This article focuses on the clinical efficacy and mechanism of action of heatclearing and detoxifying traditional Chinese medicines(TCMs)in the treatment of erosive gastritis,providing a reference for the treatment of...This article focuses on the clinical efficacy and mechanism of action of heatclearing and detoxifying traditional Chinese medicines(TCMs)in the treatment of erosive gastritis,providing a reference for the treatment of this disease.In the clinical treatment of erosive gastritis,TCM combinations such as Qing Gastric San,Semixia Diarrheal Heart Soup,and single-flavored heat-clearing and detoxifying drugs such as dandelion and Huanglian have specific efficacies and effectively improve the patient's symptoms,including killing or inhibiting Helicobacter pylori,reducing inflammatory reactions,protecting the gastric mucosa,inhibiting gastric acid secretion,regulating gastrointestinal hormones,and regulating immune function,playing therapeutic roles through multi-level and multi-target mechanisms.Thus,heat-clearing and detoxifying TCMs have broad application prospects in clinical practice for erosive gastritis.展开更多
AIM:To investigate differences in the physiopathological findings(manometry and pH monitoring) and symptoms between cases of non-erosive reflux disease(NERD) and erosive reflux disease(ERD) found positive at 24 h pH m...AIM:To investigate differences in the physiopathological findings(manometry and pH monitoring) and symptoms between cases of non-erosive reflux disease(NERD) and erosive reflux disease(ERD) found positive at 24 h pH monitoring. METHODS:For a total of 670 patients who underwent 24 h pH monitoring,esophageal manometry and upper endoscopy were retrospectively evaluated,assessing the reflux symptoms,manometric characteristics of the lower esophageal sphincter(LES) and esophageal body and the presence or absence of esophagitis and hiatal hernia. Typical and atypical symptoms were also evaluated. For inclusion in the study,patients had to have NERD or ERD and be found positive on pH monitoring(NERD+) . Patients with Gastroesophageal reflux disease(GERD) complicated by stenosis,ulcers or Barrett's esophagus were ruled out. RESULTS:214 patients were involved in the study,i.e. 107 cases of NERD+ and 107 of ERD. There were no significant gender-or age-related differences between the two groups. The ERD group had more cases of hiatal hernia(P = 0.02) and more acid reflux,both in terms of number of reflux episodes(P = 0.01) and as a percentage of the total time with a pH < 4(P = 0.00) ,when upright(P = 0.007) and supine(P = 0.00) . The NERD+ cases had more reflux episodes while upright(P = 0.02) and the ERD cases while supine(P = 0.01) . The LES pressure was higher in cases of NERD+(P = 0.03) while the amplitude and duration of their esophageal peristaltic waves tended to be better than in the ERD group(P >0.05) . The NERD+ patients presented more often with atypical symptoms(P = 0.01) . CONCLUSION:The NERD+ patients' fewer reflux episodes and the fact that they occurred mainly while in the upright position(unlike the cases of ERD) may be two factors that do not favor the onset of esophagitis. The frequently atypical symptoms seen in patients with NERD+ need to be accurately evaluated for therapeutic purposes because patients with GERD and atypical symptoms generally respond only partially to medical and surgical treatments.展开更多
AIM： To elucidate cell proliferation in erosive reflux disease （ERD） and non-erosive reflux disease （NERD）, we evaluated markers in squamous epithelial cells.METHODS： Thirty-four consecutive patients with gas- t...AIM： To elucidate cell proliferation in erosive reflux disease （ERD） and non-erosive reflux disease （NERD）, we evaluated markers in squamous epithelial cells.METHODS： Thirty-four consecutive patients with gas- troesophageal-reflux-disease-related symptoms （21 NERD and 13 ERD） were evaluated for the enrolment into the study. All patients underwent 24-h pH moni- toring, standard endoscopy, and biopsy for histological evaluation. The expression of cyclins D and A was eval- uated by real-time reverse transcription polymerase chain reaction （RT-PCR） from isolated epithelial cells. In all samples, analysis of the isolated cell population revealed the presence of epithelial cells only.RESULTS： Real-time RT-PCR showed that, in patientswith ERD, the relative expression of cyclin D1 mRNA in esophageal epithelium was strongly decreased in comparison with NERD patients. The mean value of relative expression of cyclin D1 mRNA in NERD patients was 3.44 ± 1.9, whereas in ERD patients, it was 1.32 ± 0.87 （P = 0.011）. Real-time RT-PCR showed that, in patients with ERD, relative expression of cyclin A mRNA in esophageal epithelium was decreased in comparison with that in NERD patients （2.31 ± 2.87 vs 0.66 ± 1.11）. The mean bromodeoxyuridine labeling index in the NERD patients was 5.42% ± 1.68%, whereas in ERD patients, it was 4.3% ± 1.59%.展开更多
AIM To compare vonoprazan 10 and 20 mg vs lansoprazole 15 mg as maintenance therapy in healed erosive esophagitis(EE).METHODS A total of 607 patients aged ≥ 20 years, with endoscopically-confirmed healed EE following...AIM To compare vonoprazan 10 and 20 mg vs lansoprazole 15 mg as maintenance therapy in healed erosive esophagitis(EE).METHODS A total of 607 patients aged ≥ 20 years, with endoscopically-confirmed healed EE following 8 wk of treatment with vonoprazan 20 mg once daily, were randomized 1:1:1 to receive lansoprazole 15 mg(n = 201), vonoprazan 10 mg(n = 202), or vonoprazan 20 mg(n = 204), once daily. The primary endpoint of the study was the rate of endoscopically-confirmed EE recurrence during a 24-wk maintenance period. The secondary endpoint was the EE recurrence rate at Week 12 during maintenance treatment. Additional efficacy endpoints included the incidence of heartburn and acid reflux, and the EE healing rate 4 wk after the initiation of maintenance treatment. Safety endpoints comprised adverse events(AEs), vital signs, electrocardiogram findings, clinical laboratory results, serum gastrin and pepsinogen Ⅰ/Ⅱ levels, and gastric mucosa histopathology results.RESULTS Rates of EE recurrence during the 24-wk maintenance period were 16.8%, 5.1%, and 2.0% with lansoprazole 15 mg, vonoprazan 10 mg, and vonoprazan 20 mg, respectively. Vonoprazan was shown to be non-inferior to lansoprazole 15 mg(P < 0.0001 for both doses). In a post-hoc analysis, EE recurrence at Week 24 was significantly reduced with vonoprazan at both the 10 mg and the 20 mg dose vs lansoprazole 15 mg(5.1% vs 16.8%, P = 0.0002, and 2.0% vs 16.8%, P < 0.0001, respectively); by contrast, the EE recurrence rate did not differ significantly between the two doses of vonoprazan(P = 0.1090). The safety profiles of vonoprazan 10 and 20 mg were similar to that of lansoprazole 15 mg in patients with healed EE. Treatment-related AEs were reported in 11.4%, 10.4%, and 10.3% of patients in the lansoprazole 15 mg, vonoprazan 10 mg, and vonoprazan 20 mg arms, respectively.CONCLUSION Our findings confirm the non-inferiority of vonoprazan 10 and 20 mg to lansoprazole 15 mg as maintenance therapy for patients with healed EE.展开更多
