Role of NF-κB Signaling Pathway in "Reflux Esophagitis-esophageal Cancer" and Traditional Chinese Medicine Intervention：A Review / 中国实验方剂学杂志

Reflux esophagitis is an inflammatory disease of esophageal mucosa damage caused by the reflux of gastric contents into the esophagus. Its incidence is on the rise， and it has become an important precancerous disease of esophageal cancer. Studies have shown that the continuous inflammatory response stimulates the esophageal mucosa， causing abnormal proliferation of esophageal epithelial cells and damage to esophageal mucosal tissue， which eventually leads to the occurrence of heterogeneous hyperplasia and even carcinogenesis. The nuclear transcription factor-kappa B （NF-κB） signaling pathway is one of the most classical inflammatory and cancer signaling pathways. It has been found that abnormal activation of the NF-κB signaling pathway is crucial to the development and prognosis of reflux esophagitis and esophageal cancer. It is widely involved in the proliferation， autophagy， apoptosis， and inflammatory response of esophageal epithelial cells and tumor cells， accelerating the transformation of reflux esophagitis to esophageal cancer and making it a potential target for the treatment of reflux esophagitis and esophageal cancer. Currently， there is no specific treatment for reflux esophagitis and esophageal cancer， and large side effects often appear. Therefore， finding a promising and safe drug remains a top priority. In recent years， traditional Chinese medicine scholars have conducted a lot of research on NF-κB signaling pathway， and the results indicate that NF-κB signaling pathway is an important potential target for traditional Chinese medicine to prevent and treat reflux esophagitis and esophageal cancer， but there is a lack of comprehensive and systematic elaboration. Therefore， this paper summarized the relevant studies in recent years， analyzed the relationship among NF-κB signaling pathway， reflux esophagitis， esophageal cancer， and transformation from inflammation to cancer， and reviewed the research literature on the regulation of the NF-κB signaling pathway in traditional Chinese medicine to prevent and treat reflux esophagitis and esophageal cancer， so as to provide new ideas for the prevention and treatment of reflux esophagitis and esophageal cancer.

Meta-analysis of the efficacy and safety of Ilaprazole Enteric-Coated Tablets on reflux esophagitis / 药学实践杂志

Objective To evaluate the efficacy and safety of Ilaprazole Enteric-Coated Tablets in the treatment of RE. Methods The databases of CNKI, VIP, Wanfang Data, PubMed, Embase, and The Cochrane Library were searched to collect all the randomized controlled trials (RCTs) of Ilaprazole in the treatment of RE published before April 2021. After data extraction and quality evaluation, the RCTs meeting the inclusion criteria were performed, and the meta-analysis was conducted by RevMan 5.4. Results Nine RCTs were included, with a total of 1115 patients of RE. The results of the meta-analysis showed that Ilaprazole Enteric-Coated Tablets were comparable to Esomeprazole Enteric-Coated Tablets in both endoscopic efficiency (90.08% vs. 90.00%, P > 0.05) and symptom relief rates (91.79% vs. 91.23%, P > 0.05), and there was no statistically significant difference in the incidence of adverse reactions (7.99% vs. 8.66%, P > 0.05). Conclusion Ilaprazole Enteric-Coated Tablets with lower doses were comparable to Esomeprazole Enteric-Coated Tablets which showed good efficacy and safety in the treatment of reflux esophagitis.

Study on the correlation between dietary inflammatory index and reflux esophagitis / 中华消化杂志

