OBJECTIVETo observe the clinical efficacy of self-formulated Xingchang Decoction (XCD) in treating slow-transit constipation (STC) and the dynamical parameters of colonic motility during XCD treatment.

METHODSOne hundred and eighteen patients with STC were randomly assigned to the treatment group and the control group, 59 in each group. The treatment group was treated with XCD, and the control group was treated with mosapride, an intestinal energetic agent. The therapeutic course for both groups was 30 days. The 72-h colonic transition test was conducted and the symptom scores were observed before and after treatment; the adverse reaction rate and clinical efficacy were calculated after treatment; and the recurrence rate in one year was followed-up.

RESULTSSymptom scores were significantly improved in the treatment group after treatment, with the improvement significantly superior to that in the control group (P < 0.01). The cure rate and the total effective rate were 76.27% and 93.22% in the treatment group respectively, while they were 47.45% and 72.87% in the control group, showing significant difference between the two groups (P < 0.01). Besides, the 1-year recurrence rate was significantly lower (chi2 = 10.40, P = 0.001) and the improvement of colonic motor function was more in the treatment group than those in the control group (P < 0.01). Only low incidence (5.08% in the treatment group and 8.47% in the control group) of mild gastrointestinal reactions was shown, which caused no influence on the treatment.

CONCLUSIONXCD could effectively improve the motility of the digestive tract, and it is effective and safe for the treatment of STC.

Benzamides ; therapeutic use ; Constipation ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Gastrointestinal Agents ; therapeutic use ; Gastrointestinal Transit ; drug effects ; Humans ; Morpholines ; therapeutic use

No abstract available.
Antibodies, Monoclonal/*therapeutic use ; Crohn Disease/*drug therapy ; Female ; Gastrointestinal Agents/*therapeutic use ; Humans ; Male

Human gut microbiota play an essential role in both healthy and diseased states of humans. In the past decade, the interactions between microorganisms and tumors have attracted much attention in the efforts to understand various features of the complex microbial communities, as well as the possible mechanisms through which the microbiota are involved in cancer prevention, carcinogenesis, and anti-cancer therapy. A large number of studies have indicated that microbial dysbiosis contributes to cancer susceptibility via multiple pathways. Further studies have suggested that the microbiota and their associated metabolites are not only closely related to carcinogenesis by inducing inflammation and immune dysregulation, which lead to genetic instability, but also interfere with the pharmacodynamics of anticancer agents. In this article, we mainly reviewed the influence of gut microbiota on cancers in the gastrointestinal (GI) tract (including esophageal, gastric, colorectal, liver, and pancreatic cancers) and the regulation of microbiota by diet, prebiotics, probiotics, synbiotics, antibiotics, or the Traditional Chinese Medicine. We also proposed some new strategies in the prevention and treatment of GI cancers that could be explored in the future. We hope that this review could provide a comprehensive overview of the studies on the interactions between the gut microbiota and GI cancers, which are likely to yield translational opportunities to reduce cancer morbidity and mortality by improving prevention, diagnosis, and treatment.
Anti-Bacterial Agents ; therapeutic use ; Gastrointestinal Microbiome ; drug effects ; Gastrointestinal Neoplasms ; microbiology ; prevention & control ; Gastrointestinal Tract ; microbiology ; Humans

Gastrointestinal stromal tumor(GIST) originates from interstitial cells of Cajal(ICCs). Tyrosine kinase inhibitors(TKI) such as imatinib and sunitinib, are effective agents besides surgery. However some GIST can become primarily or secondarily resistant to those drugs. The difference in gene mutation types and secondary gene mutation is the main cause. When the GIST is proved to be drug resistance, reasonable personal treatment strategies based on individualized medicine should be made to improve outcomes and quality of life.
Antineoplastic Agents ; therapeutic use ; Benzamides ; therapeutic use ; Drug Resistance, Neoplasm ; genetics ; Gastrointestinal Stromal Tumors ; drug therapy ; genetics ; Humans ; Imatinib Mesylate ; Indoles ; therapeutic use ; Piperazines ; therapeutic use ; Protein Kinase Inhibitors ; therapeutic use ; Pyrimidines ; therapeutic use ; Pyrroles ; therapeutic use