BACKGROUND Although chronic erosive gastritis(CEG)is common,its clinical characteristics have not been fully elucidated.The lack of consensus regarding its treatment has resulted in varied treatment regimens.AIM To ex...BACKGROUND Although chronic erosive gastritis(CEG)is common,its clinical characteristics have not been fully elucidated.The lack of consensus regarding its treatment has resulted in varied treatment regimens.AIM To explore the clinical characteristics,treatment patterns,and short-term outcomes in CEG patients in China.METHODS We recruited patients with chronic non-atrophic or mild-to-moderate atrophic gastritis with erosion based on endoscopy and pathology.Patients and treating physicians completed a questionnaire regarding history,endoscopic findings,and treatment plans as well as a follow-up questionnaire to investigate changes in symptoms after 4 wk of treatment.RESULTS Three thousand five hundred sixty-three patients from 42 centers across 24 cities in China were included.Epigastric pain(68.0%),abdominal distension(62.6%),and postprandial fullness(47.5%)were the most common presenting symptoms.Gastritis was classified as chronic non-atrophic in 69.9%of patients.Among those with erosive lesions,72.1%of patients had lesions in the antrum,51.0%had multiple lesions,and 67.3%had superficial flat lesions.In patients with epigastric pain,the combination of a mucosal protective agent(MPA)and proton pump inhibitor was more effective.For those with postprandial fullness,acid regurgitation,early satiety,or nausea,a MPA appeared more promising.CONCLUSION CEG is a multifactorial disease which is common in Asian patients and has non-specific symptoms.Gastroscopy may play a major role in its detection and diagnosis.Treatment should be individualized based on symptom profile.展开更多
AIM： To clarify whether insulin resistance and metabolic syndrome are risk factors for erosive esophagitis.METHODS： A case-control study was performed using the database of the Kangbuk Samsung Hospital Medical Scree...AIM： To clarify whether insulin resistance and metabolic syndrome are risk factors for erosive esophagitis.METHODS： A case-control study was performed using the database of the Kangbuk Samsung Hospital Medical Screening Center.RESULTS： A total of 1679 cases of erosive esophagitis and 3358 randomly selected controls were included. Metabolic syndrome was diagnosed in 21% of the cases and 12% of the controls （P 〈 0.001）. Multiple logistic regressions confirmed the association between erosive esophagitis and metabolic syndrome （Odds ratio, 1.25; 95% CI, 1.04-1.49）. Among the components of metabolic syndrome, increased waist circumference, elevated serum triglyceride levels and hypertension were significant risk factors for erosive esophagitis （all P 〈 0.01）. Furthermore, increased insulin resistance （Odds ratio, 0.91; 95% CI, 0.85-0.98） and fatty liver, as diagnosed by ultrasonography （odds ratio, 1.39; 95% CI, 1.20-1.60）, were also related to erosive esophagitis even afl：er adjustment for a series of confounding factors.CONCLUSION： Metabolic syndrome and increased insulin resistance are associated with an increased risk of developing erosive esophagitis.展开更多
AIMTo assess the clinical characteristics of patients with complicated erosive esophagitis (EE) and their associated factors.METHODSThis prospective, cross-sectional study included patients diagnosed with EE by upper ...AIMTo assess the clinical characteristics of patients with complicated erosive esophagitis (EE) and their associated factors.METHODSThis prospective, cross-sectional study included patients diagnosed with EE by upper gastrointestinal endoscopy between October 2014 and March 2015 at 106 Japanese hospitals. Data on medical history, general condition, gastrointestinal symptoms, lifestyle habits, comorbidities, and endoscopic findings were collected using a standard form to create a dedicated database. Logistic regression analysis was used to calculate adjusted odds ratios (aOR) and 95%CI for the association with complicated EE.RESULTSDuring the study period, 1749 patients diagnosed with EE, 38.3% of whom were prescribed proton pump inhibitors (PPIs) were included. Of them, 143 (8.2%) had EE complications. Esophageal bleeding occurred in 84 (4.8%) patients, esophageal strictures in 45 (2.6%) patients, and 14 (0.8%) patients experienced both. Multivariate analysis showed that increased age (aOR: 1.05; 95%CI: 1.03-1.08), concomitant use of psychotropic agents (aOR: 6.51; 95%CI: 3.01-13.61), and Los Angeles grades B (aOR: 2.69; 95%CI: 1.48-4.96), C (aOR: 15.38; 95%CI: 8.62-28.37), and D (aOR: 71.49; 95%CI: 37.47-142.01) were significantly associated with complications, whereas alcohol consumption 2-4 d/wk was negatively associated (aOR: 0.23; 95%CI: 0.06-0.61). Analyzing associated factors with each EE complication separately showed esophageal ulcer bleeding were associated with increased age (aOR: 1.05; 95%CI: 1.02-1.07) and Los Angeles grades B (aOR: 3.60; 95%CI: 1.52-8.50), C (aOR: 27.61; 95%CI: 12.34-61.80), and D (aOR: 119.09; 95%CI: 51.15-277.29), while esophageal strictures were associated with increased age (aOR: 1.07; 95%CI: 1.04-1.10), gastroesophageal reflux symptom (aOR: 2.51; 95%CI: 1.39-4.51), concomitant use of psychotropic agents (aOR: 11.79; 95%CI: 5.06-27.48), Los Angeles grades C (aOR: 7.35; 95%CI: 3.32-16.25), and D (aOR: 20.34; 95%CI: 8.36-49.53) and long-segment Barrett’s esophagus (aOR: 4.63; 95%CI: 1.64-13.05).CONCLUSIONAging and severe EE were common associated factors, although there were more associated factors in esophageal strictures than esophageal ulcer bleeding. Despite the availability and widespread use of PPIs, EE complications are likely to remain a problem in Japan owing to the aging population and high-stress society.展开更多
A study is carried out which analyzes the machinability of polymer matrix composites under an abrasive waterjet (AWJ) and the associated erosive process or mechanism. It shows that AWJ cutting can produce good quality...A study is carried out which analyzes the machinability of polymer matrix composites under an abrasive waterjet (AWJ) and the associated erosive process or mechanism. It shows that AWJ cutting can produce good quality kerf at high production rate if the cutting parameters are properly selected. A scanning electron microscopy (SEM) analysis of the cut surfaces reveals that the erosive process for the matrix material (resin) involves shearing and ploughing as well as intergranular cracking, while shearing is a dominant process for cutting the fibres in the upper cutting region but the fibers are mostly pulled out in the lower region.展开更多
AIM:To investigate whether erosive esophagitis is correlated with metabolic syndrome and its components,abnormal liver function,and lipoprotein profiles.METHODS:We conducted a cross-sectional,case control study of sub...AIM:To investigate whether erosive esophagitis is correlated with metabolic syndrome and its components,abnormal liver function,and lipoprotein profiles.METHODS:We conducted a cross-sectional,case control study of subjects who underwent upper endoscopy during a health examination at the Health Management and Evaluation Center of a tertiary medical care facility located in Southern Taiwan.Metabolic syndrome components,body mass index(BMI),liver function,dyslipidemia,and cardiovascular risk factors,as defined by the ratio of total cholesterol to high-density lipoprotein cholesterol(HDL-C),and the ratio of low-density lipoprotein cholesterol to HDL-C were compared betweenindividuals with and without erosive esophagitis.Risk factors for erosive esophagitis were evaluated by multivariate logistic regression.RESULTS:Erosive esophagitis was diagnosed in 507of 5015 subjects who were individually age and sex matched to 507 esophagitis-free control subjects.In patients with erosive esophagitis,BMI,waist circumference,blood pressure,fasting plasma glucose,triglyceride levels,aspartate aminotransferase,alanine aminotransferase,the ratio of total cholesterol to HDL-C,and the ratio of low-density lipoprotein cholesterol to HDL-C were significantly higher and HDL-C was significantly lower compared to patients without erosive esophagitis(all P<0.05).In a multivariate analysis,central obesity(OR=1.38;95%CI:1.0-1.86),hypertension(OR=1.35;95%CI:1.04-1.76),hypertriglyceridemia(OR=1.34;95%CI:1.02-1.76),cardiovascular risk factors as defined by a ratio of total cholesterol to HDL-C>5(OR=1.45;95%CI:1.06-1.97),and aspartate aminotransferase(OR=1.59;95%CI:1.08-2.34)were significantly associated with erosive esophagitis.CONCLUSION:Metabolic syndrome,impaired liver function,and a higher ratio of total cholesterol to HDL-C were associated with erosive esophagitis.展开更多
