Diabetic gastroparesis is a common gastrointestinal complication which develops in about 20-30% of patients with longstanding diabetes mellitus. Recent studies have shown that erythromycin stimulates gastrointestinal motor activity by binding on motilin receptors of gastrointestinal smooth muscles and that it improves gastric emptying in patients with diabetic gastroparesis. In this respect, we present a 35-year-old patient with diabetic gastroparesis, complicated with a gastric bezoar, who was successfully treated with endoscopic bezoar fragmentation and oral erythromycin for 3 weeks.
Adult ; Bezoars* ; Diabetes Mellitus ; Erythromycin ; Gastric Emptying ; Gastroparesis* ; Humans ; Motilin ; Motor Activity ; Muscle, Smooth

Adult ; Diagnosis, Differential ; Dyspepsia ; blood ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Motilin ; blood

OBJECTIVETo observe the clinical efficacy difference in treatment of functional dyspepsia (FD) between syndrome differentiation based acupuncture and ordinary acupuncture.

METHODSSeventy FD patients were assigned to a syndrome differentiation based acupuncture group (Group A) and an ordinary acupuncture group (Group B) by Excel Software randomization. Zhongwan (RN12 ), Tianshu (ST25), and Zusanli (ST36) were needled as main points for patients in Group A. Meanwhile, different combined acupoints were needled according to syndrome differentiation. Only the same main points were needled for patients in Group B. All patients were needled once per day, 30 min each time, 6 days as one treatment cycle, 2 treatment cycles in total. Fasting serum levels of gastrin (GAS) and motilin (MTL) were determined before treatment and after 2 treatment cycles. 36-item Short-form Heath Survey (SF-36) and Nepean Dyspepsia Index [NDI, including Nepean Dyspepsia Symptom Index (NDSI) and Nepean Dyspepsia Life Quality Index (NDLQI)] were assessed before treatment, after 2 treatment cycles, and one month after treatment.

RESULTSCompared with before treatment in the same group, serum levels of GAS and MLT increased in the two groups after 2 treatment cycles (P <0. 05), but changes were more obvious in Group A (P <0. 05). Compared with before treatment in the same group, SF-36 and NDLQI score increased, and NDSI score decreased in the two groups after 2 treatment cycles and 1 month after treatment (all P <0. 05). Compared with Group B, SF-36 and NDLQI score increased in Group A after 2 treatment cycles and 1 month after treatment (P <0. 05, P <0. 01). But NDSI score at 1 month after treatment was lower in Group A than in Group B (P <0.01).

CONCLUSIONSyndrome differentiation based acupuncture could evidently improve dyspeptic symptoms of FD patients, and significantly improve their quality of life with remarkable curative effect.

Acupuncture Points ; Acupuncture Therapy ; Dyspepsia ; therapy ; Humans ; Motilin ; Needles ; Quality of Life ; Surveys and Questionnaires ; Syndrome

OBJECTIVETo determine the effect of the area postrema (AP) of the medulla oblongata on gastrointestinal interdigestive migrating motor complex (MMC) and the plasma motilin level.

METHODSInterdigestive MMC activities of the antrum and duodenum were recorded by strain gauge implanted on the serosa of 8 conscious dogs. A cannula was intubated in femoral vein for motilin injection. The plasma motilin concentration was measured by RIA. We observed: (1) normal interdigestive MMC activity and fluctuations in plasma motilin concentration; (2) the effects of electrically damaging the AP on MMC activity and plasma motilin level; (3) whether intravenous injection of motilin could induce phase III contractions after the AP was destroyed.

RESULTS(1) Typical interdigestive MMC with phase I, II, III, and IV was recorded in normal dogs. Phase III was concurrent with the peak of plasma motilin level. (2) In damaged AP dogs, antroduodenal interdigestive MMC contractions were suppressed; cyclic, phasic and migratory pattern of MMC was disrupted. Plasma motilin concentration was decreased. Intravenous injection of motilin could not induce phase III contractions.

CONCLUSIONSThe area postrema might play an important role, which is mediated by motilin, on the regulation of interdigestive MMC.

Animals ; Dogs ; Fourth Ventricle ; physiology ; Medulla Oblongata ; physiology ; Motilin ; blood ; Myoelectric Complex, Migrating ; physiology ; Stomach ; physiology

OBJECTIVETo explore the effect of modified Baizhu (Rhizoma Atractylodis Macrocephalae) powder on the gastrointestinal function in mouse models with stomach-cold functional dyspepsia. Meanwhile,the mouse models were administered with Shihu (dendrobium), a traditional Chinese drug with cold nature and flavour, to explore the way via which it exert its effect on specific symptoms. Methods: Mouse models with stomach-cold functional dyspepsia were established by ice water and ice NaOH. The effects of modified Baizhu powder and dendrobium on mice were observed in terms of water intake, weight change,small intestine propulsion rate, intestinal absorption function, and effects on ghrelin and motilin.