Infliximab has shown its superiority and safety in the treatment of inflammatory bowel disease (IBD) that failed to respond to traditional medical therapy, in refractory cases with obvious adverse reactions, and in "top-down therapy". For standardized and effective management of IBD, experts worldwide have consecutively issued the 2010 European ECCO guide, 2011 London consensus, and 2012 Chinese consensus. In this paper, based on the latest expert consensus worldwide, we reviewed the efficacy of infliximab treatment on IBD and the factors affecting its therapeutic effect.
Anti-Inflammatory Agents, Non-Steroidal ; therapeutic use ; Antibodies, Monoclonal ; therapeutic use ; Gastrointestinal Agents ; therapeutic use ; Humans ; Inflammatory Bowel Diseases ; drug therapy ; Infliximab

BACKGROUND/AIMS: Infliximab has been shown to be effective and safe for treating refractory luminal and fistulizing Crohn's disease (CD). The aim of this study was to report the efficacy and adverse effect of infliximab therapy in patients with CD at our center. METHODS: Medical records of thirteen patients who were treated with infliximab for refractory luminal or fistulizing CD were reviewed. Clinical response was classified as complete response, partial response and nonresponse. RESULTS: Seven patients were treated for fistulizing CD, four patients for luminal CD, and two for both. The mean time of follow-up was 13.1 months (3.3-28.1 months). Clinical response was seen in 10/13 (77%); complete response 7/13 (54%), partial response 3/13 (23%), nonresponse 3/13 (23%). Mean time to response was 27.1 days (10-41 days). 4 of 10 responders (40%) maintained remission over 30 weeks. Those who started on immunosuppressive treatment more than 3 months before infliximab infusion achieved lower early recurrence rate (14%) compared with those less than 3 months (67%) (p=0.039). Steroid tapering was successful in 7/12 (58%). Five patients required surgical therapy; three nonresponders, one partial responder and one who recurred after initial complete response. Initial responders required less surgery than nonresponders (p=0.035). Acute infusion reactions were seen in 2/40 infusions (5%). One patient developed herpes zoster 20 weeks after infliximab infusion. During follow-up peried, no patient developed serious infection, tuberculosis or malignancy. CONCLUSIONS: Infliximab is effective and safe in clinical practice. Concurrent immunosuppressive use is associated with lower rate of early recurrence.
Adult ; Antibodies, Monoclonal/adverse effects/*therapeutic use ; Crohn Disease/*drug therapy ; Female ; Gastrointestinal Agents/adverse effects/*therapeutic use ; Humans ; Immunosuppressive Agents/therapeutic use ; Male

Hemophagocytic syndrome (HPS) is an uncommon hematological disorder that manifests as fever, splenomegaly, and jaundice, with hemophagocytosis in the bone marrow and other tissues pathologically. Secondary HPS is associated with malignancy and infection, especially viral infection. The prevalence of cytomegalovirus (CMV) infection in ulcerative colitis (UC) patients is approximately 16%. Nevertheless, HPS in UC superinfected by CMV is very rare. A 52-year-old female visited the hospital complaining of abdominal pain and hematochezia for 6 days. She was diagnosed with UC 3 years earlier and had been treated with sulfasalazine, but had stopped her medication 4 months earlier. On admission, her spleen was enlarged. The peripheral blood count revealed pancytopenia and bone marrow aspiration smears showed hemophagocytosis. Viral studies revealed CMV infection. She was treated successfully with ganciclovir. We report this case with a review of the related literature.
Antiviral Agents/therapeutic use ; Colitis, Ulcerative/*complications/drug therapy ; Cytomegalovirus Infections/*complications/drug therapy ; Female ; Ganciclovir/therapeutic use ; Gastrointestinal Agents/therapeutic use ; Gastrointestinal Hemorrhage/etiology ; Humans ; Lymphohistiocytosis, Hemophagocytic/drug therapy/*virology ; Middle Aged ; Sulfasalazine/therapeutic use ; Superinfection/*complications

OBJECTIVETo study the effect of Hewei Xiaopi Capsule (HXC) in treating patients with dyskinesis functional dyspepsia (FD).

