Premedication with pronase or N-acetylcysteine improves visibility during gastroendoscopy: An endoscopist-blinded, prospective, randomized study

AIM: To assess the efficacy of premedicaton with pronase or N-acetylcysteine (NAC) at 20 min before upper gastrointestinal (UGI) endoscopy and to determine whether pronase or NAC pretreatment influences the reliability of the rapid urease test. METHODS: A total of 146 patients were prospectively and randomly assigned into the study groups according to different premedications before endoscopy. One endoscopist assessed mucosal visibility (MV) with scores ranged from 1 to 4 at four sites in the stomach. The sum of the MV scores from these four locations was defined as the total mucosal visibility (TMV) score. Identification of H pylori was performed using CLO test, histology, and serology. RESULTS: The Group with pronase premedication had a significantly lower TMV score than did the groups with gascon and gascon water (P < 0.001 and P < 0.01, respectively). The group with NAC had a significantly lower TMV score than the group with gascon (P < 0.01) and a trend of a lower MV score than the group with gascon water (P = 0.06). The TMV score did not significantly differ between the group with pronase and the group with NAC (P = 0.39 and P = 0.14, respectively). The sensitivity and specificity of the CLO test were 92.5% and 93.9%, respectively, in groups premedicated with pronase and NAC together.CONCLUSION: Premedication with pronase or NAC at 20 min before UGI endoscopy improves the mucosal visibility of the stomach. Neither pronase nor NAC produces any obvious interference with the CLO test for the identification of H pylori infection.

Hot water-extracted Lycium barbarum and Rehmannia glutinosa inhibit proliferation and induce apoptosis of hepatocellular carcinoma cells

瞄准：在老鼠或人的肝细胞癌(HCC ) 在房间增长和 apoptosis 上调查热提取水的 Lycium 倒刺海芋属植物(LBE ) 和 Rehmannia glutinosa (RGE ) 的效果房间。方法：老鼠(H-4-II-E ) 和 HCC (HA22T/VGH ) 房间衬里的人与热提取水的 LBE 和 RGE 的各种各样的集中(0-10 g/L ) 被孵化。在 6-24 h 孵化以后，房间增长(n = 6 ) 被比色法测量。apoptotic 房间(n = 6 ) 被流动血细胞计数检测。p53 蛋白质的表示(n = 3 ) 被 SDS 页并且西方的弄污决定。结果：粗略的 LBE (2-5 g/L ) 和 RGE (2-10 g/L ) dose-dependently 在 11% 禁止了 H-4-II-E 房间的增长(P 【 0.05 ) 到 85%(P 【 0.01 ) 在 6-24 h 处理以后。在 5 g/L 的剂量的粗略的 LBE 在 6-24 h 孵化以后比粗略的 RGE 更有效地压制了 H-4-II-E 房间的房间增长(P 【 0.01 ) 。粗略的 LBE (2-10 g/L ) 和 RGE (2-5 g/L ) dose-dependently 也由 14%-43% 禁止了 HA22T/VGH 房间的增长(P 【 0.01 ) 在 24 h 以后。在 10 g/L 的剂量的粗略的 LBE 比粗略的 RGE 更有效地禁止了 HA22T/VGH 房间的增长(56.8%+/-1.6% 对 70.3%+/-3.1% 控制， P = 0.0003 【 0.01 ) 。apoptotic 房间显著地与粗略的 LBE (2-5 g/L ) 和 RGE (5-10 g/L ) 的更高的剂量在 24 h 处理以后在 H-4-II-E 房间增加了(P 【 0.01 ) 。在 H-4-II-E 房间的 p53 蛋白质的表达式是 119% 控制组和 143% 与相比对待 LBE (2， 5 g/L ) 组，和 110% 控制和 132% 组与 RGE 相比对待(5， 10 g/L ) 在 24 h 以后的组。结论：热提取水的粗略的 LBE (2-5 g/L ) 和 RGE (5-10 g/L ) 禁止增长并且在 HCC 房间刺激调停 p53 的 apoptosis。