Guoxin Zhang

Effect of CYP2C19 genetic polymorphisms on the efficacy of proton pump inhibitor-based triple therapy for Helicobacter pylori eradication: a meta-analysis.

Objective: CYP2C19 polymorphisms have been inconsistently reported to associate with the efficacy of proton pump inhibitor (PPI)‐based triple therapies for eradicating Helicobacter pylori infection. The aim of this meta‐analysis was to determine whether CYP2C19 polymorphism affect H. pylori eradication rates obtained with first‐line PPI‐based triple therapies.

Prevalence and Risk Factors for Helicobacter pylori Infection in Chinese Populations

Background:u2002 The prevalence of Helicobacter pylori is higher in developing countries. The aim of this study was to investigate the prevalence and risk factors of H. pylori infection in areas with high prevalence of gastric cancer in Jiangsu Province, China.

The Interaction Between MiR-141 and lncRNA-H19 in Regulating Cell Proliferation and Migration in Gastric Cancer.

Background/Aims: Non-coding RNAs including miRNA and lncRNA had been reported to regulate gene expression and were both related to cancer progression. MicroRNA-141 (miR-141) has been reported to play a role in the epithelial to mesenchymal transition (EMT) process and H19 has also been demonstrated to promote malignancy in various cancers. We aimed to determine the correlation between miR-141 and H19 and their roles in gastric cancer in this study. Methods: H19 and miR-141 expression were detected by qRT-PCR. By bioinformatic analysis and luciferase assay we examined the correlation between H19 and miR-141 in vitro. Results: H19 expression was found to be inversely correlated to miR-141 expression in gastric cancer cells and tissues. H19 promotes malignancy including proliferation and invasion whereas miR-141 suppresses malignancy in human cancer cells. MiR-141 binds to H19 in a sequence specific manner, and suppresses H19 expression and functions including proliferation and invasion. MiR-141 could also regulate H19 target genes and miR-141 inhibitor restores H19 siRNA function, while H19 regulates miR-141 target gene ZEB1. Conclusion: These results were the first to demonstrate that H19 and miR-141 could compete with each other and affect their target genes in gastric cancer, which provide important clues for understanding the key roles of lncRNA-miRNA functional network in cancer.

Advantages of Moxifloxacin and Levofloxacin-based triple therapy for second-line treatments of persistent Helicobacter pylori infection: a meta analysis

