Chansu has demonstrated adverse reactions in clinical settings,which is associated with its toxicity and limits its clinical applications.But there are methodological limitations for drug safety evaluation.In the curr...Chansu has demonstrated adverse reactions in clinical settings,which is associated with its toxicity and limits its clinical applications.But there are methodological limitations for drug safety evaluation.In the current study,ultra-high performance liquid chromatography,lipidomic profiling,and molecular docking were used to systemically assess Chansu-induced acute inflammatory irritation and further identify the underlying drug targets.Compared with the EtOAc extract,Chansu water fraction containing indolealkylamines caused acute inflammatory irritation in rats,including acute pain(spontaneous raising foot reaction),and inflammation(paw edema).At the molecular level,lipids analysis revealed significantly higher levels of pro-inflammatory mediators of the COX and LOX pathways.However,anti-inflammatory mediators from the CYP 450,ALA,and DHA pathways markedly decreased after exposure to Chansu water fraction.Moreover,four indolealkylamines from Chansu showed a high theoretical affinity to a known irritation target,5-HT_(2A)R.These results suggest that Chansu-induced inflammatory irritation is related to the distinct dysregulation of inflammatory lipids,and peripheral 5-HT_(2A)R is a potential target for irritation therapy.The strategy used in this study can be a crucial approach in the safety evaluation of natural medicinal substances.展开更多
Insulin is widely used in treating diabetes, but still needs to be administered by needle injection. This study investigated a new needle-free approach for insulin delivery. A portable powder needleless injection（PNI...Insulin is widely used in treating diabetes, but still needs to be administered by needle injection. This study investigated a new needle-free approach for insulin delivery. A portable powder needleless injection（PNI） device with an automatic mechanical unit was designed. Its efficiency in delivering insulin was evaluated in alloxan-induced diabetic rabbits. The skin irritation caused by the device was investigated and the results were analyzed in relation to aerodynamic parameters. Inorganic salt-carried insulin powders had hypoglycemic effects, while raw insulin powders were not effective when delivered by PNI, indicating that salt carriers play an important role in the delivery of insulin via PNI. The relative delivery efficiency of phosphate-carried insulin powder using the PNI device was 72.25%. A safety assessment test showed that three key factors（gas pressure, cylinder volume, and nozzle distance） were related to the amount of skin irritation caused by the PNI device. Optimized injection conditions caused minimal skin lesions and are safe to use in practice. The results suggest that PNI has promising prospects as a novel technology for delivering insulin and other biological drugs.展开更多
Upsalite®is a mesoporous magnesium carbonate synthesized without using surfactants and therefore highly attractive from environmental and production economy points of view. The material has recently been sugge...Upsalite®is a mesoporous magnesium carbonate synthesized without using surfactants and therefore highly attractive from environmental and production economy points of view. The material has recently been suggested as drug delivery vehicle and as topical bacteriostatic agent. In order to continue exploring these and other bio-related applications of the material, primary biocompatibility studies are needed. Herein we present the first in vivo acute systemic toxicity and skin irritation analyses as well as in vitro cytotoxicity evaluations of Upsalite®. The material was found to be non-toxic for human dermal fibroblasts cells up to a concentration of 1000 μg/ml and 48 h exposure in contrast to the mesoporous silica material SBA-15, used as reference, which significantly affected cell viability at particle concentration of 500 and 1000 μg/ml after the same exposure time. Topical application of Upsalite®resulted in negligible cutaneous reactions in a rabbit skin irritation model and no evidence of significant systemic toxicity was found when saline extracts of Upsalite®were injected in mice. Injection of sesame oil extract, however, resulted in transient weight loss, most likely due to injection of particles, and not toxic leachables. The presented results form the basis for future development of Upsalite®and similar mesoporous materials in biomedical applications and further toxicity as well as biocompatibility studies should be directed towards specific areas of use.展开更多
<strong>Purpose:</strong> To establish whether Curaderm, a topical pharmacotherapy for skin cancer, irritates or sensitizes normal skin. <strong>Methods:</strong> The dermal irritation and skin...<strong>Purpose:</strong> To establish whether Curaderm, a topical pharmacotherapy for skin cancer, irritates or sensitizes normal skin. <strong>Methods:</strong> The dermal irritation and skin sensitization toxicity of Curaderm were investigated in rabbits and guinea pigs in compliance with the Organization for Economic Cooperation and Development guideline. To assess dermal irritation, rabbits were dermally exposed to Curaderm for varying periods of time. To assess hypersensitivity, the guinea-pig maximisation test was applied. <strong>Results:</strong> Curaderm was only negligibly irritating using the criteria of erythema and oedema. Curaderm did not produce any sensitization toxicity of the skin. <strong>Conclusion:</strong> These studies confirm the non-toxic observations on normal skin experienced in the clinical setting when treating skin cancer and reinforce the specificity of Curaderm towards cancer cells.展开更多
Introduction: The Cussons Baby Sensicare Range is a newly developed set of products specially formulated for newborn, sensitive and eczema prone skin. As such, these products need to be tested to evaluate their skin i...Introduction: The Cussons Baby Sensicare Range is a newly developed set of products specially formulated for newborn, sensitive and eczema prone skin. As such, these products need to be tested to evaluate their skin irritation and sensitization potential before use. The products were evaluated with two separate tests. The first test was conducted in a single-center, within-subject comparison using assessor-blind, randomised human skin irritation patch test (48 hour/96 hour exposure) and conducted on healthy adults with sensitive, atopic skin. The second test was conducted in a single-center, controlled (sterile water), within subject using human repeat-insult patch tests (HRIPTs) and conducted on healthy female Indonesian and Asian adult female subjects, with sensitive skin. The sensitization potential of each product was determined from International Contact Dermatitis Research Group (ICDRG) scores at 30 minutes, 24 hours, 48 hours and 72 hours after patch removal. Skin irritation tests show that all products were significantly lower than the positive control sodium lauryl sulphate (SLS) (p < 0.05) but not significantly different to the negative control (sterile water) in terms of irritation scores at the respective time points. HRIPTs results show that Cussons Baby Sensicare Range was non-sensitizing. As such, it can be concluded that the Cussons Baby Sensicare Range tested is well tolerated on skin and has low skin irritation and sensitization potential. Thus, they can be considered hypoallergenic on sensitive skin and suitable for eczema prone skin.展开更多
Purpose:This study was designed to determine whether a novel anti-melanogenic agent,PF3758309,has the potential to cause acute cutaneous irritation using a human skin equivalent model (HSEM).Methods:Human skin equival...Purpose:This study was designed to determine whether a novel anti-melanogenic agent,PF3758309,has the potential to cause acute cutaneous irritation using a human skin equivalent model (HSEM).Methods:Human skin equivalent was constructed through incubation of normal human derived epidermal keratinocytes (HEKs)on collagen matrix insert with proliferation media.Using constructed human skin equivalent,the irritation potential of PF3758309 were investigated whether the viability of this agent-treated HESM is under 50%(irritant)or not (non-irritant)using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT)assay after applying the agent to the epidermal surface of the HSEM.Also,the PF3758309-mediated anti-pigmentation effects were analyzed using Fontana-Masson staining in the HSEM.Results:The integrity of the constructed HSEM was confirmed using immunohistochemical staining with differentiation markers of epidermis,and observed that Keratin 5,Keratin I and Involucrin were stained in basal,supra-basal and granular layers,respectively.In vitro irritation assay showed that the mean viabilities of the PF3758309 was 83.6%,78.8%and 77.8%at the treatment doses of 0.2,0.5 and I mg,respectively;however,the mean viability of the positive control (5%sodium dodecyl sulfate)-treated HESM was 2.8%.Also,in vitro corrosion assay showed that the mean viabilities of the PF3758309 was 95.3%,95.0%and 94.2% at the treatment doses of 0.2,0.5 and 1 mg,respectively.Furthermore,using a Fontana-Masson staining assay,the melanin levels in the PF3758309-treated HSEM was significantly decreased compared with the levels in control HSEM.Conclusion: The anti-melanogenic agent,PF3758309,has no skin irritation potential under the conditions used in this study.展开更多
