Habitual rapid food intake and ineffective esophageal motility

AIM:To study non-cardiac chest pain(NCCP) in relation to ineffective esophageal motility(IEM) and rapid food intake.METHODS:NCCP patients with a self-reported habit of fast eating underwent esophageal manometry for the diagnosis of IEM.Telephone interviews identified eating habits of additional IEM patients.Comparison of manometric features was done among IEM patients with and without the habit of rapid food intake and healthy controls.A case study investigated the effect of 6-mo gum chewing on restoration of esophageal motility in an IEM patient.The Valsalva maneuver was performed in IEM patients and healthy controls to assess the compliance of the esophagus in response to abdominal pressureincrease.RESULTS:Although most patients diagnosed with NCCP do not exhibit IEM,remarkably,all 12 NCCP patients who were self-reporting fast eaters with a main complaint of chest pain(75.0%) had contraction amplitudes in the mid and distal esophagus that were significantly lower compared with healthy controls [(23.45 mmHg(95%CI:14.06-32.85)vs 58.80 mmHg(95%CI:42.56-75.04),P < 0.01 and 28.29 mmHg(95%CI:21.77-34.81) vs 50.75 mmHg(95%CI:38.44-63.05),P < 0.01,respectively)].In 7 normal-eating IEM patients with a main complaint of sensation of obstruction(42.9%),the mid amplitude was smaller than in the controls [30.09 mmHg(95%CI:19.48-40.70) vs 58.80 mmHg(95%CI:42.56-75.04),P < 0.05].There was no statistically significant difference in manometric features between the fast-eating and normal-eating groups.One NCCP patient who self-reported fast eating and was subsequently diagnosed with IEM did not improve with proton-pump inhibition but restored swallow-induced contractions upon 6-mo gum-chewing.The Valsalva maneuver caused a markedly reduced pressure rise in the mid and proximal esophagus in the IEM patients.CONCLUSION:Habitual rapid food intake may lead to IEM.A prospective study is needed to validate this hypothesis.Gum-chewing might strengthen weakened esophageal muscles.

Based on data mining,the drug law of clinical treatment of chronic urticaria

Background:Based on clinical data mining,we introduce the medication rule and clinical application of Professor Wang Lifen in the treatment of chronic urticaria,as the reference of clinical treatment of chronic urticaria.Methods:we collected 110 traditional Chinese medicine prescriptions for the treatment of chronic urticaria,and found out tastes,functions and channel tropism of Chinese medicine.After collecting and sorting,we inputted the data into excel 2010 software and established drug electronic database.We calculated the frequency of tastes,functions and channel tropism using the Spss 20.0 and analyzed the potential relationship between the drugs using Weka 3.8.We used Cytoscape 3.6.1 to draw the related network and combine it into a new prescription.Then the clinical data of prescriptions were statistically analyzed.Results:The statistical analysis showed that the high-frequency drugs for the treatment of the disease were Gancao(Glycyrrhizae radix et rhizoma),Huangqin(Radix scutellariae),Desmopeel,Jingjie(Herba schizonepetae),parsnip,etc.,accounting for more than 69.50%of the total frequency.Moreover,the combination and drug pairs with the strongest and most commonly used high-frequency drugs were found.From the point of medicinal properties of these drugs in the treatment of chronic urticaria,the main drugs are cold,followed by warm and smooth,accounting for 70.75%of the total frequency.From the perspective of the efficacy of these drugs in the treatment of chronic urticaria,heat-clearing drugs are the main ones,followed by relieving drugs and Tonic drugs,accounting for 68.25%of the total frequency.From the perspective of medicine taste,sweet taste is the most important,followed by bitter and pungent taste,accounting for 68.00%of the total frequency.From the perspective of drugs channel tropism,the meridian of spleen is the most important,followed by the meridian of lung,liver,heart,stomach,etc.,accounting for 71.62%of the total frequency.Conclusion:According to the data mining results,traditional Chinese medicine treatment of chronic urticaria is mainly based on dispelling wind,clearing heat and removing dampness,cooling blood and detoxifying,supplemented by nourishing blood and nourishing deficiency.This data mining conforms to the law and principle of traditional Chinese medicine treatment of chronic urticaria,which has certain reference and enlightenment significance for clinical treatment of chronic urticaria.