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 investigate if there is a correlation between electrical activity measured by electrogastrography (EGG) and contractile activity of the stomach as measured by antroduodenal manometry (ADM). We also studied whe...AIM: To investigate if there is a correlation between electrical activity measured by electrogastrography (EGG) and contractile activity of the stomach as measured by antroduodenal manometry (ADM). We also studied whether the underlying motility disorder could be predicted from EGG parameters. METHODS: We compared 21 parameters measured from EGG with 8 parameters measured from ADM. The ability of EGG to identify the underlying diagnosis was tested by comparing EGG parameters for each diagnosis group against other patients. The study comprised recordings from 148 patients and 125 females. Their median age was 45 (range 17-76) years. RESULTS: We found few and weak correlations between EGG and ADM. Specifically the correlation between parameters reflecting the response to meal was poor (r = -0.07, P = 0.39). The discriminatory power of EGG for underlying motility disorder was also low. Patients with slow transit constipation (STC) showed a lower postprandial power in normogastric (3.7 ± 0.5 vs 4.0 ± 0.5) and tachygastric (3.5 ± 0.4 vs 3.7 ± 0.4) regions, a lower percentage of time with normogastria [87.2 (56.5-100)% vs 95.7 (0-100)%], and a higher percentage of time with tachygastria [9.3 (0-33)% vs 3.5 (0-100)%] and bradygastria [1.8 (0-20)% vs 0 (0-17.1)%]. Patients with irritable bowel syndrome had a higher percentage of time with normogastria [96.5 (62.5-100)% vs 93.3 (0-100)%] and a less unstable dominant frequency as measured by the instability coefficient [15 (3-77) vs 24 (2-72)]. CONCLUSION: EGG and ADM seem to measure different aspects of gastric motor activity but cannot show a spatial correlation. The diagnostic value of EGG is poor, but EGG may have some value for the identification of patients with STC.展开更多
To enhance the clinical utility of electrogastrography (EGG), which has been recorded since 1922, but is clinically unutilized. METHODSAn innovative method to salvage the promise of EGG is proposed by introducing a pr...To enhance the clinical utility of electrogastrography (EGG), which has been recorded since 1922, but is clinically unutilized. METHODSAn innovative method to salvage the promise of EGG is proposed by introducing a preliminary procedure, while maintaining the electrodes, standardized equipment, and signal processing utilized in the well-established EGG testing of today. The proposed enhanced EGG (EEGG) protocol involves swallowing an ingestible capsule containing miniature electronic oscillator embedded in an expandable, self-disintegratable, biocompatible pseudobesoar residing in the stomach for the duration of the test. The benefits of the proposed approach are outlined, tested and discussed in details. RESULTSExperiments were performed on eight mongrel dogs (6F, 4M, 23.8 ± 3.3 kg). Four were administered an active EEGG capsule, while the rest were given a deactivated (battery removed) capsule. Pharmacologically facilitated gastric motility revealed a significant (P < 0.01) Pearson correlation between gastric motility indices obtained by force transducers implanted directly on the stomach, and the motility indices obtained by EEGG. A particular emphasis was made on preserving standard EGG-related hardware and software in order to facilitate the introduction of the proposed EEGG in environments which already utilize standard EGG testing. The expanded intragastric pseudobezoar containing the miniature electronic oscillator was retained during the tests, and could be disintegrated on demand. CONCLUSIONEnhancing standard EGG by an ingestible, self-expanding and self-disintegrating pseudobesoar containing a miniature electronic oscillator can be an important avenue for clinical applicability of this test.展开更多
Diabetic gastrointestinal neuropathy is a diabetes-related complication,associated with a complex interplay of hyperglycemic damage,autoimmune responses,oxidative stress,gastrointestinal hormones,and vascular insuffic...Diabetic gastrointestinal neuropathy is a diabetes-related complication,associated with a complex interplay of hyperglycemic damage,autoimmune responses,oxidative stress,gastrointestinal hormones,and vascular insufficiency.Patients with diabetes should be monitored and therapeutic intervention introduced to prevent neuropathy due to diabetes prior to“the point of no return”.Determining gastric bioelectrical activity by body surface gastric mapping may be a promising option to monitor diabetic gastrointestinal neuropathy.展开更多
