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OBJECTIVE:To observe the efficacy and safety of proton pump inhibitors combined with Compound digestive en-zyme tablet in the treatment of epigastric pain syndrome with abdominal distension. METHODS:156 patients with epigastric pain syndrome with abdominal distension were randomly divided into control group(75 cases)and observation group(81 cases). Con-trol group was given 40 mg Esomeprazole enteric-coated tablet for once half an hour before breakfast;observation group was addi-tionally given 243.6 mg Compound digestive enzyme tablet immediately after meal,3 times a day. The treatment course for both groups was 2 weeks. Clinical efficacy,clinical symptom score,pepsinogenⅠ(PGⅠ),pepsinogenⅡ(PGⅡ),2,4 h postprandial gastric emptying rate before and after treatment,and incidence of adverse reactions in 2 groups were observed. RESULTS:The to-tal effective rate in observation group was significantly higher than control group,the difference was statistically significant (P0.05). Before treatment, there were no significant differences in the clinical symptom score,PGⅠ,PGⅡand 2,4 h postprandial gastric emptying rate(P>0.05). After treatment,clinical symptom score in 2 groups were significantly lower than before,and observation group was lower than control group;PGⅠ and PGⅡ in observation group were significantly higher than before and control group,the differences were statistically significant(P0.05). CONCLUSIONS:The efficacy of pro-ton pump inhibitors combined with Compound digestive enzyme tablet is superior to the proton pump inhibitors in the treatment of epigastric pain syndrome with abdominal distension,with similar safety.
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OBJECTIVE:To observe the clinical efficacy and safety of lactulose combined with Bacillus subtilis bifarous via-ble bacteria in the treatment of functional constipation(FC). METHODS:In a randomized double blind controlled study,60 FC pa-tients were randomly assigned into treatment group(28 cases)and control group(32 cases). Both groups received lactulose orally. Treatment group additionally receive B. subtilis bifarous viable bacteria,and control group additionally received placebo continually. 2 weeks later,both groups stopped taking lactulose but continued to take adjunctive drug till 4th week. The defecate frequencies, stool property,constipation symptoms,quality of life and ADR were compared between 2 groups before treatrnent and 2nd,4th week cofter treatment. RESULTS:In the second week ,the defecate frequencies,stool property and constipation symptoms of both groups were significantly improved,with statistical significance (P<0.05). Compared with the control group in the fourth week, these constipation symptoms of treatment group were improved more significantly,with statistical significance (P<0.05). In the fourth week,aspects of quality of life in both groups were significantly improved,with statistical significance(P<0.05);physical discomfort scores,satisfaction scores and total scores of treatment group were improved significantly,compared with the control group,there was statistical significance (P<0.05). There were no severe ADR in both groups. CONCLUSIONS:Lactulose com-bined with B. subtilis bifarous viable bacteria can effectively relieve FC,improve abdominal symptoms and slow the recurrence of constipation,which is safe and reliable.
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Objective To investigate the clinical efficacy and safety of Jianwei xiaoshi oral liquid combined with mosapride on treating postprandial distress syndrome( PDS ). Methods Eighty cases patients with PDS diagnosed according to Rome-Ⅲ PDS diagnostic criteria were randomly assigned into treatment group and control group. Patients in treatment group were treated with jianwei xiaoshi oral liquid( 1 bottle/times,3 tiems/d,after meals)and mosapride,and in the control group were taken mosapride(5 mg/times,3 times/d, before meals)only for 4 weeks. After the end of treatment,the improvement of the symptoms,the total symptoms score,the total effective rate and adverse drug reaction were recorded. Results After the treatment,symptoms were relieved in both groups. The total symptoms score of the treatment group was(2. 90 ± 1. 39)scores,lower than that in before((11. 14 ± 1. 86)scores),and the difference was significant(t=22. 328,P﹤0. 01). The total symptoms score in treatment group was(2. 90 ± 1. 39)scores,significantly lower than the control group((4. 94 ±2. 03)scores;t =5. 217,P ﹤0. 01). The total effective rate was 87. 80%(36/41),66. 67%(26/39)in treatment and control group,and the difference was significant( t=5. 122,P﹤0. 05). There was no significant in terms of adverse drug reaction in two groups during the treatment. Conclusion Jianwei xiaoshi oral liquid combined with mosapride is a safe and effective treatment of PDS patients,which is better than using mosapride alone.
