AIM:To evaluate the efficacy and safety of adjunctive mosapride citrate for bowel preparation before colonoscopy. METHODS:We conducted a randomized,double-blind, placebo-controlled study with mosapride in addition to ...AIM:To evaluate the efficacy and safety of adjunctive mosapride citrate for bowel preparation before colonoscopy. METHODS:We conducted a randomized,double-blind, placebo-controlled study with mosapride in addition to polyethylene glycol(PEG)-electrolyte solution.Of 250 patients undergoing colonoscopy,124 were randomized to receive 2 L PEG plus 15 mg of mosapride citrate (mosapride group),and 126 received 2 L PEG plus placebo(placebo group).Patients completed a questionnaire reporting the acceptability and tolerability of the bowel preparation process.The efficacy of bowel preparation was assessed by colonoscopists using a 5-point scale based on Aronchick's criteria.The primary end point was optimal bowel preparation rates(scores of excellent/good/fair vs poor/inadequate). RESULTS:A total of 249 patients were included in the analysis.In the mosapride group,optimal bowel preparation rates were significantly higher in the left colon compared with the placebo group(78.2%vs 65.6%,P<0.05),but not in the right colon(76.5%vs 66.4%,P=0.08).After excluding patients with severe constipation,there was a significant difference in bowel preparation in both the left and right colon(82.4%vs 66.7%,80.8%vs 67.5%,P<0.05,P<0.01).The incidence of adverse events was similar in both groups. Among the subgroup who had previous colonoscopy experience,a significantly higher number of patients in the mosapride group felt that the current preparation was easier compared with patients in the placebo group(34/72 patients vs 24/74 patients,P<0.05). CONCLUSION:Mosapride citrate may be an effective and safe adjunct to PEG-electrolyte solution that leads to improved quality of bowel preparation,especially in patients without severe constipation.展开更多
AIM:To evaluate the effect of prokinetic drugs on electrogastrography(EGG) parameters according to symptomatic changes in patients with functional dyspepsia(FD).METHODS:Seventy-four patients with FD were prospectively...AIM:To evaluate the effect of prokinetic drugs on electrogastrography(EGG) parameters according to symptomatic changes in patients with functional dyspepsia(FD).METHODS:Seventy-four patients with FD were prospectively enrolled in this study between December 2006 and December 2010.We surveyed the patients using a questionnaire on dyspeptic symptoms before and after an 8-wk course of prokinetic drug treatment.We also measured cutaneous pre-prandial and postprandial EGG recordings including percentage of gastric waves(normogastria,bradygastria,tachygastria),dominant frequency(DF),dominant power(DP),dominant frequency instability coefficient(DFIC),dominant power instability coefficient(DPIC),and the ratio of post-prandial to fasting in DP before and after the 8-wk course of prokinetic drug treatment.RESULTS:Fifty-two patients(70%) achieved symptomatic improvement after prokinetic drug treatment.Patients who had normal gastric slow waves showed symptom improvement group after treatment.Postprandial DF showed a downward trend in the symptom improvement group,especially in the itopride group.Post-prandial DP was increased regardless of symptom improvement,especially in the itopride group and mosapride group.Post-prandial DFIC and DPIC in the symptom improvement group were significantly increased after the treatment.The EGG power ratio was increased after treatment in the symptom improvement group(0.50 ± 0.70 vs 0.93 ± 1.77,P = 0.002),especially in the itopride and levosulpiride groups.CONCLUSION:Prokinetics could improve the symptoms of FD by regulating gastric myoelectrical activity,and EGG could be a useful tool in evaluating the effects of various prokinetics.展开更多
