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Objective:To explore the feasibility of 400 mL Sprite Zero ? in gastric preparation for magnetically controlled capsule endoscopy (MCE) . Methods:A randomized controlled trial at the Department of Gastroenterology of Changhai Hospital, Naval Medical University from December 16th, 2019 to January 15th, 2020 was conducted. The patients and healthy volunteers who intended to receive MCE were randomly divided into the Sprite Zero ? (S) group and the water (W) group at 1∶1. For subjects in the W group, 800 mL water was taken 10 minutes before swallowing the capsule. And for subjects in the S group, 400 mL Sprite Zero ? was taken. The primary endpoint was gastric filling score and the secondary endpoint included the fullness score, gastric transit time (GTT), small bowel transit time (SBTT), completion rate (CR) for small bowel examination and the diagnostic yield. Results:A total of 102 subjects were enrolled, 52 subjects in the S group and 50 subjects in the W group. The median score of gastric filling was 4 at 0-5 min, >5-10 min and >10-15 min after taking the capsule in both groups, with less median liquid consumption in the S group than the W group (500 mL VS 950 mL, P<0.001). The S group showed lower median fullness score (7.0 scores VS 7.5 scores, P=0.030) and higher proportion of patients with GTT less than 30 minutes [69.57% (16/52) VS 27.59% (8/29), P=0.030] compared with the W group. The CR of small bowel examination in the S group was 100.00%, higher than that of the W group (89.66%, P=0.245). Conclusion:Compared with 800 mL water, 400 mL Sprite Zero ? can fully fill the stomach with more comfort. It has the potential to accelerate gastric emptying and improve the CR of small bowel examination, which is feasible for the gastric preparation.
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Objective:To investigate the relationship between pancreatic fibrotic marker transforming growth factor-β(TGF-β) and platelet derived growth factor-BB(PDGF-BB) and serum glycated hemoglobin (HbA1c) levels in patients with type 3c diabetes mellitus secondary to chronic pancreatitis(CP-T3cDM).Methods:The clinical data of 39 patients with CP-T3cDM admitted to the Department of Gastroenterology of the First Affiliated Hospital of Naval Medical University between February 2018 and August 2020 were collected, and the patients' age, gender, body mass index, duration of chronic pancreatitis and diabetes mellitus, smoking history, alcohol consumption history, serum HbA1c level at admission, degree of pancreatic atrophy, morphology of the main pancreatic duct, and treatment of diabetes mellitus were recorded. Serum TGF-β and PDGF-BB were detected by ELISA. Patients were divided into high and low level group according to the median TGF-β and PDGF-BB levels, respectively. Clinical characteristics of patients were compared between the TGF-β and PDGF-BB high and low level group. The correlation between TGF-β, PDGF-BB and HbA1c was analyzed by Spearman's correlation analysis.Results:A total of 39 CP-T3cDM patients were included; 35 were male and 4 were female. The age of first onset of chronic pancreatitis was (42±14) years old, and the duration of diabetes mellitus was 24(4, 36) months. The serum HbA1c level was (7.8±1.6)%, and the serum TGF-β and PDGF-BB levels were 20.5(10.5, 43.1) and 647.5(276.9, 1349.2)pg/ml, respectively. The serum HbA1c levels of patients in the high-level group of serum TGF-β and PDGF-BB were significantly higher than those in the corresponding low-level group [8.6%(7.4%, 9.9%) vs 6.7%(6.2%, 7.8%) and 8.6%(7.4%, 9.6%) vs 6.7%(6.1%, 7.8%), respectively] , and the difference was statistically different (both P value <0.01), while none of other indicators showed statistically significant differences between both groups. The correlation analysis showed that the levels of TGF-β and PDGF-BB were significantly positively correlated with HbA1c level ( r=0.45, 0.53, both P value <0.01). Conclusions:Increased pancreatic fibrosis in patients with CP-T3cDM was an important factor contributing to elevated blood glucose level. Patients with higher serum pancreatic fibrotic factors exhibited a significant increase in HbA1c level.
