Study on the occurrence and influencing factors of gastrointestinal symptoms in hemodialysis patients with uremia

BACKGROUND Gastrointestinal symptoms are common in patients with uremia undergoing hemodialysis,and these symptoms seriously affect patients'prognosis.AIM To assess the occurrence and factors influencing gastrointestinal symptoms in patients with uremia undergoing hemodialysis.METHODS We retrospectively selected 98 patients with uremia who underwent regular hemo-dialysis treatment in the blood purification center of our hospital from December 2022 to December 2023.The gastrointestinal symptoms and scores of each dimension were evaluated using the Gastrointestinal Symptom Grading Scale(GSRS).Patients were divided into gastrointestinal symptoms and no gastrointestinal symptom groups according to whether they had gastrointestinal symptoms.The factors that may affect gastrointestinal symptoms were identified by single-factor analysis.Multiple logistic regression analysis was performed to identify independent risk factors for gastrointestinal symptoms.RESULTS Gastrointestinal symptoms included indigestion,constipation,reflux,diarrhea,abdominal pain,and eating disorders,and the total average GSRS score was 1.35±0.47.This study showed that age,number of tablets,dialysis time,glucocorticoid,parathyroid hormone(PTH),combined diabetes mellitus and C-reactive protein(CRP)were independent risk factors for gastrointestinal symptoms in patients with uremia undergoing hemodialysis,whereas body mass index(BMI),hemoglobin(Hb),and urea clearance index were independent protective factors(P<0.05).CONCLUSION Gastrointestinal symptoms are mostly mild in patients with uremia undergoing hemodialysis,most commonly including dyspepsia,eating disorders,and gastroesophageal reflux.The independent influencing factors mainly include the BMI,age,number of pills taken,dialysis time,urea clearance index,Hb,use of glucocorticoids,and thyroid hormone level.PTH,CRP,and diabetes are clinically related factors influencing the occurrence of gastrointestinal symptoms,and targeted prevention can be performed.

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.

Age,blood tests and comorbidities and AIMS65 risk scores outperform Glasgow-Blatchford and pre-endoscopic Rockall score in patients with upper gastrointestinal bleeding

BACKGROUND Upper gastrointestinal(GI)bleeding is a life-threatening condition with high mortality rates.AIM To compare the performance of pre-endoscopic risk scores in predicting the following primary outcomes:In-hospital mortality,intervention(endoscopic or surgical)and length of admission(≥7 d).METHODS We performed a retrospective analysis of 363 patients presenting with upper GI bleeding from December 2020 to January 2021.We calculated and compared the area under the receiver operating characteristics curves(AUROCs)of Glasgow-Blatchford score(GBS),pre-endoscopic Rockall score(PERS),albumin,international normalized ratio,altered mental status,systolic blood pressure,age older than 65(AIMS65)and age,blood tests and comorbidities(ABC),including their optimal cut-off in variceal and non-variceal upper GI bleeding cohorts.We subsequently analyzed through a logistic binary regression model,if addition of lactate increased the score performance.RESULTS All scores had discriminative ability in predicting in-hospital mortality irrespective of study group.AIMS65 score had the best performance in the variceal bleeding group(AUROC=0.772;P<0.001),and ABC score(AUROC=0.775;P<0.001)in the non-variceal bleeding group.However,ABC score,at a cut-off value of 5.5,was the best predictor(AUROC=0.770,P=0.001)of inhospital mortality in both populations.PERS score was a good predictor for endoscopic treatment(AUC=0.604;P=0.046)in the variceal population,while GBS score,(AUROC=0.722;P=0.024),outperformed the other scores in predicting surgical intervention.Addition of lactate to AIMS65 score,increases by 5-fold the probability of in-hospital mortality(P<0.05)and by 12-fold if added to GBS score(P<0.003).No score proved to be a good predictor for length of admission.CONCLUSION ABC score is the most accurate in predicting in-hospital mortality in both mixed and non-variceal bleeding population.PERS and GBS should be used to determine need for endoscopic and surgical intervention,respectively.Lactate can be used as an additional tool to risk scores for predicting inhospital mortality.

