Digestion and intestinal absorption allow the body to sustain itself and are the emblematic functions of the bowel.On the flip side,functions also arise from its role as an interface with the environment.Indeed,the gu...Digestion and intestinal absorption allow the body to sustain itself and are the emblematic functions of the bowel.On the flip side,functions also arise from its role as an interface with the environment.Indeed,the gut houses microorganisms,collectively known as the gut microbiota,which interact with the host,and is the site of complex immune activities.Its role in human pathology is complex and scientific evidence is progressively elucidating the functions of the gut,especially regarding the pathogenesis of chronic intestinal diseases and inflammatory conditions affecting various organs and systems.This editorial aims to highlight and relate the factors involved in the pathogenesis of intestinal and systemic inflammation.展开更多
BACKGROUND Gastroesophageal reflux is associated with poorer outcomes after lung transplant,likely through recurrent aspiration and allograft injury.Although prior studies have demonstrated a relationship between impe...BACKGROUND Gastroesophageal reflux is associated with poorer outcomes after lung transplant,likely through recurrent aspiration and allograft injury.Although prior studies have demonstrated a relationship between impedance-pH results and transplant outcomes,the role of esophageal manometry in the assessment of lung transplant patients remains debated,and the impact of esophageal dysmotility on transplant outcomes is unclear.Of particular interest is ineffective esophageal motility(IEM)and its associated impact on esophageal clearance.AIM To assess the relationship between pre-transplant IEM diagnosis and acute rejection after lung transplantation.METHODS This was a retrospective cohort study of lung transplant recipients at a tertiary care center between 2007 and 2018.Patients with pre-transplant anti-reflux surgery were excluded.Manometric and reflux diagnoses were recorded from pre-transplant esophageal function testing.Time-to-event analysis using Cox proportional hazards model was applied to evaluate outcome of first episode of acute cellular rejection,defined histologically per International Society of Heart and Lung Transplantation guidelines.Subjects not meeting this endpoint were censored at time of post-transplant anti-reflux surgery,last clinic visit,or death.Fisher’s exact test for binary variables and student’s t-test for continuous variables were performed to assess for differences between groups.RESULTS Of 184 subjects(54%men,mean age:58,follow-up:443 person-years)met criteria for inclusion.Interstitial pulmonary fibrosis represented the predominant pulmonary diagnosis(41%).During the follow-up period,60 subjects(33.5%)developed acute rejection.The all-cause mortality was 16.3%.Time-to-event univariate analyses demonstrated significant association between IEM and acute rejection[hazard ratio(HR):1.984,95%CI:1.03-3.30,P=0.04],confirmed on Kaplan-Meier curve.On multivariable analysis,IEM remained independently associated with acute rejection,even after controlling for potential confounders such as the presence of acid and nonacid reflux(HR:2.20,95%CI:1.18-4.11,P=0.01).Nonacid reflux was also independently associated with acute rejection on both univariate(HR:2.16,95%CI:1.26-3.72,P=0.005)and multivariable analyses(HR:2.10,95%CI:1.21-3.64,P=0.009),adjusting for the presence of IEM.CONCLUSION Pre-transplant IEM was associated with acute rejection after transplantation,even after controlling for acid and nonacid reflux.Esophageal motility testing may be considered in lung transplant to predict outcomes.展开更多
BACKGROUND Hydrogen sulfide(H2S)is a recently discovered gaseous neurotransmitter in the nervous and gastrointestinal systems.It exerts its effects through multiple signaling pathways,impacting various physiological a...BACKGROUND Hydrogen sulfide(H2S)is a recently discovered gaseous neurotransmitter in the nervous and gastrointestinal systems.It exerts its effects through multiple signaling pathways,impacting various physiological activities.The nucleus tractus solitarius(NTS),a vital nucleus involved in visceral sensation,was investigated in this study to understand the role of H2S in regulating gastric function in rats.AIM To examine whether H2S affects the nuclear factor kappa-B(NF-κB)and transient receptor potential vanilloid 1 pathways and the neurokinin 1(NK1)receptor in the NTS.METHODS Immunohistochemical and fluorescent double-labeling techniques were employed to identify cystathionine beta-synthase(CBS)and c-Fos co-expressed positive neurons in the NTS during rat stress.Gastric motility curves were recorded by inserting a pressure-sensing balloon into the pylorus through the stomach fundus.Changes in gastric motility were observed before and after injecting different doses of NaHS(4 nmol and 8 nmol),physiological saline,Capsazepine(4 nmol)+NaHS(4 nmol),pyrrolidine dithiocarbamate(PDTC,4 nmol)+NaHS(4 nmol),and L703606(4 nmol)+NaHS(4 nmol).RESULTS We identified a significant increase in the co-expression of c-Fos and CBS positive neurons in the NTS after 1 h and 3 h of restraint water-immersion stress compared to the expressions observed in the control group.Intra-NTS injection of NaHS at different doses significantly inhibited gastric motility in rats(P<0.01).However,injection of saline,first injection NF-κB inhibitor PDTC or transient receptor potential vanilloid 1(TRPV1)antagonist Capsazepine or NK1 receptor blockers L703606 and then injection NaHS did not produce significant changes(P>0.05).CONCLUSION NTS contains neurons co-expressing CBS and c-Fos,and the injection of NaHS into the NTS can suppress gastric motility in rats.This effect may be mediated by activating TRPV1 and NK1 receptors via the NF-κB channel.展开更多
Investigating gastrointestinal(GI)motility disorders relies on diagnostic tools to assess muscular contractions,peristalsis propagation and the integrity and coordination of various sphincters.Manometries are the gold...Investigating gastrointestinal(GI)motility disorders relies on diagnostic tools to assess muscular contractions,peristalsis propagation and the integrity and coordination of various sphincters.Manometries are the gold standard to study the GI motor function but it is increasingly acknowledged that manometries do not provide a complete picture in relation to sphincters competencies and muscle fibrosis.Endolumenal functional lumen imaging probe(EndoFLIP)an emerging technology,uses impedance planimetry to measure hollow organs cross sectional area,distensibility and compliance.It has been successfully used as a complementary tool in the assessment of the upper and lower oesophageal sphincters,oesophageal body,the pylorus and the anal canal.In this article,we aim to review the uses of EndoFLIP as a tool to investigate GI motility disorders with a special focus on paediatric practice.The majority of EndoFLIP studies were conducted in adult patients but the uptake of the technology in paediatrics is increasing.EndoFLIP can provide a useful complementary data to the existing GI motility investigation in both children and adults.展开更多
Objective:To investigate the effect of auricular acupuncture on postoperative pain and gastrointestinal motility recovery after laparoscopic surgery for colorectal cancer.Methods:The clinical data of patients who unde...Objective:To investigate the effect of auricular acupuncture on postoperative pain and gastrointestinal motility recovery after laparoscopic surgery for colorectal cancer.Methods:The clinical data of patients who underwent laparoscopic radical surgery for colorectal cancer in our hospital from April 2020 to December 2021 were collected.Based on the inclusion and exclusion criteria,76 patients were included in the retrospective analysis.Depending on whether they received auricular acupuncture or not,the patients were divided into two groups:46 patients in the experimental group(auricular acupuncture)and 30 patients in the control group.The differences between the two groups were analyzed.Results:The time to first flatus of the experimental group was significantly shorter than that of the control group(52.2±7.36 h versus 66.3±7.83 h;P<0.001).Similarly,the time to first defecation of the experimental group was significantly shorter than that of the control group(76.3±7.76 h versus 86.1±10.79 h;P<0.001).The time to first fluid intake of the auricular group was significantly shorter than that of the control group(90.4±8.92 h versus 107.3±9.66 h,P<0.001).Compared with the control group,the experimental group scored significantly lower on the visual analogue scale on postoperative days 2 and 3(P<0.001).Conclusion:Auricular acupuncture is an effective traditional Chinese medicine external treatment method.It can promote gastrointestinal motility recovery in patients after laparoscopic radical surgery for colorectal cancer and also reduce postoperative pain and discomfort.Furthermore,this therapy is easy to operate and well-accepted by patients.Therefore,it should be strongly promoted in clinical practice.展开更多
