OBJECTIVE: To observe the clinical efficacy of herb-spreading moxibustion as an adjuvant treatment for chemotherapy-induced nausea and vomiting (CINV) of spleen and stomach deficiency cold in gastric cancer. METHODS: Seventy-six patients with CINV of spleen and stomach deficiency cold in gastric cancer were randomly divided into an observation group (38 cases, 1 case was discontinued, 1 case dropped out) and a control group (38 cases, 1 case was discontinued). The patients in both groups were treated with cisplatin+tigio regimen chemotherapy, and were treated with basic anti-nausea drugs on the 1st to 3rd day of chemotherapy. The observation group was treated with herb-spreading moxibustion at Zhongwan (CV12) acupoint area (covering from Shangwan [CV13] to Shenque [CV8] of the conception vessel, and from both sides to the kidney meridian of foot-shaoyin). The herb was selected as Fuzi Lizhong decoction, once a day, about 50 min each time, with 3 consecutive days as one treatment course, with an interval of 1 day between each course, for a total of 3 treatment courses. The grading of nausea and vomiting degree in the two groups were recorded on the 1st, 3rd, 7th and 14th days of chemotherapy. Karnofsky performance status (KPS) score in the two groups was observed before treatment and on the 1st, 3rd, 7th and 14th days of chemotherapy. The TCM symptom grading and TCM syndrome score of the two groups before and after treatment were compared, and the clinical efficacy and safety of the two groups were evaluated. RESULTS: On the 7th and 14th days of chemotherapy, the grading of nausea degree in the observation group was lower than that in the control group (P<0.05). On the 3rd, 7th and 14th days of chemotherapy, the grading of vomiting degree in the observation group was lower than that in the control group (P<0.05, P<0.01). Compared before treatment, the KPS scores of the two groups on the 1st day of chemotherapy and the control group on the 7th day of chemotherapy were decreased (P<0.05, P<0.01), and the KPS scores of the observation group on the 7th day of chemotherapy and the two groups on the 14th day of chemotherapy were increased (P<0.01). On the 7th and 14th days of chemotherapy, the KPS scores of the observation group were higher than those of the control group (P<0.01). After treatment, the each item grading of TCM symptom in the two groups was better than that before treatment (P<0.01), except for loose stool, the each item grading of TCM symptom in the observation group was better than that in the control group (P<0.05, P<0.01). After treatment, the scores of TCM syndrome in the two groups were lower than those before treatment (P<0.01), and the score in the observation group was lower than that in the control group (P<0.01). The obvious effective rate of the observation group was 58.3% (21/36), which was higher than 24.3% (9/37) of the control group (P<0.01). No adverse events occurred in both groups. CONCLUSION Herb-spreading moxibustion as an adjuvant treatment for CINV of spleen and stomach deficiency cold in gastric cancer can effectively relieve nausea and vomiting, and improve the symptoms of TCM, and improve the quality of life of patients. The clinical efficacy is satisfactory and the safety is good.
Humans ; Moxibustion ; Male ; Female ; Middle Aged ; Stomach Neoplasms/drug therapy* ; Nausea/physiopathology* ; Vomiting/physiopathology* ; Aged ; Adult ; Acupuncture Points ; Antineoplastic Agents/therapeutic use* ; Drugs, Chinese Herbal/administration & dosage* ; Spleen/drug effects* ; Stomach/drug effects*

A 16-year-old Chinese male patient presented with constipation lasting five days, colicky abdominal pain, lethargy, weakness and body aches. He was able to pass flatus. Abdominal radiography showed a distended stomach causing inferior displacement of the transverse colon. Computed tomography revealed a dilated oesophagus, stomach and duodenum up to its third portion, with a short aortomesenteric distance and narrow angle. There was also consolidation in the lungs bilaterally. Based on the constellation of clinical and imaging findings, a diagnosis of superior mesenteric artery syndrome complicated by aspiration pneumonia was made. The patient was subsequently started on intravenous hydration, nasogastric tube aspiration and antibiotics. Following stabilisation of his acute condition, a nasojejunal feeding tube was inserted and a feeding plan was implemented to promote weight gain. The clinical presentation, differentials, diagnosis and treatment of superior mesenteric artery syndrome are discussed.
Adolescent ; Aged ; Child ; China ; Duodenum ; diagnostic imaging ; Enteral Nutrition ; Fluoroscopy ; Gastrointestinal Tract ; diagnostic imaging ; Humans ; Male ; Mesenteric Arteries ; diagnostic imaging ; physiopathology ; Pneumonia, Aspiration ; diagnostic imaging ; Radiography, Abdominal ; Superior Mesenteric Artery Syndrome ; diagnostic imaging ; Syndrome ; Tomography, X-Ray Computed ; Vomiting ; diagnostic imaging

