AIM: To evaluate and compare the clinical usefulness of 13C-phenylalanine and 13C-methacetin breath tests in quantitating functional hepatic mass in patients with chronic liver disease and to further compare these res...AIM: To evaluate and compare the clinical usefulness of 13C-phenylalanine and 13C-methacetin breath tests in quantitating functional hepatic mass in patients with chronic liver disease and to further compare these results with those of conventional tests, Child-Pugh score and serum bile acid levels.METHODS: One hundred and forty patients (50 HCV-related chronic hepatitis, 90 liver cirrhosis patients) and 40 matched healthy controls were studied. Both breath test and routine liver test, serum levels of cholic and chenodeoxycholic acid conjugates were evaluated.RESULTS: Methacetin breath test, expressed as 60 min cumulative percent of oxidation, discriminated the hepatic functional capacity not only between controls and liver disease patients, but also between different categories of chronic liver disease patients. Methacetin breath test was correlated with liver function tests and serum bile acids.Furthermore, methacetin breath test, as well as serum bile acids, were highly predictive of Child-Pugh scores. The diagnostic power of phenylalanine breath test was always less than that of methacetin breath test.CONCLUSION: Methacetin breath test represents a safe and accurate diagnostic tool in the evaluation of hepatic functional mass in chronic liver disease patients.展开更多
AIM: Helicobacter pylori (H pylori) resistance after failed eradication has a major impact on the outcome of a further treatment regimen. The aim of this study was to assess the validity of a non-invasive strategy usi...AIM: Helicobacter pylori (H pylori) resistance after failed eradication has a major impact on the outcome of a further treatment regimen. The aim of this study was to assess the validity of a non-invasive strategy using the 13C-urea breath test (UBT) and the gastric string test in identifying post-treatment resistance of H pylori. METHODS: The UBT was routinely performed 4 to 6 wk after H pylori eradication therapy. Forty-two patients (24 females, 18 males, mean age 48 years) with a positive UBT were included in the study. A gastric string test using a capsule containing a 90 cm-long nylon fiber was performed. Before the capsule was swallowed, the free end of the string was taped to the cheek. After one hour in the stomach, the string was withdrawn. The distal 20 cm of the string was inoculated onto an agar plate and processed under micro-aerophilic conditions. Following the string test, upper gastrointestinal endoscopy was performed to obtain gastric biopsies for conventional culture. RESULTS: H pylori was successfully cultured from the gastric string in 34 patients (81%), but not in 5 patients due to contamination with oropharyngeal flora. H py/oriwas cultured from the gastric biopsies obtained at endoscopy in 39 patients (93%). CONCLUSION: The UBT followed by the gastric string test in the case of treatment failure is a valid diagnostic strategy with the aim of determining the post-therapeutic antibiotic resistance of H pylori with little inconvenience to the patient. Upper Gl-endoscopy can be avoided in several cases by applying consequently this diagnostic package.展开更多
Understanding the ecology of the gastrointestinal tract and the impact of the contents on the host mucosa is emerging as an important area for defining both wellness and susceptibility to disease. Targeted delivery of...Understanding the ecology of the gastrointestinal tract and the impact of the contents on the host mucosa is emerging as an important area for defining both wellness and susceptibility to disease. Targeted delivery of drugs to treat specific small intestinal disorders such as small bowel bacterial overgrowth and targeting molecules to interrogate or to deliver vaccines to the remote regions of the small intestine has proven difficult. There is an unmet need for methodologies to release probes/drugs to remote regions of the gastrointestinal tract in furthering our understanding of gut health and pathogenesis. In order to address this concern, we need to know how the regional delivery of a surrogate labeled test compound is handled and in turn, if delivered locally as a liquid or powder, the dynamics of its subsequent handling and metabolism. In the studies we report on in this paper, we chose ^13 C sodium acetate（^13C-acetate）, which is a stable isotope probe that once absorbed in the small intestine can be readily measured non-invasively by collection and analysis of ^13CO2 in the breath. This would provide information of gastric emptying rates and an indication of the site of release and absorptive capacity. In a series of in vitro and in vivo pig experiments, we assessed the enteric-protective properties of a commercially available polymer EUDRAGIT L100-55 on gelatin capsules and also on DRcaps. Test results demonstrated that DRcaps coated with EUDRAGIT L100-55 possessed enhanced enteric-protective properties, particularly in vivo. These studies add to the body of knowledge regarding gastric emptying in pigs and also begin the process of gathering specifications for the design of a simple and cost-effective enteric-coated capsule for delivery of acid-labile macromolecules to the small intestine.展开更多
