AIM:To investigate the mechanism of action of Wenweiyang decoction(WWYD)in treating func-tional dyspepsia in rats based on mast cell activation and stem cell factor(SCF)/receptor tyrosine kinase c-Kit signaling pathway.METHODS:Sixty SD rats were randomly divided into control group,model group,ranitidine hydrochloride capsule group,and low-,medium-and high-dose WWYD groups,with 10 rats in each group.The rat model of functional dyspepsia was established by tail clamping and irregular feeding compound senna method.After modeling,the rats in con-trol group and model group were given normal saline,while those in low-,medium-and high-dose(0.743 g/mL,1.485 g/mL and 2.970 g/mL)WWYD groups and ranitidine hydrochloride capsule(3 g/L)group were treated with corresponding drugs by intragastric administration.After treatment,the propulsion rate of the small intestine was measured by the carbon ink propulsion method.Rat duodenal mast cells were observed and counted by toluidine blue staining.ELISA was used for determination of mast cell tryptase(MCT)and histamine(HA)content in rat duodenum.The mRNA levels of SCF and c-Kit in duodenum were detected by RT-qPCR.Western blot and immunohistochemistry were employed to determine the ex-pression levels of SCF and c-Kit in the duodenum.RESULTS:Compared with model group,WWYD treatment signifi-cantly increased the propulsion rate of the small intestine in rats(P<0.05).ELISA results showed that WWYD reduced the number of mast cells and the content of MCT and HA in the duodenal mucosa tissue of rats(P<0.05).Western blot and immunohistochemistry results suggested that WWYD up-regulated the protein expression levels of c-Kit and SCF in the duodenal tissue of rats(P<0.05),and increased the numbers of SCF and c-Kit positive cells.RT-qPCR results indicated that WWYD up-regulated the mRNA expression of c-Kit and SCF in the duodenum of rats(P<0.05).Moreover,the small intestinal propulsion rate was negatively correlated with MCT and HA content,and positively correlated with the expres-sion of SCF and c-Kit.CONCLUSION:Wenweiyang decoction promotes rat duodenal motility,and its mechanism may be related to the inhibition of rat duodenal MCT and HA production and activation of SCF/c-Kit signaling pathway.

OBJECTIVES: At present, there are many studies on Crohn's disease of terminal ileum and colon, but few studies on Crohn's disease of small intestine alone. This study aims to analyze the clinical features and therapeutic effect of small bowel in adult patients with Crohn's disease so as to strengthen the diagnosis and treatment for this disease. METHODS: From July 1, 2015 to October 31, 2018, patients with small bowel Crohn's disease at Department of Gastroenterology, Third Xiangya Hospital of Central South University, were enrolled. At the same time, patients' demographics and clinical data were collected. RESULTS: A total of 44 patients were small bowel Crohn's disease. Among them, 40 patients were male. The age at diagnosis was (35.8±10.3) years old and disease duration was (35.2±59.5) months. The subtypes included 29(65.9%) of ileum, 7(15.9%) of jejunum, 8(18.2%) of ileum with jejunum. There were 27(61.4%) of stricture behavior, 4(9.1%) of penetrating behavior, and 13(29.5%) of non-stricture and non-penetrating behavior. Endoscopic visible stricture (29/85, 34.1%) was common, followed by longitudinal ulcers (27/85, 31.8%). Non-caseate granulomatous were found in 2 cases (4.5%). The score of Crohn's disease activity index was correlated to hemoglobin, hematocrit, and erythrocyte sedimentation rate (all CONCLUSIONS Patients with ileum account for a large proportion in patients with small bowel Crohn's disease. Stricture is more common in small bowel Crohn's disease. Stricture and longitudinal ulcer are more common under enteroscopy. Crohn's disease activity index is correlated to hemoglobin, red blood cell specific volume, and erythrocyte sedimentation rate. The most common complication is intestinal obstruction. Mesalazine is less effective on small bowel Crohn's disease.
Adult ; Crohn Disease/drug therapy* ; Endoscopy, Gastrointestinal ; Humans ; Ileum ; Intestinal Obstruction/etiology* ; Intestine, Small ; Male ; Middle Aged

To evaluate the safety and efficacy of endoscopic balloon dilation (EBD) and endoscopic stricturotomy with needle knife (NKSt) in patients with inflammatory bowel diseases (IBD)-relevant strictures. 
 Methods: From July 2015 to September 2018, 14 patients undergoing double balloon-enteroscopy at the Third Xiangya Hospital of Central South University were enrolled. There was a total of 16 lesions. Endoscopic intervention was performed for 16 times. EBD was done for 11 times, and 5 stricturotomies were carried out. Regular follow-up and examinations were done to observe whether there was remission or recurrence of clinical symptoms and replacement surgery.
 Results: All 14 patients were successfully treated by endoscopy, and the success rate was 100%. Postoperative clinical symptoms were alleviated, and serious complications, such as perforation or hemorrhaging, did not occur. Obstructive symptoms were effectively alleviated at a median follow-up of 26.1 months (5.9-35.3 months) and 8.3 months (1.6-17.8 months) for patients with balloon dilatation and stricturotomy, respectively. Two patients presented with symptoms of obstruction. These were given conservative symptomatic treatment without surgical intervention.
 Conclusion: Enteroscopic treatments (EBD and NKSt) are safe and effective for intestinal strictures, and can prolong the time before surgical intervention is needed.
Constriction, Pathologic ; Double-Balloon Enteroscopy ; Humans ; Inflammatory Bowel Diseases ; Treatment Outcome