Helicobacter Pylori Clearance Research Articles

Clinical Effect of Clarithromycin Combined with Tinidazole on Helicobacter pylori-Related Gastritis and Its Influence on COX-2 Expression.

Studies have shown that COX-2 expression is upregulated in gastric cancer (GC) as well as in precancerous lesions and in Helicobacter pylori-induced inflammation, suggesting that cyclooxygenase-2 (COX-2) may play an important role in gastric carcinogenesis. We attempted to investigate the role of clarithromycin with tinidazole on Helicobacter pylori-related gastritis from the aspects of clinical effect and COX-2 expression. From January 2016 to January 2019, 130 patients with Helicobacter pylori-related chronic gastritis were collected and grouped into the observation group (OG) and the control group (CG). Altogether, 80 patients in the OG were treated with clarithromycin with tinidazole, while 50 patients in the CG were treated with amoxicillin with metronidazole. Clinical symptom improvement time, content of COX-2 and B cell lymphoma-2 (BCL-2), content of inflammatory factors interleukin-1 (IL-1), IL-4, and C-reactive protein (CRP), expression level of nutritional indicators serum albumin (ALB), realbumin (PA), and transferrin (TF), clearance of Helicobacter pylori, total effective rate, and incidence of adverse reactions were detected. Compared with the CG, the OG had shorter clinical symptom improvement time, lower COX-2 and Bcl-2, lower expression of inflammatory factors IL-1, IL-4, and CRP, higher expression of nutritional indicators ALB, TF, and PA, higher clearance rate of Helicobacter pylori, higher total effective rate, and lower incidence of adverse reactions. Clarithromycin combined with tinidazole can effectively improve the clinical effect of Helicobacter pylori-related gastritis and reduce the expression level of COX-2.

Clearance of Helicobacter pylori with formulation rCagA and LPS in a mouse model

Helicobacter pylori is the leading cause of peptic ulcer and gastric cancer. Considering the importance of Helicobacter pylori in human diseases, develop a vaccine against it is necessary. Therefore, this study aimed to investigate the clearance of H. pylori with Formulation rCagA and LPS in a mouse model.The formulations; rCagA, LPS, rCagA/LPS were evaluated against clearance of H. pylori. All of Mice groups were immunized three times orally then two times intramuscularly (IM). Mice were challenged with H. pylori strain SS1, Fourteen days after the last immunization. Spleens and gastric tissues were collected from mice. Antigen-specific interleukine responses were surveyed in the spleen of mice that immunized before and post-challenge by ELISA technique. The clearance of H. pylori was measured in spleen and gastric tissues. Data were analyzed using ANOVA followed by Dunnett's post hoc test. Differences between CFU in experimental groups were evaluated by Student's t-test. The cellular and humoral responses were compared by the non-parametric Mann–Whitney U test.Immunization of mice with formulationrCagA-LPS induced a strong Th1 immune response (P < .05). The rCagA - LPS - CpG group induced a more increase IL-4 than IFN-γ (P < .05). Splenocytes produced high levels of IL-10 after challenge with rCagA-LPS. Mice that immunized with rCagA-LPS-CpG and LPS-CpG secreted significantly more IFNγ titer than others (P < .05).The clearance test showed the reduction of 6 logs of H. pylori. Immunization with current combinations was safe in animal models and was able not only trigger appropriate responses but decrease H. pylori ss1 colonization, too.

Efficacy and safety of acupuncture therapy for chronic atrophic gastritis: A meta-analysis and trial sequential analysis protocol.

Background:The proportion of application of acupuncture for chronic atrophic gastritis (CAG) is increasing over time. We will conduct this study to explore the efficacy and safety of acupuncture as a treatment method for CAG.Methods:We will go through domestic and foreign databases until July 2019 to identify related randomized controlled trials that explored the effectiveness of acupuncture for CAG. RevMan (V.5.3) and test sequential analysis (V.0.9) will be used for mata-analysis and trial sequential analysis.Results:This study will update previous evidence summaries of acupuncture and determine the efficacy and safety of acupuncture for CAG based on clinical effectiveness rate, clearance of Helicobacter pylori (H pylori) infection, and quality of life and symptom scores.Conclusion:This study will determine the evidence for judging whether acupuncture provides benefits in the treatment of CAG, and will support the application of acupuncture in the recovery of patients with CAG.Registration number:CRD42019127916.

