ABSTRACT
Objective:To compare the efficacy of oral sulfate solution (OSS) and polyethylene glycol (PEG) electrolyte powder for colonoscopy bowel preparation.Methods:A total of 283 randomized patients from 9 centers in China taking OSS ( n=143) or PEG ( n=140) using two-day split bowel preparation regimen received colonoscopy and assessment. The primary index was the bowel preparation success rate [global Boston bowel preparation scale (BBPS)≥ 6 by independent assessment center]. Secondary indices included BBPS global and segmental scores, investigator satisfaction (5-point Likert scale) with the quality of bowel preparation, patient satisfaction assessed by questionnaires, and patient tolerance assessed by Sharma scale. Compliance and safety were compared between the two groups. Results:The bowel preparation success rates were 100.0% for OSS and 99.3% for PEG [adjusted difference 0.7% (95% CI: -5.3% - 6.7%), P<0.001 for non-inferiority]. The BBPS global score in OSS group was significantly higher than that in PEG group (8.1 VS 7.7, P<0.001). The segment BBPS scores were also higher in OSS group than those in PEG group for all 3 segments (right colon: 2.4 VS 2.3, P=0.002; transverse colon: 2.8 VS 2.7, P=0.018; left colon: 2.8 VS 2.7, P=0.007). Investigator Likert score in the OSS group was significantly higher than that in the PEG group (2.6 VS 2.3, P<0.001). There was no significant difference in compliance between OSS and PEG, except for the second dose (90.9% VS 82.6%, P=0.039). There was no significant difference in patient satisfaction, Sharma score or proportion of patients with tolerance-related symptoms between the two groups. Safety was comparable between the two groups, and all adverse events were mild to moderate. Conclusion:OSS has comparable efficacy with PEG, with higher BBPS scores in all segments, better investigator satisfaction, better compliance in split dose, and comparable patient tolerance and safety.
ABSTRACT
@#Objective To investigate the protective effect of the combination of glutamine (Gln) and ar-ginine (Arg) on intestinal barrier function in rats receiving fluorouracil (5-FU) chemotherapy.Methods Totally 40 male SD rats receiving 5-FU chemotherapy were equally randomized into four groups:enteral nutrition group,Gln group (enteral nutrition+Gln),Arg group (enteral nutrition+Arg),and Arg+Gln group (enteral nutri-tion+Arg+Gln).Observe the changes post chemotherapy such as the changes of body weight and urine lactulose/mannitol ratio before and after chemotherapy were recorded.On the 8 th post-therapy day,the blood endotoxin level in portal vein was measured,and lymph nodes and blood in portal vein were taken for bacterial culture;colon and jejunum specimens were also taken to measure the height of jejunum villus and the thickness of colon and jejunum.Results Body weights of Gln group,Arg group,and Arg+Gln group significantly increased after chemotherapy (P<0.05).The change of body weight was significantly lower in Arg+Gln group than in Gln group (P=0.002),while no such difference was found when compared with that in Arg group (P>0.05).Lactulose/manni-tol ratio in each group significantly increased after chemotherapy (P<0.05),and the change of lactulose/mannitol ratio was significantly higher in the enteral nutrition group than those in other groups (P=0.000);however,no such difference was found among other groups (P>0.05).The blood endotoxin level in portal vein was signifi-cantly higher in enteral nutrition group than in other groups (P=0.000);the endotoxin level was significantly lower in Gln group than in Arg group (P=O.035) and Arg+Gln group (P=0.000);however,no such differ-ence was found between Arg group and Arg+Gln group (P=0.109).The height of jejunum villus and the thick-ness of jejunum were significantly lower in enteral nutrition group than those in the other groups (P=O.000);the thickness of colon was significantly lower in enteral nutrition group than those in Arg group and Arg+Gln group (P=0.000);however,no such difference was found when compared with Gln group (P=0.058).The thickness of colon (P=0.040) and jejunum (P=0.010) was significantly higher in Gln group than that in Arg group;but there was no significant difference in term of the height of jejunum villus (P=0.286).Compared with Arg+Gln group,the thickness of jejunum in Gln group was significantly higher,but there was no significant difference in terms of the height of jejunum villus (P=0.286) or the thickness of jejunum (P=0.190).The thickness of co-lon was significantly lower in Arg group than in Arg+Gln group (P=0.010),while no such significant difference was found in terms of the height of jejunum villus (P=0.803) or the thickness of colon (P=0.059) when com-pared with Arg+Gln group.The bacterial culture results were not significantly different among all groups.Conclu-sions The combination of Arg and Gln has protective effects on intestinal barrier in rats receiving 5-FU chemother-apy.The protective effect of Gln is superior to that of Arg.No synergistic effect exists between Arg and Gln.