia. H. pylori was detected in 3 cases (1.55%) of chronic cholecystitis in this study population. Conclusion: Mucin histochemistry may help identify early metaplastic changes in gallbladder epithelium. The use of a combination of methods for the detection of H. pylori in gallbladder tissue may increase the detection of positive cases.

Un panorama actualizado de la dispepsia

La dispepsia es un conjunto de síntomas gastrointestinales superiores, como sensación de plenitud, saciedad temprana, náuseas, ardor o malestar abdominal que se presentan por un mínimo de 4 semanas. Se cree que los mecanismos subyacentes implican anomalías en la motilidad gastrointestinal, hipersensibilidad visceral, alteración del microbiota gastrointestinal, factores genéticos, factores psicológicos (estrés, ansiedad), así como factores dietéticos y ambientales. Se clasifica en dispepsia orgánica y funcional; en éstas existe asociación con la infección por Helicobacter pylori, uso crónico de medicamentos (antinflamatorios no esteroideos), consumo de tabaco y el sexo femenino. Los criterios de Roma IV se utilizan para identificar y clasificar la dispepsia funcional en subtipos según los síntomas, serían: Síndrome de distrés posprandial que presenta plenitud posprandial molesta o saciedad posprandial 3 veces a la semana, y el Síndrome de dolor epigástrico que demuestra al menos dolor y/o ardor epigástrico al menos 1 vez a la semana.  (provisto por Infomedic International)

Dyspepsia is a cluster of upper gastrointestinal symptoms, such as fullness, early satiety, nausea, burning or abdominal discomfort that occur for a minimum of 4 weeks. The underlying mechanisms are thought to involve gastrointestinal motility abnormalities, visceral hypersensitivity, altered gastrointestinal microbiota, genetic factors, psychological factors (stress, anxiety), as well as dietary and environmental factors. It is classified into organic and functional dyspepsia; in the latter there is an association with Helicobacter pylori infection, chronic use of medications (non-steroidal anti-inflammatory drugs), tobacco use and female sex. The Rome IV criteria are used to identify and classify functional dyspepsia into subtypes according to symptoms, which are: Postprandial Distress Syndrome presenting with bothersome postprandial fullness or postprandial satiety 3 times a week, and Epigastric Pain Syndrome demonstrating at least epigastric pain and/or burning at least 1 time a week. (provided by Infomedic International)

Infección por Helicobacter pylori y factores asociados en adultos de la sierra norte del Perú / Helicobacter pylori infection and associated factors in adults from the northern highlands of Peru

INTRODUCCIÓN: Helicobacter pylori afecta a más de 50% de la población mundial, siendo más prevalente en poblaciones de nivel socioeconómico bajo; esta bacteria constituye la principal causa de cáncer gástrico a nivel global. OBJETIVO: Determinar la frecuencia y los factores asociados a la infección por H. pylori en personas adultas que viven en el centro histórico de la ciudad de Cajamarca, en el norte del Perú. MATERIAL Y MÉTODO: Estudio descriptivo que incluyó 124 personas encuestadas mediante un cuestionario y evaluadas mediante endoscopía y cultivo de biopsia gástrica. Una biopsia por persona fue sometida a prueba de ureasa y los cultivos se confirmaron por reacción de polimerasa en cadena (RPC). RESULTADOS: La frecuencia de infección fue de 60,5 % (IC 95% 51,3 - 69,2). El análisis univariado demostró asociación significativa entre la infección y la edad (p = 0,002), y entre la infección y el antecedente de patología gástrica (p = 0,015). El análisis multivariado reveló dos factores asociados: edad (OR = 0,94; IC95% 0,90-0,97) y antecedente de infección por H. pylori (OR = 0,23; IC95% 0,08 - 0,67). CONCLUSIONES: Existe alta frecuencia de infección por H. pylori en esta población; la edad y el antecedente de infección constituyen factores asociados que deben evaluarse con mayor profundidad.

BACKGROUND: Helicobacter pylori affects more than 50% of the world's population, being more prevalent in populations of low socioeconomic status. H. pylori is the main cause of gastric cancer globally. AIM: To establish the frequency and factors associated with H. pylori infection in adults living in the historic center of Cajamarca City, in northern Peru. METHODS: This was a descriptive study that included 124 individuals surveyed through a questionnaire and evaluated through endoscopy and gastric biopsy culture. One biopsy per person underwent the urease test, and the cultures were confirmed by PCR. RESULTS: The frequency of infection was 60.5% (95% CI 51.3 - 69.2). In the univariate analysis, there was a significant association between the infection and age (p = 0.002), and between the infection and a history of gastric pathology (p = 0.015). The multivariate analysis revealed two associated factors: age (OR = 0.94; 95% CI 0.90 - 0.97), and history of H. pylori infection (OR = 0.23; 95% CI 0.08 - 0.67). CONCLUSIONS: There is a high frequency of H. pylori infection in this population, and the age and history of H. pylori infection are factors that should be further evaluated.

