AIM: To determine the prevalence of gluten sensitive enteropathy (GSE) in a large group of patients with iron deficiency anemia (IDA) of obscure origin. METHODS: In this cross-sectional study, patients with IDA of obs...AIM: To determine the prevalence of gluten sensitive enteropathy (GSE) in a large group of patients with iron deficiency anemia (IDA) of obscure origin. METHODS: In this cross-sectional study, patients with IDA of obscure origin were screened for GSE. Anti- endomysial antibody (EMA) and tissue transglutamin- ase antibody (tTG) levels were evaluated and duodenal biopsies were taken and scored according to the Marsh classification. The diagnosis of GSE was based on a positive serological test and abnormal duodenal histol- ogy. Gluten free diet (GFD) was advised for all the GSE patients. RESULTS: Of the 4120 IDA patients referred to our Hematology departments, 206 (95 male) patients were found to have IDA of obscure origin. Thirty out of 206 patients (14.6%) had GSE. The mean age of GSE pa- tients was 34.6 ± 17.03 (range 10-72 years). The female to male ratio was 1.3:1. Sixteen patients had Marsh 3,12 had Marsh 2, and 2 had Marsh 1 lesions. The sever- ity of anemia was in parallel with the severity of duode- nal lesions. Twenty-two GSE patients (73.3%) had no gastrointestinal symptoms. Fourteen GSE patients who adhered to GFD without receiving iron supplementation agreed to undergo follow up visits. After 6 mo of GFD, their mean hemoglobin levels (Hb) increased from 9.9 ± 1.6 to 12.8 ± 1.0 g/dL (P < 0.01). Interestingly, in 6 out of 14 patients who had Marsh 1/2 lesions (e.g. no villous atrophy) on duodenal biopsy, mean Hb increased from 11.0 ± 1.1 to 13.1 ± 1.0 g/dL (P < 0.01) while they did not receive any iron supplementation. CONCLUSION: There is a high prevalence (e.g. 14.6%) of GSE in patients with IDA of obscure origin. Gluten free diet can improve anemia in GSE patients who have mild duodenal lesions without villous atrophy.展开更多
Objective To observe the clinical efficacy of Zhi Shen Tiao Sui(regulating the mind and marrow)needling in treating depression after ischemic stroke.Methods A total of 145 patients with depression after ischemic strok...Objective To observe the clinical efficacy of Zhi Shen Tiao Sui(regulating the mind and marrow)needling in treating depression after ischemic stroke.Methods A total of 145 patients with depression after ischemic stroke were recruited between January 2016 and January 2018 and divided into two groups using random number table method,with 72 cases in the control group and 73 cases in the observation group.The control group received conventional treatment for ischemic stroke and medication,while the observation group was given additional Zhi Shen Tiao Sui acupuncture.The two groups were treated for 4 successive weeks.Clinical efficacy was analyzed after treatment.The neurological function pertinent scores[Hamilton depression scale(HAMD),clinical neurological deficit score(CNDS),activities of daily living(ADL),Fugl-Meyer assessment scale(FMA)and Barthel index(BI)scores],as well as the levels of cortisol(CORT)and adrenocorticotropic hormone(ACTH)were recorded in the two groups.Adverse reactions that occurred during treatment were also observed.Results The clinical total effective rate was 82.2%in the observation group,significantly higher than 66.7%in the control group(P<0.05).After treatment,the HAMD and CNDS scores were markedly reduced in both groups(all P<0.05),and the ADL,FMA and BI scores were markedly increased(all P<0.05).The HAMD and CNDS scores were significantly lower in the observation group than in the control group after treatment(both P<0.05),and the ADL,FMA and BI scores were significantly higher in the observation group than in the control group(all P<0.05).The levels of CORT and ACTH declined significantly after treatment in the two groups(all P<0.05),and were markedly lower in the observation group than in the control group(both P<0.05).The adverse reaction rate was 2.7%in the observation group,versus 4.2%in the control group,and the between-group difference was statistically insignificant(P>0.05).Conclusion Compared with sole use of Western medication,medication combined with Zhi Shen Tiao Sui acupuncture can promote the recovery of neurological function,down-regulate the levels of CORT and ACTH and enhance the clinical efficacy in treating patients with depression after ischemic stroke,with a relatively high safety rating.展开更多