Clinical effect of probiotics combined with triple therapy in the treatment of helicobacter pylori infection in children

Objective To discuss the application of combined probiotics pretreatment and late triple therapy with helicobacter pylori infection in children. Methods 300 children with helicobacter pylori infection were randomly divided into three groups according to the way of random table.Group A was treated with standard triple therapy, omeprazole, amoxicillin and clarithromycin treatment, and 10 d was 1 treatment course.B group was given probiotic pretreatment, prior to the triple therapy using compound lactobacillus acidophilus piece 1 piece/time, cold water to take after meals, taking 2 weeks, follow-up treatment with triple therapy for 10d.In group C, triple therapy before using compound lactobacillus acidophilus piece 1 piece/time, cold water to take after meals, taking 2 weeks, follow-up treatment with triple therapy for 10d.To take one week after the completion of compound lactobacillus acidophilus piece 1 piece/time, cold water after meals.The clinical therapeutic effects were recorded. Results The helicobacter pylori clearance rate of group A was 55.00%, that of group B was 86.00%, that in group C was 89.00%, the helicobacter pylori clearance rate of group B and group C was significantly higher than that in group A, the difference was statistically significant (χ2=23.103 7, 28.670 6, all P 0.05). In A group, nausea and vomiting occurred in 5 cases, 2 cases of diarrhea, abdominal distension abdominal pain in 4 cases, skin rash in 5 cases.In group B, nausea and vomiting occurred in 2 cases, 0 cases of diarrhea, abdominal distension abdominal pain in 1 case, skin rash in 1 case.In group C, nausea and vomiting occurred in 1 case, 0 cases of diarrhea, abdominal distension abdominal pain 0 cases, skin rashes in 1 case.The incidence rate of adverse reactions in group B and group C was lower than that in group A, the difference was statistically significant (χ2=11.965 8, 8.000 0, all P 0.05). Conclusion Joint probiotics pretreatment and late triple therapy application in helicobacter pylori in children can promote helicobacter pylori clearance, reduce the triple therapy drug adverse reactions, it is worthy of popularization and application in clinic. Key words: Probiotics; Triple therapy; Children; Helicobacter pylori infection

Comparison of clinical efficacy of esomeprazole in treatment of gastric ulcer in young and elderly patients

Objective To compare the clinical efficacy and safety of esomeprazole in treatment of elderly and young patients with gastric ulcer. Methods 120 cases of elderly patients with gastric ulcer and 95 cases of young and middle-aged patients with gastric ulcer were selected this study. Two groups of patients were treated with amoxicillin and clavulanate potassium dispersible tablets 0.457 g, tinidazole tablets 0.5 g and esomeprazole magnesium enteric coated tablets 20mg orally, once daily treatment 1 week for a course of treatment,1 week after continue to every morning fasting taking esomeprazole 20mg,1 times/D,treatment for 3weeks. The clinical curative effect, Hp clearance rate and incidence of adverse reactions between two groups of patients after treatment were compared. Results The total effective rate in the treatment of elderly group patients(87.50%)compared with young and middle-aged group(92.63%), there was no significant difference(χ2=1.52,P>1.52). Elderly group of patients with helicobacter pylori clearance rate(71.67%)compared with young and middle-aged group(76.84%),there was no significant difference (χ2=0.74,P>0.74). The incidence of adverse reactions(8.33%)of elderly group had obvious differences by comparing with young and middle-aged group(2.11%), and the difference was statistically significant(χ2=3.90,P<0.05). Conclusion Application of esomeprazole based triple therapy in the treatment of the elderly and young people in the gastric ulcer could heal ulcers and eradicate Hp, but young and middle-aged patients is superior to the elderly group in terms of adverse reactions. Key words: Esomeprazole; Aged; Young and middle-aged. Gastric ulcer

