简介：AbstractBismuth-containing quadruple therapy (BQT) has long been recommended for Helicobacter pylori (H. pylori) eradication in China. Meanwhile, in the latest national consensus in China, dual therapy (DT) comprising an acid suppressor and amoxicillin has also been recommended. In recent years, the eradication rate of H. pylori has reached >90% using DT, which has been used not only as a first-line treatment but also as a rescue treatment. Compared with BQT, DT has great potential for H. pylori eradication; however, it has some limitations. This review summarizes the development of DT and its application in H. pylori eradication. The H. pylori eradication rates of DT were comparable to or even higher than those of BQT or standard triple therapy, especially in the first-line treatment. The incidence of adverse events associated with DT was lower than that with other therapies. Furthermore, there were no significant differences in the effects of dual and quadruple therapies on gastrointestinal microecology. In the short term, H. pylori eradication causes certain fluctuations in the gastrointestinal microbiota; however, in the long term, the gastrointestinal microbiota eventually returns to its normal state. In the penicillin-naïve population, patients receiving DT have a high eradiation rate, better compliance, lower incidence of adverse reactions, and lower primary and secondary resistance to amoxicillin. These findings suggest the safety, efficacy, and potential of DT for H. pylori eradication.

简介：AbstractThe main challenge in the field of Helicobacter pylori (H. pylori) infection is antibiotic resistance, which influences the efficacy of eradication regimens. Bismuth-containing quadruple therapy has been confirmed as an effective regimen for eradicating H. pylori, especially in strains with antibiotic resistance. High-dose proton-pump inhibitor-amoxicillin dual therapy could decrease the use of unnecessary antibiotics, which is a promising alternative approach. Adjuvant therapy (specific probiotic or vitamin) also showed good results, although more evidence is needed. Novel anti-H. pylori drugs are needed, and the establishment of the H. pylori database is an effective way to acknowledge the real-time information of H. pylori management. This review provides the recent progress of H. pylori treatment, and further studies are needed to address the role of different regimens in improving H. pylori eradication rate, especially in strains with antibiotics resistance.

简介：EversinceHelicobacterpylori（H.pylori）wasrecognizedasaninfectiouscauseofgastriccancer,therehasbeenincreasinginterestinexaminingitspotentialroleincolorectalcarcinogenesis.Datafromcasecontrolandcross-sectionalstudies,mostlyrelyingonhospital-basedsamples,andseveralmeta-analyseshaveshownapositivestatisticalrelationshipbetweenH.pyloriinfectionandcolorectalneoplasia.However,thepossibilityexiststhattheresultshavebeeninfluencedbybias,includingtheimproperselectionofpatientsanddisparitieswithrespecttopotentialconfounders.Whiletheevidencefallsshortofadefinitivecausallink,itappearsthatinfectionwithH.pylori/H.pylori-relatedgastritisisassociatedwithanincreased,althoughmodest,riskofcolorectaladenomaandcancer.Thepathogenicmechanismsresponsibleforthisassociationremainuncertain.H.pylorihasbeendetectedincolorectalmalignanttissues;however,thepossibilitythatH.pyloriisadirectactivatorofcoloniccarcinogenesisremainspurelyhypothetical.Ontheotherhand,experimentaldatahaveindicatedaseriesofpotentialoncogenicinteractionsbetweenthesebacteriaandcolorectalmucosa,includinginductionandperpetuationofinflammatoryresponses,alterationofgutmicrofloraandreleaseoftoxinsand/orhormonalmediators,suchasgastrin,whichmaycontributetotumorformation.

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简介：ＣＬＩＮＩＣＡＬＡＮＤＥＸＰＥＲＩＭＥＮＴＡＬＳＴＵＤＹＯＦＫＩＬＬＩＮＧＥＦＦＥＣＴＯＮＨＥＬＩＣＯＢＡＣＴＥＲＰＹＬＯＲＩＣＬＩＮＩＣＡＬＡＮＤＥＸＰＥＲＩＭＥＮＴＡＬＳＴＵＤＹＯＦＫＩＬＬＩＮＧＥＦＦＥＣＴＯＮＨＥＬＩＣＯＢＡＣＴＥＲＰＹＬＯＲ...

