Barrett’s esophagus is associated with esophageal adenocarcinoma and cardia cancer,although it has no significant influence on individual’s expectation of life and the canceration rate is comparatively low. However,Barrett’s esophagus has big burden on the psychology and economy of patients. At present,there are still some debates about the diagnosis and management of Barrett ’s esophagus. American Gastroenterological Association, British Society of Gastroenterology and Chinese Society of Gastroenterology have updated their guidelines on Barrett’s esophagus. In this review,we introduced the updated progress in diagnosis and management of Barrett’s esophagus according to these three new guidelines,and compared the similarities and differences between these guidelines.

Background: Bowel preparation is important for improving the effectiveness and positivity rate of colonoscopy. At present, all laxative drugs used in clinical medicine have certain shortcomings and limitations. Exploring ideal bowel preparation drug has important clinical value. Aims: To compare the effectiveness of lactulose and polyethylene glycol electrolyte in bowel preparation before colonoscopy. Methods: A total of 150 patients underwent colonoscopy from June 2019 to November 2019 at the Second Affiliated Hospital of Baotou Medical College were enrolled and randomly divided into the lactulose group and the polyethylene glycol electrolyte group, and the laxatives were taken in two stages. The patient's basic information, subjective feelings and adverse reactions during bowel preparation, the stool frequency and the last stool consistency were collected. The score of cleanliness and foam of each segments of intestine were estimated. Results: No significant differences in gender, age, BMI, education level, stool consistency and frequency were found between lactulose group and polyethylene glycol electrolyte group. Stool frequency in Stage 1 and the total stool frequency in lactulose group were significantly higher than those in polyethylene glycol electrolyte group (P<0.05), however, cleanliness score of descending colon was significantly lower (P<0.05). The taste score was significantly lower in lactulose group than in polyethylene glycol electrolyte group (P<0.05), and the incidence of thirst was significantly higher in lactulose group (P<0.05). Correlation analysis showed that cleanliness of descending colon, sigmoid colon were negatively correlated with stool frequency in Stage 1 (P<0.05), cleanliness of rectum was negatively correlated with total stool frequency (P<0.05). Conclusions: Lactulose has good application value in bowel preparation before colonoscopy, and its taste is better than polyethylene glycol electrolyte. Evaluating the stool frequency in Stage 1 and total stool frequency can optimize the quality of bowel preparation and enhance the cleanliness of various segments of intestine.

Background: Besides acid reflux, bile reflux also plays an important role in the mucosal injury and Barrett metaplasia in gastroesophageal reflux disease (GERD). Until now, there are rarely literatures reporting whether bile reflux and acid reflux occur simultaneously, and whether they have the same pathogenic mechanism. Aims: To analyze the differences in distribution of gastroesophageal acid reflux and bile reflux during preprandial and postprandial period. Methods: A retrospective analysis was performed on individuals with typical gastroesophageal reflux symptoms and suspicious of GERD. According to the results of esophageal 24-hour pH-Bilitec 2000 monitoring, the subjects were divided into physiological acid reflux group, pathological acid reflux group and pathological bile reflux group. The preprandial and postprandial profiles of acid and bile reflux were compared. Results: Both physiological and pathological acid reflux were much more frequent during postprandial than preprandial period. In patients with pathological acid reflux, the frequency of postprandial acid reflux was two-fold over the preprandial acid reflux (P<0.05), and the postprandial longest acid reflux time was significantly shorter than preprandial (P<0.05). In patients with pathological bile reflux, the frequency of preprandial bile reflux, the preprandial longest bile reflux time, and time percentage of bile reflux were significantly increased than those of postprandial (P<0.05). Conclusions: Gastroesophageal acid reflux is prone to occur during postprandial period while bile reflux during preprandial period. There may be different mechanisms related with acid reflux and bile reflux.