Prevalence of Malaria and Helicobacter Pylori Coinfection and Associated Sociodemographic Factors among Blood Donors in Douala General Hospital

Background: The malaria parasite Plasmodium is intra-erythrocyte hence can be transmitted by transfusion of any blood component containing infected red blood cells. Helicobacter pylori infection affects more than half of the human population worldwide. Infection remains asymptomatic in most individuals, although some individuals develop acute gastritis, peptic or duodenal ulcers, gastric cancer, and mucosa associated tissue lymphoma. H. pylori infection have been implicated in some haematological manifestations such as anaemia and micronutrient deficiency. Objective: This research was designed to determine the prevalence of malaria parasitaemia and H. pylori coinfection in association with sociodemographic characteristics among donors in Douala General Hospital. Methodology: The study was a hospital-based study carried out from January to May 2022. The study population comprised of 106 donors who came to the hospital laboratory for blood donation. A structured questionnaire was used to get demographic and clinical data. Two ml of blood was collected from individuals to prepare a thick and thin blood film for malaria parasite determination and to centrifuge at 3000 rpm for 5 minutes to obtain plasma for H. pylori test strip. Results and Discussion: The overall prevalence of H. pylori in the study area was 70.8%. The female donors had a prevalence of 72.0%. A greater proportion of blood group O donors had H. pylori than groups A, AB and B but this difference was not significant (P-value = 0.571). The prevalence of malaria parasites infection was 36.8%. Those of blood group A had a higher prevalence rate of 42.3% (11/26). Out of the 106 donors, 23 (21.7%) had malaria and H. pylori coinfection. 68 (64.2%) donors had a mono-infection that is either having malaria mono-infection or H. pylori mono-infection and 15 (14.2%) had no infection. Malaria and H. pylori coinfection was higher in female donors than males (OR = 1.059, 95% Cl 0.359 -3.119, P =0.917), in donors aged below 25 years old (OR = 0.338, 95% Cl 0.075 - 1.535, P =0.160), replacement donors (OR = 1.350, 95% Cl 0.460 – 3.964, P =0.585); blood donors of blood group AB (OR = 0.654, 95% Cl 0.181 – 2.366, P =0.517) and Rhesus negative donors (OR = 1.500, 95% Cl 0.130 – 17.36, P =0.746). Conclusion: The prevalence of H. pylori infection and Malaria among blood donors in Douala General Hospital were high and coinfection was higher in females than males. Both malaria parasites and H. pylori infections have been implicated in blood parameters such as anaemia and micronutrient deficiency. It is therefore recommended that routine screening for malaria parasites and H. pylori be done in blood banks before transfusion for a high blood quality.

Screening of stable amoxicillin resistant clones of Helicobacter pylori and detection of its gene mutations / 安徽医科大学学报

Objective @# To investigate the phenotype of amoxicillin ( AMX) unstable resistant Helicobacter pylori (Hp) evolving into AMX stable high level resistance and the detection of its mutated genes．@*Methods @#Using the frozen Hp strain H390 as the starting strain，the clones resistant to AMX were continuously cultured on the medium with increasing AMX concentration，and the minimum inhibitory concentration ( MIC) of the resistant clones was detected．After frozen at －80 ℃ for 3 months，the drug resistance was stable according to whether the MIC de- creased after frozen storage． Genome sequencing analysis and efflux pump inhibition assay were performed on cloned H390r and parental strain H390 with the highest AMX MIC value，and gene mutations associated with the high level AMX resistance obtained by H390r were detected and identified. @*Results @#Four AMX high level resistant clones were obtained by AMX screening with MICs of 12，32，64 and ≥ 256 mg / L ，respectively，and none of the MICs were altered after freezing at －80 ℃ . Compared to the parental strain H390，the AMX stable resistant clone H390r had mutations in several genes，including hefC encoding the RND efflux system，hopB and hopC encoding the pore proteins and ftsI encoding the penicillin binding protein ，which were associated with AMX resistance. H390r was substantially reduced in MIC to AMX in the presence of efflux pump inhibitors．@*Conclusion @#AMX can screen stable resistant clones from unstable resistant Hp．H390r had mutations in hefC，hopB，hopC，and ftsI asso- ciated with AMX resistance．These mutations may be the main reason why H390r acquired a stable high level of re- sistance to AMX.