RESULTSThe modified Baizhu powder effectively increased food intake, water intake, body weight (P<0.05) and swimming time (P<0.01), increased the small intestine propulsion rate and serum D-xylose content (P<0.05), and up-regulated ghrelin (P<0.05). Also, it showed a trend to down-regulate the motilin, although the change was not statistically significant (P>0.05). In contrast,the use of Shihu aggravated symptoms in the mouse models. Conclusion: The changes in ghrelin and motilin levels may be the neuro-endocrine mechanisms via which the modified Baizhu powder and Shihu exert their effects on mouse models.

Animals ; Disease Models, Animal ; Dyspepsia ; Ghrelin ; Intestine, Small ; Medicine, Chinese Traditional ; Mice ; Motilin ; Powders ; Stomach

No abstract available.
*Gastric Bypass ; Humans ; Hunger/*physiology ; Motilin/*blood ; Obesity/*blood/physiopathology/*surgery

OBJECTIVE: To explore the clinical therapeutic effect of herb-partitioned moxibustion at point in patients of diabetic gastroparesis differentiated as spleen and stomach deficiency and retention of turbid dampness as well as its effect mechanism. METHODS: A total of 134 patients with diabetic gastroparesis were randomized into an observation group and a control group, 67 cases in each one. In the observation group, herb-partitioned moxibustion at point was adopted, 40 min each time, once a day for 5 times a week. In the control group, itopride hydrochloride tablets were prescribed for oral administration, 50 mg each time, three times a day. A total of 6 weeks of treatment was required in the two groups. Before and after treatment, the gastroparesis cardinal symptom index (GCSI) scores, 4-hour gastric emptying rate, TCM symptom score, as well as the levels of plasma motilin and serum gastrin were observed in the patients of the two groups. Additionally, the clinical therapeutic effect was evaluated in the two groups. RESULTS: After treatment, the score of every item of GCSI, TCM symptom scores and the levels of plasma motilin and serum gastrin were all reduced as compared with those before treatment in the patients of the two groups (<0.05), and those in the observation group were lower than the control group (<0.05). Regarding 4-hour gastric emptying rates, which were increased as compared with those before treatment in the two group (<0.05), and the rate in the observation group was higher remarkably than that in the control group (<0.05). The total effective rate was 92.5% (62/67) in the observation group, higher than 74.6% (50/67) in the control group (<0.05). CONCLUSION Herb-partitioned moxibustion at point relieves the clinical symptoms in the patients with diabetic gastroparesis and increases the gastric emptying rate, which is probably related to the regulation of the levels of plasma motilin and serum gastrin.
Acupuncture Points ; Diabetes Mellitus ; Gastric Emptying ; Gastrins ; blood ; Gastroparesis ; therapy ; Humans ; Motilin ; blood ; Moxibustion

OBJECTIVETo observe the changes in motilin (MTL), substance P (SP), vasoactive intestinal peptide (VIP) and somatostatin (SS) in plasma of rats with severe scald injury at early stage and the effect of rheum on their changes.

METHODSEighty-eight Wistar rats were randomly divided into normal control group (NC, n = 8), scald group (S, gavage of distilled water after full-thickness scald, n = 40), therapeutic group (T, gavage of rheum solution after full-thickness scald, n = 40). The blood samples were harvested from inferior vena cava at 6, 12, 24, 48, 72 post scald hours (PSH) to determine the levels of MTL, SS, SP and VIP with radioimmunoassay.

RESULTS(1) The levels of MTL and SP were (198 +/- 28), (61 +/- 10) ng/L, respectively, in NC group. The levels of MTL and SP in S group reached their minimum values [(110 +/- 15), (30 +/- 5) ng/L, respectively] at 6 PSH, then ascended slowly, peaked at 72 PSH but still lower than those in NC group (P < 0.05). The levels of MTL and SP slowly descended in T group, reached normal levels at 48 PSH, and obviously higher than those in NC group at 72 PSH [(232 +/- 32), (73 +/- 11) ng/ L, respectively, P < 0.05], which were higher than those in S group at 6 -72 PSH. (2) The levels of VIP and SS were (35 +/- 6), (30 +/- 5) ng/L, respectively, in NC group. The levels of VIP and SS in S group were (70 +/- 12), (49 +/- 9) ng/L at 6 PSH, which were obviously higher than those in NC group (P < 0.01), then descended slowly, but still higher than normal level at 72 PSH (P < 0.05). The levels of VIP and SS in T group ascended slowly, reached the normal level at 48 PSH, which were lower than those in S group at each time points, and VIP reached peak value at 12 PSH.

