AIM: To assess the diagnostic value of a combination of continuous intragastric pH and bilirubin monitoring in the detection of duodenogastric reflux (DGR), and the effects of diet on the bilirubin absorbance. METHODS...AIM: To assess the diagnostic value of a combination of continuous intragastric pH and bilirubin monitoring in the detection of duodenogastric reflux (DGR), and the effects of diet on the bilirubin absorbance. METHODS: 30 healthy volunteers were divided into two groups: standard diet group (Group 1) 18 cases, free diet group (Group 2)12 cases. Each subjects were subjected to simultaneous 24-hour intragastric pH and spectrophotometric bilirubin concentration monitoring (Bilitec 2000). RESULTS: There was no difference of preprandial phase bilirubin absorbance between two groups. The absorbance of postprandial phase was significantly increased in group 2 than group 1. There was no difference between preprandial phase and postprandial phase absorbance in group 1. Postprandial phase absorbance was significantly higher in group 2. In a comparison of bile reflux with intragastric pH during night time, there were 4 types of reflux: Simultaneous increase in absorbance and pH in only 19.6%, increase in bilirubin with unchanged pH 33.3%, pH increase with unchanged absorbance 36.3%, and both unchanged in 10.8%. Linear regression analysis showed no correlation between percentage total time of pH【4 and percentage total time of absorbance】0.14, r=0.068 P【0.05. CONCLUSION: Because of the dietary effect, high absorbance fluids or foods should be avoided in detection. Intragastric pH and bilirubin monitoring separately predict the presence of duodenal (and/or pancreatic) reflux and bile reflux. They can not substitute for each other. The detection of DGR is improved if the two parameters are combined simultaneously.展开更多
INTRODUCTIONBirth asphyxia may lead to disturbances of gastroenteric motility of newborn infants[1.2] . The change of gut pressure and reflux are the major manifestations of the motor disturbance [3-9] . To evaluate t...INTRODUCTIONBirth asphyxia may lead to disturbances of gastroenteric motility of newborn infants[1.2] . The change of gut pressure and reflux are the major manifestations of the motor disturbance [3-9] . To evaluate the effects of perinatal asphyxia on the gastroenteric motility, gastric and esophageal pressure and double pH were measured in a group of asphyxiated newborns. And. their pathophysiological and anatomical effects on gastroenteric function were discussed.展开更多
AIM:With successful surgical treatment of gastroesophageal reflux disease(GERD),there is interest in understanding the anti-reflux barrier and its mechanisms of failure.To date, the potential use of vector volumes to ...AIM:With successful surgical treatment of gastroesophageal reflux disease(GERD),there is interest in understanding the anti-reflux barrier and its mechanisms of failure.To date, the potential use of vector volumes to predict the DeMeester score has not been adequately explored. METHODS:627 patients in the referral database received esophageal manometry and ambulatory 24-hour pH monitoring.Study data included LES resting pressure(LESP), overall LES length(OL)and abdominal length(AL),total vector volume(TVV)and intrabdominal vector volume(IVV). RESULTS:In cases where LESP,TVV or IVV were all below normal,there was an 81.4%probability of a positive DeMeester score.In cases where all three were normal, there was an 86.9%probability that the DeMeester score would be negative.Receiver-operating characteristics(ROC) for LESP,TVV and IVV were nearly identical and indicated no useful cut-off values.Logistic regression demonstrated that LESP and IVV had the strongest association with a positive DeMeester score;however,the regression formula was only 76.1%accurate. CONCLUSION:While the indices based on TVV,IVV and LESP are more sensitive and specific,respectively,than any single measurement,the measurement of vector volumes does not add significantly to the diagnosis of GERD.展开更多
INTRODUCTIONCrypt epithelial cells in normal small intestineproliferate at a high speed. But they are verydifficult to culture in vitro and passage stably. A lotof studies have been done[1-16]. Some domestic labsisola...INTRODUCTIONCrypt epithelial cells in normal small intestineproliferate at a high speed. But they are verydifficult to culture in vitro and passage stably. A lotof studies have been done[1-16]. Some domestic labsisolated and cultured crypt cells from embryonalintestines and aseptic animal intestine, but failed.We introduced normal rat epithelial cell line-IEC-6from the USA and its living condition for stablepassage was successfully established after trials. Thecell line was testified to be the small intestinalepithelial cell by electron microscopy,immunihistochemistry and enzymatic histoch-emistry. It has been applied to some relatedresearch work[17-21]. It was found that manyfactors were involved in the culture system. Ourpresent study focuses on the culture method and theinfluencing factors on IEC-6.展开更多