ZusammenfassungZIEL: Das wesentliche Ziel der vorliegenden Meta Analyse war es, die Wirksamkeit und Sicherheit einer Therapie einer persistierenden Helicobacter pylori Infektion mit entweder einer Clarithromycin und 2. Generation Fluorquinolon-basierten Tripel Therapie mit einer Bismuth basierten Quadrupel Therapie zu vergleichen. METHODIK: Es wurde eine systematische Literatur Recherche nach Artikel und Abstracts des Zeitraums 1981–2009 durchgeführt. Durchforstet wurden Medline, PubMed, EMBase, Google Scholar sowie CNKI (chinesisch), Wanfang (chinesisch) Digital Database und recent Digestive Disease Week, United European Gastroenterology Week sowie Konferenzen der European Helicobacter Study Group. Die stufenweise Einengung oder Erweiterung der Recherche erfolgte durch Boolean operators (NOT, AND, OR). 16 Artikel und 4 Abstracts erfüllten die Einschlusskriterien und wurden in die Meta Analyse (Review Manager 4.2.8) einbezogen. ERGEBNISSE: Die berichteten Eradikationsraten zeigten, dass die Clarithromycin basierte Triple Therapie der Bismuth basierten Quadrupel Therapie unterlegen zu sein scheint (OR = 0,53; 95 % CI: 0,35–0,80; P = 0,002). 13 RCTs verglichen eine Laevofloxacin basierte Triple Therapie mit einer Bismuth basierten Quadrupel Therapie – diese 2 Therapiearten unterschieden sich bezüglich ihres Eradikationserfolges nicht signifikant (OR = 1,43; 95 % CI: 0,82–2,51; P = 0,21). Allerdings waren die Eradikationsraten der 10-tägigen Laevofloxacin basierte Triple Therapie einer 7tägigen Bismuth basierten Quadrupel Therapie signifikant überlegen (OR = 4,79; 95 % CI: 2,95–7,79; P < 0,00001). Die Laevofloxacin basierte Tripel Therapie wurde besser vertragen als die Bismuth basierte Quadrupel Therapie (OR = 0,41; 95 % CI: 0,27–0,61; P < 0,0001) und musste auch seltener wegen Nebenwirkungen abgebrochen werden (OR = 0,13; 95 % CI: 0,06–0,33; P < 0,0001). Außerdem lässt das Ergebnis unserer Meta Analyse vermuten, dass die Eradiaktionsraten der Moxifloxacin-basierten Tripel Therapie der Bismuth basierten Quadrupel Therapie geringfügig – allerdings ohne statistische Signifikanz – überlegen ist. SCHLUSSFOLGERUNG: Eine 2. Generation Fluoroquinolon- basierte Tripel Therapie – vor allem das 10tägige Regime mit Laevofloxacin – kann als Behandlungsart 1. Wahl zur Eradikation einer persistierenden Helicobacter pylori Infektion empfohlen werden.SummaryOBJECTIVE: The main aim of this meta-analysis was to compare the efficacy and safety of clarithromycin and second-generation fluoroquinolone-based triple therapy vs. bismuth-based quadruple therapy for the treatment of persistent Helicobacter pylori infection. METHODS: A systematic literature search was conducted for articles and abstracts from 1981 to March 2009 using Medline, PubMed, EMBase, Google Scholar and CNKI (Chinese), Wanfang (Chinese) digital database and recent Digestive Disease Week, United European Gastroenterology Week, and European Helicobacter Study Group conferences were also performed. Boolean operators (NOT, AND, OR) were used in succession to narrow and widen the search. Sixteen articles and four abstracts met the inclusion criteria, and were included in the meta-analysis by using Review Manager 4.2.8. RESULTS: The eradication rates demonstrated that clarithromycin-based triple therapy is inferior to bismuth-based quadruple therapy (OR = 0.53, 95% CI: 0.35–0.80, P = 0.002). Thirteen RCTs compared levofloxacin-based triple therapy vs. bismuth-based quadruple therapy, the eradication rates of the two regimens were shown to have no significant difference (OR = 1.43, 95% CI: 0.82–2.51, P = 0.21). But the eradication rates demonstrated superiority of the 10-day levofloxacin-based triple therapy over 7-day bismuth-based quadruple therapy (OR = 4.79, 95% CI: 2.95–7.79, P < 0.00001). Levofloxacin-based triple therapy was better tolerated than bismuth-based quadruple therapy with lower rates of side effects (OR = 0.41, 95% CI: 0.27–0.61, P < 0.0001), and lower rates of discontinuation of therapy due to adverse events (OR = 0.13, 95% CI: 0.06–0.33, P < 0.0001). Furthermore, our meta-analysis suggested that the eradication rates of the moxifloxacin-based triple therapy has a slight superiority to bismuth-based quadruple therapy, but there was no significant difference between them. CONCLUSION: Second-generation fluoroquinolone-based triple therapy can be suggested as the regimen of choice for rescue therapy in the eradication of persistent H. pylori infection especially 10-day levofloxacin-based triple therapy.

Efficacy of Helicobacter pylori eradication therapy on functional dyspepsia: a meta-analysis of randomized controlled studies with 12-month follow-up.

Background: Whether patients with functional dyspepsia (FD) should receive Helicobacter pylori eradication therapy remains controversial. Aims: This meta-analysis was to evaluate the long-term effects of H. pylori eradication on dyspeptic symptoms of patients with FD, by selecting the most recent well-designed randomized controlled trials. Methods: English-language articles in the medical literature containing information on the long-term (≥12 mo) effects of H. pylori eradication on dyspeptic symptoms in patients with FD were identified by searching the Medline, PubMed, and EMBASE databases. The MeSH and/or keywords included Helicobacter pylori OR H. pylori OR HP; functional dyspepsia OR non-ulcer dyspepsia; eradication OR cure or treatment; and improvement OR resolution. The Review Manager 4.2.2 was used for the meta-analysis. Results: Fourteen randomized controlled studies were included in the meta-analysis. Improvements of dyspepsia symptoms in patients of eradication group were significantly better than in patients of the control group [odds ratio (OR), 1.38; 95% confidence interval (CI), 1.18-1.62] (Z=4.00, P<0.0001) at the end of the follow-up period with low heterogeneity (I2=51.8%, P=0.01). In a subgroup analysis on geographical regions, improvements of dyspepsia symptoms in patients of eradication group were all significantly better than in patients of control group in the European (OR, 1.49; 95% CI, 1.10-2.02), Asian (OR, 1.54; 95% CI, 1.07-2.21), and American populations (OR, 1.43; 95% CI, 1.12-1.83). Conclusions: H. pylori eradication therapy is associated with improvement of dyspeptic symptoms in patients with FD, which is consistently demonstrated in the Asian, European, and American populations.

Effects of Helicobacter pylori Eradication on Gastroesophageal Reflux Disease

Background and Aims:u2002 Helicobacter pylori infection appears to be a protective factor for gastroesophageal reflux disease (GERD). However, H. pylori is associated with the subtype of esophageal carcinoma, and long‐term proton‐pump inhibition usage would cause gastric atrophy in patients with persistent H. pylori infection, which is a precancerous lesion. The relationship between H. pylori infection and GERD is still unclear. We aimed to confirm whether the eradication of H. pylori would worsen or improve symptomatic or endoscopic GERD.