The normal esophageal mucosa creates a protective epithelial barrier that constrains the acidic reflux in the esophageal lumen. Microscopic findings and functional studies indicate that this barrier might be impaired ...The normal esophageal mucosa creates a protective epithelial barrier that constrains the acidic reflux in the esophageal lumen. Microscopic findings and functional studies indicate that this barrier might be impaired in patients with non erosive reflux disease(NERD) but not in patients with functional heartburn(FH). Whereas endoscopy and pH monitoring are the most important diagnostic tools in the diagnosis of NERD, recent studies suggest that esophageal biopsies might have a complementary role. Particularly in the differential diagnosis between NERD and FH, the application of histological severity scores showed very promising results. Further evaluation of the scores could lead to routine application of histology in specific NERD populations.展开更多
AIM: To investigate the proportion of patients with moderate-severe erosive esophagitis (EE) who will have Barrett's esophagus (BE) after healing of inflammation. METHODS: Patients with EE of Los Angeles (LA) clas...AIM: To investigate the proportion of patients with moderate-severe erosive esophagitis (EE) who will have Barrett's esophagus (BE) after healing of inflammation. METHODS: Patients with EE of Los Angeles (LA) class B, C and D who underwent follow-up endoscopy documenting complete mucosal healing. RESULTS: A total of 86/169 patients were suspected of having BE (38 before healing and 48 after healing of EE) and, 46/86 eventually had the histological confirmation. At index esophago-gastro-duodenoscopy (EGD), BE was suspected in 38/169 (22%), and ultimately, histologically confirmed in 20 of these. In 11 patients where biopsies were performed in the presence of inflammation, BE was detected in 2 and missed in 5 (including 2 dysplasias). In 131/169 patients (77.5%), BE was not suspected at index EGD. After healing of EE though, 48 patients had suspicion of BE who underwent biopsies, and in 26 of these histology was positive for BE. The length of inflammation had a linear correlation with the length of BE (P = 0.01). Out of multiple variables to predict BE, only the suspicion at index endoscopy was statistically significant (P = 0.01). CONCLUSION: BE was seen in 46/169 (27%) patients with EE of LA class B, C and D. The length of EE can predict the length of underlying BE segment.Even when suspected, BE and associated dysplasia can be missed in the presence of inflammation; therefore, repeat evaluation should be considered after complete healing of esophagitis.展开更多
Application of laser shock processing （LSP） on 6061-T6 aluminum was made in order to evaluate its response to the erosive wear by silica sand. Impact angles of 15° , 30° , 60° and 90° were tes...Application of laser shock processing （LSP） on 6061-T6 aluminum was made in order to evaluate its response to the erosive wear by silica sand. Impact angles of 15° , 30° , 60° and 90° were tested, two particle speeds （37 and 58 m/s） and two LSP irradiation conditions were used. Erosion marks were characterized by 3D profilometry and SEM analysis was conducted to identify the erosion mechanisms for each tested angle. The results showed a maximum erosive wear at low impact angles （ductile type behavior）. Erosion strength and the erosion mechanisms were not affected by the application of LSP and they were attributed to the high strain rate of the erosion phenomena. A few differences encountered on the erosion plots were explained on the basis of the surface roughness left by the LSP process. The maximum mass loss and the maximum erosion penetration happened in different impact angles （15° and 30° , respectively）. Finally, a well-defined erosion mechanism transition was observed, from cutting action at low impact angle, to crater formation at 90° of incidence.展开更多
The base structure of in situ TiCp/Fe composites fabricated under industrial condition was changed by different heat treatments. Erosive wear tests were carried out and the results were compared with that of wear-resi...The base structure of in situ TiCp/Fe composites fabricated under industrial condition was changed by different heat treatments. Erosive wear tests were carried out and the results were compared with that of wear-resistant white cast iron. The results suggest that the wear resistance of the in situ TiCp/Fe composite is higher than that of wear-resistant white cast iron under the sand erosive wear condition. The wear mechanism of the wear-resistant white cast iron was a cycle process that base surface was worn and carbides were exposed, then carbides was broken and wear pits appeared. While the wear mechanism of in situ TiCp/Fe composite was a cycle process that base surface was worn and TiC grains were exposed and dropped. The wear resistance of in situ TiCp/Fe composite was lower than that of wear-resistant white cast iron under the slurry erosive wear condition. Under such circumstance, the material was not only undergone erosive wear but also electrochemistry erosion due to the contact with water in the medium. The wear behaviours can be a combination of two kinds of wear and the sand erosive wear is worse than slurry erosive wear.展开更多
AIM: To systematically evaluate the efficacy of H2-receptor antagonists (H2RAs) and proton pump inhibitors in healing erosive esophagitis (EE).METHODS: A meta-analysis was performed. A literature search was conducted ...AIM: To systematically evaluate the efficacy of H2-receptor antagonists (H2RAs) and proton pump inhibitors in healing erosive esophagitis (EE).METHODS: A meta-analysis was performed. A literature search was conducted in PubMed, Medline, Embase, and Cochrane databases to include randomized controlled head-to-head comparative trials evaluating the efficacy of H2RAs or proton pump inhibitors in healing EE. Relative risk (RR) and 95% confidence interval (CI) were calculated under a random-effects model.RESULTS: RRs of cumulative healing rates for each comparison at 8 wk were: high dose vs standard dose H2RAs,1.17 (95%CI, 1.02-1.33); standard dose proton pump inhibitors vsstandard dose H2RAs, 1.59 (95%CI, 1.44-1.75);standard dose other proton pump inhibitors vs standard dose omeprazole, 1.06 (95%CI, 0.98-1.06). Proton pump inhibitors produced consistently greater healing rates than H2RAs of all doses across all grades of esophagitis, including patients refractory to H2RAs. Healing rates achieved with standard dose omeprazole were similar to those with other proton pump inhibitors in all grades of esophagitis.CONCLUSION: H2RAS are less effective for treating patients with erosive esophagitis, especially in those with severe forms of esophagitis. Standard dose proton pump inhibitors are significantly more effective than H2RAs in healing esophagitis of all grades. Proton pump inhibitors given at the recommended dose are equally effective for healing esophagitis.展开更多
Taguchi technique was used to predict the influence of processing parameters on the erosive wear behavior Al7034-T6composite reinforced with SiC and Al2O3particles in different mass fractions.These hybrid metal matrix...Taguchi technique was used to predict the influence of processing parameters on the erosive wear behavior Al7034-T6composite reinforced with SiC and Al2O3particles in different mass fractions.These hybrid metal matrix composites(HMMCs)werefabricated by using a simple technique called stir casting technique.Scanning electron microscope(SEM)was used to study thesurface morphology of the composite and its evolution according to processing time.The design of experiment(DOE)based onTaguchi’s L16orthogonal array was used to identify various erosion trials.The most influencing parameter affecting the wear rate wasidentified.The results indicate that erosion wear rate of this hybrid composite is greatly influenced more by filler content and impactvelocity respectively compared to other factors.This also shows the significant wear resistance with the increase in the filler contentsof SiC and Al2O3particles,respectively.展开更多