Objective:To evaluate the correlation between inflammatory diet and reflux esophagitis (RE) with the dietary inflammatory index (DII), and to provide scientific evidence for the prevention and treatment of RE at the level of dietary guidance.Methods:From December 2021 to September 2022, 145 RE patients (RE group) who visited the First Affiliated Hospital of Xinjiang Medical University were recruited. During the same period, 145 subjects who underwent check-ups at the First Affiliated Hospital of Xinjiang Medical University were selected as the healthy control group, and age and gender were matched according to the ratio of 1 to 1. The baseline data of the 2 groups, including body mass index, the history of smoking and drinking, poor dietary habits, and physical activity intensity were collected. Dietary intake of the patients was assessed by a semi-quantitative food frequency questionnaire, and the overall DII was calculated to evaluate the potential anti-inflammatory or pro-inflammatory effects of diet. According to the tertiles of the DII of the healthy control group (33.3% and 66.7% as the cut-off), dietary inflammatory potential was divided into low (<-0.06), moderate (-0.06 to 1.11) and high pro-inflammatory potential diet (>1.11). Logistic regression model was performed to analyze the correlation between DII and RE risk. Linear trend test was used to compare the overall change trend of RE risk OR value along with the increase of DII. Independent sample t test, Mann-Whitney U test and chi-square test were used for statistical analysis. Results:The body mass index of RE group was higher than that of healthy control group( (24.11±2.57) kg/m 2 vs. (23.38 ±2.60) kg/m 2), and the difference was statistically significant ( t=-2.41, P=0.017). The proportions of smoking, drinking, over-eating, and eating within 3 h before bedtime of RE group was higher than those of the healthy control group (42.8%, 62/145 vs. 31.0%, 45/145; 31.0%, 45/145 vs. 16.6%, 24/145; 33.1%, 48/145 vs. 17.9%, 26/145; 52.4%, 76/145 vs. 13.1%, 19/145), and the differences were statistically significant ( χ2=4.28, 8.39, 8.78 and 50.86, P=0.039, 0.004, 0.003 and<0.001). While the proportions of night snacking and moderate to severe physical activity of RE group were lower than those of the healthy control group (14.5%, 21/145 vs. 24.1%, 35/145; 22.8%, 33/145 vs.37.2%, 54/145), and the differences were statistically significant ( χ2=4.34 and 7.24, P=0.037 and 0.007). The DII of RE group was higher than that of the healthy control group (1.05 (0.03, 1.62) vs. 0.34(-0.61, 1.35)), and the difference was statistically significant ( Z=8 661.50, P=0.010). Compared with the low pro-inflammatory potential diet, high pro-inflammatory potential diet had a 1.30-fold increased the risk of RE ( OR=2.30, 95% confidence interval (95% CI) 1.29 to 4.09, P=0.005). After adjusting for total energy intake, age, gender, ethnicity, body mass index, education level, and physical activity intensity, the high pro-inflammatory potential diet was still positively correlated with the risk of RE ( OR=2.58, 95% CI 1.16 to 5.76, P=0.020). In the continuous DII, the risk of RE increased by 36% for each 1 increase in DII ( OR=1.36, 95% CI 1.11 to 1.68, P=0.003). After adjusting for major confounding factors, the continuous DII was still positively correlated with the risk of RE ( OR=1.41, 95% CI 1.08 to 1.85, P=0.012; OR=1.42, 95% CI 1.05 to 1.93, P=0.023). The results of trend test showed that the higher the DII, the greater the risk of RE ( P=0.039). Conclusions:Pro-inflammatory diet is correlated with the increased risk of RE, and there is a certain dose-response relationship. Reasonable reduction of the intake of pro-inflammatory food may be beneficial to reduce the risk of RE.

Correlación diagnóstica entre fibrolaringoscopia y videoendoscopia digestiva alta en pacientes con reflujo gastroesofágico y reflujo laringofaríngeo / Diagnostic Correlation Between Fiberlaringoscopy and Upper Gastrointestinal Video Endoscopy in Patients with Gastroesophagic Reflux and Laryngopharyngeal Reflux

Introducción: el reflujo laringofaríngeo (RLF) se origina por el flujo retrógrado de contenido gástrico hacia la faringe, pero es una entidad diferente de la enfermedad por reflujo gastroesofágico (ERGE). El objetivo del estudio fue determinar la correlación entre los signos endoscópicos de la fibrolaringoscopia y la videoendoscopia digestiva alta (VEDA). Material y métodos: estudio observacional, retrospectivo y analítico. Se incluyeron pacientes que consultaron por sintomatología de RLF y ERGE. Los hallazgos visualizados por fibrolaringoscopia flexible, VEDA y biopsia de mucosa gástrica de cada paciente se compararon con la prueba de chi-cuadrado (χ²). Se consideró significativo un valor de p ≤ 0,05. Resultados: se incluyeron 318 pacientes entre 18 y 84 años. Se encontró que el 100 % de los pacientes con esofagitis tenía laringitis (p = 0,001); el 100 % de los pacientes con hernia hiatal tenían RLF (p = 0,001); el 97 % de los pacientes con Helicobacter pylori en la mucosa gástrica tenían RLF (p = 0.001). El 71 % de los pacientes con hernia hiatal tenían esofagitis (p = 0,001). Se encontró una asociación lineal entre la edad y la hernia hiatal con la edad y el RLF (p = 0,03). Conclusiones: en este estudio, los signos encontrados en la fibrolaringoscopia tuvieron una asociación estadística con la VEDA. Aproximadamente el 90 % de los pacientes con signos de laringitis tuvo una correlación con algún grado de esofagitis, esófago de Barrett, hernia hiatal y Helicobacter pylori. También se encontró que la laringitis por RLF y la hernia hiatal se relacionaron directamente con el incremento de la edad.

Introduction: Laryngopharyngeal reflux (LPR) is caused by the retrograde flow of gastric contents towards the pharynx, but it is a different entity from gastroesophageal reflux disease (GERD). The objective of the study was to determine the relationship between the endoscopic signs of fiber laryngoscopy and upper gastrointestinal video endoscopy. Material and methods: Observational, retrospective and analytical study. Patients who consulted for LPR and GERD symptoms were included. The findings visualized by flexible fiber laryngoscopy, upper gastrointestinal video endoscopy and gastric mucosal biopsy of each patient were compared with the Chi-square (χ²) test. A value of p ≤ 0.05 is estimated significantly. Results: 318 patients between 18 and 84 years old were included. A relationship was found in 100% of the patients with esophagitis had laryngitis (p = 0.001); 100% of the patients with hiatal hernia had LPR (p = 0.001); 97% of patients with Helicobacter pylori in the gastric mucosal have LPR (p= 0.001); 71% of patients with hiatal hernia had esophagitis (p = 0.001). A linear association was found between age and hiatal hernia with age and LPR. (p = 0.03). Conclusions: In this study, the signs found in fiber laryngoscopy had a statistical association with the upper gastrointestinal video endoscopy. Approximately 90% of patients with signs of laryngitis had correlation with some degree of esophagitis, Barrett's esophagus, hiatal hernia and Helicobacter pylori. It was also found that LPR and hiatal hernia were directly related to increasing age

