AIM:To investigate the effect of dietary fiber intake on constipation by a meta-analysis of randomized controlled trials(RCTs).METHODS:We searched Ovid MEDLINE(from 1946 to October 2011),Cochrane Library(2011),PubMed ...AIM:To investigate the effect of dietary fiber intake on constipation by a meta-analysis of randomized controlled trials(RCTs).METHODS:We searched Ovid MEDLINE(from 1946 to October 2011),Cochrane Library(2011),PubMed for articles on dietary fiber intake and constipation using the terms:constipation,fiber,cellulose,plant extracts,cereals,bran,psyllium,or plantago.References of important articles were searched manually for relevant studies.Articles were eligible for the meta-analysis if they were high-quality RCTs and reported data on stool frequency,stool consistency,treatment success,laxative use and gastrointestinal symptoms.The data were extracted independently by two researchers(Yang J and Wang HP) according to the described selection criteria.Review manager version 5 software was used for analysis and test.Weighted mean difference with 95%CI was used for quantitative data,odds ratio(OR)with 95%CI was used for dichotomous data.Both I2 statistic with a cut-off of ≥ 50% and the χ2 test with a P value < 0.10 were used to define a significant degree of heterogeneity.RESULTS:We searched 1322 potential relevant articles,19 of which were retrieved for further assessment,14 studies were excluded for various reasons,five studies were included in the analysis.Dietary fiber showed significant advantage over placebo in stool frequency(OR = 1.19;95%CI:0.58-1.80,P < 0.05).There was no significant difference in stool consistency,treatment success,laxative use and painful defecation between the two groups.Stool frequency were reported by five RCTs,all results showed either a trend or a significant difference in favor of the treatment group,number of stools per week increased in treatment group than in placebo group(OR = 1.19;95%CI:0.58-1.80,P < 0.05),with no significant heterogeneity among studies(I2= 0,P = 0.77).Four studies evaluated stool consistency,one of them presented outcome in terms of percentage of hard stool,which was different from others,so we included the other three studies for analysis.Two studies reported 展开更多
AIM:To compare genotype of Helicobacter pylori(H.pylori) isolated from saliva,dental plaques,gastric biopsy,and stool of each patient in order to evaluate the mode of transmission of H.pylori infection.METHODS:This cr...AIM:To compare genotype of Helicobacter pylori(H.pylori) isolated from saliva,dental plaques,gastric biopsy,and stool of each patient in order to evaluate the mode of transmission of H.pylori infection.METHODS:This cross-sectional descriptive study was performed on 300 antral gastric biopsy,saliva,dental plaque and stool samples which were obtained from patients undergoing upper gastrointestinal tract endoscopy referred to endoscopy centre of Hajar hospital of Shahrekord,Iran from March 2010 to February 2011.Initially,H.pylori strains were identified by rapid urease test(RUT) and polymerase chain reaction(PCR) were applied to determine the presence of H.pylori(ureC) and for genotyping of voculating cytotoxin gene A(vacA) and cytotoxin associated gene A(cagA) genesin each specimen.Finally the data were analyzed by using statistical formulas such as Chi-square and Fisher's exact tests to find any significant relationship between these genes and patient's diseases.P < 0.05 was considered statistically significant,RESULTS:Of 300 gastric biopsy samples,77.66% were confirmed to be H.pylori positive by PCR assay while this bacterium were detected in 10.72% of saliva,71.67% of stool samples.We were not able to find it in dental plaque specimens.The prevalence of H.pylori was 90.47% among patients with peptic ulcer disease(PUD),80% among patients with gastric cancer,and 74.13% among patients with none ulcer dyspepsia(NUD) by PCR assay.The evaluation of vacA and cagA genes showed 6 differences between gastric biopsy and saliva specimens and 11 differences between gastric and stool specimens.94.42% of H.pylori positive specimens were cagA positive and all samples had amplified band both for vacA s and m regions.There was significant relationship between vacA s1a/m1a and PUD diseases(P = 0.04),s2/m2 genotype and NUD diseases(P = 0.05).No statically significant relationship was found between cagA status with clinical outcomes and vacA genotypes(P = 0.65).The evaluation of vacA and cagA genes showed 6 differences between gastr展开更多