Objective: To compare the therapeutic effects of Radix Tripterygium hypoglaucum tablet (THT) and Tripterygium glycosides tablet (TGT) in treating erosive oral lichen planus(EOLP).Methods: The patients were randomized ...Objective: To compare the therapeutic effects of Radix Tripterygium hypoglaucum tablet (THT) and Tripterygium glycosides tablet (TGT) in treating erosive oral lichen planus(EOLP).Methods: The patients were randomized into two groups, and they were treated with THT (n=47) or TGT (n=47), respectively. The therapeutic effects were evaluated after 3 months treatment.Results: For the patients of grade 1, the total efficacy in TGT group was 85.71%, compared with 52.38% in THT group, the efficacy was statistically greater in the group receiving TGT (P=0.043). However, for the patients of grade 2, the difference was not statistically significant (P=0.173).Conclusion: TGT is more effective in treating EOLP than THT for grade 1 patients. However, TGT is not suitable for patients of child bearing age.展开更多
A geological feature in the Qaidam Basin known as the"Shell Bar"contains millions of freshwater articulated clam shells buried in-situ.Since the 1980s this feature in the now hyper-arid basin has been interp...A geological feature in the Qaidam Basin known as the"Shell Bar"contains millions of freshwater articulated clam shells buried in-situ.Since the 1980s this feature in the now hyper-arid basin has been interpreted to be lake deposits that provide evidence for a warmer and more humid climate than present during late Marine Isotope Stage 3(MIS 3)(Bowler et al.,1986).However,the global climate during展开更多
AIM:To evaluate the effect of a novel alginate-based compound,Faringel,in modifying reflux characteristics and controlling symptoms.METHODS:In this prospective,open-label study,40 patients reporting heartburn and regu...AIM:To evaluate the effect of a novel alginate-based compound,Faringel,in modifying reflux characteristics and controlling symptoms.METHODS:In this prospective,open-label study,40 patients reporting heartburn and regurgitation with proven reflux disease(i.e.,positive impedance-pH test/evidence of erosive esophagitis at upper endoscopy) underwent 2 h impedance-pH testing after eating a refluxogenic meal.They were studied for 1 h under basal conditions and 1 h after taking 10 mL Faringel.In both sessions,measurements were obtained in right lateral and supine decubitus positions.Patients also completed a validated questionnaire consisting of a 2-item 5-point(0-4) Likert scale and a 10-cm visual analogue scale(VAS) in order to evaluate the efficacy of Faringel in symptom relief.Tolerability of the treatment was assessed using a 6-point Likert scale ranging from very good(1) to very poor(6).RESULTS:Faringel decreased significantly(P < 0.001),in both the right lateral and supine decubitus positions,esophageal acid exposure time [median 10(25th75th percentil 6-16) vs 5.8(4-10) and 16(11-19) vs 7.5(5-11),respectively] and acid refluxes [5(3-8) vs 1(1-1) and 6(4-8) vs 2(1-2),respectively],but increased significantly(P < 0.01) the number of nonacid reflux events compared with baseline [2(1-3)vs 3(2-5) and 3(2-4) vs 6(3-8),respectively].Percentage of proximal migration decreased in both decubitus positions(60% vs 32% and 64% vs 35%,respectively;P < 0.001).Faringel was significantly effective in controlling heartburn,based on both the Likert scale [3.1(range 1-4) vs 0.9(0-2);P < 0.001] and VAS score [7.1(3-9.8) vs 2(0.1-4.8);P < 0.001],but it had less success against regurgitation,based on both the Likert scale [2.6(1-4) vs 2.2(1-4);P = not significant(NS)] and VAS score [5.6(2-9.6) vs 3.9(1-8.8);P = NS].Overall,the tolerability of Faringel was very good 5(2-6),with only two patients reporting modest adverse events(i.e.,nausea and bloating).CONCLUSION:Our findings demonstrate that Faringel is well-tolerated and effective in reducing heartburn by modifying esophageal acid exposure time,number of acid refluxes and their proximal migration.展开更多
AIM:To conduct a meta-analysis to estimate the determinants of the association between erosive esophagitis (EE)and body mass index(BMI). METHODS:We identified the studies using PubMed. Studies were selected for analys...AIM:To conduct a meta-analysis to estimate the determinants of the association between erosive esophagitis (EE)and body mass index(BMI). METHODS:We identified the studies using PubMed. Studies were selected for analysis based on certain inclusion and exclusion criteria.Data were extracted from each study on the basis of predefined items.Metaanalyses were performed to verify the risk factors,such as obesity and gender. RESULTS:Twenty-one studies were included in this systematic review.These studies demonstrated an association between increasing BMI and the presence of EE[95%confidence interval(CI):1.35-1.88,overweight,odds ratio(OR)=1.60,P value homogeneity =0.003,95%CI:1.65-2.55,obese,OR=2.05,P< 0.01].The heterogeneity disappeared by stratifying for gender.No publication bias was observed in this metaanalysis by the Egger method. CONCLUSION:This analysis demonstrates a positive association between BMI and the presence of EE,especially in males.The risk seems to progressively increase with increasing weight.展开更多
BACKGROUND For the treatment of gastritis,rebamipide,a mucoprotective agent,and nizatidine,a gastric acid suppressant,are commonly employed individually.AIM To compare the efficacy of Mucotra®SR(rebamipide 150 mg...BACKGROUND For the treatment of gastritis,rebamipide,a mucoprotective agent,and nizatidine,a gastric acid suppressant,are commonly employed individually.AIM To compare the efficacy of Mucotra®SR(rebamipide 150 mg)and Axid®(nizatidine 150 mg)combination therapy with the sole administration of Axid®in managing erosive gastritis.METHODS A total of 260 patients diagnosed with endoscopically confirmed erosive gastritis were enrolled in this open-label,multicenter,randomized,phase 4 clinical trial,allocating them into two groups:Rebamipide/nizatidine combination twice daily vs nizatidine twice daily for 2 weeks.The full-analysis set analysis encompassed 239 patients(rebamipide/nizatidine,n=121;nizatidine,n=118),while the per-protocol analysis included 218 patients(n=110 vs 108).Post-treatment assessments comprised primary(erosion improvement rate)and secondary(erosion and edema cure rates,erythema improvement rates,hemorrhage,and gastrointestinal symptoms)endpoints.Furthermore,drug-related adverse effects were evaluated.RESULTS Primary efficacy assessment showed a statistically significant improvement rate in mucosal erosions in the combination group compared to the control group in the full-analysis set(rebamipide/nizatidine 62.0%,nizatidine 49.2%,P=0.046),with a similar trend noted in the per-protocol analysis(62.7%vs 50.0%,P=0.058).Both groups were effective in curing erosion and edema and improvement of bleeding,erythema,and gastrointestinal symptoms,whereas no inter-group differences were noted.When confined to the participants with gastritis symptoms,improvement of erosion was more optimal in the combination group(63.0%vs 49.5%,P=0.046).No adverse events related to the drugs were observed.CONCLUSION Rebamipide/nizatidine combination is effective in treatment of erosive gastritis.展开更多
基金Supported by National Science and Technology Major Project,No.2024ZD0521002The Innovation Team Project of Traditional Chinese Medicine of Liaoning Province,No.LNZYYCXTD-CCCX-003+1 种基金General Program of the National Natural Science Foundation of China,No.82074296Construction Project of Inheritance Studios of Famous Chinese Medicine Experts in China,No.[2022]No.75.
