1.Comparison of anti-inflammatory, antibacterial and analgesic activities of formulated granules versus traditional decoction of Yinqiao Powder.
Zhuolin GUO ; Zhiheng ZHANG ; Xindeng GUO ; Weiwei YANG ; Zhiqing LIANG ; Jinying OU ; Huihui CAO ; Zibin LU ; Linzhong YU ; Junshan LIU
Journal of Southern Medical University 2025;45(5):1003-1012
OBJECTIVES:
To compare the anti-inflammatory, antibacterial and analgesic effects of Yinqiao Powder (YQS) formulated granules and decoction.
METHODS:
We first evaluated the anti-inflammatory effects of the two dosage forms of YQS in a LPS-induced RAW 264.7 cell model using RT-qPCR and Western blotting. We further constructed zebrafish models of inflammation by copper sulfate exposure, caudal fin transection, or LPS and Poly (I:C) microinjection, and evaluated anti-inflammatory effects of YQS granules and decoction by examining neutrophil aggregation and HE staining findings. In a mouse model of acute lung injury (ALI) induced by intratracheal LPS instillation, the effects of YQS gavage at 10, 15, and 20 g/kg on lung pathologies were evaluated by calculating lung wet-dry weight ratio and using HE staining, ELISA and Western blotting. The microbroth dilution method was used to evaluate the antibacterial effect of YQS. Mouse pain models established by hot plate and intraperitoneal injection of glacial acetic acid were used to evaluate the analgesic effects of YQS at 10, 15, and 20 g/kg.
RESULTS:
Both YQS granules and decoction significantly reduced TNF-α, IL-6, and IL-1β expressions and p-STAT3 (Tyr 705) phosphorylation level in LPS-induced RAW 264.7 cells, and obviously inhibited neutrophil aggregation in the zebrafish models. In ALI mice, YQS granules and decoction effectively ameliorated lung injury, lowered lung wet-dry weight ratio, and reduced p-STAT3 (Tyr 705) expression and TNF-α and IL-6 levels. YQS produced obvious antibacterial effect at the doses of 15.63 and 31.25 mg/mL, and significantly reduced body torsion and increased pain threshold in the mouse pain models.
CONCLUSIONS
The two dosage forms of TQS have similar anti-inflammatory, antibacterial and analgesic effects with only differences in their inhibitory effect on TNF-α, IL-6 and IL-1β mRNA expressions in LPS-induced RAW 264.7 cells.
Animals
;
Mice
;
Drugs, Chinese Herbal/pharmacology*
;
Anti-Inflammatory Agents/pharmacology*
;
Analgesics/pharmacology*
;
RAW 264.7 Cells
;
Zebrafish
;
Anti-Bacterial Agents/pharmacology*
;
Powders
;
Tumor Necrosis Factor-alpha/metabolism*
;
Acute Lung Injury/drug therapy*
;
Interleukin-6/metabolism*
;
Lipopolysaccharides
2.Urinary continence and short-term oncologic efficacy of total prostatic urethral preservation(TPUP)technique in laparoscopic radical prostatectomy
Xiangrong YING ; Ke GAO ; Zibin XU ; Haojie ZHANG ; Chong SHEN ; Yu REN ; Zhengang LUO ; Gangfeng WU
Chinese Journal of Urology 2025;46(10):764-768
Objective:To explore the short-term oncological efficacy of the total prostatic urethra preservation(TPUP)technique in laparoscopic radical prostatectomy and its impact on postoperative urinary continence rate.Methods:The clinical data of 17 prostate cancer patients admitted to Shaoxing People’s Hospital from July 2023 to July 2024 were retrospectively analyzed. The age was(70.5 ± 6.5)years,the body mass index was(23.6 ± 2.5)kg/m 2,and the prostate-specific antigen(PSA)level was(7.845 ± 3.929)ng/ml. The preoperative biopsy pathological Gleason score were 6 in 8 cases,and 7 in 9 cases. All patients underwent laparoscopic radical prostatectomy,and the TPUP technique was used during the operation. The integrity of the preserved urethra was improved by preserving the prostatic surgical capsule closely attached to the corpus spongiosum of the urethra. During the operation,the urethra was completely preserved in 2 cases,nearly completely preserved in 14 cases,and partially preserved in 1 case. The recovery of urinary continence on the day of catheter removal and at 1 and 3 months after the operation was recorded. Recovery of urinary continence was defined as pad within 24 hours. PSA was re - examined at 6 weeks and 3 months after the operation. Results:All 17 operations in this study were successfully completed. The operation time was(143.6 ± 31.6)minutes,and the intraoperative blood loss was 50.0(20.0,50.0)ml. None of the cases was converted to open surgery,and no Clavien - Dindo grade ≥ 2 complications such as blood transfusion or intestinal injury occurred during the peri-operative period. The PSA levels at 6 weeks and 3 months after the operation were 0.054(0.008,0.215)ng/ml and 0.008(0.005,0.037)ng/ml,respectively. The indwelling catheter time after the operation was(13.4 ± 2.1)days. The number of cases with recovered urinary continence on the day of catheter removal and at 1 and 3 months after the operation was 10,15,and 17,respectively.Conclusions:The TPUP technique in laparoscopic radical prostatectomy leads to good recovery of postoperative urinary continence,and there is a slowly PSA decrease in the short term.