Although chronic gastrointestinal dysmotility syndromes are a common worldwide health problem,underlying causes for these disorders are poorly understood.We show that flavivirus infection of enteric neurons leads to a...Although chronic gastrointestinal dysmotility syndromes are a common worldwide health problem,underlying causes for these disorders are poorly understood.We show that flavivirus infection of enteric neurons leads to acute neuronal injury and cell death,inflammation,bowel dilation,and slowing of intestinal transit in mice.Flavivirus-primed CD8+T cells promote these phenotypes,as their absence diminished enteric neuron injury and intestinal transit delays,and their adoptive transfer reestablished dysmotility after flavivirus infection.展开更多
This study aims to investigate the protective effects of peroxiredoxin 6 on the total motility and progressive motility of human spermatozoa.Semen samples with normal parameters were collected from 23 males and supple...This study aims to investigate the protective effects of peroxiredoxin 6 on the total motility and progressive motility of human spermatozoa.Semen samples with normal parameters were collected from 23 males and supplemented with different concentrations of peroxiredoxin 6.All the semen samples were measured according to the WHO 5th manual,and the motile spermatozoa were extracted using IVF fertilization medium supplemented with different peroxiredoxin 6 concentrations.Total motility and progressive motility were observed at different time-points of culture at room temperature.After peroxiredoxin 6 supplementation,all groups had a significant increase in total motility and progressive motility compared to the control group.The difference in total motility and progressive motility between the 0 and 10−7 mM groups was observed at 24 and 48 h of culture at room temperature.At 24 h,the total motility increased by 30%in the control group(16.03±11.91 vs.11.51±7.84),and progressive motility increased by 21%(10.53±9.4 vs.8.31±6.04).A similar trend was observed in the 48 h group.In addition,we also found that peroxiredoxin 6 had a well protective effect on sperm kinetic parameters at 10−7 mM.The findings of this study suggest that peroxiredoxin 6 can enhance sperm total motility and progressive motility in IVF fertilization medium.Peroxiredoxin 6 may have potential benefits for sperm preparation in assisted reproductive technology.展开更多
BACKGROUND Recently,a technique has been developed to use magnetic resonance enterography(MRE)for the evaluation of small bowel motility.The hypothesis was that assessment of the motility index(MI)should reflect diffe...BACKGROUND Recently,a technique has been developed to use magnetic resonance enterography(MRE)for the evaluation of small bowel motility.The hypothesis was that assessment of the motility index(MI)should reflect differences in motility between clinical conditions.AIM To aim of the present observational,cross-sectional study was to evaluate the use of the MI in daily clinical practice.METHODS All consecutive patients aged 18-70 years who were referred for MRE at the Department of Radiology during a 2-year period were asked to participate.Healthy volunteers were included as controls.MRE was prepared and conducted in accordance with clinical routines.On the day of examination,all the participants had to complete the visual analog scale for irritable bowel syndrome(IBS)and IBS-symptom severity scale.Maps of MI were calculated from dynamic MR images.ANOVA was used to evaluate differences in MI between groups,classified as healthy,Crohn’s disease,ulcerative colitis,IBS,other assorted disorders and dysmotility.Logistic and linear regression were applied to the MI values.All medical records were scrutinized for medical history.RESULTS In all,224 examinations were included(inclusion prevalence 76.3%),with 22 controls and 202 patients.There was a significant difference in the MI of the jejunum(P=0.021)and terminal ileum(P=0.007)between the different groups.The MI was inversely associated with the mural thickness of the terminal ileum in men(P<0.001)and women(P=0.063)after adjustments,and tended to be lower in men than in women(P=0.056).Subjectively observed reduction of motility on MRI was accomplished by reduced MI of terminal ileum in men(P<0.001)and women(P=0.030).In women,diarrhea was inversely associated with the MI of the jejunum(P=0.029),and constipation was positively associated with the MI of the terminal ileum(P=0.039).CONCLUSION Although MIs differ across diseases,a lower MI of the terminal ileum is mainly associated with male sex and an increased mural thickness.Symptoms are weakly associated with the MI.展开更多
Disorders of esophageal motility have been described in patients with cirrhosis in a small number of studies.In this review,we aim to provide an overview of the available evidence on esophageal motility disorders in c...Disorders of esophageal motility have been described in patients with cirrhosis in a small number of studies.In this review,we aim to provide an overview of the available evidence on esophageal motility disorders in cirrhosis and their clinical implications.This review delves into the following concepts:(1)Gastroesophageal reflux disease is common in liver cirrhosis due to many mechanisms;however,when symptomatic it is usually nocturnal and has an atypical presentation;(2)Endoscopic band ligation is better than sclerotherapy in terms of its effect on esophageal motility and seems to correct dysmotilities resulting from the mechanical effect of esophageal varices;(3)Chronic alcoholism has no major effects on esophageal motility activity other than lower esophageal sphincter hypertension among those with alcoholic autonomic neuropathy;(4)An association between primary biliary cholangitis and scleroderma can be present and esophageal hypomotility is not uncommon in this scenario;and(5)Cyclosporin-based immunosuppression in liver transplant patients can have a neurotoxic effect on the esophageal myenteric plexus leading to reversible achalasia-like manifestations.展开更多
Background: Previous studies on fasting and gastrointestinal motility were reported with information lacking concerning prolonged continuous fasting and gastrointestinal motility. This study investigated the effect of...Background: Previous studies on fasting and gastrointestinal motility were reported with information lacking concerning prolonged continuous fasting and gastrointestinal motility. This study investigated the effect of prolonged fasting duration on gastrointestinal motility. Methods: Forty-five (45) male Wistar rats, with body weights between 180 - 200 g were used. They were randomly assigned into three (3) groups. Group1: control (rats fasted for 18 h—common duration of fasting for motility studies), groups 2 and 3 fasted for 48 and 72 h respectively. Five (5) rats per experiment and per group were considered. Blood glucose was determined by glucose oxidase method, gastric emptying was assessed by hydrated carbohydrate meal, intestinal motility by charcoal meal, and colonic motility was assessed using bead test. Data were reported in Mean ± SEM and analyzed with one-way ANOVA. Differences in results were considered significant at p ≤ 0.05. Results: There was no significant change in the blood glucose level (mmol/L) of rats in the 48 h group (2.94 ± 0.35) and 72 h group (3.20 ± 0.32) as compared with the control (3.62 ± 0.19). There was a significant decrease in the rate of gastric emptying (g) in the 72 h group (0.20 ± 0.08) compared with the control (0.64 ± 0.16). The intestinal transit (cm) in the 48 h group (67.54 ± 6.15) and 72 h group (72.10 ± 7.60) increased significantly when compared with the control (42.14 ± 3.14). There was a significant decrease in the colonic motility time (Sec.) in the 48 h group (2707 ± 864.1) and 72 h group (6363 ± 968.1) when compared with the control (263.8 ± 64.26). Conclusion: Extended fasting durations decrease the rate of gastric emptying and colonic motility. It suggests that extended fasting durations could be beneficial in intestinal spasms or where the gut is required to relax.展开更多
