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Objective To investigate the effects of anxiety ,depression and life events on patients with non-erosive gastroesophageal reflux disease (NERD) .Methods From November 2016 to December 2017 ,at The First Affiliated Hospital of the Medical College ,Shihezi University ,135 patients with NERD (NERD group) and 133 volunteers who received physical examination at the same period were enrolled (healthy control group) .The scores of self-rating anxiety scale (SAS) ,self-rating depression scale (SDS ) ,life event scale (LES ) and gastroesophageal reflux disease questionnaire (GerdQ ) of the enrolled individuals were obtained by questionnaire .Mann-Whitney ranking test ,chi square test and Spearman rank correlation test were performed for statistical analysis .Results The patients with anxiety in NERD group accounted for 46 .67％ (63/135) ,which was higher than that in healthy control group (1 .50％ ,2/133) ,and the difference was statistically significant (χ2 =74 .38 , P< 0 .01) .The patients with depression in NERD group accounted for 12 .59％ (17/135) ,which was higher than that of healthy control group (0 ,0/133) ,and the difference was statistically significant (χ2 = 17 .88 ,P< 0 .01) .The SAS score of NERD group was 48 points (45 points ,52 points) ,which was higher than that of healthy control group (37 points (33 points ,43 points)) ,and the difference was statistically significant (Z=-11 .03 ,P<0 .01) .The SDS score of NERD group was 46 points (41 points ,50 points) ,which was higher than that of healthy control group (36 points ,32 points to 40 points) ,and the difference was statistically significant (Z= -11 .03 , P<0 .01) .The LES score of NERD group was 32 points (10 points ,45 points) , which was higher than that of healthy control group (3 points ,0 points to 32 points) ,and the difference was statistically significant (Z= -2 .18 ,P=0 .03) .The score of LES negative events in NERD group was 21 points (3 points ,36 points) ,which was higher than that of the healthy control group (0 points ,0 points to 23 points) , and the difference was statistically significant (Z= -2 .19 , P=0 .03) .GerdQ score was positively correlated with SAS ,SDS ,LES scores and LES negative event score ,and the differences were all statistically significant (r=0 .65 ,0 .60 ,0 .29 and 0 .29 ,all P< 0 .05) .Conclusions Anxiety ,depression and life events are the influencing factors of NERD .The greater the impact of anxiety ,depression and life event (especially negative live events) ,the more severe the NERD symptoms .
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[Objective] The purpose of this paper is to explore and summarize the experience of Professor ZHOU Xiaohong's treatment of non-erosive reflux disease(NERD),and promote the application in clinic.[Method] By following the professor ZHOU Xiaohong clinical copy and collecting related medical record,the autor summed up the viewpoints and medication experience of Professor ZHOU Xiaohong in the treatment of NERD,and referred to traditional Chinese medicine and western medicine literature as the theoretical basis,and attached to the corresponding test case,in order to verify.[Results] Professor ZHOU Xiaohong believes that the pathogenesis of NERD is closely related to the liver,and modern research has confirmed that it is affected by mental and psychological factors.Stagnated heat in liver and stomach is the basic pathogenesis,and to soothe the liver and relieve depression is basic treatment,and according to the severity of the disease stage,treatment is different.Clearing heat and normalizing the stomach at acute episode and relieving qi stagnancy in liver in relieving period.At the same time with relieving sore throat and resolving phlegm and eliminating stagnation medicine and symptomatic treatment,the qi regulating,and the disease can be cured.[Conclusion] Professor ZHOU Xiaohong has rich clinical experience and unique clinical effect,it is worth further study.
