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Pakistan Journal of Medical Sciences 2023To investigate the effect of different treatment methods of the left colic artery (LCA) on postoperative rehabilitation of patients undergoing laparoscopic radical...
OBJECTIVE
To investigate the effect of different treatment methods of the left colic artery (LCA) on postoperative rehabilitation of patients undergoing laparoscopic radical resection of rectal cancer.
METHODS
Retrospective analysis was performed on 70 patients undergoing laparoscopic radical resection of rectal cancer who were admitted to The Affiliated Suqian Hospital of Xuzhou Medical University from January, 2020 to December, 2022 were selected and divided into two groups according to different treatment methods of LCA. The preservation group (LCA group) (n=34 cases) and the non-preservation group (NLCA group) (n=36 cases). Both groups were treated with laparoscopic radical resection of rectal cancer. IMA was preserved in the LCA group, but not in the NLCA group. The efficacy indicators, surgical treatment and rehabilitation-related indicators, gastrointestinal hormone indicators (motilin (MTL), gastrin (GAS)), and postoperative complications risk were compared between the two groups before and after surgery.
RESULTS
No statistically significant difference was observed between the two groups in terms of efficacy indicators (total number of lymph nodes dissected and number of lymph nodes at the root of the IMA), operation time, intraoperative blood loss, and postoperative drainage tube placement time (p>0.05). However, postoperative anal flatus and hospital stay in the LCA group were considerably shorter than those in the NLCA group (p<0.05). Postoperatively, the levels of MTL and GAS in the two groups were significantly decreased, and the LCA group decreased slightly compared with the NLCA group (p<0.05). Moreover, the incidence of complications in the LCA group (5.88%) was significantly lower than that in the NLCA group (27.78%) (p<0.05).
CONCLUSION
Preservation of LCA and no-preservation of LCA in laparoscopic radical resection of rectal cancer are comparable in terms of therapeutic effect, and the surgery with preservation of LCA is worthy of clinical promotion due to its various benefits such as less impact on gastrointestinal hormone indicators, lower risk of complications, and faster postoperative recovery.
PubMed: 36694757
DOI: 10.12669/pjms.39.1.6366 -
Food Science & Nutrition Jun 2021Constipation is the most common gastrointestinal complaint all over the world, and it is a risk factor of colorectal cancer. In this study, the protective of Quercetin...
Constipation is the most common gastrointestinal complaint all over the world, and it is a risk factor of colorectal cancer. In this study, the protective of Quercetin against loperamide-induced constipation and its potential mechanism in a rat model were investigated. Results showed that Quercetin at 25 mg/kg and 50 mg/kg could significantly ( < .05) increase the intestinal transit rate, motilin, gastrin, substance P levels, and concentration of short-chain fatty acids (SCFAs), reduce the somatostatin levels, and improve the gastrointestinal peristalsis of rats. In addition, the expression levels of enteric nerve-related factors, glial cell line-derived neurotrophic factor (GDNF), transient receptor potential vanilloid 1 (TRPV1), nitric oxide synthase (NOS), c-Kit, stem cell factor (SCF), and aquaporin 3 (AQP3) were examined by RT-qPCR and/or Western blot analysis. The results suggest that Quercetin relieves loperamide-induced constipation by increasing the levels of interstitial cells of Cajal markers (c-Kit and SCF), as well as AQP3. In conclusion, the present study suggested that Quercetin exerted a protective effect against loperamide-induced constipation, which may be associated with its role in regulation of multiple signal pathways.
PubMed: 34136194
DOI: 10.1002/fsn3.2296 -
American Journal of Translational... 2021To investigate the efficacy of faecal microbiota transplantation (FMT) in the treatment of ulcerative colitis (UC) and its effect on gastrointestinal motility (GM) and...
OBJECTIVE
To investigate the efficacy of faecal microbiota transplantation (FMT) in the treatment of ulcerative colitis (UC) and its effect on gastrointestinal motility (GM) and immune function.
METHODS
A retrospective cohort study was conducted on 47 UC patients. The patients were divided into an observation group (n=17, treated with FMT) and a control group (n=30, treated with conventional treatment) according to the treatment regimen. In the observation group, FMT was used to treat colonic lesions by transplanting colonic bacteria fluid from healthy people. Clinical efficacy, immune function, level of inflammatory factors and gastrointestinal function of the two groups were observed before and after treatment.
