Efficacy of traditional Chinese medicine for chronic gastritis: A meta-analysis of randomized controlled trials.

BACKGROUND: To systematically evaluate efficacy of traditional Chinese medicine (TCM) in treating chronic gastritis (CG). METHODS: Data sources from PubMed, Embase, Springer Link, China National Knowledge Infrastructure, Chinese Scientific Journals Database, Chinese Biomedicine Database, and Wan-fang database were searched up to July 5, 2018. Review Manager software version 5.3, the Cochrane Collaboration's risk of bias tool, and the Grading of Recommendations Assessment, Development, and Evaluation profiler software were conducted for this meta-analysis. RESULTS: Sixteen studies involving 1673 participants (906 vs 767) were included in this study. Pooled data showed significant statistical differences between TCM groups and current routine pharmacotherapy (RP) groups in overall clinical efficacy (odds ratio [OR] 4.65; 95% confidence interval [CI] 3.29, 6.56; P < .00001), efficacy under endoscopy (OR 2.46; 95% CI 1.12, 5.43; P = .03), stomach distension (mean difference [MD] -0.37; 95% CI -0.56, -0.19; P < .0001), stomachache (standardized MD [SMD] -0.80; 95% CI -1.45, -0.14; P = .02), and belching (SMD -2.00; 95% CI -3.80, -0.20; P = .03). However, acid regurgitation (SMD -0.71; 95% CI -1.69, 0.28; P = .16) and anorexia (SMD -0.75; 95% CI -2.30, 0.80; P = .35) showed no significant statistical differences between 2 groups. In addition, incidence of adverse reactions of TCM groups was lower than that of RP groups. CONCLUSION: Evidence from this meta-analysis suggests that TCM could be more efficacious than current RP in treating CG. But further standardized research of rigorous design should be needed to further validate its efficacy.

Blood flow differences in cun-kou (radial) artery and anterior tibial artery: normal people vs patients with chronic gastritis.

OBJECTIVE: To explore the blood flow differences in cun-kou (radial) artery and anterior tibial artery between normal people and patients with chronic gastritis. METHODS: Using doppler ultrasonography, blood flow charts [peak systolic velocity (VP), maximum blood flow velocity in diastole (VD), mean blood flow velocity (VM), pulse index (PI), resistance index (RI), blood vessel diameter (D), vessel volume (SV), circulation blood flow periodic time (ET)] measured by at cun-kou (radial) artery and anterior tibial artery in normal group (n = 30) and chronic gastritis group (n = 30) in department of ultrasound, Beijing Anzhen hospital, capital medical university. RESULTS: In the doppler flow charts of the normal group, there were statistically significant differences in VD, VM, D, RI, SV, ET between cun-kou artery and anterior tibial artery (P < 0.05), and there were more statistically significant differences in PI between cun-kou artery and anterior tibial artery (P < 0.01). In the comparison of doppler flow charts in the chronic gastritis group, there were statistically significant differences in VD, VM, D, RI, SV, ET between cun-kou artery and anterior tibial artery (P < 0.05), and there were more statistically significant differences in PI between cun-kou artery and anterior tibial artery (P < 0.01). In the comparison of doppler flow charts between normal group and chronic gastritis group, there were statistically significant differences in SV, ET between normal group and chronic gastritis group (P < 0.05), and there were more statistically significant differences in PI between normal group and chronic gastritis group (P < 0.01). CONCLUSION: Based on the differences in doppler flow charts between the normal group and the chronic gastritis group, the doppler flow charts of cun-kou artery and anterior tibial artery were not only proved to be significantly different, but also provided quantitative objective indexes for the study of cun-kou artery and anterior tibial artery doppler flow charts of normal people and chronic gastritis patients. This study also proves that the doppler flow chart of the anterior tibial pulse is of great significance for the diagnosis of chronic gastritis.

Tongue Image Analysis and Its Mobile App Development for Health Diagnosis.

Computer-aided diagnosis provides a medical procedure that assists physicians in interpretation of medical images. This work focuses on computer-aided tongue image analysis specifically, based on Traditional Chinese Medicine (TCM). Tongue diagnosis is an important component of TCM. Computerized tongue diagnosis can aid medical practitioners in capturing quantitative features to improve reliability and consistency of diagnosis. Recently, researchers have started to develop computer-aided tongue analysis algorithms based on new advancement in digital photogrammetry, image analysis, and pattern recognition technologies. In this chapter, we will describe our recent work on tongue image analysis as well as a mobile app that we developed based on this technology.

A rare case of iron-pill induced gastritis in a female teenager: A case report and a review of the literature.