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Objective:Based on the previous animal experiments, to preliminarily explore the safety and efficacy of self-developed new smartphone-controlled vibrating capsule (VC) in the treatment of patients with functional constipation (FC).Methods:At the Outpatient Department of Gastroenterology, Changhai Hospital, Naval Medical University, 24 patients with FC were prospectively enrolled. The trial process included basic period for ≥two weeks, treatment period for six weeks, and follow-up visits ≥six (once every two weeks). During treatment period, the patients were assigned into sham capsule group, VC at low frequency mode group and VC at high frequency mode group and the patients swallowed 12 corresponding capsules. The safety of VC treatment was evaluated based on the observation the occurrence of adverse events (AE) in patients of three groups, which included abdominal pain, abdominal distention, capsule retention and abnormal laboratory indicators. The efficacy of VC treatment was assessed by comparison of the patients of three groups in mean complete spontaneous bowel movements (CSBM) per week, mean spontaneous bowel movements (SBM) per week, capsule discharge time, patient assessment of constipation quatity of life questionnaire (PAC-QOL), patient assessment of constipation symptom questionnaire (PAC-SYM). Chi-square test, least significant difference- t test, Kruskal-Wallis test, Wilcoxon rank sum test and Fisher exact test were used for statistical analysis. Results:Two patients were lost in follow up. In the end, seven, eight and seven patients were enrolled in sham capsule group, VC at low frequency mode group and VC at high frequency mode group. AE occurred in three patients. At the sixth week of treatment, the difference between average CSBM in one week and baseline of sham capsule group, VC at low frequency mode group and VC at high frequency mode group was 0.0 (0.0, 2.0), 2.0 (1.0, 2.8) and 1.0 (0.0, 5.0), respectively; and the difference between average SBM in one week and baseline of sham capsule group, VC at low frequency mode group and VC at high frequency mode group was -1.0 (2.0, 2.0), 1.0 (-0.8, 2.0) and 1.0 (0.0, 4.0), respectively. During the six weeks of treatment period, the difference between mean CSBM per week and baseline of three, seven and five patients of sham capsule group, VC at low frequency mode group and VC at high frequency mode group was more than one, and the difference between SBM per week and baseline of two, five and five patients was more than one. At the sixth week of treatment, capsule discharge time of VC at low frequency mode group and VC at high frequency mode group was shorter than that of sham capsule group ((65.7±9.3) and (59.1±3.4) h vs. (96.7±10.0) h), and during the whole treatment period capsule discharge time of VC at low frequency mode group and VC at high frequency mode group was shorter than that of sham capsule group ((63.6±8.6) and (59.8±6.6) h vs. (100.5±13.1) h), and the differences were statistically significant ( t=3.119, 3.584, 2.832 and 3.036, all P<0.05). The PAC-SYM score of patients of sham capsule group, VC at low frequency mode group and VC at high frequency mode group during the period of treatment was 14.3±2.0, 9.9±2.3 and 7.0±2.0, respectively, there were no statistically significant differences among the three groups ( P>0.05). The PAC-QOL score of patients of sham capsule group, VC at low frequency mode group and VC at high frequency mode group during the period of treatment was 31.3±4.4, 24.0±3.8 and 13.9±4.1, respectively, and the PAC-QOL score of VC at high frequency mode group was lower than that of sham capsule group, and the difference was statistically significant ( t=2.808, P=0.012), however, there was no statistically significant difference in the PAC-QOL score between VC at low frequency mode group and sham capsule group, and between VC at high frequency mode group and VC at low frequency mode group (both P>0.05). Conclusions:VC can be safely used in patients with FC, which can promote defecation and relieve the symptoms of constipation. However, there is no significant difference in the therapeutic effect of capsules with different vibration frequencies.
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As a progressive and chronic intractable disease, chronic pancreatitis (CP) is generally manifested as early chronic pain, and then exocrine and endocrine insufficiency, and various complications in clinical course. The complex clinical manifestations lead to the controversies over treatment strategies at present, involving a multidisciplinary treatment (MDT) approach. It can enable different professional medical experts to discuss the diagnosis and treatment for patients together during a specific period (online or offline), which is an effective mode for diagnosing and treating complex diseases nowadays. MDT for CP usually begins with lifestyle intervention and drug therapy, and then goes with endoscopic interventions and surgical resection, or their combination. This article reviewed the current status on MDT approaches for CP and shared the MDT experience from Changhai Hospital in order to improve the management of CP course.