BACKGROUND Peroral endoscopic myotomy is an increasingly used less invasive modality to treat esophageal dysmotility.Recently,triangular tip knife with integrated water jet function has been introduced to mitigate mul...BACKGROUND Peroral endoscopic myotomy is an increasingly used less invasive modality to treat esophageal dysmotility.Recently,triangular tip knife with integrated water jet function has been introduced to mitigate multiple instrument exchanges.AIM To compare traditional triangular tip knife and water jet knife in terms of procedural success,duration,instrument exchanges,coagulation forceps use,and adverse events.METHODS We conducted a systemic review and meta-analysis with two authors independently in electronic databases(PubMed,Embase,and Cochrane Library)from inception through May 2021.In addition,we conducted a relevant search by Reference Citation Analysis(RCA)(https://www.referencecitationanalysis.com).A fixed-effects model was used to calculate weighted mean,odds ratio(OR),and confidence intervals(CI).RESULTS We included 7 studies involving 558 patients.Triangular knife and water jet knife were similar in odds of procedural success with ratio of 4.78(95%CI=0.22-102.47)and odds of clinical success with ratio of 0.93(95%CI=0.29-2.97),respectively.Water jet knife had fewer instrument exchanges compared to triangular knife(2.21,95%CI=1.98-2.45 vs 11.9,95%CI=11.15-12.70)and usage of coagulation forceps(1.75,95%CI=1.52-1.97 vs 2.63,95%CI=2.37-2.89).Adverse events were higher in triangular knife group(OR:2.30,95%CI=1.35-3.95).CONCLUSION Peroral endoscopic myotomy using water jet knife is comparable in terms of pro cedural success to triangular tip knife.Water jet knife also required shorter procedural duration,less instrument exchanges,coagulation devices,and overall adverse events.展开更多
AIM: To investigate whether the reduction of stem cell factor (SCF) is mediated by decreased endogenous insulin-like growth factor (IGF)-1 in diabetic rat colon smooth muscle. METHODS: Sixteen Sprague-Dawley rats were...AIM: To investigate whether the reduction of stem cell factor (SCF) is mediated by decreased endogenous insulin-like growth factor (IGF)-1 in diabetic rat colon smooth muscle. METHODS: Sixteen Sprague-Dawley rats were randomly divided into two groups: control group and streptozotocin-induced diabetic group. After 8 wk of streptozotocin administration, colonic motility function and contractility of circular muscle strips were measured. The expression of endogenous IGF-1 and SCF was tested in colonic tissues. Colonic smooth muscle cells were cultured from normal adult rats. IGF-1 siRNA transfection was used to investigate whether SCF expression was affected by endogenous IGF-1 expression in smooth muscle cells, and IGF-1 induced SCF expression effects were studied. The effect of high glucose on the expression of endogenous IGF-1 and SCF was also investigated. RESULTS: Diabetic rats showed prolonged colonic transit time (252 ± 16 min vs 168 ± 9 min, P < 0.01) and weakness of circular muscle contraction (0.81 ± 0.09 g vs 2.48 ± 0.23 g, P < 0.01) compared with the control group. Endogenous IGF-1 and SCF protein expression was significantly reduced in the diabetic colonic muscle tissues. IGF-1 and SCF mRNA expression also showed a paralleled reduction in diabetic rats. In the IGF-1 siRNA transfected smooth muscle cells, SCF mRNA and protein expression was significantly decreased. IGF-1 could induce SCF expression in a concentration and time-dependent manner, mainly through the extracellular-signal-regulated kinase 1/2 signal pathway. High glucose inhibited endogenous IGF-1 and SCF expression and the addition of IGF-1 to the medium reversed the SCF expression. CONCLUSION: Myopathy may resolve in colonic motility dysfunction in diabetic rats. Deficiency of endogenous IGF-1 in colonic smooth muscle cells leads to reduction of SCF expression.展开更多
AIM:To evaluate the benefit of aerobic exercise on colonic transit time(CTT)for psychiatric inpatients in a closed ward.METHODS:Sixty consecutive adult inpatients of the Somang Hospital Psychiatry Unit(Eumsung-gun,Sou...AIM:To evaluate the benefit of aerobic exercise on colonic transit time(CTT)for psychiatric inpatients in a closed ward.METHODS:Sixty consecutive adult inpatients of the Somang Hospital Psychiatry Unit(Eumsung-gun,South Korea),without CTT-related diseases or drug therapies,were recruited for study from March to June of 2012.Upon enrollment,the patients were randomly assigned to partake in a 12-wk instructor-led group aerobic exercise program(exercise group;n=30)or to maintain their ordinary daily activities(control group;n=30).The exercise program was structured as 10 min warm-up(stretching),40 min exercise,and 10 min cool-down(stretching)for three days each week.The exercise sessions consisted of walking only in week one and aerobics from weeks two to 12,with increasing intensity(50%heart rate reserve(HRR)for weeks one to four,60%HRR for weeks five to eight,and 70%HRR for weeks nine to 12).CTT was measured before(baseline)and after(week 12)the exercise program,in duplicate(on days four and seven),using abdominal radiography and the multiple radio-opaque marker technique.Changes in the exercising patients’CTT and weight-,cardiovascular-and fitness-related parameters were statistically assessed.RESULTS:The study dropout rate was 30.0%,with 23patients in the exercise group and 19 patients in the control group completing the study.At week 12,the exercise group showed decreases in body weight(mean±SE)baseline:69.4±2.8 vs study-end:67.6±2.7;P<0.635)and body mass index(BMI)(25.2±1.1 vs24.9±0.8;P<0.810),but the extent of change was not significantly different from that experienced by the control group(body weight:68.8±4.0 vs 68.8±3.9;BMI:24.3±1.1 vs 24.4±1.2).However,the exercise group showed significant improvements in leg muscle strength(baseline:41.7±4.3 vs study-end:64.1±5.0;P<0.001),cardio-respiratory endurance(120.5±4.5vs 105.4±2.8;P<0.004),and leg muscle elasticity and power output(21.5±2.6 vs 30.6±2.8;P<0.001).The exercise group showed an exercise-induced reduction in total CTT(baseline:54.2±8.0 vs 30.3±6.1),which was significantly different from that experienced by the control group over the 12-wk period(48.6±9.3vs 48.3±12.3;P=0.027);however,the exercise-induced decreases in CTT involving the three colonic segments examined(right,left and recto-sigmoid)showed no significant differences from the control group.CONCLUSION:A 12-wk aerobic exercise program can benefit psychiatric inpatients by increasing intestinal motility,possibly decreasing risk of metabolic-and cardiovascular-related disease.展开更多
AIM To investigate the underlying effect of Jianpi Qingchang decoction(JQD) regulating intestinal motility of dextran sulfate sodium(DSS)-induced colitis in mice. METHODS C57BL/6 mice were randomly divided into four g...AIM To investigate the underlying effect of Jianpi Qingchang decoction(JQD) regulating intestinal motility of dextran sulfate sodium(DSS)-induced colitis in mice. METHODS C57BL/6 mice were randomly divided into four groups: the control group, the DSS group, the JQD group, and the 5-aminosalicylic acid group. Except for the control group, colitis was induced in other groups by giving distilled water containing 5% DSS. Seven days after modeling, the mice were administered corresponding drugs intragastrically. The mice were sacrificed on the 15^(th) day. The disease activity index, macroscopic and histopathologic lesions, and ultrastructure of colon interstitial cells of Cajal(ICC) were observed. The levels of tumor necrosis factor-alpha(TNF-α), interleukin(IL)-1β, IL-10 and interferon gamma(IFN-γ), the expression of nuclear factor-kappa B(NF-κB) p65, c-kit, microtubule-associated protein 1 light chain 3(LC3-Ⅱ) and Beclin-l m RNA, and the colonic smooth muscle tension were assessed. RESULTS Acute inflammation occurred in the mice administered DSS. Compared with the control group, the levels of IL-1β, TNF-α, IL-10 and IFN-γ, the expression of LC3-Ⅱ, Beclin-1 and NF-κB p65 m RNA, and the contractile frequency increased(P < 0.05), the expression of c-kit m RNA and the colonic smooth muscle contractile amplitude decreased in the DSS group(P < 0.05). Compared with the DSS group, the levels of IL-10 and IFN-γ, the expression of c-kit m RNA, and the colonic smooth muscle contractile amplitude increased(P < 0.05), the levels of TNF-α and IL-1β, the expression of LC3-Ⅱ, Beclin-1 and NF-κB p65 m RNA, and the contractile frequency decreased in the JQD group(P < 0.05).CONCLUSION JQD can regulate the intestinal motility of DSS-induced colitis in mice through suppressing intestinal inflammatory cascade reaction, reducing autophagy of ICC, and regulating the network path of ICC/smooth muscle cells.展开更多
Acupuncture has been used in China for thousands of years and has become more widely accepted by doctors and patients around the world. A large number of clinical studies and animal experiments have confirmed that acu...Acupuncture has been used in China for thousands of years and has become more widely accepted by doctors and patients around the world. A large number of clinical studies and animal experiments have confirmed that acupuncture has a benign adjustment effect on gastrointestinal(GI) movement;however, the mechanism of this effect is unclear, especially in terms of neural mechanisms, and there are still many areas that require further exploration. This article reviews the recent data on the neural mechanism of acupuncture on GI movements. We summarize the neural mechanism of acupuncture on GI movement from four aspects: acupuncture signal transmission, the sympathetic and parasympathetic nervous system, the enteric nervous system, and the central nervous system.展开更多