3.Effects of Zhuang Medicinal Thread Moxibustion on Apoptosis of Interstitial Cells of Cajal in Gastric Smooth Muscle of Diabetic Gastroparesis Rats Based on p38MAPK Signaling Pathway
Zibin WANG ; Yushan FAN ; Yu WU ; Hui XU ; Fangzhi ZHANG ; Yujun HE
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(12):97-105
Objective To investigate the effects of Zhuang medicinal thread moxibustion on apoptosis of interstitial cells of Cajal(ICC)in gastric smooth muscle of diabetic gastroparesis(DGP)rats via regulation of the p38MAPK signaling pathway.Methods Totally 60 rats were randomly divided into a blank group(10 rats)and a modeling group(50 rats).DGP models were established in the modeling group via intraperitoneal injection of streptozotocin.50 successfully modeled rats were further randomized into model group,Western medication group,prevention+treatment group,prevention group and treatment group,with 10 rats in each group.The Western medication group was administered mosapride citrate by gavage for 3 weeks starting at week 10;the prevention+treatment group underwent Zhuang medicinal thread moxibustion("Zhongwan",bilateral"Neiguan"and"Zusanli")intervention for 6 weeks starting at week 7;the prevention group received Zhuang medicinal thread moxibustion for 3 weeks starting at week 7;and the treatment group received Zhuang medicinal thread moxibustion for 3 weeks starting at week 10,3 cones per point,once a day;the blank group and model group received handling only.The random blood glucose and body mass of rats were detected,and the gastric emptying rate and intestinal propulsion rate were calculated.HE staining was used to observe the morphology of gastric smooth muscle tissue,TUNEL staining was used to detect the apoptosis of gastric smooth muscle tissue,ELISA was used to detect the contents of Caspase-3,TNF-α,IL-1β and IL-6 in gastric smooth muscle tissue,immunohistochemistry was used to detect the positive expressions of Cx43 and c-kit in gastric smooth muscle tissue,Western blot was used to detect the expressions of p38MAPK,p-p38MAPK,BAX and Bcl-2 protein in gastric smooth muscle tissue.Results Compared with the blank group,the random blood glucose significantly increased in the model group(P<0.01),and the body mass,gastric emptying rate and small intestinal propulsion rate significantly decreased(P<0.01),the blood vessels of gastric tissue were not clear,the surface was not smooth,the mucosal folds were less,the arrangement of gastric smooth muscle cells was disordered,the nuclear membrane was not clear,and there were vacuole like changes between cells,the apoptosis rate significantly increased(P<0.01),the contents of Caspase-3,TNF-α,IL-1β,IL-6 and the protein expressions of p38MAPK,p-p38MAPK and BAX in gastric smooth muscle tissue significantly increased(P<0.01),and the positive expressions of Cx43,c-kit,the protein expression of Bcl-2 and Bcl-2/BAX ratio significantly decreased(P<0.01).Compared with the model group,the random blood glucose of rats in each intervention group decreased,and the body mass,gastric emptying rate and intestinal propulsion rate increased(P<0.01),the blood vessels of gastric tissue were clear,the inner surface of stomach was smooth,the mucosal folds were not rich,no ulcer was found,the shape of gastric smooth muscle cells was complete,the nuclear membrane was clear,and the arrangement of muscle cells was regular,the apoptosis rate significantly decreased(P<0.01),the contents of Caspase-3,TNF-α,IL-1β,IL-6 and the expressions of p38MAPK,p-p38MAPK,BAX protein in gastric smooth muscle tissue decreased(P<0.05,P<0.01),the positive expressions of Cx43,c-kit,the protein expression of Bcl-2 and Bcl-2/BAX ratio increased(P<0.05,P<0.01).The overall effect of the prevention+treatment group was better than that of the Western medication group,prevention group and treatment group(P<0.05,P<0.01).Conclusion Zhuang medicinal thread moxibustion may reduce gastric inflammation and ICC apoptosis in DGP rats by inhibiting p38MAPK signaling pathway,so as to improve DGP gastric motility disorder,and the effect of early intervention is more significant.
