The Role of Mean Nocturnal Baseline Impedance and Post-Reflux Swallow-Induced Peristaltic Wave Index in the Diagnosis and Treatment of Gastroesophageal Reflux Disease.

BACKGROUND: As living standards improve, more and more people are becoming overweight or obese, which has led to a gradual increase in the incidence of gastroesophageal reflux disease (GERD). Esophageal multichannel intraluminal impedance pH monitoring is a technique widely used in the clinical diagnosis of GERD. Commonly used traditional impedance parameters include acid exposure time, number of reflux episodes, symptom association probability, and symptom index. Recently, mean nocturnal baseline impedance (MNBI) and post-reflux swallow-induced peristaltic wave (PSPW) index have been proposed as novel impedance parameters to evaluate esophageal mucosal integrity and esophageal chemical clearance, respectively. It was also pointed out that the MNBI and PSPW index can improve the diagnostic value of impedance pH monitoring and predict the treatment outcome of GERD. SUMMARY: MNBI and PSPW index are objective and reliable novel impedance parameters with high applicability and reproducibility, which are able to improve the diagnostic yield of impedance pH monitoring and predict treatment outcomes in GERD patients. KEY MESSAGES: In this paper, we mainly review the research progress of the MNBI and the PSPW index in the diagnosis and treatment of GERD.

Study on the prediction effect of a combined model of SARIMA and LSTM based on SSA for influenza in Shanxi Province, China.

BACKGROUND: Influenza is an acute respiratory infectious disease that is highly infectious and seriously damages human health. Reasonable prediction is of great significance to control the epidemic of influenza. METHODS: Our Influenza data were extracted from Shanxi Provincial Center for Disease Control and Prevention. Seasonal-trend decomposition using Loess (STL) was adopted to analyze the season characteristics of the influenza in Shanxi Province, China, from the 1st week in 2010 to the 52nd week in 2019. To handle the insufficient prediction performance of the seasonal autoregressive integrated moving average (SARIMA) model in predicting the nonlinear parts and the poor accuracy of directly predicting the original sequence, this study established the SARIMA model, the combination model of SARIMA and Long-Short Term Memory neural network (SARIMA-LSTM) and the combination model of SARIMA-LSTM based on Singular spectrum analysis (SSA-SARIMA-LSTM) to make predictions and identify the best model. Additionally, the Mean Squared Error (MSE), Mean Absolute Error (MAE) and Root Mean Squared Error (RMSE) were used to evaluate the performance of the models. RESULTS: The influenza time series in Shanxi Province from the 1st week in 2010 to the 52nd week in 2019 showed a year-by-year decrease with obvious seasonal characteristics. The peak period of the disease mainly concentrated from the end of the year to the beginning of the next year. The best fitting and prediction performance was the SSA-SARIMA-LSTM model. Compared with the SARIMA model, the MSE, MAE and RMSE of the SSA-SARIMA-LSTM model decreased by 38.12, 17.39 and 21.34%, respectively, in fitting performance; the MSE, MAE and RMSE decreased by 42.41, 18.69 and 24.11%, respectively, in prediction performances. Furthermore, compared with the SARIMA-LSTM model, the MSE, MAE and RMSE of the SSA-SARIMA-LSTM model decreased by 28.26, 14.61 and 15.30%, respectively, in fitting performance; the MSE, MAE and RMSE decreased by 36.99, 7.22 and 20.62%, respectively, in prediction performances. CONCLUSIONS: The fitting and prediction performances of the SSA-SARIMA-LSTM model were better than those of the SARIMA and the SARIMA-LSTM models. Generally speaking, we can apply the SSA-SARIMA-LSTM model to the prediction of influenza, and offer a leg-up for public policy.

The interaction between obesity and visceral hypersensitivity.

Obesity has been a worldwide problem associated with numerous chronic diseases such as cardiovascular disease, type 2 diabetes, and metabolic disorders. It may also play a role in visceral hypersensitivity, contributing to irritable bowel syndrome. (i) Adipose tissue secretes various inflammatory mediators, causing intestinal hyperpermeability and nerve endings activation. (ii) Obesity and gastrointestinal microbiota could affect each other, and microbial metabolites can increase sensitivity of the colon. (iii) Vitamin D deficiency contributes to both fat accumulation and disruption of the intestinal mucosal barrier. (iv) Brain-gut axis may be another bridge from obesity to visceral hypersensitivity.

Urolithin C reveals anti-NAFLD potential via AMPK-ferroptosis axis and modulating gut microbiota.