AIM To investigate the effects of Xiangbin prescription(XBP), a Chinese herbal concoction, on gastrointestinal motility.METHODS Forty healthy volunteers were recruited for this randomized controlled trial of XBP. Antr...AIM To investigate the effects of Xiangbin prescription(XBP), a Chinese herbal concoction, on gastrointestinal motility.METHODS Forty healthy volunteers were recruited for this randomized controlled trial of XBP. Antroduodenojejunal manometry was used to monitor gastrointestinal motility in these subjects. After the subjects had fasted for at least 12 h, XBP(n = 30) or placebo(n = 10) was orally administrated and gastrointestinal motility was recorded for 4 h. Plasma motilin and ghrelin were measured by enzyme-linked immunosorbent assay.RESULTS Oral administration of XBP significantly increased the amplitude of duodenal contractions [19.5(13.0-26.7) vs 16.9(12.3-23.9), P < 0.05], jejunal contractions [18.3(15.3-25.0) vs 15.4(11.7-23.9), P < 0.01], and the motility index of duodenal contractions [522.0(146.0-139.0) vs 281.0(76.5-1006.0), P < 0.01] in phase Ⅱ of the migratory motor complex(MMC), which subsequently initiated the MMC cycle [74.0(30.0-118.0) vs 116.5(24.0-219.0), P < 0.05], shortened the duration of phase I of the MMC [42.0(0.0-90.0) vs 111.5(42.0-171.0), P < 0.01], and lengthened the duration of phase Ⅱ of the MMC [120(21-240) vs 58(16-170), P < 0.01] compared to the duration before XBP administration. There were significant differences in the amplitude of jejunal contractions [19.8(14.0-30.0) vs 18.0(13.0-28.5), P < 0.05], the motility index of duodenal contractions [236.0(115.0-306.0) vs 195.0(109.0-310.0), P < 0.05], and jejunal contractions [214.0(95.0-403.0) vs 178.0(55.0-304.0), P < 0.01] in phase Ⅲ of the MMC. Oral administration of XBP greatly increased plasma motilin(57.69 ± 9.03 vs 49.38 ± 8.63, P < 0.01) and ghrelin(279.20 ± 104.31 vs 238.73 ± 115.59, P < 0.01) concentrations compared to concentrations after oral administration of the placebo.CONCLUSION XBP can stimulate duodenal and jejunal motility and increase the concentrations of plasma motilin and ghrelin. The clinical applicability of XBP in treating GDIM deserves investigation.展开更多
BACKGROUND Electroacupuncture(EA) at ST36 can significantly improve gastrointestinal symptoms, especially in promoting gastrointestinal motility. The automatic nervous system plays a main role in EA, but few studies e...BACKGROUND Electroacupuncture(EA) at ST36 can significantly improve gastrointestinal symptoms, especially in promoting gastrointestinal motility. The automatic nervous system plays a main role in EA, but few studies exist on how vagovagal and sympathetic reflexes affect EA to regulate gastrointestinal motility.AIM To study the role of vagovagal and sympathetic reflexes in EA at ST36, as well as the associated receptor subtypes that are involved.METHODS Gastric motility was measured with a manometric balloon placed in the gastric antrum area in anesthetized animals. The peripheral nervous discharge was measured using a platinum electrode hooking the vagus or greater splanchnic nerve, and the central nervous discharge was measured with a glass microelectrode in the dorsal motor nucleus of the vagus(DMV). The effects and mechanisms of EA at ST36 were explored in male Sprague-Dawley rats which were divided in to a control group, vagotomy group, sympathectomy group, and microinjection group [including an artificial cerebrospinal fluid group, glutamate(L-Glu) group, and γ-aminobutyric acid(GABA) group] and in genetically modified male mice [β1β2 receptor-knockout(β1β2^(-/-)) mice, M2M3 receptorknockout(M2M3^(-/-)) mice, and wild-type control mice].RESULTS EA at ST36 promoted gastric motility during 30-120 s. During EA, both vagus and sympathetic nerve discharges increased, with a much higher frequency of vagus nerve discharge than sympathetic discharge. The gastric motility mediated by EA at ST36 was interdicted by vagotomy. However, gastric motility mediated by EA at ST36 was increased during 0-120 s by sympathectomy, which eliminated the delay effect of EA during 0-30 s, but it was lower than the control group during 30-120 s. Using gene knockout mice and their wild-type controls to explore the receptor mechanisms, we found that EA at ST36 decreased gastric motility in M2/3^(-/-) mice, and promoted gastric motility in β1/2^(-/-) mice. Extracellular recordings showed that EA at ST36 increased spikes of the DMV. Microinjection of L-Glu into the DMV increased gastric motility, while EA at ST36 decreased gastric motility during 0-60 s, and promoted gastric motility during 60-120 s.Injection of GABA reduced or increased gastric motility, and reduced the promoting gastric motility effect of EA at ST36.CONCLUSION These data suggest that EA at ST36 modulates gastric motility via vagovagal and sympathetic reflexes mediated through M2/3 and β1/2 receptors, respectively.Sympathetic nerve activity mediated through β1/2 receptors is associated with an early delay in modulation of gastric motility by EA at ST36.展开更多
Irritable bowel syndrome(IBS)is a chronic,recurring,and remitting functional disorder of the gastrointestinal tract characterized by abdominal pain,distention,and changes in bowel habits.Although there are several dru...Irritable bowel syndrome(IBS)is a chronic,recurring,and remitting functional disorder of the gastrointestinal tract characterized by abdominal pain,distention,and changes in bowel habits.Although there are several drugs for IBS,effective and approved treatments for one or more of the symptoms for various IBS subtypes are needed.Improved understanding of pathophysiological mechanisms such as the role of impaired bile acid metabolism,neurohormonal regulation,immune dysfunction,the epithelial barrier and the secretory properties of the gut has led to advancements in the treatment of IBS.With regards to therapies for restoring intestinal permeability,multiple studies with prebiotics and probiotics are ongoing,even if to date their efficacy has been limited.In parallel,much progress has been made in targeting low-grade inflammation,especially through the introduction of drugs such as mesalazine and rifaximin,even if a better knowledge of the mechanisms underlying the low-grade inflammation in IBS may allow the design of clinical trials that test the efficacy and safety of such drugs.This literature review aims to summarize the findings related to new and investigational therapeutic agents for IBS,most recently developed in preclinical as well as Phase 1 and Phase 2clinical studies.展开更多
AIM: To investigate whether electroacupuncture(EA) at ST25 affects jejunal motility in vivo and if so, whether a sympathetic pathway is involved.METHODS: Jejunal motility was assessed using a manometric balloon placed...AIM: To investigate whether electroacupuncture(EA) at ST25 affects jejunal motility in vivo and if so, whether a sympathetic pathway is involved.METHODS: Jejunal motility was assessed using a manometric balloon placed in the jejunum approximately about 3-5 cm away from the suspensory ligament of the duodenum in anesthetized animals. The effects of EA at ST25 were measured in male Sprague-Dawley rats, some of which were treated with propranolol or clenbuterol(EA intensities: 1, 3, 5, 7, and 9 m A), and in male transient receptor potential vanilloid-1(TRPV1)(capsaicin receptor) knockout mice(EA intensities: 1, 2, and 4 m A).RESULTS: Anesthetized rats exhibited three types of fasting jejunal motor patterns(types A, B, and C), and only type C rats responded to EA stimulation. In type C rats, EA at ST25 significantly suppressed the motor activity of the jejunum in an intensity-dependent manner. The inhibitory effect of EA was weakened by propranolol(β adrenoceptor antagonist) and disappeared with clenbuterol(β adrenoceptor agonist) induced inhibition of motility, suggesting that the effect of EA on motility is mediated via a sympathetic pathway. Compared with wild-type mice, EA at ST25 was less effective in TRPV1 knockout mice, suggesting that this multi-modal sensor channel participates in the mechanism. CONCLUSION: EA at ST25 was found to inhibit jejunal motility in an intensity-dependent manner, via a mechanism in which sympathetic nerves and TRPV1 receptors play an important role.展开更多
文摘Digestion and intestinal absorption allow the body to sustain itself and are the emblematic functions of the bowel.On the flip side,functions also arise from its role as an interface with the environment.Indeed,the gut houses microorganisms,collectively known as the gut microbiota,which interact with the host,and is the site of complex immune activities.Its role in human pathology is complex and scientific evidence is progressively elucidating the functions of the gut,especially regarding the pathogenesis of chronic intestinal diseases and inflammatory conditions affecting various organs and systems.This editorial aims to highlight and relate the factors involved in the pathogenesis of intestinal and systemic inflammation.
