Immune function, gastrointestinal hormone levels, and their clinical significance in patients with gastric ulcers complicated with depression

BACKGROUND Gastric ulcer(GU)is a common digestive tract disease,and medical records of GU combined with depression are increasingly common.Currently,the risk factors and pathogenesis of GU complicated with depression remain unclear.Low immune function and gastrointestinal hormone levels may also be significant risk factors.Therefore,this study explored the immune function and gastrointestinal hormone levels in patients with GU combined with depression.AIM To explore the immune function,gastrointestinal hormone level,and clinical significance of patients with GU combined with depression.METHODS A retrospective analysis was conducted on 300 patients with GU combined with depression admitted to Guizhou Provincial People’s Hospital from January 2021 to June 2022 as the study subjects.According to the Hamilton Depression Scale(HAMD)score,patients were divided into mild-to-moderate(n=210)and heavy(n=90)groups.Basic data,immune function indices[immunoglobulin A(IgA),IgM,IgG,serum CD4+and CD8+percentage,and CD4+/CD8+ratio],and gastrointestinal hormone indices[serum gastrin(GAS),cholecystokinin(CCK),and motilin(MTL)levels]were collected.The basic data of the two groups were compared,and the immune function and gastrointestinal hormone indices were analyzed.Multivariate logistic regression was used to analyze the factors influencing the severity of GU complicated with depression.The receiver operating characteristic(ROC)curve and area under the ROC curve(AUC)were used to analyze the value of the immune function index,gastrointestinal hormone index,and combined index in predicting the severity of GU complicated with depression.RESULTS There were no marked differences in sex,age,body mass index,abdominal distension,abdominal pain,belching,nausea,vomiting,or sleep disorders between the heavy and mild-to-moderate groups(P>0.05).There was a marked difference in the family history of depression between the heavy and mild-to-moderate groups(P<0.05).There were significant differences in serum IgA and IgM levels and serum CD4+,CD8+,and CD4+/CD8+ratios between the heavy and mild-to-moderate groups(P<0.05).Multivariate analysis showed that IgA,IgM,GAS,and CCK serum levels influenced the severity of GU with depression(P<0.05).The AUC of the ROC curve for serum IgA level predicting GU with depression severity was 0.808[95%confidence interval(CI):0.760-0.857],the AUC of the serum IgM level was 0.757(95%CI:0.700-0.814),the AUC of the serum GAS level was 0.853(95%CI:0.810-0.897),the AUC of the serum CCK level was 0.762(95%CI:0.709-0.822),the AUC of immune function(IgA,IgM)and gastrointestinal hormone levels(GAS,CCK)for the prediction of GU with depression severity was 0.958(95%CI:0.933-0.976).CONCLUSION Important factors influencing GU complicated with depression are serum IgA,IgM,GAS,and CCK indicators.They can be used as indicators to predict the severity of GU complicated with depression.

Rikkunshito increases appetite by enhancing gastrointestinal and incretin hormone levels in patients who underwent pyloruspreserving pancreaticoduodenectomy: A retrospective study

BACKGROUND Rikkunshito(TJ-43)relieves gastrointestinal disturbance by increases in the levels of acylated ghrelin.AIM To investigate the effects of TJ-43 in patients undergoing pancreatic surgery.METHODS Forty-one patients undergoing pylorus-preserving pancreaticoduodenectomy(PpPD)were divided into two groups;patients took daily doses of TJ-43 after surgery or after postoperative day(POD)21.The plasma levels of acylated and desacylated ghrelin,cholecystokinin(CCK),peptide YY(PYY),gastric inhibitory peptide(GIP),and active glucagon-like peptide(GLP)-1 were evaluated.Oral calorie intake was assessed at POD 21 in both groups.The primary endpoint of this study was the total food intake after PpPD.RESULTS The levels of acylated ghrelin were significantly greater in patients treated with TJ-43 than those in patients without TJ-43 administration at POD 21,and oral intake was significantly increased in patients treated with TJ-43.The CCK and PYY levels were significantly greater in patients treated with TJ-43 than those in patients without TJ-43 treatment.Furthermore,the GIP and active GLP-1 levels increased and values at POD 21 were significantly greater in patients treated with TJ-43 than those in patients without TJ-43 administration.Insulin secretion tended to increase in patients treated with TJ-43.CONCLUSION TJ-43 may have advantages for oral food intake in patients in the early phase after pancreatic surgery.Further investigation is needed to clarify the effects of TJ-43 on incretin hormones.

