Yue Zhao, Ji Yu Zhang, Saif Ullah, Qing Fen Zheng, Dan Liu, Meng Wang, Li Xia Zhao, Miao Shi, De Liang Li, Bing Rong Liu
Objective
To evaluate the feasibility, safety, and efficacy of massive continuous irrigation (MCI) and endoscopic debridement for the treatment of refractory abscess–fistula complexes.
Methods
This was a retrospective single-center observational study involving 12 patients with refractory abscess–fistula complexes. All patients had experienced long-term treatment failure or had failed multiple treatment modalities. We used over two catheters and inserted them via the gastrointestinal (GI) tract or percutaneously to form a circulation pathway to achieve MCI of normal saline, endoscopic debridement was then performed. The treatment success rate, irrigation volume and treatment duration, time to abscess–fistula complex closure, intra-treatment complications, and recurrence rate were recorded.
Results
The treatment success rates were 100%. The median time of previous treatment was 32 days (range 7–912 days). The mean time from the use of the novel treatment strategy to abscess–fistula complex healing was 18.8 ± 11.0 days. The mean volume of irrigation was 10 804 ± 1669 mL/24 h. The mean irrigation time was 16.5 ± 9.2 days, and a median of two irrigation tubes (range 2–5) were used. No complications occurred either during or after the procedure. During the follow-up of 23.1 ± 18.1 months, no recurrence or adverse events were noted.
Conclusions
MCI and endoscopic debridement may be a feasible, safe, and effective alternative treatment for refractory abscess–fistula complexes. Large prospective studies are needed to validate our results.
{"title":"Massive continuous irrigation (MCI) and endoscopic debridement as an alternative treatment strategy for refractory abscess-fistula complexes","authors":"Yue Zhao, Ji Yu Zhang, Saif Ullah, Qing Fen Zheng, Dan Liu, Meng Wang, Li Xia Zhao, Miao Shi, De Liang Li, Bing Rong Liu","doi":"10.1111/1751-2980.13257","DOIUrl":"10.1111/1751-2980.13257","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To evaluate the feasibility, safety, and efficacy of massive continuous irrigation (MCI) and endoscopic debridement for the treatment of refractory abscess–fistula complexes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This was a retrospective single-center observational study involving 12 patients with refractory abscess–fistula complexes. All patients had experienced long-term treatment failure or had failed multiple treatment modalities. We used over two catheters and inserted them via the gastrointestinal (GI) tract or percutaneously to form a circulation pathway to achieve MCI of normal saline, endoscopic debridement was then performed. The treatment success rate, irrigation volume and treatment duration, time to abscess–fistula complex closure, intra-treatment complications, and recurrence rate were recorded.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The treatment success rates were 100%. The median time of previous treatment was 32 days (range 7–912 days). The mean time from the use of the novel treatment strategy to abscess–fistula complex healing was 18.8 ± 11.0 days. The mean volume of irrigation was 10 804 ± 1669 mL/24 h. The mean irrigation time was 16.5 ± 9.2 days, and a median of two irrigation tubes (range 2–5) were used. No complications occurred either during or after the procedure. During the follow-up of 23.1 ± 18.1 months, no recurrence or adverse events were noted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MCI and endoscopic debridement may be a feasible, safe, and effective alternative treatment for refractory abscess–fistula complexes. Large prospective studies are needed to validate our results.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"25 2","pages":"133-139"},"PeriodicalIF":3.5,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140174967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chuan Liu, Ji Xiang Zhang, Jin Ting Li, Yu Ping Wei, Jun Hai Zhen, Yan Rui Wu, Hao Dong He, Ying Chen, Jia Yi Sun, Cheng Tan, Shuo Wang, Qiu Tang Xiong, Fei Liao, Xiao Cui Yang, Ping An, Zhong Chun Liu, Chang Qing Jiang, Jie Shi, Kai Chun Wu, Wei Guo Dong, the Psychology Club of Inflammatory Bowel Disease Group, Chinese Society of Gastroenterology, Chinese Medical Association, Chinese Association for Mental Hygiene
Objective
We aimed to explore the geographic differences in psychological symptoms, sleep quality, and quality of life (QoL) among adult patients with inflammatory bowel disease (IBD).