Background:Currently,there are no effective biomarkers for predicting the progression of gastric precancerous lesions or screening early gastric cancer in clinical practice.Aims:To explore the expressions of adenylate cyclase 7(ADCY7),G protein-coupled receptor GPR86,glutamate receptor,ionotropic,N-methyl D-aspartate 2D(GRIN2D)and regulator of G protein signaling 4(RGS4)in various gastric mucosal lesions and their predictive value for progression of gastric precancerous lesions.Methods:Expressions of ADCY7,GPR86,GRIN2D,and RGS4 were detected by immuno-histochemistry,real-time PCR and Western blotting in Correa cascade(chronic non-atrophic gastritis,chronic atrophic gastritis,low-and high-grade intraepithelial neoplasia,and mucosal and submucosal early gastric cancer)and cancerous and para-cancerous tissues,among which,the differences in expression levels of these four factors were analyzed.Results:There was an increasing tendency in expression levels of ADCY7,GPR86,GRIN2D,and RGS4 from gastritis,intra-epithelial neoplasia to early gastric cancer.Except for GRIN2D expression between intraepithelial neoplasia and early gastric cancer,significant differences could be observed in any two groups(all P<0.001).Both mRNA and protein expression levels of GRP86 and GRIN2D were significantly higher in cancerous tissue than in adjacent tissue>5 cm(all P<0.05).Protein expression of RGS4 was significantly higher in cancerous tissue than in adjacent tissue>5 cm,but its mRNA expression presented an opposite trend(all P<0.05).Significant difference between cancerous tissue and adjacent tissue>5 cm in ADCY7 expression was only existed at protein level(P<0.05).Conclusions:Alterations of the expression levels of ADCY7,GPR86,GRIN2D,and RGS4 in Correa cascade and cancerous and para-cancerous tissues suggest that they are involved in the occurrence and development of gastric precancerous lesions,and might be used as predictors for progression of gastric precancerous lesions.

Background:Nocturnal gastroesophageal reflux (nGER)is associated with severe complication of gastroesophageal reflux disease (GERD),such as esophagitis,esophageal stricture and Barrett's esophagus,and has certain effect on quality of life. Aims:To study the characteristics of nGER and its influencing factor in patients with GERD. Methods:GERD patients with typical reflux symptoms (heartburn or/ and regurgitation)and nGER confirmed by MII-pH monitoring were included. Effects of gender,age,BMI,DBI on nGER were analyzed. Results:In 130 patients with GERD,97 (74. 6%)had nGER. Of the 97 patients with nGER,only 18 (18. 6%)patients complained nocturnal heartburn or/ and regurgitation. During nocturnal period,female and elderly GERD patients had delayed bolus clearance time. Percentage of time with pH < 4 and acid reflux of GERD patients with BMI≥25 kg/ m2 were significantly higher than patients with normal BMI. Nocturnal acid reflux was much lower in patients with DBI≥2. 5 hours than patients with DBI < 2. 5 hours. The weakly acidic reflux could significantly decrease along with the getting longer of DBI. Conclusions:nGER is prevalent in GERD patients,and weakly acidic reflux is the leading type,however,only a small part of patients having nocturnal reflux symptom. The female and elderly GERD patients have delayed bolus clearance time during nocturnal period. BMI≥25 kg/m2 is associated with nGER. DBI≥2. 5 hours could significantly reduce acid reflux during nocturnal period. DBI should be as long as possible for reducing weakly acidic reflux.