Gastric emptying and plasma levels of gastrointestinal hormones in patients with peptic ulcer

IM To study the plasma level of gastrointestinal hormones and gastric emptying in patients with peptic ulcer. METHODS Thirty patients with gastric ulcer (GU), and 29 duodenal ulcer (DU) and 12 controls were studied. Plasma levels of SS, VIP and SP were measured by radioimmunoassay, and gastric emptying half time (GET1/2) was determined with TC99mresin solid meal method. RESULTS GET1/2(min) was significantly longer in GU than that in controls (659±148 vs 533±43, P<001) and plasma VIP levels (ng/L) were significantly higher than in controls (375±107 vs 184±59, P<005). There was a significant positive correlation between GET1/2 and plasma VIP levels (r=055,P<001). No significant changes were found in SS and SP in GU compared with controls (P>005). GET1/2 in DU was markedly shorter than the control group (417±102 vs 533±43, P<001), and plasma SS levels (ng/L) significantly lower than those in controls (64±25 vs 119±34,P<001), there was a significant positive correlation between GET1/2 and SS levels (r=056,P<001). Plasma SP levels (ng/L) in DU were significantly higher than the controls (544±127 vs 416±58,P<001),there was a significant negative correlation between GET1/2 and SP levels (r=-068,P<001). No significant difference was found in the plasma VIP levels between DU and controls (P>005).CONCLUSION VIP elevation may contribute to the GET1/2 delay and the occurrence of GU. The increased SP and lowered SS may play important roles in the GET1/2 acceleration and the pathogensis of DU.

Role of sex hormones in gastrointestinal motility in pregnant and non-pregnant rats

AIM: To correlate gastric contractility, gastrointestinal transit, and hormone levels in non-pregnant(estrous cycle) and pregnant rats using noninvasive techniques. METHODS: Female rats(n = 23) were randomly divided into(1) non-pregnant,(contractility, n =6; transit, n = 6); and(2) pregnant(contractility, n = 5; transit, n = 6). In each estrous cycle phase or at 0, 7, 14, and 20 d after the confirmation of pregnancy, gastrointestinal transit was recorded by AC biosusceptometry(ACB), and gastric contractility was recorded by ACB and electromyography. After each recording, blood samples were obtained for progesterone and estradiol determination. RESULTS: In the estrous cycle, despite fluctuations of sex hormone levels, no significant changes in gastrointestinal motility were observed. Days 7 and 14 of pregnancy were characterized by significant changes in the frequency of contractions(3.90 ± 0.42 cpm and 3.60 ± 0.36 cpm vs 4.33 ± 0.25 cpm) and gastric emptying(168 ± 17 min and 165 ± 15 min vs 113 ± 15 min) compared with day 0. On these same days, progesterone levels significantly increased compared with control(54.23 ± 15.14 ng/m L and 129.96 ± 30.52 ng/mL vs 13.25 ± 6.31 ng/mL). On day 14, we observed the highest level of progesterone and the lowest level of estradiol compared with day 0(44.3 ± 15.18 pg/mL vs 24.96 ± 5.96 pg/mL). CONCLUSION: Gastrointestinal motility was unaffected by the estrous cycle. In our data, high progesterone and low estradiol levels can be associated with decreased contraction frequency and slow gastric emptying.

Effects of Xiangsha Liujunzi decoction drug serum on gastric antrum smooth muscle cells from rats with functional dyspepsia by regulating gastrointestinal hormones

