目的应用24 h pH阻抗监测技术分析胃食管反流性咳嗽(gastroesophageal reflux cough,GERC)患者的反流特点,探讨GERC的发病机制。方法选取慢性咳嗽患者116例,根据24 h pH阻抗监测结果和抗反流治疗结果将符合GERC诊断标准患者定为GERC组,...目的应用24 h pH阻抗监测技术分析胃食管反流性咳嗽(gastroesophageal reflux cough,GERC)患者的反流特点,探讨GERC的发病机制。方法选取慢性咳嗽患者116例,根据24 h pH阻抗监测结果和抗反流治疗结果将符合GERC诊断标准患者定为GERC组,选取健康志愿者30例设为对照组。比较两组pH阻抗联合监测结果。结果根据24 h pH阻抗监测结果和抗反流治疗结果符合GERC诊断标准的患者共有96例,其中28例患者合并弱酸反流异常,12例患者合并弱碱反流异常。GERC组24 h食管pH监测的6项参数及De Meester评分均高于对照组,差异均有统计学意义(P<0.01)。与对照组相比,GERC组24 h食管阻抗监测近端反流次数,气体反流、液体反流及混合反流次数,酸反流、弱酸反流、弱碱反流次数差异均有统计学意义(P<0.01);GERC患者总反流次数、总弱酸反流次数与总弱碱反流次数与SAP呈正相关(P<0.05)。结论 GERC患者存在反流物理性质和酸碱性方面的反流异常,直立位反流较卧位明显。GERC患者存在两种不同类型的发病机制,以低位反流为主,但57.93%的反流物可至食管近端。24 h食管pH阻抗监测是诊断GERC的可靠方法,在临床上具有较好的应用前景。展开更多
The transiting exoplanet system HAT-P-24 was observed by using CCD cameras at Yunnan Observatory and Hokoon Astronomical Centre, China in 2010 and 2012. In order to enhance the signal to noise ratio of transit events,...The transiting exoplanet system HAT-P-24 was observed by using CCD cameras at Yunnan Observatory and Hokoon Astronomical Centre, China in 2010 and 2012. In order to enhance the signal to noise ratio of transit events, the observed data are corrected for systematic errors according to Collier Cameron et al.＇s coarse de- correlation and Tamuz et al.＇s SYSREM algorithms. Three new complete transit light curves are analyzed by means of the Markov chain Monte Carlo technique, and the new physical parameters of the system are derived. They are consistent with the old ones from the discovered paper except for a new larger radius Rp = 1.364 Rj of HAT- P-24b, which confirms its inflated nature. By combining the five available epochs of mid-transit derived from complete transit light curves, the orbital period of HAT-P- 24b is refined to P = 3.3552479 d and no obvious transit timing variation signal can be found from these five transit events during 2010-2012.展开更多
AIM:To investigate the relationship between reflux and body mass index(BMI) in the asymptomatic obese population using the impedance-p H technique.METHODS:Gastroesophageal reflux is frequent in the obese population.Ho...AIM:To investigate the relationship between reflux and body mass index(BMI) in the asymptomatic obese population using the impedance-p H technique.METHODS:Gastroesophageal reflux is frequent in the obese population.However,the relationship between acid reflux and BMI in asymptomatic obese people is unclear.Forty-six obese(BMI > 25 kg/m2) people were enrolled in this prospective study.We evaluated the demographic findings and 24-h impedance p H values of the whole group.Gas,acid(p H < 4),weak acid(p H = 4-7) and weak alkaline(p H ≥ 7) reflux parameters were analyzed.RESULTS:The mean age of patients was 49.47±12.24 years,and half of them were men.The mean BMI was 30.64±3.95 kg/m2(25.14-45.58 kg/m2).BMI of 23 was over 30 kg/m2.Seventeen patients had a comorbidity(hypertension,diabetes mellitus,or ischemic heart disease).Endoscopic examination revealed esophagitis in 13 of the 28 subjects(10Grade A,3 Grade B).The subjects were divided into two groups according to BMI(<30 and>30 kg/m2).Demographic and endoscopic findings,and impedance results were similar in these two groups.However,there was a positive correlation between BMI and total and supine p H<4 episodes(P=0.002,r=0.414;P=0.000,r=0.542),p H<4 reflux time(P=0.015,r=0.319;P=0.003,r=0.403),and De Meester score(P=0.012,r=0.333).CONCLUSION:Acid reflux is correlated with BMI in asymptomatic obese individuals.展开更多