PURPOSE: Glufosinate poisoning can cause neurologic complications that may be difficult to treat due to delayed manifestation. Studies assessing possible predictors of complications are lacking. Although serum ammonia level is a potential predictor of severe neurotoxicity, it has only been assessed via case reports. Therefore, we investigated factors that predict neurologic complications in acute glufosinate-poisoned patients. MATERIALS AND METHODS: We conducted a retrospective review of 45 consecutive glufosinate-poisoning cases that were diagnosed in the emergency department (ED) of Wonju Severance Christian Hospital between May 2007 and July 2014. Patients with a Glasgow Coma Scale (GCS) score of <8, seizure, and/or amnesia were defined to a neurologic complication group. RESULTS: The neurologic complication group (29 patients, 64.4%) comprised patients with GCS<8 (27 patients, 60.0%), seizure (23 patients, 51.1%), and amnesia (5 patients, 11.1%). Non-neurologic complications included respiratory failure (14 patients, 31.1%), intubation and ventilator care (23 patients, 51.1%), shock (2 patients, 4.4%), pneumonia (16 patients, 35.6%), acute kidney injury (10 patients, 22.2%), and death (4 patients, 8.9%). Complications of GCS<8, seizure, respiratory failure, and intubation and ventilator care appeared during latent periods within 11 hrs, 34 hrs, 14 hrs, and 48 hrs, respectively. Initial serum ammonia was a predictor of neurologic complications [odds ratio 1.039, 95% confidence interval (1.001-1.078), p=0.046 and area under the curve 0.742]. CONCLUSION: Neurologic complications developed in 64.4% of patients with acute glufosinate poisoning. The most common complication was GCS<8. Initial serum ammonia level, which can be readily assessed in the ED, was a predictor of neurologic complications.
Adult ; Aged ; Aged, 80 and over ; Aminobutyrates/blood/*poisoning ; Ammonia/*blood ; *Emergency Service, Hospital ; Female ; Glasgow Coma Scale ; Humans ; Male ; Middle Aged ; Nausea/etiology ; Neurotoxicity Syndromes/blood/immunology/*physiopathology ; Respiratory Insufficiency/etiology ; Retrospective Studies ; Seizures/etiology ; Severity of Illness Index ; Vomiting/etiology

BACKGROUNDThis paper presents a retrospective study to classify patients into subtypes of the treatment according to baseline and longitudinally observed values considering heterogenity in migraine prognosis. In the classical prospective clinical studies, participants are classified with respect to baseline status and followed within a certain time period. However, latent growth mixture model is the most suitable method, which considers the population heterogenity and is not affected drop-outs if they are missing at random. Hence, we planned this comprehensive study to identify prognostic factors in migraine.

METHODSThe study data have been based on a 10-year computer-based follow-up data of Mersin University Headache Outpatient Department. The developmental trajectories within subgroups were described for the severity, frequency, and duration of headache separately and the probabilities of each subgroup were estimated by using latent growth mixture models. SAS PROC TRAJ procedures, semiparametric and group-based mixture modeling approach, were applied to define the developmental trajectories.

RESULTSWhile the three-group model for the severity (mild, moderate, severe) and frequency (low, medium, high) of headache appeared to be appropriate, the four-group model for the duration (low, medium, high, extremely high) was more suitable. The severity of headache increased in the patients with nausea, vomiting, photophobia and phonophobia. The frequency of headache was especially related with increasing age and unilateral pain. Nausea and photophobia were also related with headache duration.

CONCLUSIONSNausea, vomiting and photophobia were the most significant factors to identify developmental trajectories. The remission time was not the same for the severity, frequency, and duration of headache.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Female ; Humans ; Hyperacusis ; physiopathology ; Middle Aged ; Migraine Disorders ; pathology ; physiopathology ; Nausea ; physiopathology ; Photophobia ; physiopathology ; Retrospective Studies ; Vomiting ; physiopathology ; Young Adult

OBJECTIVETo investigate the effects of acupuncture on the morphine-related side effects (nausea, vomiting, itchiness and gastrointestinal disorders) in patients undergoing anesthesia and analgesia and try to find the clinical mechanism of acupuncture.