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OBJECTIVE:To observe the clinical efficacy and safety of prucalopride in the treatment of functional constipation (FC). METHODS:In prospective self-controlled study,87 female patients with FC were selected and given prucalopride 2 mg,1 time per day. The total course was four weeks. The defecate frequency,stool property and constipation symptom grade were ob-served before and after treatment. Related adverse drug reaction were observed during treatment. RESULTS:During the period of treatment,the defecate frequency was gradually increased,the stool property was gradually improved,and the constipation symp-tom grade of the patients was also improved. The difference had statistical significance before and after treatment(P<0.01). No sig-nificant adverse drug reaction was found during the study. CONCLUSIONS:Prucalopride is a safe and effective treatment for pa-tients with FC.
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Objective To investigate the relationship between helicobacter pylori(HP)eradication and curative effect of gastroe-sophageal reflux disease(GERD) .Methods Two hundred and fifty four patients with GERD were prospectively recruited for endo-scope and acid reflux evaluation .According to the results of gastroscope ,the eligible patients were divided into non-erosive reflux disease (NERD) and erosive esophagitis (EE) group ,and each divided into HP positive and HP negative group ,the HP positive group were randomly divided into the anti HP treatment group and not .These patients were assigned to rabeprazole triple therapy (the anti HP treatment group) or rabeprazole(20 mg ,twice per day) single(other groups) for 10 d ,then rabeprazole (20mg ,twice per day) was given to all patients until two months .Then all patients underwent acid reflux evaluation ,EE group underwent endos-copy ,and all patients underwent a 13 C urea breath test 4 weeks after cessation of rabeprazole to determine HP status .Results One hundred and seventy nine GERD patients were included in the study(NERD group 119 cases ,including anti HP treatment group 47 cases ,not anti HP treatment group 32 cases ,HP negative group 40 cases ;EE group 60 cases ,including anti HP treatment group 24 cases ,not anti HP treatment group 15 cases ,HP negative group 21 cases) .HP was eradicated in 76 .6% of the NERD anti HP treatment group and in 75 .0% of the EE anti HP treatment group .Overall ,there is no difference between the anti HP treatment group and other groups on these aspects ,including symptom、esophagitis and acid reflux improvement .Conclusion There are no significant correlation between HP eradication and GERD .
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Utilizing standardized patient(SP) for classroom simulation is common in current medical education. In this paper, incentive measures and combination of SP with theoretical examination, simulated people and clinical practice were proposed after in-depth analysis of advantages and disadvan-tages of using medical students as SP in terms of recruitment, training, and application. All these mea-sures were intended to promote the development of simulative medical education that in turn to cultivate students to be competent in practice.
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Objective To discuss the accuracy and objectivity of student standardized patients (SSP) in objective structured clinical examination(OSCE). Methods On March 30 and 31, 2013, 168 seven-year program medical students of class 2006 and 2007 took part in OSCE. Differences in as-sessment results between SPP and those given by professional doctors at 3 SP sites(angina pectoris SSP station, acute cholecystitis SSP station, depression SSP station) were analyzed. Each site had 4 items for assessment, with a total score of 100. Scores were given in strict accordance with a set of unified scoring rules. Counting data were presented as x±s. Data were verified using t test. P<0.05 was considered statis-tically considerable. Results At angina pectoris station, respective scores of SSP and professional physi-cians were 85.2±7.1 and 85.5±6.6, P=0.688. At acute cholecystitis station, respective score of SSP and professional physicians were 89.1±5.2 and 88.2±6.2, P=0.150. At depression station, respec-tive score of SSP and professional physicians were 79.8±7.5 and 78.2±7.0, P=0.078. Conclusion There is no statistical difference between scores given by SSP and those given by the physicians in OSCE. This proves that SSP who received standardized training delivers fair and accurate results in OSCE , and therefore is recommended for future application.