AIM:To investigate the pathophysiology of functional heartburn(FH) in Japanese patients.METHODS:A total of 111 patients with proton pump inhibitor(PPI)-refractory non-erosive gastroesophageal reflux disease underwent ...AIM:To investigate the pathophysiology of functional heartburn(FH) in Japanese patients.METHODS:A total of 111 patients with proton pump inhibitor(PPI)-refractory non-erosive gastroesophageal reflux disease underwent intraesophageal pressure testing and 24-h multichannel intraluminal impedancep H(24MII-p H) testing.The patients also completed several questionnaires while they were receiving the PPI treatment, including the questionnaire for the diagnosis of reflux disease(QUEST), the frequency scale for the symptoms of gastroesophageal reflux disease(FSSG), the gastrointestinal symptoms rating scale(GSRS), SF-36, and the Cornell Medical Index(CMI).The subjects were classified into FH and endoscopy-negative reflux disease(ENRD) groups based on the Rome Ⅲ criteria.RESULTS:Thirty-three patients with esophageal motility disorder were excluded from this study, while 22 patients with abnormal esophageal acid exposure time(p H-POS) and 34 with hypersensitive esophagus(HE) were included in the ENRD group.The FH group included 22 patients with no reflux involvement.Sex, age, and body mass index did not differ significantly between the groups.The mean SF-36 values were < 50(normal) for all scales in these groups, with no significant differences.The GSRS scores in these groups were not different and showed overlap with other gastrointestinal symptoms.The QUEST and the FSSG scores did not differ significantly between the groups.Neuroticism was diagnosed using the CMI questionnaire in 17 of the 78 included subjects within the p H-POS(n=4),HE(n=8),and FH(n=5)groups,with no significant differences.CONCLUSION:Clinical characteristics of the FH and PPI-refractory ENRD groups were similar.Therefore,esophageal function should be examined via manometry and 24MII-p H testing to differentiate between them.展开更多
文摘目的应用24 h pH阻抗监测技术分析胃食管反流性咳嗽(gastroesophageal reflux cough,GERC)患者的反流特点,探讨GERC的发病机制。方法选取慢性咳嗽患者116例,根据24 h pH阻抗监测结果和抗反流治疗结果将符合GERC诊断标准患者定为GERC组,选取健康志愿者30例设为对照组。比较两组pH阻抗联合监测结果。结果根据24 h pH阻抗监测结果和抗反流治疗结果符合GERC诊断标准的患者共有96例,其中28例患者合并弱酸反流异常,12例患者合并弱碱反流异常。GERC组24 h食管pH监测的6项参数及De Meester评分均高于对照组,差异均有统计学意义(P<0.01)。与对照组相比,GERC组24 h食管阻抗监测近端反流次数,气体反流、液体反流及混合反流次数,酸反流、弱酸反流、弱碱反流次数差异均有统计学意义(P<0.01);GERC患者总反流次数、总弱酸反流次数与总弱碱反流次数与SAP呈正相关(P<0.05)。结论 GERC患者存在反流物理性质和酸碱性方面的反流异常,直立位反流较卧位明显。GERC患者存在两种不同类型的发病机制,以低位反流为主,但57.93%的反流物可至食管近端。24 h食管pH阻抗监测是诊断GERC的可靠方法,在临床上具有较好的应用前景。
基金supported by the National Natural Science Foundation of China(Grant No.10873031)the Chinese Academy of Sciences(KJCX2-YW-T24)
文摘The transiting exoplanet system HAT-P-24 was observed by using CCD cameras at Yunnan Observatory and Hokoon Astronomical Centre, China in 2010 and 2012. In order to enhance the signal to noise ratio of transit events, the observed data are corrected for systematic errors according to Collier Cameron et al.＇s coarse de- correlation and Tamuz et al.＇s SYSREM algorithms. Three new complete transit light curves are analyzed by means of the Markov chain Monte Carlo technique, and the new physical parameters of the system are derived. They are consistent with the old ones from the discovered paper except for a new larger radius Rp = 1.364 Rj of HAT- P-24b, which confirms its inflated nature. By combining the five available epochs of mid-transit derived from complete transit light curves, the orbital period of HAT-P- 24b is refined to P = 3.3552479 d and no obvious transit timing variation signal can be found from these five transit events during 2010-2012.
