目的 探讨环氧化酶-2（COX-2）在幽门螺杆菌（Hp）感染与非感染性胃溃疡及胃癌的表达。 方法 选择绵阳市404医院消化内科2011年2月－2012年2月的门诊及住院患者，用免疫组织化学方法检测196例经胃镜和组织病理学检查明确为胃溃疡（病理分型：肠上皮化生、异型增生）、胃癌及正常胃黏膜者的胃黏膜COX-2蛋白的表达，比较各病理分类之间及Hp感染与非感染之间COX-2蛋白表达的差异。 结果 胃溃疡（肠上皮化生、异型增生）、胃癌组的炎症细胞、腺上皮细胞、癌细胞及极少量正常黏膜上皮细胞中有COX-2表达。从正常胃黏膜-胃溃疡（肠上皮化生、异型增生）-胃癌COX-2的阳性表达有逐渐增强的趋势（P＜0.05）。Hp阳性组COX-2的阳性表达高于Hp阴性组（P＜0.05），胃癌组COX-2的阳性表达高于胃溃疡组（P＜0．05）。 结论 COX-2在胃癌的表达高于胃溃疡。Hp感染可诱导COX-2过度表达。
ObjectiveTo systematically review the association between Helicobacter pylori (HP) infection and Parkinson's disease (PD). MethodsPubMed, EMbase, The Cochrane Library, CNKI, VIP and WanFang Data databases were electronically searched to collect case-control studies on the association between HP and PD from January 2000 to July 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software. ResultsA total of 16 case-control studies involving 2 790 subjects were included. The results of meta-analysis showed that the HP infection rate was higher in PD patients than that in healthy patients (OR=1.87, 95%CI 1.38 to 2.54, P<0.000 1). The results of subgroup analysis showed that the infection rate of HP in PD group in Asia and Africa region was significantly higher than that in control group, but not in Europe region. Breath tests and other detection methods were used to detect HP infection, and the HP infection rate in PD group was significantly higher than that in the healthy control group. However, there was no significant difference in HP infection between the two groups by ELISA. UPDRS Ⅲ score of PD patients with HP infection was significantly higher than that of PD patients without HP infection. ConclusionsCurrent evidence shows that PD patients have a higher HP infection rate than the normal population, and the rates are affected by regions and HP detection methods. In addition, HP infection can aggravate the motor symptoms and motor complications of PD patients. Due to limited quality and quantity of included studies, more high-quality studies are required to verify the above conclusions.
ObjectiveTo systematically review the efficacy and safety of probiotics for the treatment of Helicobacter pylori (H.pylori) infection in children. MethodsWe electronically searched The Cochrane Library, PubMed, EMbase, CNKI, VIP and WanFang Data databases to collect randomized controlled trials (RCTs) about probiotics for the treatment of H.pylori infection in children from inception to January 2015. The references of included studies and conference proceedings were manually searched for additional studies. Two reviewers independently screened literature, extracted data and assessed the risk of bias of include studies. Then, meta-analysis was performed by using RevMan 5.3 software. ResultsA total of twelve RCTs were included, involving 1 227 patients. The result of meta-analysis showed that the probiotics adjuvant therapy group was superior to the control group in H.pylori eradication rates (OR=2.23, 95%CI 1.66 to 2.99, P<0.000 01) and the incidence of adverse effect (OR=0.31, 95%CI 0.18 to 0.53, P<0.000 1). ConclusionCurrent evidence shows that probiotics adjuvant therapy may be a new effective and safe solution in the treatment of H.pylori infections in children. Due to the limited quality and quantity of the included studies, more higher quality studies are needed to verify the above conclusion.
