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Applied Bionics and Biomechanics 2022Pancreatic cancer is one of the deadliest solid malignancies. Its surgical resection is technically very challenging and has a high risk of complications even after...
OBJECTIVE
Pancreatic cancer is one of the deadliest solid malignancies. Its surgical resection is technically very challenging and has a high risk of complications even after discharge. This study analyzed the risk factors associated with unplanned readmission after pancreatic cancer surgery.
METHODS
Pancreatic cancer patients who were readmitted within 30 days after surgery were classified as the observation group, while those not readmitted within 30 days postsurgery were classified as the control group. The serum levels of gastrointestinal hormones, stress hormones, and peripheral immune cells of the two groups were compared at different intervals.
RESULTS
No significant differences in gender and age were observed between the two groups. At 7, 14, and 21 days postsurgery, the levels of gastrointestinal hormones motilin, gastrin, calcitonin gene-related peptide, and growth hormone-releasing peptide of the observation group were lower than the control group, while the levels of adrenocorticotropin, renin, angiotensin, and plasma aldosterone of the observation group were significantly higher than the control group. In addition, compared to the control group, lower levels of CD4+T cells, CD8+T cells, and NKT cells and higher levels of Treg, Breg, and MDSC cells were observed in the peripheral blood of the observation group.
CONCLUSION
The serum levels of gastrointestinal hormones, stress hormones, and peripheral immune cells could be associated with the risk of unplanned readmission within 30 days after pancreatic cancer surgery.
PubMed: 35528536
DOI: 10.1155/2022/6106914 -
Therapeutic Advances in Gastroenterology 2020We evaluated the safety and efficacy of fecal microbiota transplantation (FMT) for chronic functional constipation (CFC) ineffectively treated by conventional...
BACKGROUND
We evaluated the safety and efficacy of fecal microbiota transplantation (FMT) for chronic functional constipation (CFC) ineffectively treated by conventional constipation medication.
METHODS
Thirty-four patients with CFC underwent FMT treatment (three rounds, gastroscopy). Clinical scales, including the Wexner constipation score as the main index of efficiency, were completed at baseline; after each treatment, and at 2 and 3 months of follow up. Secondary evaluation indices included the self-assessment of constipation symptoms, patient assessment constipation quality-of-life questionnaire, Bristol stool form scale, and Zung's self-rating depression and anxiety scales. Gastrointestinal motility, motilin, gastrin, nitric oxide (NO), and 5-hydroxytryptamine (5-HT) were assessed before and after treatment. Intestinal flora changes were assessed by 16S ribosomal ribonucleic acid (rRNA) sequencing.
RESULTS
There were no serious adverse reactions. The clinical cure rate was 73.5% (25/34), clinical remission rate was 14.7% (5/34), and the inefficiency rate was 11.8% (4/34). Clinical scale data indicated that the FMT treatment was effective. Furthermore, FMT treatment promoted intestinal peristalsis, increased gastrointestinal motility, and increased serum NO and 5-HT levels. The 16S rRNA sequencing data indicated that high abundances of and may be the cause of constipation, and high abundances of and may be the main factors in curing constipation.
CONCLUSION
Treatment with FMT regulates the intestinal microflora and changes the abundance of CFC-associated bacterial flora to improve constipation.
PubMed: 33193813
DOI: 10.1177/1756284820968423 -
Evidence-based Complementary and... 2022Many attempts have been made to inhibit the formation of postoperative intraperitoneal adhesions, but the results have been discouraging. Therefore, the identification...
BACKGROUND
Many attempts have been made to inhibit the formation of postoperative intraperitoneal adhesions, but the results have been discouraging. Therefore, the identification of effective preventative measures or treatments is of great importance. In this study, the substantial potential of naringin (NG) to reduce peritoneal adhesions was validated in a rat model.