文摘AIM:To investigate the relationship between reflux and body mass index(BMI) in the asymptomatic obese population using the impedance-p H technique.METHODS:Gastroesophageal reflux is frequent in the obese population.However,the relationship between acid reflux and BMI in asymptomatic obese people is unclear.Forty-six obese(BMI > 25 kg/m2) people were enrolled in this prospective study.We evaluated the demographic findings and 24-h impedance p H values of the whole group.Gas,acid(p H < 4),weak acid(p H = 4-7) and weak alkaline(p H ≥ 7) reflux parameters were analyzed.RESULTS:The mean age of patients was 49.47±12.24 years,and half of them were men.The mean BMI was 30.64±3.95 kg/m2(25.14-45.58 kg/m2).BMI of 23 was over 30 kg/m2.Seventeen patients had a comorbidity(hypertension,diabetes mellitus,or ischemic heart disease).Endoscopic examination revealed esophagitis in 13 of the 28 subjects(10Grade A,3 Grade B).The subjects were divided into two groups according to BMI(<30 and>30 kg/m2).Demographic and endoscopic findings,and impedance results were similar in these two groups.However,there was a positive correlation between BMI and total and supine p H<4 episodes(P=0.002,r=0.414;P=0.000,r=0.542),p H<4 reflux time(P=0.015,r=0.319;P=0.003,r=0.403),and De Meester score(P=0.012,r=0.333).CONCLUSION:Acid reflux is correlated with BMI in asymptomatic obese individuals.
文摘AIM:To investigate the pathophysiology of functional heartburn(FH) in Japanese patients.METHODS:A total of 111 patients with proton pump inhibitor(PPI)-refractory non-erosive gastroesophageal reflux disease underwent intraesophageal pressure testing and 24-h multichannel intraluminal impedancep H(24MII-p H) testing.The patients also completed several questionnaires while they were receiving the PPI treatment, including the questionnaire for the diagnosis of reflux disease(QUEST), the frequency scale for the symptoms of gastroesophageal reflux disease(FSSG), the gastrointestinal symptoms rating scale(GSRS), SF-36, and the Cornell Medical Index(CMI).The subjects were classified into FH and endoscopy-negative reflux disease(ENRD) groups based on the Rome Ⅲ criteria.RESULTS:Thirty-three patients with esophageal motility disorder were excluded from this study, while 22 patients with abnormal esophageal acid exposure time(p H-POS) and 34 with hypersensitive esophagus(HE) were included in the ENRD group.The FH group included 22 patients with no reflux involvement.Sex, age, and body mass index did not differ significantly between the groups.The mean SF-36 values were < 50(normal) for all scales in these groups, with no significant differences.The GSRS scores in these groups were not different and showed overlap with other gastrointestinal symptoms.The QUEST and the FSSG scores did not differ significantly between the groups.Neuroticism was diagnosed using the CMI questionnaire in 17 of the 78 included subjects within the p H-POS(n=4),HE(n=8),and FH(n=5)groups,with no significant differences.CONCLUSION:Clinical characteristics of the FH and PPI-refractory ENRD groups were similar.Therefore,esophageal function should be examined via manometry and 24MII-p H testing to differentiate between them.