RESULTS
The total response rates of observation group was 94.12%, which was higher than that of control group (70.00%; P<0.05). After treatment, the contents of CD3+, CD4+ T cells and CD4+/CD8+ ratio were increased, while the content of CD8+ T cells was decreased in both groups compared with those before treatment (all P<0.05); and the contents of CD3+, CD4+ T cells and CD4+/CD8+ ratio in the observation group were higher than those in the control group, while CD8+ T cells showed an opposite trend (P<0.05). The levels of immunoglobulin A, immunoglobulin G and immunoglobulin M as well as interleukin-6, C-reactive protein, tumor necrosis factor-α and motilin were lower than those before treatment in both groups (all P<0.05), and the decreases in the observation group were more significant than those in the control group (all P<0.001). After treatment, cholecystokinin and vasoactive peptide were higher than those before treatment in both groups (all P<0.05), and the increased degree in the observation group was more obvious than that in the control group (all P<0.001).
CONCLUSION
FMT has significant clinical efficacy in the treatment of UC, which may be related to the improvement of immune function, alleviation of inflammatory response and promotion of GM recovery.
PubMed: 35035748
DOI: No ID Found -
Evidence-based Complementary and... 2021Evidence for the efficacy and safety of electroacupuncture (EA) on gastrointestinal function recovery after gynecological surgery is unclear. (Review)
Review
BACKGROUND
Evidence for the efficacy and safety of electroacupuncture (EA) on gastrointestinal function recovery after gynecological surgery is unclear.
OBJECTIVE
This meta-analysis aimed to evaluate the effects of EA on recovery of postoperative gastrointestinal function for patients receiving gynecological surgery. Data sources: PubMed, Cochrane Central Register of Controlled Trials (CINAHL), Embase, China National Knowledge Infrastructure (CNKI), Weipu (CQVIP), and Wanfang databases were systematically searched from the inception dates to May 30, 2020, for relevant randomized controlled trials (RCTs). Study selection: RCTs that evaluated EA for postoperative gastrointestinal function directly related to gynecological surgery in adults aged 18 years or over. Data extraction and synthesis: paired reviewer independently extracted the data and assessed study quality. Standardized mean differences (SMD) were calculated as the effect measure from a random effects model. Main outcomes and measures: time to first flatus (TFF), time to bowel sounds recovery (TBS), and time to first defecation (TFD) were recorded as primary outcomes; postoperative nausea and vomiting (PONV), motilin (MTL), gastrin (GAS), pH value of gastric mucosa (pHi), gastric mucosal partial pressure of carbon dioxide (PgCO2), vasoactive intestinal peptide (VIP), and adverse event were reported as secondary outcomes.
RESULTS
We included eighteen RCTs (1117 participants). Our findings suggested that compared to the control group (CG), electroacupuncture group (EG) showed significant effects on TFF (SMD = -0.98, 95% CI: [-1.28, -0.68], < 0.00001, = 69%), TBS (SMD = -0.98, 95% CI: [-1.84, -0.12], =0.03, = 92%), and TFD (SMD = -1.23, 95% CI: [-1.59, -0.88], < 0.0001, = 0%). Moreover, the incidence of PONV at postoperative 6 h (OR = 0.42, 95% CI: [0.27, 0.64], < 0.0001, = 0%) and 24 h (OR = 0.46, 95% CI: [0.32, 0.68], < 0.0001, = 0%) was lower in the EG than that in the CG, whereas no significant difference in ratio of PONV at postoperative 48 h (OR = 0.55, 95% CI: [0.20, 1.51], =0.25, = 0%) was detected between the two groups. Meanwhile, there was a significant effect in favor of EA on the level of MTL at postoperative 6 h (SMD = -0.93, 95% CI: [-1.36, -0.61], < 0.0001, = 21%), while no significant effect was observed at postoperative 24 h (SMD = -0.43, 95% CI: [-0.89, 0.02], =0.06, = 69%) in the EG when compared to the CG. Additionally, a large significant effect on decreasing PgCO was found in the EG in comparison to the CG, but no significant effect in favor of EA on GAS, VIP, or pHi was observed. It was reported that there was one participant with pain at the needling sites and bruising, and three participants withdrew because they were not intolerant to EA.
CONCLUSIONS
EA could be a promising strategy for the prevention and treatment of gastrointestinal dysfunction after gynecological surgery, including shortening TFF and TFD, TBS, regulating MTL, and decreasing the ratio of PONV within postoperative 24h. The effects on MTL and PONV varied with different intervention points, and EA used at 30 min prior to surgery might be recommended. However, the evidence quality ranged from low to very low, and large-scale and high-quality RCTs were warranted.
