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Objective:To investigate the effect of diabetic retinopathy (DR) on macular edema (ME) after cataract phacoemulsification in diabetic cataract patients and its risk factors.Methods:A total of 170 diabetic cataract patients (170 eyes) who underwent cataract phacoemulsification in the department of ophthalmology, BenQ Medical Center Affiliated to Nanjing Medical University from June 2017 to June 2019 were selected. All patients underwent monocular cataract phacoemulsification. They were divided into DR group (100 cases) and non diabetic retinopathy group (NDR group, 70 cases) according to whether or not DR was combined. The improvement of visual acuity and fundus lesions were compared between the two groups, the correlation between the severity of DR and the incidence of macular fovea retinal thickness and ME was analyzed, and the risk factors of DR were analyzed. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of diabetes course, vascular endothelial growth factor (VEGF) and interleukin-6 (IL-6) on ME.Results:Compared with NDR group, the DR group had better postoperative best corrected visual acuity (BCVA), larger area of vascular leakage and bleeding. The retinal thickness of fovea was significantly thickened, and the incidence of ME in DR group was significantly higher than that in NDR group (all P<0.05). The severity of DR was positively correlated with the retinal thickness of fovea and the incidence of ME (all P<0.05). The duration of diabetes, VEGF and IL-6 were independent risk factors for DR (all P<0.05). The best critical values for predicting me were 4.7 years, 127.82 pg/ml and 136.45 pg/ml, respectively. The combination of the three has higher diagnostic value. Conclusions:DR can accelerate the postoperative ME of diabetic cataract patients, and is positively correlated with the severity of DR. The duration of diabetes, VEGF and IL-6 are not only independent risk factors of DR, but also have high predictive value for the occurrence of ME.
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Background/Aims@#Achalasia is a rare disease, but the incidence is increasing recently. Peroral esophageal myotomy (POEM) is an effective treatment.Regurgitation is a common symptom before and after POEM. Our aim is to investigate the factors related to preoperative and postoperative reflux symptoms. @*Methods@#Our study was retrospective. The achalasia patients diagnosed by high-resolution manometry and gastroscopy were divided into reflux group and non-reflux group before and after POEM, respectively. General information, symptoms, POEM information, and manometric results were compared. @*Results@#(1) Ninety-six of 130 patients had reflux symptoms before POEM. The lower esophageal sphincter pressure (LESP) in the reflux group was significantly higher than the non-reflux group (P = 0.023), while integrated relaxation pressure (IRP) was similar. The reflux group had longer esophagus than the non-reflux group (P = 0.006). Reflux symptoms were not related to subtypes of achalasia.(2) Twenty-five of 84 patients had reflux symptoms after POEM. Postoperative Eckardt scores, LESP, and 4-second IRP (4sIRP) were significantly lower than the preoperative values (P < 0.001). The preoperative values and POEM information were similar between the postoperative 2 groups and there was no significant difference in the presence of preoperative reflux symptoms between 2 groups.The postoperative LESP and 4sIRP were similar between the 2 groups, however, the postoperative UESP was significantly higher in the reflux group than the non-reflux group (P = 0.042). The non-reflux group had more declines in Eckardt scores and LESP than the reflux group. @*Conclusions@#The reflux symptoms of achalasia patients without treatment were mainly due to food retention. The postoperative reflux symptoms were not the sign of the excessive relaxation of lower esophageal sphincter.
