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
The fracture toughness of rocks is a critical fracturing parameter in geo-energy exploitation playing a significant role in fracture mechanics and hydraulic fracturing.The edge-notched disk bending(ENDB)specimens are ...The fracture toughness of rocks is a critical fracturing parameter in geo-energy exploitation playing a significant role in fracture mechanics and hydraulic fracturing.The edge-notched disk bending(ENDB)specimens are employed to measure the entire range of mixed-modeⅠ/Ⅲfracture toughness of Longmaxi shale.To theoretically interpret the fracture mechanisms,this research first introduces the detailed derivations of three established fracture criteria.By distinguishing the volumetric and distortional strain energy densities,an improved three-dimensional mean strain energy density(MSED)criterion is proposed.As the critical volumetric to distortional MSED ratio decreases,the transition from tensiondominated fracture to shear-dominated fracture is observed.Our results indicate that both peak load and applied energy increase significantly with the transition from pure mode I(i.e.,tension)to pure modeⅢ(i.e.,torsion or tearing)since mode-Ⅲcracking happens in a twisted manner and mode-Ⅰcracking occurs in a coplanar manner.The macroscopic fracture signatures are consistent with those of triaxial hydraulic fracturing.The average ratio of pure mode-Ⅲfracture toughness to pure mode-Ⅰfracture toughness is 0.68,indicating that the obtained mode-Ⅲfracture resistance for a tensionbased loading system is apparent rather than true.Compared to the three mainstream fracture criteria,the present fracture criterion exhibits greater competitiveness and can successfully evaluate and predict mixed-modeⅠ/Ⅲfracture toughness of distinct materials and loading methods.展开更多
AIM:To survey irritable bowel syndrome(IBS) using Rome Ⅲ criteria among Malays from the north-eastern region of Peninsular Malaysia.METHODS:A previously validated Malay language Rome Ⅲ IBS diagnostic questionnaire w...AIM:To survey irritable bowel syndrome(IBS) using Rome Ⅲ criteria among Malays from the north-eastern region of Peninsular Malaysia.METHODS:A previously validated Malay language Rome Ⅲ IBS diagnostic questionnaire was used in the current study.A prospective sample of 232 Malay subjects(80% power) was initially screened.Using a stratified random sampling strategy,a total of 221 Malay subjects(112 subjects in a "full time job" and 109 subjects in "no full time job") were recruited.Subjects were visitors(friends and relatives) within the hospital compound and were representative of the local community.Red flags and psychosocial alarm symptoms were also assessed in the current study using previously translated and validated questionnaires.Subjects with IBS were sub-typed into constipation-predominant,diarrhea-predominant,mixed type and un-subtyped.Univariable and multivariable analyses were used to test for association between socioeconomic factors and presence of red flags and psychosocial alarm features among the Malays with IBS.RESULTS:IBS was present in 10.9%(24/221),red flags in 22.2%(49/221) and psychosocial alarm features in 9.0%(20/221).Red flags were more commonly reported in subjects with IBS(83.3%) than psychosocial alarm features(20.8%,P < 0.001).Subjects with IBS were older(mean age 41.4 years vs 36.9 years,P = 0.08),but no difference in gender was noted(P = 0.4).Using univariable analysis,IBS was significantly associated with a tertiary education,high individual income above RM1000,married status,exsmoker and the presence of red flags(all P < 0.05).In multiple logistic regression analysis,only the presence of red flags was significantly associated with IBS(odds ratio:0.02,95%CI:0.004-0.1,P < 0.001).The commonest IBS sub-type was mixed type(58.3%),followed by constipation-predominant(20.8%),diarrheapredominant(16.7%) and un-subtyped(4.2%).Four of 13 Malay females(30.8%) with IBS also had menstrual pain.Most subjects with IBS had at least one red flag(70.8%),12.5% had two red flags and 16.7% with no red flags.The commonest red flag was a bowel habit change in subjects > 50 years old and this was reported by 16.7% of subjects with IBS.CONCLUSION:Using the Rome Ⅲ criteria,IBS was common among ethnic Malays from the north-eastern region of Peninsular Malaysia.展开更多
