Helicobacter pylori infection rate and surgical treatment outcome of perforated peptic ulcer disease in Public Hospitals of Eastern Ethiopia: a prospective multicenter study

ObjectiveTo compare the sex differences of Helicobacter pylori (HP) infection rate and 1-year recurrence rate.MethodsA cross-sectional study was conducted on the prevalence of HP infection in 81,754 people who underwent physical examination in physical examination centers and outpatient clinics of the Affiliated Hospital of Gansu University of Traditional Chinese Medicine, the Second People’s Hospital of Zhangye City, Tianshui City Hospital of Integrated Chinese and Western Medicine, the First and Second Department of The First Hospital of Lanzhou University Physical Examination Center, from March 2010 to December 2019. Among them, 53,771 (65.77%) were males (18–91 years old) and 27,983 (34.23%) were females (18–94 years old). According to age, they were divided into young group, middle-aged group and old group. 1448 asymptomatic infected patients were selected and treated with bismuth-containing quadruple drug eradication therapy for 2 weeks. The eradication rate and recurrence rate after 1 year were compared between males and females.ResultsThe overall infection rate was 49.59%, including 49.74% in males and 49.3% in females. The risk of infection in young women was lower than that in men (OR = 0.908, 95%CI: 0.868–0.95, P < 0.01), the risk of infection in older women was higher than that in men (OR = 1.137, 95%CI: 1.041–1.243, P < 0.01). The female infection rate was positively correlated with age from 18 to 60, and Spearman’s correlation coefficient was 0.825 (P < 0.01). The overall eradication rate was 84.67% in intention-to-treat analysis (ITT) and 88.46% in protocol analysis (PP). The eradication rates of ITT and PP in the older group were 78.38% and 82.27%, respectively, which were lower than 87.25% and 89.39% in the male group (P < 0.05). The 1-year overall recurrence rate was 3.86%, including 2.82% in males and 5.44% in females (P < 0.05), female was a risk factor for recurrence after eradication after controlling for age (OR = 2.177, 95%CI 1.166–4.066, P < 0.05). There were no obvious adverse reactions during the treatment.ConclusionThere is a positive linear correlation between HP infection rate and age increase in women. Older women have the characteristics of high HP infection rate, low eradication rate and high recurrence rate.

Objective To investigate clinical value of plasma gastrin, leptin,carbohydrate antigen 125( CA 125 ), carbohydrate antigen 72-4 ( CA72-4 ) and 13C-urea breath test(13C-UBT) in diagnosis of patients with gastric carcinoma. Methods Radioimmunoassay and enzyme immunosorbent assay were used to determine the plasma gastrin, leptin, CA125 and CA72-4 levels, and helicobacter pylori ( HP ) infection rate was determined by 13C-UBT. Compared all the determined results from 126 patients with gastric carcinoma ( including 32 cases Ⅰ - Ⅱ stage gastric carcinoma, 57 cases Ⅲ stage gastric carcinoma and 37 cases Ⅳ stage gastric carcinoma ) and 60 normal controls. Results The plasma gastrin, CA125 and CA72-4 levels in 126 patients with gastric carcinoma were significantly higher (t=3.125, t=3.519, t=3.788, P＜0.01 ) but plasma level was significantly lower (t=3.524, P＜0.01 ) than those in 60 normal controls. Compared with normel controls, the result of CA72-4 was signeficantly changed. The plasma gastrin, CA125 and CA72-4 levels in 126 patients with gastric carcinoma were increased with the severity of gastric carcinoma, but plasma leptin was decreased.The HP infection rate in 126 patients with gastric carcinoma (84.9%) were significantly higher than those in 60 normal controls(15%). The HP infection rate in 32 Ⅰ - Ⅱ,57 Ⅲ and 37 Ⅳ stage gastric carcinoma were 46.9%,89.5% and 89.2% respectively and were increased with severity of gastric carcinoma. Conclusion The determination of plasma CA72-4 was the best item for diagnosis of gastric carcinoma in four tumor markers, leptin,CA 125 and gastrin followed. The determination of HP infection rate in gastric carcinoma by 13C-UBT played a considerable role for diagnosis and therapy. Key words: Stomach neoplasms; Gastrin; Leptin; CA125 antigen; Antigen, tumor-associated, carbohydrate; Helicobacter, pylori; Radioimmunoassay