4.Clinical guideline for diagnosis and treatment of nonunion of osteoporotic vertebral fractures (version 2025)
Haipeng SI ; Le LI ; Junjie NIU ; Wencan ZHANG ; Fuxin WEI ; Jinqiu YUAN ; Qiang YANG ; Hongli WANG ; Guangchao WANG ; Shihong CHEN ; Yunzhen CHEN ; Xiaoguang CHENG ; Jianwen DONG ; Shiqing FENG ; Rui GU ; Yong HAI ; Tianyong HOU ; Bo HUANG ; Xiaobing JIANG ; Lei ZANG ; Chunhai LI ; Nianhu LI ; Hua LIN ; Hongjian LIU ; Peng LIU ; Xinyu LIU ; Sheng LU ; Shibao LU ; Chunshan LUO ; Lvy CHAOLIANG ; Lvy WEIJIA ; Xuexiao MA ; Wei MEI ; Chunyang MENG ; Cailiang SHEN ; Chunli SONG ; Ruoxian SONG ; Jiacan SU ; Honglin TENG ; Hui SHENG ; Beiyu WANG ; Bingwu WANG ; Liang WANG ; Xiangyang WANG ; Nan WU ; Guohua XU ; Yayi XIA ; Jin XU ; Youjia XU ; Jianzhong XU ; Cao YANG ; Maowei YANG ; Zibin YANG ; Xiaojian YE ; Hailong YU ; Xijie YU ; Hua YUE ; Zhili ZENG ; Xinli ZHAN ; Hui ZHANG ; Peixun ZHANG ; Wei ZHANG ; Zhenlin ZHANG ; Jianguo ZHANG ; Tengyue ZHU ; Qiang LIU ; Huilin YANG
Chinese Journal of Trauma 2025;41(10):932-945
Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.
5.Clinical guideline for diagnosis and treatment of nonunion of osteoporotic vertebral fractures (version 2025)
Haipeng SI ; Le LI ; Junjie NIU ; Wencan ZHANG ; Fuxin WEI ; Jinqiu YUAN ; Qiang YANG ; Hongli WANG ; Guangchao WANG ; Shihong CHEN ; Yunzhen CHEN ; Xiaoguang CHENG ; Jianwen DONG ; Shiqing FENG ; Rui GU ; Yong HAI ; Tianyong HOU ; Bo HUANG ; Xiaobing JIANG ; Lei ZANG ; Chunhai LI ; Nianhu LI ; Hua LIN ; Hongjian LIU ; Peng LIU ; Xinyu LIU ; Sheng LU ; Shibao LU ; Chunshan LUO ; Lvy CHAOLIANG ; Lvy WEIJIA ; Xuexiao MA ; Wei MEI ; Chunyang MENG ; Cailiang SHEN ; Chunli SONG ; Ruoxian SONG ; Jiacan SU ; Honglin TENG ; Hui SHENG ; Beiyu WANG ; Bingwu WANG ; Liang WANG ; Xiangyang WANG ; Nan WU ; Guohua XU ; Yayi XIA ; Jin XU ; Youjia XU ; Jianzhong XU ; Cao YANG ; Maowei YANG ; Zibin YANG ; Xiaojian YE ; Hailong YU ; Xijie YU ; Hua YUE ; Zhili ZENG ; Xinli ZHAN ; Hui ZHANG ; Peixun ZHANG ; Wei ZHANG ; Zhenlin ZHANG ; Jianguo ZHANG ; Tengyue ZHU ; Qiang LIU ; Huilin YANG
Chinese Journal of Trauma 2025;41(10):932-945
Nonunion of osteoporotic vertebral fractures (OVF), predominantly affecting the elderly, can lead to intractable pain, vertebral collapse, progressive kyphotic deformity, and neurological impairment, significantly compromising patients′ quality of life. There exists considerable debate on diagnosis and management of OVF, encompassing key issues such as clinical diagnosis and staging criteria for nonunion, surgical indications and procedure selection, and postoperative rehabilitation planning. Currently, there lacks standardized clinical guideline and expert consensus on the diagnosis and management of OVF nonunion in China. To address this gap, Minimally Invasive Surgery Group of Chinese Orthopedic Association, Osteoporosis Committee of Chinese Association of Orthopedic Surgeons, Prevention and Rehabilitation Committee for Osteoporosis of Chinese Association of Rehabilitation Medicine and Minimally Invasive Orthopedic Surgery Branch of China Association for Geriatric Care jointly organized domestic experts in spinal surgery, endocrinology, and rehabilitation to formulate the Clinical guideline for the diagnosis and treatment for nonunion of osteoporotic vertebral fractures ( version 2025), based on existing literature and clinical experience and adhering to principles of scientific rigor and practicality. The guideline provided 13 evidence-based recommendations encompassing diagnosis and treatment of OVF nonunion, aiming to standardize its clinical management.