【摘要】 目的 探讨含铋剂的四联疗法作为一线方案对幽门螺杆菌感染的有效性和安全性。 方法 选择2008年9月-2010年9月间137例确诊幽门螺杆菌感染的初治患者，随机分为RAC组（雷贝拉唑、阿莫西林和克拉霉素）和RBAC组（雷贝拉唑、阿莫西林、克拉霉素和枸橼酸铋钾）。经治疗7 d后比较两组根除率和不良反应发生率。 结果 RAC组和RBAC组的按方案分析根除率分别为77.6%和90.3%，意向性治疗分析根除率分别为72.6%和86.7%。RBAC组的按方案分析和意向性治疗分析根除率均高于RAC组（Plt;0.05）。不良反应发生率分别为1.6%和1.3%（Pgt;0.05）。 结论 以雷贝拉唑、阿莫西林、克拉霉素和枸橼酸铋钾为组合的四联疗法能显著提高幽门螺杆菌感染的初治成功率，不良反应少，安全有效。【Abstract】 Objective To investigate the effectiveness and safety of the quadruple therapy containing a bismuth compound for first-line Helicobacter pylori eradication treatment. Methods A total of 137 patients diagnosed to be Helicobacter pylori-positive between September 2008 and September 2010 were randomized into two groups to receive the combination of rabeprazole, amoxicillin and clarithromycin (RAC group) and the combination of rabeprazole, amoxicillin, clarithromycin and bismuth potassinm citrate (RBAC group) respectively. The efficacy and tolerance were observed after the treatment for 7 days. Results The per protocol (PP) eradication rates of Helicobacter pylori were 86.7% for RAC group and 90.3% for RBAC group (Plt;0.05), respectively. The intention-to-treat protocol (ITT) eradication rates of Helicobacter pylori were 72.6% for RAC group and 86.7% for RBAC group (Plt;0.05), respectively. The was no significant difference in the incidence of side effects between the two groups (1.6% vs. 1.3%, Pgt;0.05). Conclusion The quadruple therapy containing rabeprazole, amoxicillin, clarithromycin and bismuth potassinm citrate provides a good eradication rate of Helicobacter pylori with a good compliance when compared with the standard triple therapy schemes.
【摘要】 目的 观察根除幽门螺杆菌对糖尿病胃轻瘫（DGP）的治疗作用。 方法 选择2008年3月-2010年1月100例幽门螺杆菌阳性DGP患者。随机分为A、B两组。A组给予莫沙比利5 mg，3次/d，4周，及根除幽门螺杆菌治疗（埃索美拉唑 20 mg+克拉霉素 500 mg+阿莫西林1.0 g，12次/d）2周。B组采用莫沙比利5 mg，3次/d，4周。记录患者治疗前、治疗4周及停药4周时的症状积分。 结果 92例完成实验。A组症状积分治疗4周后明显下降（Plt;0.01），与停药4周后相比差异无统计学意义（Pgt;0.05），二者均明显低于B组同期（Plt;0.05、lt;0.01）。B组症状积分治疗4周后明显下降（Plt;0.01），停药4周后明显高于治疗4周后（Plt;0.05），但仍低于治疗前（Plt;0.05）。A组治疗4周及停药4周后显效率及总有效率分别为57.4%及91.5%、40.4%及83%，明显高于B组35.6%及75.6%、15.6%及53.3%（Plt;0.05）。 结论 对幽门螺杆菌阳性的DGP患者根除幽门螺杆菌可明显提高疗效，并有效防止停药后症状复发。【Abstract】 Objective To explore the therapeutic effect of helicobacter pylori (H.pylori) eradication on diabetic gastroparesis (DGP) patients. Methods A total of 100 DGP patients with H.pylori infection diagnosed between March 2008 and January 2010 were included and randomly divided into two groups. The patients in group A underwent the treatment with mosapride 5 mg (thrice per day) for four weeks and H.pylori eradication therapy (esomeprazole 20 mg, twice per day; clarithromycin 500 mg, twice per day; amoxicillin 1.0 g, twice per day for two weeks). The patients in group B was administered with mosapride 5 mg (thrice per day) for four weeks. The symptom scores (SS) were recorded pretreatment, 4 weeks later and 4 weeks after stopping treatment. Results Ninety-two patients finished the study. The SS in group A decreased significantly (Plt;0.01) 4 weeks after the treatment and didn’t differ much from that 4 weeks after stopping the treatment. Both of the SS were lower than those in group B at the same time. In group B, compared with that before the treatment, the SS were much lower than that 4 weeks after the treatment (Plt;0.01) and 4 weeks after stopping the treatment (Plt;0.05); the former was significantly lower than the latter (Plt;0.05). The marked efficacy rate and total efficacy rate in group A were higher than those in group B (4-week treatment: 57.4% and 91.5% vs. 35.6% and 75.6%, 4 weeks after stopping the treatment: 40.4% and 83% vs. 15.6% and 53.3%) (Plt;0.05). Conclusion H.pylori eradication can increase the therapeutic effect on H.pylori positive patients with DGP and reduce the recurrence of the symptoms remarkably.