简介：Overthepastseveralyears,theseverityofHelicobacterpylori（H.pylori）infectionshasnotsignificantlydiminished.Aftersuccessfuleradication,theannualH.pylorirecurrencerateisapproximately13%duetooralH.pyloriinfection.EstablishedclinicaldiagnostictechniquesdonotidentifyanoraletiologicbasisofH.pyloripriortogastricinfection.TherehasbeendisagreementastowhetheroralinfectionofH.pyloriexistsornot,withnodefiniteconclusion.Inmedicalpractice,negativeresultswiththeureabreathtestsuggestthatthestomachinfectionofH.pyloriiscuredinthesepatients.Infact,patientscanpresentnegativeureabreathtestresultsandyetexhibitH.pyloriinfectionduetooralinfection.ThepresentpaperprovidesevidencethatH.pylorioralinfectionisnonethelesspresent,andtheoralcavityrepresentsasecondarysiteforH.pyloricolonization.

简介：AbstractBackground:Helicobacter pylori (HP) has been considered to be one of the primary causes of gastric mucosa-associated lymphoid tissue (MALT) lymphoma since 1993. Low-grade gastric MALT lymphoma with HP is widely treated with HP eradication therapy, according to each specific clinical situation. However, several studies and guidelines indicate that the modified HP eradication therapy is also valid for HP-negative gastric MALT lymphoma. The aim of this study was to perform a meta-analysis of the clinical efficacy of the modified HP eradication therapy for gastric MALT lymphoma without HP.Methods:We searched studies that reported the response rate of the modified HP eradication therapy regimen for gastric MALT lymphoma without HP by using PubMed, Medline, and Ebsco from January 1971 until February 2019. All statistical analyses were carried out using R 3.5.3 (Mathsoft Company, Cambridge, MA, USA). The pooled response rate was expressed as a decimal. The heterogeneity test was performed using the I-squared (I2) statistic.Results:A total of 14 studies were selected with a total of 148 patients with HP-negative gastric MALT lymphoma. The overall pooled response rate was 0.38 (95% confidence interval [CI]: 0.29-0.47). The combined estimate is I2 = 57% (P < 0.01). The study subjects were categorized by factors (area of patients). The pooled response rate of the sub-groups (Korea, Japan, China, and Western countries) was 0.63 (95% CI: 0.50-0.76), 0.16 (95% CI: 0.05-0.30), 0.38 (95% CI: 0.20-0.55), and 0.57 (95% CI: 0.08-1.00). The response rate showed that the modified HP eradication therapy was effective for patients with HP-negative gastric MALT lymphoma, especially in Korea and Western countries.Conclusion:Therefore, the modified HP eradication therapy can be considered an optional therapy for patients with low-grade HP-negative gastric MALT lymphoma. However, several limitations were revealed in the meta-analysis. Further systematic reviews and research are required.

简介：脱发areata是头发滤泡的疾病，与支持自体免疫的病原学的充分证据。脱发areata经常与象干癣和地衣planus那样的皮肤表明与调停免疫者的疾病被联系，或没有象自体免疫的甲状腺炎和自发的thrombocytopenic紫癜病那样的皮肤表明。Helicobacterpylori(H。pylori)感染在约50%世界人口是在场的并且包括自体免疫的甲状腺炎，自发的thrombocytopenic紫癜病，和干癣与许多调停免疫者的额外消化的混乱被联系了。有头皮和胡子的脱发areata的8瞬间历史的一个43年的老人的一个盒子被介绍。病人被一个皮肤学家正在对待并且有精神病学的支持，没有任何改进。他有消化不良的历史，脲呼吸测试证实了H。pylori感染。病人在H以后从脱发areata走进宽恕。pylori根除。如果如此的一个协会被为这个目的设计的流行病学的研究证实，新治疗学的选择能为这些病人是可得到的，特别在区域在哪儿有H的感染。pylori是高度流行的。

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简介：AIM:ToverifythemethylationstatusofCDH1,DAPK,COX2,hMLH1andCDKN2AgenesandtoevaluatetheirassociationwithHelicobacterpylori(H.pylori)-cagA+andEpsteinBarrvirus(EBV)infectionsingastricadenocarcinomas.METHODS:Methylation-specificPCR(MSP)assaywasperformedin89primarygastriccarcinomas(intestinalanddiffusetypes).Microsatelliteinstability(MSI)analysiswasperformedusingtheBAT26primersetandPCRproductswereanalyzedwiththeABIPRISM3100GeneticAnalyzerusingG...