Introduction: The rate of Helicobacter pylori (H. pylori) infection is higher in minority patients in the United States. Gastric intestinal metaplasia (IM) is associated with H. pylori infection and increased risk for gastric cancer over time, in particular for patients from regions of high gastric cancer incidence. We aimed to compare the rates of Helicobacter pylori infection and gastric intestinal metaplasia in Asian patients vs. non-Hispanic white (hereafter white) patients at our institution. Methods: After IRB approval, a chart review was performed on Asian and white patients who underwent diagnostic EGD with random stomach biopsies (antrum, body, and incisura) performed by the same endoscopist (YRW) during the study period. Endoscopy and pathology reports were used to identify the presence of peptic ulcer disease, H. pylori infection, and gastric IM. Other variables of interest included patient age and sex. The Student’s t-test, chi-square test, and multivariate logistic regression were used in statistical analysis. Results: Our study sample included 60 Asian patients (35 Korean, 11 Vietnamese, 10 Chinese, and 4 other Asian) and 67 white patients. Compared with white patients, Asian patients were older (mean age [standard deviation]: Asian 56.5 [15.4], white 49.6 [17.1], p<0.05) and similar in percentage of females (Asian 65.0%, white 68.7%). The presence of peptic ulcer disease was similar (Asian 13.3%, white 10.4%), while the rates of H. pylori infection and gastric IM were higher in Asian patients (H. pylori infection: Asian 20.0%, white 6.0%, p<0.05; gastric IM: Asian 40.0%, white 13.4%, p<0.001). Multivariate logistic regression controlling for patient age and sex confirmed Asian patients’ higher risks of H. pylori infection (odds ratio [OR] 3.96; 95% confidence interval [CI] 1.17-13.4) and gastric IM (3.93; 1.62-9.52). Conclusion: The rates of H. pylori infection and gastric IM in Asian patients were similarly 4 times as high as those in white patients, suggestive of the role of (prior or active) H. pylori infection in gastric IM.

Objective To investigate the prevalence and trend of Helicobacter pylori (HP) infection in children with gastrointestinal symptoms in Kunming area, and to provide basis for prevention and cure. Methods All of 12 932 cases with gastrointestinal symptoms were adopted by retrospective analysis method from January 2013 to December 2016, and HP infection was detected by 13C-urea breath test (13C-UBT). The epidemioloqical characteristics of children with HP infection in including prevalence trend and gender and age HP were statistically analyzed. Results The rates of HP from January 2013 to December 2016 were respectively 17.85%, 18.26%, 20.41% and 32.93%. The rate of HP positive was 24.08%(3 114/12 932), which was 24.82%(1 706/6 874) in boys and 23.24%(1 408/6 058) in girls. The rate of HP infection was significantly higher in boys than that in girls, and there was statistical differences (P<0.05). The rate of HP infection showed a gradual upward trend with age. There was statistical differences in gender between age 11 and 14[(29.03% (349/1 202) vs. 22.62% (190/840)] (P<0.05). Conclusions HP infection rate is high in the children with gastrointestinal symptoms in Kunming, and the rate of HP infection in children is related with gender. The rate of HP infection is significantly higher in boys than that in girls, and the positive rate is directly proportional. Key words: Helicobacter pylori; Children; Infection rate

The eradication rate of Helicobacter pylori (H. pylori) infection might be affected by the degree of inflammation of gastric mucosa represented by the endoscopic stage of peptic ulcer disease (PUD). The aims of this study were to evaluate the eradication rates of H. pylori infection according to the endoscopic stage of PUD and to document whether early eradication in the active stage could yield a higher eradication rate in patients with peptic ulcer bleeding (PUB). A total of 1,177 patients with PUD (380 gastric ulcer, 710 duodenal ulcer, and 87 combined ulcer) who received proton-pump inhibitor (PPI)-based triple therapy were included, and the eradication rates were compared by ulcer stage. Univariate and multivariate analyses were conducted to identify factors influencing eradication rate. In PUB, the eradication rates between the early eradication group (≤7 days) and the late eradication group (>7 days) were compared. The eradication rates according to endoscopic stage were significantly different in gastric ulcer (active vs healing vs scarring; 84.8% vs 82.7% vs 70.6%, p = .014, respectively), but there were no significant differences in duodenal ulcer (active vs healing vs scarring; 87.6% vs 80.9%% vs 80.9% p = .169, respectively). In multivariate analyses, active ulcer as well as age younger than 50 was a significantly independent predictor of successful eradication (Odds ratio; 2.799, 95% CI; 1.659-4.723, p = .0001). The eradication rate of the early eradication group was significantly higher than the late eradication group in PUB (89.2% vs 71.9%, 95% CI; 1.265-8.269, p = .011). There was a significant difference in the eradication rate according to the endoscopic stage of gastric ulcer. Active ulcer was an independent predictor of successful eradication. Furthermore, early H. pylori eradication should be considered in patients with PUB to yield a higher eradication rate.