文摘This article focuses on the clinical efficacy and mechanism of action of heatclearing and detoxifying traditional Chinese medicines(TCMs)in the treatment of erosive gastritis,providing a reference for the treatment of this disease.In the clinical treatment of erosive gastritis,TCM combinations such as Qing Gastric San,Semixia Diarrheal Heart Soup,and single-flavored heat-clearing and detoxifying drugs such as dandelion and Huanglian have specific efficacies and effectively improve the patient's symptoms,including killing or inhibiting Helicobacter pylori,reducing inflammatory reactions,protecting the gastric mucosa,inhibiting gastric acid secretion,regulating gastrointestinal hormones,and regulating immune function,playing therapeutic roles through multi-level and multi-target mechanisms.Thus,heat-clearing and detoxifying TCMs have broad application prospects in clinical practice for erosive gastritis.
文摘AIM:To investigate differences in the physiopathological findings(manometry and pH monitoring) and symptoms between cases of non-erosive reflux disease(NERD) and erosive reflux disease(ERD) found positive at 24 h pH monitoring. METHODS:For a total of 670 patients who underwent 24 h pH monitoring,esophageal manometry and upper endoscopy were retrospectively evaluated,assessing the reflux symptoms,manometric characteristics of the lower esophageal sphincter(LES) and esophageal body and the presence or absence of esophagitis and hiatal hernia. Typical and atypical symptoms were also evaluated. For inclusion in the study,patients had to have NERD or ERD and be found positive on pH monitoring(NERD+) . Patients with Gastroesophageal reflux disease(GERD) complicated by stenosis,ulcers or Barrett's esophagus were ruled out. RESULTS:214 patients were involved in the study,i.e. 107 cases of NERD+ and 107 of ERD. There were no significant gender-or age-related differences between the two groups. The ERD group had more cases of hiatal hernia(P = 0.02) and more acid reflux,both in terms of number of reflux episodes(P = 0.01) and as a percentage of the total time with a pH < 4(P = 0.00) ,when upright(P = 0.007) and supine(P = 0.00) . The NERD+ cases had more reflux episodes while upright(P = 0.02) and the ERD cases while supine(P = 0.01) . The LES pressure was higher in cases of NERD+(P = 0.03) while the amplitude and duration of their esophageal peristaltic waves tended to be better than in the ERD group(P >0.05) . The NERD+ patients presented more often with atypical symptoms(P = 0.01) . CONCLUSION:The NERD+ patients' fewer reflux episodes and the fact that they occurred mainly while in the upright position(unlike the cases of ERD) may be two factors that do not favor the onset of esophagitis. The frequently atypical symptoms seen in patients with NERD+ need to be accurately evaluated for therapeutic purposes because patients with GERD and atypical symptoms generally respond only partially to medical and surgical treatments.
文摘AIM： To elucidate cell proliferation in erosive reflux disease （ERD） and non-erosive reflux disease （NERD）, we evaluated markers in squamous epithelial cells.METHODS： Thirty-four consecutive patients with gas- troesophageal-reflux-disease-related symptoms （21 NERD and 13 ERD） were evaluated for the enrolment into the study. All patients underwent 24-h pH moni- toring, standard endoscopy, and biopsy for histological evaluation. The expression of cyclins D and A was eval- uated by real-time reverse transcription polymerase chain reaction （RT-PCR） from isolated epithelial cells. In all samples, analysis of the isolated cell population revealed the presence of epithelial cells only.RESULTS： Real-time RT-PCR showed that, in patientswith ERD, the relative expression of cyclin D1 mRNA in esophageal epithelium was strongly decreased in comparison with NERD patients. The mean value of relative expression of cyclin D1 mRNA in NERD patients was 3.44 ± 1.9, whereas in ERD patients, it was 1.32 ± 0.87 （P = 0.011）. Real-time RT-PCR showed that, in patients with ERD, relative expression of cyclin A mRNA in esophageal epithelium was decreased in comparison with that in NERD patients （2.31 ± 2.87 vs 0.66 ± 1.11）. The mean bromodeoxyuridine labeling index in the NERD patients was 5.42% ± 1.68%, whereas in ERD patients, it was 4.3% ± 1.59%.
