2018 Northeast Digestive Disease Forum

2018 Northeast Digestive Disease Forum

The "2018 Northeast Digestive Disease Forum," hosted by the Digestive Diseases Branch of the Jilin Provincial Medical Association, the Jilin Provincial Center for Quality Control in Gastroenterology, and the Digestive Diseases Branch of the Changchun Medical Association, and organized by the Third Hospital of Jilin University China-Japan Friendship Hospital, was successfully held from May 4 to 6 in Changchun, Jilin Province.

Professor Wang Jiangbin, Chairman of the Conference, Member of the Digestive Diseases Branch of the Chinese Medical Association, and Director of the Department of Gastroenterology at the China-Japan Friendship Hospital of Jilin University, delivered the opening remarks:

                              Professor Wang Jiangbin's speech

Professor Wang Jiangbin warmly introduced the attending experts and leaders, earning a warm welcome from the participants.

Lead Expert:

Professor Tang Chengwei (Acting Chairman of the Digestive Diseases Branch of the Chinese Medical Association, Director of the Department of Gastroenterology at West China Hospital, Sichuan University)

Professor Han Ying (Chairperson of the Internal Medicine Branch of the Chinese Medical Association, Vice Chairperson of the Liver Disease Branch of the Chinese Medical Association, and Deputy Director of the Department of Gastroenterology at the First Hospital of Air Force Medical University)

Professor Li Yanqing (Vice Chairman of the Digestive Diseases Branch of the Chinese Medical Association, Chairman of the Digestive Endoscopy Branch of Shandong Province, and Vice President of Qilu Hospital of Shandong University)

Professor Dou Xiaoguang (Vice Chairman of the Liver Disease Branch of the Chinese Medical Association, Chairman of the Liaoning Provincial Liver Disease Association, and Director of the Department of Infectious Diseases at Shengjing Hospital Affiliated to China Medical University)

Professor Yuan Yaozong (Member of the Digestive Disease Branch of the Chinese Medical Association, Editor-in-Chief of the *Chinese Journal of Digestive Diseases*, and Director of the Department of Gastroenterology at Ruijin Hospital, Shanghai Jiao Tong University Affiliated Hospital)

Co-Chairs of the Conference:

Professor Guo Xiaozhong (Standing Committee Member of the Digestive Disease Branch of the Chinese Medical Association, Chairman of the Liaoning Provincial Digestive Disease Association, and Director of the Department of Gastroenterology at Shenyang Military Region General Hospital)

Professor Yang Youlin (Member of the Digestive Disease Branch of the Chinese Medical Association, Chairman of the Heilongjiang Provincial Digestive Disease Association, and Director of the Department of Gastroenterology at the First Affiliated Hospital of Harbin Medical University)

Professor Zheng Changqing (Acting Chairman of the Liaoning Provincial Digestive Disease Association, Director of the Department of Gastroenterology II at Shengjing Hospital Affiliated to China Medical University)

Other experts attending the meeting:

Liu Yulan, Lü Nonghua, Xie Weifen, Tian De'an, Zhang Jun, Chen Qikui, Zhang Guoxin, Chen Ping, Zhang Zhiguang, Shi Yongquan, Zuo Xiuli, Wang Yingde, Jiang Chunmeng, Sun Mingjun

Attending leaders:

Xu Shuyou, Executive Vice President of the Jilin Provincial Medical Association

Gu Xiuli, Secretary-General of the Jilin Provincial Medical Association

Professor Zhu Dongdong, Vice President of the China-Japan Friendship Hospital at Jilin University

Vice President Xu Shuyuan, Professor Zhu Dongdong, and Professor Tang Chengwei delivered speeches, jointly wishing the conference a successful conclusion. The academic session then commenced.

                              Professor Qian Jiaming during his lecture

2017 A meta-analysis published this year, which included 100,000 individuals (including the Chinese population), revealed that the Helicobacter pylori (Hp) infection rate in China is approximately 55.8%. To better understand the true prevalence of Hp infection in our country, a rigorous epidemiological survey was conducted across communities, dividing the nation into eight major regions and 32 specific sampling points. The study involved a total of 192 resident committees, with 144 participants surveyed from each committee. The results showed that the Hp infection rate ranged from 21% to 56.28%, underscoring that the situation remains serious.

