Background/Aims: Pediatric patients with suspected gastroparesis often undergo antroduodenal manometry (ADM) and gastric emptying scintigraphy (GES) for diagnostic purposes. However, it is unknown if delayed gastric emptying (DGE) correlates with manometric findings. This study evaluates whether ADM parameters differ between normal and abnormal GES in pediatric patients. Methods: Data from pediatric patients undergoing ADM and GES at Nationwide Children’s Hospital from 2011-2020 were retrospectively reviewed. Manometry parameters including motility index (Ln [sum of amplitudes × number of contractions + 1]), number of antral contractions, and direction of the phase III migrating motor complex (MMC) were compared to GES results from age-matched patients with DGE (n = 32) and normal gastric emptying (NGE) (n = 32) of similar sex, body mass index, and weight. Results: Children with DGE had a lower post-prandial antral motility index and antral contraction number than those with NGE (9.4 vs 11.2, P = 0.005; 21.8 vs 49.6, P < 0.001). The gastric emptying percentage at 4 hours was lower in patients with retrograde phase III (59.2% vs 83.9%,P = 0.022) and in those without an antral component in the fasting phase III of the migrating motor complex (70.3% vs 86.5%, P = 0.003). Post-prandial antral hypomotility occurred more frequently in the DGE group than in the NGE group (41% vs 9%, P = 0.008). Conclusions ADM findings differ between children with DGE and NGE. Children with DGE are more likely to have abnormal fasting phase III patterns and decreased post-prandial antral activity during ADM testing.

Background/Aims: Pediatric patients with suspected gastroparesis often undergo antroduodenal manometry (ADM) and gastric emptying scintigraphy (GES) for diagnostic purposes. However, it is unknown if delayed gastric emptying (DGE) correlates with manometric findings. This study evaluates whether ADM parameters differ between normal and abnormal GES in pediatric patients. Methods: Data from pediatric patients undergoing ADM and GES at Nationwide Children’s Hospital from 2011-2020 were retrospectively reviewed. Manometry parameters including motility index (Ln [sum of amplitudes × number of contractions + 1]), number of antral contractions, and direction of the phase III migrating motor complex (MMC) were compared to GES results from age-matched patients with DGE (n = 32) and normal gastric emptying (NGE) (n = 32) of similar sex, body mass index, and weight. Results: Children with DGE had a lower post-prandial antral motility index and antral contraction number than those with NGE (9.4 vs 11.2, P = 0.005; 21.8 vs 49.6, P < 0.001). The gastric emptying percentage at 4 hours was lower in patients with retrograde phase III (59.2% vs 83.9%,P = 0.022) and in those without an antral component in the fasting phase III of the migrating motor complex (70.3% vs 86.5%, P = 0.003). Post-prandial antral hypomotility occurred more frequently in the DGE group than in the NGE group (41% vs 9%, P = 0.008). Conclusions ADM findings differ between children with DGE and NGE. Children with DGE are more likely to have abnormal fasting phase III patterns and decreased post-prandial antral activity during ADM testing.

Background/Aims: Pediatric patients with suspected gastroparesis often undergo antroduodenal manometry (ADM) and gastric emptying scintigraphy (GES) for diagnostic purposes. However, it is unknown if delayed gastric emptying (DGE) correlates with manometric findings. This study evaluates whether ADM parameters differ between normal and abnormal GES in pediatric patients. Methods: Data from pediatric patients undergoing ADM and GES at Nationwide Children’s Hospital from 2011-2020 were retrospectively reviewed. Manometry parameters including motility index (Ln [sum of amplitudes × number of contractions + 1]), number of antral contractions, and direction of the phase III migrating motor complex (MMC) were compared to GES results from age-matched patients with DGE (n = 32) and normal gastric emptying (NGE) (n = 32) of similar sex, body mass index, and weight. Results: Children with DGE had a lower post-prandial antral motility index and antral contraction number than those with NGE (9.4 vs 11.2, P = 0.005; 21.8 vs 49.6, P < 0.001). The gastric emptying percentage at 4 hours was lower in patients with retrograde phase III (59.2% vs 83.9%,P = 0.022) and in those without an antral component in the fasting phase III of the migrating motor complex (70.3% vs 86.5%, P = 0.003). Post-prandial antral hypomotility occurred more frequently in the DGE group than in the NGE group (41% vs 9%, P = 0.008). Conclusions ADM findings differ between children with DGE and NGE. Children with DGE are more likely to have abnormal fasting phase III patterns and decreased post-prandial antral activity during ADM testing.