Objective:To reveal the regular pattern characteristics of different diseases with the same treatment in the most common diseases with blood stasis syndrome; To provide reference for the clinical treatment of blood stasis syndrome and the development of new drugs.Methods:RCTs of blood stasis syndrome were retrieved from CNKI, Chongqing VIP, Wanfang Data, SinoMed, and China Medical Journal Full-text Database from the establishment of the databases to December 31, 2022. Diseases, accompanied symptoms, prescriptions and medicines were extracted. The diseases with the highest frequency among the three disease systems with the highest frequency were collected, and their medication characteristics and prescription rules were analyzed using frequency statistics and association rules Apriori algorithm. The core prescriptions of blood stasis syndrome of three kinds of diseases were excavated and their network similarity was analyzed.Results:A total of 2 052 articles were included. Stable coronary heart disease, ischemic stroke and DN were more common diseases with blood stasis syndrome. The common drugs for the three diseases were Chuanxiong Rhizoma, Carthami Flos, Persicae Semen, Angelicae Sinensis Radix. The core prescription of stable coronary heart disease was Persicae Semen- Carthami Flos- Chuanxiong Rhizoma- Angelicae Sinensis Radix- Paeoniae Radix Rubra; the core prescription of ischemic stroke is Buyang Huanwu Decoction; the core prescription of DN was Persicae Semen- Carthami Flos- Chuanxiong Rhizoma- Angelicae Sinensis Radix- Cornus Officinalis- Dioscoreae Rhizoma- Astragali Radix. The similarity between stable coronary heart disease and ischemic stroke core prescription network was 0.35, the similarity between ischemic stroke and DN core prescription network was 0.29, and the similarity between stable coronary heart disease and DN core prescription network was 0.26. Conclusions:The theory of "different diseases with the same treatment" can profoundly guide clinical practice. The core medicines of blood stasis syndrome are Persicae Semen, Carthami Flos, Angelicae Sinensis Radix, and Chuanxiong Rhizoma. On this basis, combined with different diseases and syndromes to make changes of adding and subtracting.

The value of 24 - hour multichannel intraluminal impedance - pH (24 h MII - pH) monitoring is still unknown in most patients with gastroesophageal reflux disease (GERD), and the value of mean nocturnal baseline impedance (MNBI) in the diagnosis of GERD remains controversial. Aims: To analyze the characteristics of esophageal MNBI in GERD patients, and to investigate the diagnostic value of MNBI for GERD. Methods: The clinical data of 111 patients suspected of GERD and monitored for 24 h MII-pH from May 2019 to December 2021 at the Second Affiliated Hospital of Baotou Medical College were retrospectively analyzed. According to DeMeester standard, patients were divided into non - GERD group and GERD group. Reflux parameters and MNBI of each channel between the two groups were compared. The correlation between distal and proximal esophageal MNBI and reflux parameters were analyzed. ROC curve was used to evaluate the sensitivity and specificity of MNBI for GERD. Results: Compared with non-GERD patients, the acid exposure time (AET), DeMeester score, total reflux times, acid reflux times and non-acid reflux times in GERD group were increased, the differences were statistically significant (P<0.01). MNBI at 3 cm, 5 cm and 7 cm above the dentate line and distal MNBI in the GERD group were decreased, the differences were statistically significant (P<0.01). Spearman correlation analysis showed that distal MNBI was negatively correlated with AET, DeMeester score, acid reflux times and weak acid reflux times (P<0.05). There were significant negative correlations between proximal MNBI and AET, DeMeester score and weak acid reflux times (P<0.05). ROC curve analysis showed that AUC of distal MNBI for the diagnosis of GERD was 0.72 (95% CI: 0.66-0.81, P<0.01), when the cut-off value was 1 191.42 Ω, the sensitivity and specificity of distal MNBI for diagnosis of GERD were 82.9% and 53.9%, respectively. Conclusions: Distal esophageal MNBI has good diagnostic significance for GERD patients, and can be used as a new impedance index for the auxiliary diagnosis of GERD.