Clinical effects of probiotics combined with bismuth quadruple therapy for Helicobacter pylori infected patients / 上海预防医学

ObjectiveTo investigate the effects of probiotics combined with bismuth quadruple therapy （BQT） on clinical efficacy、gastrointestinal adverse reactions and intestinal flora in Helicobacter pylori （HP） positive patients. MethodsThe patients who were positive for HP from May 2023 to July 2023 in the department of gastroenterology of Shanghai first people's hospital were randomly divided into2 groups with 40 people in each group. The probiotic group was given 2 weeks of quadruple therapy with probiotics and standard BQT， followed by 4 weeks of oral probiotics after quadruple discontinuation. The placebo group was given 2 weeks of probiotic placebo and standard BQT， followed by 4 weeks of oral probiotic placebo. 13C urea breath test was used to evaluate the clinical efficacy， gastrointestinal symptoms rating Scale was used to evaluate the gastrointestinal adverse reactions of patients before and after the intervention， and microbial diversity 16S rDNA sequencing technology was used to detect the level of intestinal flora of patients before and after the intervention. ResultsThere was no significant difference in the eradication rate between the two groups （P>0.05）. Before the intervention， there was no significant difference in the scores of the gastrointestinal symptom rating scale between the probiotic group and the placebo group. After the intervention， patients in the probiotic group had significantly lower pain scores on acid reflux （1.10±0.30 vs 1.35±0.53， P<0.05） and stomach or abdominal hunger than in the placebo group （1.07±0.26 vs 1.30±0.52， P<0.05）. Through the before-and-after comparison of the probiotic group， the scores of abdominal pain （1.24±0.44 vs 1.58±0.71， P<0.05）， stomach or abdominal hunger （1.07±0.26 vs 1.27±0.45， P<0.05） and dry and hard stool （1.24±0.49 vs 1.48±0.75，P<0.05） were significantly lower in the probiotic group than before the intervention in the probiotic group. ConclusionProbiotics combined with BQT can improve the gastrointestinal adverse reactions and intestinal flora disorders in the process of quadruple drug therapy， but it does not improve the eradication rate of HP.

Association between Helicobacter pylori and nonalcoholic fatty liver disease： A Meta-analysis / 临床肝胆病杂志

ObjectiveTo investigate the association between Helicobacter pylori infection and nonalcoholic fatty liver disease （NAFLD）. MethodsThis study was conducted acoording to the PRISMA guideline， with a PROSPERO registration number of CRD42023408932. Databases including PubMed， the Cochrane Library， Web of Science， Embase， CBM， Wanfang Data， CNKI， and VIP were searched for related articles published up to June 2023. This study was conducted for the case-control studies， cross-sectional studies， and cohort studies that included clear detection criteria for HP and evaluation criteria for NAFLD and performed the multivariate analysis to investigate the association between HP infection and NAFLD. Odds ratio （OR） and its 95% confidence interval （CI） were selected as the effect measures， and STATA 15.0 software was used to perform the Meta-analysis. ResultsA total of 33 primary studies were included， with 236 514 subjects in total. The Meta-analysis showed that HP was associated with the high prevalence rate of NAFLD （OR=1.25， 95%CI： 1.16‍ ‍—‍ ‍1.35， P<0.05， I2=93.7%）. Subgroup analysis was conducted in terms of sample size， the diagnostic method for HP， the quality of primary study， the health status of subjects， and the type of primary study， but no clear source of heterogeneity was found. The Meta-regression analysis was conducted with the covariates of sample size， the diagnostic method for HP， the quality of primary study， the health status of subjects， and the type of primary study， and the results showed that the health status of subjects and the type of primary study might be the sources of heterogeneity. Sensitivity analysis showed that the overall results were stable， and funnel plots and the Egger test showed no significant publication bias. ConclusionHP is associated with the high prevalence rate of NAFLD in the general population， and large-scale prospective cohort studies are still needed to specifically and comprehensively evaluate the association between HP and NAFLD.

Associations of TEAD1/TEAD4 gene polymorphisms with non⁃cardia gastric carcinogenesis / 安徽医科大学学报