6.Effects of Zhuang Medicinal Thread Moxibustion on Apoptosis of Interstitial Cells of Cajal in Gastric Smooth Muscle of Diabetic Gastroparesis Rats Based on p38MAPK Signaling Pathway
Zibin WANG ; Yushan FAN ; Yu WU ; Hui XU ; Fangzhi ZHANG ; Yujun HE
Chinese Journal of Information on Traditional Chinese Medicine 2025;32(12):97-105
Objective To investigate the effects of Zhuang medicinal thread moxibustion on apoptosis of interstitial cells of Cajal(ICC)in gastric smooth muscle of diabetic gastroparesis(DGP)rats via regulation of the p38MAPK signaling pathway.Methods Totally 60 rats were randomly divided into a blank group(10 rats)and a modeling group(50 rats).DGP models were established in the modeling group via intraperitoneal injection of streptozotocin.50 successfully modeled rats were further randomized into model group,Western medication group,prevention+treatment group,prevention group and treatment group,with 10 rats in each group.The Western medication group was administered mosapride citrate by gavage for 3 weeks starting at week 10;the prevention+treatment group underwent Zhuang medicinal thread moxibustion("Zhongwan",bilateral"Neiguan"and"Zusanli")intervention for 6 weeks starting at week 7;the prevention group received Zhuang medicinal thread moxibustion for 3 weeks starting at week 7;and the treatment group received Zhuang medicinal thread moxibustion for 3 weeks starting at week 10,3 cones per point,once a day;the blank group and model group received handling only.The random blood glucose and body mass of rats were detected,and the gastric emptying rate and intestinal propulsion rate were calculated.HE staining was used to observe the morphology of gastric smooth muscle tissue,TUNEL staining was used to detect the apoptosis of gastric smooth muscle tissue,ELISA was used to detect the contents of Caspase-3,TNF-α,IL-1β and IL-6 in gastric smooth muscle tissue,immunohistochemistry was used to detect the positive expressions of Cx43 and c-kit in gastric smooth muscle tissue,Western blot was used to detect the expressions of p38MAPK,p-p38MAPK,BAX and Bcl-2 protein in gastric smooth muscle tissue.Results Compared with the blank group,the random blood glucose significantly increased in the model group(P<0.01),and the body mass,gastric emptying rate and small intestinal propulsion rate significantly decreased(P<0.01),the blood vessels of gastric tissue were not clear,the surface was not smooth,the mucosal folds were less,the arrangement of gastric smooth muscle cells was disordered,the nuclear membrane was not clear,and there were vacuole like changes between cells,the apoptosis rate significantly increased(P<0.01),the contents of Caspase-3,TNF-α,IL-1β,IL-6 and the protein expressions of p38MAPK,p-p38MAPK and BAX in gastric smooth muscle tissue significantly increased(P<0.01),and the positive expressions of Cx43,c-kit,the protein expression of Bcl-2 and Bcl-2/BAX ratio significantly decreased(P<0.01).Compared with the model group,the random blood glucose of rats in each intervention group decreased,and the body mass,gastric emptying rate and intestinal propulsion rate increased(P<0.01),the blood vessels of gastric tissue were clear,the inner surface of stomach was smooth,the mucosal folds were not rich,no ulcer was found,the shape of gastric smooth muscle cells was complete,the nuclear membrane was clear,and the arrangement of muscle cells was regular,the apoptosis rate significantly decreased(P<0.01),the contents of Caspase-3,TNF-α,IL-1β,IL-6 and the expressions of p38MAPK,p-p38MAPK,BAX protein in gastric smooth muscle tissue decreased(P<0.05,P<0.01),the positive expressions of Cx43,c-kit,the protein expression of Bcl-2 and Bcl-2/BAX ratio increased(P<0.05,P<0.01).The overall effect of the prevention+treatment group was better than that of the Western medication group,prevention group and treatment group(P<0.05,P<0.01).Conclusion Zhuang medicinal thread moxibustion may reduce gastric inflammation and ICC apoptosis in DGP rats by inhibiting p38MAPK signaling pathway,so as to improve DGP gastric motility disorder,and the effect of early intervention is more significant.
