Gastric cancer is one of the major types of cancer threatening human health worldwide. Its pathogenesis has not been fully elucidated, and patients are often diagnosed at an advanced stage. The oral cavity is the second largest microbial pool after the intestine in the human body, and thus the relationship between oral bacteria and human health is attracting increasing interest. Oral bacteria are closely related to gastric cancer and potentially serve as noninvasive diagnostic screening biomarkers for the disease. Imbalance in and displacement of these bacteria can promote the occurrence and development of gastric cancer. Hence, this article reviews the association between oral bacteria and gastric cancer, aiming to provide a basis for further elucidating the pathogenesis of gastric cancer and screening it early through noninvasive methods and serve as a reference for subsequent related research.

Objective:To evaluate the influence of Helicobacter pylori ( H. pylori) infection on anxiety and depression in patients with chronic gastritis. Methods:From December 1 2020 to June 30 2021, 387 patients with chronic gastritis who visited the outpatient Department of Gastroenterology, the First Hospital Affiliated to Air Force Medical University were continuously recruited. According to the status of current H. pylori infection, the patients were divided into H. pylori uninfected group and H. pylori infected group. The general demographic information of patients was collected. Hamilton anxiety scale, Hamilton depression rating scale-24, Pittsburgh sleep quality index (PSQI) and gastrointestinal symptom rating scale (GSRS) were filled in. The detection rates of anxiety and depression were compared between the H. pylori uninfected group and the H. pylori infected group according to demographic characteristics. Chi-square test and multiple logistic regression analysis were used for statistical analysis. Results:Finally, 360 patients with chronic gastritis were enrolled, including 200 patients in H. pylori uninfected group and 160 patients in H. pylori infected group. The detection rates of anxiety and depression of the H. pylori infected group were both higher than those of the H. pylori uninfected group (48.1%, 77/160 vs. 30.0%, 60/200; 25.0%, 40/160 vs. 12.5%, 25/200), and the differences were statistically significant ( χ2=12.39 and 9.39, P<0.001 and=0.002). The detection rate of anxiety of male patients in the H. pylori infected group was higher than that in the H. pylori uninfected group (45.1%, 32/71 vs. 24.5%, 27/110); the detection rate of depression of female patients in the H. pylori infected group was higher than that in the H. pylori uninfected group (30.3%, 27/89 vs. 11.1%, 10/90), and the differences were statistically significant ( χ2=8.27 and 10.09, P=0.004 and 0.001). The detection rates of anxiety and depression of patients less than 48 years old in the H. pylori infected group were both higher than those in the H. pylori uninfected group (46.2%, 37/80 vs. 21.9%, 21/96; 20.0%, 16/80 vs. 7.3%, 7/96), and the differences were statistically significant ( χ2=11.73 and 6.20, P=0.001 and 0.013). The detection rates of anxiety and depression of the patients with high school education and below in the H. pylori infected group were higher than those in the H. pylori uninfected group (56.5%, 48/85 vs. 31.7%, 38/120; 32.9%, 28/85 vs. 14.2%, 17/120), and the differences were statistically significant ( χ2=12.57 and 10.24, P<0.001 and =0.001). The results of multivariate analysis showed that H. pylori infection, history of hypertension, PSQI score ≥8, GSRS score ≥7, chronic superficial gastritis and chronic atrophic gastritis were independent risk factors of anxiety in patients with chronic gastritis( P<0.001, =0.013, =0.001, <0.001, =0.036, =0.021), and the risk of anxiety of patients with H. pylori infection was 2.509 times as much as that in uninfected patients (95% confidence interval 1.512 to 4.163). H. pylori infection, PSQI score ≥8, GSRS score≥7, and having overnight dish ≥3 times per week all were independent risk factors of depression in patients with chronic gastritis( P=0.004, =0.002, <0.001, =0.001). The risk of depression in patients with H. pylori infection was 2.563 times as much as that in uninfected patients (95% confidence interval 1.356 to 4.846). Conclusion:H. pylori infection is correlated to anxiety and depression in patients with chronic gastritis, and it is an independent risk factor of anxiety and depression in patients with chronic gastritis.