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Background/Aims@#Achalasia is a rare disease, but the incidence is increasing recently. Peroral esophageal myotomy (POEM) is an effective treatment.Regurgitation is a common symptom before and after POEM. Our aim is to investigate the factors related to preoperative and postoperative reflux symptoms. @*Methods@#Our study was retrospective. The achalasia patients diagnosed by high-resolution manometry and gastroscopy were divided into reflux group and non-reflux group before and after POEM, respectively. General information, symptoms, POEM information, and manometric results were compared. @*Results@#(1) Ninety-six of 130 patients had reflux symptoms before POEM. The lower esophageal sphincter pressure (LESP) in the reflux group was significantly higher than the non-reflux group (P = 0.023), while integrated relaxation pressure (IRP) was similar. The reflux group had longer esophagus than the non-reflux group (P = 0.006). Reflux symptoms were not related to subtypes of achalasia.(2) Twenty-five of 84 patients had reflux symptoms after POEM. Postoperative Eckardt scores, LESP, and 4-second IRP (4sIRP) were significantly lower than the preoperative values (P < 0.001). The preoperative values and POEM information were similar between the postoperative 2 groups and there was no significant difference in the presence of preoperative reflux symptoms between 2 groups.The postoperative LESP and 4sIRP were similar between the 2 groups, however, the postoperative UESP was significantly higher in the reflux group than the non-reflux group (P = 0.042). The non-reflux group had more declines in Eckardt scores and LESP than the reflux group. @*Conclusions@#The reflux symptoms of achalasia patients without treatment were mainly due to food retention. The postoperative reflux symptoms were not the sign of the excessive relaxation of lower esophageal sphincter.
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Esophageal achalasia is a rare digestive disease. The pathogenesis of achalasia is still elusive. The main symptoms of achalasia are dysphagia, regurgitation, chest pain and weight loss. Three subtypes are defined in the Chicago Classification 3.0, and each subtype has unique clinical features and treatment consideration. This article will review the clinical features of three subtypes of esophageal achalasia.
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Esophageal achalasia is a rare digestive disease. The pathogenesis of achalasia is still elusive. The main symptoms of achalasia are dysphagia, regurgitation, chest pain and weight loss. Three subtypes are defined in the Chicago Classification 3.0, and each subtype has unique clinical features and treatment consideration. This article will review the clinical features of three subtypes of esophageal achalasia.
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OBJECTIVE:To establish quality standard for Zhuang medicine Homalocladium platycladum. METHODS:TLC method was used for qualitative identification. HPLC method was used to determine the content of quercetrin in samples:Agilent Zorbax SB-C18 column,mobile phase consisted of acetonitrile-0.1% acetic acid(20:80,V/V),flow rate of 1.0 mL/min,detection wavelength of 360 nm,column temperature of 30 ℃,injection volume of 10 μL. The contents of moisture,total ash and extract in samples were determined. referring to Chinese Pharmacopiea(2015 edition). RESULTS:TLC spots of H. platycladum were clear and well-separated without interference from negative control. The linear range of quercetin were 0.023-0.46 mg/mL(r=0.9991). RSDs of precision,stability and repeatability tests were all lower than 2.0%. The average recoveries were 98.01%-103.05%(RSD=1.71%,n=6). The contents of moisture,total ash,extract and quercetrin in samples were 6.39%-9.78%,2.82%-8.07%, 0.02%-0.27%,14.14%-28.45%,0.09%-0.50% respectively. CONCLUSIONS:Established trial can be used for quality control of Zhuang medicine H. platycladum.
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OBJECTIVE:To establish a method for the simultaneous determination of scutellarin and linarin in Scoparia dulcis. METHODS:HPLC was performed on the column of Phenomenex C18 with mobile phase of acetonitrile-0.05% phosphoric acid (gradient elution)at a flow rate of 1.0 ml/min,the detection wavelength was 330 nm,column temperature was 30 ℃,and the in-jection volume was 10 μl. RESULTS:The linear range was 0.015 8-0.316 8 mg/ml for scutellarin(r=0.999 9)and 0.000 5-0.010 4 mg/ml for linarin (r=0.999 7);RSDs of precision,stability and reproducibility tests were lower than 3%;recoveries were 99.56%-102.38%(RSD=1.07%,n=6)and 95.14%-98.29%(RSD=1.24%,n=6),respectively. CONCLUSIONS:The method is simple with good stability and reprodicibility,and can be used for the simultaneous determination of scutellarin and linarin in S. du-lcis.