MATERIALS AND METHODS
A rat peritoneal adhesion model was established by abrasion of the cecum and its opposite intraperitoneal region under aseptic surgical conditions. After the operation, three groups of NG-treated rats were given 2 mL of NG by gavage at different concentrations (40, 60, or 80 mg/kg/d). The sham, control, and hyaluronan (HA) groups were given equal volumes of normal saline daily. On the 8th day, all rats were sacrificed 30 min after the administration of an activated carbon solution (10 mL/kg) by oral gavage. Intraperitoneal adhesion formation was adequately evaluated by necropsy, hematoxylin and eosin (HE) staining, Sirius red staining, immunofluorescence staining, enzyme-linked immunosorbent assays, and reactive oxygen species (ROS) probes. The gastrointestinal dynamics of the rats were assessed on the basis of a small intestinal charcoal powder propulsion test and the detection of motilin and gastrin levels in serum.
RESULTS
Intraperitoneal adhesions were markedly reduced in the group of rats receiving high-dose NG. Compared with the control group, the high-dose NG group showed clear reductions in inflammatory reactions, oxidative stress, collagen deposition, and fibroblast formation in the adhesion tissue and enhanced gastrointestinal dynamics ( < 0.05).
CONCLUSION
NG alleviated the severity of intraperitoneal adhesions in a rat model by reducing inflammation, oxidative stress, collagen deposition, and fibroblast formation, highlighting the potential of NG as a drug candidate to prevent postoperative peritoneal adhesion formation.
PubMed: 35069760
DOI: 10.1155/2022/5331537 -
Annals of Palliative Medicine May 2020Functional dyspepsia (FD) is a common, etiologically complex disease which persistently and recurrently attacks the digestive system. However, the efficacy of Western... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Functional dyspepsia (FD) is a common, etiologically complex disease which persistently and recurrently attacks the digestive system. However, the efficacy of Western medicine in treating FD is unsatisfactory and its use is often accompanied with severe side effects. Here, this study conducted a metaanalysis on the clinical efficacy and safety of the treatment of FD with Xin kai bitter method combined with Western medicine, to produce a more objective and comprehensive systematic review to guide clinical application.
METHODS
Systematic searches were conducted of the PubMed, Cochrane Library, EMBASE, Medline, Web of Science, Wanfang Databases, and Weipu (VIP) databases, as well as China National Knowledge Infrastructure (CNKI). Randomized controlled clinical trials (RCTs) of Xin kai bitter method in the treatment of FD were included in the study. The total effective rate and safety were evaluated with relative risk (RR) and the quantitative data were evaluated with standard mean difference (SMD) and 95% confidence interval (CI). The quality of the included literature was evaluated using RevMan5.3 software, and the "meta" package of R3.5.1 software was used for all other statistical analysis.
RESULTS
A total of 24 papers involving 1,044 patients in the treatment group and 989 patients in the control group were included. A total of 23 articles reported the total effective rate after 1 month of treatment (I2 =0%), and the total effective rate in the treatment group was 1.21 times higher than that in the control group (95% CI: 1.17 vs. 1.26). A total of 4 articles reported the safety rate after 1 month of treatment (I2 =27%); the safety rate in the treatment group was 0.43 times than that in the control group (95% CI: 0.23 vs. 0.82). A total of 8 articles reported traditional Chinese medicine (TCM) symptom score or clinical symptoms before and after 1 month of treatment (I2 =91%), and the difference in TCM symptom score before and after treatment in the treatment group was significantly lower than that in the control group, with a SMD of -1.19 (95% CI: -1.71, -0.66). A total of 6 articles reported the motilin (MTL) level before and after 1 month of treatment, and the difference before and after treatment in MTL in the treatment group was not significantly different to that in the control group, with a SMD of 0.92 (95% CI: -0.12, 1.97).
CONCLUSIONS
Compared to conventional treatment, Xin kai bitter method has a higher clinical effect and lower adverse reaction rate in patients with FD, and can improve TCM symptom score. However, highquality RCT research is still needed to further explore the safety of Xin kai bitter method for treating FD.
Topics: China; Drugs, Chinese Herbal; Dyspepsia; Humans; Medicine, Chinese Traditional; Treatment Outcome
PubMed: 32434358
DOI: 10.21037/apm-20-860 -
World Journal of Gastroenterology Sep 2020Gastric cancer (GC) is a heavy burden in China. Nutritional support for GC patients is closely related to postoperative rehabilitation. However, the role of early oral...