Objective @#To investigate the associations of the single nucleotide polymorphism ( SNP) rs2304733 in TEA domain transcription factor 1 ( TEAD1) , rs7135838 and rs1990330 in TEA domain transcription factor 4 (TEAD4) genes with the risk of non⁃cardia gastric carcinogenesis . @*Methods @#Enzyme linked immunosorbent assay ( ELISA) was used to detect specific antibodies against Helicobacter pylori(Hp)in serum samples of the normal control group . 470 normal controls were divided into Hp infection negative group (n = 223) and positive group ( n = 247) based on antibody titers . In the 450 non⁃cardia gastric cancer cases and 470 controls , polymerase chain reaction⁃restriction fragment length polymorphism (PCR⁃RFLP) was used to genotype the each SNP locus . The unconditional Logistic regression method was used to evaluate the associations between each SNP locus and the risk of non⁃cardia gastric carcinogenesis .@*Results @#The SNPs of TEAD1 and TEAD4 were not associated with Hp infection . TEAD1 rs2304733 was associated with the risk of non⁃cardia gastric cancer. Compared with the carriers of TT genotype , the carries of CT and CC genotypes had an increased risk of non⁃cardia gastric cancer (CT vs TT : OR = 2. 321 , 95% CI : 1 . 690 - 3 . 188 ; CC vs TT : OR = 5 . 140 , 95% CI : 1 . 080 - 24. 463) . TEAD4 rs1990330 was associated with the risk of non⁃cardia gastric cancer. Compared with the carriers of GG genotype , those with GT genotype had an increased risk of non⁃cardia gastric cancer ( OR = 2. 405 , 95% CI : 1 . 480 - 3 . 908 ) . TEAD4 rs7135838 was not associated with the risk of non⁃cardia gastric cancer. TEAD1 rs2304733 , TEAD4 rs7135838 and rs1990330 had interaction effects on the risk of non⁃cardia gastric cancer (P < 0. 05) . @*Conclusion @#In Baotou Han population , TEAD1 rs2304733 and TEAD4 rs1990330 do not play a major role in Hp infection , but may play a role in the risk of non⁃cardia gastric cancer. TEAD4 rs7135838 may not play a major role in the risk of Hp infection and non⁃cardia gastric cancer. TEAD1 rs2304733 and TEAD4 rs1990330 have the strongest synergistic effect on the risk of non⁃cardia gastric cancer , which is the best interaction model .

Helicobacter pylori in patients with gastric upset in Yuexiu Dongshan community,Guangzhou:an epi-demiological study / 现代医院

Objective To analyze and summarize the epidemiological characteristics of gastric Helicobacter pylori in pa-tients experiencing gastric discomfort in Yuexiu Dongshan Community,Guangzhou.Methods A total of 312 patients who visited Yuexiu District Dongshan Community Health Service Center for stomach upset testing between April 2023 and July 2023 were en-rolled in the study.The distribution characteristics of positive Helicobacter pylori were analyzed among the patients of different age and gender.Results Out of the 312 cases in the population,93 cases tested positive and 219 tested negative,with a positive de-tection rate of 29.81%.Specifically,28 cases tested positive,and 74 cases tested negative in the male population,with a positive detection rate of 27.45%.In the female population,65 cases tested positive,and 145 cases tested negative,with a positive detec-tion rate of 30.95%.The difference in positive rates by gender was not statistically significant(X2 =0.402,P=0.526).Among the male patients infected with Helicobacter,the mean value of delta over baseline of the C13 urea breath test(DOB)was(17.31±11.84).The DOB value was insignificantly higher in the males than in the females(t =1.430,P=0.156).There was no signifi-cant increasing or decreasing trend in the distribution of positive rates by age.The composition ratio of positive patients was predom-inant in the group aged 40 and above,accounting for 79.57%of the total number of positive cases.Among the individuals aged less than 60 infected with Helicobacter pylori,the mean duration of the breath test was(14.95±11.87),while among those aged over 61,the mean duration of the breath test was(24.66±22.71).The disparity between the two groups was statistically significant(t =2.643,P=0.009 7).Conclusion Gastric Helicobacter pylori can be detected in individuals of all genders and ages,and it is a primary cause of gastric discomfort.Community-based C13 breath tests can detect the presence of infections of helicobacter py-lori at an early stage.Antibiotics can be administered to treat the infections,thereby reducing the incidence of gastric tumors.

The clinical study of combined capsules of live Bifidobacterium, Lactobacillus and Enterococcus assisted triple therapy in chronic gastritis children with Helicobacter pylori positive / 中国医师进修杂志