AIM: To investigate and compare the effects of spinal D-(-)-2-amino-7-phosphonoheptanoic acid (AP-7) and 6-cyano-7-nitroquinoxaline-2,3-dione disodium (CNQX),two glutamate receptor antagonists, on the responses of dor...AIM: To investigate and compare the effects of spinal D-(-)-2-amino-7-phosphonoheptanoic acid (AP-7) and 6-cyano-7-nitroquinoxaline-2,3-dione disodium (CNQX),two glutamate receptor antagonists, on the responses of dorsal horn neurons to colorectal distension (CRD) in adult rats exposed to neonatal colon irritation (CI).METHODS: Hypersensitive SD rats were generated by CI during postnatal days 8, 10 and 12. Experiments on adult rats were performed using extracellular single-unit recording. The effects of spinal application of AP-7 (0.001,0.01, 0.1, 1 mmoL) were tested on the CRD-evoked neuronal responses in 16 controls and 17 CI rats. The effects of CNQX (0.2, 2, 5, 10 μmoL) were also tested on the CRD-evoked responses of 17 controls and 18 CI neurons.RESULTS: (1) The average responses of lumbosacral neurons to all intensities of CRD in CI rats were significantly higher than those in control rats; (2) In control rats, AP-7 (0.01 mmoL) had no significant effect on the neuronal response to all intensities of CRD (20,40, 60, 80 mmHg); while AP-7 (0.1 mmoL) inhibited the neuronal response to 80-mmHg CRD. By contrast, in CI rats, AP-7 (0.01-1 mmoL) attenuated the CRD-evoked neuronal responses to all distention pressures in a dosedependent manner; (3) In control rats, CNQX (2 μmoL)had no significantly effect on the neuronal response to all intensities of CRD; however, CNQX (5 μmoL) significantly attenuated the responses to CRD in the 40-80 mmHg range. By contrast, CNQX (2-10 μmoL)significantly decreased the neuronal responses in CI rats to non-noxious and noxious CRD in a dose-dependent manner.CONCLUSION: Our results suggest that spinal N-methyl-D-aspartate (NMDA) and non-NMDA receptors may contribute to the processing of central sensitivity in a neonatal CI rat model, but they may play different roles in it.展开更多
Objective To increase the solubility and relieve the mucous irritation of cantharidin (CA) by preparing cantharidin-hydroxypropyl-β-cyclodextrin (CA/HP-β-CD) inclusion complex. Methods The inclusion complex was prep...Objective To increase the solubility and relieve the mucous irritation of cantharidin (CA) by preparing cantharidin-hydroxypropyl-β-cyclodextrin (CA/HP-β-CD) inclusion complex. Methods The inclusion complex was prepared by co-evaporation method and characterized by differential scanning calorimetry (DSC), X-ray diffractometry (XRD), and nuclear magnetic resonance (NMR). Results The disappearance of CA as well as the shift of exothermic peaks shown in DSC results indicated the complexation phenomenon. XRD results showed that the crystalline CA pattern had disappeared, and in NMR results, H-5 shifted from δ 3.731 to 3.695 after complexation and H-2 shifted from δ 3.626 to 3.598, which suggested that part of the drug had entered the HP-β-CD cavity to form an inclusion complex. The solubility increased 10.3 times after complexation and the mucous irritation of CA was relieved remarkably. Conclusion Through complexation with HP-β-CD, the solubility and dissolution rate of CA are improved significantly, and the irritation of musous is relieved.展开更多
BACKGROUND Intraoral honeybee stings are very rare.Stings by these insects occur 25%of the time in the head and neck region.In addition,a stinger intraorally can lead to persistent irritation,inflammation,and secondar...BACKGROUND Intraoral honeybee stings are very rare.Stings by these insects occur 25%of the time in the head and neck region.In addition,a stinger intraorally can lead to persistent irritation,inflammation,and secondary infections if not promptly excised.CASE SUMMARY We report the case of a 52-year-old female patient who was stung in her mouth by a honeybee,causing a local irritation.The patient presented with a one-month history of pain,swelling,and redness in the left buccal mucosa.Inadvertently retained,the stinger was discovered during a clinical evaluation following initial treatment for facial swelling and erythema.After the stinger was removed,the patient’s symptoms resolved without complications.CONCLUSION This case emphasizes the importance of thorough examination and prompt management of insect stings to prevent prolonged discomfort and potential complications.展开更多
Piezo2,a mechanosensitive ion channel,serves as a crucial mechanotransducer in dental primary afferent(DPA)neurons and is potentially involved in hypersensitivity to mild mechanical irritations observed in dental pati...Piezo2,a mechanosensitive ion channel,serves as a crucial mechanotransducer in dental primary afferent(DPA)neurons and is potentially involved in hypersensitivity to mild mechanical irritations observed in dental patients.Given Piezo2’s widespread expression across diverse subpopulations of DPA neurons,this study aimed to characterize the mechanosensory properties of Piezo2-expressing DPA neurons with a focus on distinct features of voltage-gated sodium channels(VGSCs)and neuropeptide profiles.Using whole-cell patch-clamp recordings,we observed mechanically activated action potentials(APs)and classified AP waveforms based on the presence or absence of a hump during the repolarization phase.Single-cell reverse transcription polymerase chain reaction combined with patch-clamp recordings revealed specific associations between AP waveforms and molecular properties,including tetrodotoxin-resistant VGSCs(NaV1.8 and NaV1.9)and TRPV1 expression.Reanalysis of the transcriptomic dataset of DPA neurons identified correlations between neuropeptides—including two CGRP isoforms(α-CGRP andβ-CGRP),Substance P,and Galanin—and the expression of NaV1.8 and NaV1.9,which were linked to defined AP subtypes.These molecular associations were further validated in Piezo2+DPA neurons using fluorescence in situ hybridization.Together,these findings highlight the electrophysiological and neurochemical heterogeneity of Piezo2-expressing DPA neurons and their specialized roles in distinct mechanosensory signal transmission.展开更多
BACKGROUND Irritable bowel syndrome with predominant constipation(IBS-C)is a chronic gastrointestinal disorder that significantly impacts the quality of life of patients and currently lacks a definitive treatment.The ...BACKGROUND Irritable bowel syndrome with predominant constipation(IBS-C)is a chronic gastrointestinal disorder that significantly impacts the quality of life of patients and currently lacks a definitive treatment.The use of electroacupuncture(EA)has demonstrated clinical efficacy in treating IBS-C and the gut-brain axis modulation,though its mechanisms remain unclear.AIM To investigate gut-brain-microbiota axis alteration and EA-associated microbial changes in IBS-C patients and treatment responders.METHODS This study consisted of two phases.The first phase was a cross-sectional study recruiting sixteen IBS-C patients and 16 healthy controls.Baseline fecal samples were collected to assess gut microbiota profiles between the two groups.The second phase was an observational longitudinal study in which the 16 IBS-C patients underwent nine EA sessions over one month.Gut microbiota profiles and clinical outcomes were assessed post-treatment course and at a one-month follow-up.RESULTS IBS-C patients exhibited significant gut dysbiosis,as indicated by altered beta diversity compared to healthy controls.EA significantly improved clinical outcomes and gut dysbiosis,with sustained therapeutic effects and normalization of neurotransmitter-related metabolic pathways observed at one-month follow-up.Notably,the gut bacterium Senegalimassilia was positively associated with symptom improvement,suggesting its potential as a predictive biomarker of EA responsiveness.CONCLUSION These findings support the integration of EA into IBS-C management and highlight Senegalimassilia as a candidate microbial biomarker for treatment response.展开更多