Bioactive compounds derived from herbal medicinal plants modulate various therapeutic targets and signaling pathways associated with cardiovascular diseases (CVDs), the world's primary cause of death. Ginkgo biloba, a well-known traditional Chinese medicine with notable cardiovascular actions, has been used as a cardio- and cerebrovascular therapeutic drug and nutraceutical in Asian countries for centuries. Preclinical studies have shown that ginkgolide B, a bioactive component in Ginkgo biloba, can ameliorate atherosclerosis in cultured vascular cells and disease models. Of clinical relevance, several clinical trials are ongoing or being completed to examine the efficacy and safety of ginkgolide B-related drug preparations in the prevention of cerebrovascular diseases, such as ischemia stroke. Here, we present a comprehensive review of the pharmacological activities, pharmacokinetic characteristics, and mechanisms of action of ginkgolide B in atherosclerosis prevention and therapy. We highlight new molecular targets of ginkgolide B, including nicotinamide adenine dinucleotide phosphate oxidases (NADPH oxidase), lectin-like oxidized LDL receptor-1 (LOX-1), sirtuin 1 (SIRT1), platelet-activating factor (PAF), proprotein convertase subtilisin/kexin type 9 (PCSK9) and others. Finally, we provide an overview and discussion of the therapeutic potential of ginkgolide B and highlight the future perspective of developing ginkgolide B as an effective therapeutic agent for treating atherosclerosis.

Background/Aims: To assess the effectiveness and feasibility of a brief session of hypnosis to reduce distress in children with functional constipationundergoing anorectal manometry (ARM). Methods: A partially-blinded randomized controlled pilot trial was conducted in children 4-18 years old scheduled for ARM. Children were randomized to receive a brief session of hypnosis prior to ARM or standard care. Non-blinded and blinded observers rated the child’s level of distress using the Observation Scale of Behavioral Distress and a 4-point-Likert scale, respectively. Differences between groupswere analyzed using Fisher’s exact test or Mann-Whitney U test as appropriate. Results: Data from 32 children (15 hypnosis and 17 standard care) were analyzed. Prior to insertion of the catheter, the observed mean levels of distress were lower in the hypnosis group according to both the non-blinded observer (median 0.0 [interquartile range {IQR} 0.0-0.3] vs 1.4 [IQR 0.3-2.4]; P = 0.009) and the blinded observer (median 0.0 [IQR 0.0-0.0] vs 0.5 [IQR 0.0-1.0]; P = 0.044). During ARM, observed and reported levels of distress did not differ significantly. In the hypnosis group, 92.9% of parents and childrenreported that hypnosis helped the child to relax. There were no significant differences in resting pressure, squeeze pressure, or duration of the procedure between both groups. Conclusion A brief session of hypnosis for children before ARM is an easily incorporable intervention that lowers distress levels prior to theprocedure and is positively perceived by children and parents.

Changes in structure of oral solid dosage forms (OSDF) elementally determine the drug release and its therapeutic effects. In this research, synchrotron radiation X-ray micro-computed tomography was utilized to visualize the 3D structure of enteric coated pellets recovered from the gastrointestinal tract of rats. The structures of pellets in solid state and in vitro compendium media were measured. Pellets in vivo underwent morphological and structural changes which differed significantly from those in vitro compendium media. Thus, optimizations of the dissolution media were performed to mimic the appropriate in vivo conditions by introducing pepsin and glass microspheres in media. The sphericity, pellet volume, pore volume and porosity of the in vivo esomeprazole magnesium pellets in stomach for 2 h were recorded 0.47, 1.55 × 10⁸ μm³, 0.44 × 10⁸ μm³ and 27.6%, respectively. After adding pepsin and glass microspheres, the above parameters in vitro reached to 0.44, 1.64 × 10⁸ μm³, 0.38 × 10⁸ μm³ and 23.0%, respectively. Omeprazole magnesium pellets behaved similarly. The structural features of pellets between in vitro media and in vivo condition were bridged successfully in terms of 3D structures to ensure better design, characterization and quality control of advanced OSDF.