AIM: To evaluate the prevalence of lactose intolerance (LI) following a load of 12.5 g in patients diagnosed as high-grade malabsorbers using the hydrogen breath test (HBT)-25.METHODS: Ninety patients showing high-gra...AIM: To evaluate the prevalence of lactose intolerance (LI) following a load of 12.5 g in patients diagnosed as high-grade malabsorbers using the hydrogen breath test (HBT)-25.METHODS: Ninety patients showing high-grade malabsorption at HBT-25 were submitted to a second HBT with a lactose load of 12.5 g.Peak hydrogen production,area under the curve of hydrogen excretion and occurrence of symptoms were recorded.RESULTS: Only 16 patients (17.77%) with positive HBT-25 proved positive at HBT-12.5.Hydrogen production was lower as compared to HBT-25 (peak value 21.55 parts per million (ppm) ± 29.54 SD vs 99.43 ppm ± 40.01 SD; P < 0.001).Symptoms were present in only 13 patients.The absence of symptoms during the high-dose test has a high negative predictive value (0.84) for a negative low-dose test.The presence of symptoms during the first test was not useful for predicting a positive low-dose test (positive predictive value 0.06-0.31).CONCLUSION: Most patients with a positive HBT-25 normally absorb a lower dose of lactose and a strict lactose restriction on the basis of a "standard" HBT is,in most instances,unnecessary.Thus,the 25 g lactose tolerance test should probably be substituted by the 12.5 g test in the diagnosis of LI,and in providing dietary guidelines to patients with suspected lactose malabsorption/intolerance.展开更多
The aim of this study is to evaluate the diagnostic value of ^14C-UBT for diagnosis of HP infection. The positive predictive values were above 100 bpm/mmol CO2. 202 of 256 patients with HP-positive infection were dete...The aim of this study is to evaluate the diagnostic value of ^14C-UBT for diagnosis of HP infection. The positive predictive values were above 100 bpm/mmol CO2. 202 of 256 patients with HP-positive infection were detected (sensitivity, 78%), what's more, breath test and RUT corresponded well. 256 patients diagnosed were investigated, aged 17-81 years (average 44.25 years). HP positive rate was 96.5% in 113 patients with peptic ulcer disease (PUD), 91.7% in 60 patients with chronic active gastritis, 73.3% in 15 patients with GERD,展开更多
Objective： To observe the clinical effect of acupuncture on chronic obstructive pulmonary disease （COPD）, and the improvements of patients＇ pulmonary ventilation function and 6-minute walk test （6-MWT） distance....Objective： To observe the clinical effect of acupuncture on chronic obstructive pulmonary disease （COPD）, and the improvements of patients＇ pulmonary ventilation function and 6-minute walk test （6-MWT） distance. Methods： A total of 80 COPD patients [grade 3-4 in Global Initiative for Chronic Obstructive Lung Disease （GOLD）, qi deficiency of the lung and kidney in traditional Chinese medicine （TCM） pattern] were randomly allocated into a treatment group （n=40） and a control group （n=40）. Salmeterol Xinafoate and Fluticasone Propionate powder （Seretide, 50 μg/250 μg） for inhalation was used for basic treatment in both groups （once in the morning and once in the evening）. Patients in the treatment group received acupuncture at Feishu （BL 13）, Shenshu （BL 23）, O.ihai （CV 6）, Guanyuan （CV 4）, Dingchuan （EX-B 1）, Danzhong （CV 17） and Zusanli （ST 36] twice a week for 3 months. After 3 months of treatment, clinical effects, lung ventilation functions and 6-MWT distance were observed and compared in the two groups. Results： After 3 months of treatment, the total effective rate was 95.0% in the treatment group, versus 80.0% in the control group, showing a statistical difference （P〈O.05）; the phlegm expectoration, dyspnea and shortness of breath were more significantly improved in the treatment group than those in the control group （P〈0.01, P〈0.05）; and the 6-MWT distance and forced expiratory volume in 1 second percentage of predicted value （FEV1%） were more significantly improved in the treatment group than those in the control group （P〈0.05, P〈0.01）. Conclusion： Seretide inhaler combined with acupuncture can improve signs and symptoms in COPD patients, increase the 6-MWT distance, imorove FEV1% and obtain better results than Seretide alone.展开更多