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<p><b>OBJECTIVE</b>To study the preventive effects of Lycium barbarum polysaccharide (LBP) on the development of alcoholic fatty liver (AFL) in rats and its possible mechanisms.</p><p><b>METHODS</b>One hundred twenty-five Wistar rats were randomly divided into 4 groups: a blank control group, with distilled water intragastric infusion (GI); an alcohol group, with alcohol GI; a 5% LBP plus alcohol GI group; and a 10% LBP plus alcohol GI group. Liver pathologic changes were studied together with the activity of serum ALT, AST, GGT, the activity of liver SOD, GSH-PX and the content of liver MDA, GSH, H2O2; CYP2E1 gene and protein expressions were also detected.</p><p><b>RESULTS</b>At the end of ten weeks, the activity of serum AST [(132.3+/-25.7) U/L, (127.5+/-29.1)U/L] and GGT [(1.9+/-0.5)U/L, (1.8+/-0.7)U/L] of the two LBP groups were all significantly lower than those of the alcohol group [serum AST (245.7+/-32.1) and GGT (4.4+/-0.6)]. At the end of ten weeks, the content of liver MDA [(5.1+/-0.3) nmol/mg, (5.1+/-0.4) nmol/mg] and H2O2 [(135.4+/-23.5) mmol/g, (132.6+/-31.8) mmol/g] of the two LBP groups were significantly lower than those of the alcohol group [MDA (14.5+/-3.2) nmol/mgprot) and H2O2 (328.5+/-45.6)]. The activity of SOD [(206.7+/-13.2)U/L, (203.2+/-18.8)U/L], GSH-PX [(13.5+/-1.4)U/mg/min, (13.6+/-1.5)U/mg/min] and the content of GSH [(65.1+/-11.0)mg/g, (66.6+/-11.1) mg/g] of the two LBP groups were all significantly higher than those of the alcohol group [SOD (116.5+/-13.6)U/mg/min, GSH-PX (7.2+/-1.6)U/mg/min and the content of GSH (30.5+/-10.7)mg/g] (P less than 0.01). At the end of five weeks, levels of CYP2E1 gene and protein expression of the two LBP groups were 0.39+/-0.04, 0.40+/-0.06 and 3.49+/-0.36, 3.29+/-0.30 respectively. At the end of ten weeks, levels of CYP2E1 gene and protein expression of the two LBP groups were 0.41+/-0.05, 0.42+/-0.08 and 3.58+/-0.30, 3.36+/-0.37 respectively. They were all significantly lower than those of the alcohol group [the gene expression (5 week: 0.74+/-0.05, 10 week: 1.02+/-0.08) and the protein expression (5 week: 5.63+/-0.44, 10 week: 7.90+/-0.26)]. There were no typical alcoholic fatty liver pathologic changes observed in the two LBP groups.</p><p><b>CONCLUSION</b>LBP can effectively prevent AFL. This may be due to its effects in inhibiting the hepatocyte CYP2E1 expression and prevention of lipid peroxidation.</p>
Subject(s)
Animals , Male , Rats , Cytochrome P-450 CYP2E1 , Metabolism , Drugs, Chinese Herbal , Therapeutic Uses , Fatty Liver, Alcoholic , Drug Therapy , Metabolism , Hydrogen Peroxide , Lipid Peroxidation , Liver , Metabolism , Phytotherapy , Rats, WistarABSTRACT
Case Study embodies the target teaching model with the teacher as the leading guidance and the students as the main part.Making the best design and application will help to develop high-guality medical talents.
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Diagnostics is a very important course as a bridge connecting the basic course with the clinical course. There are many problems which are very difficult to resolve in the traditional diagnostics teaching. If we widely use computer human patient simulator and establish clinical skill teaching mode, then we will greatly improve the quality and efficiency of the diagnostics teaching.
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Objective:To study the effect of Lycium Barbarum Pclysaccharide(LBP)on the expression of hepatocyte cytochrome P4502E1(CYP2E1) in rat model of alcoholic fatty liver(AFL).Methods: The AFL rats models were established by ethanol intragastric infusion in ten weeks,then,5% and 10% LBP and 10% GSH intragastric infusions were adopted to treat those AFL model rats.Liver pathologic changes were observed and CYP2E1 gene and protein expressions as well as the contents of malondialdehyde(MDA) and glutathione(GSH) in liver were detected and compared with those in the control group,treatment groups and abstinence treatment group.Results: Fatty degeneration in liver recovered normally in the LBP-treated groups.LBP could inhibit the expressions of CYP2E1 gene and protein,reduce the content of MDA,and increase the content of GSH.The curative effect of LBP was of no significant difference compared with GSH,but had more effect than abstinence treatment.Conclusion: LBP can prevent AFL though inhibiting the hepatocyte CYP2E1 expression markedly.