文摘BACKGROUND Gastroesophageal reflux is associated with poorer outcomes after lung transplant,likely through recurrent aspiration and allograft injury.Although prior studies have demonstrated a relationship between impedance-pH results and transplant outcomes,the role of esophageal manometry in the assessment of lung transplant patients remains debated,and the impact of esophageal dysmotility on transplant outcomes is unclear.Of particular interest is ineffective esophageal motility(IEM)and its associated impact on esophageal clearance.AIM To assess the relationship between pre-transplant IEM diagnosis and acute rejection after lung transplantation.METHODS This was a retrospective cohort study of lung transplant recipients at a tertiary care center between 2007 and 2018.Patients with pre-transplant anti-reflux surgery were excluded.Manometric and reflux diagnoses were recorded from pre-transplant esophageal function testing.Time-to-event analysis using Cox proportional hazards model was applied to evaluate outcome of first episode of acute cellular rejection,defined histologically per International Society of Heart and Lung Transplantation guidelines.Subjects not meeting this endpoint were censored at time of post-transplant anti-reflux surgery,last clinic visit,or death.Fisher’s exact test for binary variables and student’s t-test for continuous variables were performed to assess for differences between groups.RESULTS Of 184 subjects(54%men,mean age:58,follow-up:443 person-years)met criteria for inclusion.Interstitial pulmonary fibrosis represented the predominant pulmonary diagnosis(41%).During the follow-up period,60 subjects(33.5%)developed acute rejection.The all-cause mortality was 16.3%.Time-to-event univariate analyses demonstrated significant association between IEM and acute rejection[hazard ratio(HR):1.984,95%CI:1.03-3.30,P=0.04],confirmed on Kaplan-Meier curve.On multivariable analysis,IEM remained independently associated with acute rejection,even after controlling for potential confounders such as the presence of acid and nonacid reflux(HR:2.20,95%CI:1.18-4.11,P=0.01).Nonacid reflux was also independently associated with acute rejection on both univariate(HR:2.16,95%CI:1.26-3.72,P=0.005)and multivariable analyses(HR:2.10,95%CI:1.21-3.64,P=0.009),adjusting for the presence of IEM.CONCLUSION Pre-transplant IEM was associated with acute rejection after transplantation,even after controlling for acid and nonacid reflux.Esophageal motility testing may be considered in lung transplant to predict outcomes.
基金the Natural Science Foundation of Shandong Province,No.ZR2019MC020。
文摘BACKGROUND Hydrogen sulfide(H2S)is a recently discovered gaseous neurotransmitter in the nervous and gastrointestinal systems.It exerts its effects through multiple signaling pathways,impacting various physiological activities.The nucleus tractus solitarius(NTS),a vital nucleus involved in visceral sensation,was investigated in this study to understand the role of H2S in regulating gastric function in rats.AIM To examine whether H2S affects the nuclear factor kappa-B(NF-κB)and transient receptor potential vanilloid 1 pathways and the neurokinin 1(NK1)receptor in the NTS.METHODS Immunohistochemical and fluorescent double-labeling techniques were employed to identify cystathionine beta-synthase(CBS)and c-Fos co-expressed positive neurons in the NTS during rat stress.Gastric motility curves were recorded by inserting a pressure-sensing balloon into the pylorus through the stomach fundus.Changes in gastric motility were observed before and after injecting different doses of NaHS(4 nmol and 8 nmol),physiological saline,Capsazepine(4 nmol)+NaHS(4 nmol),pyrrolidine dithiocarbamate(PDTC,4 nmol)+NaHS(4 nmol),and L703606(4 nmol)+NaHS(4 nmol).RESULTS We identified a significant increase in the co-expression of c-Fos and CBS positive neurons in the NTS after 1 h and 3 h of restraint water-immersion stress compared to the expressions observed in the control group.Intra-NTS injection of NaHS at different doses significantly inhibited gastric motility in rats(P<0.01).However,injection of saline,first injection NF-κB inhibitor PDTC or transient receptor potential vanilloid 1(TRPV1)antagonist Capsazepine or NK1 receptor blockers L703606 and then injection NaHS did not produce significant changes(P>0.05).CONCLUSION NTS contains neurons co-expressing CBS and c-Fos,and the injection of NaHS into the NTS can suppress gastric motility in rats.This effect may be mediated by activating TRPV1 and NK1 receptors via the NF-κB channel.
文摘Investigating gastrointestinal(GI)motility disorders relies on diagnostic tools to assess muscular contractions,peristalsis propagation and the integrity and coordination of various sphincters.Manometries are the gold standard to study the GI motor function but it is increasingly acknowledged that manometries do not provide a complete picture in relation to sphincters competencies and muscle fibrosis.Endolumenal functional lumen imaging probe(EndoFLIP)an emerging technology,uses impedance planimetry to measure hollow organs cross sectional area,distensibility and compliance.It has been successfully used as a complementary tool in the assessment of the upper and lower oesophageal sphincters,oesophageal body,the pylorus and the anal canal.In this article,we aim to review the uses of EndoFLIP as a tool to investigate GI motility disorders with a special focus on paediatric practice.The majority of EndoFLIP studies were conducted in adult patients but the uptake of the technology in paediatrics is increasing.EndoFLIP can provide a useful complementary data to the existing GI motility investigation in both children and adults.
基金the Natural Science Foundation of Shaanxi Province(No.2023-YBSF-086)Xi’an Science and Technology Plan Projects(No.21YXYJ0091)+1 种基金Key Projects of Shaanxi Provincial Department of Education(No.21JS041)Shaanxi Provincial People’s Hospital Science and Technology Talent Support Plan(No.2022BJ-05).
文摘Objective:To investigate the effect of auricular acupuncture on postoperative pain and gastrointestinal motility recovery after laparoscopic surgery for colorectal cancer.Methods:The clinical data of patients who underwent laparoscopic radical surgery for colorectal cancer in our hospital from April 2020 to December 2021 were collected.Based on the inclusion and exclusion criteria,76 patients were included in the retrospective analysis.Depending on whether they received auricular acupuncture or not,the patients were divided into two groups:46 patients in the experimental group(auricular acupuncture)and 30 patients in the control group.The differences between the two groups were analyzed.Results:The time to first flatus of the experimental group was significantly shorter than that of the control group(52.2±7.36 h versus 66.3±7.83 h;P<0.001).Similarly,the time to first defecation of the experimental group was significantly shorter than that of the control group(76.3±7.76 h versus 86.1±10.79 h;P<0.001).The time to first fluid intake of the auricular group was significantly shorter than that of the control group(90.4±8.92 h versus 107.3±9.66 h,P<0.001).Compared with the control group,the experimental group scored significantly lower on the visual analogue scale on postoperative days 2 and 3(P<0.001).Conclusion:Auricular acupuncture is an effective traditional Chinese medicine external treatment method.It can promote gastrointestinal motility recovery in patients after laparoscopic radical surgery for colorectal cancer and also reduce postoperative pain and discomfort.Furthermore,this therapy is easy to operate and well-accepted by patients.Therefore,it should be strongly promoted in clinical practice.