Research Progress of Digestive System Disease and Syndrome Combined Animal Model and Traditional Chinese Medicine Target Intervention： A Review / 中国实验方剂学杂志

Reflux esophagitis （liver-stomach disharmony， Spittoon-Qi interties， Qi and blood stasis syndrome， turbid poison intrinsic） and nonalcoholic fatty liver disease （liver depression， spleen deficiency， phlegm and blood stasis syndrome， hot and humid embodiment， phlegmy wet resistance） and functional dyspepsia （liver depression syndrome， liver stomach with spleen deficient， spleen deficiency cold syndrome， in a word， fever） is a common disease and frequently encountered disease of digestive system. The course of disease is prolonged and the prevalence is high. The successful establishment of animal model combining disease and syndrome is the premise of exploring the mechanism of traditional Chinese medicine（TCM） effect and the foundation of the development of new preparations. At the same time， mastering the complex relationship network among disease， syndrome and prescription is the prerequisite of effective treatment. When the same syndrome occurs between different diseases， the concept of "treating different diseases with the same treatment" in TCM suggests that methods can be cross-referenced for the shortage of some syndrome models. TCM intervention of digestive diseases has the characteristics of multi-path， multi-target， multi-dimension and multi-level. Therefore， this article through the literature review， summarizes the reflux esophagitis， nonalcoholic fatty liver disease and functional dyspepsia is a common disease such as the combined operation method of the model and the intervention mechanism of TCM， so as to diseases of the digestive system of different syndrome types provides the theory basis for the objective of research， and the basic research of TCM prescription and achievements provide methodological guidance.

Research Progress of Digestive System Disease and Syndrome Combined Animal Model and Traditional Chinese Medicine Target Intervention： A Review / 中国实验方剂学杂志

Reflux esophagitis （liver-stomach disharmony， Spittoon-Qi interties， Qi and blood stasis syndrome， turbid poison intrinsic） and nonalcoholic fatty liver disease （liver depression， spleen deficiency， phlegm and blood stasis syndrome， hot and humid embodiment， phlegmy wet resistance） and functional dyspepsia （liver depression syndrome， liver stomach with spleen deficient， spleen deficiency cold syndrome， in a word， fever） is a common disease and frequently encountered disease of digestive system. The course of disease is prolonged and the prevalence is high. The successful establishment of animal model combining disease and syndrome is the premise of exploring the mechanism of traditional Chinese medicine（TCM） effect and the foundation of the development of new preparations. At the same time， mastering the complex relationship network among disease， syndrome and prescription is the prerequisite of effective treatment. When the same syndrome occurs between different diseases， the concept of "treating different diseases with the same treatment" in TCM suggests that methods can be cross-referenced for the shortage of some syndrome models. TCM intervention of digestive diseases has the characteristics of multi-path， multi-target， multi-dimension and multi-level. Therefore， this article through the literature review， summarizes the reflux esophagitis， nonalcoholic fatty liver disease and functional dyspepsia is a common disease such as the combined operation method of the model and the intervention mechanism of TCM， so as to diseases of the digestive system of different syndrome types provides the theory basis for the objective of research， and the basic research of TCM prescription and achievements provide methodological guidance.

Double H-flap technique, an anti-reflux adjunct to esophagogastrostomy after proximal gastrectomy for gastric leiomyoma: A case report

@#A significant challenge after performing resection of the esophagogastric region, is the reconstruction that follows. Esophagogastrostomy is a simple and direct method to restore gastrointestinal continuity using a single anastomosis but is associated with reflux esophagitis and anastomotic stenosis. This case report presents a 29-year-old man with a bleeding gastroesophageal junction leiomyoma who underwent a proximal gastrectomy and an esophagogastrostomy reconstruction with a double H-flap technique to reduce the incidence of gastric reflux. This illustrative description of the double H-flap technique created a valve mechanism that mimicked the function of the resected sphincter and cardia. This antireflux adjunct technique is reproducible and effective in preventing gastroesophageal reflux symptoms after an esophagogastrostomy.