Functional gastrointestinal disorders （FGIDs） represent a common and important class of disorders within gastroenterology. Rome Ⅰ, the first edition was published in 1994, with symptom-based diagnostic criteria for...Functional gastrointestinal disorders （FGIDs） represent a common and important class of disorders within gastroenterology. Rome Ⅰ, the first edition was published in 1994, with symptom-based diagnostic criteria for FGIDs. These criteria began to change the diagnostic approach to F-GIDs, and no longer considered ＂diagnoses of exclusion＂ but rather ＂diagnoses of inclusion＂. Rome Ⅱ, the second edition published in 2000, resulted from the continual process of analyzing new scientific and clinical evidence in the study of F-GIDs. Rome Ⅱ, diagnostic criteria for irritable bowel syndrome （IBS）, was extended with a focus on the frequency of symptoms occurring twelve weeks （not necessarily consecutive weeks） within twelve months. ROlE Ⅲ, the third edition, conservative one, was published in September 2006, with changes made only where there is good evidence to do so. Some of the differences between Rome Ⅱ and Rome Ⅲ criteria are highlighted in this issue.展开更多
Introduction: Irritable bowel syndrome (IBS) is a known public health burden in western countries while only a few studies have been published on this disease in Africa. The objective of this study was to determine th...Introduction: Irritable bowel syndrome (IBS) is a known public health burden in western countries while only a few studies have been published on this disease in Africa. The objective of this study was to determine the prevalence of IBS in the general adult population of Cotonou (Benin), its associated risk factors and its impact on patients’ daily life. Method: This was a descriptive and analytical cross-sectional study conducted over one month. Data was collected via a questionnaire. IBS was defined by the Rome IV criteria. Results: A total of 768 participants were included, with a male predominance (sex ratio 1.8). The mean age of the participants was 30.6 years, with extremes of 15 to 76 years. The prevalence of IBS in our study was 4.2%. IBS-D was the most common subtype (34.4%). IBS symptoms were influenced by diet (46.9%), stress (31.3%) and lack of sleep (15.6%). In the univariate analysis, the risk factors associated with IBS were: Dendi and Otamari ethnicity (p = 0.015), low level of education (p = 0.047), family history of IBS (p = 0.026), smoking (p Conclusion: Despite IBS frequency, patients with IBS rarely seek medical attention. The public should therefore be informed about this condition to reduce its impact on their daily life.展开更多
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.
基金supported by National Natural Science Foundation of China(Grant Nos.52364004,52264006,and 52164001).
文摘The fracture toughness of rocks is a critical fracturing parameter in geo-energy exploitation playing a significant role in fracture mechanics and hydraulic fracturing.The edge-notched disk bending(ENDB)specimens are employed to measure the entire range of mixed-modeⅠ/Ⅲfracture toughness of Longmaxi shale.To theoretically interpret the fracture mechanisms,this research first introduces the detailed derivations of three established fracture criteria.By distinguishing the volumetric and distortional strain energy densities,an improved three-dimensional mean strain energy density(MSED)criterion is proposed.As the critical volumetric to distortional MSED ratio decreases,the transition from tensiondominated fracture to shear-dominated fracture is observed.Our results indicate that both peak load and applied energy increase significantly with the transition from pure mode I(i.e.,tension)to pure modeⅢ(i.e.,torsion or tearing)since mode-Ⅲcracking happens in a twisted manner and mode-Ⅰcracking occurs in a coplanar manner.The macroscopic fracture signatures are consistent with those of triaxial hydraulic fracturing.The average ratio of pure mode-Ⅲfracture toughness to pure mode-Ⅰfracture toughness is 0.68,indicating that the obtained mode-Ⅲfracture resistance for a tensionbased loading system is apparent rather than true.Compared to the three mainstream fracture criteria,the present fracture criterion exhibits greater competitiveness and can successfully evaluate and predict mixed-modeⅠ/Ⅲfracture toughness of distinct materials and loading methods.
