Comparison of PPIs and H_2-receptor antagonists plus prokinetics for dysmotility-like dyspepsia

AIM:To compare efficacy of proton pump inhibitors(PPIs)with H2-receptor antagonists(H2RAs)plus prokinetics(Proks)for dysmotility-like symptoms in functional dyspepsia(FD).METHODS:Subjects were randomized to receive openlabel treatment with either rabeprazole 10 mg od(n= 57)or famotidine 10 mg bid plus mosapride 5 mg tid(n=57)for 4 wk.The primary efficacy endpoint was change(%)from baseline in total dysmotility-like dyspepsia symptom score.The secondary efficacy endpoint was patient satisfaction with treatment.RESULTS:The improvement in dysmotility-like dyspep-sia symptom score on day 28 was significantly greater in the rabeprazole group(22.5%±29.2%of baseline) than the famotidine+mosapride group(53.2%± 58.6%of baseline,P<0.0001).The superior benefit of rabeprazole treatment after 28 d was consistent regardless of Helicobacter pylori status.Significantly more subjects in the rabeprazole group were satisfied or very satisfied with treatment on day 28 than in the famotidine+mosapride group(87.7%vs 59.6%,P= 0.0012).Rabeprazole therapy was the only significant predictor of treatment response(P<0.0001),defined as a total symptom score improvement≥50%.CONCLUSION:PPI monotherapy improves dysmotility-like symptoms significantly better than H2RAs plus Proks,and should be the treatment of first choice for Japanese FD.

X-ray diagnosis with a bloating agent for foreign object ingestion

The location of an ingested foreign object is often difficult to determine by X-ray if gastric air bubbles are not clear in the image.Methods that provide negative contrast can facilitate precise object localization,which is important for object retrieval and treatment of the patient.This case report describes a male child,2 years and 2 mo of age,who accidentally swallowed a lithium battery while playing at home.A plain X-ray showed that the battery was in the abdomen,but it was unclear whether the object was still inside the stomach.A second X-ray examination performed after oral administration of a bloating agent to produce expansion of the stomach and provide negative contrast confirmed that the ingested battery was still in the stomach.The battery was then carefully removed using magnetic and balloon catheters under fluoroscopic guidance.This case report describes the successful use of an orally administered bloating agent without pain to the child in orderto determine the precise location of a foreign object in the abdomen.

Acute pancreatitis and cholangitis: A complication caused by a migrated gastrostomy tube

Percutaneous endoscopic gastrostomy (PEG) is generally considered safe with a low rate of serious complications. However, dislocation of the PEG-tube into the duodenum can lead to serious complications. An 86-year old Japanese woman with PEG-tube feeding sometimes vomited after her family doctor replaced the PEG-tube without radiologic confirmation. At her hospitalization, she complained of severe tenderness at the epigastric region and the PEG-tube was drawn into the stomach. Imaging studies showed that the tip of PEG-tube with the infl ated balloon was migrated into the second portion of the duodenum, suggesting that it might have obstructed the bile and pancreatic ducts, inducing cholangitis and pancreatitis. After the PEG- tube was replaced at the appropriate position, vomiting and abdominal tenderness improved dramatically and laboratory studies became normal immediately. Our case suggests that it is important to secure PEG-tube at the level of skin, especially after replacement.

Shikonin Promotes Skin Cell Proliferation and Inhibits Nuclear Factor-κB Translocation via Proteasome Inhibition In Vitro

Background：Shikonin is a major active chemical component extracted from Lithospermi Radix,an effective traditional herb in various types of wound healing.Shikonin can accelerate granulomatous tissue formation by the rat cotton pellet method and induce neovascularization in granulomatous tissue.The purpose of the study was to investigate its mechanism of action in human skin cells.Methods：MTS assay was used to measure cell growth.The collagen type Ⅰ （COL1） mRNA expression and procollagen type Ⅰ C-peptide （PIP） production were detected by real-time quantitative reverse transcription-polymerase chain reaction and enzyme-linked immunosorbent assay,respectively.Immunofluorescence and western blot analyses were carried out to investigate nuclear factor-κB （NF-κB） signaling pathway.Cell-based proteasome activity assay was used to determine proteasome activity.Results：In this study,we found that 10 μmol/L shikonin stimulated the growth of normal human keratinocytes and 1 μmol/L shikonin promoted growth of human dermal fibroblasts.However,shikonin did not directly induce COLI mRNA expression and PIP production in dermal fibroblasts in vitro.In addition,1 μmol/L shikonin inhibited translocation of NF-κB p65 from cytoplasm to nucleus induced by tumor necrosis factor-α stimulation in dermal fibroblasts.Furthermore,shikonin inhibited chymotrypsin-like activity of proteasome and was associated with accumulation ofphosphorylated inhibitor κB-α in dermal fibroblasts.Conclusions：These results suggested that shikonin may promote wound healing via its cell growth promoting activity and suppress skin inflammation via inhibitory activity on proteasome.Thus,shikonin may be a potential therapeutic reagent both in wound healing and inflammatory skin diseases.