Tojapride Reverses Esophageal Epithelial Inflammatory Responses on Reflux Esophagitis Model Rats / 中国结合医学杂志

OBJECTIVE@#To investigate the mechanism of Tojapride, a Chinese herbal formula extract, on strengthening the barrier function of esophageal epithelium in rats with reflux esophagitis (RE).@*METHODS@#Ten out of 85 SD rats were randomly selected as the sham group (n10), and 75 rats were developed a reflux esophagitis model (RE) by the esophageal and duodenal side-to-side anastomosis. Fifty successful modeling rats were divided into different medicated groups through a random number table including the model, low-, medium-, and high-dose of Tojapride as well as omeprazole groups (n10). Three doses of Tojapride [5.73, 11.46, 22.92 g/(kg•d)] and omeprazole [4.17 mg/(kg•d)] were administrated intragastrically twice daily for 3 weeks. And the rats in the sham and model groups were administered 10 mL/kg distilled water. Gastric fluid was collected and the supernatant was kept to measure for volume, pH value and acidity. Esophageal tissues were isolated to monitor the morphological changes through hematoxylin-eosin (HE) staining, and esophageal epithelial ultrastructure was observed by transmission electron microscopy. The expressions of nuclear factor kappa-light-chain-enhancer of activated B cells p65 (NF-KBp65), κB kinase beta (IKKß), occludin, and zonula occludens-1 (ZO-1) in the esophageal tissues were measured by immunohistochemistry and Western blot, respectively.@*RESULTS@#The gastric pH value in the model group was significantly lower than the sham group (P<0.05). Compared with the model group, gastric pH value in the omeprazole and medium-dose of Tojapride groups were significantly higher (P<0.05). A large area of ulceration was found on the esophageal mucosa from the model rats, while varying degrees of congestion and partially visible erosion was observed in the remaining groups. Remarkable increase in cell gap width and decrease in desmosome count was seen in RE rats and the effect was reversed by Tojapride treatment. Compared with the sham group, the IKKß levels were significantly higher in the model group (P<0.05). However, the IKKß levels were down-regulated after treatment by all doses of Tojapride (P<0.01 or P<0.05). The occluding and ZO-1 levels decreased in the model group compared with the sham group (Ps0.01 or Ps0.05), while both indices were significantly up-regulated in the Tojapride-treated groups (P<0.01 or P<0.05).@*CONCLUSIONS@#Tojapride could improve the pathological conditions of esophageal epithelium in RE rats. The underlying mechanisms may involve in down-regulating the IKKß expression and elevating ZO-1 and occludin expression, thereby alleviating the inflammation of the esophagus and strengthening the barrier function of the esophageal epithelium.

Analysis on acupoint selection rules for reflux esophagitis / 中国针灸

The data mining technology was used to explore the acupoint selection rules for reflux esophagitis (RE), so as to provide references of clinical acupuncture for RE. The clinical literature of acupuncture for RE published before June 2019 was searched in Chinese journal full-text database (CNKI), SinoMed, Wanfang and VIP databases. The literature was selected according to the inclusion and exclusion criteria and acupoint prescriptions were extracted. The software of IBM SPSS Statistics 23.0 and Clementine 12.0 were used for descriptive analysis and association analysis. A total of 46 articles were selected and 60 acupoint prescriptions were extracted. The descriptive analysis indicated that the top five acupoints used for RE were Zhongwan (CV 12), Zusanli (ST 36), Weishu (BL 21), Neiguan (PC 6) and Gongsun (SP 4). The conception vessel, bladder meridian and stomach meridian were the most commonly selected meridians. In terms of specific acupoints, the crossing points, the front- points and five- points were mainly selected, and the acupoints were mainly distributed in limbs and chest-abdomen. The core acupoint combination for RE was "Zhongwan (CV 12) and Zusanli (ST 36)" and the core prescription was "Zhongwan (CV 12), Zusanli (ST 36), Weishu (BL 21) and Neiguan (PC 6)".

Effect of Xuanfu Daizhe Tang on NLRP3/Caspase-1 Pathway of RE Model Rats / 中国实验方剂学杂志

Objective:To investigate the relationship between NOD-like receptor pyrin domain containing 3(NLRP3)/cysteine aspartate-specific protease(Caspase)-1 signaling pathway and esophageal inflammation by observing the effect of Xuanfu Daizhe Tang on the composition of inflammatory body and the expression of relevant inflammatory factors in rats with reflux esophagitis (RE), so as to explain the mechanism of Xuanfu Daizhe Tang in treating RE. Method:Sixty healthy male Wistar rats were randomly divided into four groups:the normal control group, the model control group, the Xuanfu Daizhe Tang group (9.89 g·kg-1) and the positive control group (omeprazole enteric-coated tablets+mosapride, 2.58 mg·kg-1), with 15 rats in each group. Except for the blank control group, the remaining rats were operated by " 4.2 mm pyloric clip+2/3 gastric fundus ligation" to establish models. Since the 8th day after the operation, the rats were given corresponding drugs twice a day for 14 days. The arterial blood and esophageal tissues were taken out at the 15th day after the intervention. The pathological morphology of esophagus was observed by naked eyes and under light microscopy. The secretion of cytokines Caspase-1 and interleukin(IL)-1β in serum was detected by enzyme linked immunosorbent assay(ELISA). The expressions of NLRP3, Caspase-1 and IL-1β in esophagus were detected by Western blot. Result:Compared with the normal group, the injury of esophageal mucosa in the model group was the most serious. Compared with the normal group, the levels of Caspase-1 and IL-1β in serum and the expression of NLRP3 protein in esophageal tissue of the model group were significantly increased (PPβ in serum of rats, and down-regulate the expressions of NLRP3, Caspase-1 and IL-1β protein in esophageal tissue (P0.05, PConclusion:Xuanfu Daizhe Tang can regulate the expressions of NLRP3 and Caspase-1, and reduce the content of IL-1β, suggesting that it may antagonize esophageal inflammatory response, reduce esophageal inflammatory injury and treat RE by inhibiting the activation of NLRP3/Caspase-1 signaling pathway.