Objective:To observe the effect and mechanism of Xiangsha Liujunzi decoction(XSLJZD)drug serum on gastric antrum smooth muscle cells(SMCs)in rats with functional dyspepsia(FD).Methods:Gastric antrum SMCs from rats with FD were isolated,cultured,and then divided into six groups as follows:control,model,domperidone,low-dose XSLJZD(LXSLJZD),medium-dose XSLJZD(MXSLJZD),and high-dose XSLJZD(HXSLJZD).Each group was administered the corresponding drug serum for intervention.Drug serum intervention conditions and proliferative activity of SMCs were tested by cholecystokinin octapeptide.Ghrelin,gastrin,somatostatin,and substance P(SP)levels were measured by ELISA.Somatostatin and SP mRNA expression was measured by real-time PCR.Results:A concentration of 10%drug serum for 24 h was decided to be the best intervention condition for later study.The mean optical density value in the model group was lower than that in the control group(P紏.001).Optical density values in the domperidone and HXSLJZD groups were higher than those in the model group(P?.025,P?.032,respectively).Gastrin,SP,and ghrelin levels in the model group were lower(P?.007,P?.037,P?.005,respectively),but somatostatin levels were higher,compared with those in the control group(P?.031).Gastrin,SP,and ghrelin levels in the domperidone,MXSLJZD,and HXSLJZD groups were higher than those in the model group(all P<.05).Somatostatin levels in the four drug-treated groups were lower than those in the model group(P?.002,P?.007,P?.001,P?.009,respectively).SP mRNA levels in the model group were lower than those in the control,domperidone,MXSLJZD,and HXSLJZD groups(P?.037 P?.016,P?.025,P?.002,respectively).Somatostatin mRNA levels in the model group were higher than those in the control and MXSLJZD groups(P紏.042,P紏.035).Conclusions:XSLJZD and domperidone drug serum effectively promote proliferative activity of gastric antrum SMCs in an FD model.The mechanism of this activity may be regulated by gastrointestinal hormones.

Effect of explosive noise on gastrointestinal transit and plasma levels of polypeptide hormones

AIM： To investigate the effect of firing noise on gastrointestinal transit and probe its mechanism by measuring the levels of plasma polypeptide hormones. METHODS： A total of 64 SD rats were randomly divided into a control group and three stimulating groups. Firing noise of different intensity by sub-machine guns was used as inflicting factor. The effect of firing noise on liquid substance gastrointestinal transit and solid substance gastrointestinal transit was observed by measuring the ratio of carbon powder suspension transmitting and barium sticks transmitting respectively. Plasma levels of polypeptide hormones were measured by radio-immunoassay. RESULTS： The noise accelerated gastrointestinal transit of solid food by more than 80 db;and accelerated gastrointestinal transit of liquid food significantly by more than 120 db. Meantime, plasma levels of plasma motilin （MTL）（157.47±16.08; 151.90±17.08）, somatostatin （SS）（513.97±88.77; 458.25±104.30）, substance P （SP）（115.52±20.70; 110.28±19.96） and vasoactive intestinal peptide （VIP） （214.21±63.17; 251.76±97.24） remarkably changed also. CONCLUSION： Within a certain intensity range, the firing noise changes the levels of rat plasma gastrointestinal hormones, but the gastrointestinal transit is still normal. Beyond the range, the noise induces plasma hormone levels disturbance and gastrointestinal transit disorder. ~

Effect of trimebutine in combined with alprazolam on the gastrointestinal hormones in patients with diarrhea-type IBS

Objective: To explore the effect of trimebutine in combined with alprazolam on the gastrointestinal hormones and living quality in patients with diarrhea-type IBS (IBS-D). Methods: A total of 117 patients with IBS-D who were admitted in our hospital were included in the study and randomized into the control group (n=58) and the treatment group (n=59). The patients in the control group were given trimebutine;while the patients in the treatment group were given trimebutine in combined with alprazolam. The patients in the two groups were continuously treated for 4 weeks. The levels of gastrointestinal hormones and brain-gut peptide before and after treatment in the two groups were detected and compared. SF-36 was used to analyze the living quality before and after treatment in the two groups. Results: MOT;GAS;SP;and 5-HT levels after treatment in the two groups were significantly reduced;while VIP;SS;CCK;and CGRP levels and SF-36 score in each dimension were significantly elevated;and the comparison between the two groups was statistically significant. Conclusions:Trimebutine in combined with alprazolam in the treatment of IBS-D can significantly improve the gastrointestinal hormones and brain-gut peptide;and enhance the living quality;with a significant efficacy.

