BACKGROUND Helicobacter pylori(H.pylori)stands as the predominant infectious agent linked to the onset of gastritis,peptic ulcer diseases,and gastric cancer(GC).Identified as the exclusive bacterial factor associated ...BACKGROUND Helicobacter pylori(H.pylori)stands as the predominant infectious agent linked to the onset of gastritis,peptic ulcer diseases,and gastric cancer(GC).Identified as the exclusive bacterial factor associated with the onset of GC,it is classified as a group 1 carcinogen by the World Health Organization.The elimination of H.pylori plays a crucial role in the primary prevention of GC.While the prevalence has declined in recent decades,H.pylori infection is still highly prevalent in China,accounting for a significant part of the disease burden of GC.Therefore,updated prevalence information for H.pylori infection,especially regional and demographic variations in China,is an important basis for the design of targeted strategies that will be effective for the prevention of GC and application of policies for H.pylori control.AIM To methodically evaluate the occurrence of H.pylori infection throughout China and establish a reference point for subsequent investigations.METHODS A systematic review and meta-analysis was conducted following established guidelines,as detailed in our methodology section.RESULTS Our review synthesized data from 152 studies,covering a sample of 763827 individuals,314423 of whom were infected with H.pylori.We evaluated infection rates in China's Mainland and the combined prevalence of H.pylori was 42.8%(95%CI:40.7-44.9).Subgroup analysis indicated the highest prevalence in Northwest China at 51.3%(95%CI:45.6-56.9),and in Qinghai Province,the prevalence reached 60.2%(95%CI:46.5-73.9).The urea breath test,which recorded the highest infection rate,showed a prevalence of 43.7%(95%CI:41.4-46.0).No notable differences in infection rates were observed between genders.Notably,the prevalence among the elderly was significantly higher at 44.5%(95%CI:41.9-47.1),compared to children,who showed a prevalence of 27.5%(95%CI:19.58-34.7).CONCLUSION Between 2014 and 2023,the prevalence of H.pylori infection in China decreased to 42.8%,down from the previous decade.However,the infection rates vary considerably across different geographical areas,among various populations,and by detection methods employed.展开更多
BACKGROUND Novel oral anticoagulants(NOACs)are commonly used for the anticoagulation of patients with atrial fibrillation.Reports of thrombocytopenic toxicity of NOACs are limited.In this report,we present a case of t...BACKGROUND Novel oral anticoagulants(NOACs)are commonly used for the anticoagulation of patients with atrial fibrillation.Reports of thrombocytopenic toxicity of NOACs are limited.In this report,we present a case of thrombocytopenia likely induced by rivaroxaban,which is an extremely rare adverse drug reaction.CASE SUMMARY A 70-year-old man presented to the cardiovascular department with a chief complaint of intermittent chest tightness and dyspnea over the last five years.Vital signs were within normal limits at presentation,with a heart rate of 65 beats/min,blood pressure of 138/78 mmHg,respiratory rate of 19 breaths/min,and temperature of 36.1°C.Laboratory tests indicated a platelet count of 163×109/L on admission.Anticoagulant therapy with rivaroxaban,a NOAC,was started on the second day of hospitalization.The platelet count decreased to 30×109/L on hospital day 11 and then 10×109/L on day 12.Rivaroxaban was stopped on day 13 when the platelet count decreased to 5×109/L.After the cessation of rivaroxaban,the platelet count returned to normal.The patient was diagnosed with thrombocytopenia,which was likely induced by rivaroxaban.The incidence of thrombocytopenic toxicity of NOACs is extremely low.CONCLUSION Thrombocytopenia during anticoagulation therapy may be associated with a high risk of life-threatening bleeding.For elderly patients,changes in platelet count should be carefully monitored at the beginning of NOAC treatment,and we should be on the alert for bleeding events as well.展开更多
基金Supported by The Zhongyuan Famous Doctor,No.ZYYCYU202012119Scientific Research Special Project of Traditional Chinese Medicine in Henan Province,No.2024ZY2004Scientific Research Special Project of the National TCM Inheritance and Innovation Center of Henan Provincial Health Commission,No.2023ZXZX1093.
文摘BACKGROUND Helicobacter pylori(H.pylori)stands as the predominant infectious agent linked to the onset of gastritis,peptic ulcer diseases,and gastric cancer(GC).Identified as the exclusive bacterial factor associated with the onset of GC,it is classified as a group 1 carcinogen by the World Health Organization.The elimination of H.pylori plays a crucial role in the primary prevention of GC.While the prevalence has declined in recent decades,H.pylori infection is still highly prevalent in China,accounting for a significant part of the disease burden of GC.Therefore,updated prevalence information for H.pylori infection,especially regional and demographic variations in China,is an important basis for the design of targeted strategies that will be effective for the prevention of GC and application of policies for H.pylori control.AIM To methodically evaluate the occurrence of H.pylori infection throughout China and establish a reference point for subsequent investigations.METHODS A systematic review and meta-analysis was conducted following established guidelines,as detailed in our methodology section.RESULTS Our review synthesized data from 152 studies,covering a sample of 763827 individuals,314423 of whom were infected with H.pylori.We evaluated infection rates in China's Mainland and the combined prevalence of H.pylori was 42.8%(95%CI:40.7-44.9).Subgroup analysis indicated the highest prevalence in Northwest China at 51.3%(95%CI:45.6-56.9),and in Qinghai Province,the prevalence reached 60.2%(95%CI:46.5-73.9).The urea breath test,which recorded the highest infection rate,showed a prevalence of 43.7%(95%CI:41.4-46.0).No notable differences in infection rates were observed between genders.Notably,the prevalence among the elderly was significantly higher at 44.5%(95%CI:41.9-47.1),compared to children,who showed a prevalence of 27.5%(95%CI:19.58-34.7).CONCLUSION Between 2014 and 2023,the prevalence of H.pylori infection in China decreased to 42.8%,down from the previous decade.However,the infection rates vary considerably across different geographical areas,among various populations,and by detection methods employed.
文摘BACKGROUND Novel oral anticoagulants(NOACs)are commonly used for the anticoagulation of patients with atrial fibrillation.Reports of thrombocytopenic toxicity of NOACs are limited.In this report,we present a case of thrombocytopenia likely induced by rivaroxaban,which is an extremely rare adverse drug reaction.CASE SUMMARY A 70-year-old man presented to the cardiovascular department with a chief complaint of intermittent chest tightness and dyspnea over the last five years.Vital signs were within normal limits at presentation,with a heart rate of 65 beats/min,blood pressure of 138/78 mmHg,respiratory rate of 19 breaths/min,and temperature of 36.1°C.Laboratory tests indicated a platelet count of 163×109/L on admission.Anticoagulant therapy with rivaroxaban,a NOAC,was started on the second day of hospitalization.The platelet count decreased to 30×109/L on hospital day 11 and then 10×109/L on day 12.Rivaroxaban was stopped on day 13 when the platelet count decreased to 5×109/L.After the cessation of rivaroxaban,the platelet count returned to normal.The patient was diagnosed with thrombocytopenia,which was likely induced by rivaroxaban.The incidence of thrombocytopenic toxicity of NOACs is extremely low.CONCLUSION Thrombocytopenia during anticoagulation therapy may be associated with a high risk of life-threatening bleeding.For elderly patients,changes in platelet count should be carefully monitored at the beginning of NOAC treatment,and we should be on the alert for bleeding events as well.
