Gastric motility measurement and evaluation of functional dyspepsia by a bio-impedance method

In order to investigate the complex course of the electrical and mechanical processes of functional dyspepsia (FD), it is necessary to extract gastric motility information on both electricity and mechanism. According to the clinical standardization, 36 volunteers with functional dyspepsia were selected. The signal processing device has been designed by Chongqing University of Posts and Telecommunications. Multi-resolution analysis (MRA) decomposed the two signals of impedance gastric motility (IGM) and electrogastrogram (EGG) collected from the body surface. The wavelet transform is addressed to separate the IGM and EGG signals from impedance signals due to breathing and blood flow. By means of the energy and frequency spectrum analysis technique, the signals can be classified according to the dominant power and dominant frequency. Some indices, such as frequencies of EGG and IGM, signal power spectrum and dynamic spectrum, the rates of rhythm and power for the normal EGG and IGM and so on, can also be calculated. The primary experiments of gastric motility measurement and evaluation are executed by including healthy humans (control group: CG) and patients with FD (pathologic group: PG). There are significant differences in the temporal-domain and frequency-domain properties between the two groups. The main frequency of the CG belongs to 2-4 CPM and is clear and very regular, while the main frequency of the PG is much disordered. The peak of the maximal power of the CG belongs to 2-4 CPM and 1-2 CPM for the PG. The percentage of normal frequency (PNF) for the CG is 0.704 +/- 0.255 and 0.402 +/- 1.145 for the PG. The frequency instability coefficient (FIC) for the CG is 0.182 +/- 0.059 and 0.374 +/- 0.086 for the PG. The percentage of normal power (PNP) for the CG is 0.592 +/- 0.044 and 0.468 +/- 0.142 for the PG. The power instability coefficient (PIC) for the CG is 1.576 +/- 0.481 and 4.006 +/- 0.711 for the PG. The results of the experiments show that the proposed method of impedance can be a potential tool for the noninvasive assessment of gastric motility under gastrointestinal physiology and pathology conditions.     

功能性消化不良患者健康行为自我效能问卷的编制及信效度检测

目的编制功能性消化不良患者健康行为自我效能问卷并测定其信度和效度,为临床评价功能性消化不良患者自我效能提供工具。方法以自我效能感社会认知理论为框架,初步构建功能性消化不良患者健康行为自我效能问卷。将初始问卷进行两轮专家咨询形成预测问卷,对300例功能性消化不良患者进行问卷调查,并进行信效度分析。结果问卷由营养效能、运动效能、心理安适效能、社会支持效能及健康责任效能5个维度,35个条目组成。问卷各维度Cronbachgd系数为0．670～0．831,总体CronbachgOt系数为0．924;一周后重测信度为0．936。因子分析,提取5个公因子,累计方差贡献率为57．30％;问卷的内容效度为0．953。结论功能性消化不良患者健康行为自我效能问卷具有良好的信度和效度,该问卷可作为功能性消化不良患者自我效能评估工具。     

功能性消化不良的分型及分析

目的 了解功能性消化不良（ＦＤ）各亚型比例,探讨其与幽门螺杆菌（ＨＰ）等因素的关系。方法 对１８６例ＦＤ患者以问卷形式询问病史,按症状给予分型,用尿素酶试验、涂片染色检测ＨＰ。结果 各亚型的比例及ＨＰ阳性率分别为：反流型１１．２９％、１４．２９％;溃疡型１３．９８％、４６．１５％;运动障碍型４８．３９％、４１．１１％;复合型２６．３４％、３８．７８％,ＦＤ的ＨＰ总阳性率为３８．１７％。结论 ＦＤ中     

小剂量奥美拉唑治疗功能性消化不良的疗效观察

目的探讨小剂量奥美拉唑治疗功能性消化不良（FD）的临床疗效。方法选择中山市南朗医院收治的FD患者160例,将其分为研究组与对照组,每组80例。研究组给予口服小剂量的奥美拉唑进行治疗,对照组给予口服多潘立酮联合埃索美拉唑进行治疗。结果两组症状改善情况及治疗效果比较差异无统计学意义（P均〉0．05）;研究组不良反应发生率明显低于对照组（P〈0．05）。结论小剂量奥美拉唑治疗FD效果显著,具有见效快、不良反应少、症状改善明显等优势,安全可靠,值得大力推广,应用于临床。     

Update on the management of obesity

This article updates a paper published in this journal more than a decade ago. We detail the ensuing decade's developments in the treatment of obesity, reviewing innovations, established techniques, and the current status of behavior modification. We evaluate newer developments, such as anorectic drugs, very low calorie diets, and intragastric balloon bezoars, and we describe other approaches to the treatment of obesity, such as residential and comprehensive outpatient programs. We conclude by recommending a multidisciplinary approach to this complex problem.     

Diagnosis and pathogenesis in functional dyspepsia

Functional gastrointestinal disorders (FGID) such as functional dyspepsia (FD) and irritable bowel syndrome are common gastrointestinal diseases in clinical practice. FGID is not life-threatened disease, but it is an important disease because the patients with FGID have a poor QOL. Recently the Rome criteria for the diagnosis of FGID has been established in Western countries, however, whether the criteria is suitable for clinical practice in Japan or not has not fully discussed. Many factors including gastrointestinal dysmotility, abnormality of acid secretion, visceral hypersensitivity, Helicobacter pylori infection or stress might play in the pathogenesis of FD. Our previous studies using ultrasonography indicate the decrease in gastric emptying and antral motility and the increase in duodenogastric reflux in patients with FD. In the treatment of FD, prokinetic agents, acid-suppressive drugs and antidepressants have been widely used.     