PubMed: 34970326
DOI: 10.1155/2021/8329366 -
Medicine Feb 2024Nutritional problems in the early stages of severe burns are prominent and seriously affect the clinical outcomes of patients. Our aim is to analyze the effects of early... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Nutritional problems in the early stages of severe burns are prominent and seriously affect the clinical outcomes of patients. Our aim is to analyze the effects of early enteral nutrition (EEN) in patients with severe burns.
METHODS
In this study, relevant articles were searched in 8 English and Chinese data, with a time limit from the creation of the database to June 2023. Two researchers independently completed the search, screening and quality assessment of the articles. We conducted a systematic review and meta-analysis of randomized controlled trials that examined EEN therapy in people with severe burns. We compared the effects of EEN and non-EEN therapy in severely burned patients. The outcomes were mortality, gastrointestinal complications, nutritional indicators, gastrointestinal hormones, sepsis, length of hospital stay and wound healing time. Categorical variables were expressed as OR and 95% CI was calculated, and continuous variables were expressed as MD and 95% CI was calculated. The protocol for this systematic review was registered in PROSPERO on May 12, 2023 (identifier CRD42023422895).
RESULTS
Nineteen studies with a total of 1066 participants met the inclusion criteria. When comparing EEN therapy with non-EEN therapy, the experiment group had significantly lower mortality [OR = 0.39, 95% CI (0.20, 0.74), P = .004], lower wound healing time [MD = -10.77, 95% CI (-13.66,-7.88), P < .00001], fewer gastrointestinal complications [OR = 0.18, 95% CI (0.09, 0.36), P < .00001], lower rates of gastrointestinal hemorrhage [OR = 0.12, 95% CI (0.04, 0.36), P = .0001], lower rates of sepsis [OR = 0.40, 95% CI (0.24, 0.66), P = .0005], shorter length of hospital stay [MD = -12.08, 95% CI (-13.61, 9.19-10.56), P < .00001], and higher prealbumin levels [MD = 29.04, 95% CI (21.98, 36.10), P < .00001], higher total albumin levels [MD = 6.74, 95% CI (4.29, 9.19), P < .00001], and gastrin levels [MD = 15.93, 95% CI (10.12, 21.73), P < .00001]. However, there was no significant difference in albumin between the 2 groups [MD = 2.62, 95% CI (-0.30, 5.55), P = .08] or motilin levels [MD = 12.48, 95% CI (-43.59, 68.56), P = .66].
CONCLUSIONS
EEN plays an important role in the rehabilitation of patients with severe burns. EEN is beneficial to reduce complications and the length of hospital stay, maintain organ function, optimize the nutritional status of patients, promote wound healing, and improve the survival rate of patients.
Topics: Humans; Enteral Nutrition; Time Factors; Burns; Gastrointestinal Diseases; Sepsis; Length of Stay
PubMed: 38363893
DOI: 10.1097/MD.0000000000037023 -
Experimental and Clinical Endocrinology... Jan 2020The study aimed to investigate the associations between glycaemic control after acute pancreatitis and gastrointestinal motility, using plasma motilin concentration and... (Clinical Trial)
Clinical Trial
AIM
The study aimed to investigate the associations between glycaemic control after acute pancreatitis and gastrointestinal motility, using plasma motilin concentration and gastroparesis cardinal symptom index score as proxies.
METHODS
This cross-sectional study recruited a total of 93 individuals after acute pancreatitis. Gastroparesis cardinal index scores, demographic and anthropometric factors, as well as pancreatitis-related factors were analysed. Fasting venous blood was collected to measure motilin, glycated haemoglobin, and fasting blood glucose. Linear regression analyses were conducted to investigate the associations between glycaemic control and gastrointestinal motility in unadjusted and adjusted models.
RESULTS
Motilin was significantly higher in individuals with diabetes across all adjusted models, with the highest ß-coefficient (95% confidence interval) of 588.89 (138.50, 1039.28); P=0.010. Fasting blood glucose was significantly associated with motilin across all models, with the highest ß-coefficient (95% confidence interval) of 156.30 (55.49, 257.10); P=0.002. Glycated haemoglobin was significantly associated with motilin in one adjusted model with ß-coefficient (95% confidence interval) of 18.78 (1.53, 36.02); P=0.033. Gastroparesis cardinal symptom index was not significantly associated with any measure of glycaemic control.