基金Supported by Malaysian Society of Gastroenterology and Hepatology Research Award 2008
文摘AIM:To survey irritable bowel syndrome(IBS) using Rome Ⅲ criteria among Malays from the north-eastern region of Peninsular Malaysia.METHODS:A previously validated Malay language Rome Ⅲ IBS diagnostic questionnaire was used in the current study.A prospective sample of 232 Malay subjects(80% power) was initially screened.Using a stratified random sampling strategy,a total of 221 Malay subjects(112 subjects in a "full time job" and 109 subjects in "no full time job") were recruited.Subjects were visitors(friends and relatives) within the hospital compound and were representative of the local community.Red flags and psychosocial alarm symptoms were also assessed in the current study using previously translated and validated questionnaires.Subjects with IBS were sub-typed into constipation-predominant,diarrhea-predominant,mixed type and un-subtyped.Univariable and multivariable analyses were used to test for association between socioeconomic factors and presence of red flags and psychosocial alarm features among the Malays with IBS.RESULTS:IBS was present in 10.9%(24/221),red flags in 22.2%(49/221) and psychosocial alarm features in 9.0%(20/221).Red flags were more commonly reported in subjects with IBS(83.3%) than psychosocial alarm features(20.8%,P < 0.001).Subjects with IBS were older(mean age 41.4 years vs 36.9 years,P = 0.08),but no difference in gender was noted(P = 0.4).Using univariable analysis,IBS was significantly associated with a tertiary education,high individual income above RM1000,married status,exsmoker and the presence of red flags(all P < 0.05).In multiple logistic regression analysis,only the presence of red flags was significantly associated with IBS(odds ratio:0.02,95%CI:0.004-0.1,P < 0.001).The commonest IBS sub-type was mixed type(58.3%),followed by constipation-predominant(20.8%),diarrheapredominant(16.7%) and un-subtyped(4.2%).Four of 13 Malay females(30.8%) with IBS also had menstrual pain.Most subjects with IBS had at least one red flag(70.8%),12.5% had two red flags and 16.7% with no red flags.The commonest red flag was a bowel habit change in subjects > 50 years old and this was reported by 16.7% of subjects with IBS.CONCLUSION:Using the Rome Ⅲ criteria,IBS was common among ethnic Malays from the north-eastern region of Peninsular Malaysia.
文摘Functional gastrointestinal disorders （FGIDs） represent a common and important class of disorders within gastroenterology. Rome Ⅰ, the first edition was published in 1994, with symptom-based diagnostic criteria for FGIDs. These criteria began to change the diagnostic approach to F-GIDs, and no longer considered ＂diagnoses of exclusion＂ but rather ＂diagnoses of inclusion＂. Rome Ⅱ, the second edition published in 2000, resulted from the continual process of analyzing new scientific and clinical evidence in the study of F-GIDs. Rome Ⅱ, diagnostic criteria for irritable bowel syndrome （IBS）, was extended with a focus on the frequency of symptoms occurring twelve weeks （not necessarily consecutive weeks） within twelve months. ROlE Ⅲ, the third edition, conservative one, was published in September 2006, with changes made only where there is good evidence to do so. Some of the differences between Rome Ⅱ and Rome Ⅲ criteria are highlighted in this issue.
文摘Introduction: Irritable bowel syndrome (IBS) is a known public health burden in western countries while only a few studies have been published on this disease in Africa. The objective of this study was to determine the prevalence of IBS in the general adult population of Cotonou (Benin), its associated risk factors and its impact on patients’ daily life. Method: This was a descriptive and analytical cross-sectional study conducted over one month. Data was collected via a questionnaire. IBS was defined by the Rome IV criteria. Results: A total of 768 participants were included, with a male predominance (sex ratio 1.8). The mean age of the participants was 30.6 years, with extremes of 15 to 76 years. The prevalence of IBS in our study was 4.2%. IBS-D was the most common subtype (34.4%). IBS symptoms were influenced by diet (46.9%), stress (31.3%) and lack of sleep (15.6%). In the univariate analysis, the risk factors associated with IBS were: Dendi and Otamari ethnicity (p = 0.015), low level of education (p = 0.047), family history of IBS (p = 0.026), smoking (p Conclusion: Despite IBS frequency, patients with IBS rarely seek medical attention. The public should therefore be informed about this condition to reduce its impact on their daily life.