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OBJECTIVE:To optimize the content determination conditions of total alkaloids from Zhuang medicine Munronia delavayi,and to determine the content of total alkaloids in M. delavayi from different producing areas. METHODS:With the con-tent of total alkaloids as index,using solvent amount,ultrasonic time,ultrasonic extraction times and pH value of buffer as fac-tors,the content determination conditions of total alkaloids from Zhuang medicine M. delavayi were optimized by orthogonal test. Optimized content determination conditions were adopted to determine the content of total alkaloids in M. delavayi from 18 produc-ing areas in different harvest time. RESULTS:The optimum content determination conditions were as follows as the amount of sol-vent(CHCl3)20 ml,ultrasonic processing for 3 times,lasting for 15 min each time,pH value of buffer 4.5. The contents of total alkaloids in M. delavayi from 18 producing areas were between 0.6-11.98 mg/g,showing great difference. M. delavayi from Long-lin county and Tianlin county harvested in Oct. had the lowest content of total alkaloids. CONCLUSIONS:Optimized content deter-mination condition can be used for the content determination of total alkaloids in Zhuang medicine M. delavayi and quality control of it. The content determination of total alkaloids in M. delavayi is related to producing area and harvest time.
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Irritable bowel syndrome(IBS)is one of the most common functional gastrointestinal disorders,which severely affects the life quality of patients. Currently,the pathogenesis of IBS has not yet been clarified. Visceral hypersensitivity and central algesia abnormality may be involved in the pathogenesis of IBS. Antidepressants can improve abdominal pain,abdominal discomfort,mental disorders and abnormal defecation and enhance the quality of life. This article reviewed the advances in study on antidepressants in treatment of IBS.
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Objective To investigate the correlation between the clinical symptoms of patients with achalasia of cardia (AC) and high-resolution manometry (HRM) parameters.Methods The clinical data of 30 AC patients were retrospectively analyzed.The severe degree of symptoms was evaluated by Eckardt score questionnaires,and motility of esophagus was assessed by HRM parameters.According to Chicago classification,patients were divided into three types.Mann-Whitney U test was performed for non normal distribution quantitative data comparison.Spearman correlation was used to analyze the correlation between AC symptoms and the HRM parameters.Results The reflux symptom of type Ⅱ patients was more severe than that of type Ⅰ patients (2.50(1.00) vs 1.00(1.50),U=56.000,P＜0.05).The integrated relaxation pressure (IRP) was moderately correlated with total Eckardt score of all AC patients,the frequency of reflux and the degree of body weight loss (r=0.528,0.441 and 0.662,all P＜0.05),furthermore IRP was strongly correlated with the degree in weight loss in type Ⅰ AC patients (r =0.703,P＜ 0.05).Lower esophageal sphincter resting pressure was weakly correlated with the degree of weight loss in all AC patients (r=0.398,P＜0.05).Conclusions The degree of severity of symptoms may be different in different types of AC patients.HRM parameters,especially IRP,might play a role in the assessment of severity of AC symptoms.