Objective:To study the clinical effect of combined capsules of live Bifidobacterium, Lactobacillus and Enterococcus assisted triple therapy in chronic gastritis children with Helicobacter pylori ( Hp) positive. Methods:The clinical data of 80 chronic gastritis children with Hp positive from January 2019 to March 2022 in Wuxi Children′s Hospital were retrospectively analyzed. Among them, 40 children (combination group) were treated with combined capsules of live Bifidobacterium, Lactobacillus and Enterococcus combined with triple therapy (omeprazole, amoxicillin and clarithromycin), 40 children (control group) were treated with triple therapy, and all children were treated for 4 weeks. The efficacy, Hp clearance rate (performed 13C breath test after 4 weeks of discontinuation) and symptom improvement (the scores of upper abdomen pain, anorexia and sour regurgitation) were compared between two groups. The feces before treatment and after treatment were collected, and the intestinal flora was detected, including Bifidobacterium, Lactobacillus, Bifidobacterium/ Enterobacteria; the levels of C-reactive protein (CRP), tumor necrosis factor α (TNF-α), interleukin 10 (IL-10) and nuclear transcription factor κB (NF-κB) before treatment and 14 d after treatment were detected; the adverse reactions (vomiting, diarrhea, dizziness and erythra) were detected. Results:The total effective rate and Hp clearance rate in combination group were significantly higher than those in control group: 95.00% (38/40) vs. 80.00% (32/40) and 92.50% (37/40) vs. 75.00% (30/40), and there were statistical differences ( P<0.05). The scores of upper abdomen pain, anorexia and sour regurgitation after treatment in combination group were significantly lower than those in control group: (0.56 ± 0.14) scores vs. (1.12 ± 0.35) scores, (1.20 ± 0.37) scores vs. (1.50 ± 0.42) scores and (1.02 ± 0.28) scores vs. (1.39 ± 0.43) scores, and there were statistical differences ( P<0.01). The Bifidobacterium, Lactobacillus, Bifidobacterium/ Enterobacteria after treatment in combination group were significantly higher than those in control group: (8.56 ± 1.35) lgcfu/g vs. (7.94 ± 1.32) lgcfu/g, (9.27 ± 1.63) lgcfu/g vs. (8.35 ± 1.58) lgcfu/g and 1.85 ± 0.40 vs. 1.25 ± 0.34, and there were statistical differences ( P<0.01). The CRP, TNF-α and NF-κB after treatment in combination group were significantly lower than those in control group: (12.06 ± 3.14) ng/L vs. (17.36 ± 3.08) ng/L, (10.74 ± 3.25) μg/L vs. (15.30 ± 4.18) μg/L and (1.17 ± 0.34) μg/L vs. (2.21 ± 0.82) μg/L, the IL-10 after treatment was significantly higher than that in control group: (43.14 ± 6.38) μg/L vs. (35.29 ± 5.03) μg/L, and there were statistical differences ( P<0.01). There was no statistical difference in the incidence of adverse reactions between two group ( P>0.05). Conclusions:The combined capsules of live Bifidobacterium, Lactobacillus and Enterococcus assisted triple therapy has clear efficacy in chronic gastritis children with Hp positive, with few adverse reactions. It can significantly improve clinical symptoms, and its mechanism may be related to the regulation of intestinal microbiota and serum inflammation.

The expression changes and clinical significance of serum microRNA-155 and 135b-5p in patients with peptic ulcer complicated with Helicobacter pylori infection / 中国医师进修杂志

Objective:To investigate the expression levels and clinical significance of serum microRNA (miR) -155 and miR-135b-5p in patients with peptic ulcer complicated with Helicobacter pylori ( Hp) infection. Methods:A prospective study was conducted, and 263 patients with peptic ulcer were selected consecutively from July 2021 to February 2023 at the Affiliated Hospital of Jining Medical College. Among them, 146 cases were confirmed as Hp infection ( Hp infection group) and 117 cases were not complicated with Hp infection (non Hp infection group) by 14C breath test; type Ⅰ Hp infection was in 110 cases, and type Ⅱ Hp infection was in 36 cases by immunoblotting method. The serum expression levels of miR-155 and miR-135b-5p were detected by real-time fluorescence quantitative polymerase chain reaction, serum gastrin level was detected by radioimmunoassay method, and the serum pepsinogen (PG) Ⅰ and PG Ⅱ were detected by enzyme linked immunosorbent assay. The clinical data were recorded. Multivariate Logistic regression analysis was used to analyze the independent risk factors of Hp infection in patients with peptic ulcer; receiver operating characteristic (ROC) curve was used to analyze the efficacy of serum miR-155 and miR-135b-5p in diagnosis the Hp infection in patients with peptic ulcer. Results:The gastrin, PG Ⅰ, PG Ⅱ, ulcer bleeding rate and recurrence rate in Hp infection group were significantly higher than those in non Hp infection group: (108.47 ± 15.35) ng/L vs. (79.63 ± 10.58) ng/L, (295.41 ± 37.26) pg/L vs. (236.75 ± 29.17) pg/L, (44.08 ± 8.52) pg/L vs. (39.29 ± 6.74) pg/L, 25.34% (37/146) vs. 15.38% (18/117) and 21.92% (32/146) vs. 11.97% (14/117), and there were statistical differences ( P<0.01 or <0.05). The serum miR-155 and miR-135b-5p in Hp infection group were significantly higher than those in non Hp infection group (1.94 ± 0.63 vs. 0.95 ± 0.29 and 1.86 ± 0.57 vs. 1.03 ± 0.31), and there were statistical differences ( P<0.01). The serum miR-155 and miR-135b-5p in patients with typeⅠ Hp infection were significantly higher than those in patients with type Ⅱ Hp infection (2.05 ± 0.66 vs. 1.60 ± 0.54 and 1.97 ± 0.61 vs. 1.52 ± 0.45), and there were statistical differences ( P<0.01). Multivariate Logistic regression analysis result showed that serum miR-155, miR-135b-5p, gastrin and PG Ⅰwere independent risk factors of Hp infection in patients with peptic ulcer ( OR = 1.443, 1.436, 1.452 and 1.438; 95% CI 1.165 to 1.787, 1.146 to 1.799, 1.187 to 1.777 and 1.150 to 1.798; P<0.01). ROC curve analysis result showed that the area under the curve of serum miR-155 combined with miR-135b-5p in the diagnosis of Hp infection in patients with peptic ulcer was significantly greater than that of serum miR-155 and miR-135b-5p alone (0.907 vs. 0.839 and 0.836, Z = 2.57 and 2.81, P = 0.010 and 0.005). Conclusions:The serum levels of miR-155 and miR-135b-5p are high in patients with peptic ulcer complicated with Hp infection, and the combination of the two has high diagnostic value for Hp infection in patients with peptic ulcer.