For some time now,the research on gastric motility and function has fallen behind in the amount of research on gastric endocrine,exocrine secretion,and gastric morphology.In this paper,a noninvasive method to study ga...For some time now,the research on gastric motility and function has fallen behind in the amount of research on gastric endocrine,exocrine secretion,and gastric morphology.In this paper,a noninvasive method to study gastric motility was developed,taking bioimpedance measurements over the gastric area simultaneously with the electrogastrography(EGG).This is based on the concept of observing and analyzing simultaneously the intrinsic electrical gastric activity(basic electric rhythm) and the mechanical gastric activity.Additionally,preliminary clinical studies of healthy subjects and subjects with functional dyspepsia(FD) and gastritis were carried out.The impedance gastric motility(IGM) measurements of the healthy and FD subjects were compared,along with the studies of the FD subjects before treatment and after one week and three weeks of treatment.We also compared IGM measurements of healthy subjects and subjects with erosive gastritis,along with the studies of the subjects with erosive gastritis before treatment and after one week of treatment.Results show that FD subjects have poor gastric motility(P<0.01).After a week of treatment,the gastric motility of FD subjects was not yet improved although the EGG had returned to normal by this time.By three weeks of treatment,the regular IGM rhythm returned in FD subjects.There was a significant difference of IGM parameters between the gastritis and healthy subjects(P<0.05).The EGG rhythm of the gastritis subjects returned to normal at one week post-treatment,while IGM parameters showed a trend to improvement(P>0.05),These results suggest the possibility of clinic application of the proposed method.展开更多
AIM: To investigate whether gastric myoelectrical activity was impaired in patients with chronic pancreatitis (CP) and to explore the role of pancreatic enzyme in regulating gastric myoelectrical activity. METHODS: Tw...AIM: To investigate whether gastric myoelectrical activity was impaired in patients with chronic pancreatitis (CP) and to explore the role of pancreatic enzyme in regulating gastric myoelectrical activity. METHODS: Twenty CP patients and 20 controls participated in the study. Gastric myoelectrical activity was recorded by a homemade electrogastrography (EGG) device. Two experiments were carried out. In experiment one, EGG was recorded in both controls and CP patients. While in experiment two, either pancreatic enzymes or placebo was given together with test meals. Spectral analysis was used to generate various EGG parameters. RESULTS: The control subjects, but not the CP patients, showed typically increased postprandial dominant frequency. The postprandial dominant power (DP) increment (2.24±1.13 vs 5.35±0.96 dB, P= 0.04) and the percentage of normal 2-4 cpm slow waves (63.0±3.8% vs 77.4±3.1%, P<0.05) were lower in CP patients when compared with the control. In the 20 CP patients, the DP increment (4.76±1.02 vs 2.53±1.20 dB, P<0.05) and the postprandial percentage of normal 2-4 cpm (74.4±2.8% vs 64.8±5.7%, P<0.05) were significantly higher with pancreatic enzyme replacement than the placebo. CONCLUSION: CP patients have an abnormal postprandial stomach myoelectricity showing poor response in dominant frequency/power and regularity, whereas these abnormalities are corrected after pancreatic enzyme replacement. Maldigestion is likely to be the factor leading to abnormal postprandial gastric myoelectricity of CP patients.展开更多
AIM: To investigate the electric and contractile mechanisms involved in the deranged function of the transposed stomach in relation to the course of the symptoms and the changes in contractile and electrical parameter...AIM: To investigate the electric and contractile mechanisms involved in the deranged function of the transposed stomach in relation to the course of the symptoms and the changes in contractile and electrical parameters over time.METHODS: Twenty-one patients after subtotal esophagectomy and 18 healthy volunteers were studied.Complaints were compiled by using a questionnaire, and a symptom score was formed. Synchronous electrogastrography and gastric manometry were performed in the fasting state and postprandially.RESULTS: Eight of the operated patients were symptomfree and 13 had symptoms. The durations of the postoperative periods for the symptomatic (9.1±6.5 mo)and the asymptomatic (28.3±8.8 mo) patients were significantly different. The symptom score correlated negatively with the time that had elapsed since the operation. The percentages of the dominant frequency in the normogastric, bradygastric and tachygastric ranges differed significantly between the controls and the patients.A significant difference was detected between the power ratio of the controls and that of the patients. The occurrence of tachygastria in the symptomatic and the symptom-free patients correlated negatively both with the time that had elapsed and with the symptom score. There was a significant increase in motility index after feeding in the controls, but not in the patients. The contractile activity of the stomach increased both in the controls and in the symptom-free patients. In contrast, in the group of symptomatic patients, the contractile activity decreased postprandially as compared with the fasting state.CONCLUSION: The patients' post-operative complaints and symptoms change during the post-operative period and correlate with the parameters of the myoelectric and contractile activities of the stomach. Tachygastria seems to be the major pathogenetic factor involved in the contractile dysfunction.展开更多