Aim To develop pluronic F127 （PF127） based formulations of penciclovir （PCV） aimed at enhancing its ocular bioavailability. Methods Thermosensitive in situ gels of penciclovir were prepared through combination of ...Aim To develop pluronic F127 （PF127） based formulations of penciclovir （PCV） aimed at enhancing its ocular bioavailability. Methods Thermosensitive in situ gels of penciclovir were prepared through combination of HPMC K4M or carbopol 934P and pluronic F127. Optimized formulations were examined through measuring gelation temperature, rheology speciality, drug release behavior, pharmacokinetics and ocular irritation. Results The gelation temperature was reduced by adding HPMC K4M or carbopol 934P, and the viscosity was enhanced slightly. Either HPMC K4M or carbopol 934P delayed the release of PCV from in situ gel. PCV was released by non-Fickian diffusion. The study of ocular irritation for different PCV formulations did not show any irritation or damage for the cornea. PCV bioavailability from combination of carbopol 934P and pluronic F127 gels was higher than that obtained from any other gels. Conclusion Pluronic F127 formulations of PCV can be used as liquid for administration by instilling into the eye. Facilitated by the appropriate eye temperature, the formulations were transformed to gel phase. On the basis of in vitro and in vivo results, PCV formulations containing HPMC K4M or carbopol 934P and low concentration of pluronic F127 （12%） showed potential for use as a drug delivery system with improved ocular bioavailability.展开更多
Objectives To investigate the barriers and facilitators influencing the sustainable implementation of evidence-based practice(EBP)for Peristomal Irritant Contact Dermatitis(PICD)based on the Consolidated Framework for...Objectives To investigate the barriers and facilitators influencing the sustainable implementation of evidence-based practice(EBP)for Peristomal Irritant Contact Dermatitis(PICD)based on the Consolidated Framework for Implementation Research(CFIR).Methods The sample consisted of 17 nurses from three urology wards at a tertiary hospital in Beijing,China,who had participated in the EBP.Guided by the CFIR,we identified constructs influencing the sustainability of implementation by conducting a directed content analysis of the 17 individual in-depth interviews.By rating,the valence and magnitude of each construct were determined.Results This study identified 19 factors across the five domains of the CFIR.Among these determinants,16 were identified as barriers,while three were recognized as facilitators.Common barriers across different contexts were identified,such as delayed evidence updating,the complexity of intervention components and steps,and incompatibility between the implementation process and clinical practices.In contrast,facilitators of intervention implementation were regular communication and feedback,support and drive from principals and a positive cultural atmosphere.In addition,we identified“regular evidence updating”as an independent construct outside of the CFIR,a finding that will provide key information for updating the CFIR framework.Conclusions Regular evidence updating is crucial for the sustainability of EBP implementation.Researchers should receive consistent feedback from practitioners and adjust or modify the EBP as necessary.Additionally,researchers must consider the compatibility or adaptability of the EBP’s content with clinical practice in formulating it rather than adding additional complexity to the original workflow.展开更多
BACKGROUND Irritable bowel syndrome(IBS)affects approximately 9%-12%of the global population,presenting substantial diagnostic challenges due to symptom subjectivity and lack of definitive biomarkers.AIM To systematic...BACKGROUND Irritable bowel syndrome(IBS)affects approximately 9%-12%of the global population,presenting substantial diagnostic challenges due to symptom subjectivity and lack of definitive biomarkers.AIM To systematically examine the diagnostic accuracy of artificial intelligence(AI)models applied to various biomarkers in IBS diagnosis.METHODS A comprehensive search of six databases identified 18053 articles published up to May 31,2024.Following screening and eligibility criteria,six observational studies involving 1366 participants from the United Kingdom,China,and Japan were included.Risk of bias and reporting quality were assessed using quality assessment of diagnostic accuracy studies-2,prediction model risk of bias assessment tool-AI,and transparent reporting of a multivariable prediction model for individual prognosis or diagnosis-AI tools.Key metrics included sensitivity,specificity,accuracy,and area under the curve(AUC).RESULTS The included studies applied AI models such as random forests,support vector machines,and neural networks to biomarkers like fecal microbiome composition,gas chromatography data,neuroimaging features,and protease activity.Diagnostic accuracy ranged from 54% to 98%(AUC:0.61-0.99).Models using fecal microbiome data achieved the highest performance,with one study reporting 98%sensitivity and specificity(AUC=0.99).While most studies demonstrated high methodological quality,significant variability in datasets,biomarkers,and validation methods limited meta-analysis feasibility and generalizability.CONCLUSION AI models show potential to improve IBS diagnostic accuracy by integrating complex biomarkers which will aid the development of algorithms to direct treatment strategies.However,methodological inconsistencies and limited population diversity underscore the need for standardized protocols and external validation to ensure clinical applicability.展开更多
BACKGROUND Irritable bowel syndrome(IBS)is a prevalent functional gastrointestinal(FGITD)disorder,the diagnosis is based on Rome Criteria and other subjective tools.Because IBS overlaps with other FGITD and organic di...BACKGROUND Irritable bowel syndrome(IBS)is a prevalent functional gastrointestinal(FGITD)disorder,the diagnosis is based on Rome Criteria and other subjective tools.Because IBS overlaps with other FGITD and organic diseases,and the subjective tools do not apply to patients with cognitive decline,objective diagnostic tools are important in this category of patients.AIM To discuss the role of imaging in IBS diagnosis.METHODS We systematically searched three databases for articles published in the English language with no limitation to a specific period.The literature search was conducted in June and July 2024.The keywords used are IBS and functional bowel disorders,computed tomography,Magnetic Resonance Imaging,functional brain magnetic resonance imaging(MRI),and static brain MRI,and were linked with the terms"AND"and"OR".Out of the 679 articles,578 remained after duplication removal.However,50 full texts were used in the review.RESULTS Magnetic resonance imaging is superior due to its sensitivity,lack of radiation exposure,and lack of need for bowel preparation.Patients with IBS had smaller colonic and rectal volumes compared to healthy controls and functional constipation.Dynamic and static Magnetic Resonance Imaging of the brain showed increased activity,thinning,and increased volumes in specific areas of pain modulation.The above abnormalities are not uniform and vary significantly according to the type of IBS,the duration and intensity of symptoms,gender,and culture.CONCLUSION Magnetic resonance imaging shows smaller colonic and rectal volumes,and increased activity,thinning,and increased volumes in specific areas of pain modulation.Large trials incorporating all above limitations are needed.展开更多