Down-Regulation of miR-141 Induced by Helicobacter Pylori Promotes the Invasion of Gastric Cancer by Targeting STAT4

Background: The association between Helicobacter pylori infection and gastric cancer has been identified recently. However, the molecular mechanism remained largely unknown. Methods and Results: We found that miR-141 was decreased in Helicobacter pylori positive specimens (n=75) compared with negative tissues (n=75). The knockdown of miR-141 enhanced the invasion ability of gastric cancer cells; meanwhile, over-expression of miR-141 could inhibit the abilities of gastric cancer cells in vitro. A luciferase assay revealed that miR-141 was directly bound to the 3-untranslated regions (3-UTR) of STAT4. STAT4 was found up-regulated at mRNA and protein levels, as shown by qRT-PCR and western blot. Over-expression of STAT4 was used to mimic miR-141 action in the invasion of gastric cancer. Conclusion: MiR-141 may play a pivotal role in controlling gastric cancer invasion through regulating STAT4 and maybe a potential target to treat gastric cancer.

Prophylactic Antibiotics Reduce Pancreatic Necrosis in Acute Necrotizing Pancreatitis: A Meta-Analysis of Randomized Trials

Background and Aim: The use of prophylactic antibiotics to prevent infection and reduce mortality in patients with acute necrotizing pancreatitis (ANP) remains controversial. The aim of this study is to perform a systematic review of the data from randomized controlled trials to compare prophylactic antibiotic treatment of patients with ANP versus placebo. Methods: A computerized literature search was conducted using Medline, PubMed, EMBase and Cochrane Central Register of Controlled Trials (CENTRAL) for relevant articles published in English from January 1990 to March 2010. MeSH terms and keywords used to identify articles included ‘antibiotic’, ‘pancreatitis’, and ‘randomized’. Outcome measures were infected pancreatic necrosis (IPN), mortality, nonpancreatic infection (NPN) and need for surgical intervention. Results: Nine trials involving 564 patients were included. Analysis suggested that IPN was significantly reduced by treatment with antibiotics (RR 0.73, 95% CI 0.54–0.98, p = 0.04). Mortality (p = 0.1), NPN (p = 0.07), and need for surgical intervention (p = 0.17) were not significantly reduced by antibiotic treatment. Subsequent subgroup analysis confirmed that antibiotics were statistically superior to controls in reducing of infected necrosis (p = 0.003) and also mortality (p = 0.02) in single-blinded randomized controlled trials. Conclusion: Prophylactic antibiotic treatment reduced occurrence of IPN, but did not affect mortality, NPN, or surgical intervention in patients with ANP.

Genetic polymorphisms in the osteopontin promoter increases the risk of distance metastasis and death in Chinese patients with gastric cancer

BackgroundIn vitro and in vivo studies have suggested that osteopontin (OPN) is associated with many types of cancers. However, no studies have reported the incidence of OPN polymorphisms and the risk of gastric cancer. The aim of this study was to investigate the association between OPN polymorphisms and gastric cancer in a Chinese patient population.MethodsThree genetic variants in the OPN promoter were genotyped using direct sequencing in 200 gastric cancer patients and 200 gender- and age-matched cancer-free controls. The 4-year survival curve was calculated using the Kaplan-Meier method and compared using the log-rank test for each single nucleotide polymorphism (SNP) site. We measured the promoter activity of the -443 T → C polymorphism using a dual luciferase reporter assay.ResultFor the variant at nt -443 (CC), there was a significant difference between the number of patients with stage IV and those with stage I gastric cancer (IA + IB; Pu2009=u20090.014) and between those with stage IV and all other stages of gastric cancer (IA + IB + II + III; Pu2009=u20090.02). For the variant at nt -443 (CT), there was a significant difference between the number of gastric cancer patients with stage IV and those with stage II (Pu2009=u20090.013). The survival rates for patients with the C/C genotype were significantly lower than for patients with the other two genotypes (C/T, T/T). Moreover, significantly higher luciferase activities were observed in the pGL3-C construct compared to the pGL3-T construct.ConclusionsThis study provides the first evidence that variation at nt -443 in the OPN promoter increases the potential for gastric cancer metastasis and subsequent death in the Chinese population.

Levofloxacin-containing triple and sequential therapy or standard sequential therapy as the first line treatment for Helicobacter pylori eradication in China.

To compare the efficacy and the adverse effects of levofloxacin‐containing triple therapy, standard sequential therapy, and levofloxacin‐containing sequential therapy as first‐line treatment for Helicobacter pylori eradication.