Percutaneous local therapies, such as percutaneous ethanol injection （PEI）, microwave coagulation and radiofrequency ablation （RFA）, are frequently used worldwide for the treatment of hepatocellular carcinoma （HC...Percutaneous local therapies, such as percutaneous ethanol injection （PEI）, microwave coagulation and radiofrequency ablation （RFA）, are frequently used worldwide for the treatment of hepatocellular carcinoma （HCC） because of their high effectiveness. Although these treatment modalities can induce effectively coagulated tumor necrosis in the liver, they may cause adverse effects on extrahepatic abdominal organs. There are, however, no published reports on the influence of percutaneous local therapies on the gastric myenteric activity. Therefore, it is unclear whether or not gastric function is affected by percutaneous local therapies. In this study, to make clear the effect of PEI and RFA on the gastric function, we continuously recorded the gastric myoelectric activity by electrogastrography （EGG） and estimated the effect of percutaneous local therapies for HCC on gastric function.展开更多
AIM:To investigate the influence of percutaneous local therapy on gastric myoelectrical activity in patients with hepatocellular carcinomas.METHODS:Forty-four patients with hepatocellular carcinoma(HCC) [27 males and ...AIM:To investigate the influence of percutaneous local therapy on gastric myoelectrical activity in patients with hepatocellular carcinomas.METHODS:Forty-four patients with hepatocellular carcinoma(HCC) [27 males and 17 females,ranging in age from 49 to 81 years old(69.7 ± 8.01 years)] who were admitted for percutaneous local therapy were enrolled in this study.We examined clinical abdominal symptoms using the Gastrointestinal Symptom Rating Scale(GSRS) before and 3 d after percutaneous local therapy.We also measured cutaneous fasting and postprandial electrogastrography(EGG) recordings before and 3 d after percutaneous local therapy.RESULTS:We found that the percentage of normogastria in the fasting period was lower in the Child B group than in the Child A group(66.8% ± 8.6% vs 84.0% ± 3.8%).After percutaneous local therapy for HCC,the percentages of normogastria in the fasting period were significantly decreased(81.6% ± 3.5% vs 75.2% ± 4.5%).None of the postprandial EGG parameters changed significantly after percutaneous local therapy for HCC.Percutaneous local therapy for HCC reduced the power ratio(PR).In particular,the PR of tachygastria was significantly decreased after therapy(P < 0.01).However,no significant differences were found in the postprandial EGG parameters.Likewise,no significant differences were found in the calculated GSRS scores obtained from the questionnaire before and after therapy.CONCLUSION:Gastric slow-wave dysrhythmias were induced by percutaneous local therapy in HCC patients,even though the GSRS scores obtained from the questionnaire did not change significantly.展开更多
Objective: To study the effects of highly selective vagotomy plus resection of antral mucosa (HSV+RAM) or highly selective vagotomy (HSV) alone on the motility function of the pyloric antrum. Methods: 48 patients with...Objective: To study the effects of highly selective vagotomy plus resection of antral mucosa (HSV+RAM) or highly selective vagotomy (HSV) alone on the motility function of the pyloric antrum. Methods: 48 patients with duodenal ulcer were studied. 18 dogs were employed as experimental animals. 20 patients were operated on with HSV and 28 with HSV+RAM. The frequency of gastric evacuation and the amplitude of electrogastrography were determined 4 to 6 months after operation. 18 dogs were divided into the control group, HSV group and HSV+RAM group. The time of gastric evacuation, antral myoelectric activity and antral pressure were determined in the dogs 4 to 6 months after operation. The preoperative findings of the patients and the control dogs served as the control. Results: After operation, barium meal revealed that the shape of the stomach and duodenum was normal and the gastric peristalsis was clearly visible in human patients and experimental dogs. In the HSV+RAM group of dogs, the initial evacuation time was (5.0+0.06) min and the time of complete evacuation was (4.0+0.4) h after food-taking, which were similar to those of the control and the HSV group of dogs (P>0.05). The frequency of the antral myoelectric action potential was (3.11+0.65) cycles/min in the dog HAS+RAM group and the frequency of electrogastrography was (3.25+0.75) cycles/min in the human HSV+RAM group, which were significantly lower than those of the control and the dog and human HSV groups (P<0.05). Injection of pentagastrin in dogs and food-taking in human beings significantly increased the antral pressure and the amplitude and frequency of electrogastrography. Conclusion: The findings of this study suggest that the motility function of the reconstructed pyloric antrum in the HSV+RAM group of both the experimental dogs and human patients approaches to the normal even though there is a decrease of antral myoelectric frequency. It is suggested that HSV+RAM should be the first choice for the surgical management of duodenal ulcer.展开更多