AIM: To investigate the effect of a fermented milk containing Bifidobacterium lactis DN-173010 and yogurt strains (BIO) on adult women with constipation in Beijing.METHODS: A total of 135 adult females with constipati...AIM: To investigate the effect of a fermented milk containing Bifidobacterium lactis DN-173010 and yogurt strains (BIO) on adult women with constipation in Beijing.METHODS: A total of 135 adult females with constipation were randomly allocated to consume for 2 wk either 100 g of the test fermented milk or 100 g of an acidified milk containing non-living bacteria (control).Stool frequency,defecation condition scores,stool consistency and food intake were recorded at baseline and after 1 and 2 wk in an intention-to-treat population of 126 subjects.In parallel,safety evaluation parameters were performed.RESULTS: At baseline,no differences were found between groups.Following consumption of test product,stool frequency was significantly increased after 1 wk (3.5 ± 1.5 vs 2.4 ± 0.6,P < 0.01) and 2 wk (4.1 ± 1.7 vs 2.4 ± 0.6,P < 0.01),vs baseline.Similarly,after 1 and 2 wk,of test product consumption,defecation condition (1.1 ± 0.9 vs 1.9 ± 1.2,P < 0.01 and 0.8 ± 1.0 vs 1.9 ± 1.2,P < 0.01,respectively) and stool consistency (1.0 ± 0.8 vs 1.5 ± 1.1,P < 0.01 and 0.6 ± 0.8 vs 1.5 ± 1.1,P < 0.01,respectively) were significantly improved.Compared with the control group,stool frequency was also significantly increased (3.5 ± 1.5 vs 2.5 ± 0.9,P < 0.01 and 4.1 ± 1.7 vs 2.6 ± 1.0,P < 0.01,respectively),and defecation condition (1.1 ± 0.9 vs 1.6 ± 1.1,P < 0.01 and 0.8 ± 1.0 vs 1.6 ± 1.1,P < 0.01,respectively) and stool consistency (1.0 ± 0.8 vs 1.4 ± 1.0,P < 0.05 and 0.6 ± 0.8 vs 1.3 ± 1.0,P < 0.01,respectively) significantly decreased after 1 and 2 wk of product consumption.During the same period,food intake did not change between the two groups,and safety parameters of the subjects were within normal ranges.CONCLUSION: This study suggests a beneficial effect of a fermented milk containing B.lactis DN-173010 on stool frequency,defecation condition and stool consistency in adult women with constipation constipated women after 1 and 2 wk of consumption.展开更多
AIM: To investigate the feasibility of detecting aberrantly hypermethylated Wnt-antagonist gene promoters (SFRP2 and WIF-1) in fecal DNA as non-invasive biomarkers for early colorectal cancer (CRC).
AIM:To present a critical discussion of the efficacy of the faecal pyruvate kinase isoenzyme type M2(faecal M2-PK) test for colorectal cancer(CRC) screening based on the currently available studies.METHODS:A literatur...AIM:To present a critical discussion of the efficacy of the faecal pyruvate kinase isoenzyme type M2(faecal M2-PK) test for colorectal cancer(CRC) screening based on the currently available studies.METHODS:A literature search in PubMed and Embase was conducted using the following search terms:fecal Tumor M2-PK,faecal Tumour M2-PK,fecal M2-PK,faecal M2-PK,fecal pyruvate kinase,faecal pyruvate kinase,pyruvate kinase stool and M2-PK stool.RESULTS:Stool samples from 704 patients with CRC and from 11 412 healthy subjects have been investigated for faecal M2-PK concentrations in seventeen independent studies.The mean faecal M2-PK sensitivity was 80.3%;the specificity was 95.2%.Four studies compared faecal M2-PK head-to-head with guaiacbased faecal occult blood test(gFOBT).Faecal M2PK demonstrated a sensitivity of 81.1%,whereas the gFOBT detected only 36.9% of the CRCs.Eight independent studies investigated the sensitivity of faecal M2-PK for adenoma(n = 554),with the following sensitivities:adenoma < 1 cm in diameter:25%;adenoma > 1 cm:44%;adenoma of unspecified diameter:51%.In a direct comparison with gFOBT of adenoma > 1 cm in diameter,47% tested positive with the faecal M2-PK test,whereas the gFOBT detected only 27%.CONCLUSION:We recommend faecal M2-PK as a routine test for CRC screening.Faecal M2-PK closes a gap in clinical practice because it detects bleeding and nonbleeding tumors and adenoma with high sensitivity and specificity.展开更多
Considering the recommended indications for Helicobacter pylori(H.pylori)eradication therapy and the broad spectrum of available diagnostic methods,a reliable diagnosis is mandatory both before and after eradication t...Considering the recommended indications for Helicobacter pylori(H.pylori)eradication therapy and the broad spectrum of available diagnostic methods,a reliable diagnosis is mandatory both before and after eradication therapy.Only highly accurate tests should be used in clinical practice,and the sensitivity and specificity of an adequate test should exceed 90%.The choice of tests should take into account clinical circumstances,the likelihood ratio of positive and negative tests,the cost-effectiveness of the testing strategy and the availability of the tests.This review concerns some of the most recent developments in diagnostic methods of H.pylori infection,namely the contribution of novel endoscopic evaluation methodologies for the diagnosis of H.pylori infection,such as magnifying endoscopy techniques and chromoendoscopy.In addition,the diagnostic contribution of histology and the urea breath test was explored recently in specific clinical settings and patient groups.Recent studies recommend enhancing the number of biopsy fragments for the rapid urease test.Bacterial culture from the gastric biopsy is the gold standard technique,and is recommended for antibiotic susceptibility test.Serology is used for initial screening and the stool antigen test is particularly used when the urea breath test is not available,while molecular methods have gained attention mostly for detecting antibiotic resistance.展开更多
