[Show abstract][Hide abstract] ABSTRACT: Background
This prospective and randomized study was designed to compare safety, potential complications, and patient and examiner satisfaction of 2 anesthetic combinations – etomidate-remifentanil and propofol-remifentanil – in elderly patients undergoing diagnostic gastroscopy.
A group of 720 patients, aged 60–80 years, scheduled for diagnostic gastroscopy under sedation were prospectively randomized. After 0.4–0.6 μg kg−1 of remifentanil was infused, etomidate or propofol was administered. Patients in the etomidate group received doses of etomidate at 0.1–0.15 mg kg−1 followed by 4–6 mg. Patients in the propofol group received doses of propofol at 1–2 mg kg−1 followed by 20–40 mg. Physiological indexes were evaluated for the 715 of 720 patients that completed the treatment. The onset time, duration time, and discharge time were recorded. Physicians, anesthetists, and patients were surveyed to assess their satisfaction.
Systolic pressure and diastolic pressure decreased significantly after the procedure in the propofol group (P<0.001). The average heart rate was significantly lower in the propofol group (P<0.05). No periods of desaturation (SpO2 <95%) were observed in either group. The onset time was earlier in the etomidate group (P=0.00). All adverse events, with the exception of myoclonus, were greater in the propofol group, and physician and patient satisfaction in both groups was similar.
Etomidate-remifentanil administration for sedation and analgesia during gastroscopy resulted in more stable hemodynamic responses and less adverse events in older patients.
Preview · Article · Jan 2015 · Medical science monitor: international medical journal of experimental and clinical research
[Show abstract][Hide abstract] ABSTRACT: This single center, randomized, and controlled study aimed to compare the effectiveness and safety of polyethylene glycol electrolyte lavage (PEG-EL) solution and colonic hydrotherapy (CHT) for bowel preparation before colonoscopy. A total of 196 eligible outpatients scheduled for diagnostic colonoscopy were randomly assigned to the PEG-EL (n = 102) or CHT (n = 94) groups. Primary outcome measures included colonic cleanliness and adverse effects. Secondary outcome measures were patient satisfaction and preference, colonoscopic findings, ileocecal arrival rate, examiner satisfaction, and cecal intubation time. The results show that PEG-EL group was associated with significantly better colonic cleanliness than CHT group, fewer adverse effects, and increased examiner satisfaction. However, the CHT group had higher patient satisfaction and higher diverticulosis detection rates. Moreover, the results showed the same ileocecal arrival rate and patient preference between the two groups (P > 0.05). These findings indicate that PEG-EL is the preferred option in patients who followed the preparation instructions completely.
Preview · Article · Jun 2014 · Gastroenterology Research and Practice
[Show abstract][Hide abstract] ABSTRACT: Background and AimThis study was designed to demonstrate the safety and efficacy of esomeprazole combined with flupentixol/melitracen for the treatment of gastroesophageal reflux disease (GERD) patients with emotional disorders. Methods
Two hundred eighty-nine GERD patients with emotional disorders were divided randomly into two groups: group 1 received esomeprazole only (monotherapy) and group 2 received esomeprazole and flupentixol/melitracen (combination therapy). The patients' GERD questionnaire (GerdQ) and hospital anxiety and depression (HAD) scores were obtained before and after treatment. Changes in the scores, rates of symptom remission, and adverse effects were compared between the two groups. ResultsAfter 2 weeks of treatment, the average decrease in GerdQ score in the combination group (4.042.34) was significantly greater than that in the monotherapy group (3.34 +/- 2.74; P<0.05). Significant differences between the two groups were also found for changes in HAD anxiety scores (5.45 +/- 2.41 vs 3.34 +/- 2.43, P<0.05), depression scores (5.47 +/- 2.47 vs 3.00 +/- 3.28, P<0.05), and anxiety-depression scores (5.20 +/- 2.71 vs 3.60 +/- 2.56, P<0.05). The remission of symptoms (eructation, abdominal pain, anorexia, and other accompanying symptoms) in the combination group was significantly better than that in the monotherapy group, and no significant difference in the incidence of adverse events was observed between the two groups. Conclusions
The combination therapy has better efficacy than the monotherapy in improving the symptoms of gastroesophageal reflux in patients with emotional disorders. In addition, this combination treatment is safe, with a low incidence of adverse events.
No preview · Article · Jun 2014 · Journal of Gastroenterology and Hepatology
[Show abstract][Hide abstract] ABSTRACT: Background:
To assess the diagnostic effectiveness, cardiopulmonary safety, and patient comfort of transnasal endoscopy (TNE), compared with conventional endoscopy (CES) and sedated endoscopy (SES), and to compare procedural risks and patient satisfaction/preference.
In this prospective, randomized, and controlled protocol, eligible patients (n = 397) in an outpatient clinic were randomized to CES (n = 133), SES (n = 134), or unsedated TNE (n = 130) due to upper gastrointestinal (GI) complaints. Patients were continuously monitored for systolic/diastolic blood pressure (SBP/DBP), pulse rate (PR), and SpO(2) throughout the endoscopy. All subjects (n = 392) completing their assigned endoscopy were asked to evaluate endoscopy satisfaction, pain, and nausea/vomiting on visual analog scales. Patient preference for the assigned endoscopy was assessed against previous endoscopy experience or by willingness to repeat the assigned endoscopy.