文摘AIM: To evaluate and compare the clinical usefulness of 13C-phenylalanine and 13C-methacetin breath tests in quantitating functional hepatic mass in patients with chronic liver disease and to further compare these results with those of conventional tests, Child-Pugh score and serum bile acid levels.METHODS: One hundred and forty patients (50 HCV-related chronic hepatitis, 90 liver cirrhosis patients) and 40 matched healthy controls were studied. Both breath test and routine liver test, serum levels of cholic and chenodeoxycholic acid conjugates were evaluated.RESULTS: Methacetin breath test, expressed as 60 min cumulative percent of oxidation, discriminated the hepatic functional capacity not only between controls and liver disease patients, but also between different categories of chronic liver disease patients. Methacetin breath test was correlated with liver function tests and serum bile acids.Furthermore, methacetin breath test, as well as serum bile acids, were highly predictive of Child-Pugh scores. The diagnostic power of phenylalanine breath test was always less than that of methacetin breath test.CONCLUSION: Methacetin breath test represents a safe and accurate diagnostic tool in the evaluation of hepatic functional mass in chronic liver disease patients.
文摘AIM: Helicobacter pylori (H pylori) resistance after failed eradication has a major impact on the outcome of a further treatment regimen. The aim of this study was to assess the validity of a non-invasive strategy using the 13C-urea breath test (UBT) and the gastric string test in identifying post-treatment resistance of H pylori. METHODS: The UBT was routinely performed 4 to 6 wk after H pylori eradication therapy. Forty-two patients (24 females, 18 males, mean age 48 years) with a positive UBT were included in the study. A gastric string test using a capsule containing a 90 cm-long nylon fiber was performed. Before the capsule was swallowed, the free end of the string was taped to the cheek. After one hour in the stomach, the string was withdrawn. The distal 20 cm of the string was inoculated onto an agar plate and processed under micro-aerophilic conditions. Following the string test, upper gastrointestinal endoscopy was performed to obtain gastric biopsies for conventional culture. RESULTS: H pylori was successfully cultured from the gastric string in 34 patients (81%), but not in 5 patients due to contamination with oropharyngeal flora. H py/oriwas cultured from the gastric biopsies obtained at endoscopy in 39 patients (93%). CONCLUSION: The UBT followed by the gastric string test in the case of treatment failure is a valid diagnostic strategy with the aim of determining the post-therapeutic antibiotic resistance of H pylori with little inconvenience to the patient. Upper Gl-endoscopy can be avoided in several cases by applying consequently this diagnostic package.
基金Project supported by the Australian Research Council(ARC)Linkage Project Grant(No.LP0990847)
文摘Understanding the ecology of the gastrointestinal tract and the impact of the contents on the host mucosa is emerging as an important area for defining both wellness and susceptibility to disease. Targeted delivery of drugs to treat specific small intestinal disorders such as small bowel bacterial overgrowth and targeting molecules to interrogate or to deliver vaccines to the remote regions of the small intestine has proven difficult. There is an unmet need for methodologies to release probes/drugs to remote regions of the gastrointestinal tract in furthering our understanding of gut health and pathogenesis. In order to address this concern, we need to know how the regional delivery of a surrogate labeled test compound is handled and in turn, if delivered locally as a liquid or powder, the dynamics of its subsequent handling and metabolism. In the studies we report on in this paper, we chose ^13 C sodium acetate（^13C-acetate）, which is a stable isotope probe that once absorbed in the small intestine can be readily measured non-invasively by collection and analysis of ^13CO2 in the breath. This would provide information of gastric emptying rates and an indication of the site of release and absorptive capacity. In a series of in vitro and in vivo pig experiments, we assessed the enteric-protective properties of a commercially available polymer EUDRAGIT L100-55 on gelatin capsules and also on DRcaps. Test results demonstrated that DRcaps coated with EUDRAGIT L100-55 possessed enhanced enteric-protective properties, particularly in vivo. These studies add to the body of knowledge regarding gastric emptying in pigs and also begin the process of gathering specifications for the design of a simple and cost-effective enteric-coated capsule for delivery of acid-labile macromolecules to the small intestine.