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

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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

瞄准：调查在胃肠的运输上发射噪音的效果并且由测量血浆多肽荷尔蒙的层次探查它的机制。方法：64 只 SD 老鼠的一个总数随机被划分成一个控制组和三刺激组。由亚机器枪的不同紧张的开火的噪音被用作造成因素。在液体物质上发射噪音的效果胃肠的运输和稳固的物质胃肠的运输被测量碳粉末暂停播送和分别地播送的钡棍子的比率观察。多肽荷尔蒙的血浆层次被放射性免疫测定测量。结果：噪音由超过 80 db 加速了稳固的食物的胃肠的运输；并且由超过 120 db 显著地加速了液体食物的胃肠的运输。同时，血浆 motilin (MTL ) 的血浆层次(157.47+/-16.08；151.90+/-17.08 ) ， somatostatin (SS )(513.97+/-88.77；458.25+/-104.30 ) ，物质 P (SP )(115.52+/-20.70；110.28+/-19.96 ) 并且血管作用的肠的肽(贵宾)(214.21+/-63.17；251.76+/-97.24 ) 显著地也变化了。结论：在某个紧张范围以内，开火的噪音改变老鼠血浆胃肠激素的层次，但是胃肠的运输仍然是正常的。在范围以外，噪音导致血浆荷尔蒙层次骚乱和胃肠的运输混乱。

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

Efficacy of ankaferd blood stopper application on nonvariceal upper gastrointestinal bleeding

AIM:To prospectively assess the hemostatic efficacy of the endoscopic topical use of ankaferd blood stopper(ABS) in active non-variceal upper gastrointestinal system(GIS) bleeding.METHODS:Endoscopy was performed on 220 patients under suspiciency of GIS bleeding.Patients with active non-variceal upper gastrointestinal bleeding(NVUGIB) with a spurting or oozing type were included.Firstly,8-10 cc of isotonic saline was sprayed to bleeding lesions.Then,8 cc of ABS was applied on lesions in which bleeding continued after isotonic saline application.The other endoscopic therapeutic methods were applied on the lesions in which the bleeding did not stop after ABS.RESULTS:Twenty-seven patients had an active NVUGIB with a spurting or oozing type and 193 patients were excluded from the study since they did not have non-variceal active bleeding.8 cc of ABS was sprayed on to the lesions of 26 patients whose bleeding continued after isotonic saline and in 19 of them,bleeding stopped after ABS.Other endoscopic treatment methods were applied to the remaining patients and the bleeding was stopped with these interventions in 6 of 7 patients.CONCLUSION:ABS is an effective method on NVUGIB,particularly on young patients with no coagulopathy.ABS may be considered as part of a combination treatment with other endoscopic methods.

The effect of the ratio of standardized ileal digestible lysine to metabolizable energy on growth performance,blood metabolites and hormones of lactating sows

A total of 335 lactating sows （Landrace x Large White） were used in two experiments to determine the optimum ratio of standardized ileal digestible lysine （SID-Lys） to metabolizable energy （ME） for mixed parity sows during lactation. In Exp. 1, 185 sows （weighing an average of 256.2 ± 6.5 kg and having an average parity of 3.4 ± 0.3） were allocated to one of six experimental diets in a completely randomized block design within parity groups （1, 2, and 3＋）. The experimental diets were formulated to contain 3.06, 3.16, 3.20, 3.25, 3.30 or 3.40 Mcal/kg of ME and each diet was fed to the sows throughout a 28 day lactation. All diets provided a similar SID-lysine level （0.86%）. As a result, the diets provided a SID-Lys：ME ratio of 2.81, 2.72, 2.69, 2.65, 2.61 or 2.53 g/Mcal ME. Sow feed intake was significantly （P 〈 0.01） affected by the energy content of the diet as well as by sow parity. Using regression analysis, feed intake was shown to be maximized at 3.25, 3.21, 3.21 and 3.21 Mcal/kg of ME for parity 1, 2, 3＋ sows and the entire cohort of sows respectively （quadratic; P 〈 0.01）. In addition, the result of feed intake can be expressed as 2.65, 2.69, 2.69 and 2.68 g/Mcal based on analysis of SID-Lys：ME ratio. Litter weight gain was affected by dietary treatment for parity 3＋ sows and the entire cohort （P 〈 0.01）. Based on regression analysis, litter weight gain was maximized at 3.25 and 3.24 Mcal/kg of ME for parity 3＋ （quadratic; P 〈 0.01） and the entire cohort （quadratic; P 〈 0.01）. Similarly, the result of litter weight gain could be expressed as 2.65 and 2.66 g/Mcal of SID- Lys：ME ratio. Therefore, 3.25 Mcal/kg of ME was selected for Exp. 2 in which 150 sows （weighing 254.6 ± 7.3 kg and having an average parity of 3.4 ± 0.4） were allocated to one of five treatments in a completely randomized block design within parity （1, 2, and 3＋）. The experimental diets were formulated to contain 2.1, 2.4, 2.7, 3.0 or 3.3 g/Mcal of SID-Lys：ME ratio with all diets providing 3.25 Mcal/kg of ME. The diets were fed to the sows throughout a 28 day lactation. Sow body weight loss was affected by dietary treatment （parity 3＋ sows, P = 0.02; entire cohort, P 〈 0.01） and by sow parity （P 〈 0.01）. Litter weight at weaning and litter weight gain were affected by dietary treatment for parity 1, 2, 3＋ sows and the entire cohort （P 〈 0.01） as well as by sow parity （P 〈 0.01）. Plasma urea nitrogen （P 〈 0.01）, creatinine （P 〈 0.01） and non-esterifide fatty acids （P = 0.04） were decreased as the SID-Lys：ME ratio of the diet increased. Insulin-like growth factor-1 （P = 0.02）, estradiol （P 〈 0.01） and luteinizing hormone （P = 0.02） were increased as the SID-Lys：ME ratio in diet increased. Based on a broken-line model, the estimated SID-Lys： ME ratio to maximize litter weight gain was estimated to be 3.05 g/Mcal.