文摘Although chronic gastrointestinal dysmotility syndromes are a common worldwide health problem,underlying causes for these disorders are poorly understood.We show that flavivirus infection of enteric neurons leads to acute neuronal injury and cell death,inflammation,bowel dilation,and slowing of intestinal transit in mice.Flavivirus-primed CD8+T cells promote these phenotypes,as their absence diminished enteric neuron injury and intestinal transit delays,and their adoptive transfer reestablished dysmotility after flavivirus infection.
基金supported by the Peking Post-doctoral Research Fund(EE2019-50)and Peking University International Hospital Research Funds(No.YN2019QN13).
文摘This study aims to investigate the protective effects of peroxiredoxin 6 on the total motility and progressive motility of human spermatozoa.Semen samples with normal parameters were collected from 23 males and supplemented with different concentrations of peroxiredoxin 6.All the semen samples were measured according to the WHO 5th manual,and the motile spermatozoa were extracted using IVF fertilization medium supplemented with different peroxiredoxin 6 concentrations.Total motility and progressive motility were observed at different time-points of culture at room temperature.After peroxiredoxin 6 supplementation,all groups had a significant increase in total motility and progressive motility compared to the control group.The difference in total motility and progressive motility between the 0 and 10−7 mM groups was observed at 24 and 48 h of culture at room temperature.At 24 h,the total motility increased by 30%in the control group(16.03±11.91 vs.11.51±7.84),and progressive motility increased by 21%(10.53±9.4 vs.8.31±6.04).A similar trend was observed in the 48 h group.In addition,we also found that peroxiredoxin 6 had a well protective effect on sperm kinetic parameters at 10−7 mM.The findings of this study suggest that peroxiredoxin 6 can enhance sperm total motility and progressive motility in IVF fertilization medium.Peroxiredoxin 6 may have potential benefits for sperm preparation in assisted reproductive technology.
基金the Development Foundation of Region Skåne,No.REGSKANE-619091the Foundation of Skåne University Hospital,No.2017-008and the Dir Albert Påhlsson’s Foundation,No.2019.
文摘BACKGROUND Recently,a technique has been developed to use magnetic resonance enterography(MRE)for the evaluation of small bowel motility.The hypothesis was that assessment of the motility index(MI)should reflect differences in motility between clinical conditions.AIM To aim of the present observational,cross-sectional study was to evaluate the use of the MI in daily clinical practice.METHODS All consecutive patients aged 18-70 years who were referred for MRE at the Department of Radiology during a 2-year period were asked to participate.Healthy volunteers were included as controls.MRE was prepared and conducted in accordance with clinical routines.On the day of examination,all the participants had to complete the visual analog scale for irritable bowel syndrome(IBS)and IBS-symptom severity scale.Maps of MI were calculated from dynamic MR images.ANOVA was used to evaluate differences in MI between groups,classified as healthy,Crohn’s disease,ulcerative colitis,IBS,other assorted disorders and dysmotility.Logistic and linear regression were applied to the MI values.All medical records were scrutinized for medical history.RESULTS In all,224 examinations were included(inclusion prevalence 76.3%),with 22 controls and 202 patients.There was a significant difference in the MI of the jejunum(P=0.021)and terminal ileum(P=0.007)between the different groups.The MI was inversely associated with the mural thickness of the terminal ileum in men(P<0.001)and women(P=0.063)after adjustments,and tended to be lower in men than in women(P=0.056).Subjectively observed reduction of motility on MRI was accomplished by reduced MI of terminal ileum in men(P<0.001)and women(P=0.030).In women,diarrhea was inversely associated with the MI of the jejunum(P=0.029),and constipation was positively associated with the MI of the terminal ileum(P=0.039).CONCLUSION Although MIs differ across diseases,a lower MI of the terminal ileum is mainly associated with male sex and an increased mural thickness.Symptoms are weakly associated with the MI.
文摘Disorders of esophageal motility have been described in patients with cirrhosis in a small number of studies.In this review,we aim to provide an overview of the available evidence on esophageal motility disorders in cirrhosis and their clinical implications.This review delves into the following concepts:(1)Gastroesophageal reflux disease is common in liver cirrhosis due to many mechanisms;however,when symptomatic it is usually nocturnal and has an atypical presentation;(2)Endoscopic band ligation is better than sclerotherapy in terms of its effect on esophageal motility and seems to correct dysmotilities resulting from the mechanical effect of esophageal varices;(3)Chronic alcoholism has no major effects on esophageal motility activity other than lower esophageal sphincter hypertension among those with alcoholic autonomic neuropathy;(4)An association between primary biliary cholangitis and scleroderma can be present and esophageal hypomotility is not uncommon in this scenario;and(5)Cyclosporin-based immunosuppression in liver transplant patients can have a neurotoxic effect on the esophageal myenteric plexus leading to reversible achalasia-like manifestations.
文摘Background: Previous studies on fasting and gastrointestinal motility were reported with information lacking concerning prolonged continuous fasting and gastrointestinal motility. This study investigated the effect of prolonged fasting duration on gastrointestinal motility. Methods: Forty-five (45) male Wistar rats, with body weights between 180 - 200 g were used. They were randomly assigned into three (3) groups. Group1: control (rats fasted for 18 h—common duration of fasting for motility studies), groups 2 and 3 fasted for 48 and 72 h respectively. Five (5) rats per experiment and per group were considered. Blood glucose was determined by glucose oxidase method, gastric emptying was assessed by hydrated carbohydrate meal, intestinal motility by charcoal meal, and colonic motility was assessed using bead test. Data were reported in Mean ± SEM and analyzed with one-way ANOVA. Differences in results were considered significant at p ≤ 0.05. Results: There was no significant change in the blood glucose level (mmol/L) of rats in the 48 h group (2.94 ± 0.35) and 72 h group (3.20 ± 0.32) as compared with the control (3.62 ± 0.19). There was a significant decrease in the rate of gastric emptying (g) in the 72 h group (0.20 ± 0.08) compared with the control (0.64 ± 0.16). The intestinal transit (cm) in the 48 h group (67.54 ± 6.15) and 72 h group (72.10 ± 7.60) increased significantly when compared with the control (42.14 ± 3.14). There was a significant decrease in the colonic motility time (Sec.) in the 48 h group (2707 ± 864.1) and 72 h group (6363 ± 968.1) when compared with the control (263.8 ± 64.26). Conclusion: Extended fasting durations decrease the rate of gastric emptying and colonic motility. It suggests that extended fasting durations could be beneficial in intestinal spasms or where the gut is required to relax.
文摘BACKGROUND Peroral endoscopic myotomy is an increasingly used less invasive modality to treat esophageal dysmotility.Recently,triangular tip knife with integrated water jet function has been introduced to mitigate multiple instrument exchanges.AIM To compare traditional triangular tip knife and water jet knife in terms of procedural success,duration,instrument exchanges,coagulation forceps use,and adverse events.METHODS We conducted a systemic review and meta-analysis with two authors independently in electronic databases(PubMed,Embase,and Cochrane Library)from inception through May 2021.In addition,we conducted a relevant search by Reference Citation Analysis(RCA)(https://www.referencecitationanalysis.com).A fixed-effects model was used to calculate weighted mean,odds ratio(OR),and confidence intervals(CI).RESULTS We included 7 studies involving 558 patients.Triangular knife and water jet knife were similar in odds of procedural success with ratio of 4.78(95%CI=0.22-102.47)and odds of clinical success with ratio of 0.93(95%CI=0.29-2.97),respectively.Water jet knife had fewer instrument exchanges compared to triangular knife(2.21,95%CI=1.98-2.45 vs 11.9,95%CI=11.15-12.70)and usage of coagulation forceps(1.75,95%CI=1.52-1.97 vs 2.63,95%CI=2.37-2.89).Adverse events were higher in triangular knife group(OR:2.30,95%CI=1.35-3.95).CONCLUSION Peroral endoscopic myotomy using water jet knife is comparable in terms of pro cedural success to triangular tip knife.Water jet knife also required shorter procedural duration,less instrument exchanges,coagulation devices,and overall adverse events.