AIM:To compare triple therapy vs quadruple therapy for 10 d as first-line treatment ofHelicobacter pylori(H.pylori) infection.METHODS:Consecutive H.pylori positive patients never treated in the past for this infection...AIM:To compare triple therapy vs quadruple therapy for 10 d as first-line treatment ofHelicobacter pylori(H.pylori) infection.METHODS:Consecutive H.pylori positive patients never treated in the past for this infection were randomly treated with triple therapy of pantoprazole(PAN) 20 mg bid,amoxicillin(AMO) 1 g bid and moxifloxacin(MOX) 400 mg bid for 10 d(PAM) or with quadruple therapy of PAN 20 mg bid,AMO 1 g bid,MOX 400 mg bid and bismuth subcitrate 240 mg bid for 10 d(PAMB).All patients were found positive at 13 C-Urea breath test(UBT) performed within ten days prior to the start of the study.A successful outcome was confirmed with an UBT performed 8 wk after the end of treatment.χ 2 analysis was used for statistical comparison.Per protocol(PP) and intention-to-treat(ITT) values were also calculated.RESULTS:Fifty-seven patients were enrolled in the PAM group and 50 in the PAMB group.One patient in each group did not return for further assessment.Eradication was higher in the PAMB group(negative:46 and positive:3) vs the PAM group(negative:44 and positive:12).The H.pylori eradication rate was statistically significantly higher in the PAMB group vs the PAM group,both with the PP and ITT analyses(PP:PAMB 93.8%,PAM 78.5%,P < 0.02;ITT:PAMB 92%,PAM 77.1 %,P <0.03).CONCLUSION:The addition of bismuth subcitrate can be considered a valuable adjuvant to triple therapy in those areas where H.pylori shows a high resistance to fluoroquinolones.展开更多
Worldwide prevalence of Helicobacter pylori(H.pylori) infection is approximately 50%,with the highest being in developing countries.We compared cure rates and tolerability(SE) of second-line anti-H.pylori levofloxacin...Worldwide prevalence of Helicobacter pylori(H.pylori) infection is approximately 50%,with the highest being in developing countries.We compared cure rates and tolerability(SE) of second-line anti-H.pylori levofloxacin/amoxicillin(LA)-based triple regimens vs standard quadruple therapy(QT).An English language literature search was performed up to October 2010.A meta-analysis was performed including randomized clinical trials comparing 7-or 10-d LA with 7-d QT.In total,10 articles and four abstracts were identified.Overall eradication rate in LA was 76.5%(95% CI:64.4%-97.6%).When only 7-d regimens were included,cure rate was 70.6%(95% CI:40.2%-99.1%),whereas for 10-d combinations,cure rate was significantly higher(88.7%;95% CI:56.1%-109.9%;P < 0.05).Main eradication rate for QT was 67.4%(95% CI:49.7%-67.9%).The 7-d LA and QT showed comparable efficacy [odds ratio(OR):1.09;95% CI:0.63-1.87],whereas the 10-d LA regimen was significantly more effective than QT(OR:5.05;95% CI:2.74-9.31;P < 0.001;I 2 = 75%).No differences were reported in QT eradication rates among Asian and European studies,whereas LA regimens were more effective in European populations(78.3% vs 67.7%;P = 0.05).Incidence of SE was lower in LA therapy than QT(OR:0.39;95% CI:0.18-0.85;P = 0.02).A higher rate of side effects was reported in Asian patients who received QT.Our findings support the use of 10-d LA as a simple second-line treatment for H.pylori eradication with an excellent eradication rate and tolerability.The optimal second-line alternative scheme might differ among countries depending on quinolone resistance.展开更多
OBJECTIVE: To investigate the therapeutic effect of the herbal medication Xiao Pi-II on the symptoms and gastric motility of patients with functional dysepsia (FD). METHODS: A total of 180 FD patients were divided ran...OBJECTIVE: To investigate the therapeutic effect of the herbal medication Xiao Pi-II on the symptoms and gastric motility of patients with functional dysepsia (FD). METHODS: A total of 180 FD patients were divided randomly and equally into Xiao Pi-II and mosapride groups. The two groups were treated with Xiao Pi-II (100 mL, t.d.s., ante cibum) and mosapride (5 mg, t. d.s., ante cibum) for 2 weeks. Before treatment and 3 days after all medication was stopped, patients responded to a questionnaire evaluating gastrointestinal symptoms and were assessed with abdominal three dimensional ultrasonography (3D-US) for gastric motility. RESULTS: Gastrointestinal symptoms (especially bloating, post-prandial fullness and eructation) were improved significantly in FD patients treated with Xiao Pi-II (P<0.05, P<0.05, and P<0.05), but no significant difference was found in the mosapride group (P>0.05). The effective rates in the Xiao Pi-II and mosapride group were 86.7% and 60.0%, respectively (P<0.05). The gastric liquid emptyingrate (GLER) in the Xiao Pi-II group showed a significant increase (P<0.01) after 2 weeks of treatment but there was no significant change (P>0.05) of GLER in the mosapride group. CONCLUSION: Compared with mosapride, Xiao Pi-II improved symptoms and GLER significantly in FD patients with delayed gastric emptying.展开更多