7.Urinary continence and short-term oncologic efficacy of total prostatic urethral preservation(TPUP)technique in laparoscopic radical prostatectomy
Xiangrong YING ; Ke GAO ; Zibin XU ; Haojie ZHANG ; Chong SHEN ; Yu REN ; Zhengang LUO ; Gangfeng WU
Chinese Journal of Urology 2025;46(10):764-768
Objective:To explore the short-term oncological efficacy of the total prostatic urethra preservation(TPUP)technique in laparoscopic radical prostatectomy and its impact on postoperative urinary continence rate.Methods:The clinical data of 17 prostate cancer patients admitted to Shaoxing People’s Hospital from July 2023 to July 2024 were retrospectively analyzed. The age was(70.5 ± 6.5)years,the body mass index was(23.6 ± 2.5)kg/m 2,and the prostate-specific antigen(PSA)level was(7.845 ± 3.929)ng/ml. The preoperative biopsy pathological Gleason score were 6 in 8 cases,and 7 in 9 cases. All patients underwent laparoscopic radical prostatectomy,and the TPUP technique was used during the operation. The integrity of the preserved urethra was improved by preserving the prostatic surgical capsule closely attached to the corpus spongiosum of the urethra. During the operation,the urethra was completely preserved in 2 cases,nearly completely preserved in 14 cases,and partially preserved in 1 case. The recovery of urinary continence on the day of catheter removal and at 1 and 3 months after the operation was recorded. Recovery of urinary continence was defined as pad within 24 hours. PSA was re - examined at 6 weeks and 3 months after the operation. Results:All 17 operations in this study were successfully completed. The operation time was(143.6 ± 31.6)minutes,and the intraoperative blood loss was 50.0(20.0,50.0)ml. None of the cases was converted to open surgery,and no Clavien - Dindo grade ≥ 2 complications such as blood transfusion or intestinal injury occurred during the peri-operative period. The PSA levels at 6 weeks and 3 months after the operation were 0.054(0.008,0.215)ng/ml and 0.008(0.005,0.037)ng/ml,respectively. The indwelling catheter time after the operation was(13.4 ± 2.1)days. The number of cases with recovered urinary continence on the day of catheter removal and at 1 and 3 months after the operation was 10,15,and 17,respectively.Conclusions:The TPUP technique in laparoscopic radical prostatectomy leads to good recovery of postoperative urinary continence,and there is a slowly PSA decrease in the short term.
8.Research progress on the application of exosomes in periodontal regeneration
Xinyue HUANG ; Xu GONG ; Weiwei GUO ; Zibin ZHANG ; Zihao GONG ; Zhongshan WANG
Journal of Practical Stomatology 2024;40(1):117-121
The prevalence of periodontal disease in Chinese population is more than 90%.The present treatment techniques can only control the development of the disease,inducement of bone tissue regeneration is a promising strategy and a challenge for the treatment.Exosomes are multivesicle structures derived from endosomes.More and more studies have been conducted on their application in perio-dontal regeneration.This paper reviews the application of exosome in periodontal regeneration in recent years,which is expected to pro-vide new idea for periodontal regeneration therapy.