AIMS To establish optimal thresholds of pH variation(pH fluc- tuations and reflux episodes)in separating physiological and pathological gastroesophageal reflux(GER),and to evaluate their significance in the diagnosis ...AIMS To establish optimal thresholds of pH variation(pH fluc- tuations and reflux episodes)in separating physiological and pathological gastroesophageal reflux(GER),and to evaluate their significance in the diagnosis of GER disease. METHODS Twenty-four-hour intraesophageal pH monitoring and endoscopy were performed in 400 patients with GER symptoms and in 100 healthy controls. RESULTS The results showed that the percentages of the time with pH fluctuations in patients with and without esophagitis,and in healthy controls were,on average,12.65%,9.5% and 2. 76% in 24h,respectively,and the respective percentages of the time with reflux episodes in the same groups in 24h were,on average,3.12%,2.04% and 0.18%,respectively.Using a receiver-operating-characteristic curve analysis,<6.7% of the time with pH fluctuations and<0.1% of the time with reflux episodes were defined as the combined thresholds for physiologi- cal versus pathological reflux.The sensitivity of the combuned thresholds for the detection of GER patients with and without esophagitis was 96.7% and 90.0%,respectively,and their specificity for the diagnosis of patients with abnormal GER disease was 100%. CONCLUSIONS pH flucuations and reflux episodes,when e- valuated together,are more useful for classifying patients with GER and their combined thresholds yield higher diagnostic accura- cy in assessing patients with GER disease.展开更多
目的探讨24 h 咽喉 pH 检测在咽喉反流性疾病诊断中的价值。方法选取2006年8月至10月于北京同仁医院就诊由同一医师诊断可疑有反流性咽喉炎患者50例,征得患者同意后以就诊时间为配伍因素,按区组随机排列方法采用半随机分组。第一组25例...目的探讨24 h 咽喉 pH 检测在咽喉反流性疾病诊断中的价值。方法选取2006年8月至10月于北京同仁医院就诊由同一医师诊断可疑有反流性咽喉炎患者50例,征得患者同意后以就诊时间为配伍因素,按区组随机排列方法采用半随机分组。第一组25例患者均行24 h 咽喉 pH检测,筛选出阳性患者作为试验组接受奥美拉唑抗酸治疗;第二组25例患者直接给予相同药物及剂量的试验性抗酸治疗作为对照组。服药3个月后进行随访,根据反流症状评分对比治疗前后效果,以主观症状评估总分下降≤4分为治疗无效,>4分为有效。结果行24 h 咽喉 pH 检测的25例患者中有病理性咽喉部反流者17例,阳性率为68.0%(17/25)。24 h 平均总反流次数(35.71±41.70)次(±s,以下同),总反流时间(35.71±33.19)min,总反流指数即每小时反流次数(1.53±1.73)次/h,每次反流平均时间(1.12±0.91)min。抗酸治疗前试验组症状评估总分平均(14.88±4.11)分,对照组总分平均(13.00±4.17)分,组间差异采用 t 检验,无统计学意义(P>0.05)。在抗酸治疗3个月后随访,试验组有效率为82.4%(14/17),对照组失访2例,其余患者治疗有效率为52.2%(12/23)。试验组症状评估总分平均下降(7.47±3.18)分,对照组症状评估总分下降(3.96±4.25)分,总分差值比较,差异有统计学意义(P<0.01)。结论 24 h 咽喉 pH 检测作为诊断咽喉反流性疾病的金标准,可以作为临床中可疑咽喉反流患者的确诊检查手段,并可大大提高抗酸治疗的有效性,值得在临床普遍开展和推广。展开更多
基金the Public Health Ministry Foundation of China,No.06-9602-13
文摘AIM: To assess the diagnostic value of a combination of continuous intragastric pH and bilirubin monitoring in the detection of duodenogastric reflux (DGR), and the effects of diet on the bilirubin absorbance. METHODS: 30 healthy volunteers were divided into two groups: standard diet group (Group 1) 18 cases, free diet group (Group 2)12 cases. Each subjects were subjected to simultaneous 24-hour intragastric pH and spectrophotometric bilirubin concentration monitoring (Bilitec 2000). RESULTS: There was no difference of preprandial phase bilirubin absorbance between two groups. The absorbance of postprandial phase was significantly increased in group 2 than group 1. There was no difference between preprandial phase and postprandial phase absorbance in group 1. Postprandial phase absorbance was significantly higher in group 2. In a comparison of bile reflux with intragastric pH during night time, there were 4 types of reflux: Simultaneous increase in absorbance and pH in only 19.6%, increase in bilirubin with unchanged pH 33.3%, pH increase with unchanged absorbance 36.3%, and both unchanged in 10.8%. Linear regression analysis showed no correlation between percentage total time of pH【4 and percentage total time of absorbance】0.14, r=0.068 P【0.05. CONCLUSION: Because of the dietary effect, high absorbance fluids or foods should be avoided in detection. Intragastric pH and bilirubin monitoring separately predict the presence of duodenal (and/or pancreatic) reflux and bile reflux. They can not substitute for each other. The detection of DGR is improved if the two parameters are combined simultaneously.
基金Project supported ty the Research Fund of the Ministry of Healty of China,No.96-2-170(1996)
文摘INTRODUCTIONBirth asphyxia may lead to disturbances of gastroenteric motility of newborn infants[1.2] . The change of gut pressure and reflux are the major manifestations of the motor disturbance [3-9] . To evaluate the effects of perinatal asphyxia on the gastroenteric motility, gastric and esophageal pressure and double pH were measured in a group of asphyxiated newborns. And. their pathophysiological and anatomical effects on gastroenteric function were discussed.