The management of dyspepsia

Dyspepsia is a general term that describes pain or discomfort that is centred in the upper abdomen. It reportedly affects up to 40 per cent of adults in any one year. A test and treat strategy is now recommended for all patients with uncomplicated dyspepsia. Any patient presenting with alarm features, such as recurrent vomiting or dysphagia, should be referred to a specialist for further investigation.     

心理干预对功能性消化不良病人的影响

[目的]研究心理干预对功能性消化不良（FD）病人的影响。[方法]75例门诊FD病人随机分为常规治疗组、心理干预组、综合治疗组3组,分别采用汉密顿焦虑量表（HAMA）和抑郁量表（HAMD）对各组病人治疗前、治疗后6周精神心理进行评分,计算减分率,同时观察功能性消化不良病人胃电节律的变化。[结果]治疗后6周心理干预组及综合治疗组FD病人情绪障碍评分减分率较高,与常规组比较有统计学意义（P〈0.01）;胃电节律紊乱得到有效改善,综合治疗组优于常规治疗组（P〈0.05）。[结论]心理干预能明显提高FD病人心理及情绪障碍评分减分率,改善胃电节律紊乱,可以作为治疗FD病人的重要手段之一。     

根除幽门螺旋杆菌对功能性消化不良的影响

目的 观察中西药结合根除幽门螺旋杆菌(Hp)治疗功能性消化不良(FD)的临床疗效.方法 将Hp阳性FD病人108例随机分为两组,治疗组采用六味安消胶囊加标准三联抗Hp疗法治疗Hp阳性FD病人,对照组仅采用六味安消胶囊加雷贝拉唑治疗.结果 治疗组根除率82.7%,症状改善率及半年持续症状缓解率均优于对照组.结论 Hp阳性FD病人采用中西药结合方法根除Hp治疗,症状明显改善.     

心理干预对功能性消化不良病人的影响

[目的]研究心理干预对功能性消化不良(FD)病人的影响.[方法]75例门诊FD病人随机分为常规治疗组、心理干预组、综合治疗组3组,分别采用汉密顿焦虑量表(HAMA)和抑郁量表(HAMD)对各组病人治疗前、治疗后6周精神心理进行评分,计算减分率,同时观察功能性消化不良病人胃电节律的变化.[结果]治疗后6周心理干预组及综合治疗组FD病人情绪障碍评分减分率较高,与常规组比较有统计学意义(P＜0.01);胃电节律紊乱得到有效改善,综合治疗组优于常规治疗组(P＜0.05).[结论]心理干预能明显提高FD病人心理及情绪障碍评分减分率,改善胃电节律紊乱,可以作为治疗FD病人的重要手段之一.     

功能性消化不良与幽门螺杆菌感染关系的探讨

目的：探讨功能性消化不良（functional dyspepsia,FD）与幽门螺杆菌（helicobacter pylori,Hp）的关系。方法：FD患者342例和健康对照组36例均在内镜下从胃窦部取粘膜标本行快速尿素酶试验，并做^14C尿素呼气试验，两试验都阳性者确诊Hp感染。结果：对照组36例中，Hp阳性8例，阴性28例，Hp阳性率22．2％；342例FD病人中，Hp阳性230例，阴性112例，Hp感染率67．3％。两者有显著差异（P＜0．05），提示FD病人的Hp感染率明显高于健康人。     

Evaluation and management of nonulcer dyspepsia

When no organic cause for dyspepsia is found, the condition generally is considered to be functional, or idiopathic. Nonulcer dyspepsia can cause a variety of symptoms, including abdominal pain, bloating, nausea, and vomiting. Many patients with nonulcer dyspepsia have multiple somatic complaints, as well as symptoms of anxiety and depression. Extensive diagnostic testing is not recommended, except in patients with serious risk factors such as dysphagia, protracted vomiting, anorexia, melena, anemia, or a palpable mass. In these patients, endoscopy should be considered to exclude gastroesophageal reflux disease, peptic or duodenal ulcer, and gastric cancer. In patients without risk factors, consideration should be given to empiric therapy with a prokinetic agent (e.g., metoclopramide), an acid suppressant (histamine-H2 receptor antagonist), or an antimicrobial agent with activity against Helicobacter pylori. Treatment of patients with H. pylori infection and nonulcer dyspepsia (rather than peptic ulcer) is controversial and should be undertaken only when the pathogen has been identified. Psychotropic agents should be used in patients with comorbid anxiety or depression. Treatment of nonulcer dyspepsia can be challenging because of the need to balance medical management strategies with treatments for psychologic or functional disease.     

Update on vertigo management

Summary  Vertigo can present significant diagnostic and management challenges. In the past decade, less invasive means of achieving relief from vertigo have been established. Many treatment options carry some degree of controversy. With vertigo, as in all areas of medicine, clinicians must constantly reevaluate the efficacy of their treatment algorithms.     

分级管理模式在功能性消化不良患者健康教育中的应用与效果评价

目的探讨在功能性消化不良患者治疗中采用分级管理模式实施健康教育的方法与效果。方法对照组采用常规健康教育,实验组采用由健康教育组长、准专科护士、责任护士组成的三级管理方式实施健康教育。结果在入院2周后和出院4周后实验组患者症状得分及心理障碍得分均低于对照组(P<0.01)。结论应用分级管理模式能有效提高健康教育效果,改善功能性消化不良患者的症状及减轻心理障碍。