BACKGROUND Irritable bowel syndrome(IBS)symptoms are common in patients with inflammatory bowel disease(IBD),with systematic review reporting an overall pooled prevalence of 35-39%in patients with clinical remission.T...BACKGROUND Irritable bowel syndrome(IBS)symptoms are common in patients with inflammatory bowel disease(IBD),with systematic review reporting an overall pooled prevalence of 35-39%in patients with clinical remission.This subset of patients reports a reduced quality of life and increased anxiety and depression.A multistrain probiotic(Symprove™,Symprove Ltd,Farnham,United Kingdom)has been shown to improve overall symptom severity in patients with IBS and is associated with decreased intestinal inflammation in patients with ulcerative colitis(UC),but not in Crohn’s disease(CD).AIM To ascertain whether this multi-strain probiotic would be effective in an IBS/IBD overlap population.METHODS The treatment of symptoms in the absence of inflammation in inflammatory bowel diseases trial was a randomized,double-blind,placebo-controlled trial of a four-strain probiotic Symprove,containing Lactobacillus rhamnosus NCIMB 30174,Lactobacillus plantarum NCIMB 30173,Lactobacillus acidophilus NCIMB 30175 and Enterococcus faecium NCIMB 30176.The duration of the study was 3 months,at the end of which IBS-Symptom Severity Score(IBS-SSS)was repeated.Primary Endpoint was a 100-point reduction in IBS-SSS.RESULTS 61 participants were randomized into the intention-to-treat analysis.45%of patients receiving the active agent achieved the endpoint compared to 33%of those receiving placebo(P=0.42).In UC,50%of patients receiving placebo achieved the endpoint compared to 44%of those receiving the active agent(P=1.00).In CD 45%of those receiving the active agent achieved the endpoint compared to 29%of those receiving placebo(P=0.34).The mean change in IBS-SSS for patients receiving placebo was a reduction of 61 points,compared to a reduction in 90 points for patients receiving active agent(P=0.31).There was no difference between the groups with regard to IBD outcomes.CONCLUSION Probiotics may represent a safe and effective means of addressing the unmet clinical need for symptom relief in patients with overlapping IBS and IBD,especially in those with CD.展开更多
This study explored the therapeutic effect of trimebutine maleate dispersible tablets combined with berberine on PI-IBS rats with liver depression and spleen deficiency.Fifty male rats were divided into five groups:no...This study explored the therapeutic effect of trimebutine maleate dispersible tablets combined with berberine on PI-IBS rats with liver depression and spleen deficiency.Fifty male rats were divided into five groups:normal,model,berberine(XB),trimebutine(QM),and combination(XB+QM).The PI-IBS model was established using maternal separation,TNBS perfusion,and chronic restraint.After 20 days of drug intervention,DAI,CMDI,TDI,AWR scores,histopathology,and expression levels of c-Fos,VIP,NOS,and CHAT in the hippocampus and colon were assessed.The model group showed significant gut and brain changes,while the combination group(XB+QM)improved fecal characteristics,reduced inflammation,regulated brain-gut peptide expression,and alleviated visceral hypersensitivity and colon tissue damage(P<0.05).展开更多
[Objectives]This study was conducted to analyze the medication laws of traditional Chinese medicine prescriptions for the treatment of spleen-deficiency irritable bowel syndrome in Guanling Autonomous County Hospital ...[Objectives]This study was conducted to analyze the medication laws of traditional Chinese medicine prescriptions for the treatment of spleen-deficiency irritable bowel syndrome in Guanling Autonomous County Hospital of Traditional Chinese Medicine.[Methods]Prescriptions for the treatment of spleen-deficiency irritable bowel syndrome(IBS)were retrieved from the TCM family of the hospital,traditional Chinese medical doctor Wu Zhongli,in the period from November 2023 to April 2024.Microsoft Excel 2007 was employed to set up an information table of TCM prescriptions,and the age,gender,herbal properties,efficacy categories and the frequency of use were analyzed to explore the medication laws of TCM in the hospital for the treatment of spleen-deficiency irritable bowel syndrome.[Results]Among the 259 TCM prescriptions included,152 kinds of TCM decoction pieces were used.The decoction pieces were mainly warm in nature,and decoction pieces cold in nature took the second place.The flavors of the herbs were mostly sweet,bitter and pungent.Most of them were attributive to the spleen,stomach meridian and lung meridians,and the herbs were mainly used for tonifying deficiency and regulating qi.The herbs with higher frequency of use included Radix Glycyrrhiza,Pericarpium Citri Reticulatae,poria,and Angelicae Sinensis Radix,the main effects of which are replenishing qi to invigorate the spleen,activating qi and eliminating phlegm,clearing damp and promoting diuresis,and relaxing bowel.[Conclusions]Chinese medicine treatment of IBS with spleen deficiency in hospitals is mainly based on replenishing qi to invigorate the spleen,activating qi and eliminating phlegm,clearing damp and promoting diuresis,and relaxing bowel,and Xiangsha Liujunzi Decoction is commonly used in clinical treatment based on syndrome differentiation with modifications.展开更多
BACKGROUND The relationship between exercise and gastrointestinal(GI)health is complex and bidirectional.While moderate exercise generally promotes gut health by enhancing motility,reducing inflammation,and supporting...BACKGROUND The relationship between exercise and gastrointestinal(GI)health is complex and bidirectional.While moderate exercise generally promotes gut health by enhancing motility,reducing inflammation,and supporting microbial balance,intense or prolonged physical activity may exacerbate GI symptoms,particularly in individuals with preexisting digestive disorders.A deeper understanding of this interplay is essential for optimizing both exercise performance and GI well-being.AIM To synthesize current evidence on exercise-related GI disorders,exploring the prevalence,mechanisms,risk factors,and management strategies associated with exercise-induced GI symptoms.METHODS Following PRISMA guidelines,comprehensive searches of databases,including PubMed,Scopus,Web of Science,and EMBASE were conducted.Studies were included if they focused on exercise-induced GI disorders,encompassed randomized controlled trials,cohort studies,case-control studies,and cross-sectional designs,and addressed symptoms across various exercise modalities.Data were extracted and analyzed to identify patterns and implications for clinical and athletic practice.RESULTS A total of 231 studies met the inclusion criteria,highlighting both the benefits and risks of exercise on GI health.Regular moderate-intensity exercise,including activities such as walking,cycling,and yoga has been associated with improved GI function in conditions like gastroesophageal reflux disease,irritable bowel syndrome,inflammatory bowel disease,and constipation.These benefits are attributed to enhanced intestinal motility,reduced systemic inflammation,and improved gut barrier integrity.Additionally,exercise plays a role in regulating the gut-brain axis,with practices like yoga and Tai Chi demonstrating particular effectiveness in alleviating functional GI disorders.Conversely,high-intensity or prolonged exercise may contribute to symptoms such as nausea,diarrhea,and abdominal pain due to mechanisms like splanchnic hypoperfusion and increased intestinal permeability.Individual factors,including fitness level,dietary habits,hydration status,and underlying GI conditions,significantly influence the body’s response to exercise.CONCLUSION Moderate-intensity exercise is a beneficial and well-tolerated intervention for promoting GI health,whereas highintensity activities require careful monitoring,particularly in individuals with pre-existing GI disorders.Personalized exercise and dietary strategies are essential for balancing the benefits of physical activity with the risk of GI distress.Further research is needed to explore the long-term effects of exercise on gut microbiota composition and overall digestive health.展开更多
The recent study published in the World Journal of Gastroenterology examines the interplay among the neuroendocrine axis,gut microbiota,inflammatory markers,and gastrointestinal symptoms in irritable bowel syndrome(IB...The recent study published in the World Journal of Gastroenterology examines the interplay among the neuroendocrine axis,gut microbiota,inflammatory markers,and gastrointestinal symptoms in irritable bowel syndrome(IBS).By integrating all these factors into a single study,this approach reflects the modern concept of functional gastrointestinal disorders as disorders of the gut-brain interaction to be approached in a multiparametric manner,also incorporating non-gastroentero-logical elements and extending evaluations to parameters related to the neuroen-docrine axis.This invited letter to the editor summarizes the main results of the aforementioned study and highlights its multiparametric approach,including variables not strictly gastroenterological,in the study of IBS,and discusses its strengths and limitations.展开更多
基金This work was supported by the National Natural Science Foundation of China(Nos.82073975,81673563,81102762,and 2018YFC1706200)the Open Project Program of Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization/Jiangsu Key Laboratory for High Technology Research ofTCM Formulae(Nos.ZDXM-1-14,FJGJS-2015-15)the Fund of Quality Standardization of Liu-Shen-Wan(Nos.BA2016104,ZYBZH-C-JS-30),and Jiangsu Qing Lan Project for Young academic leaders.