Methods
A unified questionnaire was developed to collect data on psychological status and QoL of IBD patients from 42 hospitals across 22 provinces, municipalities, and autonomous regions in China's mainland from September 2021 to May 2022.
Results
A total of 2478 patients with IBD were surveyed. The proportions of patients with anxiety (28.5% vs 23.1%), depression (32.3% vs 27.8%), and poor QoL (44.8% vs 32.2%) were significantly higher in patients from the northern region compared to the southern region (all P < 0.05). In the western region, the proportions of patients with anxiety (31.9% vs 23.0%), depression (37.7% vs 26.7%), sleep disturbances (64.5% vs 58.5%), and poor QoL (44.9% vs 34.8%) were significantly higher than in the eastern and central regions (all P < 0.01). Patients from inland regions had significantly higher rates of anxiety (27.1% vs 23.3%), depression (32.5% vs 26.0%), sleep disturbance (62.0% vs 57.7%), and poor QoL (43.5% vs 29.9%) compared to those from coastal regions (all P < 0.05). In economically underdeveloped areas, the proportions of patients with depression (33.1% vs 28.5%) and poor QoL (52.0% vs 32.4%) were significantly higher than in economically (relatively) developed areas (both P < 0.05).
Conclusion
There are significant geographic differences in psychological symptoms, sleep quality, and QoL among Chinese patients with IBD, which might provide valuable insights for global IBD research and clinical practice.
目的我们旨在探讨成年炎症性肠病（IBD）患者在心理症状、睡眠质量和生活质量（QoL）方面的地域差异：方法： 采用统一的调查问卷，收集 2021 年 9 月至 2022 年 5 月中国大陆 22 个省、市、自治区 42 家医院 IBD 患者的心理状态和 QoL 数据：共调查了 2478 名 IBD 患者。与南方地区相比，北方地区患者的焦虑（28.5% vs 23.1%）、抑郁（32.3% vs 27.8%）和生活质量差（44.8% vs 32.2%）的比例明显更高（均为 P 结论：北方地区与南方地区的心理症状存在显著的地域差异：中国 IBD 患者在心理症状、睡眠质量和 QoL 方面存在明显的地域差异，这可能会为全球 IBD 研究和临床实践提供有价值的启示。
{"title":"Geographic differences in psychological symptoms, sleep quality, and quality of life in patients with inflammatory bowel disease: A multicenter study in China","authors":"Chuan Liu, Ji Xiang Zhang, Jin Ting Li, Yu Ping Wei, Jun Hai Zhen, Yan Rui Wu, Hao Dong He, Ying Chen, Jia Yi Sun, Cheng Tan, Shuo Wang, Qiu Tang Xiong, Fei Liao, Xiao Cui Yang, Ping An, Zhong Chun Liu, Chang Qing Jiang, Jie Shi, Kai Chun Wu, Wei Guo Dong, the Psychology Club of Inflammatory Bowel Disease Group, Chinese Society of Gastroenterology, Chinese Medical Association, Chinese Association for Mental Hygiene","doi":"10.1111/1751-2980.13259","DOIUrl":"10.1111/1751-2980.13259","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>We aimed to explore the geographic differences in psychological symptoms, sleep quality, and quality of life (QoL) among adult patients with inflammatory bowel disease (IBD).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A unified questionnaire was developed to collect data on psychological status and QoL of IBD patients from 42 hospitals across 22 provinces, municipalities, and autonomous regions in China's mainland from September 2021 to May 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 2478 patients with IBD were surveyed. The proportions of patients with anxiety (28.5% vs 23.1%), depression (32.3% vs 27.8%), and poor QoL (44.8% vs 32.2%) were significantly higher in patients from the northern region compared to the southern region (all <i>P</i> < 0.05). In the western region, the proportions of patients with anxiety (31.9% vs 23.0%), depression (37.7% vs 26.7%), sleep disturbances (64.5% vs 58.5%), and poor QoL (44.9% vs 34.8%) were significantly higher than in the eastern and central regions (all <i>P</i> < 0.01). Patients from inland regions had significantly higher rates of anxiety (27.1% vs 23.3%), depression (32.5% vs 26.0%), sleep disturbance (62.0% vs 57.7%), and poor QoL (43.5% vs 29.9%) compared to those from coastal regions (all <i>P</i> < 0.05). In economically underdeveloped areas, the proportions of patients with depression (33.1% vs 28.5%) and poor QoL (52.0% vs 32.4%) were significantly higher than in economically (relatively) developed areas (both <i>P</i> < 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There are significant geographic differences in psychological symptoms, sleep quality, and QoL among Chinese patients with IBD, which might provide valuable insights for global IBD research and clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"25 2","pages":"109-122"},"PeriodicalIF":3.5,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140174966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Qi Bai Tian, Shui Jiao Chen, Li Jun Xiao, Jia Qi Xie, Hong Bo Zhao, Xian Zhang
