Spectrum-effect relationship of hemostatic effects of Notoginseng Radix et Rhizoma with different commodity specifications / 中国中药杂志

This article aims to establish the fingerprints, determine the hemostatic pharmacodynamic indicators, and explore the spectrum-effect relationship of Notoginseng Radix et Rhizoma in 12 different specifications. Firstly, HPLC and liquid chromatography-mass spectrometry(LC-MS) were employed to establish the fingerprints of Notoginseng Radix et Rhizoma. The rat plasma recalcification experiment and the rat gastric bleeding experiment were conducted to determine the pharmacodynamic indicators, including plasma recalcification time(PRT), thrombin time(TT), prothrombin time(PT), and activated partial thromboplastin time(APTT). Afterwards, the partial least squares method was employed to explore the spectrum-effect relationship of Notoginseng Radix et Rhizoma in different specifications. Twenty-six common peaks were detected in the HPLC fingerprints of different specifications of Notoginseng Radix et Rhizoma, and 11 out of the 26 common peaks represented saponins. The content of dencichine was determined by LC-MS. The rat experiments showed that the pharmacodynamic indicators were significantly different among different specifications of Notoginseng Radix et Rhizoma. The spectrum-effect relationship was explored between 27 common components and pharmacodynamic indicators. Among them, 16 components had positive effects on the pharmacodynamic indicators of Notoginseng Radix et Rhizoma, and 11 exerted negative effects. This study provides a basis for the precision medication and quality control of Notoginseng Radix et Rhizoma.

Clinical Observation of Rebamipide Triple Therapy in the Treatment of Gastric Ulcer with Bleeding / 中国药房

OBJECTIVE:To observe the efficacy and safety of rebamipide triple therapy in the treatment of gastric ulcer with bleeding. METHODS:130 patients with gastric ulcer with bleeding were randomly divided into control group(65 cases)and obser-vation group(65 cases). Control group received Omeprazole enteric-coated capsule 20 mg,orally,twice a day+Aluminum magne-sium carbonate tablet 500 mg,orally,once a day;observation group was additionally received Rebamipide tablet 0.1 g,orally,3 times a day. They were treated for 12 weeks. Clinical efficacy,remission time of belching,abdominal pain,bloating,hematemesis/hematochezia,clinical symptom score before and after treatment,rebleeding and the incidence of adverse reactions in 2 groups were observed. RESULTS:The total effective rate in observation group was significantly higher than control group,remission time of symptoms and signs were significantly shorter than control group,the incidence of rebleeding was significantly lower than con-trol group,with statistical significances (P0.05). After treatment,the clinical symptom scores in 2 groups were significantly lower than before,and observation group was lower than control group,with statistical significances (P0.05). CONCLUSIONS:Rebamipide triple therapy shows obvious short-term efficacy in the treat-ment of gastric ulcer with bleeding,which can effectively improve patients'gastrointestinal symptoms,reduce rebleeding risk,and does not increase the incidence of adverse reactions.

Curative Effect Analysis of Hydrotalcite Combined with Omeprazole in the Treatment of Gastric Ulcer with Gastrorrhagia / 中国药师

Objective:To study the curative effect of hydrotalcite combined with omeprazole in the treatment of gastric ulcer with gastric bleeding. Methods:Seventy-six patients with gastric ulcer and bleeding in the stomach were selected and randomly divided into two groups. Thirty-two patients in the control group were treated with omeprazole alone while 44 patients in the observation group were treated with hydrotalcite combined with omeprazole. The therapeutic effects were compared between the two groups. Results:The total effective rate in the observation group was 100% while that was 87. 5% in the control group,and the difference between the two groups was statistically significant(P0. 05). Conclusion:Hydro-talcite combined with omeprazole in the treatment of gastric ulcer with gastric bleeding is effective and safe.

Gastric Bleeding Arisen in a Patient with Situs Inversus Totalis and Large Accessory Spleen

Situs inversus totalis is a rare congenital disorder, which is total transposition of thoracic and abdominal organs. Its incidence is 1 in 10,000~50,000 live births. This might be associated with multiple abnormalities such as accessory spleen, asplenia, intestinal malrotation and so on. For this reason, in cases of operation in patients with situs inversus totalis, we need to scrutinize the presence of accompanied anomalies. Moreover, if Dieulafoy gastric bleeding has occurred, vascular anomalies can be accompanied. This 31-year-old male patient with situs inverses totalis was admitted to our hospital for management of UGI (upper gastrointestinal) bleeding. Gastroendoscopy revealed Dieulafoy disease in the upper body of the stomach as the cause of UGI bleeding. Several attempts with endovascular embolization and hemoclips were applied but failed. We performed a suture & ligation of the Dieulafoy lesion as well as total resection of accessory spleen with devascularization of prominently developed vessels around the upper stomach. We report this case with a review of the literature.