【摘要】目的探讨幽门螺杆菌(Hp)感染的根除与治疗糖尿病性胃轻瘫疗效的关系。方法 采用碳14呼气试验测定出67例糖尿病性胃轻瘫并Hp感染患者,经正规抗Hp治疗后进行疗效分析。结果67例中,Hp根除41例,症状明显改善33例,症状无明显改善8例;Hp未根除26例,症状明显改善17例,症状无明显改善9例。结论 糖尿病性胃轻瘫并Hp感染者经有效抗Hp治疗,对提高该病疗效有明显作用
ObjectiveTo determine the expressions of Lgr5 protein and Ki-67 protein in gastric cancer tissues, and to analyze the possible function in the carcinogenesis and development of gastric cancer.MethodsThe SABC immunohistochemical method was adopted to examine the expressions of Lgr5 protein and Ki-67 protein in the 69 paraffin slices of gastric cancer from the patients, with the adjacent normal gastric tissue as the control group. The statistical relationship between the expressions of these two kinds of proteins and clinicopathologic features of gastric cancer was examined respectively.ResultsIn the gastric cancer tissue group, the expressions of Lgr5 protein and Ki-67 protein upregulated in comparison to the adjacent normal gastric tissue group [Lgr5 protein: 87.0% (60/69) versus 16.7% (5/30), χ2=45.81, P<0.001; Ki-67 protein: 79.7% (55/69) versus 36.7% (11/30), χ2=17.43, P<0.001]. The expressions of Lgr5 protein and Ki-67 protein all upregulated in the N1–N3 stage groups, lowly differentiated+undifferentiated groups and positive Helicobacter pylori (HP) groups. The expression of Lgr5 protein upregulated in the T3+T4 stage groups in comparison to T1+T2 stage groups, while, no significant relationship was found in the expression of Ki-67 protein and tumor T staging. No significant relationship was found between the gender or metastasis and the expression of these two proteins. There was a positive correlation between the Lgr5 protein expression and the Ki-67 protein expression in the gastric cancer (rs=0.340, P=0.004).ConclusionsIn the development progress of gastric cancer, the Lgr5 protein might get involved in the mechanism of tumor invasion, lymph nodal metastasis, and low differentiation. Ki-67 protein might get involved in the mechanism of lymph nodal metastasis and low differentiation. The two proteins, together with the HP infection, might play a synergistic role in tumorigenesis and development.
目的:观察两种常用一线根除幽门螺杆菌(H.pylori)三联方案在本地区(成都市)的疗效。方法:纳入70例诊断为消化性溃疡、慢性糜烂性胃炎、慢性萎缩性胃炎伴H.pylori感染的患者。随机分为A、B两组。A组采用埃索美拉唑(E)20 mg bid+克拉霉素(C)500 mg bid+甲硝唑(M)400 mg bid,B组采用E 20 mg bid+ C 500 mg bid+阿莫西林(A)1.0g bid治疗,疗程7天。H.pylori根除失败者以1周四联方案:E 20 mg bid+胶体次枸櫞酸铋(B)220 mg bid+呋喃唑酮100 mg bid+ A1.0g bid治疗,观察疗效。结果:64例完成实验。三联方案H.pylori根除率:A组62.5%,B组84.4%,有显著差异(Plt;0.05)。二线四联方案根除率94.1%。结论:ECA方案H.pylori根除率明显高于ECM方案,可能更适合于本地区根除H.pylori的一线治疗,EBFA方案作为二线治疗具有较高疗效。