文摘AIM To compare vonoprazan 10 and 20 mg vs lansoprazole 15 mg as maintenance therapy in healed erosive esophagitis(EE).METHODS A total of 607 patients aged ≥ 20 years, with endoscopically-confirmed healed EE following 8 wk of treatment with vonoprazan 20 mg once daily, were randomized 1:1:1 to receive lansoprazole 15 mg(n = 201), vonoprazan 10 mg(n = 202), or vonoprazan 20 mg(n = 204), once daily. The primary endpoint of the study was the rate of endoscopically-confirmed EE recurrence during a 24-wk maintenance period. The secondary endpoint was the EE recurrence rate at Week 12 during maintenance treatment. Additional efficacy endpoints included the incidence of heartburn and acid reflux, and the EE healing rate 4 wk after the initiation of maintenance treatment. Safety endpoints comprised adverse events(AEs), vital signs, electrocardiogram findings, clinical laboratory results, serum gastrin and pepsinogen Ⅰ/Ⅱ levels, and gastric mucosa histopathology results.RESULTS Rates of EE recurrence during the 24-wk maintenance period were 16.8%, 5.1%, and 2.0% with lansoprazole 15 mg, vonoprazan 10 mg, and vonoprazan 20 mg, respectively. Vonoprazan was shown to be non-inferior to lansoprazole 15 mg(P < 0.0001 for both doses). In a post-hoc analysis, EE recurrence at Week 24 was significantly reduced with vonoprazan at both the 10 mg and the 20 mg dose vs lansoprazole 15 mg(5.1% vs 16.8%, P = 0.0002, and 2.0% vs 16.8%, P < 0.0001, respectively); by contrast, the EE recurrence rate did not differ significantly between the two doses of vonoprazan(P = 0.1090). The safety profiles of vonoprazan 10 and 20 mg were similar to that of lansoprazole 15 mg in patients with healed EE. Treatment-related AEs were reported in 11.4%, 10.4%, and 10.3% of patients in the lansoprazole 15 mg, vonoprazan 10 mg, and vonoprazan 20 mg arms, respectively.CONCLUSION Our findings confirm the non-inferiority of vonoprazan 10 and 20 mg to lansoprazole 15 mg as maintenance therapy for patients with healed EE.
基金the National Key Clinical Specialty Construction Project,No.ZK108000CAMS Innovation Fund for Medical Sciences,No.2021-I2M-C&T-A-001 and No.2022-I2M-C&T-B-012.
文摘BACKGROUND Although chronic erosive gastritis(CEG)is common,its clinical characteristics have not been fully elucidated.The lack of consensus regarding its treatment has resulted in varied treatment regimens.AIM To explore the clinical characteristics,treatment patterns,and short-term outcomes in CEG patients in China.METHODS We recruited patients with chronic non-atrophic or mild-to-moderate atrophic gastritis with erosion based on endoscopy and pathology.Patients and treating physicians completed a questionnaire regarding history,endoscopic findings,and treatment plans as well as a follow-up questionnaire to investigate changes in symptoms after 4 wk of treatment.RESULTS Three thousand five hundred sixty-three patients from 42 centers across 24 cities in China were included.Epigastric pain(68.0%),abdominal distension(62.6%),and postprandial fullness(47.5%)were the most common presenting symptoms.Gastritis was classified as chronic non-atrophic in 69.9%of patients.Among those with erosive lesions,72.1%of patients had lesions in the antrum,51.0%had multiple lesions,and 67.3%had superficial flat lesions.In patients with epigastric pain,the combination of a mucosal protective agent(MPA)and proton pump inhibitor was more effective.For those with postprandial fullness,acid regurgitation,early satiety,or nausea,a MPA appeared more promising.CONCLUSION CEG is a multifactorial disease which is common in Asian patients and has non-specific symptoms.Gastroscopy may play a major role in its detection and diagnosis.Treatment should be individualized based on symptom profile.
文摘AIM： To clarify whether insulin resistance and metabolic syndrome are risk factors for erosive esophagitis.METHODS： A case-control study was performed using the database of the Kangbuk Samsung Hospital Medical Screening Center.RESULTS： A total of 1679 cases of erosive esophagitis and 3358 randomly selected controls were included. Metabolic syndrome was diagnosed in 21% of the cases and 12% of the controls （P 〈 0.001）. Multiple logistic regressions confirmed the association between erosive esophagitis and metabolic syndrome （Odds ratio, 1.25; 95% CI, 1.04-1.49）. Among the components of metabolic syndrome, increased waist circumference, elevated serum triglyceride levels and hypertension were significant risk factors for erosive esophagitis （all P 〈 0.01）. Furthermore, increased insulin resistance （Odds ratio, 0.91; 95% CI, 0.85-0.98） and fatty liver, as diagnosed by ultrasonography （odds ratio, 1.39; 95% CI, 1.20-1.60）, were also related to erosive esophagitis even afl：er adjustment for a series of confounding factors.CONCLUSION： Metabolic syndrome and increased insulin resistance are associated with an increased risk of developing erosive esophagitis.
基金Supported by An Investigator Sponsored Study Programme of Astra Zeneca
文摘AIMTo assess the clinical characteristics of patients with complicated erosive esophagitis (EE) and their associated factors.METHODSThis prospective, cross-sectional study included patients diagnosed with EE by upper gastrointestinal endoscopy between October 2014 and March 2015 at 106 Japanese hospitals. Data on medical history, general condition, gastrointestinal symptoms, lifestyle habits, comorbidities, and endoscopic findings were collected using a standard form to create a dedicated database. Logistic regression analysis was used to calculate adjusted odds ratios (aOR) and 95%CI for the association with complicated EE.RESULTSDuring the study period, 1749 patients diagnosed with EE, 38.3% of whom were prescribed proton pump inhibitors (PPIs) were included. Of them, 143 (8.2%) had EE complications. Esophageal bleeding occurred in 84 (4.8%) patients, esophageal strictures in 45 (2.6%) patients, and 14 (0.8%) patients experienced both. Multivariate analysis showed that increased age (aOR: 1.05; 95%CI: 1.03-1.08), concomitant use of psychotropic agents (aOR: 6.51; 95%CI: 3.01-13.61), and Los Angeles grades B (aOR: 2.69; 95%CI: 1.48-4.96), C (aOR: 15.38; 95%CI: 8.62-28.37), and D (aOR: 71.49; 95%CI: 37.47-142.01) were significantly associated with complications, whereas alcohol consumption 2-4 d/wk was negatively associated (aOR: 0.23; 95%CI: 0.06-0.61). Analyzing associated factors with each EE complication separately showed esophageal ulcer bleeding were associated with increased age (aOR: 1.05; 95%CI: 1.02-1.07) and Los Angeles grades B (aOR: 3.60; 95%CI: 1.52-8.50), C (aOR: 27.61; 95%CI: 12.34-61.80), and D (aOR: 119.09; 95%CI: 51.15-277.29), while esophageal strictures were associated with increased age (aOR: 1.07; 95%CI: 1.04-1.10), gastroesophageal reflux symptom (aOR: 2.51; 95%CI: 1.39-4.51), concomitant use of psychotropic agents (aOR: 11.79; 95%CI: 5.06-27.48), Los Angeles grades C (aOR: 7.35; 95%CI: 3.32-16.25), and D (aOR: 20.34; 95%CI: 8.36-49.53) and long-segment Barrett’s esophagus (aOR: 4.63; 95%CI: 1.64-13.05).CONCLUSIONAging and severe EE were common associated factors, although there were more associated factors in esophageal strictures than esophageal ulcer bleeding. Despite the availability and widespread use of PPIs, EE complications are likely to remain a problem in Japan owing to the aging population and high-stress society.
文摘A study is carried out which analyzes the machinability of polymer matrix composites under an abrasive waterjet (AWJ) and the associated erosive process or mechanism. It shows that AWJ cutting can produce good quality kerf at high production rate if the cutting parameters are properly selected. A scanning electron microscopy (SEM) analysis of the cut surfaces reveals that the erosive process for the matrix material (resin) involves shearing and ploughing as well as intergranular cracking, while shearing is a dominant process for cutting the fibres in the upper cutting region but the fibers are mostly pulled out in the lower region.