CONCLUSIONS
Diabetes in individuals after acute pancreatitis appears to be characterised by elevated plasma motilin but not gastroparesis cardinal symptom index. The role of motilin in this setting warrants further investigations.
Topics: Adult; Blood Glucose; Cross-Sectional Studies; Diabetes Mellitus; Female; Gastroparesis; Humans; Male; Middle Aged; Motilin; Pancreatitis
PubMed: 30873575
DOI: 10.1055/a-0859-7168 -
Frontiers in Surgery 2022To explore the efficacy and safety of laparoscopic radical resection of colorectal cancer in the elderly patients and its impact on gastrointestinal function.
OBJECTIVE
To explore the efficacy and safety of laparoscopic radical resection of colorectal cancer in the elderly patients and its impact on gastrointestinal function.
METHODS
A total of 122 elderly patients with colorectal cancer admitted to our hospital from March 2020 to June 2021 were selected as the research subjects, and they were divided into the control group ( = 61) and the observation group ( = 61). The control group was treated with traditional laparotomy, and the observation group was treated with laparoscopic radical resection of colorectal cancer. The clinical data of operation time, incision length, intraoperative bleeding volume, and hospitalization time in the two groups were recorded. Serum motilin (MTL) and gastrin (GAS) levels were measured pre- and post-operatively. The duration of abdominal distension, the time for the abdominal sound to return to normal, the time for the anal exhaust to normal, and the time for normal food intake were recorded after operation. The patients were followed up for 6 months post-operatively, and the complications during follow-up were recorded.
RESULTS
The total response rate of the observation group (95.08%) was higher than that of the control group (81.97%) ( < 0.05). The operation time, incision length, intraoperative bleeding volume, and hospitalization time of the observation group were lower than those of the control group ( < 0.05). The duration of abdominal distension, the time for bowel sounds to return to normal, the time for the anus to exhaust gas to normal, and the normal eating time in the observation group were all lower than those in the control group ( < 0.05). After surgery, the levels of MTL and GAS in the two groups were lower than those before surgery, and those in the observation group were lower than those in the control group ( < 0.05). The total incidence of complications in the observation group (3.28%) was lower than that in the control group (13.12%) ( < 0.05).
CONCLUSION
Laparoscopic radical resection of colorectal cancer in the elderly patients has good effect, short operation time, less trauma, less blood loss during operation, short hospital stay, good recovery of gastrointestinal function, fewer complications, and high safety.
PubMed: 35284487
DOI: 10.3389/fsurg.2022.840461 -
Cellular and Molecular Biology... Jun 2022it was aimed to investigate the efficacy and safety of cupping moxibustion in patients with functional diarrhea. 51 patients diagnosed with functional diarrhea from... (Randomized Controlled Trial)
Randomized Controlled Trial
it was aimed to investigate the efficacy and safety of cupping moxibustion in patients with functional diarrhea. 51 patients diagnosed with functional diarrhea from January 2021 to December 2021 were selected as the objects, and they were randomly divided into the control group (oral montmorillonite powder) and the experiment group (oral montmorillonite powder combined with cupping moxibustion). The number of diarrheas, Bristol stool, traditional Chinese medicine (TCM) syndromes, clinical efficacy indexes, self-rating anxiety scale (SAS) score, the MOS item short from health survey (SF-36) scale score, peripheral blood cell levels of CD4+, CD8+, and Th17, gastrin (GAS), motilin (MTL), and cholecystokinin (CCK) levels was assessed before and after treatment. The adverse events were also recorded. Compared with those before treatment, all indexes of both groups were significantly improved (P<0.05). Compared with those of the control group, the number of diarrheas, Bristol stool, TCM syndrome score, SAS score, and CD8+ cell levels was significantly decreased after treatment in the experiment group (P<0.05). The clinical cure rate (48.0% vs. 73.1%), SF-36 score, GAS, MTL, CCK contents, and CD4+, and Th17 cell levels were significantly increased (P<0.05). No significant difference was in the incidence of adverse events between the two groups (P>0.05). It could be suggested that cupping moxibustion could be applied in the treatment of functional diarrhea, improving the clinical symptoms, relieving anxiety, enhancing gastrointestinal and immune functions, and promoting the quality of life of patients significantly.