AIM： To detect tumor-associated DNA changes in stool samples among Iranian patients with colorectal cancer （CRC） compared to healthy individuals using BAT-26, p16 hypermethylation and long DNA markers. METHODS： St...AIM： To detect tumor-associated DNA changes in stool samples among Iranian patients with colorectal cancer （CRC） compared to healthy individuals using BAT-26, p16 hypermethylation and long DNA markers. METHODS： Stool DNA was isolated from 45 subjects including 25 CRC patients and 20 healthy individuals using a new, fast and easy extraction method. Long DNA associated with tumor was detected using polymerase chain reaction method. Microsatellite studies were performed utilizing denaturating polyacrylamide gel to determine the instability of BAT-26. Methylation status of p16 promoter was analyzed using methylation-specific PCR （MSP）. RESULTS： The results showed a significant difference in existence of long DNA （16 in patients vs 1 in controls, P 〈 0.001） and p16 （5 in patients vs none in controls, P = 0.043） in the stool samples of two groups. Long DNA was detected in 64% of CRC patients; whereas just one of the healthy individuals was positive for Long DNA. p16 methylation was found in 20% of patients and in none of healthy individuals. Instability of BATo26 was not detected in any of stool samples. CONCLUSION： We could detect colorectal cancer related genetic alterations by analyzing stool DNA with a sensitivity of 64% and 20% and a specificity of 95% and 100% for Long DNA and p16 respectively. A non- invasive molecular stool-based DNA testing can provide a screening strategy in high-risk individuals. However, additional testing on more samples is necessary from Iranian subjects to determine the exact specificity and sensitivity of these markers.展开更多
Colorectal cancer(CRC)is a global problem affecting millions of people worldwide.This disease is unique because of its slow progress that makes it preventable and often curable.CRC symptoms usually emerge only at adva...Colorectal cancer(CRC)is a global problem affecting millions of people worldwide.This disease is unique because of its slow progress that makes it preventable and often curable.CRC symptoms usually emerge only at advanced stages of the disease,consequently its early detection can be achieved only through active population screening,which markedly reduces mortality due to this cancer.CRC screening tests that employ non-invasively detectable biomarkers are currently being actively developed and,in most cases,samples of either stool or blood are used.However,alternative biological substances that can be collected non-invasively(colorectal mucus,urine,saliva,exhaled air)have now emerged as new sources of diagnostic biomarkers.The main categories of currently explored CRC biomarkers are:(1)Proteins(comprising widely used haemoglobin);(2)DNA(including mutations and methylation markers);(3)RNA(in particular microRNAs);(4)Low molecular weight metabolites(comprising volatile organic compounds)detectable by metabolomic techniques;and(5)Shifts in gut microbiome composition.Numerous tests for early CRC detection employing such non-invasive biomarkers have been proposed and clinically studied.While some of these studies generated promising early results,very few of the proposed tests have been transformed into clinically validated diagnostic/screening techniques.Such DNA-based tests as Food and Drug Administration-approved multitarget stool test(marketed as Cologuard®)or blood test for methylated septin 9(marketed as Epi proColon®2.0 CE)show good diagnostic performance but remain too expensive and technically complex to become effective CRC screening tools.It can be concluded that,despite its deficiencies,the protein(haemoglobin)detection-based faecal immunochemical test(FIT)today presents the most cost-effective option for non-invasive CRC screening.The combination of non-invasive FIT and confirmatory invasive colonoscopy is the current strategy of choice for CRC screening.However,continuing intense research in the area pr展开更多
AIM: To describe the ages at diagnosis and operation of biliary atresia(BA) and its incidence over a 15-year period in Taiwan.METHODS: This was a population-based cohort study. BA cases were identified from the Taiwan...AIM: To describe the ages at diagnosis and operation of biliary atresia(BA) and its incidence over a 15-year period in Taiwan.METHODS: This was a population-based cohort study. BA cases were identified from the Taiwan National Health Insurance Research Database based on the International Classification of Diseases,Ninth Revision(ICD-9) code of BA 751.61 plus Kasai operation(ICD-9 procedure code 51.37) or liver transplantation(LT,ICD-9 procedure code 50.5). The patients' characteristics including sex,age at diagnosis,age at receiving Kasai operation and age at receiving LT were compared among three birth cohorts:(1) 1997 to 2001;(2) 2002 to 2006; and(3) 2007 to 2011.RESULTS: There were a total of 540 BA cases(275 females) with an incidence of 1.62 per 10000 live births. No seasonality of BA was noted. The mean ages at diagnosis of three cohorts were 57.9,55.6 and 52.6 d.A linear regression model demonstrated a decreasing trend of the mean age at diagnosis(1.27 d per year). The proportion of BA cases that received the Kasai operation within 60 d of age increased from 76% to 81%. A total of 189(35%) BA patients underwent LT. The mean age at LT was reduced from 3-year-old to 1-year-old. The rates of LT were 25.6% and 32.3% in patients who received the Kasai operation within 60 d or after 60 d of age,respectively. All patients who did not undergo a Kasai operation eventually required LT.CONCLUSION: The ages at diagnosis and operation in BA cases have decreased over time. Kasai operation performed at younger age reduces the need for LT. The incidence of BA in Taiwan fluctuates,but without certain trend.展开更多