Meta-analysis of the Efficacy and Safety of High-dose Dual Therapy for the First-line Helicobacter pylori Infection / 医学研究杂志

Objective To systematically evaluate the efficacy and safety of high-dose dual therapy(HDDT)versus quadruple ther-apy(QT)for the first-line helicobacter pylori(Hp)infection.Methods The randomized controlled trial(RCT)about HDDT versus QT for the first-line treatment of Hp infection were searched from CNKI,VIP,Wanfang,CBM,PubMed,Embase,Cochrane Library and other databases from the establishment of databases to 3 July 2022.RevMan 5.4 and Stata 17.0software were used for Meta-analysis.Results A total of 1l studies with 4015 patients were included.The results of Meta-analysis showed that:the eradication rate of HDDT was statistically superior to that of QT(RR=1.04,95％CI:1.01-1.06,P＜0.01)in the intention-to-treat analysis;the eradica-tion rate of the two groups was not statistically significant(RR=1.02,95％CI:1.00-1.04,P=0.08)in the coincidence protocol a-nalysis.HDDT had a significantly lower rate of adverse reactions than QT(RR=0.47,95％CI:0.36-0.61,P＜0.01);but HDDT and QT both had achieved a similar eradication rate(RR=1.01,95％CI:1.00-1.02,P=0.06)in the per-protocol analysis.Conclusion The efficacy of HDDT in eradicating Hp infection for the first time is better than that of QT,and the safety is better,so it can be used as a first-line treatment in clinic.

Correlation of blood lipids and body mass index with Helicobacter pylori infection / 中国基层医药

Objective:To correlate blood lipids and body mass index (BMI) with Helicobacter pylori (Hp) infection. Methods:A total of 303 participants who underwent physical examinations at The 903 Hospital of PLA Joint Logistics Support Force from May 2022 to May 2023 were included in this case-control study. These patients were divided into an Hp-infected group ( n = 97) and a non-Hp-infected group ( n = 206) based on whether they had Hp infection or not. Participants' body height and weight were recorded, and BMI was calculated. The levels of four blood lipid indicators were determined using an automatic biochemical analyzer. The distribution of different BMIs and abnormal statuses of these four blood lipid indicators were compared between the two groups. Spearman correlation analysis was used to analyze the correlation between Hp infection and these four blood lipid indicators. A multivariate logistic regression model was applied to analyze the influential factors for Hp infection. Results:The number of participants who had 24 kg/m 2 ≤ BMI < 28 kg/m 2 [39.17% (38/97)] and the number of participants who had BMI ≥ 28 kg/m 2 [10.31% (10/97)] in the Hp-infected group was significantly higher than those in the non-Hp-infected group [19.90% (41/206) and 2.43% (5/206), χ2 = 12.71, 7.11, P < 0.001, 0.008]. The decrease rate of high-density lipoprotein cholesterol (HDL-C), increase rate of low-density lipoprotein cholesterol (LDL-C), increase rate of triglyceride (TG), and increase rate of total cholesterol (TC) in the Hp-infected group were 23.71% (23/97), 31.96% (31/97), 17.53% (17/97), and 22.68% (22/97), respectively, which were significantly higher than 9.22% (19/206), 11.17% (23/206), 7.28% (15/206), and 8.74% (18/206) in the non-Hp-infected group ( χ2 = 11.59, 19.47, 7.33, 11.19, P = 0.001, < 0.001, 0.007, 0.001). The Spearman analysis showed that Hp infection was linearly positively correlated with BMI, LDL-C, TG, and TC ( r = 0.571, 0.519, 0.473, 0.535, all P < 0.001), while it was linearly negatively correlated with HDL-C ( r = -0.628, P < 0.001). Multivariate logistic regression analysis showed that BMI ≥ 24 kg/m 2, decreased HDL-C, increased LDL-C, elevated TG, and elevated TC are independent risk factors for Hp infection. Conclusion:Blood lipids and BMI are closely associated with Hp infection, and abnormal blood lipids and elevated BMI are independent risk factors for Hp infection.