The incidence of gastroesophageal junction adenocarcinoma (GEJAC) in Western countries has increased in recent decades, in addition to a rise in the incidence of esophageal adenocarcinoma (EAC). Gastroesophageal reflux disease (GERD), obesity, smoking, alcohol consumption, and low Helicobacter pylori (HP) infection rate have been nominated as risk factors for such cancers. Among these risk factors, the increased prevalence of GERD and obesity and the decreased prevalence of HP infection are of special interest owing to the currently increasing prevalence of GEJAC in Western countries. Although similar trends in the prevalence of GERD, obesity, and HP infection are observed in Asian countries after a time lag from Western countries, it is still uncertain if the prevalence of GEJAC in Asian countries is increasing, especially in Korea. The incidence of GERD in Korea is currently increasing; it was below 3% in the 1990s. The incidence of obesity in the Korean population is increasing owing to the adoption of westernized lifestyles, including food preferences, and the HP infection rate in Korea is known to be decreasing. Therefore, based on logical extrapolation of observations of Western countries, the incidence of GEJAC will increase in Korea. However, the proportion of GEJAC among other upper gastrointestinal malignancies in Korea appears to be currently unchanged compared with that in the 1990s. Presently, there is a lack of epidemiologic studies on this issue in this region; therefore, more studies are needed to clarify the characteristics of these tumors and to improve clinical outcomes for patients with these tumors.

Background According to statistics, 50% of the global population is infected with Helicobacter pylori (HP), with infection rates influenced by factors such as national development status, age, and occupation. Furthermore, HP infection rates vary significantly across different regions within the same country. Although HP infections in China have been declining in recent years, a substantial number of individuals remain affected. Methods This retrospective study analyzed 2,729 participants from Guangxi, China, to examine the distribution of HP infection among different populations. The analysis focused on overall HP infection rates, differences in infection rates between males and females, variations across age groups, and disparities among occupational categories. Results The findings indicate that the overall HP infection rate is 31.4%, with male and female infection rates of 31.5% and 31.2%, respectively. The data show that HP infection rates increase with age, with significant differences observed among age groups. Aging is the independent risk factor for HP infection. Among various professions, civil servants exhibit the lowest HP infection rate, while teachers have the highest. Conclusions This study determined that the prevalence of HP infection in Guangxi, China, is relatively low. Age was identified as a significant risk factor for HP infection in this region. Teachers demonstrated the highest infection rates among all professions. Further investigation is needed to explore the underlying causes of this phenomenon, particularly in relation to the social conditions and economic development of Guangxi, China.

Objective To investigate the prevalence of Helicobacter pylori (HP) infection in patients with Parkinson's disease (PD), and analyze the relationship of HP infection with the symptoms, disease progression and motor complications of PD. Methods 72 PD outpatients were randomly selected, and 100 gender and age-matched subjects who took health physical examination were considered as healthy controls. Basic data were collected and estimated by Unified Parkinson's Disease Rating Scale (UPDRS), Hoehn and Yahr stage, the 39-item Parkinson's Disease Questionnaire (PDQ-39), Activity of Daily Living Scale (ADL), Minimum Mental State Examination (MMSE), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA). All subjects underwent 13C-urea breath test to determine Helicobacter pylori infection status. Results There was no significant difference in HP infection rate between PD and control groups〔37.5% (27 cases) vs. 32.0% (32 cases), P=0.45〕. According to the initial symptoms, PD patients were divided into two groups: bradykinesia/ rigidity group and tremor group. The HP infection rate was higher in bradykinesia/ rigidity group than in tremor group〔52.2% (12 cases) vs. 30.6% (15 cases)〕, but had no significant difference (P=0.08). The mean HY stage was higher in the HP-infected patient group than in the non-infected group〔(2.6±0.7) vs. (2.2±0.9), P=0.03〕. The HP infection rate was higher in patients with HY stage ≥2 than with HY stage <2〔46.4% (26 cases) vs. 6.3% (1 case), P=0.003〕. There were no correlations of HP infection with gender, age, age of onset, UPDRS, UPDRS-Ⅲ, PDQ-39, the course of the disease, wearing-off phenomenon, and dyskinesias. Conclusions The PD patients with HP infection are mainly at middle- and late-stage. HP infection may be related with the progress of the disease. It needs further study and validation by expanding the sample to investigate whether HP infection affects the motor complications. Key words: Parkinson's disease; Helicobacter pylori; Dyskinesias