Objective To investigate the therapeutic effect of Xiakucao Xiaoliu mixture on Lewis lung cancer mice. Methods 30 mice with C₅₇BL/6 mouse Lewis lung cancer xenograft model were randomly divided into three groups: model control group, Xiakucao Xiaoliu mixture group (M group), cisplatin group (DDP group). M group and DDP group were administered continuously for 14 days. Through the general observation of Lewis lung cancer mice, tumor size was determined, HE staining method was used to determine the histopathological changes of tumors, and the expression of CyclinD1 and P16 in tumor tissues was determined by immunohistochemistry. Results The tumor weight of the model control group was the heaviest, and the difference was statistically significant compared with other groups. (P<0.05). Survival state and quality of life of mice had been improved to some extent in M group. The results of tumor growth curve and HE staining in each group of mice showed that the growth of tumor cells had been inhibited and normal cells had been protected. The positive expression of CyclinD1 was significantly decreased in M group and DDP group (P<0.01), but the effect of M group on the improvement of P16 positive expression was not significant. Conclusion Xiakucao Xiaoliu mixture had a good effect on inhibiting lung tumor growth.

Background:Functional dyspepsia (FD)with anxiety and gastric hypersensitivity is still one of the therapeutic difficulties in clinic. Gastrodin (Gas)may have dual effects of modulating gastric sensitivity and anxiety. Aims:To investigate the effect of Gas on gastric sensitivity and anxiety-like behavior in FD with anxiety-like gastric hypersensitivity in rats. Methods:Forty rats were randomly divided into control group,model group,buspirone group,low-dose Gas group and high-dose Gas group. Maternal separation,acute gastric irritation and restraint stress were sequentially performed to induce FD model with anxiety-like gastric hypersensitivity. At the 8th week,rats in control group and model group were intraperitoneally injected with 0. 9% NaCl solution 2. 0 mL/ kg,rats in buspirone group were given buspirone 3. 125 mg/kg,and rats in low- and high-dose Gas groups were given 62. 5,125. 0 mg/ kg Gas,respectively. The course was 7 days. Then elevated plus maze (EPM),open field test,abdominal withdrawal reflex (AWR)and electromyography (EMG) were performed. Results:Compared with control group,EPM test showed that proportions of open arms entries and duration were significantly decreased (P < 0. 01);open field test showed that virtual central grids duration (P < 0. 05),number of virtual grids climbed and times of lifting were significantly decreased (P < 0. 01);when gastric balloon dilatation pressure was equal or greater than 40 mm Hg,AWR score,area under ROC curve (AUC)of EMG was significantly increased in model group (P < 0. 05). Compared with model group,above-mentioned indices in low- and high-dose Gas groups were significantly ameliorated (P < 0. 05). Conclusions:Gas could influence the gastric sensitivity and anxiety-like behavior of the brain-stomach axis regulated anxiety-like gastric hypersensitivity in FD rat model.

Objective To identify the chemical constituents of Xiakucao Xiaoliu mixture by high performance liquid chromatography-high resolution time-of-flight mass spectrometry (HPLC-TOF/MS). Methods The chromatographic separation ACE (3.0mm×150 mm) column was used. The mobile phase was methanol (A) and 0.1% formic acid (B). The gradient elution was: 0-5 min, 5% A; 5-10 min, 5%-15% A; 10-30 min, 15%-45%A; 30-40 min, 45%-70%B; 40-50 min, 70%-90%B. The injection volume was 2 μl. The flow rate was 0.4 ml/min. The column temperature was 25°C. The mass spectrometry was characterized by time-of-flight mass spectrometry, using ESI ion source. The common monitoring was in positive and negative ion mode. The reference ion was m/z 121.9856, 1033.9881. The scanning range was m/z 100-1200. Results A total of 37 chemical constituents were identified in the Xiakucao Xiaoliu mixture, 8 in the positive ion mode fragment voltage of 160 V, 28 in the negative ion mode fragment voltage of 160 V, and 19 in the fragment voltage of 260 V. Both positive and negative ions had 4 responses. The negative ion mode has 16 responses under both fragment voltages. And the ingredients were medicinal. Conclusion An effective method for the identification of the chemical constituents of Prunella vulgaris L. by HPLC-TOF/MS was established, which laid a foundation for its quality control and in-depth study in vivo.