HP Eradicating Helicobacter pylori holds significant importance for gastric cancer prevention, but the rising rate of antibiotic resistance poses a major challenge to successful Hp eradication. Fortunately, bismuth-based agents—well-known as one of the effective solutions to this issue—are proving particularly promising. Bismuth agents are a type of mucosal protective agent, and there is a wide array of clinically available options in this category. Notably, clinical evidence from both domestic and international studies suggests that combining bismuth agents with other therapies, such as ecabet sodium, rebamipide, or polyprazin zinc, can significantly enhance the rate of H. pylori eradication.

Polypruzine Zinc is primarily an L-carnosine-zinc chelate, originally developed in Japan and backed by nearly 20 years of clinical experience. It was successfully formulated and launched in 2012 by Jilin Boda Weiye Pharmaceutical Co., Ltd. Polypruzine Zinc has a wide range of clinical applications—beyond enhancing the eradication rate of *Hp*, it can also be used for NSAID-related ulcers, post-ESD ulcers, ulcerative colitis, radiation-induced oral mucositis following head and neck radiotherapy, radiation-induced esophagitis during concurrent chemoradiotherapy for small-cell lung cancer, as well as pressure ulcers and bedsores.

Numerous basic research findings indicate that, in enhancing *Helicobacter pylori* (Hp) eradication rates, Proliprazine Zinc not only directly exhibits antibacterial activity, inhibits *H. pylori* colonization, and suppresses urease activity, but also effectively eliminates urease and monochloramine while simultaneously modulating inflammatory factors and boosting antioxidant defenses—mechanisms that collectively lay the foundation for Proliprazine Zinc's enhanced efficacy against Hp. Additionally, rat studies have demonstrated that Proliprazine Zinc possesses a unique mucosal protective mechanism, safeguarding gastric mucosa from damage by upregulating the cytoprotective factor HSP72.

A prospective, controlled study published in *Alimentary Pharmacology and Therapeutics* revealed that the combination of polyprill zinc with lansoprazole, amoxicillin, and clarithromycin significantly boosted the Helicobacter pylori (Hp) eradication rate—from 77% (24 out of 31 patients) to 94% (33 out of 35). Importantly, this regimen showed no significant differences in terms of adverse events such as diarrhea, nausea, vomiting, rash, or taste alterations. Inspired by these findings, a multicenter, prospective, randomized, parallel-group, controlled study is now underway in China, led by Peking Union Medical College Hospital and spearheaded by Professor Jiaming Qian as the principal investigator. The study aims to evaluate the clinical efficacy of polyprill zinc combined with the standard triple therapy in enhancing Hp eradication rates, while also comparing the clinical outcomes associated with different doses of polyprill zinc. Ultimately, the researchers hope to recommend and optimize an improved treatment protocol for eradicating Hp in clinical practice. The study plans to enroll 330 patients, who will be randomly assigned to three groups: - **Control group**: Omeprazole plus amoxicillin plus clarithromycin triple therapy for 2 weeks; - **Treatment group A**: Omeprazole plus amoxicillin plus clarithromycin plus polyprill zinc 75 mg twice daily for 2 weeks; - **Treatment group B**: Omeprazole plus amoxicillin plus clarithromycin plus polyprill zinc 150 mg twice daily for 2 weeks. Preliminary results indicate that both Treatment Group A and Treatment Group B achieved significantly higher Hp eradication rates compared to the control group—yet there was no statistically significant difference between the two treatment groups.

In terms of safety, although the incidence of adverse events was higher in the high-dose polypruzine zinc group compared to the control and standard-dose groups, no serious adverse events were reported.

The research findings suggest:

*  As a chelating agent for the trace element zinc and carnosine in the human body, it can enhance the HP eradication rate when used in combination with conventional triple therapy against Helicobacter pylori.

*   Triple anti-Hp therapy combined with standard-dose polypruzine zinc showed no significant difference in the incidence of adverse reactions compared to triple anti-Hp therapy alone.

*   Triple therapy for *Hp* combined with high-dose polypruzine zinc resulted in more adverse reactions compared to standard-dose polypruzine zinc combined with triple therapy for *Hp*; however, it did not further improve the *Hp* eradication rate.