The relationship between diabetes and Helicobacter pylori (HP) infection is controversial. In this study, we examined the possible relationship between HP infection and type 2 diabetes in Chinese subjects. Sixty-three Chinese type 2 diabetic patients (mean age ± SD: 49.9 ± 12.0 years; range: 17–76 years) were recruited irrespective of the duration of diabetes or type of therapy. Twenty-nine (46%) of them had upper gastrointestinal symptoms and the other 34 (54%) did not. Another 55 age- and sex-matched non-diabetic subjects (mean age ± SD: 45.6 ± 15.6 years, p = 0.098; range 18–79 years) with dyspepsia indicated for upper endoscopy were recruited as a comparison group. Upper endoscopy was performed with antral mucosal biopsy specimens taken for rapid urease test (CLO test). HP infection was considered to be present if the rapid urease test was positive. The rates of HP infection of the diabetic and non-diabetic individuals were 50.8% and 56.4% respectively (p: NS). The rate of HP infection was similar between the 2 groups of diabetic patients with or without gastrointestinal symptoms (42.9% vs. 56.3%, p: NS). Using logistic regression analysis (forward stepwise) with age, sex, glycaemic control, duration of diabetes and upper gastrointestinal symptoms as independent variables to predict the risk of HP infection in diabetic patients, none of the parameters enter into the model. In conclusion, the rate of HP infection in Hong Kong Chinese subjects with type 2 diabetes is around 50%, which is similar to control subjects. No association was found between HP infection, glycaemic status, and duration of diabetes and upper gastrointestinal symptoms in these diabetic subjects.

Objective To explore the association of functional dyspepsia (FD) with Helicobacter pylori (HP)infection and concentrations of nitric oxide (NO) in the serum and gastric juice.Methods Concentrations of nitric oxide and HP were detected in 90 FD patients,88 healthy controls,and 70 pateints with duodenal ulcer (DU).NO in the serum and gastric juice was detected by the modified Griess method and HP were determined by colloidal gold method.The test results were compared among the three groups.Results The rate of HP infection was significantly higher in FD patients and patients with DU than in the healthy controls (34％ and 42％ vs.6％,P＜0.001); nitric oxide levels were lower in of patients with DU and FD patients than in the control subjects (P＜0.05).The nitric oxide levels were significantly lower in FD patients with HP infection than in those with no HP infection (P＜0.05).Conclusions Nitric oxide and Helicobacter pylori infection are the factors causing functional dyspepsia.Helicobacter pylori infection and nitric oxide play a synergistic role in the development of functional dyspepsia. Key words: Functional dyspepsia; Helicobacter pylori; Nitric oxide; Duodenal ulcer