METHODSPatients scheduled to have transurethral prostatic resection: enrolled in the study (69 patients), characterized as Grade II or III by the American Society of Anesthesiologists physical status classification, were randomly assigned to three groups, 23 patients in each group: the placebo group (control group), non-anesthesia area (NAA) group, and the anesthesia area (AA) group. After spinal anesthesia, all patients received Patients Controlled Epidural Analgesia. The vital signs, bowel sounds, visual analogue scales, itchiness, nausea and vomiting, and time for first exhaust post operation were observed.

RESULTSAltogether, nine cases were eliminated, three in each group. Finally, sixty cases completed this study,: twenty in each group. There was a significant decrease of bowel sounds after morphine spinal anesthesia in the three groups. Compared with the control or AA group, the bowel sound recovered after acupuncture, the incidences of nausea and vomiting, itchiness, and time for first exhaust after operation decreased in the NAA group (P<0.05). There was a significant decrease of the incidence for itchiness in the NAA group compared with

CONCLUSIONSOn the basis of this study, it is obviously seen that acupuncture could: decrease the incidence of morphine-related side effects (nausea and vomiting, itchiness and gastrointestinal disorders) when the spinal cord conduct is normal. However, it decreases only the incidence of itchiness but not for gastrointestinal dysfunction when the spinal cord is blocked.

Acupuncture Therapy ; Aged ; Aged, 80 and over ; Analgesia ; adverse effects ; Analgesia, Epidural ; adverse effects ; Anesthesia, Epidural ; adverse effects ; methods ; Anesthesia, Spinal ; adverse effects ; methods ; Humans ; Intestines ; physiopathology ; Male ; Middle Aged ; Morphine ; administration & dosage ; adverse effects ; Postoperative Complications ; prevention & control ; Postoperative Nausea and Vomiting ; prevention & control ; therapy ; Prostatic Hyperplasia ; physiopathology ; surgery ; Pruritus ; therapy ; Transurethral Resection of Prostate ; rehabilitation ; Treatment Outcome

OBJECTIVETo determine the prevalence of functional gastrointestinal disorders in children in Shanghai.

METHODThis study was conducted on the infants and young children who were below 24 months of age recruited consecutively from April 2008 to June 2008 from the 12 communities in Minhang district in Shanghai. The questionnaire on gastrointestinal symptoms and growth was sent to 5030 children < 24 months old. The age distribution of the 5030 children was: < 6 months: 1922 infants (38.2%), 6 - < 12 months: 1933 (38.4%) infants; 12 - < 18 months: 811 (16.1%) children; 18 - < 24 months: 364 (7.2%) children.

RESULTAmong the 5030 children, 1909 had gastrointestinal disorders (38.0%). There was no significant difference in the rate of the disorders between sexes (P = 0.06). Regurgitation was found in 899 (17.9%) infants/children, constipation in 690 (13.7%), 619 (12.3%) infants/children suffered from diarrhea and only 71 (1.4%) suffered from colic. The incidence of gastrointestinal disorders was significantly different among different age groups. The incidence of constipation and regurgitation decreased and the incidence of diarrhea increased with growth (P < 0.01). Infants growth parameters in the group with gastrointestinal disorders especially in those with regurgitation were lower than those without gastrointestinal disorders, the difference is statistically significant. The hospital visit rate of infants with diarrhea was 62.68%, which was higher than the rate of the other three symptoms (4.45% - 16.90%).

CONCLUSIONGastrointestinal disorders are common in infants and young children in Shanghai and may have a great impact on growth. Early management could relieve the disorders and ensure infants to get normal growth and development.

China ; epidemiology ; Colic ; epidemiology ; Diarrhea ; epidemiology ; Female ; Gastrointestinal Diseases ; epidemiology ; physiopathology ; Humans ; Incidence ; Infant ; Male ; Prevalence ; Vomiting ; epidemiology

AIMTo explore the antagonism mechanism of inulae and ochrae decoction on toxicity damage of gastrointestinal tissue induced by DDP (cisplatin).

METHODSTwenty-four healthy hybrid rabbits were divided into three groups in random: the control group, DDP group, inulae and ochrae decoction + DDP group. The change of rabbits EGG, the concentration of 5-HT,5-HIAA of serum and the content of sinus ventriculi mucosa and the upper part of duodenum tissue were examined. Ultrastructure changes were observed by transmission electron microscope (TEM).