Curative effect and safety of the adjuvant therapy of bifidobacterium bifidum-sine capsules to helicobacter pylori positive peptic ulcer

Objective To discuss the curative effect and safety of the adjuvant therapy （ AT） of bifidobacteri-um bifidum-sine capsules to helicobacter pylori （ HP） positive peptic ulcer .Methods 76 HP infected peptic ulcer patients were selected and divided into the observation group and control group at random .The patients in control group were given traditional triple therapy of omeprazole ,amoxicillin and carat enzyme for 4 weeks,while the patients in observation group were given bifidobacterium bifidum-sine capsules（420mg） three times daily for 4 weeks.Clinical symptom remission,ulcer healing and HP clearance of patients in two groups were observed and compared .The inci-dence rate of drug adverse reaction （ DAR） during treatment period was observed ,and the recurrence rates of peptic ulcer within half a year and one year were followed up .Results The HP clearance rate of the observation group was significantly higher than control group （χ2 =4.21,P〈0.05）.The incidence rate of DAR of the observation group was 10.26%,which was significantly lower than 29.73%of the control group （χ2 =4.55,P〈0.05）.34 cases in the ob-servation group and 30 cases in the control group were healed ,these patients were followed up for half a year and one year,and the recurrence rate of peptic ulcer in observation group was significantly lower than that in control group （χ2 =4.51,5.23,all P〈0.05）.Conclusion The bifidobacterium bifidum-sine capsules combined with PPI triple therapy,can increase the eradication rate of HP ,reduce DAR and the recurrence rate of ulcer . Key words: Peptic ulcer; Helicobacter pylori （ HP）; Bifidobacterium bifidum-sine capsules; Curative effect; Security

Effects of Long-term Rofecoxib on Gastric Intestinal Metaplasia: Results of a Randomized Controlled Trial

Gastric cancer and its premalignant gastric lesion, intestinal metaplasia (IM), frequently express cyclooxygenase-2 (COX-2) at high levels. We tested whether long-term use of specific COX-2 inhibitors regress gastric IM. This is a double-blind, randomized, placebo-controlled trial. Individuals with confirmed IM and Helicobacter pylori clearance were randomized to receive rofecoxib 25 mg daily or placebo. Endoscopy was done at baseline, at the end of year 1, and at the end of year 2, with multiple biopsies taken from the antrum and corpus. The primary end point was the proportion of subjects with regression of IM. Secondary end points were the severity of other histologic variables and the proportion of subjects with complete regression of IM. Two-hundred and thirteen subjects with confirmed IM were randomized. The proportion of subjects with the regression of IM did not differ significantly between rofecoxib and placebo groups (antrum, 24.5% versus 26.9%; P = 0.74; corpus, 4.3% versus 2.2%; P = 0.68). Patients on rofecoxib (19.1%) and on placebo (16.1%) had no IM detected in the stomach (P = 0.59). There was also no significant difference in the severity of IM between the two treatment groups (P >or= 0.3). There was no trend to suggest that treatment with rofecoxib for 2 years resulted in the regression of gastric IM. Although our findings cast doubt on the reversibility of gastric IM by COX-2 inhibitor, further studies are needed to establish the role of COX-2 inhibitors in different stages of gastric carcinogenesis.

Floating-Bioadhesive Microspheres Containing Acetohydroxamic Acid for Clearance of Helicobacter Pylori

A new strategy based on gastric retention is proposed for the treatment of Helicobacter pylori. (H. pylori) . A synergism between a floating and a bioadhesive system has been explored. Floating microspheres containing the antiurease drug acetohydroxamic acid (AHA) were prepared by a novel quasi-emulsion solvent diffusion method. The microballons were characterized for size distribution, morphology, drug content, drug release, and in vitro floating property. The microballons were coated with 2% w/v solution of polycarbophil by the air suspension coating method. The bioadhesive property of the microspheres was investigated by the detachment force measurement method. In vitro growth inhibition studies were performed in isolated H. pylori culture. The results suggest that AHA-loaded floating microspheres are superior as potent urease inhibitors whereas urease plays an important role in the colonization of H. pylori. We suggest that an oral dosage containing floating-bioadhesive microspheres may form a useful drug delivery system for the treatment of H. pylori.