文摘Chansu has demonstrated adverse reactions in clinical settings,which is associated with its toxicity and limits its clinical applications.But there are methodological limitations for drug safety evaluation.In the current study,ultra-high performance liquid chromatography,lipidomic profiling,and molecular docking were used to systemically assess Chansu-induced acute inflammatory irritation and further identify the underlying drug targets.Compared with the EtOAc extract,Chansu water fraction containing indolealkylamines caused acute inflammatory irritation in rats,including acute pain(spontaneous raising foot reaction),and inflammation(paw edema).At the molecular level,lipids analysis revealed significantly higher levels of pro-inflammatory mediators of the COX and LOX pathways.However,anti-inflammatory mediators from the CYP 450,ALA,and DHA pathways markedly decreased after exposure to Chansu water fraction.Moreover,four indolealkylamines from Chansu showed a high theoretical affinity to a known irritation target,5-HT_(2A)R.These results suggest that Chansu-induced inflammatory irritation is related to the distinct dysregulation of inflammatory lipids,and peripheral 5-HT_(2A)R is a potential target for irritation therapy.The strategy used in this study can be a crucial approach in the safety evaluation of natural medicinal substances.
基金Project supported by the National Key Technologies R&D Program of China(Nos.2008ZXJ09014-004 and 2012ZX10005010-002-002)
文摘Insulin is widely used in treating diabetes, but still needs to be administered by needle injection. This study investigated a new needle-free approach for insulin delivery. A portable powder needleless injection（PNI） device with an automatic mechanical unit was designed. Its efficiency in delivering insulin was evaluated in alloxan-induced diabetic rabbits. The skin irritation caused by the device was investigated and the results were analyzed in relation to aerodynamic parameters. Inorganic salt-carried insulin powders had hypoglycemic effects, while raw insulin powders were not effective when delivered by PNI, indicating that salt carriers play an important role in the delivery of insulin via PNI. The relative delivery efficiency of phosphate-carried insulin powder using the PNI device was 72.25%. A safety assessment test showed that three key factors（gas pressure, cylinder volume, and nozzle distance） were related to the amount of skin irritation caused by the PNI device. Optimized injection conditions caused minimal skin lesions and are safe to use in practice. The results suggest that PNI has promising prospects as a novel technology for delivering insulin and other biological drugs.
基金The Swedish Research Council and the Swedish Energy Agency are gratefully acknowledged for financial supportthe China Scholarship Council(CSC)for financial support.
文摘Upsalite®is a mesoporous magnesium carbonate synthesized without using surfactants and therefore highly attractive from environmental and production economy points of view. The material has recently been suggested as drug delivery vehicle and as topical bacteriostatic agent. In order to continue exploring these and other bio-related applications of the material, primary biocompatibility studies are needed. Herein we present the first in vivo acute systemic toxicity and skin irritation analyses as well as in vitro cytotoxicity evaluations of Upsalite®. The material was found to be non-toxic for human dermal fibroblasts cells up to a concentration of 1000 μg/ml and 48 h exposure in contrast to the mesoporous silica material SBA-15, used as reference, which significantly affected cell viability at particle concentration of 500 and 1000 μg/ml after the same exposure time. Topical application of Upsalite®resulted in negligible cutaneous reactions in a rabbit skin irritation model and no evidence of significant systemic toxicity was found when saline extracts of Upsalite®were injected in mice. Injection of sesame oil extract, however, resulted in transient weight loss, most likely due to injection of particles, and not toxic leachables. The presented results form the basis for future development of Upsalite®and similar mesoporous materials in biomedical applications and further toxicity as well as biocompatibility studies should be directed towards specific areas of use.
文摘<strong>Purpose:</strong> To establish whether Curaderm, a topical pharmacotherapy for skin cancer, irritates or sensitizes normal skin. <strong>Methods:</strong> The dermal irritation and skin sensitization toxicity of Curaderm were investigated in rabbits and guinea pigs in compliance with the Organization for Economic Cooperation and Development guideline. To assess dermal irritation, rabbits were dermally exposed to Curaderm for varying periods of time. To assess hypersensitivity, the guinea-pig maximisation test was applied. <strong>Results:</strong> Curaderm was only negligibly irritating using the criteria of erythema and oedema. Curaderm did not produce any sensitization toxicity of the skin. <strong>Conclusion:</strong> These studies confirm the non-toxic observations on normal skin experienced in the clinical setting when treating skin cancer and reinforce the specificity of Curaderm towards cancer cells.
文摘Introduction: The Cussons Baby Sensicare Range is a newly developed set of products specially formulated for newborn, sensitive and eczema prone skin. As such, these products need to be tested to evaluate their skin irritation and sensitization potential before use. The products were evaluated with two separate tests. The first test was conducted in a single-center, within-subject comparison using assessor-blind, randomised human skin irritation patch test (48 hour/96 hour exposure) and conducted on healthy adults with sensitive, atopic skin. The second test was conducted in a single-center, controlled (sterile water), within subject using human repeat-insult patch tests (HRIPTs) and conducted on healthy female Indonesian and Asian adult female subjects, with sensitive skin. The sensitization potential of each product was determined from International Contact Dermatitis Research Group (ICDRG) scores at 30 minutes, 24 hours, 48 hours and 72 hours after patch removal. Skin irritation tests show that all products were significantly lower than the positive control sodium lauryl sulphate (SLS) (p < 0.05) but not significantly different to the negative control (sterile water) in terms of irritation scores at the respective time points. HRIPTs results show that Cussons Baby Sensicare Range was non-sensitizing. As such, it can be concluded that the Cussons Baby Sensicare Range tested is well tolerated on skin and has low skin irritation and sensitization potential. Thus, they can be considered hypoallergenic on sensitive skin and suitable for eczema prone skin.