Massive Gastric Bleeding Occuring after the Replacement of Percutaneous Endoscopic Gastrostomy Tube / 대한소화기내시경학회지

Percutaneous endoscopic gastrostomy (PEG) tube placement is preferred one of the standard method for providing enteral nutrition to infants and children with feeding problems. It was introduced into clinical practice in 1980 and now considered as a widely used technique. It is simple to perform and does not require general anesthesia. However, acute complications can occur with the use of PEG tubes such as wound infection, pneumoperitoneum and transient ileus. Because long-term placement of PEG tube is frequently required in pediatric patients with neurologic impairment, late-onset complications should be observed in them. We report a case of massive gastric bleeding occuring after the replacement of the PEG tube in an 8-year-old boy, as one of the late complication of PEG placement. We assumed that the mechanical trauma to hypertrophic gastric mucosa associated with incomplete buried-bumper syndrome was the cause of massive bleeding.

Endoscopic Management with Ethanol Injection in a Child with Gastric Dieulafoy Lesion / 대한소아소화기영양학회지

The Dieulafoy's lesion is a rare cause of recurrent massive gastrointestinal bleeding in children. The bleeding results from an abnormally large submucosal artery that protrudes through a small mucosal defect. The lesion is commonly found on proximal stomach. Surgical intervention was believed to be the best treatment in the past, but recent advancement in endoscopy has made effective hemostasis possible. We report a case of a 9-year-old boy with underlying mycoplasma pneumonia with effusion who presented with massive upper gastrointestinal bleeding. Bleeding was controlled with endoscopic treatment by epinephrine and ethanol injection and the patient was successfully treated.

A Case of Gastric Candidiasis Presented with Massive Gastric Bleeding / 대한소화기내시경학회지

Candida albicans is a saprophytic organism that frequently resides in the mouth, skin, gastrointestinal and vaginal mucosa. It is also an opportunistic pathogen in immune compromised individuals, alcoholics, and debilitated subjects treated with antibiotics, steroids, or antineoplastic drugs. Although the most common site of gastrointestinal involvement is the esophagus, gastric candidiasis may occur in immune suppressed patients and is rarely apparent in healthy individuals. Symptoms are nonspecific; indigestion, abdominal pain, fever and weight loss have been described. The diagnosis can usually be established by visualizing yeast and/or mycelial forms in endoscopic biopsy or in mucosal brushings of the lesions. A case of gastric candidiasis presented with bleeding was experienced in a 69-year-old female with chronic renal failure due to diabetic nephropathy. She underwent orthopedic surgery because of intertrochanteric fracture of her femur. On the 6th day of the postoperative period, the patient began suffering from a large amount of melena. Endoscopic findings revealed multiple whitish or central necrotic plaques in the body and antrum of the stomach. Endoscopic biopsy revealed budding yeast and pseudohyphae infiltrating through the ulcerated stomach wall. After the patient was treated with mycostatin for 7 days, endoscopic and pathologic findings did not show any evidence of the candidiasis. The case is herein reported of gastric candidiasis presented with gastric bleeding, along with a review of corresponding literature.

Abnormal Gastrointestinal Accumulation of Radiotracer by Gastric Bleeding During 99mTc-MDP Bone Scintigraphy / 대한핵의학회잡지

We present a case in which a patient with acute hemorrhagic gastritis demonstrated abnormal gastrointestinal accumulation of radiotracer during Tc-99m-methylene diphosphonate (MDP) skeletal scintigraphy. A hemorrhage gastritis was subsequsently demonstrated by endoscopy. The menchanism for the intestinal localization of Tc-99m-MDP in this patient is not clear, but we guess that the extravasated blood containing the radiopharmaceutical cannot recirculate and stays at the bleedings site, so we can see the intestinal activity.

Long-term outcome following transjugular intrahepatic portosystemic shunt for variceal bleeding due to portal hypertension / 介入放射学杂志

Objective To study the 6 year outcome following transjugular intrahepatic portosystemic shunt (TIPSS) for variceal bleeding due to portal hypertension. Methods 65 patients, 51 males, 14 females, aged 35～72 years old with averaged 4.5 years, have been undergone TIPSS because of portal hypertension due to cirrhosis or Budd Chiari syndrome. The portal pressures were measured before and after TIPSS. Follow up study was done by color Doppler sonography or Barium esophageal radiogaphy for 3 months to 6 years (averaged 18 months). Repeated interventional treatments were done in cases of restenosis of the shunts. Results There were 0,2,10,5,0 cases of recurrent bleeding after 3 months, 6 months, 1 year, 2 year and 3—6 year following TIPSS respectively. Stenosis occurred in shunt paths due to thrombosis or smooth muscle cell proliferation or neointimal hyperplasia were relieved after thrombolytic therapy and repeated balloon angioplasty or stent plant among most of them. 2 were failed due to serious stenosis. 7 cases died, 2 of massive bleeding, 1 of the other cause and 4 of hepatic cancer. The other patients are getting well. Conclusions Although there were very high rates of restenosis (34%), but most of them could be treated again with interventional therapy, and in kept patency effectively. TIPSS is a still practical valuable management for massive gastric bleeding.