简介：LongbeforethediscoveryofHelicobacterpylori,thereweremanyexcellentobservationalstudiesthatdocumenteddifferencesinthepatternsofgastroduodenaldisease.Itwasclearthatinthedevelopingworld,gastriculcerandgastriccancerweremorecommonthaninthedevelopedworldwhereduodenalulcerpredominated.Thiscorrelatedwiththedistributionofgastritisinduodenalulcerpatientswheretheinflammationwasantralpredominantwhileingastriculcerpatientsthegastritiswasmoreevenlydistributedthroughthestomach.Gastriculcersusuallyappearedinafairlyrestricteddistributioninthestomachneartheangulusandclosetothetransitionalzonebetweenantrumandbodymucosa.Asasocietydevelopedsothesepatternsofdiseasechanged.

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简介：文章介绍在放射治疗以后为侵略aspergilloma经历了部分肺切除术的一个48岁的白人的案例研究。CYP4503A4的posaconazole抑制引起了病人的提高的topiramate层次，这被假设。这也被报导以便证实相互作用并且阐明精确机制，在posaconazole和topiramate之间的相互作用的进一步的pharmacokinetic分析被保证。

简介：AbstractInflammatory bowel disease (IBD) is a non-specific inflammatory disease of the gastrointestinal (GI) tract that is generally accepted to be closely related to intestinal dysbiosis in the host. GI infections contribute a key role in the pathogenesis of IBD; however, although the results of recent clinical studies have revealed an inverse correlation between Helicobacter pylori (H. pylori) infection and IBD, the exact mechanism underlying the development of IBD remains unclear. H. pylori, as a star microorganism, has been a focus for decades, and recent preclinical and real-world studies have demonstrated that H. pylori not only affects the changes in the gastric microbiota and microenvironment but also influences the intestinal microbiota, indicating a potential correlation with IBD. Detailed analysis revealed that H. pylori infection increased the diversity of the intestinal microbiota, reduced the abundance of Bacteroidetes, augmented the abundance of Firmicutes, and produced short-chain fatty acid-producing bacteria such as Akkermansia. All these factors may decrease vulnerability to IBD. Further studies investigating the H. pylori-intestinal microbiota metabolite axis should be performed to understand the mechanism underlying the development of IBD.

简介：AIM:ToevaluatehowwidelyHelicobacterpylori(H.pylori)HopEandHopVporinsareexpressedamongChileanisolatesandhowseroprevalenttheyareamonginfectedpatientsinChile.METHODS:H.pylorihopEandhopVgenesderivedfromstrainCHCTX-1wereclonedbypolymerasechainreaction(PCR),sequencedandexpressedinEscherichiacoliAD494(DE3).Gel-purifiedporinswereusedtopreparepolyclonalantibodies.ThepresenceofbothgeneswastestedbyPCRinacollectionofH.pyloriclinicalisolatesan...

