Biomedical subjects

F L Hu

Publications and source records attributed to F L Hu.

13 recordsLinked to original sources

PubMed2001

Three-day lansoprazole quadruple therapy for Helicobacter pylori-positive duodenal ulcers: a randomized controlled study.

AIM: To compare the efficacy and tolerability of a 3-day quadruple therapy with a standard 7-day triple therapy in eradicating Helicobacter pylori infection and healing duodenal ulcers. METHODS: Patients with H. pylori-positive duodenal ulcers were randomized to receive either lansoprazole 30 mg, clarithromycin 500 mg, and metronidazole 400 mg twice daily for 7 days (LCM-7) or lansoprazole 30 mg, clarithromycin 500 mg, metronidazole 400 mg, and bismuth subcitrate 240 mg twice daily for 3 days (LCMB-3). No pre- or post-treatment acid suppression was used. Follow-up endoscopy was performed at week 6. RESULTS: A total of 118 patients were recruited. Sixty patients in the LCM-7 group and 53 patients in the LCMB-3 group returned for endoscopy. Intention-to-treat eradication rates were 87% and 86% (P=0.94) and per protocol eradication rates were 87% and 94% (P=0.29) in the LCM-7 and LCMB-3 groups, respectively. Per protocol and intention-to-treat ulcer healing rates were 98% and 98% in LCM-7 and 100% and 91% in LCMB-3, respectively. There were no significant differences in efficacy in relation to the initial metronidazole and clarithromycin susceptibility. Significant reduction in the duration of side-effects was found in the LCMB-3 group. CONCLUSION: The 3-day quadruple therapy is highly effective, better tolerated and can be considered as a first-line therapy in duodenal ulcer management.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMed2000

Comparison of lansoprazole-based triple and dual therapy for treatment of Helicobacter pylori-related duodenal ulcer: an Asian multicentre double-blind randomized placebo controlled study.

BACKGROUND: [corrected] In Asian countries with limited resources, clarithromycin-based triple therapy may not be readily available. There are also few direct comparisons of different regimens in Asia. AIM: To compare two lansoprazole-based non-clarithromycin triple therapies and one dual therapy in a prospective double-blind placebo-controlled study of Helicobacter pylori eradication and duodenal ulcer healing. METHODS: Fourteen centres in Asia participated in this study. Patients with acute duodenal ulcer who were H. pylori-positive were recruited. They were randomized to receive: (a) lansoprazole 30 mg b.d., amoxycillin 1 g b.d. and metronidazole 500 mg b.d. for 2 weeks (LAM-2 W), or (b) LAM for 1 week and placebo (LAM-1 W), or (c) lansoprazole 30 mg b.d., amoxycillin 1 g b.d. and placebo for 2 weeks (LA-2 W). Upper endoscopy was repeated at week 6 to check for duodenal ulcer healing. Symptoms and side-effects were recorded. RESULTS: A total of 228 patients were recruited, and two patients took less than 50% of the drugs. H. pylori eradication rates (intention-to-treat) were 68 out of 82 (83%) with LAM-2 W, 55 out of 71 (78%) with LAM-1 W and 43 out of 75 (57%) with LA-2 W. There were significant differences (P=0. 001) in eradication rates when comparing either LAM-2 W or LAM-1 W with LA-2 W. The eradication rate in patients with metronidazole resistant H. pylori strains were significantly lower than those with metronidazole sensitive strains (P=0.0001). The duodenal ulcer healing rates at week 6 were 85%, 85% and 72% in LAM-2 W, LAM-1 W and LA-2 W, respectively (P=0.065). Side-effects occurred in 13%, 11% and 9% in LAM-2 W, LAM-1 W and LA-2 W, respectively. H. pylori eradication and initial ulcer size were factors affecting duodenal ulcer healing. CONCLUSIONS: This Asian multicentre study showed that 1-week lansoprazole-based triple therapy without clarithromycin has similar efficacy in H. pylori eradication and ulcer healing compared with a 2-week regimen. Both triple therapies were significantly better than dual therapy in H. pylori eradication. Therefore, 1-week lansoprazole-based triple therapy is as safe and effective as 2-week therapy in eradication of H. pylori infection and healing of duodenal ulcer in these Asian centres.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMed1993

Molecular basis of cystathionine beta-synthase deficiency in pyridoxine responsive and nonresponsive homocystinuria.