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BACKGROUND/AIMS: Approximately one-third of non-erosive reflux disease (NERD) patients are refractory to proton pump inhibitors (PPI) and face a therapeutic challenge. Therefore, it is important to differentiate between pathological and non-pathological reflux utilizing multichannel intraluminal impedance-pH (MII-pH) to analyze symptom-reflux association and diagnose true NERD versus hyper-sensitive esophagus (HE) and functional heartburn (FH). Herein, we evaluated the diagnostic yield of MII-pH in refractory NERD and sub-classified it based on quantity and quality of acid/non-acid reflux and reflux-symptom association. METHODS: Sixty symptomatic NERD patients on twice daily PPI for > 2 months were prospectively evaluated by MII-pH. Distal and proximal refluxes, bolus exposure time (BET), esophageal acid exposure time, symptom index (SI) and symptom association probability (SAP) were measured. RESULTS: Thirty-two (53%) patients had BET > 1.4% (MII-pH positive-true NERD), while 28 (47%) had BET 80% of symptoms were associated with non-acid reflux. The number of distal refluxes in true NERD versus FH or HE were significantly different, but not between FH and HE. CONCLUSIONS: Approximately 60% of refractory PPI NERD patients had positive reflux-symptom association, primarily due to non-acid reflux. Nearly half of NERD patients on PPI had normal MII-pH monitoring, sub-divided further into FH and HE equally.
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Humans , Esophagus , Heartburn , Prospective Studies , Proton Pump InhibitorsABSTRACT
Pacientes com doença do refluxo não erosiva apresentam sintomas típicos causados pelo refluxo do conteúdo gástrico para o esôfago. Entretanto, estes pacientes não apresentam alterações de mucosa visualizadas à endoscopia. O objetivo deste estudo é caracterizar a expressão de moléculas relacionadas à junção celular (claudinas 1, 3 e 4), da proteína pró-inflamatória Cox-2, da população global de linfócitos (CD45), população de linfócitos T (CD3), linfócitos B (CD20) e natural killer (CD57) em portadores de esofagite de refluxo erosiva e não erosiva. O estudo verificou que quanto mais intensa e crônica a inflamação no epitélio escamoso esofágico, menor a expressão das proteínas juncionais (claudinas 1 e 4), não alterando a expressão da claudina 3. Em relação à Cox-2 o estudo mostra aumento de sua expressão na forma erosiva da doença. Em relação à população de linfócitos, não foi detectada diferença significativa.
Patients with non-erosive reflux disease conditions show typical symptons caused by the reflux of the gastric content to the esophagus. However, these patients dont show any alteration on the mucous membrane visualized trhough endoscopy. The aim of this study is to characterize the molecule expression related to the cell junction (claudins 1 , 3 and 4)the Cox 2 pro-inflamatory protein, the general population of (CD45) lymphocytes ,the population of lymphocytes T (CD3),the B (CD20) lymphocytes and the(CD57) natural killer in patients with erosive and non-erosive reflux esophagitis. The study found that the more intense and chronic the inflamation is in the esophageal squamous epithelium, less junction protein expressios (claudins 1 and 4) were found, not altering the 3 expressions of claudin 3. Regarding Cox 2, the study shows increase in its expression in the erosive form of the disease. Regarding the population of lymphocytes, no significant difference was detected.
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Humans , Male , Female , Biopsy , Esophagus , Gastroesophageal Reflux , ImmunohistochemistryABSTRACT
0.05).Conclusion Omeprazole and Tegaserod improved the reflux symptoms of the NERD patients.Omeprazole improves abnormal acid exposure but not abnormal bile exposure.Tegaserod improved neither abnormal acid exposure nor abnormal bile exposure.
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Objective The aim of this study was to evaluate and to characterize the visceral hypersensitivity in non-erosive reflux disease(NERD)through the detection of esophageal distension-cerebral evoked potentials(ED-CEP)and calcitonin gene related peptide(CGRP)and substance P(SP)levels in esophageal mucosa.Methods NERD patients(N 26)and 12 controls were enrolled in this study from Oct.2004 to Mar.2005.Mechanical distention stimulation was performed using the balloon-affixed and polyvinyl multilumen catheter.The ED- CEP was recorded with a muti-channel international 10~20 system of electroencephalograph.The esophageal specimens were immune-histologically evaluated for CGRP/SP-stain positive contents.Results Esophageal distention may evoke recognizable and reproducible muti-peak CEP.CEP morphology of NERD patients was characterized by randomly distributed patterns,and the peak latencies for N1,P1,and N2 were significantly shorter compared with control group(P