文摘Purpose:This study was designed to determine whether a novel anti-melanogenic agent,PF3758309,has the potential to cause acute cutaneous irritation using a human skin equivalent model (HSEM).Methods:Human skin equivalent was constructed through incubation of normal human derived epidermal keratinocytes (HEKs)on collagen matrix insert with proliferation media.Using constructed human skin equivalent,the irritation potential of PF3758309 were investigated whether the viability of this agent-treated HESM is under 50%(irritant)or not (non-irritant)using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT)assay after applying the agent to the epidermal surface of the HSEM.Also,the PF3758309-mediated anti-pigmentation effects were analyzed using Fontana-Masson staining in the HSEM.Results:The integrity of the constructed HSEM was confirmed using immunohistochemical staining with differentiation markers of epidermis,and observed that Keratin 5,Keratin I and Involucrin were stained in basal,supra-basal and granular layers,respectively.In vitro irritation assay showed that the mean viabilities of the PF3758309 was 83.6%,78.8%and 77.8%at the treatment doses of 0.2,0.5 and I mg,respectively;however,the mean viability of the positive control (5%sodium dodecyl sulfate)-treated HESM was 2.8%.Also,in vitro corrosion assay showed that the mean viabilities of the PF3758309 was 95.3%,95.0%and 94.2% at the treatment doses of 0.2,0.5 and 1 mg,respectively.Furthermore,using a Fontana-Masson staining assay,the melanin levels in the PF3758309-treated HSEM was significantly decreased compared with the levels in control HSEM.Conclusion: The anti-melanogenic agent,PF3758309,has no skin irritation potential under the conditions used in this study.
文摘AIM: To investigate and compare the effects of spinal D-(-)-2-amino-7-phosphonoheptanoic acid (AP-7) and 6-cyano-7-nitroquinoxaline-2,3-dione disodium (CNQX),two glutamate receptor antagonists, on the responses of dorsal horn neurons to colorectal distension (CRD) in adult rats exposed to neonatal colon irritation (CI).METHODS: Hypersensitive SD rats were generated by CI during postnatal days 8, 10 and 12. Experiments on adult rats were performed using extracellular single-unit recording. The effects of spinal application of AP-7 (0.001,0.01, 0.1, 1 mmoL) were tested on the CRD-evoked neuronal responses in 16 controls and 17 CI rats. The effects of CNQX (0.2, 2, 5, 10 μmoL) were also tested on the CRD-evoked responses of 17 controls and 18 CI neurons.RESULTS: (1) The average responses of lumbosacral neurons to all intensities of CRD in CI rats were significantly higher than those in control rats; (2) In control rats, AP-7 (0.01 mmoL) had no significant effect on the neuronal response to all intensities of CRD (20,40, 60, 80 mmHg); while AP-7 (0.1 mmoL) inhibited the neuronal response to 80-mmHg CRD. By contrast, in CI rats, AP-7 (0.01-1 mmoL) attenuated the CRD-evoked neuronal responses to all distention pressures in a dosedependent manner; (3) In control rats, CNQX (2 μmoL)had no significantly effect on the neuronal response to all intensities of CRD; however, CNQX (5 μmoL) significantly attenuated the responses to CRD in the 40-80 mmHg range. By contrast, CNQX (2-10 μmoL)significantly decreased the neuronal responses in CI rats to non-noxious and noxious CRD in a dose-dependent manner.CONCLUSION: Our results suggest that spinal N-methyl-D-aspartate (NMDA) and non-NMDA receptors may contribute to the processing of central sensitivity in a neonatal CI rat model, but they may play different roles in it.
基金National S&T Major Special Project on Major New Drug Innovation (2009ZX09301-003&2008ZX09103-390)
文摘Objective To increase the solubility and relieve the mucous irritation of cantharidin (CA) by preparing cantharidin-hydroxypropyl-β-cyclodextrin (CA/HP-β-CD) inclusion complex. Methods The inclusion complex was prepared by co-evaporation method and characterized by differential scanning calorimetry (DSC), X-ray diffractometry (XRD), and nuclear magnetic resonance (NMR). Results The disappearance of CA as well as the shift of exothermic peaks shown in DSC results indicated the complexation phenomenon. XRD results showed that the crystalline CA pattern had disappeared, and in NMR results, H-5 shifted from δ 3.731 to 3.695 after complexation and H-2 shifted from δ 3.626 to 3.598, which suggested that part of the drug had entered the HP-β-CD cavity to form an inclusion complex. The solubility increased 10.3 times after complexation and the mucous irritation of CA was relieved remarkably. Conclusion Through complexation with HP-β-CD, the solubility and dissolution rate of CA are improved significantly, and the irritation of musous is relieved.
文摘BACKGROUND Intraoral honeybee stings are very rare.Stings by these insects occur 25%of the time in the head and neck region.In addition,a stinger intraorally can lead to persistent irritation,inflammation,and secondary infections if not promptly excised.CASE SUMMARY We report the case of a 52-year-old female patient who was stung in her mouth by a honeybee,causing a local irritation.The patient presented with a one-month history of pain,swelling,and redness in the left buccal mucosa.Inadvertently retained,the stinger was discovered during a clinical evaluation following initial treatment for facial swelling and erythema.After the stinger was removed,the patient’s symptoms resolved without complications.CONCLUSION This case emphasizes the importance of thorough examination and prompt management of insect stings to prevent prolonged discomfort and potential complications.
基金supported by the National Research Foundation(NRF)of Korea(grant number:RS-2022-NR072217 to P.RL,RS-2021-NR059709,RS-2023-00264409,and RS-2024-00441103)funded by the Korean government(MSIT).
文摘Piezo2,a mechanosensitive ion channel,serves as a crucial mechanotransducer in dental primary afferent(DPA)neurons and is potentially involved in hypersensitivity to mild mechanical irritations observed in dental patients.Given Piezo2’s widespread expression across diverse subpopulations of DPA neurons,this study aimed to characterize the mechanosensory properties of Piezo2-expressing DPA neurons with a focus on distinct features of voltage-gated sodium channels(VGSCs)and neuropeptide profiles.Using whole-cell patch-clamp recordings,we observed mechanically activated action potentials(APs)and classified AP waveforms based on the presence or absence of a hump during the repolarization phase.Single-cell reverse transcription polymerase chain reaction combined with patch-clamp recordings revealed specific associations between AP waveforms and molecular properties,including tetrodotoxin-resistant VGSCs(NaV1.8 and NaV1.9)and TRPV1 expression.Reanalysis of the transcriptomic dataset of DPA neurons identified correlations between neuropeptides—including two CGRP isoforms(α-CGRP andβ-CGRP),Substance P,and Galanin—and the expression of NaV1.8 and NaV1.9,which were linked to defined AP subtypes.These molecular associations were further validated in Piezo2+DPA neurons using fluorescence in situ hybridization.Together,these findings highlight the electrophysiological and neurochemical heterogeneity of Piezo2-expressing DPA neurons and their specialized roles in distinct mechanosensory signal transmission.
