Serum Gastrin and the Antral Mucosa in Atrophic Gastritis

The gastric antral mucosa was studied histologically in 22 patients with atrophic gastritis, of whom 11 had high levels and 11 had normal levels of serum gastrin. The antrum was graded histologically from normal to grade 3 gastritis. All patients with hypergastrinaemia (nine seropositive and two seronegative for parietal cell antibody) had either a normal antrum or minimal (grade 1) antral gastritis. In contrast all but one patient without raised serum gastrin (nine seronegative and two seropositive for parietal cell antibody) had severe (grades 2-3) antral gastritis. Thus circulating gastrin levels observed in patients with gastritis and achlorhydria can be directly related to the presence or absence of antral mucosal damage.Comparison of the histological appearances of the antral mucosa with serum gastrin and parietal cell antibody status has provided a basis for the separation of two distinctive forms of atrophic gastritis.     

胃复春联合三联疗法治疗慢性萎缩性胃炎患者的临床疗效及对血清胃泌素、胃动素及降钙素原水平的影响

目的:探讨胃复春联合三联疗法治疗慢性萎缩性胃炎患者的临床疗效及对血清胃泌素、胃动素及降钙素原水平的影响。方法:选择我院收治的慢性萎缩性胃炎患者96例,将其随机分为对照组与观察组,每组各48例。对照组患者给予三联抗HP治疗,观察组在对照组基础上给予胃复春片治疗,两组患者均连续治疗4周。比较两组患者的临床疗效,治疗前后血清胃泌素、胃动素、降钙素原(PCT)、白介素-6(IL-6)及肿瘤坏死因子-α(TNF-α)水平的变化。结果:治疗后,对照组患者临床总有效率(81.25%)明显低于观察组(93.75%)(P0.05);两组患者血清胃泌素、胃动素、PCT、IL-6及TNF-α水平与本组治疗前比较均明显降低,且观察组患者治疗后以上指标均明显低于对照组(P0.05)。结论:胃复春联合三联疗法治疗慢性萎缩性胃炎可显著提高临床疗效,可能与其有效抑制患者胃泌素及胃动素分泌,缓解炎症反应有关。     

Acid Secretion and Serum Gastrin Levels in the Zollinger-Ellison Syndrome

Thirteen cases of patients with the Zollinger-Ellison syndrome were reviewed. In two cases the diagnosis was made by incidental biopsy of small liver nodules at operation for peptic ulcer disease.Seven patients had gastric secretory tests which showed a basal acid output to maximum acid output ratio of more than 65 percent. Five patients had bao:mao ratios less than 50 percent.A 30-month interval between incidental discovery of tumor and clinically evident disease was observed in two patients. Recurrence of symptoms after excision of tumor was noted after a similar interval in another case.Serum gastrin levels, before total gastrectomy, were elevated in all cases. The lowest preoperative level in this series of patients was 550 picograms per ml (normal 100 to 150 picograms). They were diagnostic in two patients with normal gastric secretory studies. The levels fell to normal following total gastrectomy in six patients. Two patients still had elevated levels five years and 14 years after total gastrectomy. One was discovered to have a parathyroid adenoma with hypercalcemia.Total gastrectomy was curative in all the patients with the Zollinger-Ellison syndrome; lesser operations were not.     

慢性多灶萎缩性胃炎患者胃酸分泌与Hp感染及血清胃泌素的关系

目的:探讨多灶萎缩性胃炎(BAG)患者胃酸分泌与幽门螺杆菌(HP)感染及血清胃泌素水平的关系。方法:根据病理结果将60例确诊的慢性BAG患者分为轻度、中度、重度BAG组,监测各组患者24小时胃内PH值的变化、血清胃泌素水平及HP感染情况。结果:随着萎缩程度的加重,HP阳性率、胃内中位PH值及算数均数p H值逐渐升高,血清胃泌素水平逐渐降低;轻度、中度、重度BAG组组间中位p H值、算数均数p H值及血清胃泌素水平比较有显著差异(均P0.05);重度BAG组HP感染与轻度组、中度组比较有统计学差异(均P0.05),而轻度组HP感染与中度组差异无统计学意义(P0.05)。结论:随着慢性BAG萎缩程度的加重,HP阳性率和p H值逐渐升高,血清胃泌素水平逐渐降低。HP感染、胃泌素水平及胃酸分泌水平三者相互影响,相互作用。     