Effect of early enteral immunonutrition intervention on gastrointestinal hormones, stress hormones and immune response after pancreatic cancer surgery

Objective: To study the effect of early enteral immunonutrition intervention on gastrointestinal hormones, stress hormones and immune response after pancreatic cancer surgery. Methods:A total of 68 patients who received radical operation for pancreatic cancer in Chengdu Third People's Hospital between May 2015 and February 2017 were selected as the research subjects and randomly divided into TPF-T group and TP group who received early postoperative enteral immunonutrition intervention and conventional enteral nutrition intervention respectively. The levels of gastrointestinal hormones MTL, GAS, CGRP, Ghrelin and stress hormones ACTH, Cor,R, AT-II, ALD in serum as well as the levels of immune cells CD4+T, CD8+T, NKT, Treg, Breg, MDSC in peripheral blood were detected before surgery as well as 3 d and 7 d after surgery. Results: 3 d and 7 d after surgery, MTL, GAS, CGRP and Ghrelin levels in serum as well as CD4+T cell, CD8+T cell and NKT cell levels in peripheral blood of both groups of patients were significantly lower than those before surgery while ACTH, Cor, R, AT-II and ALD levels in serum as well as Treg, Breg and MDSC levels in peripheral blood were significantly higher than those before surgery, and MTL, GAS, CGRP and Ghrelin levels in serum as well as CD4+T cell, CD8+T cell and NKT cell levels in peripheral blood of TPF-T group were significantly higher than those of TP group while ACTH, Cor, R, AT-II and ALD levels in serum as well as Treg, Breg and MDSC levels in peripheral blood were significantly lower than those of TP group. Conclusion: Early postoperative enteral immunonutrition intervention can regulate the gastrointestinal hormone secretion, inhibit stress response and improve immune response.

Effect of intestinal flora from children with Henoch-Sch?nlein purpura on visceral sensitivity, gastrointestinal hormones and cytokines secretion in pseudo-sterile rats

Objective:To investigate the effect of intestinal flora from Henoch-Schönlein purpura(HSP)on visceral sensitivity,gastrointestinal hormones and cytokines in pseudo-sterile rats.Methods:The pseudo-sterile rat model was established.The rats were was given fecal microbiota solutions of children with abdominal HSP and healthy children,respectively.The visceral sensitivity was determined by abdominal withdrawal reflex(AWR)which was induced by rectal balloon distention in all the rats.And serum gastrin(Gas),motilin(MTL),cholecystokinin(CCK),substance P(SP),tumor necrosis factor(TNF)-αand interleukin(IL)-6 levels in rats were measured with ELISA method.Results:The volume of rectum water injection under the score 3 of AWR in the rats administrated with fecal microbiota solution from HSP children(HSP group)was significantly decreased compared with that in the rats administrated with fecal microbiota solution from healthy children(HC group),and there was significant difference between these two groups(P<0.05).The serum Gas,MTL,CCK and SP levels were higher in HSP group than those in HC group.And serum MTL,CCK and SP levels in HSP group were significantly different from those in the HC group.The serum TNF-αandIL-6 levels were higher in HSP group than those in HC group,there was significant difference between these two groups(P<0.05).Conclusion:Intestinal flora from HSP can induce the production of visceral sensitivity,inhibit gastrointestinal hormone secretion and prompt cytokine production.

Correlation between serum CGRP and gastrointestinal hormones, inflammatory response in patients with reflux esophagitis

Objective:To detect serum content of calcitonin gene-related peptide (CGRP) in patients with reflux esophagitis (RE), evaluate the relationship between CGRP and gastrointestinal hormones, inflammatory response.Methods: 119 cases of RE patients diagnosed in our hospital during August 2015 to March 2018 were divided into stage I-II RE group (n=72) and stage III-IV RE group (n=47) according to Savary-Miller criteria, 100 cases of healthy volunteers underwent routine gastroenteroscopy at the same time were selected as Normal control group. Serum content of CGRP, gastrointestinal hormones and inflammatory response indexes were measured and their correlations were evaluated.Results: Serum content of CGRP in stage I-II RE group, stage III-IV RE group were higher than those in Normal control group;contents of GAS and MTL in stage I-II RE group, stage III-IV RE group were lower than those in Normal control group, contents of VIP and SS were higher than those in Normal control group;contents of inflammatory reaction indexes such as IL-4, IL-17, IL-23 and IFN-γwere higher than those in Normal control group (P<0.05). Along with aggravation of RE, above indexes increased significantly (P<0.05). Correlation analysis showed that, serum content of CGRP in RE patients were directly related to the levels of gastrointestinal hormones and inflammatory markers (P<0.05).Conclusion: Expression of CGRP in RE patients is abnormally high, and the specific content is directly related to the degree of gastrointestinal hormone secretion disorder and systemic inflammatory reaction, which is of great significance to the auxiliary evaluation of RE.