Prospective Single Arm Study on the Effect of Ilaprazole in Patients with Heartburn but No Reflux Esophagitis

PURPOSE: Patients with gastroesophageal reflux disease without esophagitis show varying responses to proton pump inhibitors (PPIs). The aim of this study was to objectively evaluate the effect of a new PPI, ilaprazole, on patients with heartburn but without reflux esophagitis. MATERIALS AND METHODS: This prospective study was performed on 20 patients with heartburn but without reflux esophagitis. All patients underwent upper endoscopy and 24-hr combined multichannel intraluminal impedance and pH esophageal monitoring (MII-pH). They were then treated with ilaprazole (20 mg) once daily for 4 weeks. The GerdQ questionnaire, histologic findings, and inflammatory biomarkers were used for assessment before and after ilaprazole. RESULTS: Among the 20 patients, 13 (65%) showed GerdQ score ≥8. Based on MII-pH results, patients were classified as true nonerosive reflux disease (n=2), hypersensitive esophagus (n=10), and functional heartburn (n=8). After treatment, patients showed a statistically significant improvement in GerdQ score (p < 0.001). Among histopathologic findings, basal cell hyperplasia, papillary elongation, and infiltration of intraepithelial T lymphocytes improved significantly (p=0.008, p=0.021, and p=0.008; respectively). Expression of TNF-α, IL-8, TRPV1, and MCP-1 decreased marginally after treatment (p=0.049, p=0.046, p=0.045, and p=0.042; respectively). CONCLUSION: Daily ilaprazole (20 mg) is efficacious in improving symptom scores, histopathologic findings, and inflammatory biomarkers in patients with heartburn but no reflux esophagitis.

Frecuencia del esofago de barrett por reflujo gastroesofagico en la universidad central de venezuela / Frecuency of barret's esophagus for gastroesophageal reflux in the central university of venezuela

Introducción: Enfermedad por reflujo se desarrolla cuando el contenido gástrico provoca síntomas y/o complicaciones esofágicas y extra esofágicas. Las esofágicas incluyen el reflujo, esofagitis de reflujo y el esófago de Barrett. Esta última premaligna, caracterizada por una metaplasia intestinal especializada cuya importancia es el conocimiento de la displasia por su evolución a cáncer. Trabajos anteriores determinaron, displasia en esófago de Barrett 33,3%; prevalencia de enfermedad por reflujo no erosiva 82,70% y erosiva 17,30%; de esofagitis con hallazgo endoscópico e histológico 84,37%. Objetivo: Evaluar la prevalencia del esófago de Barrett por reflujo y esofagitis por reflujo en el Instituto Anatomopatológico de la Universidad Central de Venezuela. Método: Se realizó un estudio descriptivo, retrospectivo. Se estudiaron las muestras endoscópicas de biopsias esofágicas que ingresaron en el período 2005 al 2015, con diagnóstico de reflujo y esofagitis por reflujo. Se evaluó la ausencia o presencia de displasia en el esófago de Barrett, con su gradación correspondiente. Se utilizó un análisis descriptivo presentado en forma de frecuencias absolutas y relativas. Resultados: 35,85% reflujo y 64,12% esofagitis por reflujo, ambas con predominio en mujeres y edad promedio de 55,2 y 53,1 años respectivamente. Dieciocho casos (8%) con esófago de Barrett en relación a enfermedad por reflujo. Displasia de bajo grado 5,55%, indefinido para displasia 50% y negativo para displasia 44,44%. Conclusiones: La prevalencia de esófago de Barrett asociado a enfermedad por reflujo gastroesofágico fue del 8%. La mayor frecuencia fue en el sexo femenino con 66,66%, y las edades comprendidas entre 30 y 78 años con una media de 59,25 años.