A new method of enantioselective synthesis of （S,S）-2,8-diazobicyclo [4.3.0] nonane was found by using （R）-2-amino-2- phenyl-ethanol as chiral induction reagent. The entire synthetic process included 8 steps which...A new method of enantioselective synthesis of （S,S）-2,8-diazobicyclo [4.3.0] nonane was found by using （R）-2-amino-2- phenyl-ethanol as chiral induction reagent. The entire synthetic process included 8 steps which were easy to operate with high yield. The purification method was only simple recrystallization or even used directly in the next step without further purifica- tion. The total yield was 29%.展开更多
文摘AIM:To evaluate the efficacy and safety of adjunctive mosapride citrate for bowel preparation before colonoscopy. METHODS:We conducted a randomized,double-blind, placebo-controlled study with mosapride in addition to polyethylene glycol(PEG)-electrolyte solution.Of 250 patients undergoing colonoscopy,124 were randomized to receive 2 L PEG plus 15 mg of mosapride citrate (mosapride group),and 126 received 2 L PEG plus placebo(placebo group).Patients completed a questionnaire reporting the acceptability and tolerability of the bowel preparation process.The efficacy of bowel preparation was assessed by colonoscopists using a 5-point scale based on Aronchick's criteria.The primary end point was optimal bowel preparation rates(scores of excellent/good/fair vs poor/inadequate). RESULTS:A total of 249 patients were included in the analysis.In the mosapride group,optimal bowel preparation rates were significantly higher in the left colon compared with the placebo group(78.2%vs 65.6%,P<0.05),but not in the right colon(76.5%vs 66.4%,P=0.08).After excluding patients with severe constipation,there was a significant difference in bowel preparation in both the left and right colon(82.4%vs 66.7%,80.8%vs 67.5%,P<0.05,P<0.01).The incidence of adverse events was similar in both groups. Among the subgroup who had previous colonoscopy experience,a significantly higher number of patients in the mosapride group felt that the current preparation was easier compared with patients in the placebo group(34/72 patients vs 24/74 patients,P<0.05). CONCLUSION:Mosapride citrate may be an effective and safe adjunct to PEG-electrolyte solution that leads to improved quality of bowel preparation,especially in patients without severe constipation.
文摘AIM:To evaluate the effect of prokinetic drugs on electrogastrography(EGG) parameters according to symptomatic changes in patients with functional dyspepsia(FD).METHODS:Seventy-four patients with FD were prospectively enrolled in this study between December 2006 and December 2010.We surveyed the patients using a questionnaire on dyspeptic symptoms before and after an 8-wk course of prokinetic drug treatment.We also measured cutaneous pre-prandial and postprandial EGG recordings including percentage of gastric waves(normogastria,bradygastria,tachygastria),dominant frequency(DF),dominant power(DP),dominant frequency instability coefficient(DFIC),dominant power instability coefficient(DPIC),and the ratio of post-prandial to fasting in DP before and after the 8-wk course of prokinetic drug treatment.RESULTS:Fifty-two patients(70%) achieved symptomatic improvement after prokinetic drug treatment.Patients who had normal gastric slow waves showed symptom improvement group after treatment.Postprandial DF showed a downward trend in the symptom improvement group,especially in the itopride group.Post-prandial DP was increased regardless of symptom improvement,especially in the itopride group and mosapride group.Post-prandial DFIC and DPIC in the symptom improvement group were significantly increased after the treatment.The EGG power ratio was increased after treatment in the symptom improvement group(0.50 ± 0.70 vs 0.93 ± 1.77,P = 0.002),especially in the itopride and levosulpiride groups.CONCLUSION:Prokinetics could improve the symptoms of FD by regulating gastric myoelectrical activity,and EGG could be a useful tool in evaluating the effects of various prokinetics.