To the Editor: We conducted a study to compare the effects of, and any correlation between, chronic nonsteroidal antiinflammatory agent (NSAID) intake and Helicobacter pylori (HP) infection, in terms of upper gastrointestinal (GI) symptoms and lesions, in younger compared with older subjects. NSAIDs and HP are known to interfere with gastroduodenal mucosal protective mechanisms, and are implicated in the etiology of peptic ulcer disease.1 In older people, NSAID usage is associated with more GI complications,2 and HP infection is also more common.3 Controversy exists in the relationship between NSAID use and HP infection in peptic ulcer disease: while some studies found NSAID-related ulcers to be more common in HP-infected subjects,4 other researchers have shown that although HP prevalence increases with age, this was independent of NSAID intake and showed no correlation with the severity of dyspeptic symptoms.5,6 A total of 186 subjects referred for upper GI endoscopy for suspected GI hemorrhage, dyspepsia, or anemia were recruited from medical clinics and wards. Exclusion criteria included use of warfarin or steroids in the past year, previous upper GI surgery, actively bleeding lesions, and conditions in which endoscopy or biopsy were contraindicated. Subjects were stratified according to age (<50 or >60 years), NSAID intake (therapeutic doses for >3 months), and HP infection status. All subjects were interviewed for demographic data, cigarette and alcohol consumption, and details of NSAID or anti-ulcer drug intake, if any, and past history of peptic ulcer disease (Table 1). Frequency and severity of upper GI symptoms, including dyspepsia, pain, bloating, and gas, were graded by a standardized score. At endoscopy, lesions were recorded by the modified Lanza score,7 and antral biopsies were obtained for the CLO test,8 histology, and culture to confirm HP infection. Our findings showed that the HP infection rate was 42% in subjects aged less than 50 and 49% in those over age 65. Among NSAID users, there was a nonsignificant trend (P = .29) toward a lower HP prevalence in younger subjects (35 %) compared with the older group (50%). Table 2 summarizes the relationship between NSAID use, HP infection, upper GI symptoms, and endoscopic findings. Overall, significantly more older subjects were asymptomatic, and NSAID users were less symptomatic at all ages compared with non-users. Younger non-users had more severe symptoms, particularly those who were infected with HP. In terms of endoscopic lesions, there was no correlation with NSAID intake in the younger group. On the other hand, older chronic NSAID users were less likely to have normal endoscopic examinations, particularly the subgroup who were infected with HP. This subgroup also had significantly more mucosal hemorrhages (44%) compared with non-NSAID users (12%) and showed a trend toward more duodenal and gastric ulcers. Among young NSAID users, there was significantly more HP infection found in those with duodenal ulcers than in uninfected individuals. The lower than predicted HP infection rate in our older subjects may be related to the high prevalence of infection at an earlier age (childhood or adolescence) among Orientals.9 Our study has shown that in older people, dyspeptic symptoms are less prominent, particularly in subjects infected with HP, although they were more likely to have abnormal endoscopic findings. This highlights the need for caution in the management of upper GI problems in this group of patients. In summary, our findings suggest that in older subjects, HP infection is associated with more upper GI pathology, and chronic NSAID intake has an independent and additive effect to HP in causing such injuries, although symptoms are few in this group.

A meta-analysis was conducted to examine the correlation between Helicobacter pylori infection and chronic urticaria. We searched Chinese and English databases, including CNKI, Wanfang, and Weipu, using search terms such as Helicobacter pylori infection, and chronic urticaria for articles published from the establishment of the databases to February 2021 examining the correlation between Helicobacter pylori infection and chronic urticaria. The retrieved articles contained data on Helicobacter pylori infection rates in chronic urticaria cases in different regions of the north and south in China. The retrieved articles underwent strict screenings according to inclusion and exclusion criteria. Revman5.3 software was used to perform a meta-analysis on the data of the included articles. A total of 39 documents were retrieved following the searches. According to the inclusion and exclusion criteria, a total of 6 articles on 6 studies, comprising a total of 1,320 patients, were finally included in the meta-analysis. The results showed that the heterogeneity was high (I2=58%). A random-effects model was performed. An analysis of the correlation between Helicobacter pylori infection and chronic urticaria revealed significant differences between the study group and the control group [odds ratio (OR) =3.00; 95% confidence interval (CI): 1.98-4.55; P<0.00001]. The infection rate of Helicobacter pylori among chronic urticaria cases in the northern population was 16.1% (95% CI: 15.6-16.6%); of these patients 12.2% were male and 21.4% were female. The infection rate of Helicobacter pylori among chronic urticaria cases in the southern population was 18.0% (95% CI: 17.5-18.5%); of these patients, 12.3% were male and 23.1% were female. There was no significant difference in the prevalence between the male population, the female population, and the general population in the north and the south (P>0.05). Helicobacter pylori infection is correlated with the occurrence of chronic urticaria. There is no significant difference in the infection rate of Helicobacter pylori in chronic urticaria cases in different regions of the north and south. This study had some limitations. First, the number of patients included in each study was low, which may affect the accuracy of the results. Second, the detection methods were not uniform; thus, further research is required to support the conclusions drawn.