Inflammatory bowel disease (IBD), mainly comprising ulcerative colitis and Crohn's disease, is a group of gradually progressive diseases bringing significant mental anguish and imposes serious economic burdens. Interplay of genetic, environmental, and immunological factors have been implicated in its pathogenesis. Nutrients, as crucial environmental determinants, mainly encompassing carbohydrates, fats, proteins, and micronutrients, are closely related to the pathogenesis and development of IBD. Nutrition is essential for maintaining the dynamic balance of intestinal eco-environments to ensure intestinal barrier and immune homeostasis, while this balance can be disrupted easily by maladjusted nutrition. Research has firmly established that nutrition has the potential to shape the composition and function of gut microbiota to affect the disease course. Unhealthy diet and eating disorders lead to gut microbiota dysbiosis and further destroy the function of intestinal barrier such as the disruption of membrane integrity and increased permeability, thereby triggering intestinal inflammation. Notably, appropriate nutritional interventions, such as the Mediterranean diet, can positively modulate intestinal microecology, which may provide a promising strategy for future IBD prevention. In this review, we provide insights into the interplay between nutrition and gut microbiota and its effects on IBD and present some previously overlooked lines of evidence regarding the role of derived metabolites in IBD processes, such as trimethylamine N-oxide and imidazole propionate. Furthermore, we provide some insights into reducing the risk of onset and exacerbation of IBD by modifying nutrition and discuss several outstanding challenges and opportunities for future study.
{"title":"Potential effects of nutrition-induced alteration of gut microbiota on inflammatory bowel disease: A review","authors":"Qi Bai Tian, Shui Jiao Chen, Li Jun Xiao, Jia Qi Xie, Hong Bo Zhao, Xian Zhang","doi":"10.1111/1751-2980.13256","DOIUrl":"10.1111/1751-2980.13256","url":null,"abstract":"<p>Inflammatory bowel disease (IBD), mainly comprising ulcerative colitis and Crohn's disease, is a group of gradually progressive diseases bringing significant mental anguish and imposes serious economic burdens. Interplay of genetic, environmental, and immunological factors have been implicated in its pathogenesis. Nutrients, as crucial environmental determinants, mainly encompassing carbohydrates, fats, proteins, and micronutrients, are closely related to the pathogenesis and development of IBD. Nutrition is essential for maintaining the dynamic balance of intestinal eco-environments to ensure intestinal barrier and immune homeostasis, while this balance can be disrupted easily by maladjusted nutrition. Research has firmly established that nutrition has the potential to shape the composition and function of gut microbiota to affect the disease course. Unhealthy diet and eating disorders lead to gut microbiota dysbiosis and further destroy the function of intestinal barrier such as the disruption of membrane integrity and increased permeability, thereby triggering intestinal inflammation. Notably, appropriate nutritional interventions, such as the Mediterranean diet, can positively modulate intestinal microecology, which may provide a promising strategy for future IBD prevention. In this review, we provide insights into the interplay between nutrition and gut microbiota and its effects on IBD and present some previously overlooked lines of evidence regarding the role of derived metabolites in IBD processes, such as trimethylamine N-oxide and imidazole propionate. Furthermore, we provide some insights into reducing the risk of onset and exacerbation of IBD by modifying nutrition and discuss several outstanding challenges and opportunities for future study.</p>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"25 2","pages":"78-90"},"PeriodicalIF":3.5,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140049594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cong Ding, Jian Feng Yang, Bin Yang, Wen Lu, Xia Wang, Yi Feng Zhou, Xiao Feng Zhang
{"title":"A pancreaticogastric fistula related to intraductal papillary mucinous neoplasm of the pancreas developed during follow-up: A case report and literature review","authors":"Cong Ding, Jian Feng Yang, Bin Yang, Wen Lu, Xia Wang, Yi Feng Zhou, Xiao Feng Zhang","doi":"10.1111/1751-2980.13255","DOIUrl":"10.1111/1751-2980.13255","url":null,"abstract":"","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"25 2","pages":"140-146"},"PeriodicalIF":3.5,"publicationDate":"2024-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140021887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yan Sheng Liu, Gui Jia, Da Wei Ding, Lin Hua Zheng, Rui Qing Sun, Xiu Fang Wang, Juan Deng, Chun Mei Yang, Li Na Cui, Chang Cun Guo, Yu Long Shang, Ying Han
Objectives
Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease that affects the quality of life (QoL) of patients. This study aimed to evaluate the differences in perceptions of PBC among physicians from different hospital departments and patients with PBC.