Background Constipation is a common problem in children with spastic cerebral palsy(sCP)with a prevalence that reaches 75%.We hypothesized that treating constipation in those children will improve their health and sho...Background Constipation is a common problem in children with spastic cerebral palsy(sCP)with a prevalence that reaches 75%.We hypothesized that treating constipation in those children will improve their health and shorten time spent in daily care.Our aim was to evaluate the efficacy and safety of oral magnesium sulfate for treating chronic constipation in children with sCP.Methods A prospective,double-blinded randomized control trial was carried out involving 100 children aged 2-12 years with sCP(level Ⅲ-Ⅴ of the Gross Motor Functional Classification system)and chronic constipation.They were followed up in the Pediatric neurology clinic,Children's hospital,Ain Shams University,May 2017-January 2019.The intervention group(O-Mg)received oral magnesium sulfate 1 mL/kg/day daily for 1 month compared to the placebo.Outcome measures were constipation improvement and decrease in bowel evacuation time after 1 month.Results Initially,weekly bowel movements,constipation scores and stool consistency were comparable in both groups.After 1 month of regular administration of oral magnesium sulfate,the constipation score,stool frequency and consistency improved compared to the placebo group(P<0.001).Effective safe treatment was achieved in 31(68%)and 4(9.5%)patients in the O-Mg and placebo groups,respectively(RR,2.95;95%CI 2.0-4.5)(P<0.001).Painful bowel evacuation attempts spent by mothers decreased from 25(55.6%)of the cases initially to 10(22%)cases after one month in the O-Mg group(P=0.001).In contrast,in the placebo group,the decrease went from 21(50%)cases initially to 18(42.9%)after 1 month and was not significant(P=0.5).Conclusions Oral magnesium sulfate seems effective in alleviating chronic constipation and pain experience in children with sCP.Consequently,saving maternal time spent in daily bowel evacuation attempts.展开更多
Stool antigen tests(SATs)are noninvasive diagnostic modules for Helicobacter pylori(H.pylori)infection.Two types of SATs exist for the diagnosis of H.pylori infection,one based on enzyme immunoassay(EIA)and another on...Stool antigen tests(SATs)are noninvasive diagnostic modules for Helicobacter pylori(H.pylori)infection.Two types of SATs exist for the diagnosis of H.pylori infection,one based on enzyme immunoassay(EIA)and another on immunochromatography(ICA).SATs do not require expensive chemical agents or specified equipment;hence,they are less expensive compared with the urea breath test.Both European and Japanese guidelines have shown that EIA-based SATs using monoclonal antibodies are useful for primary diagnosis as well as for the assessment of eradication therapy.ICA-based tests do not require particular equipment and are therefore useful in developing countries.SATs are also useful for the diagnosis of H.pylori infection in children and post gastric surgery patients.SATs performed via EIA can assess H.pylori infection in a large number of subjects,almost as well as serology.Thus,SATs would be useful or detecting current infection in such a survey to identify and eradicate H.pylori infection.The accuracy of SATs is lower when the stool samples are unformed or watery,because H.pylorispecific antigens in the stool samples are diluted.Temperature and the interval between stool sample collection and measurement also affect the results of SATs.The choice of test kit depends on the sensitivity and specificity in each region and the circumstances of each patient.展开更多
Objective:To verify the effectiveness of acupuncture for diarrhea-predominant irritable bowel syndrome(IBS-D).Methods:Sixty-five patients with IBS-D were randomized into an acupuncture group(33 cases)and a sham-acupun...Objective:To verify the effectiveness of acupuncture for diarrhea-predominant irritable bowel syndrome(IBS-D).Methods:Sixty-five patients with IBS-D were randomized into an acupuncture group(33 cases)and a sham-acupuncture group(32 cases).In the acupuncture group,Tiānshū(天枢ST25),Zhōngwǎn(中脘CV12),Zúsānlǐ(足三里ST36),Shàngjùxū(上巨虚ST37),Gōngsūn(公孙SP4),Fēnglóng(丰隆ST40),Zhāngmén(章门LR13)and Yīnlíngquán(阴陵泉SP9)were selected and stimulated with routine acupuncture technique,once every two days,3 times weekly,for 8 weeks consecutively,24 times in total.In the shamacupuncture group,the sham-acupoints were selected,0.5 cun or 1 cun superior,inferior,lateral or medial to the corresponding points separately.The blunt-tip needles were used to stimulate only the skin surface of each point.The treatment