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简介：AIM:Helicobacterpylori(Hpylori)hasbeenlinkedtochronicgastritis,pepticulcer,gastriccancerandMALT-lymphoma.ThelinkofgenotypesofHpyloritogastriccancerremainscontroversial.TheaimofthisstudywastoinvestigatetheHpylorivacAalleles,cagAandiceAinpatientswithgastriccancerinTaiwan.METHODS:Patientswithgastriccancer,pepticulcerandchronicgastritiswereenrolledinthisstudy.Weobtainedbiopsyspecimensfromthestomachatleast2cmawayfromthetumormargininpatientswithgastriccancer,andfromtheantrumofstomachinpatientswithpepticulcerorchronicgastritis.DNAextractionandpolymerasechainreactionwereusedtodetectthepresenceorabsenceofcagAandtoassessthepolymorphismofvacAandiceA.RESULTS:Atotalof168patients(gastriculcer:77,duodenalulcer:66,andchronicgastritis:25)werefoundtohavepositivePCRresultsofthebiopsyspecimensfrompatientswithpepticulcerandchronicgastritis.WefoundpositivecagA(139/168,83%),m2(84/168,50%)andiceA1(125/168,74%)strainsinthemajorityofpatients.Inpatientswithgastriccancer,thevacAslaandslcsubtypeswerelesscommonlyfoundthanthoseinnon-cancerpatients(35/66vs127/168,P=0.0001forslaand13/66vs93/168,P<0.0001forslc).Inthemiddleregion,themlTstraininpatientswithgastriccancerwasmorethanthatofnon-cancerpatients(23/66vs33/168,P=0.02).CONCLUSION:InTaiwan,HpyloriwithpositivevacAsla,cagAandiceA1strainsarefoundinthemajorityofpatientswithgastriccancerornon-cancerpatients.Inpatientswithgastriccancer,thevacAs1aandslcsubtypesarelessandm1Tismorethaninpatientswithpepticulcerandchronicgastritis.

简介：由表2可见用丽珠胃三联治疗本地区H.pylori阳性的慢性胃炎和消化性溃疡,有报道慢性胃炎患者的胃粘膜活检标本中H.pylori检出率可达80%～90%,丽珠胃三联治疗本地区H.pylori阳性的慢性胃炎和消化性溃疡

简介：AIM:Toconstructanon-resistantandattenuatedSalmonellatyphimurium(S.typhimurium)strainwhichexpressesconservativeregionofadhesionABofHelicobacterpylori(Hpylon)andevaluateitsimmunogenicity.METHODS:TheABgeneamplifiedbyPCRwasinsertedintotheexpressionvectorpYA248containingasdgeneandthroughtwotransformationsintroducedintothedeltaCya1deltaCrp1deltaAsdattenuatedSalmonellatyphimuriumstrain,constructingbalancedlethalattenuatedSalmonellatyphimuriumstrainsX4072(pYA248-AB).BridgedELISAmethodwasusedtomeasuretheexpressionofABantigeninsonicateandculturesupematant.AccordingtothemethoddescribedbyMeacock,stabilityoftherecombinantwasevaluated.Semi-lethalcapacitytestwasusedtoevaluatethesafetyofrecombinant.Theimmunogenicityofrecombinantwasevaluatedwithanimalexperiments.RESULTS:TheattenuatedS.typhimuriumX4072(pYA248-AB)whichexpressesABwassuccessfullyconstructed.Furthermore,bridgedELISAassayshowedthatthecontentofABinrecombinantX4072(pYA248-AB)culturesupematantwashigherthanthatwasinthalluslyticliquor.AndafterrecombinantX4072(pYA248-AB)wasculturedfor100generationswithoutselectionpressure,bheentirerecombinantbacteriaselectedrandomlycouldgrow,andtheABantigenwasdefectedpositivebyELISA.ThegrowthcurveoftherecombinantbacteriashowedthatthegrowthstatesofX4072(pYA248)andX4072(pYA248-AB)werebasicallyconsistent.ThesurvivalrateofC57BL/6wasstill100%,at30daftermicetakingX4072(pYA248-AB)1.0×l0^10cfuorally.OralimmunizationofmicewithX4072(pYA248-AB)inducedaspecificimmuneresponse.CONCLUSION:Invitrorecombinantplasmidappearstobestableandexperimentsonanimalsshowedthattherecombinantstrainsweresafeandimmunogenicinvitro,whichprovidinganewliveoralvaccinecandidateforprotectionandcareofHpyloriinfection.

简介：H.pylori相关性胃炎是消化内科的常见病、多发病。据报道,90%以上的慢性胃炎都有H.pylori感染[1]。临床主要表现为上腹胀满、嘈杂、纳呆和上腹隐痛等症状,病程缠绵,容易复发和癌变,治疗棘手。肖国辉教授,主任医师,硕士研究生导师。幼有异禀,