Methods
An online survey regarding the general knowledge, diagnosis, and management of PBC was completed by physicians and patients.
Results
A total of 239 patients with PBC and 239 physicians from eight hospital departments (gastroenterology, infectious diseases, rheumatology, hepatobiliary surgery, pathology, clinical laboratory, ultrasound, and radiology) completed the survey. The results showed that physicians from departments other than gastroenterologists and rheumatologists lacked knowledge of PBC, and that junior gastroenterologists were uncertain about the diagnostic and treatment pathways of PBC. Importantly, the lack of knowledge significantly impacted the QoL of patients, especially the emotional scores of PBC-40 (odds ratio −2.556, 95% confidence interval −3.852 to −1.260, P < 0.001). In addition, there was a perceived knowledge gap between patients and gastroenterologists.
Conclusions
Physicians must improve their awareness of PBC. Patient education and patient–physician communication are important for improving the patient's QoL.
{"title":"Differences in the perceptions of patients with primary biliary cholangitis and physicians from various hospital departments: An online survey","authors":"Yan Sheng Liu, Gui Jia, Da Wei Ding, Lin Hua Zheng, Rui Qing Sun, Xiu Fang Wang, Juan Deng, Chun Mei Yang, Li Na Cui, Chang Cun Guo, Yu Long Shang, Ying Han","doi":"10.1111/1751-2980.13254","DOIUrl":"10.1111/1751-2980.13254","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease that affects the quality of life (QoL) of patients. This study aimed to evaluate the differences in perceptions of PBC among physicians from different hospital departments and patients with PBC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>An online survey regarding the general knowledge, diagnosis, and management of PBC was completed by physicians and patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 239 patients with PBC and 239 physicians from eight hospital departments (gastroenterology, infectious diseases, rheumatology, hepatobiliary surgery, pathology, clinical laboratory, ultrasound, and radiology) completed the survey. The results showed that physicians from departments other than gastroenterologists and rheumatologists lacked knowledge of PBC, and that junior gastroenterologists were uncertain about the diagnostic and treatment pathways of PBC. Importantly, the lack of knowledge significantly impacted the QoL of patients, especially the emotional scores of PBC-40 (odds ratio −2.556, 95% confidence interval −3.852 to −1.260, <i>P</i> < 0.001). In addition, there was a perceived knowledge gap between patients and gastroenterologists.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Physicians must improve their awareness of PBC. Patient education and patient–physician communication are important for improving the patient's QoL.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"25 1","pages":"61-69"},"PeriodicalIF":3.5,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1751-2980.13254","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139972086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Song Feng Chen, Xing Yu Jia, Xun Hou, Mi Mi Tang, Nian Di Tan, Meng Yu Zhang, Ying Lian Xiao, Jin Hui Wang
{"title":"High-resolution manometry evaluation and endoscopic myotomy for pediatric cricopharyngeal achalasia: A case report and literature review","authors":"Song Feng Chen, Xing Yu Jia, Xun Hou, Mi Mi Tang, Nian Di Tan, Meng Yu Zhang, Ying Lian Xiao, Jin Hui Wang","doi":"10.1111/1751-2980.13253","DOIUrl":"10.1111/1751-2980.13253","url":null,"abstract":"","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"25 1","pages":"70-74"},"PeriodicalIF":3.5,"publicationDate":"2024-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tian Hui Zou, Qin Yan Gao, Si De Liu, Yan Qing Li, Xiang Jun Meng, Guo Xin Zhang, Zi Bin Tian, Xiao Ping Zou, Song He, Xiao Hua Hou, Rong Lin, Jing Nan Li, Zhong Yin Zhou, Yan Li, Meng Chun Wang, Bang Mao Wang, De An Tian, Shu Jie Chen, Qian Cao, Liang Ping Li, Zhi Rong Wang, Xi Zhong Shen, Bing Rong Liu, Xiao Yan Yan, Ying Xuan Chen, Jing-Yuan Fang
Objective
To investigate the clinical potential and safety of Moluodan to reverse gastric precancerous lesions.