Objective To determine the expression of human protection of telomeres 1 (hPOT1) and its relationship with Helicobacter pylori (HP) infection in gastric carcinoma. Methods The expressions of hPOT1 protein and hPOT mRNA were detected in 53 gastric carcinoma specimens (observed group) and 20 normal gastric mucosa tissues (control group) by SP immunohistochemical method and in situ hybridization (ISH), respectively. HP infection was examined by Warthin-Starry method in observed group. Results The positive expression rate of hPOT1 protein was 84.91 % (45/53) in observed group, higher than that in control group [30.00 % (6/20)] (P<0.01). The positive expression rate of hPOT1 mRNA was 58.49 % (31/53) in observed group, higher than that in control group [10.00 % (2/20)] (P<0.05). The positive co-expression rate of hPOT1 protein and mRNA was 56.60 % (30/53), both had positive relationship in gastric carcinoma (r=0.394, P<0.05). The rate of HP infection in 53 cases of gastric carcinoma was 52.83 % (28/53). The positive expression rates of hPOT1 protein and mRNA in observed group with HP infection were significantly higher than those in observed group without HP infection[protein: 96.43 % (27/28) vs 72.00 % (18/25), P<0.05; mRNA: 85.75 % (24/28) vs 28.00 % (7/25), P<0.01]. Conclusions hPOT1 may be associated with occurrence of gastric carcinoma. Combined detection of hPOT1 protein and mRNA can be used for the diagnosis of gastric carcinoma. HP infection may be associated with abnormal expression of hPOT1 in occurrence of gastric carcinoma. Key words: Stomach neoplasms; Human protection of telomeres 1; Helicobacter pylori

The association between Helicobacter pylori (HP) infection and duration of dialysis in dialysis patients is conflicting, this meta-analysis was conducted to elucidate the association between duration of dialysis and HP infection status in dialysis patients, and subgroup study was conducted to explore its influencing factors. Furthermore, our study aims to provide advice on the treatment of dialysis patients. Articles published up to 30 September 2018 were searched from PubMed, Embase, Sinomed, Medline, China Knowledge Resource Integrated Database (CNKI) and Wang fang database. Two researchers independently identified whether studies met the eligibility criteria. The adjusted relative risk (RR) or the weighted mean difference (WMD) and their 95% CI were estimated. I2 was performed to evaluate the statistical heterogeneity. Publication bias was evaluated using Egger's test and a funnel plot. Fourteen studies were included involving 2087 dialysis patients, 815 of them were HP positive, 1272 of them were HP negative. Quantitative data and qualitative data were analyzed, respectively. For quantitative data, statistical differences were observed in the association between HP infection and duration of dialysis (P = 0.008), also in the hemodialysis subgroup (P = 0.006). After stratifying by detection methods, differences still existed in groups with different detection methods (P = 0.001, P = 0.033). For qualitative data, there was no statistical difference in the association between HP infection rate and duration of dialysis (P = 0.295). Furthermore, we found that the age was higher in HP positive patients than in HP negative patients (P < 0.001). Our meta-analysis found that HP infection rate was negatively correlated with accumulative dialysis time, and methods of HP detection did not influence the association between HP infection and accumulative dialysis time. We also found that age was the risk factor of HP infection in dialysis patients. Further studies need to be performed to elucidate the mechanism of the correlation between HP infection and duration of dialysis, to explore which timing period of dialysis is most susceptible to HP infection, then, improve the prognosis of patients with renal diseases.

There have been few reports comparing pre and postoperative prevalence of Helicobacter pylori infection and gastritis in patients with gastric cancer surgery. Seventy patients with primary gastric cancer were identified to be infected with Helicobacter pylori preoperatively and tested for Helicobacter pylori infection after subtotal gastrectomy. We analyzed changes in Helicobacter pylori infectivity and histological features of gastric mucosa. The overall spontaneous regression rate of Helicobacter pylori infection was 38.6% (27/70). The mean time between surgery and follow-up tests was 1.02±0.5 years. The activity and chronic inflammation scores were significantly decreased in regression group. In non-regression group, there was no significant difference in activity scores, but the chronic inflammation score was significantly increased. There were no significant changes in atrophic gastritis and intestinal metaplasia scores in either group. The grade of Helicobacter pylori infection was significantly decreased in non-regression group. The spontaneous regression rate of Helicobacter pylori infection after subtotal gastrectomy was 38.6% (27/70), it occurred in larger scale of patients and it occurred earlier (1.02±0.5 years) than in previous studies. We suggest that further prospective study on spontaneous regression rate of Helicobacter pylori infection after subtotal gastrectomy and its mechanism is needed in the future.