Mechanism of Helicobacter pylori metabolites antagonizing host innate immunity / 中国免疫学杂志

Objective:To investigate potential mechanism of Helicobacter pylori metabolites antagonizing host innate immunity.Methods:RNA sequencing and pathway enrichment analysis were used to analyze only LPS-stimulated gastric mucosal cells GES-1,GES-1 cells co-treated with LPS and Helicobacter pylori culture supernatant,and untreated GES-1 cells.The culture supernatant of He-licobacter pylori was filtered by a 3KD ultrafiltration tube,and the filtered filtrate(metabolite part)and the retained solution(protein part)were treated with LPS-stimulated GES-1 cells to detect activity of NF-κB pathway,phosphorylation level of NF-κB,secretion levels of NF-κB pathway effectors TNF-α,IL-6 and IL-8.Identification of key metabolites by untargeted metabolic mass spectrometry.Results:Compared with GES-1 cells stimulated only by LPS,after co-treated with LPS and Helicobacter pylori culture supernatant,expression levels of various genes were regulated and tended to the level of GES-1 in untreated gastric mucosal cells,mainly in the NF-κB pathway.After co-treatment with LPS and culture supernatant of Helicobacter pylori,activity of NF-κB pathway was inhibited(P<0.05).Helicobacter pylori metabolites could inhibit the activity of NF-κB pathway,inhibit phosphorylation of NF-κB,and inhibit the secretion of NF-κB pathway effectors TNF-α,IL-6 and IL-8(P<0.05).1,5 and 25 μmol/L of Helicobacter pylori metabolite 2-D-Glu-copyranose(2DG)treatment inhibited activity of NF-κB pathway and phosphorylation of NF-κB in GES-1 cells,and secretion of NF-κB pathway effectors TNF-α,IL-6 and IL-8 were inhibited(P<0.05).After 2DG treatment,activity of NF-κB in GES-1 cells with TLR3,TLR4,TLR5,TLR6,TLR7,TLR8,TLR9 and TLR10 knockout were significantly decreased(P<0.05);while there was no significant changes in activity of NF-κB in TLR1 and TLR2 knockout GES-1 cells.Both TLR1 and TLR2 interactions were attenuated in GES-1 cells after 2DG treatment.Molecular docking showed that 2DG could bind to TLR2 amino acid disabled R321,K347 and F349,the binding energy was-12 kcal/mol.TLR2 wild-type and mutant plasmids(R321K,K347R,F349A)were constructed,and TLR2-knockout GES-1 cells were respectively transfected.It was found that 2DG treatment did not reduce NF-κB activity in GES-1 cells transfected with TLR2 mutant.Conclusion:Helicobacter pylori metabolite 2DG can interact with TLR2,reduce the formation of het-erodimers between TLR2 and TLR1,and inhibit the activity of innate immune NF-κB pathway.