frequency and courses were the same as the acupuncture group.Before treatment,in 4 weeks of treatment,after treatment and in follow-up,the changes in the score of IBS symptom severity scale(IBS-SSS),Bristol stool form scale and defecation satisfaction were observed in the patients of two groups.After treatment,the effectiveness was assessed in the two groups.Results:In 4 weeks of treatment,after treatment and in follow-up,IBS-SSS score,Bristol stool form scale and defecation satisfaction were all lower than those before treatment in either group(all P<0.01).Bristol stool form scale in the acupuncture group was lower than that in the sham-acupuncture group in4 weeks of treatment,after treatment and in follow-up,while,IBS-SSS score and defecation satisfaction were lower than the sham-acupuncture group in follow-up(all P<0.05).Conclusion:Acupuncture can effectively relieve diarrhea and improves defecation satisfaction in the patients with IBS-D.展开更多
文摘AIM:To investigate the effect of dietary fiber intake on constipation by a meta-analysis of randomized controlled trials(RCTs).METHODS:We searched Ovid MEDLINE(from 1946 to October 2011),Cochrane Library(2011),PubMed for articles on dietary fiber intake and constipation using the terms:constipation,fiber,cellulose,plant extracts,cereals,bran,psyllium,or plantago.References of important articles were searched manually for relevant studies.Articles were eligible for the meta-analysis if they were high-quality RCTs and reported data on stool frequency,stool consistency,treatment success,laxative use and gastrointestinal symptoms.The data were extracted independently by two researchers(Yang J and Wang HP) according to the described selection criteria.Review manager version 5 software was used for analysis and test.Weighted mean difference with 95%CI was used for quantitative data,odds ratio(OR)with 95%CI was used for dichotomous data.Both I2 statistic with a cut-off of ≥ 50% and the χ2 test with a P value < 0.10 were used to define a significant degree of heterogeneity.RESULTS:We searched 1322 potential relevant articles,19 of which were retrieved for further assessment,14 studies were excluded for various reasons,five studies were included in the analysis.Dietary fiber showed significant advantage over placebo in stool frequency(OR = 1.19;95%CI:0.58-1.80,P < 0.05).There was no significant difference in stool consistency,treatment success,laxative use and painful defecation between the two groups.Stool frequency were reported by five RCTs,all results showed either a trend or a significant difference in favor of the treatment group,number of stools per week increased in treatment group than in placebo group(OR = 1.19;95%CI:0.58-1.80,P < 0.05),with no significant heterogeneity among studies(I2= 0,P = 0.77).Four studies evaluated stool consistency,one of them presented outcome in terms of percentage of hard stool,which was different from others,so we included the other three studies for analysis.Two studies reported
基金Supported by The Islamic Azad University,Shahre Kord Branch-Iran grant 89/8761
文摘AIM:To compare genotype of Helicobacter pylori(H.pylori) isolated from saliva,dental plaques,gastric biopsy,and stool of each patient in order to evaluate the mode of transmission of H.pylori infection.METHODS:This cross-sectional descriptive study was performed on 300 antral gastric biopsy,saliva,dental plaque and stool samples which were obtained from patients undergoing upper gastrointestinal tract endoscopy referred to endoscopy centre of Hajar hospital of Shahrekord,Iran from March 2010 to February 2011.Initially,H.pylori strains were identified by rapid urease test(RUT) and polymerase chain reaction(PCR) were applied to determine the presence of H.pylori(ureC) and for genotyping of voculating cytotoxin gene A(vacA) and cytotoxin associated gene A(cagA) genesin each specimen.Finally the data were analyzed by using statistical formulas such as Chi-square and Fisher's exact tests to find any significant relationship between these genes and patient's diseases.P < 0.05 was considered statistically significant,RESULTS:Of 300 gastric biopsy samples,77.66% were confirmed to be H.pylori positive by PCR assay while this bacterium were detected in 10.72% of saliva,71.67% of stool samples.We were not able to find it in dental plaque specimens.The prevalence of H.pylori was 90.47% among patients with peptic ulcer disease(PUD),80% among patients with gastric cancer,and 74.13% among patients with none ulcer dyspepsia(NUD) by PCR assay.The evaluation of vacA and cagA genes showed 6 differences between gastric biopsy and saliva specimens and 11 differences between gastric and stool specimens.94.42% of H.pylori positive specimens were cagA positive and all samples had amplified band both for vacA s and m regions.There was significant relationship between vacA s1a/m1a and PUD diseases(P = 0.04),s2/m2 genotype and NUD diseases(P = 0.05).No statically significant relationship was found between cagA status with clinical outcomes and vacA genotypes(P = 0.65).The evaluation of vacA and cagA genes showed 6 differences between gastr
基金Danone (Shanghai) Consulting Co.Ltd115 national science and technology program