Introduction: Reflux disease develops when gastric content causes esophageal and extra esophageal symptoms and/or complications. The esophageal complications include reflux, reflux esophagitis and Barrett's esophagus. The last is a pre-malignant condition characterized by a specialized intestinal metaphase whose importance lies in the knowledge of dysplasia due to its evolution to cancer. Previous investigations determined the prevalence of: dysplasia in Barrett's esophagus 33,3%; non erosive reflux disease 82,70% and erosive 17,30%; esophagitis with endoscopic and morphologic findings 84,37%. Objective: To evaluate the prevalence of Barrett's esophagus in patients with reflux and reflux esophagitis in the Anatomopathologic Institute of Universidad Central de Venezuela. Method: A descriptive and retrospective study was conducted. There were evaluated the esophageal endoscopic biopsies between 2005-2015, with diagnosis of reflux and reflux esophagitis.The presence or absence of dysplasia was reviewed in the Barrett's esophagus cases, with the respective grade. Absolute and relative frequencies were obtained by a descriptive analysis. Results: 35,85% of cases were reflux and 64,12% were reflux esophagitis, both with women predominance and the average age was 55,2 and 53,1 years respectively. Eighteen cases (8%) with Barrett's esophagus were related to reflux disease. Low grade dysplasia represented 5,55%, indefinite for dysplasia 50% and negative for dysplasia 44,44%. Conclusions: The prevalence of Barrett's esophagus associated with gastroesophageal reflux disease was 8%.The highest frequency was in the female sex with 66,66%, and the ages between 30 and 78 years with an average of 59,25 years.

Effect of tubular gastric anastomosis on gastric emptying dysfunction and reflux esophagitis after radical gastrectomy / 中国医师进修杂志

Objective To investigate the effect of tubular gastric anastomosis on delayed gastric emptying and reflux esophagitis after radical gastrectomy. Methods From January 2014 to June 2017, 142 patients with radical gastrectomy were selected from our hospital. The patients were divided into observation group (71 cases) and control group (71 cases) according to the mode of anastomosis. In the control group, the residual stomach and esophagus were directly anastomosed with anastomat, and in the observation group patients were treated with tubular gastric anastomosis after operation. The postoperative exhaust time, operation time and hospital stay, postoperative infection and abdominal bleeding, postoperative reflux esophagitis and postoperative gastric emptying disorder were compared between the two groups. Results Postoperative exhaust time, operation time and postoperative hospitalization time showed no significant difference in two groups of patients (P>0.05); the incidence rate of reflux esophagitis in observation group was more than that in the control group : 29.58％(21/71) vs. 47.89％(34/71) (P<0.05);the postoperative gastric emptying rate in observation group was more than that in the control group:4.23％(3/71) vs. 19.72％(14/71) (P<0.01). Conclusions Tubular gastric anastomosis can significantly reduce the gastric emptying disorder and reflux esophagitis after radical gastrectomy, which is worthy of further clinical study.

Correlation of GerdQ Score with Severity of Reflux Esophagitis / 胃肠病学

Background:Gastroesophageal reflux disease questionnaire(GerdQ)is a potentially useful tool for diagnosis of gastroesophageal reflux disease(GERD). Reflux esophagitis(RE)is a clinical type of GERD characterized by endoscopic mucosal injury of esophagus. Aims:To study the correlation of GerdQ score with severity of RE. Methods:Patients with typical reflux-related symptoms and meeting the inclusion criteria were recruited consecutively from Department of Gastroenterology,the People's Hospital of Xinjiang Uygur Autonomous Region during Aug. 2014 to Dec. 2015. All patients recruited were asked to complete the GerdQ scoring scale,meanwhile,the demographic information was collected and an upper gastrointestinal endoscopy was performed. The severity of RE was graded endoscopically by Los Angeles classification system. Results:A total of 1 554 patients were enrolled in this study,664 with RE(RE group)and 890 without RE(control group). The proportion of males in RE group was significantly higher than those in control group (50.9% vs. 37.1%,P<0.05). The prevalence of RE was significantly higher in Uygur than in Han and other ethnics (48.5% vs. 40.5% and 39.3%,P all <0.05). The proportions of patients with RE rose up with the increase of GerdQ score in a cut-off range from 0-14(0%,19.7%,50.1% and 51.7% for 0-2,3-7,8-11 and 11-14,respectively). The mean GerdQ score was significantly higher in RE group than in control group(9.95 ± 2.76 vs. 9.09 ± 3.33,P<0.05), and GerdQ score was positively correlated with severity of RE(r=0.243,P<0.05). When stratified by nationality,the correlation of GerdQ score with severity of RE was unchanged. Conclusions:GerdQ is a useful complementary tool for the diagnosis of RE. A cut-off value of 8 might predict the presence of RE and the GerdQ score might reflect the disease severity.

The correlation between traditional Chinese medicine differentiation syndrome and gastrointestinal hormone in reflux esophagitis / 国际中医中药杂志