An electrogastrogram （EGG） is a recording of the electrical activity in the stomach, as measured on the abdominal surface. In this study, the goal is to obtain a mathematical model of an EGG; to achieve this, the EG...An electrogastrogram （EGG） is a recording of the electrical activity in the stomach, as measured on the abdominal surface. In this study, the goal is to obtain a mathematical model of an EGG; to achieve this, the EGG of 14 subjects （seven males and seven females） will be obtained. Initially, the Wayland algorithm to the EGG to measure the degree of determinism is applied. However, it could not be determined whether the EGG could be generated by a chaotic process. In addition, the waveform of the electric potential in the interstitial cells of Cajal is similar to the graphs of the numerical solutions to the Van der Pol equation. Therefore, the Van der Pol equation to a periodic function was added, and random white noise was used to represent the intestinal motility and other biosignals. The EGG and numerical solutions were compared and evaluated on the basis of the translation error （Etrans） in the Wayland algorithm and the maximum Lyapunov exponent （2） in Rosenstein＇s algorithm. By projecting the data from an obtained stationary EGG from the subjects, along with the numerical solutions, onto the Etrans-λ plane, the affinity between them was qualitatively evaluated. The EGG was well described by stochastic resonance from the stochastic differential equations.展开更多
ABSTRACT Objective： To explore clinical short and long-term effect of combining Dalitong Granule （达立通颗粒） and electroacupuncture group （EA） in the treatment of functional dyspepsia. Methods： Totally 640 pati...ABSTRACT Objective： To explore clinical short and long-term effect of combining Dalitong Granule （达立通颗粒） and electroacupuncture group （EA） in the treatment of functional dyspepsia. Methods： Totally 640 patients with confirmed functional dyspepsia were randomly divided into 4 groups using a randomized digital table： the DG group, the EA group, the combined group and the control group, 160 cases in each group. The DG group was treated with 6 g DG 3 times daily; the EA group was treated with puncture of points Zusanli （ST36）, Zhongwan （CV12）, Neiguan （PC6）, Taichong （LR3） and Gongsun （SP4） twice daily; the combined group with above-mentioned DG and EA; and the control group with 5 mg mosapride 3 times, 20 mg pantoprazole and 25 mg amitriptylines twice daily. The treatment course was 4 weeks for all groups. The symptom score, quality of life score by Short Form 36 Health Survey Ouestionnaires （SF-36）, plasma motilin by radioimmunoassay, electrogastrographic frequencies by electrogastrogram （EGG） and gastric emptying by B-sonography were examined, and adverse reactions were observed before, at the end of treatment and 60 weeks post-treatment. Results： In the DG group 1 case dropped out for not taking medicine strictly and 1 case was lost to follow-up, while 1 case in the EA group and 2 cases in the combined therapy group were lost to follow-up. Compared with pre-treatment, quality of life score, plasma motilin, electrogastrographic frequencies and gastric emptying were all increased significantly, while symptom score was decreased significantly at the end of treatment in each group （P〈0.01）; in the combined group quality of life score, plasma motilin, electrogastrographic frequencies and gastric emptying were all significantly higher than those in the other groups, while symptom score was significantly lower than in the other groups （P〈0.05）. Compared with at the end of treatment, these indices changed insignificantly in the combined group and the EA group 60 weeks post-treatment （P〉0.05）, but the 4 increased indices were all decreased significantly, and symptom score was increased significantly in the DG and the control groups （P〉0.05）. The short and long-term total effective rates in the combined group were all significantly higher than those in the other treatment groups （P〈0.05 or P〈0.01）. No serious adverse reaction occurred in the four groups. Conclusion： Combined treatment of DG and EA could increase both plasma motilin and electrogastrographic frequencies, promote gastric emptying, alleviate the symptom of dyspepsia so as to increase quality of life, with better safety and long-term effect.展开更多
Objective: To explore the clinical effectiveness and therapeutic mechanism of Shuwei Decoction (舒胃汤) in treating functional dyspepsia (FD). Methods: A total of 124 FD patients were randomly divided into two groups:...Objective: To explore the clinical effectiveness and therapeutic mechanism of Shuwei Decoction (舒胃汤) in treating functional dyspepsia (FD). Methods: A total of 124 FD patients were randomly divided into two groups: Shuwei Decoction group (60 cases) and the control group (64 cases) treated with cisapride. After one month treatment, all patients were examined with motilin and electrogastrography (EGG). Results: The therapeutic effectiveness of Shuwei Decoction group was much better than that of the control group ( P <0.05), while the changes on motilin and EGG in the two groups were relatively similar ( P <0.05). Conclusion: Shuwei Decoction could effectively raise motilin level, promote gastric movement and improve the clinical symptoms in FD patients.展开更多
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.