基金Supported by Local funds from Digestive Disease Research Centre, University of Tehran and Gastrointestinal and Liver Disease Research Centre, Iran University of Medical Science
文摘AIM: To determine the prevalence of gluten sensitive enteropathy (GSE) in a large group of patients with iron deficiency anemia (IDA) of obscure origin. METHODS: In this cross-sectional study, patients with IDA of obscure origin were screened for GSE. Anti- endomysial antibody (EMA) and tissue transglutamin- ase antibody (tTG) levels were evaluated and duodenal biopsies were taken and scored according to the Marsh classification. The diagnosis of GSE was based on a positive serological test and abnormal duodenal histol- ogy. Gluten free diet (GFD) was advised for all the GSE patients. RESULTS: Of the 4120 IDA patients referred to our Hematology departments, 206 (95 male) patients were found to have IDA of obscure origin. Thirty out of 206 patients (14.6%) had GSE. The mean age of GSE pa- tients was 34.6 ± 17.03 (range 10-72 years). The female to male ratio was 1.3:1. Sixteen patients had Marsh 3,12 had Marsh 2, and 2 had Marsh 1 lesions. The sever- ity of anemia was in parallel with the severity of duode- nal lesions. Twenty-two GSE patients (73.3%) had no gastrointestinal symptoms. Fourteen GSE patients who adhered to GFD without receiving iron supplementation agreed to undergo follow up visits. After 6 mo of GFD, their mean hemoglobin levels (Hb) increased from 9.9 ± 1.6 to 12.8 ± 1.0 g/dL (P < 0.01). Interestingly, in 6 out of 14 patients who had Marsh 1/2 lesions (e.g. no villous atrophy) on duodenal biopsy, mean Hb increased from 11.0 ± 1.1 to 13.1 ± 1.0 g/dL (P < 0.01) while they did not receive any iron supplementation. CONCLUSION: There is a high prevalence (e.g. 14.6%) of GSE in patients with IDA of obscure origin. Gluten free diet can improve anemia in GSE patients who have mild duodenal lesions without villous atrophy.
文摘Objective To observe the clinical efficacy of Zhi Shen Tiao Sui(regulating the mind and marrow)needling in treating depression after ischemic stroke.Methods A total of 145 patients with depression after ischemic stroke were recruited between January 2016 and January 2018 and divided into two groups using random number table method,with 72 cases in the control group and 73 cases in the observation group.The control group received conventional treatment for ischemic stroke and medication,while the observation group was given additional Zhi Shen Tiao Sui acupuncture.The two groups were treated for 4 successive weeks.Clinical efficacy was analyzed after treatment.The neurological function pertinent scores[Hamilton depression scale(HAMD),clinical neurological deficit score(CNDS),activities of daily living(ADL),Fugl-Meyer assessment scale(FMA)and Barthel index(BI)scores],as well as the levels of cortisol(CORT)and adrenocorticotropic hormone(ACTH)were recorded in the two groups.Adverse reactions that occurred during treatment were also observed.Results The clinical total effective rate was 82.2%in the observation group,significantly higher than 66.7%in the control group(P<0.05).After treatment,the HAMD and CNDS scores were markedly reduced in both groups(all P<0.05),and the ADL,FMA and BI scores were markedly increased(all P<0.05).The HAMD and CNDS scores were significantly lower in the observation group than in the control group after treatment(both P<0.05),and the ADL,FMA and BI scores were significantly higher in the observation group than in the control group(all P<0.05).The levels of CORT and ACTH declined significantly after treatment in the two groups(all P<0.05),and were markedly lower in the observation group than in the control group(both P<0.05).The adverse reaction rate was 2.7%in the observation group,versus 4.2%in the control group,and the between-group difference was statistically insignificant(P>0.05).Conclusion Compared with sole use of Western medication,medication combined with Zhi Shen Tiao Sui acupuncture can promote the recovery of neurological function,down-regulate the levels of CORT and ACTH and enhance the clinical efficacy in treating patients with depression after ischemic stroke,with a relatively high safety rating.