Methods
Patients aged 18–70 years diagnosed with moderate-to-severe atrophy and/or moderate-to-severe intestinal metaplasia, with or without low-grade dysplasia, and negative for Helicobacter pylori were recruited in this randomized, double-blind, parallel-controlled trial. The primary outcome was the improvement of global histological diagnosis at 1-year follow-up endoscopy using the operative link for gastritis assessment, the operative link for gastric intestinal metaplasia assessment, and the disappearance rate of dysplasia.
Results
Between November 3, 2017 and January 27, 2021, 166 subjects were randomly assigned to the Moluodan group, 168 to the folic acid group, 84 to the combination group, and 84 to the high-dose Moluodan group. The improvement in global histological diagnosis was achieved in 60 (39.5%) subjects receiving Moluodan, 59 (37.8%) receiving folic acid, 26 (32.1%) receiving the combined drugs, and 36 (47.4%) receiving high-dose Moluodan. Moluodan was non-inferior to folic acid (95% confidence interval: −9.2 to 12.5; P = 0.02). High-dose Moluodan had a trend for better protective efficacy, though there was no statistical significance. The disappearance rate of dysplasia was 82.8% in the Moluodan group, which was superior to folic acid (53.9%; P = 0.006). No drug-related serious adverse events were observed.
Conclusions
One pack of Moluodan three times daily for 1 year was safe and effective in reversing gastric precancerous lesions, especially dysplasia. Doubling its dose showed a better efficacy trend.
{"title":"Effectiveness and safety of Moluodan in the treatment of precancerous lesions of gastric cancer: A randomized clinical trial","authors":"Tian Hui Zou, Qin Yan Gao, Si De Liu, Yan Qing Li, Xiang Jun Meng, Guo Xin Zhang, Zi Bin Tian, Xiao Ping Zou, Song He, Xiao Hua Hou, Rong Lin, Jing Nan Li, Zhong Yin Zhou, Yan Li, Meng Chun Wang, Bang Mao Wang, De An Tian, Shu Jie Chen, Qian Cao, Liang Ping Li, Zhi Rong Wang, Xi Zhong Shen, Bing Rong Liu, Xiao Yan Yan, Ying Xuan Chen, Jing-Yuan Fang","doi":"10.1111/1751-2980.13251","DOIUrl":"10.1111/1751-2980.13251","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate the clinical potential and safety of Moluodan to reverse gastric precancerous lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients aged 18–70 years diagnosed with moderate-to-severe atrophy and/or moderate-to-severe intestinal metaplasia, with or without low-grade dysplasia, and negative for <i>Helicobacter pylori</i> were recruited in this randomized, double-blind, parallel-controlled trial. The primary outcome was the improvement of global histological diagnosis at 1-year follow-up endoscopy using the operative link for gastritis assessment, the operative link for gastric intestinal metaplasia assessment, and the disappearance rate of dysplasia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between November 3, 2017 and January 27, 2021, 166 subjects were randomly assigned to the Moluodan group, 168 to the folic acid group, 84 to the combination group, and 84 to the high-dose Moluodan group. The improvement in global histological diagnosis was achieved in 60 (39.5%) subjects receiving Moluodan, 59 (37.8%) receiving folic acid, 26 (32.1%) receiving the combined drugs, and 36 (47.4%) receiving high-dose Moluodan. Moluodan was non-inferior to folic acid (95% confidence interval: −9.2 to 12.5; <i>P</i> = 0.02). High-dose Moluodan had a trend for better protective efficacy, though there was no statistical significance. The disappearance rate of dysplasia was 82.8% in the Moluodan group, which was superior to folic acid (53.9%; <i>P</i> = 0.006). No drug-related serious adverse events were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>One pack of Moluodan three times daily for 1 year was safe and effective in reversing gastric precancerous lesions, especially dysplasia. Doubling its dose showed a better efficacy trend.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"25 1","pages":"27-35"},"PeriodicalIF":3.5,"publicationDate":"2024-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139717633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cai Ling Li, Kai Zhou, Yue Xi Zhang, Bao Jun Suo, Xue Li Tian, Yu Xin Zhang, Xin Lu Ren, Yan Yan Shi, Li Ya Zhou, Zhi Qiang Song
Objectives
We aimed to explore the efficacy and safety of tailored therapy guided by genotypic resistance in the first-line treatment of Helicobacter pylori (H. pylori) infection in treatment-naive patients.
