Enhanced electrogastrography: A realistic way to salvage a promise that was never kept?

AIM To enhance the clinical utility of electrogastrography(EGG), which has been recorded since 1922, but is clinically unutilized.METHODS An innovative method to salvage the promise of EGG is proposed by introducing a preliminary procedure, while maintaining the electrodes, standardized equipment, and signal processing utilized in the well-established EGG testing of today. The proposed enhanced EGG(EEGG) protocol involves swallowing an ingestible capsule containing miniature electronic oscillator embedded in an expandable, self-disintegratable, biocompatible pseudobesoar residing in the stomach for the duration of the test. The benefits of the proposed approach are outlined, tested and discussed in details. RESULTS Experiments were performed on eight mongrel dogs(6F, 4M, 23.8 ± 3.3 kg). Four were administered an active EEGG capsule, while the rest were given a deactivated(battery removed) capsule. Pharmacologically facilitated gastric motility revealed a significant(P < 0.01) Pearson correlation between gastric motility indices obtained by force transducers implanted directly on the stomach, and the motility indices obtained by EEGG. A particular emphasis was made on preserving standard EGG-related hardware and software in order to facilitate the introduction of the proposed EEGG in environments which already utilize standard EGG testing. Theexpanded intragastric pseudobezoar containing the miniature electronic oscillator was retained during the tests, and could be disintegrated on demand. CONCLUSION Enhancing standard EGG by an ingestible, selfexpanding and self-disintegrating pseudobesoar containing a miniature electronic oscillator can be an important avenue for clinical applicability of this test.

Gastric motility functional study based on electrical bioimpedance measurements and simultaneous electrogastrography

For some time now,the research on gastric motility and function has fallen behind in the amount of research on gastric endocrine,exocrine secretion,and gastric morphology.In this paper,a noninvasive method to study gastric motility was developed,taking bioimpedance measurements over the gastric area simultaneously with the electrogastrography(EGG).This is based on the concept of observing and analyzing simultaneously the intrinsic electrical gastric activity(basic electric rhythm) and the mechanical gastric activity.Additionally,preliminary clinical studies of healthy subjects and subjects with functional dyspepsia(FD) and gastritis were carried out.The impedance gastric motility(IGM) measurements of the healthy and FD subjects were compared,along with the studies of the FD subjects before treatment and after one week and three weeks of treatment.We also compared IGM measurements of healthy subjects and subjects with erosive gastritis,along with the studies of the subjects with erosive gastritis before treatment and after one week of treatment.Results show that FD subjects have poor gastric motility(P<0.01).After a week of treatment,the gastric motility of FD subjects was not yet improved although the EGG had returned to normal by this time.By three weeks of treatment,the regular IGM rhythm returned in FD subjects.There was a significant difference of IGM parameters between the gastritis and healthy subjects(P<0.05).The EGG rhythm of the gastritis subjects returned to normal at one week post-treatment,while IGM parameters showed a trend to improvement(P>0.05),These results suggest the possibility of clinic application of the proposed method.

Influence of percutaneous local therapy for hepatocellular carcinoma on gastric function

AIM:To investigate the influence of percutaneous local therapy on gastric myoelectrical activity in patients with hepatocellular carcinomas.METHODS:Forty-four patients with hepatocellular carcinoma(HCC) [27 males and 17 females,ranging in age from 49 to 81 years old(69.7 ± 8.01 years)] who were admitted for percutaneous local therapy were enrolled in this study.We examined clinical abdominal symptoms using the Gastrointestinal Symptom Rating Scale(GSRS) before and 3 d after percutaneous local therapy.We also measured cutaneous fasting and postprandial electrogastrography(EGG) recordings before and 3 d after percutaneous local therapy.RESULTS:We found that the percentage of normogastria in the fasting period was lower in the Child B group than in the Child A group(66.8% ± 8.6% vs 84.0% ± 3.8%).After percutaneous local therapy for HCC,the percentages of normogastria in the fasting period were significantly decreased(81.6% ± 3.5% vs 75.2% ± 4.5%).None of the postprandial EGG parameters changed significantly after percutaneous local therapy for HCC.Percutaneous local therapy for HCC reduced the power ratio(PR).In particular,the PR of tachygastria was significantly decreased after therapy(P < 0.01).However,no significant differences were found in the postprandial EGG parameters.Likewise,no significant differences were found in the calculated GSRS scores obtained from the questionnaire before and after therapy.CONCLUSION:Gastric slow-wave dysrhythmias were induced by percutaneous local therapy in HCC patients,even though the GSRS scores obtained from the questionnaire did not change significantly.