文摘AIM: To evaluate the prevalence of lactose intolerance (LI) following a load of 12.5 g in patients diagnosed as high-grade malabsorbers using the hydrogen breath test (HBT)-25.METHODS: Ninety patients showing high-grade malabsorption at HBT-25 were submitted to a second HBT with a lactose load of 12.5 g.Peak hydrogen production,area under the curve of hydrogen excretion and occurrence of symptoms were recorded.RESULTS: Only 16 patients (17.77%) with positive HBT-25 proved positive at HBT-12.5.Hydrogen production was lower as compared to HBT-25 (peak value 21.55 parts per million (ppm) ± 29.54 SD vs 99.43 ppm ± 40.01 SD; P < 0.001).Symptoms were present in only 13 patients.The absence of symptoms during the high-dose test has a high negative predictive value (0.84) for a negative low-dose test.The presence of symptoms during the first test was not useful for predicting a positive low-dose test (positive predictive value 0.06-0.31).CONCLUSION: Most patients with a positive HBT-25 normally absorb a lower dose of lactose and a strict lactose restriction on the basis of a "standard" HBT is,in most instances,unnecessary.Thus,the 25 g lactose tolerance test should probably be substituted by the 12.5 g test in the diagnosis of LI,and in providing dietary guidelines to patients with suspected lactose malabsorption/intolerance.
文摘The aim of this study is to evaluate the diagnostic value of ^14C-UBT for diagnosis of HP infection. The positive predictive values were above 100 bpm/mmol CO2. 202 of 256 patients with HP-positive infection were detected (sensitivity, 78%), what's more, breath test and RUT corresponded well. 256 patients diagnosed were investigated, aged 17-81 years (average 44.25 years). HP positive rate was 96.5% in 113 patients with peptic ulcer disease (PUD), 91.7% in 60 patients with chronic active gastritis, 73.3% in 15 patients with GERD,
基金supported by Shanghai Key Laboratory for Clinical Chinese Medicine~~
文摘Objective： To observe the clinical effect of acupuncture on chronic obstructive pulmonary disease （COPD）, and the improvements of patients＇ pulmonary ventilation function and 6-minute walk test （6-MWT） distance. Methods： A total of 80 COPD patients [grade 3-4 in Global Initiative for Chronic Obstructive Lung Disease （GOLD）, qi deficiency of the lung and kidney in traditional Chinese medicine （TCM） pattern] were randomly allocated into a treatment group （n=40） and a control group （n=40）. Salmeterol Xinafoate and Fluticasone Propionate powder （Seretide, 50 μg/250 μg） for inhalation was used for basic treatment in both groups （once in the morning and once in the evening）. Patients in the treatment group received acupuncture at Feishu （BL 13）, Shenshu （BL 23）, O.ihai （CV 6）, Guanyuan （CV 4）, Dingchuan （EX-B 1）, Danzhong （CV 17） and Zusanli （ST 36] twice a week for 3 months. After 3 months of treatment, clinical effects, lung ventilation functions and 6-MWT distance were observed and compared in the two groups. Results： After 3 months of treatment, the total effective rate was 95.0% in the treatment group, versus 80.0% in the control group, showing a statistical difference （P〈O.05）; the phlegm expectoration, dyspnea and shortness of breath were more significantly improved in the treatment group than those in the control group （P〈0.01, P〈0.05）; and the 6-MWT distance and forced expiratory volume in 1 second percentage of predicted value （FEV1%） were more significantly improved in the treatment group than those in the control group （P〈0.05, P〈0.01）. Conclusion： Seretide inhaler combined with acupuncture can improve signs and symptoms in COPD patients, increase the 6-MWT distance, imorove FEV1% and obtain better results than Seretide alone.
