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Objective:To investigate the impact of the destruction of dorsal motor nucleus of the vagus(DMV)on lower esophageal sphincter pressure in a rat model of acute esophagitis.Methods:A total of 40 male Sprague-Dawley(SD)rats were randomly divided into four groups: the control group, sham group, DMV destruction group, DMV destruction + vagal stimulation group.Two weeks after DMV destruction or sham operation, hydrochloric acid with pepsin was perfused into the esophagogastric junction of rats for 90 min, and lower esophageal sphincter pressure was measured before and after operation and 60 min after acid perfusion.Rats in the control group received assessment of lower esophageal sphincter pressure directly.Rats in the DMV destruction + vagus stimulation group were given electric current stimulation for 30 minutes before and after 15 min of esophageal acid perfusion.Rats were sacrificed after 60 min of the acid perfusion.The esophagus was prepared for hematoxylin and eosin(HE)staining, and the degree of inflammation and the expression of inflammatory cytokines were examined.Results:In the DMV destruction group, lower esophageal sphincter pressure decreased 2 weeks after DMV destruction compared with pre-destruction levels(25.9±8.8 cmH 2O vs.34.0±8.9 cmH 2O, P<0.05), and lower esophageal sphincter pressure decreased after 60 min of acid perfusion compared with pre-destruction levels(18.6±3.6 cmH 2O vs.25.9±8.8 cmH 2O, P<0.01). In the DMV destruction + vagus stimulation group, lower esophageal sphincter pressure increased after vagus nerve stimulation(22.3±2.9 cmH 2O vs.18.6±3.6 cmH 2O, P<0.05). There was no significant difference in lower esophageal sphincter pressure in the sham group before and after sham operation, while the pressure increased after acid perfusion(30.0± 9.5 cmH 2O vs.37.8±5.8 cmH 2O, P<0.05). The degree of inflammation in the lower esophagus was aggravated and the expression of tumor necrosis factor-α, interleukin(IL)-6, IL-1β and prostaglandin E2 in esophageal tissues increased in the DMV destruction group compared with the sham group( P<0.01). The inflammation degree and the expression of inflammatory factors in the lower esophagus improved after vagal nerve stimulation compared with pre-stimulation levels( P<0.01). Conclusions:DMV destruction decreases lower esophageal sphincter pressure and aggravates esophageal inflammation and injury in a rat model of acute esophagitis.Vagus nerve stimulation can strengthen the pressure of the lower esophageal sphincter and improve the inflammation of the lower esophageal segment.
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Objective To investigate the clinical manifestations,endoscopy and pathological features of Behcet's disease (BD) in gastrointestinal systems in elderly patients.Methods Totally 8 patients aged ≥ 60 years with BD were collected.Clinical characteristics and endoscopic performances of gastrointestinal tracts in patients were summarized.All patients were received gastrointestinal biopsy and the histology change was observed.The vasculitis of gastrointestinal tracts was confirmed by histochemical staining.Results The proportion of patients with BD involving the esophagus was 16.7％ (9/54) and among whom 6 cases (11.1 ％) were elderly,so the proportion of BD patients with esophageal lesions in elderly patients was 66.7 ％ (6/9).The proportion of patients with BD involving the ileocolon was 9.3％ (5/54) and 4 cases (7.4％) were elderly patients,so the proportion of BD patients with ileocolon lesions in elderly patients was 80.0％ (4/5).6 patients had retrosternal chest pain,among whom 2 patients with dysphagia and 4 patients with abdominal pain and hematochezia.In the laboratory tests,the levels of erythrocyte sedimentation rate (ESR) and C reactive protein were elevated in 4 cases,and antinuclear antibodies (ANA) and anti-neutrophil cytoplasm antibody(ANCA)were negative in all patients.In the physical examination,oral and genital ulcers in 6 patients,and a history of recurrent oral and genital ulcers were found in the other 2 patients.6 patients had ophthalmia and 4 patients with skin lesions.6 patients had multiple esophageal ulcers,in which shallow ulcers was more common,and the surface of ulcer was clean and white with congestion and edema at the periphery of ulcers.BD involving the ileocecal and ascending colon were found in 4 cases.Typical small vessel vasculitis was the pathological performance.The retrosternal chest pain disappeared and the esophageal ulcers were healed after the treatment.Conclusions Gastrointestinal involvement in BD patients is associated with the the course of disease.Longer duration can increase the possibility of gastrointestinal involvement in BD.Elderly BD patients are more common with esophageal involvement.Rctrosternal chest pain may be a relatively specific clinical symptom in BD involving esophageal tract.Glucocorticoids and (or) thalidomide are effective for the treatment of BD with esophageal involvement.