Clinical analysis of helicobacter pylori biopsy in gastric antrum / 中国内镜杂志

Objective To analyze the detection of helicobacter pylori(Hp)in different parts of gastric antrum,and to provide clinical guidance for finding the best biopsy site for Hp.Methods Patients who underwent 13C urea breath test and electronic gastroscopy from January 2020 to December 2022 were retrospectively analyzed and divided into 13C urea breath test positive group[delta over baseline(DOB)≥4]and 13C urea breath test negative group(DOB<4)according to DOB value.Gastroscopy reports and pathological data of patients were collected.According to different biopsy sites in gastric antrum,patients were divided into conventional biopsy site group,elevated erosive site group and flat erosive site group,and the detection rate of Hp in different biopsy sites was compared.13C urea breath test positive group was divided into group A(4<DOB≤16),group B(16<DOB≤35)and group C(DOB>35)according to DOB value,and the gastric antral biopsy and pathology of each group were classified and analyzed.Combined with endoscopic reports and pathological data,patients were divided into atrophic gastritis group and non-atrophic gastritis group.Results In the 13C urea breath test positive group,the detection rate of Hp in the elevated erosive site group(96.4%)was higher than that in the conventional biopsy site group(92.7%)and the flat erosive site group(93.9%),and the difference was statistically significant(P = 0.036).In DOB group A,the detection rate of Hp was the highest at the site of elevated erosive and the lowest at the site of conventional biopsy,and the detection rate of Hp at the three biopsy sites was compared,the difference was statistically significant(P = 0.016);There was no significant difference in the detection rate of Hp at three biopsy sites between group B and group C(P = 0.622;P = 0.721);the non-atrophic gastritis group,the detection rate of Hp at the elevated erosive site(96.5%)was higher than that at the conventional biopsy site(91.2%)and the flat erosive site(92.0%),and the difference was statistically significant(P = 0.043).There was no significant difference in the detection rate of Hp at three biopsy sites in the atrophic gastritis group(P = 0.614).13C urea breath test negative group:There was no significant difference in Hp detection rate among the three biopsy sites(P = 0.255).Conclusion For patients with positive 13C urea breath test but low DOB value,the positive rate of Hp in the elevated erosive site is higher.For non-atrophic gastritis patients,the detection rate of Hp was higher in the elevated erosive sites than in the conventional biopsy sites.But for patients with atrophic gastritis,there was little difference in the detection rate of Hp in different parts of antrum.For patients with negative 13C urea breath test,there was no significant difference in Hp detection rate among the three biopsy sites.In future clinical work,for similar patients,precise biopsy can be performed to improve the detection rate of Hp.

Drug resistance and genetic diversity of clinical strains of Helicobacter pylori in the Qiannan Prefecture and Guiyang City,and their relationships with diseases / 中国人兽共患病学报

To understand Helicobacter pylori's drug resistance,genetic diversity,and relationship with clinical diseases in the Guiyang and Qiannan minority areas of Guizhou Province,we collected samples through endoscopy,and isolated and cul-tured H.pylori.The drug resistance and genotype characteristics were determined.The differences in different regions and dis-ease types were compared,and the structural characteristics of H.pylori and mixed infections with different strains of H.py-lori in Qiannan Prefecture were analyzed.A difference in the composition ratio of EPYIA typing in the cagA variable region was observed between the two areas(P=0.012),and the composition ratio of the vacA genotype differed(P=0.000).A total of 94.6％(53/56)new sequences of H.pylori strains from two regions were obtained by MLST.The rate of infection by H.pylori mixed with different strains was 44.4％in Qiannan Pre-fecture,and no significant difference was observed in the com-position of H.pylori mixed infections among patients with dif-ferent clinical diseases(P=0.349).Differences in EPI YA typ-ing and the vacA genotype composition ratio in the cagA varia-ble region of H.pylori were observed between the Qiannan Prefecture and Guiyang City.

The effect of bismuth containing triple therapy on serum Gas, TGF-α, hs-CRP levels in children with Hp positive peptic ulcers / 中国医师杂志

Objective:To explore the effect of bismuth containing triple therapy on serum gastrin (Gas), transforming growth factor-α (TGF-α), and high-sensitivity C-reactive protein (hs-CRP) levels in children with Helicobacter pylori (Hp) positive peptic ulcers.Methods:A total of 96 children with Hp positive peptic ulcers admitted to the Second Hospital of Jiaxing from January 2020 to December 2021 were selected as the study subjects. They were randomly divided into two groups using the remainder of a random number table. The control group (48 cases) received treatment with omeprazole, clarithromycin, and amoxicillin, while the observation group (48 cases) received treatment with bismuth containing triple therapy (amoxicillin+ metronidazole+ bismuth potassium citrate). After 10 days of treatment, the clinical efficacy of the two groups was evaluated The improvement time of clinical symptoms, Hp conversion rate, serum indicators (Gas, TGF-α, hs-CRP) before and after treatment, and incidence of adverse reactions were observed.Results:The total effective rate and Hp conversion rate of the observation group were significantly higher than those of the control group [95.83%(46/48) vs 81.25%(39/48), 97.92%(47/48) vs 83.33%(40/48), P<0.05]. The improvement time of upper abdominal pain, heartburn, and acid reflux symptoms was significantly shorter than that of the control group (all P<0.05). After 10 days of treatment, the serum Gas and hs-CRP levels in both groups significantly decreased compared to before treatment (all P<0.05), and the observation group was lower than the control group after treatment ( P<0.05); The levels of TGF-α in both groups increased compared to before treatment (all P<0.05), and the observation group was higher than the control group after treatment ( P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups [4.17%(2/48) vs 2.08%(1/48), P>0.05]. Conclusions:The triple therapy with bismuth containing agents has a better therapeutic effect on children with Hp positive peptic ulcers, and can promote ulcer mucosal repair by improving inflammatory response, with good safety.