Scintigraphic evaluation of gallbladder motor functions in H pylori positive and negative patients in the stomach with dyspepsia

AIM：To evaluate the relationship between gallbladder （GB） motor function and H pylori infection in the stomach.
METHODS： All cases （86） underwent the 14C urea breath test （UBT）. ^14C-UBT was found as positive in 58 and negative in 28 dyspeptic patients. ^14C- UBT was accepted as a gold standard test. Clo test and histopathologic examination were compared with the results of ^14C-UBT in cases who tolerated upper gastrointestinal endoscopy procedure. Cholescintigraphy with ^99mTc-mebrofenin was used to determine the parameters of GB motor function （GB filling and emptying time, half of the emptying time, ejection fraction at 30th and 60th min） in all patients.
RESULTS： We found the sensitivity and specificity as 88% and 86% for Clo test and as 89% and 80% for histologic evaluation, respectively. The parameters of GB function were not significantly different in H pylori positive and negative patients. The GB emptying was normal in both groups. Minimum GB filling time was 30 min in 34 of 86 cases （39.5%）, filling was not observed in 2 cases. The GB ultrasonography （USG） results were normal for all cases and bile composition abnormality was not determined.
CONCLUSION： Our study showed that ^14C-UBT is highly reliable method to detect the presence of H pylori. The presence of H pylori infection does not directly affect the GB function.     

肠易激综合征与功能性消化不良重叠的治疗进展

肠易激综合征(irritable bowel syndrome,IBS)与功能性消化不良(functional dyspepsia,FD)重叠的治疗,以益生菌和胃肠动力剂为主;精神心理和行为疗法具有协同作用,能增加胃肠动力,改善患者症状;中药治疗强调整体观念和辩证论治;针刺和物理疗法是有效的非药物疗法,综合治疗能提高临床疗效。     

浙江省高校学生功能性消化不良流行病学调查及其与心理因素的关系

目的 了解浙江省高校学生功能性消化不良(FD)患病情况及其与心理因素的关系.方法 选取浙江省两所高校学生,采用多级分层随机整群抽样方法,以罗马Ⅲ成人功能性胃肠病诊断调查问卷(ROMEⅢ-DQ)及心理学症状自评量表(SCL-90)对其进行分析调查.统计学处理采用x2检验和t检验.结果 共调查浙江省高校学生1870名,FD患病率为5.78％;女性患病率高于男性(7.53％比4.14％,x2=9.884,P＜0.05);高校四年级学生FD患病率最高,各年级之间差异有统计学意义(x2=13.83,P＜0.05).FD亚型中餐后不适综合征明显多于上腹痛综合征;FD患者与其他功能性胃肠病重叠以功能性排便障碍和功能性便秘最多.SCL-90调查中FD组各项因子评分均高于健康对照组.结论 FD在浙江省高校学生中有较高的患病率,心理因素与其发病有相关性.     

Comprehensive assessment of gastric emptying with a stable isotope breath test

Background The [¹³C]‐Spirulina platensis gastric emptying breath test (GEBT) with five samples is accurate relative to scintigraphy. This study was primarily designed to further validate this GEBT using a slightly different process for incorporating [¹³C] in Spirulina and to evaluate the utility of additional samples for assessing early gastric emptying. Methods After a 223 kcal, test meal labeled with ^99mTc and [¹³C]‐S. platensis, scintigraphic images, and five breath samples (45, 90, 120, 180, and 240 min, GEBT5) were collected in 14 controls (Part A). In Part B, nine breath samples were collected at 15, 30, 45, 60, 90, 120, 150, 180, and 240 min (GEBT9) in 30 subjects (15 controls, 15 dyspepsia). Using correlation between [¹³C] breath excretion and scintigraphic emptying, lag time (t₁₀, time for 10% emptying), emptying at 30 min (GE₃₀), and half time (t₅₀) were estimated for GEBT5 (Parts A and B) and GEBT9 (Part B). Key Results Half time values for scintigraphy, GEBT5, and GEBT9 were highly concordant. t₁₀ by GEBT9 (90%CI, 6–15 min) was more strongly correlated [CCC 0.80 (95% CI, 0.63–0.90)] with scintigraphy (90% CI, 5–12 min), than GEBT5 [10–19 min, CCC 0.73 (95% CI, 0.54–0.85)]. The correlation between estimated values (GEBT9) and linearly interpolated values (GEBT5) was closer at 60 [CCC 0.95 (95% CI, 0.91–0.97)] than 30 min [CCC 0.81 (95% CI, 0.71–0.89)]. Conclusions & Inferences The [¹³C]‐S. platensis GEBT can accurately measure GE. While 5‐ and 9‐samples are equally accurate for measuring t₅₀, GEBT9 provides a more comprehensive assessment of early GE (t₁₀ and GE₃₀).     