文摘BACKGROUND Irritable bowel syndrome with predominant constipation(IBS-C)is a chronic gastrointestinal disorder that significantly impacts the quality of life of patients and currently lacks a definitive treatment.The use of electroacupuncture(EA)has demonstrated clinical efficacy in treating IBS-C and the gut-brain axis modulation,though its mechanisms remain unclear.AIM To investigate gut-brain-microbiota axis alteration and EA-associated microbial changes in IBS-C patients and treatment responders.METHODS This study consisted of two phases.The first phase was a cross-sectional study recruiting sixteen IBS-C patients and 16 healthy controls.Baseline fecal samples were collected to assess gut microbiota profiles between the two groups.The second phase was an observational longitudinal study in which the 16 IBS-C patients underwent nine EA sessions over one month.Gut microbiota profiles and clinical outcomes were assessed post-treatment course and at a one-month follow-up.RESULTS IBS-C patients exhibited significant gut dysbiosis,as indicated by altered beta diversity compared to healthy controls.EA significantly improved clinical outcomes and gut dysbiosis,with sustained therapeutic effects and normalization of neurotransmitter-related metabolic pathways observed at one-month follow-up.Notably,the gut bacterium Senegalimassilia was positively associated with symptom improvement,suggesting its potential as a predictive biomarker of EA responsiveness.CONCLUSION These findings support the integration of EA into IBS-C management and highlight Senegalimassilia as a candidate microbial biomarker for treatment response.
文摘Aim To develop pluronic F127 （PF127） based formulations of penciclovir （PCV） aimed at enhancing its ocular bioavailability. Methods Thermosensitive in situ gels of penciclovir were prepared through combination of HPMC K4M or carbopol 934P and pluronic F127. Optimized formulations were examined through measuring gelation temperature, rheology speciality, drug release behavior, pharmacokinetics and ocular irritation. Results The gelation temperature was reduced by adding HPMC K4M or carbopol 934P, and the viscosity was enhanced slightly. Either HPMC K4M or carbopol 934P delayed the release of PCV from in situ gel. PCV was released by non-Fickian diffusion. The study of ocular irritation for different PCV formulations did not show any irritation or damage for the cornea. PCV bioavailability from combination of carbopol 934P and pluronic F127 gels was higher than that obtained from any other gels. Conclusion Pluronic F127 formulations of PCV can be used as liquid for administration by instilling into the eye. Facilitated by the appropriate eye temperature, the formulations were transformed to gel phase. On the basis of in vitro and in vivo results, PCV formulations containing HPMC K4M or carbopol 934P and low concentration of pluronic F127 （12%） showed potential for use as a drug delivery system with improved ocular bioavailability.
基金supported by the Peking University Nursing Discipline Research Development Fund(No.TYZH2023001)。
文摘Objectives To investigate the barriers and facilitators influencing the sustainable implementation of evidence-based practice(EBP)for Peristomal Irritant Contact Dermatitis(PICD)based on the Consolidated Framework for Implementation Research(CFIR).Methods The sample consisted of 17 nurses from three urology wards at a tertiary hospital in Beijing,China,who had participated in the EBP.Guided by the CFIR,we identified constructs influencing the sustainability of implementation by conducting a directed content analysis of the 17 individual in-depth interviews.By rating,the valence and magnitude of each construct were determined.Results This study identified 19 factors across the five domains of the CFIR.Among these determinants,16 were identified as barriers,while three were recognized as facilitators.Common barriers across different contexts were identified,such as delayed evidence updating,the complexity of intervention components and steps,and incompatibility between the implementation process and clinical practices.In contrast,facilitators of intervention implementation were regular communication and feedback,support and drive from principals and a positive cultural atmosphere.In addition,we identified“regular evidence updating”as an independent construct outside of the CFIR,a finding that will provide key information for updating the CFIR framework.Conclusions Regular evidence updating is crucial for the sustainability of EBP implementation.Researchers should receive consistent feedback from practitioners and adjust or modify the EBP as necessary.Additionally,researchers must consider the compatibility or adaptability of the EBP’s content with clinical practice in formulating it rather than adding additional complexity to the original workflow.
文摘BACKGROUND Irritable bowel syndrome(IBS)affects approximately 9%-12%of the global population,presenting substantial diagnostic challenges due to symptom subjectivity and lack of definitive biomarkers.AIM To systematically examine the diagnostic accuracy of artificial intelligence(AI)models applied to various biomarkers in IBS diagnosis.METHODS A comprehensive search of six databases identified 18053 articles published up to May 31,2024.Following screening and eligibility criteria,six observational studies involving 1366 participants from the United Kingdom,China,and Japan were included.Risk of bias and reporting quality were assessed using quality assessment of diagnostic accuracy studies-2,prediction model risk of bias assessment tool-AI,and transparent reporting of a multivariable prediction model for individual prognosis or diagnosis-AI tools.Key metrics included sensitivity,specificity,accuracy,and area under the curve(AUC).RESULTS The included studies applied AI models such as random forests,support vector machines,and neural networks to biomarkers like fecal microbiome composition,gas chromatography data,neuroimaging features,and protease activity.Diagnostic accuracy ranged from 54% to 98%(AUC:0.61-0.99).Models using fecal microbiome data achieved the highest performance,with one study reporting 98%sensitivity and specificity(AUC=0.99).While most studies demonstrated high methodological quality,significant variability in datasets,biomarkers,and validation methods limited meta-analysis feasibility and generalizability.CONCLUSION AI models show potential to improve IBS diagnostic accuracy by integrating complex biomarkers which will aid the development of algorithms to direct treatment strategies.However,methodological inconsistencies and limited population diversity underscore the need for standardized protocols and external validation to ensure clinical applicability.
基金acknowledge the Saudi Digital Library for accessing the databases.
文摘BACKGROUND Irritable bowel syndrome(IBS)is a prevalent functional gastrointestinal(FGITD)disorder,the diagnosis is based on Rome Criteria and other subjective tools.Because IBS overlaps with other FGITD and organic diseases,and the subjective tools do not apply to patients with cognitive decline,objective diagnostic tools are important in this category of patients.AIM To discuss the role of imaging in IBS diagnosis.METHODS We systematically searched three databases for articles published in the English language with no limitation to a specific period.The literature search was conducted in June and July 2024.The keywords used are IBS and functional bowel disorders,computed tomography,Magnetic Resonance Imaging,functional brain magnetic resonance imaging(MRI),and static brain MRI,and were linked with the terms"AND"and"OR".Out of the 679 articles,578 remained after duplication removal.However,50 full texts were used in the review.RESULTS Magnetic resonance imaging is superior due to its sensitivity,lack of radiation exposure,and lack of need for bowel preparation.Patients with IBS had smaller colonic and rectal volumes compared to healthy controls and functional constipation.Dynamic and static Magnetic Resonance Imaging of the brain showed increased activity,thinning,and increased volumes in specific areas of pain modulation.The above abnormalities are not uniform and vary significantly according to the type of IBS,the duration and intensity of symptoms,gender,and culture.CONCLUSION Magnetic resonance imaging shows smaller colonic and rectal volumes,and increased activity,thinning,and increased volumes in specific areas of pain modulation.Large trials incorporating all above limitations are needed.