Isolation of a (+)-δ-cadinene synthase gene CAD1-A and analysis of its expression pattern in seedlings of Gossypium arboreum L.

The cotton sesquiterpene cyclase, (+)-δ-cadinene synthase.is encoded by a gene family, which can be divided into two subfamilies: CAD1-A and CAD1-C. The gene CAD1-A was isolated from G. arboreum. In situ hybridization performed on seven-day-old cotton seedlings localized transcripts of both the CAD1-A and CAD1-C mainly in lateral root primordium and apical ground meristem, vascular tissues of emerging lateral roots, and also in procambium and some subepidermal cells of the hypocotyl. The CAD1-A promoter showed a similar tissue-specificity in transgenic tobacco plants. Histochemistry showed occurrence of sesquiterpene aldehydes in outer cells of the lateral root tips, as well as in pigment glands. The CAD1 gene expression in G. arboreum seedlings and the spatial pattern of sesquiterpene biosynthesis constitute a chemical defense machinery in cotton seedlings.

Morphological changes of roof of subacromial bursa in patients with rotator cuff tear

Objective: To investigate the morphological chan ges of the roof of the subacromial bursa (SAB) and its involvement extent after rotator cuff tear. Methods: In the experimental group,the roof of SAB was obtaine d from 30 cases of rotator cuff tear both at the tear site and a site 2.5 - 3.0 cm distal to the tear site during rotator cuff repair. In the control gr oup,the roof of SAB was obtained from the exposed site of recurrently dislocate d shoulder or fractured humeral shaft of 8 cases. The specimens were stained wit h hematoxylin and eosin and observed under a transmission electron microscope. T he cell number was quantitated through counting the blue-stained nucleus in SAB with a computer image analysis system.Results: The number of cells increased significantly in the roo f of SAB in the experimental group compared with that of the control group. Howe ver,no difference of the bursal reaction was found among the type of rotator cu ff tear,the bursa thickness and the presence of fluid in the bursa. The great m ajority of cells were type B cells observed under the transmission electron micr oscope.Conclusions: The increase in cell number in the roof of SAB in the experimental group is a reactive increase rather than an inflammatory proces s and the involvement of SAB is not limited in extent. The change of the roof of SAB is a secondary reaction to the rotator cuff tear.

The Emergent Constructive Approach to Evolinguistics:Considering Hierarchy and Intention Sharing in Linguistic Communication

Evolinguistics is an attempt to clarify the origins and evolution of language and communication,thereby deepening our understanding of humans from an evolutionary perspective.The origins of language is characterized by the biological evolution of abilities related to language and communication,and the evolution of language by the structuralization and complexification of language knowledge as well as communication systems through cultural evolution.In Evolinguistics,two idiosyncrasies of human linguistic communication are the primary focus,namely,using hierarchically organized symbol sequences in language and sharing intentions in communication.We believe that the integration of these two characteristics made humans co-creative and smart,and in particular gave us knowledge co-creation capacity.The emergent constructive approach plays an important role in this research,which is a methodology to analyze complex systems by constructing and operating the evolutionary and emergent process of complex phenomena.Two studies taking this approach are introduced in this paper.One is a language evolution experiment in a laboratory to consider the process,mechanisms,and neural basis of symbolic communication systems.The other is an evolutionary simulation of recursive combination,which is thought of as the essential ability to form hierarchical structures.A hypothesis integrating intention sharing and recursive combination is discussed as an abductive reasoning mechanism for understanding others intentions.