Effect of minimally invasive surgery under anus and colonoscopy on pain stress, gastrointestinal hormones and vascular endothelial function in patients with rectal cancer

Objective: To discuss the effects of minimally invasive surgery under transrectal anoscope on pain stress, gastrointestinal hormones and vascular endothelial function in patients with rectal cancer. Methods Totally 64 patients with rectal cancer who underwent minimally invasive surgery under transanal anastomosis from January 2017 to December 2018 in our hospital were selected as the observation group and the retrospective analysis of clinical data was conducted. Another 64 patients who underwent traditional laparotomy at the same time in our hospital were selected as the control group. Pain stress, gastrointestinal hormones, vascular endothelial function, and tumor marker changes were compared between the two groups. Results There were no significant differences in pain stress index, gastrointestinal hormone, vascular endothelial function index and tumor marker level between the two groups before operation (P>0.05). After operation, the levels of SP, BK and PGE2 in the two groups were higher than those before surgery (P<0.05), and the levels of GAS, MTL, VIP, VEGF, MMP-9, ET-1, CEA, CA724, CA125 and CA19-9 were higher with preoperative reduction of P<0.05. The levels of SP, BK, PGE2, VEGF, MMP-9, ET-1, CEA, CA724, CA125 and CA19-9 in the observation group after operation were lower than those in the control group (P<0.05), and the GAS, MTL and VIP levels were significantly higher than the control group (P<0.05). Conclusion Minimally invasive surgery under transanal anoscope can reduce the pain stress of patients with rectal cancer, and the influence of gastrointestinal hormones is slight. It can effectively reduce the vascular endothelial function index and tumor marker level, help the immune function recovery of patients, and promote postoperative rehabilitation of patients.

Effect of laparoscopic radical resection of rectal cancer on gastrointestinal hormones, visceral protein and pain stress in patients

Objective: To investigate the effects of laparoscopic radical resection of rectal cancer on gastrointestinal hormones, visceral protein and pain stress. Methods: A total of 96 patients with rectal cancer radical resection from January 2017 to December 2017 in our hospital, were selected as the research objects, the patients were randomly divided into the observation group (48 cases) and the control group (48 cases). The observation group received laparoscopic radical resection of rectal cancer, while the control group underwent open radical resection of rectal cancer. The levels of gastrin (GAS), motilin (MTL), vasoactive intestinal peptide (VIP), transferrin (TRF), retinol binding protein (RbP), albumin (ALB), prealbumin (PRE), P substance (SP), bradykinin (BK), and prostaglandin-E2 (PGE2) were measured and compared in the two groups. Results: Before operation, there was no significant difference in GAS, MTL and VIP between the two groups. 1, 3, and 5 d after operation, the GAS, MTL and VIP of the two groups were significantly lower than those before operation, and the differences were statistically significant. 1, 3, and 5 d after operation, GAS of the observation group were (66.60±5.79) μmol/L, (71.95±6.16) μmol/L and (77.68±6.38) μmol/L respectively, MTL were (225.68±19.83) pg/mL, (253.76±21.42) pg/mL and (289.98±24.74) pg/mL, VIP were (1.99±0.42) μmol/L, (2.43±0.46) μmol/L, (2.80±0.51) μmol/L, respectively, which were higher than that of the control group at the same time, and the difference was statistically significant. Before operation, there was no significant difference in TRF, RbP, ALB and PRE levels in the two groups. 1, 3 and 5 d after operation, the TRF, RbP, ALB and PRE levels in the two groups were significantly lower than those before operation, and the differences were statistically significant. 1, 3 and 5 d after operation, TRF of the observation group were (1.64±0.33) ng/L, (1.44±0.30) ng/L, (1.46 ±0.32) ng/L, RbP were (19.05±3.85) mg/L, (21.83±4.26) mg/L and (24.54±4.45) mg/L respectively, and ALB were (31.49±2.54) ng/L, (28.21±2.05) ng/L and (28.43±1.99) ng/L, PRE were (0.20±0.06) ng/L, (0.16±0.05) ng/L, (0.15±0.05) ng/L, which were all higher than those in the control group at the same time, and the differences were statistically significant. Before operation, there was no significant difference in SP, BK and PGE2 between the two groups. 1, 3 and 5 d after operation, the SP, BK and PGE2 of the two groups were significantly higher than those before operation and the differences were statistically significant. 1, 3 and 5 d after operation, SP of the observation group was (7.31±0.87) μg/mL, (5.43±0.51) μg/mL and (3.10±0.24) μg/mL, BK was (9.53±0.80) μg/L, (7.81±0.79) μg/L and 6.30±0.53) pg/mL, and PGE2 were (152.42±14.80) pg/mL, (131.22±13.35) pg/mL, (117.86±11.95) pg/mL, which were all lower than those in the control group at the same time, and the differences were statistically significant. Conclusion: Laparoscopic radical resection of rectal cancer can help patients recover gastrointestinal function faster and cause less pain stress.