文摘AIM:To compare triple therapy vs quadruple therapy for 10 d as first-line treatment ofHelicobacter pylori(H.pylori) infection.METHODS:Consecutive H.pylori positive patients never treated in the past for this infection were randomly treated with triple therapy of pantoprazole(PAN) 20 mg bid,amoxicillin(AMO) 1 g bid and moxifloxacin(MOX) 400 mg bid for 10 d(PAM) or with quadruple therapy of PAN 20 mg bid,AMO 1 g bid,MOX 400 mg bid and bismuth subcitrate 240 mg bid for 10 d(PAMB).All patients were found positive at 13 C-Urea breath test(UBT) performed within ten days prior to the start of the study.A successful outcome was confirmed with an UBT performed 8 wk after the end of treatment.χ 2 analysis was used for statistical comparison.Per protocol(PP) and intention-to-treat(ITT) values were also calculated.RESULTS:Fifty-seven patients were enrolled in the PAM group and 50 in the PAMB group.One patient in each group did not return for further assessment.Eradication was higher in the PAMB group(negative:46 and positive:3) vs the PAM group(negative:44 and positive:12).The H.pylori eradication rate was statistically significantly higher in the PAMB group vs the PAM group,both with the PP and ITT analyses(PP:PAMB 93.8%,PAM 78.5%,P < 0.02;ITT:PAMB 92%,PAM 77.1 %,P <0.03).CONCLUSION:The addition of bismuth subcitrate can be considered a valuable adjuvant to triple therapy in those areas where H.pylori shows a high resistance to fluoroquinolones.
文摘Worldwide prevalence of Helicobacter pylori(H.pylori) infection is approximately 50%,with the highest being in developing countries.We compared cure rates and tolerability(SE) of second-line anti-H.pylori levofloxacin/amoxicillin(LA)-based triple regimens vs standard quadruple therapy(QT).An English language literature search was performed up to October 2010.A meta-analysis was performed including randomized clinical trials comparing 7-or 10-d LA with 7-d QT.In total,10 articles and four abstracts were identified.Overall eradication rate in LA was 76.5%(95% CI:64.4%-97.6%).When only 7-d regimens were included,cure rate was 70.6%(95% CI:40.2%-99.1%),whereas for 10-d combinations,cure rate was significantly higher(88.7%;95% CI:56.1%-109.9%;P < 0.05).Main eradication rate for QT was 67.4%(95% CI:49.7%-67.9%).The 7-d LA and QT showed comparable efficacy [odds ratio(OR):1.09;95% CI:0.63-1.87],whereas the 10-d LA regimen was significantly more effective than QT(OR:5.05;95% CI:2.74-9.31;P < 0.001;I 2 = 75%).No differences were reported in QT eradication rates among Asian and European studies,whereas LA regimens were more effective in European populations(78.3% vs 67.7%;P = 0.05).Incidence of SE was lower in LA therapy than QT(OR:0.39;95% CI:0.18-0.85;P = 0.02).A higher rate of side effects was reported in Asian patients who received QT.Our findings support the use of 10-d LA as a simple second-line treatment for H.pylori eradication with an excellent eradication rate and tolerability.The optimal second-line alternative scheme might differ among countries depending on quinolone resistance.
文摘OBJECTIVE: To investigate the therapeutic effect of the herbal medication Xiao Pi-II on the symptoms and gastric motility of patients with functional dysepsia (FD). METHODS: A total of 180 FD patients were divided randomly and equally into Xiao Pi-II and mosapride groups. The two groups were treated with Xiao Pi-II (100 mL, t.d.s., ante cibum) and mosapride (5 mg, t. d.s., ante cibum) for 2 weeks. Before treatment and 3 days after all medication was stopped, patients responded to a questionnaire evaluating gastrointestinal symptoms and were assessed with abdominal three dimensional ultrasonography (3D-US) for gastric motility. RESULTS: Gastrointestinal symptoms (especially bloating, post-prandial fullness and eructation) were improved significantly in FD patients treated with Xiao Pi-II (P<0.05, P<0.05, and P<0.05), but no significant difference was found in the mosapride group (P>0.05). The effective rates in the Xiao Pi-II and mosapride group were 86.7% and 60.0%, respectively (P<0.05). The gastric liquid emptyingrate (GLER) in the Xiao Pi-II group showed a significant increase (P<0.01) after 2 weeks of treatment but there was no significant change (P>0.05) of GLER in the mosapride group. CONCLUSION: Compared with mosapride, Xiao Pi-II improved symptoms and GLER significantly in FD patients with delayed gastric emptying.
文摘A new method of enantioselective synthesis of （S,S）-2,8-diazobicyclo [4.3.0] nonane was found by using （R）-2-amino-2- phenyl-ethanol as chiral induction reagent. The entire synthetic process included 8 steps which were easy to operate with high yield. The purification method was only simple recrystallization or even used directly in the next step without further purifica- tion. The total yield was 29%.