Background:Duodenal neuroendocrine tumors(DNETs)are rare tumors,their disease characteristics are currently not well understood.At present,there are no research data on non-ampullary region DNETs in China.Aims:To analyze the clinical characteristics of patients with non-ampullary region DNETs in order to guide clinical practice.Methods:The clinical data ofnon-ampullary region DNETs diagnosed in the First Affiliated Hospital of Air Force Military Medical University from June 2011 to July 2022 were collected.Using the method of retrospective study,analyze the clinical characteristics of patients.Results:Twenty-two non-ampullary region DNETs patients were screened.Among them,8(36.4%)patients'tumor diameter<2 cm,14(63.6%)patients'tumor diameter≥2 cm.When non-ampullary region DNETs were diagnosed,the main clinical symptoms were abdominal distension(59.1%),followed by abdominal pain(41.0%).When diagnosed,half(50%)of patients with non-ampullary DNETs with tumor diameter<2 cm have no clinical symptoms.The clinical symptoms of non-ampullary DNETs patients with tumor diameter≥2 cm were mainly abdominal distension(85.7%),followed by abdominal pain(57.1%),and a few(14.3%)patients had no clinical symptoms.After diagnosed,the survival time of patients with tumor diameter<2 cm was longer than that of patients with tumor diameter≥2 cm(P=0.048).By the end of follow-up,the median survival time of patients with non-ampullary region DNETs was 451.0 months.Six patients had died,all of their tumor diameter were≥2 cm at diagnosis.Three of patients who died had stage Ⅳ at diagnosis,and all had liver metastases.Patients with tumor diameter<2 cm underwent surgical treatment and all survived after surgery.Conclusions:Abdominal distension is the main clinical manifestation of non-ampullary region DNETs patients,and the organ that is more likely to metastasize is the liver.The survival time of patients with non-ampullary region DNETs with tumor diameter<2 cm was longer than that of patients with tumor diameter≥2 cm.

Spasmolytic polypeptide expressing metaplasia(SPEM)is a kind of metaplasia of gastric mucosa.There are three hypotheses of its origin,including chief cell transdifferentiation,stem cell differentiation,and pre-SPEM hypotheses.Currently,animal models are commonly used for the mechanism research.According to results of the researches,SPEM plays a role in the repair of gastric mucosal damage,Helicobacter pylori infection and the development of gastric cancer.This paper provides an overview of the above issues and the multiple ways of modeling the SPEM.

Background:Therapeutic drug monitoring(TDM)has emerged as the important method for managing loss of response to infliximab.The effect of reactive and proactive TDM on clinical outcomes in inflammatory bowel disease(IBD)is uncertain.Aims:To evaluate the effect of proactive and reactive TDM of infliximab on the prognosis of patients with IBD.Methods:Clinical data of 99 IBD patients treated with IFX from January 2017 to October 2021 at the First Affiliated Hospital of Air Force Military Medical University were retrospectively analyzed,including 34 patients with proactive TDM and 65 patients with reactive TDM.The rate of treatment failure,IBD-related surgery or hospitalization were compared between the two groups.Logistic regression analysis was used to determine the independent risk factors of treatment failure.Results:The median follow-up of the patients was 21(13,32)months.The rate of treatment failure,IBD-related hospitalization rate of proactive TDM group were significantly lower than those of reactive TDM group(P<0.05),however,no significant difference in IBD-related surgery rate was found between two groups(P=0.081).Univariate analysis showed that ileocolonic resection before TDM,antibodies to infliximab(ATI)and reactive TDM might be correlated with treatment failure(P<0.05).Logistic regression analysis showed that reactive TDM(OR=5.829,95%CI:1.070-31.754,P=0.042)was the risk factor of treatment failure,and ileocolonic resection before TDM(OR=0.119,95%CI:0.019-0.736,P=0.022)was the protective factor of treatment failure.Conclusions:Compared with reactive TDM group,proactive TDM can significantly decrease the rate of treatment failure and IBD-related hospitalization rate.Reactive TDM is the risk factor of treatment failure,and ileocolonic resection before TDM is the protective factor of treatment failure.

Humans ; Bile Reflux/complications* ; Cross-Sectional Studies ; Risk Factors ; Gastric Mucosa