文摘AIM:To investigate whether erosive esophagitis is correlated with metabolic syndrome and its components,abnormal liver function,and lipoprotein profiles.METHODS:We conducted a cross-sectional,case control study of subjects who underwent upper endoscopy during a health examination at the Health Management and Evaluation Center of a tertiary medical care facility located in Southern Taiwan.Metabolic syndrome components,body mass index(BMI),liver function,dyslipidemia,and cardiovascular risk factors,as defined by the ratio of total cholesterol to high-density lipoprotein cholesterol(HDL-C),and the ratio of low-density lipoprotein cholesterol to HDL-C were compared betweenindividuals with and without erosive esophagitis.Risk factors for erosive esophagitis were evaluated by multivariate logistic regression.RESULTS:Erosive esophagitis was diagnosed in 507of 5015 subjects who were individually age and sex matched to 507 esophagitis-free control subjects.In patients with erosive esophagitis,BMI,waist circumference,blood pressure,fasting plasma glucose,triglyceride levels,aspartate aminotransferase,alanine aminotransferase,the ratio of total cholesterol to HDL-C,and the ratio of low-density lipoprotein cholesterol to HDL-C were significantly higher and HDL-C was significantly lower compared to patients without erosive esophagitis(all P<0.05).In a multivariate analysis,central obesity(OR=1.38;95%CI:1.0-1.86),hypertension(OR=1.35;95%CI:1.04-1.76),hypertriglyceridemia(OR=1.34;95%CI:1.02-1.76),cardiovascular risk factors as defined by a ratio of total cholesterol to HDL-C>5(OR=1.45;95%CI:1.06-1.97),and aspartate aminotransferase(OR=1.59;95%CI:1.08-2.34)were significantly associated with erosive esophagitis.CONCLUSION:Metabolic syndrome,impaired liver function,and a higher ratio of total cholesterol to HDL-C were associated with erosive esophagitis.
文摘The normal esophageal mucosa creates a protective epithelial barrier that constrains the acidic reflux in the esophageal lumen. Microscopic findings and functional studies indicate that this barrier might be impaired in patients with non erosive reflux disease(NERD) but not in patients with functional heartburn(FH). Whereas endoscopy and pH monitoring are the most important diagnostic tools in the diagnosis of NERD, recent studies suggest that esophageal biopsies might have a complementary role. Particularly in the differential diagnosis between NERD and FH, the application of histological severity scores showed very promising results. Further evaluation of the scores could lead to routine application of histology in specific NERD populations.
文摘AIM: To investigate the proportion of patients with moderate-severe erosive esophagitis (EE) who will have Barrett's esophagus (BE) after healing of inflammation. METHODS: Patients with EE of Los Angeles (LA) class B, C and D who underwent follow-up endoscopy documenting complete mucosal healing. RESULTS: A total of 86/169 patients were suspected of having BE (38 before healing and 48 after healing of EE) and, 46/86 eventually had the histological confirmation. At index esophago-gastro-duodenoscopy (EGD), BE was suspected in 38/169 (22%), and ultimately, histologically confirmed in 20 of these. In 11 patients where biopsies were performed in the presence of inflammation, BE was detected in 2 and missed in 5 (including 2 dysplasias). In 131/169 patients (77.5%), BE was not suspected at index EGD. After healing of EE though, 48 patients had suspicion of BE who underwent biopsies, and in 26 of these histology was positive for BE. The length of inflammation had a linear correlation with the length of BE (P = 0.01). Out of multiple variables to predict BE, only the suspicion at index endoscopy was statistically significant (P = 0.01). CONCLUSION: BE was seen in 46/169 (27%) patients with EE of LA class B, C and D. The length of EE can predict the length of underlying BE segment.Even when suspected, BE and associated dysplasia can be missed in the presence of inflammation; therefore, repeat evaluation should be considered after complete healing of esophagitis.
文摘Application of laser shock processing （LSP） on 6061-T6 aluminum was made in order to evaluate its response to the erosive wear by silica sand. Impact angles of 15° , 30° , 60° and 90° were tested, two particle speeds （37 and 58 m/s） and two LSP irradiation conditions were used. Erosion marks were characterized by 3D profilometry and SEM analysis was conducted to identify the erosion mechanisms for each tested angle. The results showed a maximum erosive wear at low impact angles （ductile type behavior）. Erosion strength and the erosion mechanisms were not affected by the application of LSP and they were attributed to the high strain rate of the erosion phenomena. A few differences encountered on the erosion plots were explained on the basis of the surface roughness left by the LSP process. The maximum mass loss and the maximum erosion penetration happened in different impact angles （15° and 30° , respectively）. Finally, a well-defined erosion mechanism transition was observed, from cutting action at low impact angle, to crater formation at 90° of incidence.
文摘The base structure of in situ TiCp/Fe composites fabricated under industrial condition was changed by different heat treatments. Erosive wear tests were carried out and the results were compared with that of wear-resistant white cast iron. The results suggest that the wear resistance of the in situ TiCp/Fe composite is higher than that of wear-resistant white cast iron under the sand erosive wear condition. The wear mechanism of the wear-resistant white cast iron was a cycle process that base surface was worn and carbides were exposed, then carbides was broken and wear pits appeared. While the wear mechanism of in situ TiCp/Fe composite was a cycle process that base surface was worn and TiC grains were exposed and dropped. The wear resistance of in situ TiCp/Fe composite was lower than that of wear-resistant white cast iron under the slurry erosive wear condition. Under such circumstance, the material was not only undergone erosive wear but also electrochemistry erosion due to the contact with water in the medium. The wear behaviours can be a combination of two kinds of wear and the sand erosive wear is worse than slurry erosive wear.
基金Supported by the Gastroenterological Research Fund, University of Hong Kong, Hong Kong, China
文摘AIM: To systematically evaluate the efficacy of H2-receptor antagonists (H2RAs) and proton pump inhibitors in healing erosive esophagitis (EE).METHODS: A meta-analysis was performed. A literature search was conducted in PubMed, Medline, Embase, and Cochrane databases to include randomized controlled head-to-head comparative trials evaluating the efficacy of H2RAs or proton pump inhibitors in healing EE. Relative risk (RR) and 95% confidence interval (CI) were calculated under a random-effects model.RESULTS: RRs of cumulative healing rates for each comparison at 8 wk were: high dose vs standard dose H2RAs,1.17 (95%CI, 1.02-1.33); standard dose proton pump inhibitors vsstandard dose H2RAs, 1.59 (95%CI, 1.44-1.75);standard dose other proton pump inhibitors vs standard dose omeprazole, 1.06 (95%CI, 0.98-1.06). Proton pump inhibitors produced consistently greater healing rates than H2RAs of all doses across all grades of esophagitis, including patients refractory to H2RAs. Healing rates achieved with standard dose omeprazole were similar to those with other proton pump inhibitors in all grades of esophagitis.CONCLUSION: H2RAS are less effective for treating patients with erosive esophagitis, especially in those with severe forms of esophagitis. Standard dose proton pump inhibitors are significantly more effective than H2RAs in healing esophagitis of all grades. Proton pump inhibitors given at the recommended dose are equally effective for healing esophagitis.