基金Supported by The National Natural Science Foundation of China, No. 30971354The International Cooperation Project of Jiangsu Province Department of Health, No. SBZ201100103The Graduate Innovation Foundation of Jiangsu Province, China,No. CXZZ11_0704
文摘AIM: To investigate whether the reduction of stem cell factor (SCF) is mediated by decreased endogenous insulin-like growth factor (IGF)-1 in diabetic rat colon smooth muscle. METHODS: Sixteen Sprague-Dawley rats were randomly divided into two groups: control group and streptozotocin-induced diabetic group. After 8 wk of streptozotocin administration, colonic motility function and contractility of circular muscle strips were measured. The expression of endogenous IGF-1 and SCF was tested in colonic tissues. Colonic smooth muscle cells were cultured from normal adult rats. IGF-1 siRNA transfection was used to investigate whether SCF expression was affected by endogenous IGF-1 expression in smooth muscle cells, and IGF-1 induced SCF expression effects were studied. The effect of high glucose on the expression of endogenous IGF-1 and SCF was also investigated. RESULTS: Diabetic rats showed prolonged colonic transit time (252 ± 16 min vs 168 ± 9 min, P < 0.01) and weakness of circular muscle contraction (0.81 ± 0.09 g vs 2.48 ± 0.23 g, P < 0.01) compared with the control group. Endogenous IGF-1 and SCF protein expression was significantly reduced in the diabetic colonic muscle tissues. IGF-1 and SCF mRNA expression also showed a paralleled reduction in diabetic rats. In the IGF-1 siRNA transfected smooth muscle cells, SCF mRNA and protein expression was significantly decreased. IGF-1 could induce SCF expression in a concentration and time-dependent manner, mainly through the extracellular-signal-regulated kinase 1/2 signal pathway. High glucose inhibited endogenous IGF-1 and SCF expression and the addition of IGF-1 to the medium reversed the SCF expression. CONCLUSION: Myopathy may resolve in colonic motility dysfunction in diabetic rats. Deficiency of endogenous IGF-1 in colonic smooth muscle cells leads to reduction of SCF expression.
文摘AIM:To evaluate the benefit of aerobic exercise on colonic transit time(CTT)for psychiatric inpatients in a closed ward.METHODS:Sixty consecutive adult inpatients of the Somang Hospital Psychiatry Unit(Eumsung-gun,South Korea),without CTT-related diseases or drug therapies,were recruited for study from March to June of 2012.Upon enrollment,the patients were randomly assigned to partake in a 12-wk instructor-led group aerobic exercise program(exercise group;n=30)or to maintain their ordinary daily activities(control group;n=30).The exercise program was structured as 10 min warm-up(stretching),40 min exercise,and 10 min cool-down(stretching)for three days each week.The exercise sessions consisted of walking only in week one and aerobics from weeks two to 12,with increasing intensity(50%heart rate reserve(HRR)for weeks one to four,60%HRR for weeks five to eight,and 70%HRR for weeks nine to 12).CTT was measured before(baseline)and after(week 12)the exercise program,in duplicate(on days four and seven),using abdominal radiography and the multiple radio-opaque marker technique.Changes in the exercising patients’CTT and weight-,cardiovascular-and fitness-related parameters were statistically assessed.RESULTS:The study dropout rate was 30.0%,with 23patients in the exercise group and 19 patients in the control group completing the study.At week 12,the exercise group showed decreases in body weight(mean±SE)baseline:69.4±2.8 vs study-end:67.6±2.7;P<0.635)and body mass index(BMI)(25.2±1.1 vs24.9±0.8;P<0.810),but the extent of change was not significantly different from that experienced by the control group(body weight:68.8±4.0 vs 68.8±3.9;BMI:24.3±1.1 vs 24.4±1.2).However,the exercise group showed significant improvements in leg muscle strength(baseline:41.7±4.3 vs study-end:64.1±5.0;P<0.001),cardio-respiratory endurance(120.5±4.5vs 105.4±2.8;P<0.004),and leg muscle elasticity and power output(21.5±2.6 vs 30.6±2.8;P<0.001).The exercise group showed an exercise-induced reduction in total CTT(baseline:54.2±8.0 vs 30.3±6.1),which was significantly different from that experienced by the control group over the 12-wk period(48.6±9.3vs 48.3±12.3;P=0.027);however,the exercise-induced decreases in CTT involving the three colonic segments examined(right,left and recto-sigmoid)showed no significant differences from the control group.CONCLUSION:A 12-wk aerobic exercise program can benefit psychiatric inpatients by increasing intestinal motility,possibly decreasing risk of metabolic-and cardiovascular-related disease.
基金Supported by the National Natural Science Foundation of China,No.81403355 and No.81573892the Project of 3-Year Action Plan for Shanghai Municipal Chinese Medicine Development,No.ZY3-RCPY-2-2001
文摘AIM To investigate the underlying effect of Jianpi Qingchang decoction(JQD) regulating intestinal motility of dextran sulfate sodium(DSS)-induced colitis in mice. METHODS C57BL/6 mice were randomly divided into four groups: the control group, the DSS group, the JQD group, and the 5-aminosalicylic acid group. Except for the control group, colitis was induced in other groups by giving distilled water containing 5% DSS. Seven days after modeling, the mice were administered corresponding drugs intragastrically. The mice were sacrificed on the 15^(th) day. The disease activity index, macroscopic and histopathologic lesions, and ultrastructure of colon interstitial cells of Cajal(ICC) were observed. The levels of tumor necrosis factor-alpha(TNF-α), interleukin(IL)-1β, IL-10 and interferon gamma(IFN-γ), the expression of nuclear factor-kappa B(NF-κB) p65, c-kit, microtubule-associated protein 1 light chain 3(LC3-Ⅱ) and Beclin-l m RNA, and the colonic smooth muscle tension were assessed. RESULTS Acute inflammation occurred in the mice administered DSS. Compared with the control group, the levels of IL-1β, TNF-α, IL-10 and IFN-γ, the expression of LC3-Ⅱ, Beclin-1 and NF-κB p65 m RNA, and the contractile frequency increased(P < 0.05), the expression of c-kit m RNA and the colonic smooth muscle contractile amplitude decreased in the DSS group(P < 0.05). Compared with the DSS group, the levels of IL-10 and IFN-γ, the expression of c-kit m RNA, and the colonic smooth muscle contractile amplitude increased(P < 0.05), the levels of TNF-α and IL-1β, the expression of LC3-Ⅱ, Beclin-1 and NF-κB p65 m RNA, and the contractile frequency decreased in the JQD group(P < 0.05).CONCLUSION JQD can regulate the intestinal motility of DSS-induced colitis in mice through suppressing intestinal inflammatory cascade reaction, reducing autophagy of ICC, and regulating the network path of ICC/smooth muscle cells.
基金Supported by National Natural Science Foundation of China,No.81574071,No.81673883,and No.81873238Leading Talents of Traditional Chinese Medicine in Jiangsu Province(Second Batch),No.SLJ0225。
文摘Acupuncture has been used in China for thousands of years and has become more widely accepted by doctors and patients around the world. A large number of clinical studies and animal experiments have confirmed that acupuncture has a benign adjustment effect on gastrointestinal(GI) movement;however, the mechanism of this effect is unclear, especially in terms of neural mechanisms, and there are still many areas that require further exploration. This article reviews the recent data on the neural mechanism of acupuncture on GI movements. We summarize the neural mechanism of acupuncture on GI movement from four aspects: acupuncture signal transmission, the sympathetic and parasympathetic nervous system, the enteric nervous system, and the central nervous system.