甘海胃康胶囊治疗慢性浅表性胃炎的临床疗效分析

目的:探讨甘海胃康胶囊治疗慢性浅表性胃炎的临床疗效。方法:选择2013年3月到2015年3月我院消化内科收治的慢性浅表性胃炎患者128例,根据随机抽签法分为治疗组与对照组各64例,对照组服用多潘立酮片治疗,治疗组在对照组基础上给予甘海胃康胶囊,两组均治疗4周。之后对两组治疗效果,中医评分及生活质量评分情况进行考察。结果:治疗组总有效率为96.9%,对照组总有效率为84.4%,治疗组明显高于对照组(P0.05)。治疗后治疗组与对照组的中医评分分别为2.19±1.11分和5.09±1.56分,都明显低于治疗前的17.34±1.34分和17.39±1.45分(P0.05),同时组间对比差异明显(P0.05)。治疗后治疗组的生理功能、总体健康、生理职能、社会职能、生命活力、情感职能与精神健康明显高于对照组(P0.05)。结论:甘海胃康胶囊治疗慢性浅表性胃炎能有效缓解临床症状,提高治疗疗效,有利于患者生活质量的改善,值得推广应用。     

小建中颗粒治疗慢性浅表性胃炎合并消化不良的效果观察

目的:观察小建中颗粒在慢性浅表性胃炎合并消化不良中的应用效果。方法:选取我院收治的慢性浅表性胃炎合并消化不良患者166例,采取数字随机法分成观察组(n=83)和对照组(n=83)。对照组采取常规西药治疗,观察组在对照组基础上采取小建中颗粒治疗,比较两组临床效果。结果:观察组与对照组总有效率分别为91.57%、79.52%,观察组总有效率高于对照组,差异具有统计学意义(P0.05)。两组不良反应发生率比较,差异无统计学意义(P0.05)。结论:小建中颗粒在慢性浅表性胃炎合并消化不良中的应用效果显著,可复合奥美拉唑进行治疗,保证安全的基础上提高临床疗效。     

Netazepide,a Gastrin Receptor Antagonist,Normalises Tumour Biomarkers and Causes Regression of Type 1 Gastric Neuroendocrine Tumours in a Nonrandomised Trial of Patients with Chronic Atrophic Gastritis

Introduction

Autoimmune chronic atrophic gastritis (CAG) causes hypochlorhydria and hypergastrinaemia, which can lead to enterochromaffin-like (ECL) cell hyperplasia and gastric neuroendocrine tumours (type 1 gastric NETs). Most behave indolently, but some larger tumours metastasise. Antrectomy, which removes the source of the hypergastrinaemia, usually causes tumour regression. Non-clinical and healthy-subject studies have shown that netazepide (YF476) is a potent, highly selective and orally-active gastrin/CCK-2 receptor antagonist. Also, it is effective in animal models of ECL-cell tumours induced by hypergastrinaemia.

Aim

To assess the effect of netazepide on tumour biomarkers, number and size in patients with type I gastric NETs.

Methods

We studied 8 patients with multiple tumours and raised circulating gastrin and chromogranin A (CgA) concentrations in an open trial of oral netazepide for 12 weeks, with follow-up 12 weeks later. At 0, 6, 12 and 24 weeks, we carried out gastroscopy, counted and measured tumours, and took biopsies to assess abundances of several ECL-cell constituents. At 0, 3, 6, 9, 12 and 24 weeks, we measured circulating gastrin and CgA and assessed safety and tolerability.

Results

Netazepide was safe and well tolerated. Abundances of CgA (p<0.05), histidine decarboxylase (p<0.05) and matrix metalloproteinase-7(p<0.10) were reduced at 6 and 12 weeks, but were raised again at follow-up. Likewise, plasma CgA was reduced at 3 weeks (p<0.01), remained so until 12 weeks, but was raised again at follow-up. Tumours were fewer and the size of the largest one was smaller (p<0.05) at 12 weeks, and remained so at follow-up. Serum gastrin was unaffected.

Conclusion

The reduction in abundances, plasma CgA, and tumour number and size by netazepide show that type 1 NETs are gastrin-dependent tumours. Failure of netazepide to increase serum gastrin further is consistent with achlorhydria. Netazepide is a potential new treatment for type 1 NETs. Longer, controlled trials are justified.

Trial Registration

European Union EudraCT database 2007-002916-24 https://www.clinicaltrialsregister.eu/ctr-search/search?query=2007-002916-24 ClinicalTrials.gov {"type":"clinical-trial","attrs":{"text":"NCT01339169","term_id":"NCT01339169"}}NCT01339169 http://clinicaltrials.gov/ct2/show/{"type":"clinical-trial","attrs":{"text":"NCT01339169","term_id":"NCT01339169"}}NCT01339169?term=yf476&rank=5     