文摘Taguchi technique was used to predict the influence of processing parameters on the erosive wear behavior Al7034-T6composite reinforced with SiC and Al2O3particles in different mass fractions.These hybrid metal matrix composites(HMMCs)werefabricated by using a simple technique called stir casting technique.Scanning electron microscope(SEM)was used to study thesurface morphology of the composite and its evolution according to processing time.The design of experiment(DOE)based onTaguchi’s L16orthogonal array was used to identify various erosion trials.The most influencing parameter affecting the wear rate wasidentified.The results indicate that erosion wear rate of this hybrid composite is greatly influenced more by filler content and impactvelocity respectively compared to other factors.This also shows the significant wear resistance with the increase in the filler contentsof SiC and Al2O3particles,respectively.
文摘Objective: To compare the therapeutic effects of Radix Tripterygium hypoglaucum tablet (THT) and Tripterygium glycosides tablet (TGT) in treating erosive oral lichen planus(EOLP).Methods: The patients were randomized into two groups, and they were treated with THT (n=47) or TGT (n=47), respectively. The therapeutic effects were evaluated after 3 months treatment.Results: For the patients of grade 1, the total efficacy in TGT group was 85.71%, compared with 52.38% in THT group, the efficacy was statistically greater in the group receiving TGT (P=0.043). However, for the patients of grade 2, the difference was not statistically significant (P=0.173).Conclusion: TGT is more effective in treating EOLP than THT for grade 1 patients. However, TGT is not suitable for patients of child bearing age.
文摘A geological feature in the Qaidam Basin known as the"Shell Bar"contains millions of freshwater articulated clam shells buried in-situ.Since the 1980s this feature in the now hyper-arid basin has been interpreted to be lake deposits that provide evidence for a warmer and more humid climate than present during late Marine Isotope Stage 3(MIS 3)(Bowler et al.,1986).However,the global climate during
文摘AIM:To evaluate the effect of a novel alginate-based compound,Faringel,in modifying reflux characteristics and controlling symptoms.METHODS:In this prospective,open-label study,40 patients reporting heartburn and regurgitation with proven reflux disease(i.e.,positive impedance-pH test/evidence of erosive esophagitis at upper endoscopy) underwent 2 h impedance-pH testing after eating a refluxogenic meal.They were studied for 1 h under basal conditions and 1 h after taking 10 mL Faringel.In both sessions,measurements were obtained in right lateral and supine decubitus positions.Patients also completed a validated questionnaire consisting of a 2-item 5-point(0-4) Likert scale and a 10-cm visual analogue scale(VAS) in order to evaluate the efficacy of Faringel in symptom relief.Tolerability of the treatment was assessed using a 6-point Likert scale ranging from very good(1) to very poor(6).RESULTS:Faringel decreased significantly(P < 0.001),in both the right lateral and supine decubitus positions,esophageal acid exposure time [median 10(25th75th percentil 6-16) vs 5.8(4-10) and 16(11-19) vs 7.5(5-11),respectively] and acid refluxes [5(3-8) vs 1(1-1) and 6(4-8) vs 2(1-2),respectively],but increased significantly(P < 0.01) the number of nonacid reflux events compared with baseline [2(1-3)vs 3(2-5) and 3(2-4) vs 6(3-8),respectively].Percentage of proximal migration decreased in both decubitus positions(60% vs 32% and 64% vs 35%,respectively;P < 0.001).Faringel was significantly effective in controlling heartburn,based on both the Likert scale [3.1(range 1-4) vs 0.9(0-2);P < 0.001] and VAS score [7.1(3-9.8) vs 2(0.1-4.8);P < 0.001],but it had less success against regurgitation,based on both the Likert scale [2.6(1-4) vs 2.2(1-4);P = not significant(NS)] and VAS score [5.6(2-9.6) vs 3.9(1-8.8);P = NS].Overall,the tolerability of Faringel was very good 5(2-6),with only two patients reporting modest adverse events(i.e.,nausea and bloating).CONCLUSION:Our findings demonstrate that Faringel is well-tolerated and effective in reducing heartburn by modifying esophageal acid exposure time,number of acid refluxes and their proximal migration.
文摘AIM:To conduct a meta-analysis to estimate the determinants of the association between erosive esophagitis (EE)and body mass index(BMI). METHODS:We identified the studies using PubMed. Studies were selected for analysis based on certain inclusion and exclusion criteria.Data were extracted from each study on the basis of predefined items.Metaanalyses were performed to verify the risk factors,such as obesity and gender. RESULTS:Twenty-one studies were included in this systematic review.These studies demonstrated an association between increasing BMI and the presence of EE[95%confidence interval(CI):1.35-1.88,overweight,odds ratio(OR)=1.60,P value homogeneity =0.003,95%CI:1.65-2.55,obese,OR=2.05,P< 0.01].The heterogeneity disappeared by stratifying for gender.No publication bias was observed in this metaanalysis by the Egger method. CONCLUSION:This analysis demonstrates a positive association between BMI and the presence of EE,especially in males.The risk seems to progressively increase with increasing weight.
文摘BACKGROUND For the treatment of gastritis,rebamipide,a mucoprotective agent,and nizatidine,a gastric acid suppressant,are commonly employed individually.AIM To compare the efficacy of Mucotra®SR(rebamipide 150 mg)and Axid®(nizatidine 150 mg)combination therapy with the sole administration of Axid®in managing erosive gastritis.METHODS A total of 260 patients diagnosed with endoscopically confirmed erosive gastritis were enrolled in this open-label,multicenter,randomized,phase 4 clinical trial,allocating them into two groups:Rebamipide/nizatidine combination twice daily vs nizatidine twice daily for 2 weeks.The full-analysis set analysis encompassed 239 patients(rebamipide/nizatidine,n=121;nizatidine,n=118),while the per-protocol analysis included 218 patients(n=110 vs 108).Post-treatment assessments comprised primary(erosion improvement rate)and secondary(erosion and edema cure rates,erythema improvement rates,hemorrhage,and gastrointestinal symptoms)endpoints.Furthermore,drug-related adverse effects were evaluated.RESULTS Primary efficacy assessment showed a statistically significant improvement rate in mucosal erosions in the combination group compared to the control group in the full-analysis set(rebamipide/nizatidine 62.0%,nizatidine 49.2%,P=0.046),with a similar trend noted in the per-protocol analysis(62.7%vs 50.0%,P=0.058).Both groups were effective in curing erosion and edema and improvement of bleeding,erythema,and gastrointestinal symptoms,whereas no inter-group differences were noted.When confined to the participants with gastritis symptoms,improvement of erosion was more optimal in the combination group(63.0%vs 49.5%,P=0.046).No adverse events related to the drugs were observed.CONCLUSION Rebamipide/nizatidine combination is effective in treatment of erosive gastritis.