文摘BACKGROUND Irritable bowel syndrome(IBS)symptoms are common in patients with inflammatory bowel disease(IBD),with systematic review reporting an overall pooled prevalence of 35-39%in patients with clinical remission.This subset of patients reports a reduced quality of life and increased anxiety and depression.A multistrain probiotic(Symprove™,Symprove Ltd,Farnham,United Kingdom)has been shown to improve overall symptom severity in patients with IBS and is associated with decreased intestinal inflammation in patients with ulcerative colitis(UC),but not in Crohn’s disease(CD).AIM To ascertain whether this multi-strain probiotic would be effective in an IBS/IBD overlap population.METHODS The treatment of symptoms in the absence of inflammation in inflammatory bowel diseases trial was a randomized,double-blind,placebo-controlled trial of a four-strain probiotic Symprove,containing Lactobacillus rhamnosus NCIMB 30174,Lactobacillus plantarum NCIMB 30173,Lactobacillus acidophilus NCIMB 30175 and Enterococcus faecium NCIMB 30176.The duration of the study was 3 months,at the end of which IBS-Symptom Severity Score(IBS-SSS)was repeated.Primary Endpoint was a 100-point reduction in IBS-SSS.RESULTS 61 participants were randomized into the intention-to-treat analysis.45%of patients receiving the active agent achieved the endpoint compared to 33%of those receiving placebo(P=0.42).In UC,50%of patients receiving placebo achieved the endpoint compared to 44%of those receiving the active agent(P=1.00).In CD 45%of those receiving the active agent achieved the endpoint compared to 29%of those receiving placebo(P=0.34).The mean change in IBS-SSS for patients receiving placebo was a reduction of 61 points,compared to a reduction in 90 points for patients receiving active agent(P=0.31).There was no difference between the groups with regard to IBD outcomes.CONCLUSION Probiotics may represent a safe and effective means of addressing the unmet clinical need for symptom relief in patients with overlapping IBS and IBD,especially in those with CD.
基金Science and Technology Fund Project of Guizhou Provincial Health Commission(Project No.:gawkj2021-225).
文摘This study explored the therapeutic effect of trimebutine maleate dispersible tablets combined with berberine on PI-IBS rats with liver depression and spleen deficiency.Fifty male rats were divided into five groups:normal,model,berberine(XB),trimebutine(QM),and combination(XB+QM).The PI-IBS model was established using maternal separation,TNBS perfusion,and chronic restraint.After 20 days of drug intervention,DAI,CMDI,TDI,AWR scores,histopathology,and expression levels of c-Fos,VIP,NOS,and CHAT in the hippocampus and colon were assessed.The model group showed significant gut and brain changes,while the combination group(XB+QM)improved fecal characteristics,reduced inflammation,regulated brain-gut peptide expression,and alleviated visceral hypersensitivity and colon tissue damage(P<0.05).
文摘[Objectives]This study was conducted to analyze the medication laws of traditional Chinese medicine prescriptions for the treatment of spleen-deficiency irritable bowel syndrome in Guanling Autonomous County Hospital of Traditional Chinese Medicine.[Methods]Prescriptions for the treatment of spleen-deficiency irritable bowel syndrome(IBS)were retrieved from the TCM family of the hospital,traditional Chinese medical doctor Wu Zhongli,in the period from November 2023 to April 2024.Microsoft Excel 2007 was employed to set up an information table of TCM prescriptions,and the age,gender,herbal properties,efficacy categories and the frequency of use were analyzed to explore the medication laws of TCM in the hospital for the treatment of spleen-deficiency irritable bowel syndrome.[Results]Among the 259 TCM prescriptions included,152 kinds of TCM decoction pieces were used.The decoction pieces were mainly warm in nature,and decoction pieces cold in nature took the second place.The flavors of the herbs were mostly sweet,bitter and pungent.Most of them were attributive to the spleen,stomach meridian and lung meridians,and the herbs were mainly used for tonifying deficiency and regulating qi.The herbs with higher frequency of use included Radix Glycyrrhiza,Pericarpium Citri Reticulatae,poria,and Angelicae Sinensis Radix,the main effects of which are replenishing qi to invigorate the spleen,activating qi and eliminating phlegm,clearing damp and promoting diuresis,and relaxing bowel.[Conclusions]Chinese medicine treatment of IBS with spleen deficiency in hospitals is mainly based on replenishing qi to invigorate the spleen,activating qi and eliminating phlegm,clearing damp and promoting diuresis,and relaxing bowel,and Xiangsha Liujunzi Decoction is commonly used in clinical treatment based on syndrome differentiation with modifications.
文摘BACKGROUND The relationship between exercise and gastrointestinal(GI)health is complex and bidirectional.While moderate exercise generally promotes gut health by enhancing motility,reducing inflammation,and supporting microbial balance,intense or prolonged physical activity may exacerbate GI symptoms,particularly in individuals with preexisting digestive disorders.A deeper understanding of this interplay is essential for optimizing both exercise performance and GI well-being.AIM To synthesize current evidence on exercise-related GI disorders,exploring the prevalence,mechanisms,risk factors,and management strategies associated with exercise-induced GI symptoms.METHODS Following PRISMA guidelines,comprehensive searches of databases,including PubMed,Scopus,Web of Science,and EMBASE were conducted.Studies were included if they focused on exercise-induced GI disorders,encompassed randomized controlled trials,cohort studies,case-control studies,and cross-sectional designs,and addressed symptoms across various exercise modalities.Data were extracted and analyzed to identify patterns and implications for clinical and athletic practice.RESULTS A total of 231 studies met the inclusion criteria,highlighting both the benefits and risks of exercise on GI health.Regular moderate-intensity exercise,including activities such as walking,cycling,and yoga has been associated with improved GI function in conditions like gastroesophageal reflux disease,irritable bowel syndrome,inflammatory bowel disease,and constipation.These benefits are attributed to enhanced intestinal motility,reduced systemic inflammation,and improved gut barrier integrity.Additionally,exercise plays a role in regulating the gut-brain axis,with practices like yoga and Tai Chi demonstrating particular effectiveness in alleviating functional GI disorders.Conversely,high-intensity or prolonged exercise may contribute to symptoms such as nausea,diarrhea,and abdominal pain due to mechanisms like splanchnic hypoperfusion and increased intestinal permeability.Individual factors,including fitness level,dietary habits,hydration status,and underlying GI conditions,significantly influence the body’s response to exercise.CONCLUSION Moderate-intensity exercise is a beneficial and well-tolerated intervention for promoting GI health,whereas highintensity activities require careful monitoring,particularly in individuals with pre-existing GI disorders.Personalized exercise and dietary strategies are essential for balancing the benefits of physical activity with the risk of GI distress.Further research is needed to explore the long-term effects of exercise on gut microbiota composition and overall digestive health.
文摘The recent study published in the World Journal of Gastroenterology examines the interplay among the neuroendocrine axis,gut microbiota,inflammatory markers,and gastrointestinal symptoms in irritable bowel syndrome(IBS).By integrating all these factors into a single study,this approach reflects the modern concept of functional gastrointestinal disorders as disorders of the gut-brain interaction to be approached in a multiparametric manner,also incorporating non-gastroentero-logical elements and extending evaluations to parameters related to the neuroen-docrine axis.This invited letter to the editor summarizes the main results of the aforementioned study and highlights its multiparametric approach,including variables not strictly gastroenterological,in the study of IBS,and discusses its strengths and limitations.