文摘AIM: To investigate the effect of a fermented milk containing Bifidobacterium lactis DN-173010 and yogurt strains (BIO) on adult women with constipation in Beijing.METHODS: A total of 135 adult females with constipation were randomly allocated to consume for 2 wk either 100 g of the test fermented milk or 100 g of an acidified milk containing non-living bacteria (control).Stool frequency,defecation condition scores,stool consistency and food intake were recorded at baseline and after 1 and 2 wk in an intention-to-treat population of 126 subjects.In parallel,safety evaluation parameters were performed.RESULTS: At baseline,no differences were found between groups.Following consumption of test product,stool frequency was significantly increased after 1 wk (3.5 ± 1.5 vs 2.4 ± 0.6,P < 0.01) and 2 wk (4.1 ± 1.7 vs 2.4 ± 0.6,P < 0.01),vs baseline.Similarly,after 1 and 2 wk,of test product consumption,defecation condition (1.1 ± 0.9 vs 1.9 ± 1.2,P < 0.01 and 0.8 ± 1.0 vs 1.9 ± 1.2,P < 0.01,respectively) and stool consistency (1.0 ± 0.8 vs 1.5 ± 1.1,P < 0.01 and 0.6 ± 0.8 vs 1.5 ± 1.1,P < 0.01,respectively) were significantly improved.Compared with the control group,stool frequency was also significantly increased (3.5 ± 1.5 vs 2.5 ± 0.9,P < 0.01 and 4.1 ± 1.7 vs 2.6 ± 1.0,P < 0.01,respectively),and defecation condition (1.1 ± 0.9 vs 1.6 ± 1.1,P < 0.01 and 0.8 ± 1.0 vs 1.6 ± 1.1,P < 0.01,respectively) and stool consistency (1.0 ± 0.8 vs 1.4 ± 1.0,P < 0.05 and 0.6 ± 0.8 vs 1.3 ± 1.0,P < 0.01,respectively) significantly decreased after 1 and 2 wk of product consumption.During the same period,food intake did not change between the two groups,and safety parameters of the subjects were within normal ranges.CONCLUSION: This study suggests a beneficial effect of a fermented milk containing B.lactis DN-173010 on stool frequency,defecation condition and stool consistency in adult women with constipation constipated women after 1 and 2 wk of consumption.
基金Supported by The National Natural Science Foundation of China,No.81101868The Natural Science Foundation of Hubei Province of China,No.2011CDB505
文摘AIM: To investigate the feasibility of detecting aberrantly hypermethylated Wnt-antagonist gene promoters (SFRP2 and WIF-1) in fecal DNA as non-invasive biomarkers for early colorectal cancer (CRC).
文摘AIM:To present a critical discussion of the efficacy of the faecal pyruvate kinase isoenzyme type M2(faecal M2-PK) test for colorectal cancer(CRC) screening based on the currently available studies.METHODS:A literature search in PubMed and Embase was conducted using the following search terms:fecal Tumor M2-PK,faecal Tumour M2-PK,fecal M2-PK,faecal M2-PK,fecal pyruvate kinase,faecal pyruvate kinase,pyruvate kinase stool and M2-PK stool.RESULTS:Stool samples from 704 patients with CRC and from 11 412 healthy subjects have been investigated for faecal M2-PK concentrations in seventeen independent studies.The mean faecal M2-PK sensitivity was 80.3%;the specificity was 95.2%.Four studies compared faecal M2-PK head-to-head with guaiacbased faecal occult blood test(gFOBT).Faecal M2PK demonstrated a sensitivity of 81.1%,whereas the gFOBT detected only 36.9% of the CRCs.Eight independent studies investigated the sensitivity of faecal M2-PK for adenoma(n = 554),with the following sensitivities:adenoma < 1 cm in diameter:25%;adenoma > 1 cm:44%;adenoma of unspecified diameter:51%.In a direct comparison with gFOBT of adenoma > 1 cm in diameter,47% tested positive with the faecal M2-PK test,whereas the gFOBT detected only 27%.CONCLUSION:We recommend faecal M2-PK as a routine test for CRC screening.Faecal M2-PK closes a gap in clinical practice because it detects bleeding and nonbleeding tumors and adenoma with high sensitivity and specificity.
文摘Considering the recommended indications for Helicobacter pylori(H.pylori)eradication therapy and the broad spectrum of available diagnostic methods,a reliable diagnosis is mandatory both before and after eradication therapy.Only highly accurate tests should be used in clinical practice,and the sensitivity and specificity of an adequate test should exceed 90%.The choice of tests should take into account clinical circumstances,the likelihood ratio of positive and negative tests,the cost-effectiveness of the testing strategy and the availability of the tests.This review concerns some of the most recent developments in diagnostic methods of H.pylori infection,namely the contribution of novel endoscopic evaluation methodologies for the diagnosis of H.pylori infection,such as magnifying endoscopy techniques and chromoendoscopy.In addition,the diagnostic contribution of histology and the urea breath test was explored recently in specific clinical settings and patient groups.Recent studies recommend enhancing the number of biopsy fragments for the rapid urease test.Bacterial culture from the gastric biopsy is the gold standard technique,and is recommended for antibiotic susceptibility test.Serology is used for initial screening and the stool antigen test is particularly used when the urea breath test is not available,while molecular methods have gained attention mostly for detecting antibiotic resistance.