RATIONALE: The treatment of iron-deficiency anemia with oral iron supplements can present side-effects on the GI tract mucosa including necrosis, ulceration, or ischemia. The particular endoscopic findings and the histopathological exam will establish the diagnosis of erosive gastritis with iron deposits in the gastric mucosa. PATIENT CONCERNS: We present the case of a 14-year-old female admitted in our clinic for upper digestive hemorrhage, nausea, melena, and abdominal pain. Her personal history revealed iron deficiency anemia receiving oral iron supplements for approximately 2 weeks. DIAGNOSIS: The laboratory tests at the moment of admission pointed out anemia, increased level of serum iron, increased liver transaminases, a decreased level of ferritin, but with normal levels of both total iron-binding capacity and transferrin. INTERVENTIONS: The eso-gastro-duodenoscopy revealed multiple brown deposits on the surface of the gastric mucosa and multiple hemorrhagic lesions, under the aspect of erosions all over the gastric mucosa, but more severe in the antral part, and the histopathological exam confirmed the presence of iron deposits at this level. CONCLUSION: Iron-pill induced gastritis is a rare, under-diagnosed entity that can be present even at pediatric ages with potential severe clinical impact.

Double-contrast barium examination of the upper gastrointestinal tract with nonendoscopic biopsy: findings in 100 patients.

PURPOSE: To evaluate the performance of double-contrast barium examination of the upper gastrointestinal tract augmented with nonendoscopic gastric mucosal biopsy. MATERIALS AND METHODS: One hundred twenty-six patients (aged 9-81 years) underwent double-contrast barium examination of the upper gastrointestinal tract and nasogastric biopsy. Pathology reports were recovered for 100 patients. These patients' records were searched for procedural complications, sufficiency of biopsy tissue, diagnoses among various age groups, and radiographic findings. RESULTS: Forty-nine (49%) of the 100 patients had biopsy-proved Helicobacter pylori infection with chronic active gastritis. Twenty-one patients (21%) with H pylori-negative biopsy specimens had chronic gastritis. One patient with eosinophilic gastritis and one with granulomatous gastritis were identified. Twenty-nine patients (29%) had negative biopsy results. Nineteen (30%) of the patients with negative barium studies had a positive biopsy specimen, and four (6%) of the patients with positive barium studies had negative biopsy specimens. Eight patients (8%) had a second diagnosis of intestinal metaplasia. CONCLUSION: Use of double-contrast barium examination of the upper gastrointestinal tract combined with nonendoscopic biopsy is quick and safe and can provide reliable histologic information to the primary care physician.

Prone compression with the pneumatic paddle during barium studies.

Prone compression with the pneumatic paddle is easy to perform, effective with high-density suspensions and less uncomfortable for the patient than other methods of compression. It provides accurate graduated compression over a wide field with an unimpeded view. Its routine use is recommended in double-contrast barium meals and all types of small-bowel examinations.

Double versus single contrast gastrointestinal radiology.

With experience, air contrast examination of the esophagus, stomach, and duodenum can be performed routinely as quickly and easily as the standard UGI. The air contrast examination is superior for detection of small gastric polyps and the Japanese have found it superior for detection of early carcinoma. The postoperative stomach and the fundus and cardia are most easily examined by air contrast. Clear superiority in the diagnosis of peptic ulcers and peptic esophagitis has not been proved. The most accurate routine examination may be a multiphasic or combined approach utilizing air contrast views as well as filled compression views and careful fluoroscopy. With respect to the colon, we do not suggest that air contrast BE must be done exclusively. However, it is superior for the detection of polyps and small carcinomas. The technique should be available in all radiology departments and should be an integral part of the evaluation of patients at increased risk of developing carcinoma. This includes patients over 40 years of age, with chronic ulcerative colitis, familial multiple polyposis or Gardner's syndrome, family history of inherited cancer, and medical history of adenomatous polyps, colorectal cancer, or female genital cancer. In addition, air contrast enema should be utilized for the sensitive and accurate evaluation of early inflammatory bowel disease. Finally, with respect to the colon examination one fact must be stressed. Irregardless of full column or air contrast method, most missed lesions are due to poor bowel preparation, poor technique, or perceptive error by the radiologist. There can be no substitute for a clean colon, meticulous attention to technical details, and careful review of the radiographs.

Radiologic appearance of complete gastric erosions.

At gastroscopy of 656 patients, complete gastric erosions were found in 58 (11%). Radiography performed in 46 of these demonstrated erosions in 21 of 33 with a time span less than one month between radiography and gastroscopy but in only 4 of 13 with a time span of one to 3 months. Double contrast technique supplemented with films of compressed barium-filled antrum demonstrate the lesions best. Complete erosions have often appearances simulating gastric polyps or large mucosal folds and are often found together with ulcers.