9.Study on the efficacy and safety of linaclotide combined with polyethylene glycol for bowel preparation in patients with functional constipation
Hanqing LI ; Yukun LI ; Xingsi QI ; Peng ZHANG ; Yanan YU ; Zibin TIAN
Chinese Journal of Digestion 2024;44(9):605-612
Objective:To investigate the efficacy and safety of linaclotide(LIN) combined with polyethylene glycol(PEG) for bowel preparation in patients with functional constipation (FC).Methods:From August 1, 2022 to April 30, 2023, a total of 300 patients with FC (FC group) and 300 subjects with non-functional constipation (NFC, NFC group) undergoing colonoscopy at the Affiliated Hospital of Qingdao University were selected. According to simple random sampling method, both FC group and NFC group were divided into 3 L PEG subgroup, 3 L PEG+ LIN subgroup, and 2 L PEG+ LIN subgroup, respectively, with 100 cases in each group and a total of 6 subgroups. All subjects were enrolled based on a random number table and received the corresponding bowel preparation protocols. The Ottawa bowel preparation score (OBPS) and the rate of adequate bowel preparation were calculated. Ordered logistic regression analysis was used to analyze the independent influencing factors of OBPS. The incidence of adverse events (such as bloating) and the repetition rate of regimen intention were analyzed. One-way ANOVA, least significant difference analysis, and chi-square test were used for statistical analysis.Results:The OBPS of the 3 L PEG subgroup, 3 L PEG+ LIN subgroup, and 2 L PEG+ LIN subgroup in the FC group were 6.06±1.67, 3.86±2.20, and 4.06±2.03, respectively, while the OBPS of the 3 corresponding subgroups in the NFC group were 5.08±1.92, 3.42±2.04, and 3.63±1.93, respectively. The OBPS scores of the 2 L PEG+ LIN and 3 L PEG+ LIN subgroups in FC and NFC group were lower than those of the 3 L PEG subgroup within the respective group, and the differences were statistically significant ( t=7.16, 7.55, 4.59, and 6.06; all P<0.001). The rates of adequate bowel preparation of the 3 L PEG subgroup, 3 L PEG+ LIN subgroup, and 2 L PEG+ LIN subgroup in the FC group were 83.0% (78/94), 95.6% (87/91), and 96.8% (92/95), respectively, while the rates of adequate bowel preparation of the 3 subgroups in the NFC group were 88.0% (88/100), 96.9%(94/97), and 97.0%(96/99), respectively. The rates of adequate bowel preparation of 2 L PEG+ LIN and 3 L PEG+ LIN subgroups in FC and NFC group were higher than those of the 3 L PEG subgroup in the respective group, and the differences were statistically significant( χ2=10.04, 7.64, 5.74, and 5.55, P=0.001, 0.008, 0.029, 0.029). The FC group was divided into 2 L PEG+ LIN compared to 3 L PEG+ LIN subgroup, as well as 3 L PEG+ LIN compared to 3 L PEG subgroup for ordinal logistic regression analysis, and the result showed that the bowel preparation regimen was an independent influencing factor for OBPS ( OR=0.940 and 3.072, 95% confidence interval 0.368 to 1.483 and 1.564 to 3.252; both P<0.001). The incidence of abdominal distension of the 3 L PEG subgroup in FC group and NFC group was higher than that of the 2 L PEG+ LIN subgroup in the respective group (11.7%(11/94) vs. 3.2%(3/95), 12.0%(12/100) vs. 4.0%(4/99)), and the differences were statistically significant( χ2=5.03 and 4.26, P=0.028 and 0.045). The repetition rates of regimen intention of the 2 L PEG+ LIN and 3 L PEG+ LIN subgroups in FC and NFC groups were higher than that of the 3 L PEG subgroup in respective group (93.7%(89/95), 93.4%(85/91) vs. 80.9%(76/94); 92.9%(92/99), 92.8%(90/97) vs. 82.0%(82/100)), and the differences were statistically significant ( χ2=5.25, 8.70, 4.31, and 5.40; P=0.009, 0.015, 0.020, and 0.023). Conclusions:The 2 L PEG+ LIN regimen can effectively decrease OBPS, improve qualified rate of bowel preparation and repetition rate of regimen intention, and reduce adverse events and the amount of fluid intake, in order to improve the tolerance and compliance of patients. Therefore, the 2 L PEG+ LIN regimen is recommended as a bowel preparation for colonoscopy in patients with FC.
