Search

Objective(s): Acute renal ischemia may cause acute renal dysfunction due to lack of blood supply; the manifestations are renal tubular cell apoptosis, infiltration of macrophages, and microvascular destruction. Many studies have shown that erythropoietin (EPO) and vitamin D3 (VD3) can be used to prevent or treat renal ischemia-reperfusion (I/R) injury, and VD3 may interact with EPO. In the present study, the effects of the combination of VD3 and EPO in I/R acute kidney injury were studied. Materials and Methods: Rats were divided into 5 groups: sham-operated (SHAM), AKI without treatment (AKI-control), AKI treatment with VD3(AKI+VD3), AKI treatment with EPO(AKI+EPO), AKI treatment with VD3 and EPO(AKI+VD3+EPO). The effects of the combination of VD3 and EPO on AKI were assessed by histologic, inflammation, and apoptosis studies. Results: The degree of damage in renal tissue was significantly reduced in VD3, EPO, and combined groups. Combination therapy with VD3 and EPO markedly improved Creatinine clearance rate (CCr). The combined treatment group showed the lowest F4/80+ and CD68+ expressions. The expression of Bcl-2 in the combined treatment group was higher than those in VD3 group and the EPO group, while Bax's expression goes in the opposite direction. Conclusion: This provides further evidence that VD3 and EPO have beneficial effects in I/R injury via anti-inflammatory and anti-apoptosis pathways. The synergistic protective effect of VD3 and EPO is of profound significance in the development of new strategies for the prevention and treatment of acute kidney injury (AKI). [ABSTRACT FROM AUTHOR]

Background/aims: Functional dyspepsia (FD) overlapping with other gastrointestinal disorders are quite common. The characteristics of FD overlap in Chinese population with latest Rome IV criteria were unclear. This large-scale outpatient-based study assessed the characteristics of FD overlap in South China., Methods: Consecutive FD patients visited the Gastroenterology Clinic at 2 tertiary medical centers in Hangzhou, China who fulfilled the Rome IV criteria were enrolled. Complete questionnaires related to the gastrointestinal symptoms (Rome IV criteria), Reflux Disease Questionnaire, anxiety and depression, quality of sleep and life, and demographic information were collected., Results: Among the total of 3281 FD patients, 50.69% overlapped with gastroesophageal reflux disease, 21.46% overlapped with irritable bowel syndrome, 6.03% overlapped with functional constipation. FD overlap had higher proportion of single/divorced/widowed rate, high education level, being employed, drinking, night shift, unhealthy dietary habit than FD only ( P < 0.05). They had higher frequency of consultation and economic burden, as well as lower scores in quality of life ( P < 0.001). Multivariate logistic regression showed that increasing age, female, low body mass index, history of gastroenteritis, anxiety, depression, and poor sleep quality were independent risk factors for FD overlap., Conclusions: FD overlap was quite common in China with high economic burden and poor quality of life, FD patients with history of gastroenteritis, anxiety, depression, and poor sleep quality were more likely to have overlap disorders. Awareness of the physical and psychosocial stressors in overlapping condition would help optimize the management of FD overlap in clinical practice.

Aim: To validate 4-sample lactose hydrogen breath testing (4SLHBT) compared to standard 13-sample LHBT in the clinical setting., Methods: Irritable bowel syndrome patients with diarrhea (IBS-D) and healthy volunteers (HVs) were enrolled and received a 10 g, 20 g, or 40 g dose lactose hydrogen breath test (LHBT) in a randomized, double-blinded, controlled trial. The lactase gene promoter region was sequenced. Breath samples and symptoms were acquired at baseline and every 15 min for 3 h (13 measurements). The detection rates of lactose malabsorption (LM) and lactose intolerance (LI) for a 4SLHBT that acquired four measurements at 0, 90, 120, and 180 min from the same data set were compared with the results of standard LHBT., Results: Sixty IBS-D patients and 60 HVs were studied. The genotype in all participants was C/C-13910. LM and LI detection rates increased with lactose dose from 10 g, 20 g to 40 g in both groups (P < 0.001). 4SLHBT showed excellent diagnostic concordance with standard LHBT (97%-100%, Kappa​​ 0.815-0.942) with high sensitivity (90%-100%) and specificity (100%) at all three lactose doses in both groups., Conclusion: Reducing the number of measurements from 13 to 4 samples did not significantly impact on the accuracy of LHBT in health and IBS-D. 4SLHBT is a valid test for assessment of LM and LI in clinical practice.

Objective: To observe the expression of Th1 type cytokine IL-12 and Th2 type cytokine IL-4 in different development phases of postinfectious irritable bowel syndrome in mouse model., Methods: Mice were infected by Trichinella spiralis (350-400 Trichinella) and weighted weekly after infection. Visceral sensitivity of colorectal distention in mice was assessed by abdominal withdrawal reflex (AWR) at Weeks 0, 2, 4, 8, 12 post-infection. Tissues of terminal ileum were collected. Histological pathology and inflammation were evaluated by HE staining., Results: The weights of mice in 2 and 4-week groups were lower than those in the control group [(31.1±3.7) g vs (35.6±2.7) g, (36.1±3.4) g vs (39.8±2.7) g, all P<0.05)]. The weights of 8, 12-week groups had no statistical difference with the control group (all P>0.05). Severe intestinal inflammation was observed at Week 2 during acute infectious period, but after a 4-week infection it recovered from intestinal inflammation, until Weeks 8-12, there was no difference with the control group. At 30, 45, 60 mm Hg, the AWR scores of the infectious group was higher than those in the control group. The 2-week group was the highest (2.60±0.55 vs 1.00±0.35, 2.90±0.20 vs 1.50±0.70, 3.30±0.50 vs 2.00±0.35, all P<0.05). Mice infected at Week 8 could serve as a successful model of postinfectious irritable bowel syndrome. An elevated expression of IL-12, IL-4 mRNA and protein was observed in ileocecum at Week 2 during acute phase (0.77±0.04 and 0.40±0.05, 0.42±0.04 and 0.33±0.05), decreased expression of IL-4 mRNA and protein was observed in ileocecum at Weeks 8, 12 (0.10±0.03 and 0.08±0.03, 0.08±0.03 and 0.06±0.03). However a prolonged high expression of IL-12 mRNA and protein was observed in ileocecum at Weeks 8, 12 (0.42±0.03 and 0.25±0.05, 0.39±0.02 and 0.24±0.04), but lower than those in the 2-week group (all P<0.05)., Conclusion: A differential expression of Th type cytokines is observed in different development phases of postinfectious irritable bowel syndrome in a mouse model. All cytokines increase during acute infection stage; However Th1 type cytokine increases continuously while Th2 type cytokine decreases in the established model.