基金Supported by Guangdong Provincial Department of Science and Technology,No.[2013]173
文摘AIM To investigate the effects of Xiangbin prescription(XBP), a Chinese herbal concoction, on gastrointestinal motility.METHODS Forty healthy volunteers were recruited for this randomized controlled trial of XBP. Antroduodenojejunal manometry was used to monitor gastrointestinal motility in these subjects. After the subjects had fasted for at least 12 h, XBP(n = 30) or placebo(n = 10) was orally administrated and gastrointestinal motility was recorded for 4 h. Plasma motilin and ghrelin were measured by enzyme-linked immunosorbent assay.RESULTS Oral administration of XBP significantly increased the amplitude of duodenal contractions [19.5(13.0-26.7) vs 16.9(12.3-23.9), P < 0.05], jejunal contractions [18.3(15.3-25.0) vs 15.4(11.7-23.9), P < 0.01], and the motility index of duodenal contractions [522.0(146.0-139.0) vs 281.0(76.5-1006.0), P < 0.01] in phase Ⅱ of the migratory motor complex(MMC), which subsequently initiated the MMC cycle [74.0(30.0-118.0) vs 116.5(24.0-219.0), P < 0.05], shortened the duration of phase I of the MMC [42.0(0.0-90.0) vs 111.5(42.0-171.0), P < 0.01], and lengthened the duration of phase Ⅱ of the MMC [120(21-240) vs 58(16-170), P < 0.01] compared to the duration before XBP administration. There were significant differences in the amplitude of jejunal contractions [19.8(14.0-30.0) vs 18.0(13.0-28.5), P < 0.05], the motility index of duodenal contractions [236.0(115.0-306.0) vs 195.0(109.0-310.0), P < 0.05], and jejunal contractions [214.0(95.0-403.0) vs 178.0(55.0-304.0), P < 0.01] in phase Ⅲ of the MMC. Oral administration of XBP greatly increased plasma motilin(57.69 ± 9.03 vs 49.38 ± 8.63, P < 0.01) and ghrelin(279.20 ± 104.31 vs 238.73 ± 115.59, P < 0.01) concentrations compared to concentrations after oral administration of the placebo.CONCLUSION XBP can stimulate duodenal and jejunal motility and increase the concentrations of plasma motilin and ghrelin. The clinical applicability of XBP in treating GDIM deserves investigation.
基金Supported by the National Natural Science Foundation of China,No.81373749No.81574071,and No.81673883
文摘BACKGROUND Electroacupuncture(EA) at ST36 can significantly improve gastrointestinal symptoms, especially in promoting gastrointestinal motility. The automatic nervous system plays a main role in EA, but few studies exist on how vagovagal and sympathetic reflexes affect EA to regulate gastrointestinal motility.AIM To study the role of vagovagal and sympathetic reflexes in EA at ST36, as well as the associated receptor subtypes that are involved.METHODS Gastric motility was measured with a manometric balloon placed in the gastric antrum area in anesthetized animals. The peripheral nervous discharge was measured using a platinum electrode hooking the vagus or greater splanchnic nerve, and the central nervous discharge was measured with a glass microelectrode in the dorsal motor nucleus of the vagus(DMV). The effects and mechanisms of EA at ST36 were explored in male Sprague-Dawley rats which were divided in to a control group, vagotomy group, sympathectomy group, and microinjection group [including an artificial cerebrospinal fluid group, glutamate(L-Glu) group, and γ-aminobutyric acid(GABA) group] and in genetically modified male mice [β1β2 receptor-knockout(β1β2^(-/-)) mice, M2M3 receptorknockout(M2M3^(-/-)) mice, and wild-type control mice].RESULTS EA at ST36 promoted gastric motility during 30-120 s. During EA, both vagus and sympathetic nerve discharges increased, with a much higher frequency of vagus nerve discharge than sympathetic discharge. The gastric motility mediated by EA at ST36 was interdicted by vagotomy. However, gastric motility mediated by EA at ST36 was increased during 0-120 s by sympathectomy, which eliminated the delay effect of EA during 0-30 s, but it was lower than the control group during 30-120 s. Using gene knockout mice and their wild-type controls to explore the receptor mechanisms, we found that EA at ST36 decreased gastric motility in M2/3^(-/-) mice, and promoted gastric motility in β1/2^(-/-) mice. Extracellular recordings showed that EA at ST36 increased spikes of the DMV. Microinjection of L-Glu into the DMV increased gastric motility, while EA at ST36 decreased gastric motility during 0-60 s, and promoted gastric motility during 60-120 s.Injection of GABA reduced or increased gastric motility, and reduced the promoting gastric motility effect of EA at ST36.CONCLUSION These data suggest that EA at ST36 modulates gastric motility via vagovagal and sympathetic reflexes mediated through M2/3 and β1/2 receptors, respectively.Sympathetic nerve activity mediated through β1/2 receptors is associated with an early delay in modulation of gastric motility by EA at ST36.
文摘Irritable bowel syndrome(IBS)is a chronic,recurring,and remitting functional disorder of the gastrointestinal tract characterized by abdominal pain,distention,and changes in bowel habits.Although there are several drugs for IBS,effective and approved treatments for one or more of the symptoms for various IBS subtypes are needed.Improved understanding of pathophysiological mechanisms such as the role of impaired bile acid metabolism,neurohormonal regulation,immune dysfunction,the epithelial barrier and the secretory properties of the gut has led to advancements in the treatment of IBS.With regards to therapies for restoring intestinal permeability,multiple studies with prebiotics and probiotics are ongoing,even if to date their efficacy has been limited.In parallel,much progress has been made in targeting low-grade inflammation,especially through the introduction of drugs such as mesalazine and rifaximin,even if a better knowledge of the mechanisms underlying the low-grade inflammation in IBS may allow the design of clinical trials that test the efficacy and safety of such drugs.This literature review aims to summarize the findings related to new and investigational therapeutic agents for IBS,most recently developed in preclinical as well as Phase 1 and Phase 2clinical studies.
基金Supported by The National Key Basic Research Program(973 Program)No.2011CB505206+3 种基金the National Natural Science Foundation of ChinaNo.81202744No.81373749 and No.81574071Jiangsu Provincial Qinglan Project Sci-tech Innovation Team
文摘AIM: To investigate whether electroacupuncture(EA) at ST25 affects jejunal motility in vivo and if so, whether a sympathetic pathway is involved.METHODS: Jejunal motility was assessed using a manometric balloon placed in the jejunum approximately about 3-5 cm away from the suspensory ligament of the duodenum in anesthetized animals. The effects of EA at ST25 were measured in male Sprague-Dawley rats, some of which were treated with propranolol or clenbuterol(EA intensities: 1, 3, 5, 7, and 9 m A), and in male transient receptor potential vanilloid-1(TRPV1)(capsaicin receptor) knockout mice(EA intensities: 1, 2, and 4 m A).RESULTS: Anesthetized rats exhibited three types of fasting jejunal motor patterns(types A, B, and C), and only type C rats responded to EA stimulation. In type C rats, EA at ST25 significantly suppressed the motor activity of the jejunum in an intensity-dependent manner. The inhibitory effect of EA was weakened by propranolol(β adrenoceptor antagonist) and disappeared with clenbuterol(β adrenoceptor agonist) induced inhibition of motility, suggesting that the effect of EA on motility is mediated via a sympathetic pathway. Compared with wild-type mice, EA at ST25 was less effective in TRPV1 knockout mice, suggesting that this multi-modal sensor channel participates in the mechanism. CONCLUSION: EA at ST25 was found to inhibit jejunal motility in an intensity-dependent manner, via a mechanism in which sympathetic nerves and TRPV1 receptors play an important role.