Helicobacter pylori infection and gastrointestina hormones:a review

INTRODUCTIONHelicobacter pylori(Hp)infection is closely relatedto gastrointestinal hormones and involves theformation of gastritis,gastric carcinoma and pepticulcer.Its pathogenesis relevant

Gastrointestinal hormone abnormalities and G and D cells in functional dyspepsia patients with gastric dysmotility

AIM: To investigate the relationship between gastric dysmotility,gastrointestinal hormone abnormalities, and neuroendocrine cells in gastrointestinal mucosa in patients with functional dyspepsia (FD).METHODS: Gastric emptying was assessed with solid radiopaque markers in 54 FD patients, and the patients were divided into two groups according to the results, one with delayed gastric emptying and the other with normal gastric emptying. Seventeen healthy volunteers acted as normal controls. Fasting and postprandial plasma levels and gastroduodenal mucosal levels of gastrointestinal hormones gastrin, somatostatin (SS) and neurotensin (NT)were measured by radioimmunoassay in all the subjects.G cells (gastrin-producing cells) and D cells (SS-producing cells) in gastric antral mucosa were immunostained with rabbit anti-gastrin polyclonal antibody and rabbit anti-SS polyclonal antibody, respectively, and analyzed quantitatively by computerized image analysis.RESULTS: The postprandial plasma gastrin levels, the fasting and postprandial plasma levels and the gastric and duodenal mucosal levels of NT were significantly higher in the FD patients with delayed gastric emptying than in those with normal gastric emptying and normal controls. The number and gray value of G and D cells and the G cell/D cell number ratio did not differ significantly between normal controls and the FD patients with or without delayed gastric emptying.CONCLUSION: Our findings suggest that the abnormalities of gastrin and NT may play a role in the pathophysiology of gastric dysmotility in FD patients, and the abnormality of postprandial plasma gastrin levels in FD patients with delayed gastric emptying is not related to the changes both in the number and gray value of G cells and in the G cell/D cell number ratio in gastric antral mucosa.

Role of corticotrophin releasing hormone in cerebral infarction-related gastrointestinal barrier dysfunction

BACKGROUND： Corticotrophin releasing hormone （CRH） is believed to mediate stress-induced behaviors, implying a broader, integrative role for the hormone in the psychological stress response, and studies on CRH in physical stress are few. This study was undertaken to investigate whether CRH plays an important role in cerebral infarction-related gastrointestinal barrier dysfunction.METHODS： Thirty male Wistar rats were randomly divided into a pseudo-operation group （group C, n=10）, a cerebral infarction group （group I, n=10）, and a cerebral infarction ＋ ic α-helical-CRH （9-41） group （group Aic, n=10）. Urine samples were collected to determine the levels of epinephrine, norepinephrine, cortisol, and sucrose. At 24 hours after establishment of the models, blood samples were taken to determine the activity of diamine oxidase （DAO） and the concentration of D-lactic acid （D-lac）. The stomach was taken to determine gastric Guth score, and the hypothalamus was also taken to determine tissue CRH protein expression using Western blotting.RESULTS： The hypothalamus CRH protein, the indicators of stress, the plasma DAO activity and plasma D-lac, urine sucrose exertion and gastric Guth score in group I were higher than those in groups Aic and C.CONCLUSIONS： After cerebral infarction, CRH in the hypothalamus was increased, the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system were activated, gastrointestinal permeability was increased, and gastrointestinal barrier function was destroyed. CRH receptor antagonist alleviated the gastrointestinal barrier function.