Topics: Bentonite; Cholecystokinin; Diarrhea; Gastrins; Humans; Immunity; Motilin; Moxibustion; Powders; Quality of Life
PubMed: 36227672
DOI: 10.14715/cmb/2022.68.6.16 -
Bioorganic & Medicinal Chemistry Letters Mar 2022Motilin is a 22-amino-acid gastrointestinal (GI) hormone and is involved in the regulation of GI motility through binding to GPR38, the motilin receptor which is...
Motilin is a 22-amino-acid gastrointestinal (GI) hormone and is involved in the regulation of GI motility through binding to GPR38, the motilin receptor which is expressed on smooth muscle cells in the GI tract. Therefore, GPR38 agonists are expected to be novel gastrointestinal prokinetic agents for the treatment of functional gastrointestinal disorders such as gastroparesis and chronic constipation. We identified a series of N-methylanilide derivatives as novel non-macrolide GPR38 agonists. Among them, 12 di-l-tartrate (DS-3801b) was selected as a clinical candidate for further evaluation.
Topics: Aniline Compounds; Animals; Cyclohexanes; Dose-Response Relationship, Drug; Drug Discovery; Gastrointestinal Agents; Gastroparesis; Humans; Molecular Structure; Piperazines; Rabbits; Receptors, G-Protein-Coupled; Structure-Activity Relationship
PubMed: 35051575
DOI: 10.1016/j.bmcl.2022.128554 -
American Journal of Translational... 2023This study was designed to explore the effects of ulinastatin combined with somatostatin on disease control and serum inflammatory factors in patients with severe...
OBJECTIVE
This study was designed to explore the effects of ulinastatin combined with somatostatin on disease control and serum inflammatory factors in patients with severe pancreatitis.
METHODS
The data of 80 patients with severe pancreatitis treated in the First Affiliated Hospital of Jiangxi Medical College from May 2020 to April 2022 were analyzed retrospectively. Among them, 36 patients treated with somatostatin alone (3 mg somatostatin added in 50 mL normal saline) on the basis of standard treatment were assigned to a control group, and the other 44 patients treated with both ulinastatin (100,000 U of ulinastatin injection added in 250 mL 5% glucose solution) and somatostatin (3 mg somatostatin added in 50 mL normal saline) were enrolled into a study group. The levels of serum inflammatory factors (interleukin-1β (IL-1β), interleukin-6 (IL-6), and soluble intercellular adhesion molecule-1 (sICAM-1)), biochemical indexes (C-reactive protein, white blood cell count, and serum amylase) and gastrointestinal function indexes (motilin and gastrin) in the two groups were analyzed and compared before and after treatment. Additionally, the alleviation of clinical symptoms, treatment response and occurrence of adverse reactions were compared between the two groups. The mortality rate of patients within 1 month after the treatment was evaluated, and the risk factors affecting the prognosis were analyzed through logistics regression.
RESULTS
Before treatment, there was no significant difference between the two groups in the levels of IL-1β, IL-6 and sICAM-1 (P>0.05), while after treatment, the levels of all three factors decreased significantly in both groups (P<0.0001), with more notable decreases in the study group than those in the control group (P<0.0001). Before treatment, the two groups were not significantly different in the levels of C-reactive protein, white blood cell count, and serum amylase (P>0.05), while after treatment, all the three levels decreased notably in both groups (P<0.0001), with notably lower levels in the study group than those in the control group (P<0.0001). Before treatment, the levels of motilin and gastrin in the two groups were not significantly different (P>0.05), while after treatment, motilin increased significantly and gastrin decreased significantly in both groups (P<0.0001), and the study group showed a notably higher motilin level and a notably lower gastrin level than the control group (P<0.0001). The study group experienced a significantly earlier disappearance time of abdominal distension and abdominal pain and a significantly shorter hospitalization time than the control group (P<0.0001). Moreover, the study group showed a notably higher overall response rate than the control group (P=0.029), and presented a notably lower incidence of adverse reactions than the control group (P=0.036). According to univariate analysis, age, onset time, Acute Physiology and Chronic Health Evaluation II score and therapeutic regimen were the factors impacting the patients' prognosis. According to logistics regression analysis, therapeutic regimen was an independent risk factor affecting the prognosis.
CONCLUSION
Compared with somatostatin alone, ulinastatin combined with somatostatin is more effective in the treatment of severe pancreatitis. The combination can substantially alleviate the inflammatory response and improve the gastrointestinal function and clinical symptoms of patients, without increasing adverse reactions. Therefore, ulinastatin combined with somatostatin is worthy of clinical promotion.
PubMed: 37854214
DOI: No ID Found