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Objective To study the biological characteristics of, antibiotic resistance in and ger-micidal efficacy at different temperatures against Vibrio parahaemolyticus ( V. parahaemolyticus) strains isola-ted from different sources in order to provide reference for clinical treatment and prevention. Methods Stool samples from patients with diarrhea and small seafood product specimens from markets were collected and an-alyzed with biochemical identification method, serotyping analysis, drug susceptibility test and germicidal ef-ficacy test at different temperatures. Results There were 107 V. parahaemolyticus strains isolated from 1166 stool samples of patients with foodborne diarrhea with a positive rate of 9. 18％ and 42 from 72 seafood product samples with a positive rate of 58. 30％. V. parahaemolyticus strains isolated from the foodborne diar-rhea cases were divided into eight serogroups and among them, O3 and O4 were the predominant serogroups, accounting for 49. 53％ and 34. 58％, respectively. Most of the O antigens in small seafood products be-longed to serogroups of O4, O1 and O3, and four strains of O3 : K6 were isolated. Results of the drug sus-ceptibility test showed that both of the clinical isolates and marine product isolates were highly resistant to ampicillin and the drug resistance rates were 94. 39％ and 88. 10％, respectively. Antibiotic-sensitive strains to monocyclicβ-lactams, aminoglycosides, quinolones, carbapenems, tetracyclines and sulfonamides accounted for over 90. 00％ or even nearly 100. 00％. There were 17 (15. 89％) clinical strains and three (7. 14％) marine product isolates resistant to three or more kinds of antibiotics. At 80℃, the bactericidal rate for marine product isolates was 85. 71％ in 60 s and reached 100. 00％ in 90 s. At 90℃ and 100℃, these isolates could be completely killed in 40 s and 30 s. It took 120 s, 90 s and 50 s to kill clinical isolates at 80℃, 90℃ and 100℃, respectively. Conclusions This study systematically analyzed and compared the drug-resistant phenotypes of and the bactericidal efficacy at different temperatures on V. parahaemolyticus strains isolated from clinical samples and marine products. It would provide reference for preventing and con-trolling the spread of V. parahaemolyticus and hospital infection and for studying treatment strategies.
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Aim To study the relationship between the anti-proliferation effect of tetrandrine(Tet) and TGF-β1 in human colon cancer cells.Methods Cell viability assay, Western blot, flow cytometry and Annexin Ⅴ-EGFP staining were introduced to analyze the anti-cancer effect of Tet on HCT116 cells.Real-time PCR, Western blot,cell viability and immunofluorescent were employed to determine the relationship between the anti-cancer effect of Tet and TGF-β1 in HCT116 cells, the relationship between the anti-cancer effect of Tet and PI3K/Akt on HCT116 cells, and how TGF-β1 mediated the anti-cancer effect of Tet on HCT116 cells.Results Compared with the control groups, Tet apparently inhibited the proliferation, and induced cell cycle arrest at G1 phase and apoptosis in HCT116 cells.Tet greatly up-regulated the expression of TGF-β1 either the mRNA or protein level, and exogenous expression of TGF-β1 potentiated the anti-cancer effect of Tet in HCT116 cells, while TGF-β1 inhibitor attenuated it notably.Tet decreased the phosphorylation of Akt1/2/3, but no apparent effect was observed on total protein level of Akt1/2;PI3K inhibitor enhanced the anti-cancer effect of Tet in HCT116 substantially.Exogenous expression of TGF-β1 enhanced the Tet-induced decrease phorphorylation of Akt1/2/3, which was partly reversed by TGF-β1 inhibitor in HCT116 cells.Meanwhile, knockdown of PTEN elevated the level of phorphorylated Akt1/2/3, which was abolished by the exogenous expression of TGF-β1 in HCT116 cells.Conclusion Tet may be a potent candidate drug for colon cancer treatment, and the anti-cancer effect of Tet may be partly mediated by up-regulating TGF-β1 to inactivate PI3K/Akt signal.
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Objective:To explore the lactate metabolism in brain tissue of the mice with early acute hypoxia-ischemia injury,and to provide data support for 9.4T 1 H-NMR spectroscopy in detecting the lactate level clinically.Methods:Eighty Kunming mice were randomly divided into sixteen groups (0 s,20 s,40 s,60 s,2 min,4 min, 6 min,8 min, 10 min, 12 min, 14 min, 16 min, 18 min,and 20 min)according to the duration of hypoxia-ischemia (n=5).The changes of lactate levels were detected by 9.4T 1 H-NMR spectroscopy. Results:After the initiation of hypoxia-ischemia injury,the lactate level began to increase rapidly to the highest value of (6.89 ± 0.34)μmol·g-1 at 20 s,then started to decline quickly from 40 s to 2 min,and eventually decreased to a stable level of (4.85±0.36)μmol·g-1 until 6 min.Compared with control group,the levels of lactate in brain tissue of the mice in hypoxic-ischemic groups were increased (P <0.01).Conclusion:40 s of acute hypoxia-ischemia may be the lactate cerebral neuron threshold during the anaerobic glycolysis. 9.4T1 H-MRS can provide the exact time window for detecting the lactate metabolism.