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Objective To evaluate the clinical efficacy and safety of hydrotalcite chewable tablets in treatment of patients with functional dyspepsia epigastric pain syndrome(EPS), and to investigate the onset time of hydrotalcite after the first dosage and whether use of hydrotalcite in EPS is a costeffective strategy. Methods A multicenter, randomized, open, positive controlled clinical trial was carried out in 240 patients with EPS. The subjects randomly received eigher hydrotalcite or omeprazole for 2 weeks. The improvemcnt and the disappear time of symptoms were evaluated before and after treatment and cost-effective was analyzed between two groups. Results It was demonstrated that both hydrotalcite and omeprazole could relief symptoms after treatment. After treatment for 2 weeks, the total effective rate was 85. 71% in hydrotalcite group and 90. 43% in omeprazole group with no significant difference (P＞0.05). The median onset time of hydrotalcite after first dosage was 0.417 h. The overall direct cost per patient was RMB ￥122. 29 for hydrotalcite treatment and RMB ￥242.95 for omeprazole treatment. The main adverse events included diarrhea, thirst, bloating,headache and belching. No severe adverse event was found in two groups. Conclusions Hydrotalcite has fast effect on relief of EPS symptoms. Use of hydrotalcite is a cost-effective strategy in the management of EPS. It is a safe and effective medicine in treatment of EPS.
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Objective To investigate the efficacy and safety of compound azintamide on dyspepsia symptoms. Methods One hundred and eighty dyspepsia patients were divided into two groups according to dyspepsia symptom related with gastrointestinal disease ( group A) or biliary system disease (group B),whose dyspepsia symptom were not improved by the Domperidone 10 mg tid for 2 weeks. Two tablets of compound azintamide were administered orally following a meal, tid for 2 weeks. The changes of symptoms score of upper abdominal distention, upper abdominal pain or discomfort anorexia and effective rate as well as adverse events were recorded. Results Compound azintamide greatly improved the symptoms of upper abdominal distention, upper abdominal pain or discomfort and anorexia. All symptoms scores were significantly decreased after 2 weeks of compound azintamide (P < 0.01). The effective rate of each symptom and total symptoms score were more than 84.9% and 92.5%. One patient reported mild rash at the fourteenth days, which disappeared 3 days later. Conclusion Compound azintamide showed effective and safety in treatment of patient with dyspepsia symptoms when Domperidone therapy is not satisfactory.
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Objective To observe the effect of atropine and N-nitro-L-arginine methyl ester (L-NAME) on the pressure of lower esophageal sphincter (LESP) regulated by electro-acupuncturing (EA) at Zusanli acupoint (He-Sea, st 36) of stomach meridian and explore the neural mechanism of EA. Methods Forty-eight rats were divided into six groups:control group, EA group, atropine group, atropine+EA group, L-NAME group and L-NAME+EA group. LESP was observed and recorded by using three-channel perfusion manometric measurement system. Results LESP increased significantly under or after EA at Zusanli acupoint. Cholinergic M receptor blocker partly abolished the influence of EA on LESP, but EA could restore the decreased pressure of cholinergic M receptor blocked rats. Nitric oxide synthase (NOS) inhibitor increased LESP, and EA could make it higher. Conclusions The main efferent pathway of regulating effect of EA at Zusanli acupoint on LESP is via the chlinergic nerve of vagus, and other mechanism possibly exits.