BACKGROUND
Gastric cancer (GC) is a heavy burden in China. Nutritional support for GC patients is closely related to postoperative rehabilitation. However, the role of early oral feeding after laparoscopic radical total gastrectomy in GC patients is unclear and high-quality research evidence is scarce.
AIM
To prospectively explore the safety, feasibility and short-term clinical outcomes of early oral feeding after laparoscopic radical total gastrectomy for GC patients.
METHODS
This study was a prospective cohort study conducted between January 2018 and December 2019 based in a high-volume tertiary hospital in China. A total of 206 patients who underwent laparoscopic radical total gastrectomy for GC were enrolled. Of which, 105 patients were given early oral feeding (EOF group) after surgery, and the other 101 patients were given the traditional feeding strategy (control group) after surgery. Perioperative clinical data were recorded and analyzed. The primary endpoints were gastrointestinal function recovery time and postoperative complications, and the secondary endpoints were postoperative nutritional status, length of hospital stay and expenses, .
RESULTS
Compared with the control group, patients in the EOF group had a significantly shorter postoperative first exhaust time (2.48 ± 1.17 d 3.37 ± 1.42 d, = 0.001) and first defecation time (3.83 ± 2.41 d 5.32 ± 2.70 d, = 0. 004). In addition, the EOF group had a significant shorter postoperative hospitalization duration (5.85 ± 1.53 d 7.71 ± 1.56 d, < 0.001) and lower postoperative hospitalization expenses (16.60 ± 5.10 K¥ 21.00 ± 7.50 K¥, = 0.014). On the 5 day after surgery, serum prealbumin level (214.52 ± 22.47 mg/L 204.17 ± 20.62 mg/L, = 0.018), serum gastrin level (246.30 ± 57.10 ng/L 223.60 ± 55.70 ng/L, = 0.001) and serum motilin level (424.60 ± 68.30 ng/L 409.30 ± 61.70 ng/L, = 0.002) were higher in the EOF group. However, there was no significant difference in the incidence of total postoperative complications between the two groups ( = 0.507).
CONCLUSION
Early oral feeding after laparoscopic radical total gastrectomy can promote the recovery of gastrointestinal function, improve postoperative nutritional status, reduce length of hospital stay and expenses while not increasing the incidence of related complications, which indicates its safety, feasibility and potential benefits for gastric cancer patients.
Topics: China; Gastrectomy; Humans; Laparoscopy; Length of Stay; Postoperative Complications; Prospective Studies; Stomach Neoplasms; Treatment Outcome
PubMed: 33024401
DOI: 10.3748/wjg.v26.i36.5508 -
Translational Pediatrics Aug 2021The purpose of the study was to investigate the effects of cefuroxime axetil combined with Xingpi Yanger granules on the treatment of upper respiratory tract infection...
Effects of cefuroxime axetil combined with Xingpi Yanger granules on the serum gastrin, motilin, and somatostatin levels in children with upper respiratory tract infection accompanied by diarrhea: results of a randomized trial.
BACKGROUND
The purpose of the study was to investigate the effects of cefuroxime axetil combined with Xingpi Yanger granules on the treatment of upper respiratory tract infection accompanied by diarrhea and on serum gastrin (GAS), motilin (MOT), and somatostatin (SS) levels in children.
METHODS
In total, 124 children with upper respiratory tract infection accompanied by diarrhea admitted to the department of pediatrics in our hospital from May 2019 to May 2020 were selected and divided into a study group (n=62) and a reference group (n=62), according to admission number. The reference group children received routine treatment, while the children in the study group were treated with cefuroxime axetil combined with Xingpi Yanger granules. After treatment, each clinical index of the children in both groups was detected to evaluate the clinical efficacy of the different treatment methods.