Methods
Gastric mucosal specimens were taken during gastroscopy, and main mutations of clarithromycin- and levofloxacin-resistant genes were detected by polymerase chain reaction (PCR). Sensitive antibiotics were selected individually for treating H. pylori infection with tailored bismuth-containing quadruple therapy (BQT) consisting of esomeprazole 20 mg twice daily, bismuth potassium citrate 220 mg twice daily, amoxicillin 1 g twice daily, and clarithromycin 500 mg twice daily, or levofloxacin 500 mg once daily, or metronidazole 400 mg four times daily. Safety and patient compliance were assessed 1–3 days after eradication. Treatment outcome was evaluated by urea breath test 4–8 weeks after eradication.
Results
One hundred and thirty-two treatment-naive patients with H. pylori infection were included. PCR results suggested resistance rates of 47.7% and 34.9% for clarithromycin and levofloxacin, respectively, and a dual resistance rate of 18.2%. Eradication rates of tailored BQT were 87.1% and 95.8% by intention-to-treat (ITT) analysis and per-protocol (PP) analysis, respectively. There was no statistically significant difference in the efficacy of 7-day clarithromycin-containing, 7-day levofloxacin-containing, and 14-day full-dose metronidazole-containing BQT (ITT analysis: P = 0.488; PP analysis: P = 0.833). The incidence of adverse events was 19.7%, and patient compliance was 97.7%.
Conclusion
Tailored BQT guided by genotypic resistance can achieve satisfactory efficacy, safety, and patient compliance in the first-line treatment of H. pylori infection.
{"title":"Tailored therapy guided by genotypic resistance of clarithromycin and levofloxacin detected by polymerase chain reaction in the first-line treatment of Helicobacter pylori infection","authors":"Cai Ling Li, Kai Zhou, Yue Xi Zhang, Bao Jun Suo, Xue Li Tian, Yu Xin Zhang, Xin Lu Ren, Yan Yan Shi, Li Ya Zhou, Zhi Qiang Song","doi":"10.1111/1751-2980.13250","DOIUrl":"10.1111/1751-2980.13250","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>We aimed to explore the efficacy and safety of tailored therapy guided by genotypic resistance in the first-line treatment of <i>Helicobacter pylori</i> (<i>H. pylori</i>) infection in treatment-naive patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Gastric mucosal specimens were taken during gastroscopy, and main mutations of clarithromycin- and levofloxacin-resistant genes were detected by polymerase chain reaction (PCR). Sensitive antibiotics were selected individually for treating <i>H. pylori</i> infection with tailored bismuth-containing quadruple therapy (BQT) consisting of esomeprazole 20 mg twice daily, bismuth potassium citrate 220 mg twice daily, amoxicillin 1 g twice daily, and clarithromycin 500 mg twice daily, or levofloxacin 500 mg once daily, or metronidazole 400 mg four times daily. Safety and patient compliance were assessed 1–3 days after eradication. Treatment outcome was evaluated by urea breath test 4–8 weeks after eradication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One hundred and thirty-two treatment-naive patients with <i>H. pylori</i> infection were included. PCR results suggested resistance rates of 47.7% and 34.9% for clarithromycin and levofloxacin, respectively, and a dual resistance rate of 18.2%. Eradication rates of tailored BQT were 87.1% and 95.8% by intention-to-treat (ITT) analysis and per-protocol (PP) analysis, respectively. There was no statistically significant difference in the efficacy of 7-day clarithromycin-containing, 7-day levofloxacin-containing, and 14-day full-dose metronidazole-containing BQT (ITT analysis: <i>P</i> = 0.488; PP analysis: <i>P</i> = 0.833). The incidence of adverse events was 19.7%, and patient compliance was 97.7%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Tailored BQT guided by genotypic resistance can achieve satisfactory efficacy, safety, and patient compliance in the first-line treatment of <i>H. pylori</i> infection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"25 1","pages":"36-43"},"PeriodicalIF":3.5,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139697539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xin Liu, Chun Hua Han, Tao Mao, Jie Wu, Le Yong Ke, Ying Jie Guo, Rong Shuang Han, Zi Bin Tian
Objective
The intestine is responsible for approximately one-third of uric acid (UA) excretion. The effect of commensal Enterococcus faecalis (E. faecalis), one of the most colonized bacteria in the gut, on UA excretion in the intestine remains to be investigated. The aim of this study was to evaluate the effect of commensal E. faecalis on UA metabolism and gut microbiota.