国产琥乙红霉素颗粒质量分析

目的综合评价琥乙红霉素颗粒的质量现状。方法采用现行法定标准检验结合探索性研究结果,对市场上14家企业生产的191批琥乙红霉素颗粒的质量进行系统比较,通过对原料药和制剂组分、有关物质、游离红霉素等的考察,结合稳定性和原辅料相容性试验,分析不同企业产品的质量差异。结果法定标准检验191批琥乙红霉素颗粒,合格率为99.5%;探索性研究显示,法定标准中组分、有关物质及游离红霉素检查项的缺失,导致质量控制不到位。结论国内琥乙红霉素颗粒整体质量一般,现行质量标准有待提高。     

缺血性卒中后功能性消化不良严重程度的影响因素研究

背景 缺血性卒中后功能性消化不良（FD）属于卒中后胃肠功能紊乱的一种,在中老年患者中十分普遍。卒中患者由于自身躯体与心理的变化,其FD的影响因素可能与一般人群存在差异。 目的 探讨缺血性卒中后FD严重程度的影响因素。 方法 连续选取2017年3月至2018年7月在天津中医药大学第一附属医院针灸科住院治疗的缺血性卒中后并发FD的中老年患者180例,住院期间采用自拟消化不良症状积分量表对患者FD严重程度进行评估,按照量表评分结果将患者分为轻度FD组（评分≤7分,n=115）和中重度FD组（评分>7分,n=65）。通过病历系统收集患者资料,采用多因素Logistic回归探究缺血性卒中后FD严重程度的影响因素。 结果 180例患者FD症状评分3~12分,平均（7.2±1.7）分,其中115例（63.9%）患者症状评分≤7分,65例（36.1%）患者症状评分>7分。不同年龄（43~55岁、>55岁）和卒中病程（急性期、恢复期、后遗症期）缺血性卒中患者FD严重程度比较,差异有统计学差异（P<0.05）。多因素Logistic回归分析结果显示,年龄43~55岁〔OR=3.367,95%CI（1.399,8.104）,P=0.007〕以及丘脑梗死〔OR=2.111,95%CI（1.038,4.290）,P=0.039〕是缺血性卒中后FD严重程度的危险因素。 结论 年龄43~55岁和丘脑梗死是缺血性卒中患者FD严重程度的危险因素,可作为评估FD发展的依据,为临床医生对缺血性卒中患者FD的早期干预提供参考。     

Prevalence of Helicobacter pylori cagA genotype among dyspeptic patients in Southern Thailand

ObjectiveTo investigate the prevalence of Helicobacter pylori (H. pylori) infection in dyspepsia patients and its relation to virulence factor cagA gene.MethodsIn total, 110 gastric biopsies from dyspeptic patients were comparatively studied using rapid urease test and multiplex PCR. Multiplex PCR detected three genes of 16S rRNA, cagA, and ureC.ResultsH. pylori was detected in 14 gastric biopsies (13%). Significantly higher number of female were infected. Furthermore, cagA gene was found in all H. pylori–positive specimens. In addition, the result indicated that the multiplex PCR with annealing temperature at 57 oC was able to effectively amplify specific products.ConclusionThe results confirmed that high preva¬lence of cagA gene in H. pylori among dyspeptic patients in Southern Thailand.     

Acute and subchronic toxicities of QX100626, a 5-HT4 receptor agonist,in rodents and Beagle dogs

Serotonin 5-hydroxytryptamine 4(5-HT4) receptor agonists have been widely prescribed as a prokinetics drug for patients with gastro-esophageal reflux disease and functional dyspepsia. QX100626, one of the 5-HT4 receptor agonists, has been studied as a promising agent for this clinical use. The objective of the present study was to identify possible target organs of toxicity and propose a non-toxic dose of QX100626 for clinical usage. After single lethal dose oral and intravenous testing in rodents, some signs indicative of adverse CNS effects were observed. The minimum toxic dose of QX100626 for a single oral administration for dogs was 90.0 mg/kg b.w., and the severe toxic dose was more than 300 mg/kg b.w. The No Observed Adverse Effect Level (NOAEL) of QX100626 by daily oral administration for rats and dogs was 20 mg/kg and 10 mg/kg, respectively, whereas the minimum toxic dosages were 67 and 30 mg/kg, respectively. All of the adverse effects suggested that kidney, digestive tract, as well as nervous, hematological, and respiratory systems might be the target organs of toxicity for humans induced by QX100626. The compound could be a safe alternative to other existing prokinetic agents for the treatment of functional bowel disorders.     

阿奇霉素联合红霉素治疗小儿支原体肺炎53例疗效观察

目的探讨阿奇霉素联合红霉素治疗小儿支原体肺炎的疗效。方法选取符合条件的支原体肺炎的患儿158例,分为红霉素组、阿奇霉素组和联合治疗组,分别为55例、50例和53例,分析比较其临床疗效。结果 3组治疗方案有效率分别为70.9%、76%、92.5%,红霉素组和阿奇霉素组的临床治疗总有效率比较差异无统计学意义（P〉0.05）,联合治疗组与前2组比较差异有统计学意义（P〈0.05）。结论红霉素和阿奇霉素两种药物联合治疗小儿支原体肺炎,具有良好的临床效果,值得临床上推广。