RESULTS
There were no significant differences in gender ratio, average age, mean body temperature, mean duration of diarrhea, average weight, or place of residence between the 2 groups (P>0.05); the total clinical effective rate after treatment in the study group was significantly higher than that in the reference group (P<0.05); the dehydration correction time, antipyretic time, antidiarrheal time, and total treatment time in the study group were all significantly lower than those in the reference group (P<0.001); the serum GAS and MOT levels at T1, T2, and T3 in the study group were significantly lower than those in the reference group (P<0.001), whereas the SS levels at T1, T2, and T3 in the study group were significantly higher than those in the reference group (P<0.001); and the incidence of adverse reactions of the children in the study group was significantly lower than that in the reference group (P<0.05).
CONCLUSIONS
Cefuroxime axetil combined with Xingpi Yanger granules can significantly lower serum GAS, MOT, and SS levels and shorten treatment time in children with upper respiratory tract infection accompanied by diarrhea, with significant clinical efficacy and high safety, and is thus worthy of application and promotion.
TRIAL REGISTRATION
Chinese Clinical Trial Registry ChiCTR2100049234.
PubMed: 34584881
DOI: 10.21037/tp-21-314 -
The Turkish Journal of Pediatrics 2021Feeding intolerance (FI) is a common complication that may cause great harm to preterm infants. The mechanism of FI remains unclear, but probiotics may help prevent and...
BACKGROUND
Feeding intolerance (FI) is a common complication that may cause great harm to preterm infants. The mechanism of FI remains unclear, but probiotics may help prevent and alleviate its symptoms. We hypothesized that the alteration in gut microbiota may be associated with the development of FI. Our study aimed to investigate the association between gut microbiota and FI in preterm infants.
METHODS
Ninety-seven preterm infants were divided into the FI group (N=42) and the feeding tolerance (FT) group (N=55) depending on whether the infants were diagnosed with FI. The fecal samples of each infant were collected on the 7th day after birth. Fecal microbiota was analyzed by 16S rRNA sequencing. Plasma motilin were detected on day-1, 7, 14, and 21.
RESULTS
The microbial diversity of the FI group was significantly lower than that of the FT group. The abundance levels of phylum Proteobacteria, class Gammaproteobacteria, genera such as Escherichia/Shigella were higher in the FI group than in the FT group. The abundance levels of phylum Firmicutes, class Negativicutes, and genus Veillonella were higher in the FT group than in the FI group. The motilin levels on days 7 and 14 were negatively correlated with the FI-enriched genera Planomicrobium and Vibrio, respectively. Our study also found gut microbiota was correlated with FI clinical characteristics, including gestational age, birth weight, age of FI diagnosis, age of FI disappearance, and FI duration.
CONCLUSIONS
Altered gut microbiota is associated with FI in preterm infants. FI cases typically have lower microbial diversity, a decreased abundance of beneficial bacteria, and an increased abundance of pathogenic bacteria. Gut microbiota is correlated with the clinical characteristics of FI. The decrease in motilin secretion caused by some bacteria may lead to the occurrence of FI.
Topics: Bacteria; Feces; Gastrointestinal Microbiome; Humans; Infant; Infant, Newborn; Infant, Premature; RNA, Ribosomal, 16S
PubMed: 33929110
DOI: 10.24953/turkjped.2021.02.004 -
The Journal of Pediatrics Feb 2020To determine the effect of gastric residual aspiration and evaluation on preterm very low birth weight infants' gastrointestinal function, intestinal inflammation, and... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To determine the effect of gastric residual aspiration and evaluation on preterm very low birth weight infants' gastrointestinal function, intestinal inflammation, and gastrointestinal mucosal bleeding.
STUDY DESIGN
This single-center, randomized trial compared omission of gastric residuals vs prefeed gastric residuals in 143 infants ≤32 weeks of gestation with a birthweight of ≤1250 g for 6 weeks after birth. Serum levels of gastrin and motilin were collected between 14 and 21 days of life. Stools were collected at 3 and 6 weeks of age and analyzed for calprotectin and S100A12 levels. All stools were tested for occult blood for 6 weeks.
RESULTS
Means for gastrin (P = .999) and motilin (P = .694) were similar between groups and there were no statistically significant differences in adjusted means for transformed calprotectin (P = .580), and S100A12 (P = .212). Both calprotectin (P = .003) and S100A12 (P = .002) increased from week 3 to week 6. The mean percentage of stools positive for occult blood (P = .888) were similar between the groups.