Cystathionine beta-synthase (CBS) deficiency is an autosomal recessive disorder associated with multisystem clinical disease. We analyzed PCR amplified products from patients' RNA and genomic DNA. Direct sequencing of the entire coding region of the CBS gene revealed a G-919 to A transition in exon 8, resulting in replacement of Gly 307 by Ser (G307S) in the protein. The mutation was detected in one allele of patient L171 of French/Scottish ancestry and in both alleles of patient L198 of Irish ancestry. Amplifying and sequencing exon 8 from the genomic DNA showed that both parents of L198 were heterozygotes for G307S. The pathogenicity of the mutation was demonstrated in an expression experiment. The mutant protein was apparently stable in E.coli extracts and lacked catalytic activity. Sequencing of exon 8 revealed the G307S mutation in five additional families. All patients have pyridoxine nonresponsive homocystinuria. We have now observed this mutation in 9 of 52 apparently unrelated alleles of varied ethnic backgrounds. All 9 are from patients with Celtic (Irish/English/Scottish/French) ancestry in either one or both parents. The G307S mutation was detected in 50% (9 of 18) of the Celtic alleles in our series. The second mutation found in exon 8 is the I278T mutation, which was described previously in one allele of a pyridoxine responsive patient. This missense mutation was detected in one allele of a pyridoxine nonresponsive patient and in both alleles of a pyridoxine responsive patient. The latter suggests that I278T is probably associated with pyridoxine responsiveness.

Adult↗

PubMed1993

[Comparison of acid and Helicobacter pylori in ulcerogenesis of duodenal ulcer disease].

To test the efficacy of short-term ranitidine and antibacterial drugs in patients with H. Pylori associated duodenal ulcer disease and to compare the importance of acid and H. Pylori in ulcerogenesis, 90 outpatients were randomly assigned to one of five regimens: ranitidine, 150 mg in the morning and at bedtime; gentamicin, 40 mg tid; terramycin, 500 mg tid; furazolidone, 100 mg tid; or berberine, 300 mg tid. The patients were evaluated endoscopically, microbiologically and histologically before and 6 weeks after oral administration of the drugs. There were no significant differences among the 5 groups with regard to age, sex, duration of disease, nonsmokers and ulcer size. The efficacy of ranitidine and antibacterial drugs was as follows: ulcer healing: ranitidine 97%; antibacterial drugs 53%-67%; H. Pylori clearance, ranitidine 3%, antibacterial drugs 40%-60%; improvement of accompanying antral gastritis, ranitidine 7%, antibacterial drugs 67%-73%; disappearance of active antral gastritis, ranitidine 7%, antibacterial drugs 50%-71%. We conclude that the healing of duodenal ulcer is not influenced by the presence of H. Pylori, and does not appear to be associated with improvement of accompanying antral gastritis and disappearance of active antral gastritis. These findings suggest that acid secretion is more important than H. Pylori in ulcerogenesis.

Adult↗

PubMed1990

[Comparison of colloidal bismuth subcitrate with ranitidine in healing and relapse of Campylobacter pylori-associated duodenal ulcers].

Eighty patients with Campylobacter pylori-associated duodenal ulcer disease were randomly allocated to receive colloidal bismuth subcitrate (CBS)tablet 120 mg four times a day or ranitidine 150 mg twice daily in a trial comparing the effects of these drugs in short-term healing and post-healing relapse rates of duodenal ulceration. At 8 weeks 88.1% (37/42) of those on CBS and 92.1% (35/38) of those on ranitidine had ulcers healed. The difference is not significant. After ulcer healing, the cumulative rates of relapse, as determined endoscopically, for symptomatic and asymptomatic ulcers were 19.4% (6/31) for CBS and 46.7% (14/30) for ranitidine at 6 months (P less than 0.05) and 41.9% (13/31) for CBS and 73.3% (22/30) for ranitidine at 12 months (P less than 0.05). As campylobacter pylori was cleared in 35 of the 42 patients (83.3%) in the CBS group, while only one of the 38 patients (2.63%) in the ranitidine group (P less than 0.005), it is possible that the clearance of Campylobacter pylori by CBS is instrumental to the reduction of the rate of reulceration.

Adult↗

PubMed1988

Use of a multinational survey to provide clinical guidelines for upper gastrointestinal bleeding in developing countries.

The OMGE multinational survey of patients with upper gastrointestinal bleeding demonstrated that it was possible to predict patient outcome, using a computer and a database of information from many centres. It remained to be seen whether this database could be used in specific remote areas of the world. To answer this question, two areas have been studied, Sikkim and China. In Sikkim, when the computer-aided prognostic system was used, 69% of patients put into a high-risk group for rebleeding actually did so; and 54% died. By contrast, only 2% of patients placed into a low-risk group for rebleeding did so. As there is little computer technology in Sikkim, a simplified scoring system was developed which gave the same predictive accuracy as the computer system. In China there was a slightly lower accuracy with both systems. Hence a new database and scoring system were created, using only information from Chinese patients. This database improved the results. From the studies it is suggested that these types of systems can be of value to patients in remote areas by targeting patients at high risk rebleeding or dying, so that the scarce resources available can be best used.

China↗

PubMed1988