基金Supported by a grant from the vice chancellor for research at Mashhad University of Medical Sciences,NO. 84082
文摘AIM： To detect tumor-associated DNA changes in stool samples among Iranian patients with colorectal cancer （CRC） compared to healthy individuals using BAT-26, p16 hypermethylation and long DNA markers. METHODS： Stool DNA was isolated from 45 subjects including 25 CRC patients and 20 healthy individuals using a new, fast and easy extraction method. Long DNA associated with tumor was detected using polymerase chain reaction method. Microsatellite studies were performed utilizing denaturating polyacrylamide gel to determine the instability of BAT-26. Methylation status of p16 promoter was analyzed using methylation-specific PCR （MSP）. RESULTS： The results showed a significant difference in existence of long DNA （16 in patients vs 1 in controls, P 〈 0.001） and p16 （5 in patients vs none in controls, P = 0.043） in the stool samples of two groups. Long DNA was detected in 64% of CRC patients; whereas just one of the healthy individuals was positive for Long DNA. p16 methylation was found in 20% of patients and in none of healthy individuals. Instability of BATo26 was not detected in any of stool samples. CONCLUSION： We could detect colorectal cancer related genetic alterations by analyzing stool DNA with a sensitivity of 64% and 20% and a specificity of 95% and 100% for Long DNA and p16 respectively. A non- invasive molecular stool-based DNA testing can provide a screening strategy in high-risk individuals. However, additional testing on more samples is necessary from Iranian subjects to determine the exact specificity and sensitivity of these markers.
文摘Colorectal cancer(CRC)is a global problem affecting millions of people worldwide.This disease is unique because of its slow progress that makes it preventable and often curable.CRC symptoms usually emerge only at advanced stages of the disease,consequently its early detection can be achieved only through active population screening,which markedly reduces mortality due to this cancer.CRC screening tests that employ non-invasively detectable biomarkers are currently being actively developed and,in most cases,samples of either stool or blood are used.However,alternative biological substances that can be collected non-invasively(colorectal mucus,urine,saliva,exhaled air)have now emerged as new sources of diagnostic biomarkers.The main categories of currently explored CRC biomarkers are:(1)Proteins(comprising widely used haemoglobin);(2)DNA(including mutations and methylation markers);(3)RNA(in particular microRNAs);(4)Low molecular weight metabolites(comprising volatile organic compounds)detectable by metabolomic techniques;and(5)Shifts in gut microbiome composition.Numerous tests for early CRC detection employing such non-invasive biomarkers have been proposed and clinically studied.While some of these studies generated promising early results,very few of the proposed tests have been transformed into clinically validated diagnostic/screening techniques.Such DNA-based tests as Food and Drug Administration-approved multitarget stool test(marketed as Cologuard®)or blood test for methylated septin 9(marketed as Epi proColon®2.0 CE)show good diagnostic performance but remain too expensive and technically complex to become effective CRC screening tools.It can be concluded that,despite its deficiencies,the protein(haemoglobin)detection-based faecal immunochemical test(FIT)today presents the most cost-effective option for non-invasive CRC screening.The combination of non-invasive FIT and confirmatory invasive colonoscopy is the current strategy of choice for CRC screening.However,continuing intense research in the area pr
基金Supported by The Ditmanson Medical Foundation Chia-Yi Christian Hospital Research ProgramNo.R102-11
文摘AIM: To describe the ages at diagnosis and operation of biliary atresia(BA) and its incidence over a 15-year period in Taiwan.METHODS: This was a population-based cohort study. BA cases were identified from the Taiwan National Health Insurance Research Database based on the International Classification of Diseases,Ninth Revision(ICD-9) code of BA 751.61 plus Kasai operation(ICD-9 procedure code 51.37) or liver transplantation(LT,ICD-9 procedure code 50.5). The patients' characteristics including sex,age at diagnosis,age at receiving Kasai operation and age at receiving LT were compared among three birth cohorts:(1) 1997 to 2001;(2) 2002 to 2006; and(3) 2007 to 2011.RESULTS: There were a total of 540 BA cases(275 females) with an incidence of 1.62 per 10000 live births. No seasonality of BA was noted. The mean ages at diagnosis of three cohorts were 57.9,55.6 and 52.6 d.A linear regression model demonstrated a decreasing trend of the mean age at diagnosis(1.27 d per year). The proportion of BA cases that received the Kasai operation within 60 d of age increased from 76% to 81%. A total of 189(35%) BA patients underwent LT. The mean age at LT was reduced from 3-year-old to 1-year-old. The rates of LT were 25.6% and 32.3% in patients who received the Kasai operation within 60 d or after 60 d of age,respectively. All patients who did not undergo a Kasai operation eventually required LT.CONCLUSION: The ages at diagnosis and operation in BA cases have decreased over time. Kasai operation performed at younger age reduces the need for LT. The incidence of BA in Taiwan fluctuates,but without certain trend.