基金Supported by funds from the Swedish Research Council (grant 2002-5489) and the Swedish Society of Medicine (Ihre’s fond)
文摘AIM: To investigate if there is a correlation between electrical activity measured by electrogastrography (EGG) and contractile activity of the stomach as measured by antroduodenal manometry (ADM). We also studied whether the underlying motility disorder could be predicted from EGG parameters. METHODS: We compared 21 parameters measured from EGG with 8 parameters measured from ADM. The ability of EGG to identify the underlying diagnosis was tested by comparing EGG parameters for each diagnosis group against other patients. The study comprised recordings from 148 patients and 125 females. Their median age was 45 (range 17-76) years. RESULTS: We found few and weak correlations between EGG and ADM. Specifically the correlation between parameters reflecting the response to meal was poor (r = -0.07, P = 0.39). The discriminatory power of EGG for underlying motility disorder was also low. Patients with slow transit constipation (STC) showed a lower postprandial power in normogastric (3.7 ± 0.5 vs 4.0 ± 0.5) and tachygastric (3.5 ± 0.4 vs 3.7 ± 0.4) regions, a lower percentage of time with normogastria [87.2 (56.5-100)% vs 95.7 (0-100)%], and a higher percentage of time with tachygastria [9.3 (0-33)% vs 3.5 (0-100)%] and bradygastria [1.8 (0-20)% vs 0 (0-17.1)%]. Patients with irritable bowel syndrome had a higher percentage of time with normogastria [96.5 (62.5-100)% vs 93.3 (0-100)%] and a less unstable dominant frequency as measured by the instability coefficient [15 (3-77) vs 24 (2-72)]. CONCLUSION: EGG and ADM seem to measure different aspects of gastric motor activity but cannot show a spatial correlation. The diagnostic value of EGG is poor, but EGG may have some value for the identification of patients with STC.
文摘To enhance the clinical utility of electrogastrography (EGG), which has been recorded since 1922, but is clinically unutilized. METHODSAn innovative method to salvage the promise of EGG is proposed by introducing a preliminary procedure, while maintaining the electrodes, standardized equipment, and signal processing utilized in the well-established EGG testing of today. The proposed enhanced EGG (EEGG) protocol involves swallowing an ingestible capsule containing miniature electronic oscillator embedded in an expandable, self-disintegratable, biocompatible pseudobesoar residing in the stomach for the duration of the test. The benefits of the proposed approach are outlined, tested and discussed in details. RESULTSExperiments were performed on eight mongrel dogs (6F, 4M, 23.8 ± 3.3 kg). Four were administered an active EEGG capsule, while the rest were given a deactivated (battery removed) capsule. Pharmacologically facilitated gastric motility revealed a significant (P < 0.01) Pearson correlation between gastric motility indices obtained by force transducers implanted directly on the stomach, and the motility indices obtained by EEGG. A particular emphasis was made on preserving standard EGG-related hardware and software in order to facilitate the introduction of the proposed EEGG in environments which already utilize standard EGG testing. The expanded intragastric pseudobezoar containing the miniature electronic oscillator was retained during the tests, and could be disintegrated on demand. CONCLUSIONEnhancing standard EGG by an ingestible, self-expanding and self-disintegrating pseudobesoar containing a miniature electronic oscillator can be an important avenue for clinical applicability of this test.