CONCLUSIONS
Gastrointestinal function, intestinal inflammation, and gastrointestinal mucosal bleeding were similar whether aspiration and evaluation of gastric residuals were eliminated or not, suggesting routinely evaluating gastric residuals before every feeding may be unnecessary. TRIAL REGISTRATION CLINICALTRIALS.GOV:: NCT01863043.
Topics: Enteral Nutrition; Enterocolitis, Necrotizing; Female; Follow-Up Studies; Gastrointestinal Contents; Gastrointestinal Hemorrhage; Humans; Incidence; Infant, Newborn; Infant, Very Low Birth Weight; Male; Retrospective Studies; Risk Factors; United States
PubMed: 31757473
DOI: 10.1016/j.jpeds.2019.10.036 -
Frontiers in Psychiatry 2020Functional dyspepsia (FD) and gastroparesis (GP) are common disorders of the upper gastrointestinal tract. The pathophysiology of these conditions is likely to be...
Functional dyspepsia (FD) and gastroparesis (GP) are common disorders of the upper gastrointestinal tract. The pathophysiology of these conditions is likely to be heterogenous, and factors such as altered motility, sensitivity and response to nutrition have been identified as putative underlying mechanisms. Motility, sensitivity as well as responses to nutrition can be influenced or mediated by peptide hormones and serotonin released from the gastrointestinal mucosa. This review summarizes the role of GI peptides in functional dyspepsia and gastroparesis. In most studies, the levels of somatostatin, ghrelin, and motilin did not differ between healthy volunteers and FD or GP patients, but higher symptom burden was often correlated with higher peptide levels. Ghrelin and motilin receptor agonists showed promising results in improvement of the gastric emptying, but the link with improvement of symptoms is less predictable. Serotonin agonists have a potential to improve symptoms in both FD and idiopathic gastroparesis. Drugs acting on the GLP-1 and on the PYY receptors deserve further investigation. There is a need for systematic large scale studies.
PubMed: 32256403
DOI: 10.3389/fpsyt.2020.00172 -
Pharmaceutical Biology Dec 2023Linnaeus (Bombacaceae) is known as silk cotton tree, the flowers of which are used in many medicinal applications.
CONTEXT
Linnaeus (Bombacaceae) is known as silk cotton tree, the flowers of which are used in many medicinal applications.
OBJECTIVE
To investigate the therapeutic effect of flower aqueous extracts (BCE) against loperamide-induced constipation and characterize the chemical composition of BCE.
MATERIALS AND METHODS
Sixty male Kunming mice were divided into control (saline), model (10 mg/kg loperamide + saline), phenolphthalein (10 mg/kg loperamide + 10 mg/kg phenolphthalein) and different dosage of BCE (10 mg/kg loperamide + 40, 80 and 160 mg/kg BCE, respectively) groups, and received intragastric administrations for eight days. Faecal water content, number of faeces, first black-stool defecation time and gastrointestinal transit rates were evaluated. Various biochemical and molecular biomarkers were assessed in blood and colon. UPLC-ESI-QTOF-MS/MS was used to tentatively identify the composition of the BCE.
RESULTS
BCE treatment (160 mg/kg) could increase faecal water (15.75%), faeces number (11.65%), gastrointestinal transit rate (25.37%) and decrease first black-stool defecation time (24.04%). The BCE (80 mg/kg) increased the serum level of motilin (30.62%), gastrin (54.46%) and substance P (18.99%), and decreased somatostatin (19.47%). Additionally, the BCE (160 mg/kg) reduced the mucosal damage, restored colonic goblet cell function, down-regulated the protein expression of AQP (33.60%) and increased c-kit protein expression (11.63%). Twelve known compounds, including protocatechuic acid, chlorogenic acid and rutin, previously reported in were identified in the BCE.
DISCUSSION AND CONCLUSIONS
This study suggested that BCE is a promising agent for the treatment of constipation.
Topics: Mice; Animals; Loperamide; Bombax; Tandem Mass Spectrometry; Constipation; Flowers; Water; Phenolphthaleins
PubMed: 36582187
DOI: 10.1080/13880209.2022.2157841