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Objective To investigate the role and mechanism of simvastatin on colonic fibrosis in rats with 2,4,6-trinitrobenzene sulphonic acid (TNBS) induced colitis.Methods Forty-eight healthy male Sprague-Dawley rats were evenly divided into six groups:control group,TNBS group,simvastatin treated group Ⅰ,group Ⅱ (from zero to 21 days after modeling,simvastatin 5 mg/kg or simvastatin 20 mg/kg treated),group Ⅲ and group Ⅳ (from seven to 21 days after modeling,simvastatin 5 mg/kg or 20 mg/kg treated).Body weight and disease activity index (DAI) of the rats were inspected,and general colon,histological injury and fibrosis were scored.The expressions of collagen types Ⅰ and connective tissue growth factor (CTGF) at mRNA level were detected by reverse transcription-polymerase chain reaction (RT-PCR).The expressions of collagen types Ⅰ,CTGF and phosphorylation of myosin phosphatase target subunit-1 (p-MYPT-1) at protein level were determined by Western blotting.The data were analyzed by one-way ANOVA.Results Compared with control group,the colon length shortened,while colon weight,DAI score,general colon score,histological injury and fibrosis score significantly increased in TNBS group.And the expressions of collagen types Ⅰ also obviously increased.After intervention of simvastatin,both the colon length and weight of rats were improved.The DAI score,general score,histological injury and fibrosis score were lower than those of TNBS group.The expressions of collagen types Ⅰ,CTGF and p-MYPT-1 (group Ⅰ:0.68±0.22 ; group Ⅱ:0.59 ± 0.27 ; group Ⅲ:0.71 ± 0.20 ; group Ⅳ:0.59± 0.25) in colonic tissue were all lower than those of TNBS group (F=5.169,P＜0.05).There were no statistical significance among four groups (al1 P＞0.05).Conclusion Simvastatin can effectively prevent TNBS-induced rat colitis from colonic fibrosis,the mechanism may be related with Rho-kinase inhibition and down-regulation of CTGF over-expression.
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ObjectiveTo investigate the influence of gender and psychosocial parameters on the quality of life in patients with irritable bowel syndrome(IBS). MethodsOut-patients from Jan to Oct 2008 in the Department of Gastroenterology at the First Affiliated Hospital of Nanjing Medical University were enrolled. Based on Rome teria IBS was diagnosed. Interviewed by a GI physician with questionnaire of demographic data,Zung self-rating anxiety and depression scale(SAS/SDS) and IBS-specific quality of life(IBS-QOL) questionnaire. Results452 patients were diagnosed as IBS according to Rome Ⅲ criteria. IBS was more common in female. In male, anxiety and depression scales were significantly increased( t =7. 191、6. 459 ,P ＜ 0. 01 ) and the scale of IBS-QOL was significantly decreased ( t =9.119, P ＜ 0.01 ) in female IBS patients. In IBS patients, IBS-QOL scales were negatively associated with the anxiety and depression scales(P ＜0. 01 ). ConclusionThese results suggest that there were gender differences in psychological status and quality of life in IBS patients,and difference psychological status based on gender should influence the quality of life of patients with IBS.
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0.05).The prevalence of strains with resistance to rifampin was lower than that of strains with resistance to clarithromycin(P
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Objective To investigate whether stem cell factor(SCF)was responsible for the diabetesassociated depletion of interstitial cells of Cajal in colon(ICC)in diabetic mice.Methods Forty male C57/BL6 mice were randomly divided into the control group(n=10),the diabetic group(n=10),the normal group with immunoneutralization of endogenous SCF(n=10)and the diabetic group with exogenous SCF (n=10).All mice were sacrificed 6 weeks after modeling.The ICC in the proximal colon tissues were investigated by flow cytometry,transmission electron microscopy and Western blot.The SCF in colon tissues and serum were analyzed by Western blot and ELISA.Results The SCF in the serum and proximal colon muscle was significantly reduced in diabetic group compared with the control group(P＜0.05).The changes were accompanied with the depletion of ICC and the uhrastructure damage of ICC.The expression of SCF was significantly decreased in the serum and proximal colon tissues in the normal group after immunoneutralization of SCF.Meanwhile,the depletion of ICC and the ultrastructure damage of ICC was similar to the diabetic group.The expression of SCF in the serum and proximal colon tissues of the diabetic group with exogenous SCF was significantly increased,and which was along with the quantity of ICC and the ultrastructure improved dramatically compared with the diabetic group.Conclusions The decrease of SCF in the serum and colon of the diabetic mice may be responsible for the diabetes-associated depletion of ICC in colon.Exogenous SCF may improve the ICC lesions in diabetic gastroimestinal tract.