文摘Diabetic gastrointestinal neuropathy is a diabetes-related complication,associated with a complex interplay of hyperglycemic damage,autoimmune responses,oxidative stress,gastrointestinal hormones,and vascular insufficiency.Patients with diabetes should be monitored and therapeutic intervention introduced to prevent neuropathy due to diabetes prior to“the point of no return”.Determining gastric bioelectrical activity by body surface gastric mapping may be a promising option to monitor diabetic gastrointestinal neuropathy.
基金Project (Nos. 60471041 and 60901045) supported by the National Natural Science Foundation of China
文摘For some time now,the research on gastric motility and function has fallen behind in the amount of research on gastric endocrine,exocrine secretion,and gastric morphology.In this paper,a noninvasive method to study gastric motility was developed,taking bioimpedance measurements over the gastric area simultaneously with the electrogastrography(EGG).This is based on the concept of observing and analyzing simultaneously the intrinsic electrical gastric activity(basic electric rhythm) and the mechanical gastric activity.Additionally,preliminary clinical studies of healthy subjects and subjects with functional dyspepsia(FD) and gastritis were carried out.The impedance gastric motility(IGM) measurements of the healthy and FD subjects were compared,along with the studies of the FD subjects before treatment and after one week and three weeks of treatment.We also compared IGM measurements of healthy subjects and subjects with erosive gastritis,along with the studies of the subjects with erosive gastritis before treatment and after one week of treatment.Results show that FD subjects have poor gastric motility(P<0.01).After a week of treatment,the gastric motility of FD subjects was not yet improved although the EGG had returned to normal by this time.By three weeks of treatment,the regular IGM rhythm returned in FD subjects.There was a significant difference of IGM parameters between the gastritis and healthy subjects(P<0.05).The EGG rhythm of the gastritis subjects returned to normal at one week post-treatment,while IGM parameters showed a trend to improvement(P>0.05),These results suggest the possibility of clinic application of the proposed method.
文摘AIM: To investigate whether gastric myoelectrical activity was impaired in patients with chronic pancreatitis (CP) and to explore the role of pancreatic enzyme in regulating gastric myoelectrical activity. METHODS: Twenty CP patients and 20 controls participated in the study. Gastric myoelectrical activity was recorded by a homemade electrogastrography (EGG) device. Two experiments were carried out. In experiment one, EGG was recorded in both controls and CP patients. While in experiment two, either pancreatic enzymes or placebo was given together with test meals. Spectral analysis was used to generate various EGG parameters. RESULTS: The control subjects, but not the CP patients, showed typically increased postprandial dominant frequency. The postprandial dominant power (DP) increment (2.24±1.13 vs 5.35±0.96 dB, P= 0.04) and the percentage of normal 2-4 cpm slow waves (63.0±3.8% vs 77.4±3.1%, P<0.05) were lower in CP patients when compared with the control. In the 20 CP patients, the DP increment (4.76±1.02 vs 2.53±1.20 dB, P<0.05) and the postprandial percentage of normal 2-4 cpm (74.4±2.8% vs 64.8±5.7%, P<0.05) were significantly higher with pancreatic enzyme replacement than the placebo. CONCLUSION: CP patients have an abnormal postprandial stomach myoelectricity showing poor response in dominant frequency/power and regularity, whereas these abnormalities are corrected after pancreatic enzyme replacement. Maldigestion is likely to be the factor leading to abnormal postprandial gastric myoelectricity of CP patients.
文摘AIM: To investigate the electric and contractile mechanisms involved in the deranged function of the transposed stomach in relation to the course of the symptoms and the changes in contractile and electrical parameters over time.METHODS: Twenty-one patients after subtotal esophagectomy and 18 healthy volunteers were studied.Complaints were compiled by using a questionnaire, and a symptom score was formed. Synchronous electrogastrography and gastric manometry were performed in the fasting state and postprandially.RESULTS: Eight of the operated patients were symptomfree and 13 had symptoms. The durations of the postoperative periods for the symptomatic (9.1±6.5 mo)and the asymptomatic (28.3±8.8 mo) patients were significantly different. The symptom score correlated negatively with the time that had elapsed since the operation. The percentages of the dominant frequency in the normogastric, bradygastric and tachygastric ranges differed significantly between the controls and the patients.A significant difference was detected between the power ratio of the controls and that of the patients. The occurrence of tachygastria in the symptomatic and the symptom-free patients correlated negatively both with the time that had elapsed and with the symptom score. There was a significant increase in motility index after feeding in the controls, but not in the patients. The contractile activity of the stomach increased both in the controls and in the symptom-free patients. In contrast, in the group of symptomatic patients, the contractile activity decreased postprandially as compared with the fasting state.CONCLUSION: The patients' post-operative complaints and symptoms change during the post-operative period and correlate with the parameters of the myoelectric and contractile activities of the stomach. Tachygastria seems to be the major pathogenetic factor involved in the contractile dysfunction.