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0.20), but decreased the number of nNOS positive cells in central canal (79% of H saline, P
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Objective: To study the clinical features of primary biliary cirrhosis (PBC) in order to facilitate cognition of the disease. Methods: Clinical data of 42 patients clinically and/or histologically diagnosed with PBC were reviewed. Anti mitochondrial antibody (AMA) negative/positive patients as well as the patients who were/were not associated with Sj?gren Syndrome (SS) were compared in terms of clinical, biochemical and immunological features. Results: Among the 42 patients, 78.6%(33/42) of the cases were females; the mean age at diagnosis was (61.1?10.8) years. The most frequent symptoms were fatigue. Serum alkaline phosphatase (ALP), ?-glutamyltranspeptidase (?-GT) and total bile acid (TBA) levels were markedly elevated in the majority of the patients, whereas ALT and AST levels were mildly to moderately elevated. Thirty-one patients had a total bilirubin (TBil) level above normal. The levels of TBil and prothrombin time had positive correlationship with years of the course (P=0.000, r=0.696; P=0.005, r=0.424), whereas serum albumin level had negative correlationship with years of the course (P=0.002, r=-0.462). Thirty-seven patients had elevated serum IgM and 34 patients were AMA/AMA-M2 positive. AMA negative and AMA positive patients were similar in terms of clinical manifestations and liver biochemistries findings. Serum IgM and IgA levels were significantly lower, whereas total cholesterol level was higher in AMA negative patients when compared with AMA positive cases. Fifteen cases were associated with SS, which were similar in terms of clinical, biochemical and immunological features when compared with the PBC patients were not associated with SS. Conclusion: PBC is mostly found in middle aged and old women. Elevated serum ALP, TBA and ?-GT levels together with positive AMA/AMA-M2 can help to diagnose PBC. AMA negative PBC patients are characterized by relatively lower serum IgM and IgA levels and higher total cholesterol level. PBC patients who are associated with SS have not substantial differences in the clinical, biochemical and immunological spectra of the disease.
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Objective To assess the effects of tegaserod on rat with visceral hypersensitivity. Methods Neonatal SD rats were randomized to receive colonic acetic acid irritation between postnatal days 8 and 21 as visceral hypersensitive model (Group H) or by saline intrarectally as control group (Group C). While rats were grown-up, rectal distention (RD) was performed by a balloon rapidly inflated with increasing volumes of saline (0.4, 0.8 and 1.2 ml) for 20 seconds at five-minute intervals. The 5 subgroups of Group H were injected randomly with saline, vehicle (1-methyl-2-thpyrrolidone) or tegaserod at doses of 0.1, 0.3 and 1 mg/kg i.p., respectively. The 2 subgroups of Group C were injected with saline or tegaserod at dose of 1 mg/kg i.p.. RD was performed 10 min after injection and abdominal withdrawal reflex (AWR) was recorded, and then c-Fos expression in spinal cord (L6-S1) was analyzed quantitatively by immunohistochemistry. Results 1) Compared to saline, vehicle did not affect AWR and c-Fos expression. 2) Compared to saline, tegaserod significantly (P
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Objective To observe the changes of plasma ghrelin in patients with severe sepsis and to explore the correlation of the plasma ghrelin and cytokines with sepsis.Methods Choose the healthy volunteer(n=10)as control group,and measure the plasma ghrelin(by ELISA),TNF-?,IL-1?,PCT(procalcitonin)and CRP at the 1st day,3rd day and 10th day in sepsis group(n=26).Results The plasma ghrelin level in sepsis group increased significantly compared with control group(P