METHODSSixty-three patients with FD were randomly assigned to two groups, 33 in the treated group and 30 in the control group, who were treated respectively with HXC and domperidone for 4 weeks to observe the clinical effect and changes in electrogastrogram (EGG) before and after treatment.

RESULTSSymptoms were alleviated in both groups after treatment, 3 patients in the treated group were cured, the efficacy was judged as markedly effective in 11, effective in 14 and ineffective in 5, while in the control group, 1 cured, 8 markedly effective, 14 effective and 7 ineffective, difference between the two groups showed no statistical significance. EGG showed that in the treated group, the normal slow-wave percentage was 41.93 +/- 18.22 before treatment and 50.86 +/- 16.03 after treatment, showing significant difference (P < 0.05).

CONCLUSIONHXC is markedly effective in treating patients with FD.

Drugs, Chinese Herbal ; therapeutic use ; Dyskinesias ; drug therapy ; Dyspepsia ; drug therapy ; Gastrointestinal Agents ; therapeutic use ; Humans ; Tablets

OBJECTIVES: To study the association between infliximab trough level (IFX-TL) prior to maintenance treatment and disease outcome in children with Crohn's disease (CD). METHODS: A retrospective analysis was performed on 35 children with CD who received induction therapy with infliximab (IFX) and the measurement of IFX-TL before maintenance treatment from August 2018 to November 2021. Clinical data and laboratory markers at baseline and before maintenance treatment were collected, and the association between outcome and IFX-TL was analyzed. RESULTS: The clinical remission group, endoscopic remission group, and combined remission group had a significantly higher IFX-TL level than the corresponding non-remission groups (P<0.05), and there was no significant difference in the IFX-TL level between the biological remission and non-biological remission groups (P>0.05). The receiver operating characteristic (ROC) curve showed that IFX-TL had an area under the ROC curve of 0.959 (95%CI: 0.894-1) in predicting clinical remission, with a sensitivity of 90% and a specificity of 100% at the optimal cutoff value of 2.3 µg/mL (P<0.001). CONCLUSIONS Among children with CD receiving infliximab induction therapy, the children achieving clinical and endoscopic remission before maintenance treatment tend to have a higher level of IFX-TL. IFX-TL has a certain predictive value for clinical remission.
Child ; Humans ; Infliximab/therapeutic use* ; Crohn Disease/drug therapy* ; Gastrointestinal Agents/therapeutic use* ; Retrospective Studies ; C-Reactive Protein/analysis*

Solitary rectal ulcer syndrome (SRUS) is a rare, benign disorder in children that usually presents with rectal bleeding, constipation, mucous discharge, prolonged straining, tenesmus, lower abdominal pain, and localized pain in the perineal area. The underlying etiology is not well understood, but it is secondary to ischemic changes and trauma in the rectum associated with paradoxical contraction of the pelvic floor and the external anal sphincter muscles; rectal prolapse has also been implicated in the pathogenesis. This syndrome is diagnosed based on clinical symptoms and endoscopic and histological findings, but SRUS often goes unrecognized or is easily confused with other diseases such as inflammatory bowel disease, amoebiasis, malignancy, and other causes of rectal bleeding such as a juvenile polyps. SRUS should be suspected in patients experiencing rectal discharge of blood and mucus in addition to previous disorders of evacuation. We herein report six pediatric cases with SRUS.
Adolescent ; Anti-Inflammatory Agents, Non-Steroidal/therapeutic use ; Anti-Ulcer Agents/therapeutic use ; Child ; Colonoscopy ; Female ; Gastrointestinal Hemorrhage/*diagnosis ; Humans ; Male ; Mesalamine/therapeutic use ; Rectal Diseases/*diagnosis/drug therapy ; Steroids/therapeutic use ; Sucralfate/therapeutic use ; Syndrome ; Ulcer/*diagnosis/drug therapy