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In order to raise international comprehensive medical talents to have strong competition capability,the bilingual teaching is on the rise in the domain of medical education. Questionnaire-based survey among the 5-year-proguam medicinal undergraduate students was conducted to investigate the students'learning condition,acquaintanceship and requirements on the bilingual teaching so as to further reform and explore ways to improve the quality of bilingual teaching
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Objective To compare the effects of tibolone and cisapride on gastrointestinal motility in menopausal patients with functional dyspepsia (MPFD).Methods Fifty-three MPFD and 31 MPFD complicated with bile reflux were divided into 3 groups randomly.They were treated with tibolone,cisapride and both drugs for 4 weeks,respectively.The gastric emptying,serum motilin and intragastric bile were measured before and after the treatment.Results The 30-min gastric emptying rates of all groups were significantly improved (P
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OBJECTIVE:To observe the efficacy of Qianggan capsule in the treatment of nonalcoholic fatty liver.METHODS:28 patients with nonalcoholic fatty liver disease were randomly divided into experimental group (n=16) and control group (n=12).Both groups were given basic treatment of hepatoprotective drug for six months.Experimental group were treated with Qianggan capsule additionally.Clinical symptom,hepatic function,the biomarkers of oxidative stess,hepatic fibrosis indicators of 2 groups' before and after treatment were observed as well as liver biopsy.RESULTS:As compared with before treatment,experimental group were improved significantly in respects of GSH-PX,SOD,MDA,HA,PcⅢ,ⅣC,LN,TIMP-1,histopathological score (P
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Objective: To establish an experimental animal model of chromic alcoholic fatty liver.Methods: Fifty three Wister rats were divided into four groups: control group and model groups(lower dose ethanol group?medium dose ethanol group and higher dose ethanol group).The rats in model groups were induced by ethanol intragastric infusion of 40%(v/v)ethanol orally [7g/(kg?d) for lower group?8 g/(kg?d) for medium group and 9 g/(kg?d) for higher group],two times a day for the first 4 weeks.Ethanol intragastric infusion of 50%(v/v)ethanol orally [8 g/(kg?d) for lower group,9 g/(kg?d) for medium group and 10 g/(kg?d) for higher group],two times a day for the second 4 weeks.Then,the liver was examined by Ultrasonography.The pathologic changes were observed and the amount of ALT?AST??-GT in serum were detected at the end of the eighth week.Results: At the end of eighth week,serum AST and ?-GT levels were increased significantly in model groups.The typical fatty liver pathologic changes of chronic alcoholism were observed in rats in medium and higher dose model groups.Conclusions: Experimental model of chronic alcoholic fatty liver can be established in rats with ethanol intragastric infusion.
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Objective:To study the effect of Lycium Barbarum Polysaccharide(LBP) on the activity and gene expression of hepatocyte cytochrome P4503A(CYP3A) in rat model with alcoholic fatty liver (AFL). Methods:The AFL rats models were established by ethanol intragastric infusion for ten weeks. Then,those AFL model rats were treated with 5% and 10% LBP and 10% GSH intragastric infusion. Liver pathologic changes were observed and the activity of CYP3A and its gene expression as well as the contents of malondialdehyde(MDA) and glutathione(GSH) in liver were detected and compared among the control group,treatment group and abstinence treatment group. Results:Fatty degeneration in liver recovered normally in the LBP treatment groups. LBP could inhibit the expression of CYP3A gene,reduce the activity of CYP3A and the content of MDA,and increase the content of GSH. The curative effect of LBP was not significantly different from that of GSH,but greater than that of abstinence treatment. Conclusion:LBP can prevent AFL through markedly inhibiting the hepatocyte CYP3A activity and gene expression.
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Objective:To investigate the effect of tibolone on the symptoms of functional dyspepsia in menopausal women.Methods:143 menopausal patients with functional dyspepsia were divided into 3 groups at random.They were treated with tibolone or cisapride or both drugs respectively for 4 weeks.The scores of symptoms including epigastric pain and fullness,abdominal distention after meal,early satiety and belching were recorded before and after 2 or 4 weeks' treatment.From the 3 guoups we drew out 20 patients at random.The gastric emptying was measured before and after 4 weeks' treatment respectively.Results:The symptoms of epigastric pain and fullness,abdominal distention after meal were improved after 2,4 weeks' treatment in three groups.Either tibolone or tibolone combined with cisapride remarkably relieved early satiety and belching,but no response was observed in the treatment of cisapride.The combination of tibolone and cisapride did not show better effect than tibolone treatment alone.The 30-min gastric emptying rates of all groups were significantly improved ( P 0.05).Conclusion:Compared with cisapride,tibolone can increase gastric emptying and show better relief for the symptoms of functional dyspepsia in menopausal patients.
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Objective:To evaluate the effect of hydrotalcid combined with Tibolone,a compound with the effects of estrogen,progestogen and androgen on the menopause patients with bile-reflux gastritis and 24-hour intragastric bile.Methods:Nineteen menopause women with bile-reflux gastritis proven by gastroscope and 24-hour intragastric bile monitoring were divided into 2 groups at random, which were treated with hydtotalcid 1.0g three times a day and the same dose of hydrotalcid combined with Tibolone 2.5mg one time a day.The severity of the symptoms including heartburn,epigastric distention,nausea and bile vomiting was investigated before and after 2,4 weeks treatment.Twenty-four hour intragastrie bile monitoring was also reexamined.Results:The severity of all the symptoms in the two groups decreased greatly after 2 weeks treatment.After 4 weeks treatment,the severity of all the symptoms decreased further.The total fraction time of bile reflux,the time of the longest bile reflux in two groups decreased greatly after treatment ( P