文摘AIM:With successful surgical treatment of gastroesophageal reflux disease(GERD),there is interest in understanding the anti-reflux barrier and its mechanisms of failure.To date, the potential use of vector volumes to predict the DeMeester score has not been adequately explored. METHODS:627 patients in the referral database received esophageal manometry and ambulatory 24-hour pH monitoring.Study data included LES resting pressure(LESP), overall LES length(OL)and abdominal length(AL),total vector volume(TVV)and intrabdominal vector volume(IVV). RESULTS:In cases where LESP,TVV or IVV were all below normal,there was an 81.4%probability of a positive DeMeester score.In cases where all three were normal, there was an 86.9%probability that the DeMeester score would be negative.Receiver-operating characteristics(ROC) for LESP,TVV and IVV were nearly identical and indicated no useful cut-off values.Logistic regression demonstrated that LESP and IVV had the strongest association with a positive DeMeester score;however,the regression formula was only 76.1%accurate. CONCLUSION:While the indices based on TVV,IVV and LESP are more sensitive and specific,respectively,than any single measurement,the measurement of vector volumes does not add significantly to the diagnosis of GERD.
基金Supported by the National Natural Science Foundation of China, No.39100119
文摘INTRODUCTIONCrypt epithelial cells in normal small intestineproliferate at a high speed. But they are verydifficult to culture in vitro and passage stably. A lotof studies have been done[1-16]. Some domestic labsisolated and cultured crypt cells from embryonalintestines and aseptic animal intestine, but failed.We introduced normal rat epithelial cell line-IEC-6from the USA and its living condition for stablepassage was successfully established after trials. Thecell line was testified to be the small intestinalepithelial cell by electron microscopy,immunihistochemistry and enzymatic histoch-emistry. It has been applied to some relatedresearch work[17-21]. It was found that manyfactors were involved in the culture system. Ourpresent study focuses on the culture method and theinfluencing factors on IEC-6.
文摘AIMS To establish optimal thresholds of pH variation(pH fluc- tuations and reflux episodes)in separating physiological and pathological gastroesophageal reflux(GER),and to evaluate their significance in the diagnosis of GER disease. METHODS Twenty-four-hour intraesophageal pH monitoring and endoscopy were performed in 400 patients with GER symptoms and in 100 healthy controls. RESULTS The results showed that the percentages of the time with pH fluctuations in patients with and without esophagitis,and in healthy controls were,on average,12.65%,9.5% and 2. 76% in 24h,respectively,and the respective percentages of the time with reflux episodes in the same groups in 24h were,on average,3.12%,2.04% and 0.18%,respectively.Using a receiver-operating-characteristic curve analysis,<6.7% of the time with pH fluctuations and<0.1% of the time with reflux episodes were defined as the combined thresholds for physiologi- cal versus pathological reflux.The sensitivity of the combuned thresholds for the detection of GER patients with and without esophagitis was 96.7% and 90.0%,respectively,and their specificity for the diagnosis of patients with abnormal GER disease was 100%. CONCLUSIONS pH flucuations and reflux episodes,when e- valuated together,are more useful for classifying patients with GER and their combined thresholds yield higher diagnostic accura- cy in assessing patients with GER disease.
文摘目的探讨24 h 咽喉 pH 检测在咽喉反流性疾病诊断中的价值。方法选取2006年8月至10月于北京同仁医院就诊由同一医师诊断可疑有反流性咽喉炎患者50例,征得患者同意后以就诊时间为配伍因素,按区组随机排列方法采用半随机分组。第一组25例患者均行24 h 咽喉 pH检测,筛选出阳性患者作为试验组接受奥美拉唑抗酸治疗;第二组25例患者直接给予相同药物及剂量的试验性抗酸治疗作为对照组。服药3个月后进行随访,根据反流症状评分对比治疗前后效果,以主观症状评估总分下降≤4分为治疗无效,>4分为有效。结果行24 h 咽喉 pH 检测的25例患者中有病理性咽喉部反流者17例,阳性率为68.0%(17/25)。24 h 平均总反流次数(35.71±41.70)次(±s,以下同),总反流时间(35.71±33.19)min,总反流指数即每小时反流次数(1.53±1.73)次/h,每次反流平均时间(1.12±0.91)min。抗酸治疗前试验组症状评估总分平均(14.88±4.11)分,对照组总分平均(13.00±4.17)分,组间差异采用 t 检验,无统计学意义(P>0.05)。在抗酸治疗3个月后随访,试验组有效率为82.4%(14/17),对照组失访2例,其余患者治疗有效率为52.2%(12/23)。试验组症状评估总分平均下降(7.47±3.18)分,对照组症状评估总分下降(3.96±4.25)分,总分差值比较,差异有统计学意义(P<0.01)。结论 24 h 咽喉 pH 检测作为诊断咽喉反流性疾病的金标准,可以作为临床中可疑咽喉反流患者的确诊检查手段,并可大大提高抗酸治疗的有效性,值得在临床普遍开展和推广。