文摘Percutaneous local therapies, such as percutaneous ethanol injection （PEI）, microwave coagulation and radiofrequency ablation （RFA）, are frequently used worldwide for the treatment of hepatocellular carcinoma （HCC） because of their high effectiveness. Although these treatment modalities can induce effectively coagulated tumor necrosis in the liver, they may cause adverse effects on extrahepatic abdominal organs. There are, however, no published reports on the influence of percutaneous local therapies on the gastric myenteric activity. Therefore, it is unclear whether or not gastric function is affected by percutaneous local therapies. In this study, to make clear the effect of PEI and RFA on the gastric function, we continuously recorded the gastric myoelectric activity by electrogastrography （EGG） and estimated the effect of percutaneous local therapies for HCC on gastric function.
文摘AIM:To investigate the influence of percutaneous local therapy on gastric myoelectrical activity in patients with hepatocellular carcinomas.METHODS:Forty-four patients with hepatocellular carcinoma(HCC) [27 males and 17 females,ranging in age from 49 to 81 years old(69.7 ± 8.01 years)] who were admitted for percutaneous local therapy were enrolled in this study.We examined clinical abdominal symptoms using the Gastrointestinal Symptom Rating Scale(GSRS) before and 3 d after percutaneous local therapy.We also measured cutaneous fasting and postprandial electrogastrography(EGG) recordings before and 3 d after percutaneous local therapy.RESULTS:We found that the percentage of normogastria in the fasting period was lower in the Child B group than in the Child A group(66.8% ± 8.6% vs 84.0% ± 3.8%).After percutaneous local therapy for HCC,the percentages of normogastria in the fasting period were significantly decreased(81.6% ± 3.5% vs 75.2% ± 4.5%).None of the postprandial EGG parameters changed significantly after percutaneous local therapy for HCC.Percutaneous local therapy for HCC reduced the power ratio(PR).In particular,the PR of tachygastria was significantly decreased after therapy(P < 0.01).However,no significant differences were found in the postprandial EGG parameters.Likewise,no significant differences were found in the calculated GSRS scores obtained from the questionnaire before and after therapy.CONCLUSION:Gastric slow-wave dysrhythmias were induced by percutaneous local therapy in HCC patients,even though the GSRS scores obtained from the questionnaire did not change significantly.
文摘Objective: To study the effects of highly selective vagotomy plus resection of antral mucosa (HSV+RAM) or highly selective vagotomy (HSV) alone on the motility function of the pyloric antrum. Methods: 48 patients with duodenal ulcer were studied. 18 dogs were employed as experimental animals. 20 patients were operated on with HSV and 28 with HSV+RAM. The frequency of gastric evacuation and the amplitude of electrogastrography were determined 4 to 6 months after operation. 18 dogs were divided into the control group, HSV group and HSV+RAM group. The time of gastric evacuation, antral myoelectric activity and antral pressure were determined in the dogs 4 to 6 months after operation. The preoperative findings of the patients and the control dogs served as the control. Results: After operation, barium meal revealed that the shape of the stomach and duodenum was normal and the gastric peristalsis was clearly visible in human patients and experimental dogs. In the HSV+RAM group of dogs, the initial evacuation time was (5.0+0.06) min and the time of complete evacuation was (4.0+0.4) h after food-taking, which were similar to those of the control and the HSV group of dogs (P>0.05). The frequency of the antral myoelectric action potential was (3.11+0.65) cycles/min in the dog HAS+RAM group and the frequency of electrogastrography was (3.25+0.75) cycles/min in the human HSV+RAM group, which were significantly lower than those of the control and the dog and human HSV groups (P<0.05). Injection of pentagastrin in dogs and food-taking in human beings significantly increased the antral pressure and the amplitude and frequency of electrogastrography. Conclusion: The findings of this study suggest that the motility function of the reconstructed pyloric antrum in the HSV+RAM group of both the experimental dogs and human patients approaches to the normal even though there is a decrease of antral myoelectric frequency. It is suggested that HSV+RAM should be the first choice for the surgical management of duodenal ulcer.