Methods
The 16S rRNA gene sequencing was used to examine the species of Enterococcus in mouse fecal content. E. faecalis strain was isolated from mouse feces and identified to be E. faecalis W5. The hyperuricemia (HUA) animal model was established with yeast-rich forage and 250 mg·kg−1·day−1 potassium oxonate. Oral administration of E. faecalis W5 was given for 20 days, serving as the Efa group.
Results
Disrupted intestinal barrier, activated proinflammatory response and low UA excretion in the intestine were found in HUA mice. After E. faecalis W5 treatment, the gut barrier was restored and serum UA level was decreased. Additionally, fecal and intestinal UA levels were elevated, intestinal urate transporter ABCG2 and purine metabolism were upregulated. Moreover, short-chain fatty acid levels were increased, and intestinal inflammation was ameliorated.
Conclusions
Commensal E. faecalis W5 ameliorated HUA through reversing the impaired gut barrier, promoting intestinal UA secretion by regulating ABCG2 expression, and decreasing intestinal UA synthesis by regulating purine metabolism. The results may provide the potential for developing treatments for HUA through the intestine.
{"title":"Commensal Enterococcus faecalis W5 ameliorates hyperuricemia and maintains the epithelial barrier in a hyperuricemia mouse model","authors":"Xin Liu, Chun Hua Han, Tao Mao, Jie Wu, Le Yong Ke, Ying Jie Guo, Rong Shuang Han, Zi Bin Tian","doi":"10.1111/1751-2980.13249","DOIUrl":"10.1111/1751-2980.13249","url":null,"abstract":"<div>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The intestine is responsible for approximately one-third of uric acid (UA) excretion. The effect of commensal <i>Enterococcus faecalis</i> (<i>E. faecalis</i>), one of the most colonized bacteria in the gut, on UA excretion in the intestine remains to be investigated. The aim of this study was to evaluate the effect of commensal <i>E. faecalis</i> on UA metabolism and gut microbiota.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The 16S rRNA gene sequencing was used to examine the species of <i>Enterococcus</i> in mouse fecal content. <i>E. faecalis</i> strain was isolated from mouse feces and identified to be <i>E. faecalis</i> W5. The hyperuricemia (HUA) animal model was established with yeast-rich forage and 250 mg·kg<sup>−1</sup>·day<sup>−1</sup> potassium oxonate. Oral administration of <i>E. faecalis</i> W5 was given for 20 days, serving as the Efa group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Disrupted intestinal barrier, activated proinflammatory response and low UA excretion in the intestine were found in HUA mice. After <i>E. faecalis</i> W5 treatment, the gut barrier was restored and serum UA level was decreased. Additionally, fecal and intestinal UA levels were elevated, intestinal urate transporter ABCG2 and purine metabolism were upregulated. Moreover, short-chain fatty acid levels were increased, and intestinal inflammation was ameliorated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Commensal <i>E. faecalis</i> W5 ameliorated HUA through reversing the impaired gut barrier, promoting intestinal UA secretion by regulating ABCG2 expression, and decreasing intestinal UA synthesis by regulating purine metabolism. The results may provide the potential for developing treatments for HUA through the intestine.</p>\u0000 </section>\u0000 </div>","PeriodicalId":15564,"journal":{"name":"Journal of Digestive Diseases","volume":"25 1","pages":"44-60"},"PeriodicalIF":3.5,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138824587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号