Dalitong Granule(达立通颗粒)Combined with Electroacupuncture in the Treatment of Functional Dyspepsia:A Randomized Controlled Trial

ABSTRACT Objective： To explore clinical short and long-term effect of combining Dalitong Granule （达立通颗粒） and electroacupuncture group （EA） in the treatment of functional dyspepsia. Methods： Totally 640 patients with confirmed functional dyspepsia were randomly divided into 4 groups using a randomized digital table： the DG group, the EA group, the combined group and the control group, 160 cases in each group. The DG group was treated with 6 g DG 3 times daily; the EA group was treated with puncture of points Zusanli （ST36）, Zhongwan （CV12）, Neiguan （PC6）, Taichong （LR3） and Gongsun （SP4） twice daily; the combined group with above-mentioned DG and EA; and the control group with 5 mg mosapride 3 times, 20 mg pantoprazole and 25 mg amitriptylines twice daily. The treatment course was 4 weeks for all groups. The symptom score, quality of life score by Short Form 36 Health Survey Ouestionnaires （SF-36）, plasma motilin by radioimmunoassay, electrogastrographic frequencies by electrogastrogram （EGG） and gastric emptying by B-sonography were examined, and adverse reactions were observed before, at the end of treatment and 60 weeks post-treatment. Results： In the DG group 1 case dropped out for not taking medicine strictly and 1 case was lost to follow-up, while 1 case in the EA group and 2 cases in the combined therapy group were lost to follow-up. Compared with pre-treatment, quality of life score, plasma motilin, electrogastrographic frequencies and gastric emptying were all increased significantly, while symptom score was decreased significantly at the end of treatment in each group （P〈0.01）; in the combined group quality of life score, plasma motilin, electrogastrographic frequencies and gastric emptying were all significantly higher than those in the other groups, while symptom score was significantly lower than in the other groups （P〈0.05）. Compared with at the end of treatment, these indices changed insignificantly in the combined group and the EA group 60 weeks post-treatment （P〉0.05）, but the 4 increased indices were all decreased significantly, and symptom score was increased significantly in the DG and the control groups （P〉0.05）. The short and long-term total effective rates in the combined group were all significantly higher than those in the other treatment groups （P〈0.05 or P〈0.01）. No serious adverse reaction occurred in the four groups. Conclusion： Combined treatment of DG and EA could increase both plasma motilin and electrogastrographic frequencies, promote gastric emptying, alleviate the symptom of dyspepsia so as to increase quality of life, with better safety and long-term effect.

Clinical Study on Therapeutic Effect of Shuwei Decoction (舒胃汤) on Functional Dyspepsia

Objective: To explore the clinical effectiveness and therapeutic mechanism of Shuwei Decoction (舒胃汤) in treating functional dyspepsia (FD). Methods: A total of 124 FD patients were randomly divided into two groups: Shuwei Decoction group (60 cases) and the control group (64 cases) treated with cisapride. After one month treatment, all patients were examined with motilin and electrogastrography (EGG). Results: The therapeutic effectiveness of Shuwei Decoction group was much better than that of the control group ( P <0.05), while the changes on motilin and EGG in the two groups were relatively similar ( P <0.05). Conclusion: Shuwei Decoction could effectively raise motilin level, promote gastric movement and improve the clinical symptoms in FD patients.