文摘An electrogastrogram （EGG） is a recording of the electrical activity in the stomach, as measured on the abdominal surface. In this study, the goal is to obtain a mathematical model of an EGG; to achieve this, the EGG of 14 subjects （seven males and seven females） will be obtained. Initially, the Wayland algorithm to the EGG to measure the degree of determinism is applied. However, it could not be determined whether the EGG could be generated by a chaotic process. In addition, the waveform of the electric potential in the interstitial cells of Cajal is similar to the graphs of the numerical solutions to the Van der Pol equation. Therefore, the Van der Pol equation to a periodic function was added, and random white noise was used to represent the intestinal motility and other biosignals. The EGG and numerical solutions were compared and evaluated on the basis of the translation error （Etrans） in the Wayland algorithm and the maximum Lyapunov exponent （2） in Rosenstein＇s algorithm. By projecting the data from an obtained stationary EGG from the subjects, along with the numerical solutions, onto the Etrans-λ plane, the affinity between them was qualitatively evaluated. The EGG was well described by stochastic resonance from the stochastic differential equations.
文摘ABSTRACT Objective： To explore clinical short and long-term effect of combining Dalitong Granule （达立通颗粒） and electroacupuncture group （EA） in the treatment of functional dyspepsia. Methods： Totally 640 patients with confirmed functional dyspepsia were randomly divided into 4 groups using a randomized digital table： the DG group, the EA group, the combined group and the control group, 160 cases in each group. The DG group was treated with 6 g DG 3 times daily; the EA group was treated with puncture of points Zusanli （ST36）, Zhongwan （CV12）, Neiguan （PC6）, Taichong （LR3） and Gongsun （SP4） twice daily; the combined group with above-mentioned DG and EA; and the control group with 5 mg mosapride 3 times, 20 mg pantoprazole and 25 mg amitriptylines twice daily. The treatment course was 4 weeks for all groups. The symptom score, quality of life score by Short Form 36 Health Survey Ouestionnaires （SF-36）, plasma motilin by radioimmunoassay, electrogastrographic frequencies by electrogastrogram （EGG） and gastric emptying by B-sonography were examined, and adverse reactions were observed before, at the end of treatment and 60 weeks post-treatment. Results： In the DG group 1 case dropped out for not taking medicine strictly and 1 case was lost to follow-up, while 1 case in the EA group and 2 cases in the combined therapy group were lost to follow-up. Compared with pre-treatment, quality of life score, plasma motilin, electrogastrographic frequencies and gastric emptying were all increased significantly, while symptom score was decreased significantly at the end of treatment in each group （P〈0.01）; in the combined group quality of life score, plasma motilin, electrogastrographic frequencies and gastric emptying were all significantly higher than those in the other groups, while symptom score was significantly lower than in the other groups （P〈0.05）. Compared with at the end of treatment, these indices changed insignificantly in the combined group and the EA group 60 weeks post-treatment （P〉0.05）, but the 4 increased indices were all decreased significantly, and symptom score was increased significantly in the DG and the control groups （P〉0.05）. The short and long-term total effective rates in the combined group were all significantly higher than those in the other treatment groups （P〈0.05 or P〈0.01）. No serious adverse reaction occurred in the four groups. Conclusion： Combined treatment of DG and EA could increase both plasma motilin and electrogastrographic frequencies, promote gastric emptying, alleviate the symptom of dyspepsia so as to increase quality of life, with better safety and long-term effect.
文摘Objective: To explore the clinical effectiveness and therapeutic mechanism of Shuwei Decoction (舒胃汤) in treating functional dyspepsia (FD). Methods: A total of 124 FD patients were randomly divided into two groups: Shuwei Decoction group (60 cases) and the control group (64 cases) treated with cisapride. After one month treatment, all patients were examined with motilin and electrogastrography (EGG). Results: The therapeutic effectiveness of Shuwei Decoction group was much better than that of the control group ( P <0.05), while the changes on motilin and EGG in the two groups were relatively similar ( P <0.05). Conclusion: Shuwei Decoction could effectively raise motilin level, promote gastric movement and improve the clinical symptoms in FD patients.