Endoscopic outcomes for the esophagus, stomach, and duodenum were comparable among the three groups. SBP/DBP and PR were more stable in patients undergoing TNE than in those undergoing CES or SES, while SpO(2) remained stable and above 95% among all three groups. Patients were more satisfied with TNE than with CES and experienced less pain and nausea/vomiting. Patients exhibited a high preference for SES, whereas 67.6% of patients who previously underwent SES and were randomly assigned to TNE were willing to undergo TNE again.
TNE has comparable diagnostic effectiveness to CES and SES, but is less stressful on cardiopulmonary function, indicating that TNE is a more comfortable, preferred, and cost-effective endoscopic technique than CES and SES.
No preview · Article · Sep 2012 · Surgical Endoscopy
[Show abstract][Hide abstract] ABSTRACT: H. pylori interacts with gastric epithelial cells, which may activate signaling pathways important for gastric cancer invasion. Ezrin, a membrane cytoskeletal crosslinker protein, is well documented to regulate cell adhesion and cell motility. The aim of the present study was to determine whether ezrin is involved in H. pylori-induced cancer cell motility and invasion.
The VIL-2 of RNA interference plasmid vector and control plasmid vector were constructed. AGS (a human gastric adenocarcinoma cell line) cells were transfected by these plasmid vectors. The stable expression cell lines AGS(ezrin) was obtained by G418 resistance screening. The express levels of ezrin protein and the cellular invasive potential of four groups, including the AGS control, AGS(ezrin) control, AGS co-culture with H. pylori, AGS(ezrin) co-culture with H. pylori were detected. Meanwhile, the morphology, cell migration and adhesion were determined respectively.
Co-culture with H. pylori stimulated AGS cell motility and invasion, up-regulated ezrin expression at the protein level and induced a Hummingbird phenotype. The silencing of ezrin expression suppressed the motility and invasion of gastric cancer cells and inversed the cell invasion phenotype and enhanced the ability for cell adhesion.
Knockdown of ezrin by RNAi suppresses H. pylori-enhanced migration and invasion of gastric cancer cells. These findings indicate that ezrin may play a key role in the migration and invasion of gastric cancer cells, and thus may be a therapeutic target to prevent metastasis of gastric cancer promoted by H. pylori infection.
[Show abstract][Hide abstract] ABSTRACT: To clarify the role of the mitochondrial pathway in apoptosis induced by H. pylori infection in gastric epithelial cells.
Cells of a gastric adenocarcinoma cell line SGC-7,901 were co-cultured with H. pylori NCTC 11,637, with or without preincubation with the inhibitors of caspases -3, -8, and -9. Apoptosis was determined by flow cytometry. RT-PCR was used to determine the expression of Bid, Bax, and Bcl-2 mRNA, and Western blotting was used to determine the expression of Bid, Bax, and Bcl-2 proteins, and the activation of caspases -3 and -9.
H. pylori directly induced apoptosis in SGC-7,901 cells. Apoptotic indices (AIs) were 6.30 +/- 0.40%, 11.57 +/- 0.78%, 8.63 +/- 0.67%, and 7.22 +/- 0.97%, respectively, at 6, 12, 24, and 48 h after SGC-7,901 cells were co-cultured with H. pylori. H. pylori up-regulated the expression of Bid and Bax at both protein and mRNA levels, and induced a time-dependent activation of caspases -3 and -9. Apoptosis was inhibited significantly by the preincubation of SGC-7,901 cells with the inhibitors of caspase-3 (AIs were 1.72 +/- 0.59%, 2.97 +/- 0.55%, 4.38 +/- 1.56%, and 3.29 +/- 0.83%, respectively, at 6, 12, 24, and 48 h), and caspase -9 (AIs were 2.47 +/- 0.53%, 6.68 +/- 0.47%, 5.97 +/- 0.46%, and 5.43 +/- 0.15%, respectively, at 6, 12, 24, and 48 h). The caspase-8 inhibitor also reduced H. pylori-induced apoptosis by 20%.
H. pylori infection induces apoptosis and the activation of caspases -3 and -9 in gastric cancer cells. Moreover, the caspase inhibitors significantly suppress H. pylori-induced apoptosis. These findings suggest that the mitochondrial pathway may be the major pathway in H. pylori-induced apoptosis in gastric epithelial cells.
No preview · Article · Aug 2007 · Journal of Gastroenterology and Hepatology
[Show abstract][Hide abstract] ABSTRACT: To explain the role of mitochondrial pathway in the apoptosis of SGC-7901 cell line induced by concentrated Helicobacter pylori culture supernatant (CHCS).
Cytochrome oxidase (COX) I expression was detected by Western blotting. Cell apoptosis and mitochondrial membrane potential were measured by flow cytometry.
CHCS could induce the apoptosis of SGC-7901 in a dose- and time-dependent manner. Apoptotic rates gradually enhanced followed by the concentrations increasing. The mitochondrial membrane potential (MMP) began to descend after treating CHCS for 4 h, and MMP descended most distinctly in 8 h. It descended the lowest point in 12 h, and it had no special changes in 24 h. The expression of COX I was notably lower than that of control group after CHCS treating (632.8 +/- 40.6 vs 895.1 +/- 44.2, P < 0.05).
Mitochondrial pathway may play an important role in the apoptosis of SGC-7901 cells induced by CHCS.
No preview · Article · Nov 2005 · Zhonghua nei ke za zhi [Chinese journal of internal medicine]