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.

The effects of consumption of raw garlic on serum lipid level, blood sugar and a number of effective hormones on lipid and sugar metabolism in hyperglycemic and/or hyperlipidemic individuals ——Benefit of raw garlic consumption

Diabetes mellitus is one of the worldwide largest growing metabolic diseases. In this study the effects of consumption of raw garlic on serum lipid level, blood sugar and a number of effective hormones on lipid and sugar metabolism (thyroid hormones and insulin) in individuals either with high level of blood sugar or lipid were investigated. Eighty five volunteers having following clinical history enrolled in the study: Group 1: having blood sugar more than 126 mg/dl (30 vo-lunteers);Group 2: having cholesterol higher than 245 mg/dl (30 volunteers);Group 3: having blood sugar over 126 mg/dl and cholesterol more than 245 mg/dl (25 volunteers). In group 1, there wasn’t a sig-nificant differences between biochemical factors be-fore and after garlic consumption, whereas, in the second group after 6 weeks of garlic consumption a decline in cholesterol (P < 0.001), FBS and TG (P < 0.01) was observed but HDL-C (P < 0.001) was in-creased. Six weeks after termination of garlic con-sumption, cholesterol (P < 0.001), FBS and TG (P < 0.05) were in- creased and HDL-C (P < 0.01) was de-creased. In the third group, total cholesterol (P < 0.001), FBS (P < 0.01) and HbA1c decreased while HDL-C was in- creased. Other factors, including thy-roid hormones (T3, T4), TSH and insulin showed no significant alte- ration. In conclusion our results shown that raw garlic consumption can reduce the FBS and Lipid in hyperglycemic and/or hyperlipidemic individuals.

Rare finding of primary aortoduodenal fistula on single-photon emission computed tomography/computed tomography of gastrointestinal bleeding: A case report

BACKGROUND Primary aortoduodenal fistula is a rare cause of gastrointestinal(GI)bleeding consisting of abnormal channels between the aorta and GI tract without previous vascular intervention that results in massive intraluminal hemorrhage.CASE SUMMARY A 67-year-old man was hospitalized for coffee ground vomiting,tarry stools,and colic abdominal pain.He was repeatedly admitted for active GI bleeding and hypovolemic shock.Intermittent and spontaneously stopped bleeders were undetectable on multiple GI endoscopy,angiography,computed tomography angiography(CTA),capsule endoscopy,and ^(99)mTc-labeled red blood cell(RBC)scans.The patient received supportive treatment and was discharged without signs of rebleeding.Thereafter,he was re-admitted for bleeder identification.Repeated CTA after a bleed revealed a small aortic aneurysm at the renal level contacting the fourth portion of the duodenum.A ^(99)mTc-labeled RBC singlephoton emission CT(SPECT)/CT scan performed during bleeding symptoms revealed active bleeding at the duodenal level.According to his clinical symptoms(intermittent massive GI bleeding with hypovolemic shock,dizziness,dark red stool,and bloody vomitus)and the abdominal CTA and ^(99)mTc-labeled RBC SPECT/CT results,we suspected a small aneurysm and an aortoduodenal fistula.Subsequent duodenal excision and duodenojejunal anastomosis were performed.A 7-mm saccular aneurysm arising from the anterior wall of the abdominal aorta near the left renal artery was identified.Percutaneous intravascular stenting of the abdominal aorta was performed and his symptoms improved.CONCLUSION Our findings suggest that ^(99)mTc-labeled RBC SPECT/CT scanning can aid the diagnosis of a rare cause of active GI bleeding.