Two new polyketides, chinoketides A and B (1 – 2) with a known compound xylarphthalide A (3), were isolated from the solid medium of the endophytes from the leaves of the relic plant Distylium chinense with the “black-box” co-culture method, and the structures of two new compounds were elucidated by NMR, MS and CD spectra. And the absolute configurations of chinoketides A (1) and B (2) were determined as 2R,3R,8S and 5R,6S by calculating their ECD spectra to compare with the experimental CD spectra. Finally, the antimicrobial activities were evaluated to Erwinia carotovora sub sp. Carotovora (Jones) Bersey et al, and the results showed that compounds 1 – 3 displayed the antimicrobial activities with MIC value at 20.5, 30.4 and 10.2 µg/mL.
Coculture Techniques ; Endophytes ; Methods ; Pectobacterium carotovorum ; Plants ; Polyketides

The purpose of this study was to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) on patients with sleep bruxism (SB). Twelve patients with SB were included in an open, single-intervention pilot study. rTMS at 1 Hz and an intensity of 80% of the active motor threshold was applied to the ‘hot spot’ of the masseter muscle representation at the primary motor cortex bilaterally for 20 min per side each day for 5 consecutive days. The jaw-closing muscle electromyographic (EMG) activity during sleep was recorded with a portable EMG recorder at baseline, during rTMS treatment and at follow-up for 5 days. In addition, patients scored their jaw-closing muscle soreness on a 0–10 numerical rating scale (NRS). Data were analysed with analysis of variance. The intensity of the EMG activity was suppressed during and after rTMS compared to the baseline (P 5 0.04; P 5 0.02, respectively). The NRS score of soreness decreased significantly during and after rTMS compared with baseline (P,0.01). These findings indicated a significant inhibition of jaw-closing muscle activity during sleep along with a decrease of muscle soreness. This pilot study raises the possibility of therapeutic benefits from rTMS in patients with bruxism and calls for further and more controlled studies.

Female ; Hearing Loss, Noise-Induced ; diagnosis ; Humans ; Leisure Activities ; Male ; Music ; Noise ; adverse effects

To validate the use of the Index of Complexity, Outcome and Need (ICON) in assessing orthodontic treatment need among 12-13 year-olds in southern China, we determined the threshold value of ICON based on Chinese orthodontists' judgments. The samples consisted of 335 students in grade 7 from 16 randomly selected middle schools in Chengdu, China. Three associate professors provided ICON scores for each participant and the results were compared with the gold standard judgments from 25 experts on treatment needs. Based on the gold standard, 195 casts belonged to the treatment category, while the rest 140 belonged to the no-treatment category. With the international cutoff point of 43, the sensitivity and specificity of the ICON score were 0.29 and 0.98.The best compromise between sensitivity and specificity in Chengdu, compared with the gold standard, was found at a cutoff point of 29, and the sensitivity and specificity were 0.88 and 0.83. When used to evaluate the treatment need of 12-13 year-olds in southern China, the international ICON cutoff value did not correspond well with Chinese orthodontists' judgments; a lower cutoff value of 29 offered a greater sensitivity and specificity with respect to expert orthodontists' perception of treatment need.
Adolescent ; Child ; China ; epidemiology ; Cross-Cultural Comparison ; Data Collection ; Dental Health Surveys ; methods ; standards ; Female ; Health Services Needs and Demand ; statistics & numerical data ; Humans ; Male ; Malocclusion ; diagnosis ; epidemiology ; Needs Assessment ; statistics & numerical data ; Observer Variation ; Orthodontics, Corrective ; standards ; statistics & numerical data ; Reference Values ; Reproducibility of Results ; Sensitivity and Specificity