Accelerated Infliximab Induction for Severe Lower Gastrointestinal Bleeding in a Young Patient with Crohn’s Disease:A Case Report

BACKGROUND Severe lower gastrointestinal bleeding(SLGIB)is a rare complication of Crohn's disease(CD).The treatment of these patients is a clinical challenge.Monoclonal anti-TNFαantibody(IFX)can induce relatively fast mucosal healing.It has been reported for the treatment of SLGIB,but there are few reports on accelerated IFX induction in CD patients with SLGIB.CASE SUMMARY A 16-year-old boy with a history of recurrent oral ulcers for nearly 1 year presented to the Gastroenterology Department of our hospital complaining of recurrent periumbilical pain for more than 1 mo and having bloody stool 4 times within 2 wk.Colonoscopy showed multiple areas of inflammation of the colon and a sigmoid colon ulcer with active bleeding.Hemostasis was immediately performed under endoscopy.The physical examination of the patient showed scattered small ulcers in the lower lip of the mouth and small cracks in the perianal area.Combined with his medical history,physical examination,laboratory examinations with high C-reactive protein(CRP),platelet count(PLT),erythrocyte sedimentation rate(ESR)and fecal calprotectin levels,imaging examinations and pathology,a diagnosis of CD was taken into consideration.According to the pediatric CD activity index 47.5,methylprednisolone(40 mg QD)was given intravenously.The abdominal pain disappeared,and CRP,PLT,and ESR levels decreased significantly after the treatment.Unfortunately,he had a large amount of bloody stool again after 1 wk of methylprednisolone treatment,and his hemoglobin level decreased quickly.Although infliximab(IFX)(5 mg/kg)was given as a combination therapy regimen,he still had bloody stool with his hemoglobin level decreasing from 112 g/L to 80 g/L in a short time,so-called SLGIB.With informed consent,accelerated IFX(5 mg/kg)induction was given 7 days after initial presentation.The bleeding then stopped.Eight weeks after the treatment,repeat colonoscopy showed mucosal healing;thus far,no recurrent bleeding has occurred,and the patient is symptom-free.CONCLUSION This case highlights the importance of accelerated IFX induction in SLGIB secondary to CD,especially after steroid hormone treatment.

Biofeedback therapy combined with Baduanjin on quality of life and gastrointestinal hormone level in patients with colorectal cancer

BACKGROUND With the change in people’s lifestyles,the incidence of colorectal cancer(CRC)is increasing.It is essential to study the efficacy of various treatment methods for CRC patients to prevent and treat CRC.AIM To investigate the efficacy of biofeedback therapy combined with Baduanjin in improving the quality of life and gastrointestinal hormone levels of patients with CRC.METHODS A total of 120 patients with CRC who were admitted to our hospital from June 2020 to June 2021 were included in the study.They were randomly divided into four groups(n=30):the control group(group A),the biofeedback therapy intervention group(group B),the Baduanjin exercise intervention group(group C),and the combination group(group D).Patients in group A adopted the standard nursing mode and necessary health education.Patients in group B were treated with biofeedback therapy based on routine nursing care.Patients in group C were given Baduanjin intervention for 12 wk based on conventional drug treatment and care.Patients in group D were treated with biofeedback therapy and Baduanjin exercise.In this study,patients’quality of life,gastrointestinal hormone levels,and clinical efficacy in the four groups were observed at baseline and 12 wk after intervention.Meanwhile,the correlation between gastrointestinal hormone levels and various functional areas of quality of life was analyzed.By comparing the observed indicators of patients in the four groups,the efficacy of biofeedback therapy combined with Baduanjin in improving the quality of life and gastrointestinal hormone levels of patients with CRC was explored.RESULTS At baseline,there were no significant differences in quality of life,gastrointestinal hormone levels,or clinical efficacy among the four groups(P>0.05).Twelve weeks after the intervention,the combination group’s quality of life,gastrointestinal hormone levels,and clinical effectiveness were better than those of the three other groups.CONCLUSION On the basis of routine nursing care,patients with CRC combined with biofeedback therapy and Baduanjin exercise can improve the quality of life of patients with CRC and the efficacy of gastrointestinal hormone levels.

