| 1 | Analysis of negative DSA findings in patients with acute nonvariceal gastrointestinal bleeding: A retrospective study of 133 patients显示文摘Purpose: To analyze causes of acute nonvariceal gastrointestinal bleeding(GIB) with negative digital subtraction angiography(DSA) results.Materials and methods: The clinical and follow-up data of 133 patients-recruited between February 2008 and November 2016-with acute nonvariceal GIB and negative DSA results were included in this study. DSA results,diagnoses, and clinical outcomes were recorded.Results: The DSA results were negative in all 133 patients. Of the total, 55 patients(41.4%) chose to undergo surgery and 78(58.6%) opted for conservative treatment. Within 30 days, there was no significant difference in the rebleeding or mortality rates between the two groups(P <.05). Of all 133 patients, 76(57.1%) had upper GIB and 57(42.9%) had lower GIB;within 30 days, the rebleeding rate in the upper GIB group(44.7%, 34/76) was significantly higher than that in the lower GIB group(26.3%, 15/57). There was no significant statistical difference(P <.05) within 30 days in the mortality rates between the two groups.Among patients with upper GIB, 26(34.2%, 26/76) opted to undergo surgery and 50(65.8%, 50/76) chose conservative treatment;within 30 days, the rebleeding rate in the group that chose surgery(61.5%, 16/26) was higher than that in the conservative treatment group(36%, 18/50). There was no significant difference(P <.05)within 30 days in the mortality rate between the two groups.Among the patients with lower GIB, 29(50.9%, 29/57) chose to undergo surgery and 28(49.1%, 28/57) opted for conservative treatment. Within 30 days, the rebleeding rate in the surgery group(13.8%, 4/29) was lower than that in conservative treatment group(39.3%, 11/28). There was no significant difference(P <.05) within 30 days in the mortality rate between the two groups.Sixteen patients underwent prophylactic arterial embolization;in 6 of these, bleeding was stopped for 30 days.DSA was then repeated in these 16 patients after a median interval of 1 day, and a positive bleeding site was found in 9 of the 16. Causes of bleeding were found in 111 patients by surgery or endoscopy, whereas the causes remained unknown in 22 patients.Conclusions: Upper GIB with negative DSA results was stopped by conservative treatment, whereas lower GIB required surgery to detect the culprit bleeding site. Rare causes of GIB should be considered and appropriate management selected in a timely manner in order to detect unusual causes. | Tianhe Ye Lian Yang Qi Wang Jiacheng Liu Chen Zhou Chuansheng Zheng Bin Xiong | 2019 | Journal of Interventional Medicine2019，2，1： | 3 |
| 2 | Screening the effective components in treating dampness stagnancy due to spleen deficiency syndrome and elucidating the potential mechanism of Poria water extract显示文摘Poria is an important medicine for inducing diuresis to drain dampness from the middle energizer.However,the specific effective components and the potential mechanism of Poria remain largely unknown.To identify the effective components and the mechanism of Poria water extract(PWE)to treat dampness stagnancy due to spleen deficiency syndrome(DSSD),a rat model of DSSD was established through weight-loaded forced swimming,intragastric ice-water stimulation,humid living environment,and alternate-day fasting for 21 days.After 14 days of treatment with PWE,the results indicated that PWE increased fecal moisture percentage,urine output,D-xylose level and weight;amylase,albumin,and total protein levels;and the swimming time of rats with DSSD to different extents.Eleven highly related components were screened out using the spectrum-effect relationship and LC-MS.Mechanistic studies revealed that PWE significantly increased the expression of serum motilin(MTL),gastrin(GAS),ADCY5/6,p-PKAα/β/γcat,and phosphorylated cAMP-response element binding protein in the stomach,and AQP3 expression in the colon.Moreover,it decreased the levels of serum ADH,the expression of AQP3 and AQP4 in the stomach,AQP1 and AQP3 in the duodenum,and AQP4 in the colon.PWE induced diuresis to drain dampness in rats with DSSD.Eleven main effective components were identified in PWE.They exerted therapeutic effect by regulating the AC-cAMP-AQP signaling pathway in the stomach,MTL and GAS levels in the serum,AQP1 and AQP3 expression in the duodenum,and AQP3 and AQP4 expression in the colon. | LI Huijun ZHANG Dandan WANG Tianhe LUO Xinyao XIA Heyuan PAN Xiang HAN Sijie YOU Pengtao WEI Qiong LIU Dan ZOU Zhongmei YE Xiaochuan | 2023 | Chinese Journal of Natural Medicines2023，21，2： | 0 |
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