Objective To provide evidence for TCM treatment according to syndrome differentiation by studying the correlation between TCM syndromes and serum gastrin (GAS), motilin (MTL), cholecystokinin (CCK) and vasoactive intestinal peptide (VIP) levels of reflux esophagitis (RE) patients. Methods A total of 120 eligible RE patients from Dongzhimen Hospital were differentiated with TCM syndromes, and blood samples were taken to test for GAS, MTL, CCK and VIP levels. Differences between the different TCM syndromes in terms of serum gastrointestinal hormones levels were analysed. Results The male patients had the most distribution of stagnation of heat in the liver and stomach syndrome, but the female patients had the most distribution of disharmony of the liver and stomach syndrome (χ2=27.994, Ps<0.001). The Grades A, B and C were mainly associated with the obstruction of phlegm syndrome, disharmony of the liver and stomach syndrome, and stagnation of heat in the liver and stomach syndrome respectively (χ2=9.951, P=0.007). For patients with the syndrome of stagnation of heat in the liver and stomach, the serum GAS level was significantly lower than the syndrome of disharmony of the liver and stomach, the syndrome of obstruction of phlegm, the syndrome of deficiency of the center and upward flow of qi, and mixture of cold and heat syndrome (P<0.01 or P<0.05). For patients with mixture of cold and heat and patients with deficiency of qi and stagnation of blood, there was a significant raise in serum CCK level, compared to the patients with stagnation of heat in the liver and stomach, patients with disharmony of the liver and stomach, or patients with deficiency of the center and upward flow of qi (P<0.01). Compared with the patients with disharmony of the liver and stomach and patients with the syndrome of obstruction of phlegm, the serum CCK level of patients with the syndrome of deficiency of the center and upward flow of qi rose significantly (P<0.01). Compared with the patients with the syndrome of stagnation of heat in the liver and stomach, the serum MTL levels of patients with obstruction of phlegm and patients with mixture of cold and heat rose significantly (P<0.01). There was a significant raise in serum MTL level of patients with the syndrome of mixture of cold and heat compared to patients with disharmony of the liver and stomach and patients with deficiency of the center and upward flow of qi (P<0.05). Conclusions The RE patients with mixture of cold and heat, and patients with deficiency of qi and stagnation of blood, and patients with deficiency of the center and upward flow of qi may be related to the rise in CCK levels. The patients with the syndrome of stagnation of heat in the liver and stomach are related to the decrease in GAS and MTL levels.

Study on Efficacy of Shunwei Jiangni Fang in Treating the Recurrent Reflux Esophagitis / 世界科学技术-中医药现代化

Objective: To evaluate the clinical efficacy and long-term efficacy of Shunwei Jiangni Fang in treating the liver- spleen- stomach disharmony and cold- dampness- heat recurrent reflux esophagitis. Methods: A total of 100 recurrent RE patients were divided into treatment group and control group by the random and control principle, with 50 cases in each group. Patients of 2 groups were treated with Shunwei Jiangni Fang and pantoprazole sodium entericcoated capsules respectively for 8 weeks. By comparing TCM syndrome scores and esophagus 24 h- pH parameters improvement, the clinical efficacy and safety of Shunwei Jiangni Fang in treating the liver-spleen-stomach disharmony and cold-dampness-heat recurrent reflux esophagitis, and perform statistics on the recurrence 6 months after treatment ending were evaluated. Results: ① For the patients with TCM syndromes in the treatment group, 4 cases were recovered, 17 cases were improved, 22 cases were effective, and the total effective rate was 86％; for the patients with TCM syndromes in the control group, 2 cases were recovered, 8 cases were improved, 14 cases were effective, and total effective rate was 48％. Difference of total effective rate for 2 groups was significant (P ＜ 0.05). The heartburn, belching, dry mouth, bitter taste, tiredness, distended abdomen and sticky stool in treatment group were more improved than those of control group (P ＜ 0.05); ② In the control group, the patient's 24 h-pH parameters could be improved, especially, the 24h gastric reflux times and times of reflux ＞ 5min could be reduced more than the control group, and difference was significant (P ＜ 0.05). ③ The treatment group was able to improve the patients' esophageal mucosal inflammation, with no statistically significant difference from the control group (P ＞ 0.05). ④ At 6 months after treatment, the recurrence rate of treatment group and control group was 6.0％ and 28％ respectively, and difference was significant (P ＜ 0.05). Conclusions: Shunwei Jiangni Fang can treat the liver-spleen-stomach disharmony and cold-dampness-heat recurrent reflux esophagitis, with apparently efficacy. It can effectively improve the clinical symptoms, reduce the reflux occurrence times, reduce esophageal mucosal inflammation, lower the recurrence rate, prevent apparent adverse reactions, thus, it shall be widely promoted.

The Prevalence of Nontuberculous Mycobacterial Lung Disease with orwithout Reflux Esophagitis / 대한소화기학회지

BACKGROUND/AIMS: Gastrointestinal reflux disease (GERD) is defined as ‘a condition that develops when the reflux of stomach contents causes troublesome symptoms and/or complications’. It is associated with various lung diseases, including bronchial asthma, chronic bronchitis, and bronchiectasis. GERD may also affect nontuberculous mycobacterial (NTM) lung disease. We presumed that the normal mucosal barrier of the bronchial epithelium is broken due to the aspiration of gastric juice and consequent chronic bronchial inflammation. This study investigated the prevalence of GERD in accordance with the presence or absence of NTM lung disease and analyzed the difference. METHODS: We screened patients with NTM lung disease in this hospital between January 2011 and December 2015. Among these patients, gastroscopic examinations as a health check-up were performed on 93 patients. We obtained the prevalence of Reflux esophagitis (RE) in patients with NTM and compared it with the prevalence of RE in the normal control subjects. RESULTS: Among 93 patients with NTM, patients without RE was 66.7% (62/93). RE-minimal change was diagnosed in 29.0% (27/93), and RE LA-A was diagnosed in 4.3% (4/93). Comparing the prevalence of RE minimal change, 29.0% (27/93) had NTM and 11.9% (3043/25536) did not have NTM. This was statistically significant. CONCLUSIONS: We showed a greater prevalence of RE minimal change in patients with NTM than those without NTM with statistical significance.