BACKGROUND: With the development of traditional Chinese medicine research, berberine has shown good efficacy and safety in the eradication of Helicobacter pylori (H. pylori). The present study aimed to evaluate the efficacy and safety of triple therapy containing berberine, amoxicillin, and vonoprazan for the initial treatment of H. pylori. METHODS: This study was a single-center, open-label, parallel, randomized controlled clinical trial. Patients with H. pylori infection were randomly (1:1:1) assigned to receive berberine triple therapy (berberine 500 mg, amoxicillin 1000 mg, vonoprazan 20 mg, A group), vonoprazan quadruple therapy (vonoprazan 20 mg, amoxicillin 1000 mg, clarithromycin 500 mg, colloidal bismuth tartrate 220 mg, B group), or rabeprazole quadruple therapy (rabeprazole 10 mg, amoxicillin 1000 mg, clarithromycin 500 mg, colloidal bismuth tartrate 220 mg, C group). The drugs were taken twice daily for 14 days. The main outcome was the H. pylori eradication rate. The secondary outcomes were symptom improvement rate, patient compliance, and incidence of adverse events. Furthermore, factors affecting the eradication rate of H. pylori were further analyzed. RESULTS: A total of 300 H. pylori-infected patients were included in this study, and 263 patients completed the study. An intention-to-treat (ITT) analysis showed that the eradication rates of H. pylori in berberine triple therapy, vonoprazan quadruple therapy, and rabeprazole quadruple therapy were 70.0% (70/100), 77.0% (77/100), and 69.0% (69/100), respectively. The per-protocol (PP) analysis showed that the eradication rates of H. pylori in these three groups were 81.4% (70/86), 86.5% (77/89), and 78.4% (69/88), respectively. Both ITT analysis and PP analysis showed that the H. pylori eradication rate did not significantly differ among the three groups (P >0.05). In addition, the symptom improvement rate, overall adverse reaction rate, and patient compliance were similar among the three groups (P >0.05). CONCLUSIONS The efficacy of berberine triple therapy for H. pylori initial treatment was comparable to that of vonoprazan quadruple therapy and rabeprazole quadruple therapy, and it was well tolerated. It could be used as one choice of H. pylori initial treatment.
Humans ; Amoxicillin/therapeutic use* ; Helicobacter pylori ; Anti-Bacterial Agents ; Clarithromycin/therapeutic use* ; Rabeprazole/therapeutic use* ; Berberine/therapeutic use* ; Bismuth ; Helicobacter Infections/drug therapy* ; Drug Therapy, Combination ; Treatment Outcome ; Proton Pump Inhibitors/therapeutic use*

Background: The efficacy of ustekinumab (UST) in the treatment of patients with inflammatory bowel disease (IBD) has been affirmed abroad, but its efficacy and safety have not been reported in China due to its short term of use. Aims: To analyze the clinical efficacy and safety of UST in the treatment of IBD. Methods: The clinical data of IBD patients treated with UST from November 2020 to June 2022 in the First Affiliated Hospital of Air Force Medical University were analyzed retrospectively. Results: A total of 46 patients with IBD treated with UST were enrolled, including 41 patients with Crohn’s disease (CD) and 5 patients with ulcerative colitis (UC). At the 8

Background: Gastric mucosal atrophy and intestinal metaplasia (IM) are precancerous conditions of gastric cancer. Although Moluodan has been used in the treatment of chronic atrophic gastritis (CAG), there is little study on efficacy evaluation of Moluodan based on pathological stages. Aims: To assess the efficacy of Moluodan on reversal of gastric mucosal atrophy and IM based on OLGA and OLGIM staging systems, and to analyze the related factors. Methods: A total of 104 patients with CAG and IM from October 2019 to January 2022 at Xijing Hospital of Air Force Medical University were enrolled retrospectively in this study. All the patients received Moluodan treatment (one bag each time, three times daily) for 6 months. Changes of OLGA and OLGIM stages before and after treatment, and the related factors affecting the efficacy were analyzed. Results: After treatment with Moluodan for 6 months, the reversal rates for gastric mucosal atrophy and IM were 47.1% (49/104) and 51.0% (53/104), respectively, and the overall efficacy was 65.4% (68/104). There were 49.3% (34/69) and 52.4% (22/42) of patients with higher OLGA and OLGIM stages (III-) reversed to lower stages (0-Ⅱ), respectively. In addition, patients with OLGA and OLGIM stage III- showed a higher reversal rate than those with stage -Ⅱ (all P<0.01). No correlations were found between the demographic data, life and dietary styles, family history of gastric cancer, operation history, comorbidities, severity of mucosal inflammation and the efficacy of Moluodan (all P>0.05). Conclusions: Moluodan could reverse gastric mucosal atrophy and IM effectively in patients with CAG, which suggests that Moluodan has good potential in prevention of gastric cancer.

Chronic atrophic gastritis (CAG) and gastric intestinal metaplasia (GIM) significantly increase the risk of gastric cancer. Blocking the development of CAG and GIM would help to decrease the incidence of gastric cancer. It was revealed that eradication of Helicobacter pylori could reverse gastric mucosa atrophy. Recent studies reported that GIM could also be reversed to a certain extent. Clinical studies demonstrated that Lamb’s tripe extract and vitamin B12 capsule exhibited significant reversal effect on GIM. The present study systemically reviewed the diagnosis and treatment of CAG and clinical application of Lamb’s tripe extract and vitamin B12 capsule, and established the specialist instruction that would guide the reversal treatment of CAG and GIM.