Characteristics and Risk Factors of Functional Dyspepsia Fulfilling the Rome IV Criteria Overlapping With Gastroesophageal Reflux Disease, Irritable Bowel Syndrome, and Functional Constipation in South China

Background/Aims@#Functional dyspepsia (FD) overlapping with other gastrointestinal disorders are quite common. The characteristics of FD overlap in Chinese population with latest Rome IV criteria were unclear. This large-scale outpatient-based study assessed the characteristics of FD overlap in South China. @*Methods@#Consecutive FD patients visited the Gastroenterology Clinic at 2 tertiary medical centers in Hangzhou, China who fulfilled the Rome IV criteria were enrolled. Complete questionnaires related to the gastrointestinal symptoms (Rome IV criteria), Reflux Disease Questionnaire, anxiety and depression, quality of sleep and life, and demographic information were collected. @*Results@#Among the total of 3281 FD patients, 50.69% overlapped with gastroesophageal reflux disease, 21.46% overlapped with irritable bowel syndrome, 6.03% overlapped with functional constipation. FD overlap had higher proportion of single/divorced/widowed rate, high education level, being employed, drinking, night shift, unhealthy dietary habit than FD only (P < 0.05). They had higher frequency of consultation and economic burden, as well as lower scores in quality of life (P < 0.001). Multivariate logistic regression showed that increasing age, female, low body mass index, history of gastroenteritis, anxiety, depression, and poor sleep quality were independent risk factors for FD overlap. @*Conclusions@#FD overlap was quite common in China with high economic burden and poor quality of life, FD patients with history of gastroenteritis, anxiety, depression, and poor sleep quality were more likely to have overlap disorders. Awareness of the physical and psychosocial stressors in overlapping condition would help optimize the management of FD overlap in clinical practice.

Determination of strobilurin fungicide residues in fruits and vegetables by micellar electrokinetic capillary chromatography with sweeping.

A new assay of micellar electrokinetic capillary chromatography with sweeping was developed to determine azoxystrobin, kresoxim-methyl and pyraclostrobin in fruits and vegetables. The key factors affecting resolution and peak height were studied and the optimum conditions were obtained for separation and enrichment. The running buffer consisted of 40 mM borate, 25 mM sodium dodecyl sulfate and 15% acetonitrile, and its pH was adjusted to 8.4. The sample was injected for 677 nL and the separation voltage was 25 kV. Under the optimum conditions, the enrichment factors of azoxystrobin, kresoxim-methyl and pyraclostrobin were 861, 550 and 403; the linear dynamic ranges were all 0.01-5.0 mg/L; the limits of detection were 0.002, 0.001 and 0.002 mg/kg; the recoveries of spiked samples were 85.1-98.5%, 87.5-97.0% and 89.1-99.1%, respectively. The assay can meet the requirement of maximum residue limits for these three strobilurin fungicides, and has been applied for determining their residues in fruits and vegetables.

Double balloon endoscopy in diagnosis of patients with obscure gastrointestinal bleeding / 浙江大学学报·医学版

<p><b>OBJECTIVE</b>To assess the diagnostic value of double balloon endoscopy (DBE) for obscure gastrointestinal bleeding (OGIB) METHODS: The data of 103 OGIB patients who underwent DBE from January 2007 to September 2010 in the First Affiliated Hospital, Zhejiang University School of Medicine were retrospectively analyzed.</p><p><b>RESULTS</b>DBE was successfully performed in all 103 patients without complications. Of 103 patients, 66(64.1 %) had positive DBE findings and 28 had surgery procedures(27.2 %). Ninety-four patients finally acquired positive diagnosis, including small intestine tumor(31.1 %), angiodysplasia(22.3 %), exulceratio simplex(9.7 %), Crohn's disease(6.8 %), diverticulum(4.9 %), abdominal purpure(4.9 %), etc. Lesions occurred more frequently in proximal small intestine than in distal small intestine (56.3 % Compared with 30.1 %, P<0.001).</p><p><b>CONCLUSION</b>DBE is a safe, effective and reliable procedure for the diagnosis of OGIB.</p>

The value of endoscopic ultrasonography on diagnosis and treatment of esophageal hamartoma / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

<p><b>OBJECTIVE</b>To examine the values of endoscopic ultrasonography (EUS) on diagnosis and treatment of esophageal hamartoma.</p><p><b>METHODS</b>We compared and analyzed various kinds of imaging examinations such as barium esophagram, contrast-enhanced computed tomography (CT) and conventional gastroscopy in retrospectively reviewing the clinical data of an esophageal hamartoma patient seen in our clinic in the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. Having received various imaging examinations, this patient was finally diagnosed with esophageal hamartoma and underwent gastroscopic resection of hamartoma with the diagnostic information obtained from EUS. The patient had been regularly followed up for 13 months after treatment.</p><p><b>RESULTS</b>Barium esophagram, CT and conventional gastroscopy detected the lesion, but were unable to distinguish it from common esophagopolypus and other submucosal lesions, and unable to determine etiopathogenisis. EUS detected the hamartoma and identified its internal structure, echo, exact size, depth of invasion, origin and the relationship between adjacent tissues and organs, differentiating the lesion from other submucosal tumors and clearly defining the diagnosis. EUS-guided fine needle aspiration (FNA) also helped to identify the etiological diagnosis.</p><p><b>CONCLUSION</b>EUS was superior to other imaging means in diagnosis and treatment of hamartoma.</p>