The pharmacology of urolithin C (UroC) on non-alcoholic fatty liver disease (NAFLD) is largely undetermined. We sought to investigate the potential for NAFLD improvement by administration of UroC and the underlying mechanisms. We verified the therapeutic effect of UroC on choline-deficient amino acid-defined high fat diet (CDAHFD) induced NAFLD mice via evaluating NAFLD activity score (NAS), AST, ALT, hepatic phosphorylated AMPK, and 4-hydroxynonenal. Oleic acid-induced AML12 cell was appraised by oil red staining and western blotting to explore the effect and mechanism of UroC in vitro. Transcriptional regulation of UroC was explored by liver RNA sequencing, gut microbiota composition was explored by 16SrRNA sequencing, and colorectal tight junctional proteins were detected by western blotting and immunohistochemistry. The detrimental effects of CDAHFD included the increased liver index, AST, ALT, hepatic 4-hydroxynonenal, impaired intestinal mucosal barrier, and most importantly, pathological damage in liver. Oral administration of UroC largely protected against these harmful alterations. Remarkably, both RNA sequencing and western blotting results indicated an activation in hepatic AMPK signaling pathway which was thought to inhibit ferroptosis response to UroC in vivo, while no change were found in AMPK-ferroptosis axis response to UroC in oleic acid-induced AML12 cells, hinted an indispensable linkage between UroC and hepatic AMPK, presumably the gut-liver axis. Furthermore, UroC could neither alleviate lipid deposition nor inhibit ferroptosis in vitro. The 16SrRNA showed UroC partially counteracted the dysbiosis induced by CDAHFD. Specifically, UroC reversed the elevated proportion of Firmicutes/Bacteroidota and enhanced the level of Parabacteroides goldsteinii and Lactobacillus vaginalis, which played a beneficial role in metabolic disorders. Oral administration of Urolithin C protected against the detrimental impact of CDAHFD via regulating AMPK-ferroptosis axis, maintaining intestinal mucosal barrier and counteracting gut dysbiosis.

Safety and immunogenicity of a quadrivalent, inactivated, split-virion influenza vaccine (IIV4-W) in healthy people aged 3-60 years: a phase III randomized clinical noninferiority trial.

BACKGROUND: A quadrivalent split influenza vaccine IIV4-W against both influenza A and B viruses is urgently needed. METHODS: To evaluate the safety and immunogenicity of IIV4-W in people aged 3-60 years, 2400 participants recruited in a double-blind phase III trial and were randomly assigned to the IIV4-W, TIV1 and TIV2 groups. The immunogenicity indicators were measured at 28 days postvaccination and for 180 days for safety follow-up. RESULTS: Adverse events (AEs) occurred in 162 (20.28%), 116 (14.55%) and 123 (15.41%) participants in the IIV4-W, TIV1 and TIV2 groups, respectively. All these AEs were mild and self-limiting, and no serious AEs related to the vaccines were observed. IIV4-W elicited a non-inferior immune response for matched strains (the lower limit of 95% CI for GMT ratio >0.67, for SCR and SPR difference >-10%) and superior immune response for the additional B strains (the lower limit of 95% CI for GMT ratio >1.5, for SCR difference >10%) versus TIVs. The lower limit of the 95% confidence interval of the GMT increase fold, the seroconversion rate and the seroprotection rate exceeded 2.5, 40% and 70% for the four strains in IIV4-W respectively. CONCLUSIONS: IIV4-W was noninferior to the TIV-matched strains and was superior to the additional B strain. IIV4-W was safe in the participants and elicited high antibody titers.

The Impact of Colonoscopy Quality Control Table on Adenoma Detection Rates.

Objective. This study aims to investigate the effects of reporting colonoscopy findings and the regular review of outcomes on adenoma detection rates. Methods. Patients who underwent colonoscopy from August 2013 to February 2014 were selected as the intervention group. The preintervention group included patients who underwent colonoscopy from January 2013 to July 2013, in which the procedure sheet for this group of patients was not accomplished. The primary outcome was adenoma detection rate (ADR), and secondary outcomes included the success rate of intubation and withdrawal time. Results. This study included 2,467 cases: 1,302 cases in the intervention group and 1,165 cases in the preintervention group. There was no significant difference in demographic characteristics between the two groups. In the intervention group, withdrawal time of colonoscopy was longer (P < 0.01), and the success rate of intubation (92.5% versus 89.1%, P < 0.05) and detection rate of polyps (32.6% versus 27.6%, P < 0.05) and adenomas (20.0% versus 16.1%, P < 0.05) were higher. Significantly high detection rates for proximal adenomas, flat adenomas, and adenomas with a diameter <5 mm were observed in the intervention group (all P < 0.01). Conclusion. The reporting and review of procedure details help to improve quality indicators of colonoscopy.