• Alternative medicines
• Antiplatelets
• Forrest classification
• Mortality
• Non variceal bleed
• Re-bleed

• Adult
• Algorithms
• Computational Biology
• Dictionaries, Medical as Topic
• Female
• Gastrointestinal Hemorrhage/diagnostic imaging
• Gastrointestinal Hemorrhage/etiology
• Gastroscopy
• Helicobacter Infections/complications
• Helicobacter pylori
• Humans
• Image Interpretation, Computer-Assisted/statistics & numerical data
• Machine Learning
• Male
• Middle Aged
• Peptic Ulcer/diagnostic imaging
• Peptic Ulcer/etiology
• Ultrasonography

• endoscopy
• gastrointestinal bleeding
• guidelines
• hemostasis
• non-steroidal anti-inflammatory drugs
• risk factors

AIM: To investigate the clinical characteristics and outcomes of idiopathic Helicobacter pylori (H. pylori)-negative and drug-negative] peptic ulcer bleeding (PUB).

METHODS: A consecutive series of patients who experienced PUB between 2006 and 2012 was retrospectively analyzed. A total of 232 patients were enrolled in this study. The patients were divided into four groups according to the etiologies of PUB: idiopathic, H. pylori-associated, drug-induced and combined (H. pylori-associated and drug-induced) types. We compared the clinical characteristics and outcomes between the groups. When the silver stain or rapid urease tests were H. pylori-negative, we obtained an additional biopsy specimen by endoscopic re-examination and performed an H. pylori antibody test 6-8 wk after the initial endoscopic examination. For a diagnosis of idiopathic PUB, a negative result of an H. pylori antibody test was confirmed. In all cases, re-bleeding was confirmed by endoscopic examination. For the risk assessment, the Blatchford and the Rockall scores were calculated for all patients.

RESULTS: For PUB, the frequency of H. pylori infection was 59.5% (138/232), whereas the frequency of idiopathic cases was 8.6% (20/232). When idiopathic PUB was compared to H. pylori-associated PUB, the idiopathic PUB group showed a higher rate of re-bleeding after initial hemostasis during the hospital stay (30% vs 7.4%, P = 0.02). When idiopathic PUB was compared to drug-induced PUB, the patients in the idiopathic PUB group showed a higher rate of re-bleeding after initial hemostasis upon admission (30% vs 2.7%, P < 0.01). When drug-induced PUB was compared to H. pylori-associated PUB, the patients in the drug-induced PUB were older (68.49 ± 14.76 years vs 47.83 ± 15.15 years, P < 0.01) and showed a higher proportion of gastric ulcer (77% vs 49%, P < 0.01). However, the Blatchford and the Rockall scores were not significantly different between the two groups. Among the patients who experienced drug-induced PUB, no significant differences were found with respect to clinical characteristics, irrespective of H. pylori infection.

CONCLUSION: Idiopathic PUB has unique clinical characteristics such as re-bleeding after initial hemostasis upon admission. Therefore, these patients need to undergo close surveillance upon admission.

• Peptic ulcer
• Gastrointestinal bleeding
• Helicobacter pylori
• Non-steroidal anti-inflammatory drug

• Adult
• Aged
• Anti-Inflammatory Agents, Non-Steroidal/adverse effects
• Aspirin/adverse effects
• Biopsy
• Breath Tests
• Endoscopy, Gastrointestinal
• Female
• Helicobacter Infections/complications
• Helicobacter Infections/microbiology
• Helicobacter pylori/pathogenicity
• Hemostatic Techniques
• Humans
• Male
• Middle Aged
• Peptic Ulcer Hemorrhage/chemically induced
• Peptic Ulcer Hemorrhage/diagnosis
• Peptic Ulcer Hemorrhage/etiology
• Peptic Ulcer Hemorrhage/microbiology
• Peptic Ulcer Hemorrhage/therapy
• Predictive Value of Tests
• Recurrence
• Retrospective Studies
• Risk Factors
• Severity of Illness Index
• Treatment Outcome

• Diagnosis
• Endoscopy
• Epidemiology
• Nonvariceal bleeding
• Peptic ulcer
• Risk factors
• Timing

Upper gastrointestinal (UGI) bleeding is the most frequently encountered complication of peptic ulcer disease. Helicobacter pylori (Hp) infection and nonsteroidal anti-inflammatory drug (NSAID) administration are two independent risk factors for UGI bleeding. Therefore, testing for and diagnosing Hp infection are essential for every patient with UGI hemorrhage. The presence of the infection is usually underestimated in cases of bleeding peptic ulcers. A rapid urease test (RUT), with or without histology, is usually the first test performed during endoscopy. If the initial diagnostic test is negative, a delayed ¹³C-urea breath test (UBT) or serology should be performed. Once an infection is diagnosed, antibiotic treatment is advocated. Sufficient evidence supports the concept that Hp infection eradication can heal the ulcer and reduce the likelihood of rebleeding. With increased awareness of the effects of Hp infection, the etiologies of bleeding peptic ulcers have shifted to NSAID use, old age, and disease comorbidity.

AIM: To investigate the clinical efficacy of Bifidobacterium tetravaccine tablets and Jinghua Weikang capsules in the eradication of Helicobacter pylori (H. pylori).

METHODS: One hundred and twenty patients with H. pylori infection who were treated from January 2011 to December 2013 at our hospital were randomly and equally divided into three groups: A, B and C. Group A was treated with standard triple therapy, groups B and C were given Bifidobacterium tetravaccine tablets and Jinghua Weikang capsules on the basis of standard triple therapy, respectively. The clinical effects were compared between the three groups.

RESULTS: The rates of H. pylori eradication in groups B and C were higher than that in group A (82.5%, 80.0% vs 72.5%, P > 0.05), but the difference was not significant. There was also no significant difference between groups B and C (P > 0.05). The incidence of adverse reactions was significantly higher in group A than in groups B and C (37.5% vs 12.5%, 10.0%, P < 0.05), although there was no significant difference between groups B and C (P > 0.05).

CONCLUSION: Bifidobacterium tetravaccine tablets and Jinghua Weikang capsules show good clinical effects in H. pylori eradication therapy in terms of improved H. pylori eradication rate and fewer adverse reactions.

• Helicobacter pylori
• Bifidobacterium tetravaccine tablets
• Jinghua Weikang capsules
• Eradication rate
• Clinical efficacy