Efficacy observation on Yunnan Baiyao ("Equation missing" ) combined with antibiotics in treating Helicobacter pylori related duodenal ulcer) combined with antibiotics in treating Helicobacter pylori related duodenal ulcer

Objective: To observe the clinical efficacy of Yunnan Baiyao ( , YNBY) combined with antibiotics in treating Helicobacter pylori (HP) related duodenal ulcer (DU).Methods: Eighty-two HP positive DU patients were randomly divided into two groups: Treated group (44 cases) used YNBY plus amoxicillin and metronidazole; control group (38 cases) used de-nol plus amoxicillin and metronidazole).Results: After a 2-week treatment course, the effect of epigastric pain relief was 68.3% in treated group, and 44.4% in control group, the difference between them was significant (P < 0.05). Marked effect in acid regurgitation and belching relief was observed in both groups. The rate of DU healing in treated and control group was respectively 88.6% and 89.5%; the clearance of HP 84.1% and 89.5%; and the side-effects 4.5% and 13.5%, with insignificant difference between these two groups.Conclusion: YNBY combined with antibiotics in treating DU, and clearance of HP is an economic, safe and effective therapy.

Duodenal ulcer healing associated with Helicobacter pylori clearance at the end of treatment using ranitidine bismuth citrate-based regimens

Duodenal ulcer healing associated with Helicobacter pylori clearance at the end of treatment using ranitidine bismuth citrate-based regimens

Effect of partial gastrectomy on serum anti-Helicobacter pylori immunoglobulins in peptic ulcer patients

Since biliary enterogastric reflux is suggested to eradicate gastric infection with Helicobacter pylori (HP), we have investigated in a prospective randomized study the effect of partial gastrectomy with either Billroth II or Roux-en-Y anastomosis on infection with HP as assessed by the titers of IgG and IgA antibodies against HP in serum. These antibodies were measured by ELISA in serum of 22 patients before and at 10 days and 6, 15, and 24 months after either Billroth II (N = 11) or Roux-en-Y (N = 11) gastrectomy for peptic ulcer. All patients had HP demonstrated in their preoperative endoscopic gastric biopsies. The preoperative serum IgA antibodies against HP (anti-HP IgA) were increased in 20 of the 22 patients (range 0.21-1.69) while the IgG antibodies (anti-HP IgG) were increased in all 22 patients (range 0.38-1.31). Four of the Billroth II patients had clearance of HP from gastric biopsies accompanied by rapid and pronounced decrease of anti-HP IgA. In contrast, the patients with Roux-en-Y gastrectomy and the Billroth II patients with persistent HP infection had no change in anti-HP IgA after surgery. Anti-HP IgG showed variable results in the four patients without gastric HP infection and was not affected by gastrectomy in the patients with persistent HP infection. We concluded that serum anti-HP IgA, but not anti-HP IgG, is helpful in identifying those patients in whom HP is no longer demonstrable after Billroth II gastrectomy. Gastrectomy with Roux-en-Y anastomosis had no effect on gastric HP infection.

Treatment of Duodenal Ulcer with Sucralfate

Sucralfate attains a healing rate of about 79% for duodenal ulcer in 4 weeks, which is similar to the effects of cimetidine and ranitidine. Whereas cigarette smoking significantly affects duodenal ulcer healing by acid-reducing agents, the healing rates of smokers and non-smokers treated with sucralfate or colloidal bismuth are indistinguishable, suggesting an inherent advantage through the cytoprotective mechanisms of these agents. The 12-month relapse curves for duodenal ulcers initially healed with sucralfate and colloidal bismuth subcitrate closely overlap each other and are significantly lower than the curves for the histamine H2-receptor antagonists. These findings cannot be accounted for by clearance of Helicobacter pylori, on which sucralfate has little effect. Preliminary evidence suggests that the use of acid-reducing agents results in up-regulation of the parietal cells and may help to explain the differences in relapse rates. Sucralfate is superior to placebo and comparable to H2 antagonists in the prevention of duodenal ulcer recurrence.