Effects of combination of tandospirone,mosapride and Bella ray on the levels of oxygen free radicals and inflammatory cytokines in patients with reflux esophagitis / 中国综合临床

Objective To investigate the effects of combination of tandospirone,mosapride and Bella ray on the levels of oxygen free radicals and inflammatory cytokines in patients with reflux esophagitis.Methods From March 2016 to March 2017,ninety cases with reflux esophagitis treated in Nanchong Central Hospital were involved in this study.The patients were divided into the observation group and the control group according to different treatment methods,45 cases in each group.Patients in the observation group were treated with tandospirone and mosapride combined with ray Bella with treatment,patients in the control group were treated with Mosapride combined with Bella ray,the therapeutic effect of two groups were observed and compared,oxygen free radical and inflammatory cytokines before and after treatment of the two groups were compared.Results After treatment,MDA and AOPP of the patients in the observation group were(16.51±2.6)U/L and(36.5 ±4.5)μmol/L,significantly lower than those in the control group(MDA:(20.8±2.9)U/L,AOPP:(59.9 ±4.8)mol/L).Glutathione peroxidase(GSH-PX)and superoxide dismutase(SOD)in the observation group were significantly higher than those in the control group((249.4 ± 32.3)mg/L vs.(228.6 ± 17.2)mg/L, (27.3± 3.4)mg/L vs.(18.8 ± 2.7)mg/L),the differences were statistically significant(t=33.5,32.3, 31.4.32.7,P<0.05).After treatment,the levels of TNF-a,IL-6,IL-8 were significantly lower than those in the control group(17.7±2.8)μg/L vs.(26.3±1.5)μg/L,(4.9±0.3)ng/L vs.(6.5±1.8)ng/L,(5.4±0.7) μg/L vs.(6.6±0.8)μg/L),the differences were statistically significant(t=36.3,31.5,32.4,P<0.05).In the observation group,22 cases were significantly effective,19 cases were effective and 4 cases were ineffective, the effective rate was 91.1%,which was significantly higher than that of the control group(86.7%),(χ2=29.5,P=0.02).Conclusion Tandospirone combined with Bella ray can reduce the levels of oxygen free radicals and inflammatory cytokines in patients with reflux esophagitis.

Treatment of Reflux Esophagitis from Cold / 浙江中医药大学学报

[Objective]This paper mainly introduced the etiology, pathogenesis and treatment of reflux esophagitis due to cold, and tried to help doctors of TCM explore the new thinking for clinical treatment.[Methods]Based on the relevant account of past dynasties literature of traditional Chinese medicine, clinically,we conclude that reflux esophagitis can result from pathogenic cold, inner cold and transmission between Zang and Fu organs.Moreover,we explain the corresponding treatment.In order to better describe this therapy, a clinical case was reported. [Results]Adverse rising of gastric qi is a basic TCM pathogenesis in reflux esophagitis.Syndromes due to cold can be divided into cold pathogen attacking stomach,Yang deficiency of the spleen and stomach, deficiency of kidney-YANG and liver cold.So the corresponding prescriptions are given respectively.[Conclusion]This has solid theoretical basis and important clnical significance to treat the disease from cold.Cold can come from outside, but also from the inside.For this kind of patients,we have to identify the excess cold and asthenia cold and the related zang-fu organs,then choose a flexible medication, and get a good curative effect.

Clinical observation of rabeprazole combined with mosapride in the treatment of reflux esophagitis / 中国生化药物杂志

Objective To explore the clinical efficacy of rabeprazole combined with mosapride in the treatment of reflux esophagitis.MethodsThe clinical data of 315 patients with reflux esophagitis from December 2015 to December 2016 in our hospital were retrospectively analyzed, were randomly divided into two groups according to the time of admission.The control group (157 cases)was treated with rabeprazole, the observation group (158 cases) given rabeprazole combined with mosapride treatment.The clinical symptom scores before and after treatment, the effective rate of treatment, the quality of life before and one month after treatment and three months after treatment of two groups were compared.ResultsAfter treatment,the symptoms scores of the two groups were significantly lower than those before treatment, but the the scores in the observation group were significantly lower than those in the control group (P<0.05);The total effective rate was 96.2% in the observation group, which was significantly higher than that in the control group (79.0%), the difference between the two groups was statistically significant (P<0.05);The quality of life scores of the two groups were significantly higher than that before treatment, but the scores of one months after treatment and three months after treatment in observation group were significantly higher than those in control group (P<0.05).ConclusionReflux esophagitis with rabeprazole combined with mosapride treatment is significant,can better improve the clinical symptoms of patients, improve the treatment efficiency, and improve the quality of life of patients.