文摘Background Constipation is a common problem in children with spastic cerebral palsy(sCP)with a prevalence that reaches 75%.We hypothesized that treating constipation in those children will improve their health and shorten time spent in daily care.Our aim was to evaluate the efficacy and safety of oral magnesium sulfate for treating chronic constipation in children with sCP.Methods A prospective,double-blinded randomized control trial was carried out involving 100 children aged 2-12 years with sCP(level Ⅲ-Ⅴ of the Gross Motor Functional Classification system)and chronic constipation.They were followed up in the Pediatric neurology clinic,Children's hospital,Ain Shams University,May 2017-January 2019.The intervention group(O-Mg)received oral magnesium sulfate 1 mL/kg/day daily for 1 month compared to the placebo.Outcome measures were constipation improvement and decrease in bowel evacuation time after 1 month.Results Initially,weekly bowel movements,constipation scores and stool consistency were comparable in both groups.After 1 month of regular administration of oral magnesium sulfate,the constipation score,stool frequency and consistency improved compared to the placebo group(P<0.001).Effective safe treatment was achieved in 31(68%)and 4(9.5%)patients in the O-Mg and placebo groups,respectively(RR,2.95;95%CI 2.0-4.5)(P<0.001).Painful bowel evacuation attempts spent by mothers decreased from 25(55.6%)of the cases initially to 10(22%)cases after one month in the O-Mg group(P=0.001).In contrast,in the placebo group,the decrease went from 21(50%)cases initially to 18(42.9%)after 1 month and was not significant(P=0.5).Conclusions Oral magnesium sulfate seems effective in alleviating chronic constipation and pain experience in children with sCP.Consequently,saving maternal time spent in daily bowel evacuation attempts.
文摘Stool antigen tests(SATs)are noninvasive diagnostic modules for Helicobacter pylori(H.pylori)infection.Two types of SATs exist for the diagnosis of H.pylori infection,one based on enzyme immunoassay(EIA)and another on immunochromatography(ICA).SATs do not require expensive chemical agents or specified equipment;hence,they are less expensive compared with the urea breath test.Both European and Japanese guidelines have shown that EIA-based SATs using monoclonal antibodies are useful for primary diagnosis as well as for the assessment of eradication therapy.ICA-based tests do not require particular equipment and are therefore useful in developing countries.SATs are also useful for the diagnosis of H.pylori infection in children and post gastric surgery patients.SATs performed via EIA can assess H.pylori infection in a large number of subjects,almost as well as serology.Thus,SATs would be useful or detecting current infection in such a survey to identify and eradicate H.pylori infection.The accuracy of SATs is lower when the stool samples are unformed or watery,because H.pylorispecific antigens in the stool samples are diluted.Temperature and the interval between stool sample collection and measurement also affect the results of SATs.The choice of test kit depends on the sensitivity and specificity in each region and the circumstances of each patient.
基金Supported by Evaluation of the clinical effect of acupuncture on diarrhea-type irritable bowel syndrome:2017S382。
文摘Objective:To verify the effectiveness of acupuncture for diarrhea-predominant irritable bowel syndrome(IBS-D).Methods:Sixty-five patients with IBS-D were randomized into an acupuncture group(33 cases)and a sham-acupuncture group(32 cases).In the acupuncture group,Tiānshū(天枢ST25),Zhōngwǎn(中脘CV12),Zúsānlǐ(足三里ST36),Shàngjùxū(上巨虚ST37),Gōngsūn(公孙SP4),Fēnglóng(丰隆ST40),Zhāngmén(章门LR13)and Yīnlíngquán(阴陵泉SP9)were selected and stimulated with routine acupuncture technique,once every two days,3 times weekly,for 8 weeks consecutively,24 times in total.In the shamacupuncture group,the sham-acupoints were selected,0.5 cun or 1 cun superior,inferior,lateral or medial to the corresponding points separately.The blunt-tip needles were used to stimulate only the skin surface of each point.The treatment frequency and courses were the same as the acupuncture group.Before treatment,in 4 weeks of treatment,after treatment and in follow-up,the changes in the score of IBS symptom severity scale(IBS-SSS),Bristol stool form scale and defecation satisfaction were observed in the patients of two groups.After treatment,the effectiveness was assessed in the two groups.Results:In 4 weeks of treatment,after treatment and in follow-up,IBS-SSS score,Bristol stool form scale and defecation satisfaction were all lower than those before treatment in either group(all P<0.01).Bristol stool form scale in the acupuncture group was lower than that in the sham-acupuncture group in4 weeks of treatment,after treatment and in follow-up,while,IBS-SSS score and defecation satisfaction were lower than the sham-acupuncture group in follow-up(all P<0.05).Conclusion:Acupuncture can effectively relieve diarrhea and improves defecation satisfaction in the patients with IBS-D.