10.Study on the efficacy and safety of linaclotide combined with polyethylene glycol for bowel preparation in patients with functional constipation
Hanqing LI ; Yukun LI ; Xingsi QI ; Peng ZHANG ; Yanan YU ; Zibin TIAN
Chinese Journal of Digestion 2024;44(9):605-612
Objective:To investigate the efficacy and safety of linaclotide(LIN) combined with polyethylene glycol(PEG) for bowel preparation in patients with functional constipation (FC).Methods:From August 1, 2022 to April 30, 2023, a total of 300 patients with FC (FC group) and 300 subjects with non-functional constipation (NFC, NFC group) undergoing colonoscopy at the Affiliated Hospital of Qingdao University were selected. According to simple random sampling method, both FC group and NFC group were divided into 3 L PEG subgroup, 3 L PEG+ LIN subgroup, and 2 L PEG+ LIN subgroup, respectively, with 100 cases in each group and a total of 6 subgroups. All subjects were enrolled based on a random number table and received the corresponding bowel preparation protocols. The Ottawa bowel preparation score (OBPS) and the rate of adequate bowel preparation were calculated. Ordered logistic regression analysis was used to analyze the independent influencing factors of OBPS. The incidence of adverse events (such as bloating) and the repetition rate of regimen intention were analyzed. One-way ANOVA, least significant difference analysis, and chi-square test were used for statistical analysis.Results:The OBPS of the 3 L PEG subgroup, 3 L PEG+ LIN subgroup, and 2 L PEG+ LIN subgroup in the FC group were 6.06±1.67, 3.86±2.20, and 4.06±2.03, respectively, while the OBPS of the 3 corresponding subgroups in the NFC group were 5.08±1.92, 3.42±2.04, and 3.63±1.93, respectively. The OBPS scores of the 2 L PEG+ LIN and 3 L PEG+ LIN subgroups in FC and NFC group were lower than those of the 3 L PEG subgroup within the respective group, and the differences were statistically significant ( t=7.16, 7.55, 4.59, and 6.06; all P<0.001). The rates of adequate bowel preparation of the 3 L PEG subgroup, 3 L PEG+ LIN subgroup, and 2 L PEG+ LIN subgroup in the FC group were 83.0% (78/94), 95.6% (87/91), and 96.8% (92/95), respectively, while the rates of adequate bowel preparation of the 3 subgroups in the NFC group were 88.0% (88/100), 96.9%(94/97), and 97.0%(96/99), respectively. The rates of adequate bowel preparation of 2 L PEG+ LIN and 3 L PEG+ LIN subgroups in FC and NFC group were higher than those of the 3 L PEG subgroup in the respective group, and the differences were statistically significant( χ2=10.04, 7.64, 5.74, and 5.55, P=0.001, 0.008, 0.029, 0.029). The FC group was divided into 2 L PEG+ LIN compared to 3 L PEG+ LIN subgroup, as well as 3 L PEG+ LIN compared to 3 L PEG subgroup for ordinal logistic regression analysis, and the result showed that the bowel preparation regimen was an independent influencing factor for OBPS ( OR=0.940 and 3.072, 95% confidence interval 0.368 to 1.483 and 1.564 to 3.252; both P<0.001). The incidence of abdominal distension of the 3 L PEG subgroup in FC group and NFC group was higher than that of the 2 L PEG+ LIN subgroup in the respective group (11.7%(11/94) vs. 3.2%(3/95), 12.0%(12/100) vs. 4.0%(4/99)), and the differences were statistically significant( χ2=5.03 and 4.26, P=0.028 and 0.045). The repetition rates of regimen intention of the 2 L PEG+ LIN and 3 L PEG+ LIN subgroups in FC and NFC groups were higher than that of the 3 L PEG subgroup in respective group (93.7%(89/95), 93.4%(85/91) vs. 80.9%(76/94); 92.9%(92/99), 92.8%(90/97) vs. 82.0%(82/100)), and the differences were statistically significant ( χ2=5.25, 8.70, 4.31, and 5.40; P=0.009, 0.015, 0.020, and 0.023). Conclusions:The 2 L PEG+ LIN regimen can effectively decrease OBPS, improve qualified rate of bowel preparation and repetition rate of regimen intention, and reduce adverse events and the amount of fluid intake, in order to improve the tolerance and compliance of patients. Therefore, the 2 L PEG+ LIN regimen is recommended as a bowel preparation for colonoscopy in patients with FC.

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