CONCLUSIONRheum may regulate secretion and release of gastrointestinal hormones to plasma in rats with severe scald injury at early stage.

Animals ; Burns ; blood ; drug therapy ; Motilin ; blood ; Phytotherapy ; Rats ; Rats, Wistar ; Rheum ; chemistry ; Substance P ; blood ; Vasoactive Intestinal Peptide ; blood

AIMTo investigate the role of motilin in paraventricular nucleus (PVN) of hypothalamus on the regulation of gastric motility and the mechanism.

METHODSImmunohistochemistry and microinjection of motilin into PVN were used to observe motilin neural cells in PVN, the neural path between PVN and dorsal vagal complex (DVC) and the changes of gastric motility in conscious rats.

RESULTS(1) There were motilin immunoreactive-cells in PVN and a significant increase was found in groups of fasting and HCL-perfusion into duodenum. (2) HRP-positive cells were found in PVN after microinjection HRP into dorsal nucleus of vagal nerve. It proved that there was neural relationship between PVN and DVC. (3) The amplitude and frequency of gastric motility increased significantly by microinjection motilin into PVN in conscious rats. The effects produced by motilin could be abolished by vagotomy.

CONCLUSIONAll these results presented imply that motilin in PVN may increase gastric motility through PVN-DVC-Vagal nerve axis.

Animals ; Female ; Gastrointestinal Motility ; physiology ; Hypothalamus ; physiology ; Male ; Motilin ; physiology ; Paraventricular Hypothalamic Nucleus ; physiology ; Rats ; Rats, Wistar

OBJECTIVETo observe the effect of gastric dynamics by transcutaneous electrical acupoint stimulation (TEAS) combined general anesthesia when controlled hypotension dropped to 60% of the mean arterial prenssure (MAP) baseline, and to provide experimental evidence for organ protection in clinical controlled hypotension.

METHODSEighteen male beagles were randomly divided into three groups, the general anesthesia group (blank), the general anesthesia induced controlled hypotension group (control), and the general anesthesia combined TEAS induced controlled hypotension group (experiment), 6 in each group. Controlled hypotension was performed in the latter two groups with isoflurane inhalation and intravenous injection of sodium nitroprusside (SNP). The mean arterial pressure (MAP) was lowered to 60% of the MAP baseline and kept for 60 min. Controlled hypotension was not performed in Beagles of the control group. For Beagles in the experiment group, TEAS [2/100 Hz, (4 ± 1) mA] was applied to bilateral Hegu (LI4), Quchi (LI11), Zusanli (ST36), and Sanyinjiao (SP6) from stable physiological conditions to the end of maintaining stages. Changes of EGG frequencies and EGG amplitudes were monitored. Serum levels of gastrin (GAS) and motilin (MTL) were also detected at corresponding time points during and after experiment.

RESULTSAs for the pressure control effect of TEAS combined general anesthesia in the controlled hypotension, during the process of controlled hypotension (T1-T4), MAP levels of two controlled pressure groups remained relatively stable, and were kept at 60% of the MAP baseline. When the blood pressure dropped to the target low MAP and maintained at 60 min (T1-T4), EGG amplitudes of Beagles in all the three groups showed decreasing tendency. But it was more obviously lower than its basic level in the control group (P <0.05), while it was not obviously decreased in the experiment group (P < 0.05). EGG frequencies of Beagles in all the three groups showed no obvious change during this stage. By the end of the MAP rising stage (T8), the EGG amplitude of the experimental group was significantly higher than that of the control group and the blank group (P < 0.05), while it didn' t show any obvious increase in the control group. During this period, EGG frequencies of the two controlled hypotension groups decreased more than those of the blank group. Two h after rising blood pressure (at T9), EGG amplitudes and frequencies in the two controlled hypotension groups basically restored to their respective baselines and levels of the blank group at T9. At 2 h (T9) after controlled hypotension, serum levels of GAS and MTL were lower than those of basic levels in the two controlled hypotension groups (P <0.05). However, serum levels of GAS and MTL had an increasing trend in the two controlled hypotension groups at 24-72 h (T10-T12). Besides, the increasing speed and amplitude was better in experiment group than in the control group at T10-T12. However, there was no statistical difference between the two groups (P > 0.05). At 72 h (T12) serum levels of GAS and MTL had basically restored to their basic levels in the two controlled hypotension groups and that of the blank control group.

CONCLUSIONEGG amplitudes could be effectively improved in TEAS combined general anesthesia for controlled hypotension at 60% of the MAP baseline, the recovery of the serum GAS level accelerated, gastric power improved and stomach protected.

Acupuncture Points ; Anesthesia ; methods ; Anesthesia, General ; Animals ; Arteries ; Dogs ; Gastrins ; Hypotension, Controlled ; Male ; Motilin ; Nitroprusside ; Transcutaneous Electric Nerve Stimulation