RESULTSThe EGG amplitude of DDP group was increased and the frequency was fast (P < 0.05) after i.v. DDP, meanwhile the concentration of 5-HT, 5-HIAA was increased (P < 0.05), and the content of sinus ventriculi mucosa and the upper part of duodenum tissue were higher than that of Inulae and Ochrae Decoction + DDP group (P < 0.05), and the change was seriously under the TEM observing; while inulae and ochrae decoction could prevent the change of EGG caused by DDP, showing the amplitude decreased, and the frequency was slow, and the concentration of 5-HT, 5-HIAA of serum and the content of tissue became lower than that of DDP group.

CONCLUSIONInulae and ochrae decoction could antagonize the change of EGG caused by DDP, which maybe have relations with the over-releasing of gastrointestinal 5-HT.

Animals ; Antineoplastic Agents ; adverse effects ; Cisplatin ; adverse effects ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Electromyography ; drug effects ; methods ; Inula ; chemistry ; Nausea ; chemically induced ; drug therapy ; Phytotherapy ; Rabbits ; Serotonin ; metabolism ; Stomach ; metabolism ; physiopathology ; Vomiting ; chemically induced ; drug therapy

OBJECTIVETo investigate the clinical characteristics of acute arsenic poisoning and its influential factors.

METHODSClinical data of 47 cases of arsenic poisoning were collected and analyzed. Two cases of observation, 40 cases of mild acute poisoning, and 5 severe acute poisoning were investigated in this group.

RESULTSMyocardial enzyme activity was correlated with age and urine arsenic concentrations. Myocardial enzyme, the liver ALT, total bilirubin (TBil) and indirect bilirubin (IBil) were negatively correlated with vomiting frequency, with statistical significance (P < 0.05). Urine arsenic concentration was correlated with vomiting frequency and amount of soup drunk, with statistically significant difference (P < 0.05). Despite no statistical significance in age and amount of soup drunk, the patients with more vomiting or diarrhea had less urine arsenic concentrations, cardiac enzymes and liver enzyme concentration.

CONCLUSIONAcute arsenic poisoning can lead to multiple organ damage. The damage is relevant with amount of arsenic intake, vomiting, diarrhea and urinary frequency arsenic concentration. So early use of gastric lavage, vomiting, poison discharges, and adequate application of effective antidote (Na-DMPS) as soon as possible, symptomatic treatment and the reinforced monitoring, are the rescue key for patients with acute arsenic poisoning.

Acute Disease ; Adolescent ; Adult ; Arsenic ; urine ; Arsenic Poisoning ; physiopathology ; Diarrhea ; chemically induced ; Female ; Food Contamination ; Humans ; Liver ; enzymology ; Male ; Middle Aged ; Vomiting ; chemically induced ; Young Adult

OBJECTIVE: To describe the sonographic (US) and clinical features of spontaneously reduced small bowel intussusception, and to discuss the management options for small bowel intussusception based on US findings with clinical correlation. MATERIALS AND METHODS: During a five years of period, 34 small bowel intussusceptions were diagnosed on US in 32 infants and children. The clinical presentations and imaging findings of the patients were reviewed. RESULTS: The clinical presentations included abdominal pain or irritability (n = 25), vomiting (n = 5), diarrhea (n = 3), bloody stool (n = 1), and abdominal distension (n = 1), in combination or alone. US showed multi-layered round masses of small (mean, 1.5+/-0.3 cm) diameters and with thin (mean, 3.5+/-1 mm) outer rims along the course of the small bowel. The mean length was 1.8+/-0.5 cm and peristalsis was seen on the video records. There were no visible lead points. The vascular flow signal appeared on color Doppler images in all 21 patients examined. Spontaneous reduction was confirmed by combinations of US (n = 28), small bowel series (n = 6), CT scan (n = 3), and surgical exploration (n = 2). All patients discharged with improved condition. CONCLUSION: Typical US findings of the transient small bowel intussusception included 1) small size without wall swelling, 2) short segment, 3) preserved wall motion, and 4) absence of the lead point. Conservative management with US monitoring rather than an immediate operation is recommended for those patient with typical transient small bowel intussusceptions. Atypical US findings or clinical deterioration of the patient with persistent intussusception warrant surgical exploration.
Abdomen/physiopathology ; Abdominal Pain/etiology ; Child ; Child, Preschool ; Diarrhea/etiology ; Female ; Humans ; Infant ; Intestine, Small/*ultrasonography ; Intussusception/*ultrasonography ; Irritable Mood ; Male ; Occult Blood ; Ultrasonography, Doppler, Color ; Vomiting/etiology