Growth hormone used to control intractable bleeding caused by radiation-induced gastritis

Intractable bleeding caused by radiation-induced gastritis is rare. We describe a 69-year-old man with intractable hemorrhagic gastritis induced by postoperative radiotherapy for the treatment of esophageal carcinoma. Although anti-secretory therapy with or without octreotide was initiated for hemostasis over three months,melena still occurred off and on,and the patient required blood transfusions to maintain stable hemoglobin. Finally growth hormone was used in the treatment of hemorrhage for two weeks,and hemostasis was successfully achieved. This is the first report that growth hormone has been used to control intractable bleeding caused by radiation-induced gastritis.

Gut microbiota in gastrointestinal diseases during pregnancy

Gut microbiota(GM)is a micro-ecosystem composed of all microorganisms in the human intestine.The interaction between GM and the host plays an important role in maintaining normal physiological functions in the host.Dysbiosis of the GM may cause various diseases.GM has been demonstrated to be associated with human health and disease,and changes during individual development and disease.Pregnancy is a complicated physiological process.Hormones,the immune system,metabolism,and GM undergo drastic changes during pregnancy.Gastrointestinal diseases during pregnancy,such as hepatitis,intrahepatic cholestasis of pregnancy,and pre-eclampsia,can affect both maternal and fetal health.The dysregulation of GM during pregnancy may lead to a variety of diseases,including gastrointestinal diseases.Herein,we review recent research articles on GM in pregnancy-related gastrointestinal diseases,discuss the interaction of the GM with the host under normal physiological conditions,gastrointestinal diseases,and pregnancy-specific disorders.As more attention is paid to reproductive health,the pathogenic mechanism of GM in gastrointestinal diseases during pregnancy will be further studied to provide a theoretical basis for the use of probiotics to treat these diseases.

温肾健脾法联合耳穴埋豆对腹泻型肠易激综合征的疗效观察

目的探讨温肾健脾法联合耳穴埋豆对腹泻型肠易激综合征(diarrhea-predominant irritable bowel syndrome,IBS-D)患者的临床疗效。方法选择中国中医科学院望京医院于2020年6月—2022年6月收治的IBS-D患者104例为研究对象,依据随机数表法,分为对照组和观察组各52例。对照组接受温肾健脾法治疗,观察组在对照组的基础上接受耳穴埋豆。治疗4周后,比较两组临床疗效、症状评分、肠易激综合征生活质量评分(irritable bowel syndrome-quality of life,IBS-QOL)及胃肠激素[包括血清5-羟色胺(5-hydroxy tryptamine,5-HT)、血管活性肠肽(vasoactive intestinal peptide,VIP)、P物质(substance P,SP)、生长抑素(somatostatin,SS)、胆囊收缩素(cholecystokinin,CCK)]水平。结果观察组总有效率明显高于对照组,差异有统计学意义(P<0.05);治疗前,两组症状及IBS-QOL评分相比,差异无统计学意义(P>0.05);治疗后,两组症状评分明显低于治疗前,IBS-QOL评分明显高于治疗前,且观察组症状评分明显低于对照组,IBS-QOL评分明显高于对照组,差异有统计学意义(P<0.05);治疗前,两组5-HT、VIP、SP、SS、CCK水平相比,差异无统计学意义(P>0.05);治疗后,观察组5-HT、VIP、SP、CCK水平明显低于对照组,SS水平明显高于对照组,差异有统计学意义(P<0.05)。结论温肾健脾法联合耳穴埋豆应用于IBS-D患者可显著提升临床疗效,改善症状及生活质量评分,同时还能有效改善胃肠激素水平,值得推广应用。