胃复春和瑞巴派特联合治疗慢性萎缩性胃炎临床疗效观察

目的:观察胃复春和瑞巴派特联合治疗慢性萎缩性胃炎(CAG)的临床疗效,以探索更好的治疗慢性萎缩性胃炎的临床方法。方法:选择经胃镜检查符合慢性萎缩性胃炎患者150例,随机分为瑞巴派特组、胃复春组和联合治疗组各50例,联合治疗组给予胃复春和瑞巴派特,疗程均为l2周,观察治疗前后症状变化,并复查胃镜及活检进行组织病理学改善的评估。并考察联合治疗组治疗前后血液流变学变化。结果:组织病理学改善方面联合治疗组总有效率为92%,明显优于各组总有效率;症状改善方面联合治疗组优于瑞巴派特组和胃复春组,联合治疗组治疗前后血液流变学变化差异有统计学意义(P<0.01)。结论:联合应用胃复春和瑞巴派特可有效提高慢性萎缩性胃炎的临床疗效。     

Serum Parathyroid Hormone Levels in Chronic Endemic Fluorosis

Endemic waterborne fluorosis is a public health problem in Isparta, a city located in southern Turkey. Fluoride is a cumulative element that increases metabolic turnover of the bone and also affects the homeostasis of bone mineral metabolism. There are number of similarities between the effects of excess parathyroid hormone (PTH) and fluorosis on bone. So fluoride might show its effect via PTH. We aimed to determine PTH levels in patients with endemic fluorosis to estimate the possible toxic effects of chronic fluoride intake. Fifty-six patients with endemic fluorosis and 28 age-, sex-, and body-mass-index-matched healthy controls were included in this study. Endemic fluorosis was diagnosed according to the clinical diagnosis criteria of Wang. The urine fluoride levels of fluorosis patients were significantly higher than those of control subjects as expected (1.9 ± 0.1 vs. 0.4 ± 0.1 mg/L, respectively; P < 0.001). PTH levels in fluorosis group were significantly higher than control group (65.09 ± 32.91 versus 47.40 ± 20.37, respectively; P = 0.01). The results of our study demonstrate that serum PTH levels are increased in patients with endemic fluorosis. Fluoride, by interfering calcium balance, may be the cause of secondary hyperparathyroidism.     

小柴胡汤加减联合奥美拉唑对慢性胃炎具有治疗增效作用

本研究选取本院收治的慢性胃炎患者114例并根据治疗方法不同分为对照组和观察组。对照组患者采用奥美拉唑治疗,观察组患者采用奥美拉唑联合小柴胡汤加减治疗,分析小柴胡汤加减联合奥美拉唑对慢性胃炎血清表皮生长因子(EGF)、胃黏膜氧化酶-2 (COX-2)蛋白表达情况的影响及护理对策。研究结果表明,治疗前两组患者胃镜检查充血水肿、糜烂、黏膜白相、颗粒增生发生率比较无统计学差异(p>0.05);治疗后,观察组患者各项指标发生率低于对照组(p<0.05);治疗前,两组患者血清EGF、Bcl-2、CRP和胃黏膜COX-2、P-p65表达水平比较无统计学差异(p>0.05),治疗后发现观察组患者血清EGF水平高于对照组,血清Bcl-2、CRP和胃黏膜COX-2、P-p65表达水平低于对照组(p<0.05);治疗前,两组患者在躯体功能、躯体职能、躯体疼痛、情感职能、心理健康评分等生活质量评分上比较无统计学差异(p<0.05),治疗后,观察组患者各项评分高于对照组(p>0.05)。本研究初步结论说明,小柴胡汤加减联合奥美拉唑治疗慢性胃炎疗效显著,可改善患者血清EGF、Bcl-2和胃黏膜COX-2表达水平,提高患者生活质量。     

小儿慢性胃炎的消化道外表现(附864 例报道)

目的:分析和总结小儿慢性胃炎的消化道外表现。方法:选择2008年1月~2008年10月哈尔滨医科大学附属第二医院儿科门诊诊治的经腹部胃区叩诊法确诊为慢性胃炎的患儿864例,建立随访卡片,分析和总结其消化道内及消化道外的临床表现。结果:864例患儿常见的消化道症状依次为腹痛、恶心呕吐、便秘、上腹压痛。消化道外表现依次为头痛、刀枪刺、鼻出血、胸痛、多动抽动、手足搐搦。消化道外表现的发病率并不低于消化道表现,特别是头痛的发病率高达58.54%。腹痛、恶心呕吐症状缓解得最快,其次是头痛、头晕、胸闷、胸痛,多动症状较晚缓解,腹部叩痛的消失时间最晚。结论:小儿慢性胃炎的胃肠道外表现广泛存在,且极易与脑炎、心肌炎误诊,值得关注。头痛、胸痛的产生原因可能与内脏-内脏之间的牵涉痛有关。     

胃癌与萎缩性胃炎的血清拉曼光谱数据分析

利用激光诱导拉曼光谱技术,测定了萎缩性胃炎患者、胃癌患者血清的拉曼光谱。采用主成分分析法和判别分析法对拉曼光谱数据进行了分析和处理,得到辨别胃癌和萎缩性胃炎的准确率为92％。