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Objective: Although pathological acid reflux in patients with reflux symptoms is uncommon, it affects one‐third of patients with epigastric symptoms in China. The aim of this study was to evaluate and compare the relevance of esophageal and epigastric symptoms in diagnosing gastroesophageal reflux disease (GERD) in China. Methods: Consecutive outpatients with predominantly esophageal symptoms (heartburn, regurgitation, chest pain, dysphagia) or predominantly epigastric symptoms (epigastric pain, epigastric burning, early satiety, postprandial fullness) were enrolled. Patients underwent upper endoscopy and esophageal function tests, and took proton pump inhibitor (PPI) treatment. The prevalence of GERD and PPI efficacy was assessed and compared among patients with different dominant symptoms. Results: Altogether 374 patients (244 with predominantly esophageal symptoms and 130 with predominantly epigastric symptoms) were enrolled. Patients with predominantly epigastric symptoms had a slightly lower prevalence of reflux esophagitis and pathological acid reflux but a significantly lower PPI response rate than those with predominantly esophageal symptoms. Multivariable logistic regression analysis revealed that the predominant symptom was independently associated with PPI efficacy but could not predict the objective existence of GERD. GERD was objectively found in 136 patients, 30% of whom complained of predominantly epigastric symptoms and had similar reflux profiles and symptom outcomes as patients with predominantly esophageal symptoms. Conclusions: Approximately 30% of patients with GERD complain of predominantly epigastric symptoms and have comparable reflux profiles and symptom outcomes as those with predominantly esophageal symptoms. Epigastric symptoms may be part of the diagnosis for GERD in a Chinese population. The study was registered with Clinicaltrials.gov (NCT02506634). [ABSTRACT FROM AUTHOR]

OBJECTIVE: The monocyte chemoattractant protein-1 (MCP-1) -A2518G gene polymorphism has been found to be involved in the susceptibility to inflammatory bowel disease (IBD); however, the results of existing studies are controversial. The aim of this meta-analysis was to assess the relationship between the MCP-1 -A2518G polymorphism and the risk of IBD. METHODS: PubMed, EMBASE and MEDLINE were searched for studies assessing the relationship between the -A2518G polymorphism in MCP-1 gene and the risk of IBD. Available data were extracted and statistically analyzed using STATA 12.0. RESULTS: A total of five publications involving 3137 individuals (1818 IBD cases and 1319 controls) were included in the meta-analysis. A combined analysis revealed that the MCP-1 -A2518G polymorphism in was a protective factor for GG + AG vs AA (OR 0.76, 95% CI 0.67-0.87, P = 0.000). Subgroup analysis by ethnicity showed that among European patients the AG + GG homozygote, unlike the AA homozygote, had a protective effect against IBD (OR 0.73, 95% CI 0.63-0.84, P = 0.000), but did not do so among Asian and African patients. Subgroup analysis by disease subtype suggested the -A2518G polymorphism in MCP-1 had a protective effect against Crohn's disease (OR 0.69, 95% CI 0.58-0.81, P = 0.000), but not against ulcerative colitis. CONCLUSIONS: Our meta-analysis suggested that the -A2518G polymorphism in MCP-1 may be a protective factor for IBD in European populations. Further studies are required to confirm these findings. [ABSTRACT FROM AUTHOR]

Objective This study aimed to investigate the efficacy of fluorescence spectroscopy of gastric juice for early gastric cancer ( EGC) screening. Methods Gastric juice was collected from 101 participants who underwent endoscopy in the Outpatient Endoscopy Center of Peking University Third Hospital. The participants were divided into three groups: the normal mucosa or chronic non-atrophic gastritis ( NM-CNAG) group ( n = 35), advanced gastric cancer ( AGC) group ( n = 33) and EGC group ( n = 33). Fluorescence spectroscopic analysis was performed in all the gastric juice samples and the maximum fluorescence intensity of the first peak ( P1FI) was measured. Results The mean fluorescence intensity of P1FI of gastric juice in AGC (92.1 ± 10.7) and EGC (90.8 ± 12.0) groups was significantly higher than that in the NM-CNAG group (55.7 ± 7.5) ( AGC vs NM-CNAG, P = 0.006 and EGC vs NM-CNAG, P = 0.015, respectively). The areas under the receiver operating characteristic curves for the detection of AGC and EGC were 0.681 (95% confidence interval [ CI] 0.553-0.810, P = 0.010) and 0.655 (95% CI 0.522-0.787, P = 0.028). With the P1FI of ≥47.7, the sensitivity, specificity and accuracy for detecting EGC were 69.7%, 57.1% and 63.2%, respectively. Conclusions The enhancement of P1FI of gastric juice occurs at the early stage of gastric cancer. Fluorescence spectroscopy of gastric juice may be used as a novel screening tool for the early detection of gastric cancer. [ABSTRACT FROM AUTHOR]

ABSTRACT CRF1 antagonists DMP696 and DMP904 were designed as drug development candidates for the treatment of anxiety and depression. Both compounds display nanomolar affinity for human CRF1 receptors, and exhibit >1000-fold selectivity for CRF1 over CRF2 receptors and over a broad panel of other proteins. DMP696 and DMP904 block CRF-stimulated adenylyl cyclase activity in cortical homogenates and cell-lines expressing CRF1 receptors. Both compounds inhibit CRF-stimulated ACTH release from rat pituitary corticotropes. Binding and functional studies indicate that DMP696 and DMP904 behave as noncompetitive full antagonists. DMP696 and DMP904 exhibit anxiolytic-like efficacy in several rat anxiety models. In the defensive withdrawal test, both compounds reduce exit latency with lowest effective doses of 3 and 1 mg/kg, respectively. The anxiolytic-like effect is maintained over 14 days of repeated dosing. In the context of a novel environment used in this test, DMP696 and DMP904 reverse mild stress-induced increases in plasma CORT secretion but at doses 3-4-fold greater than those required for anxiolytic-like efficacy. DMP696 and DMP904 are ineffective in three depression models including the learned helplessness paradigm at doses up to 30 mg/kg. At lowest anxiolytic-like doses, DMP696 and DMP904 occupy >50% CRF1 receptors in the brain. The in vivo IC50 values (plasma concentrations required for occupying 50% CRF1 receptors) estimated based upon free, but not total, plasma concentrations are an excellent correlation with the in vitro IC50 values. Neither compound produces sedation, ataxia, chlordiazepoxide-like subjective effects or adverse effects on cognition at doses 10-fold higher than anxiolytic-like doses. Neither compound produces physiologically significant changes in cardiovascular, respiratory, gastrointestinal or renal functions at anxiolytic-like doses. DMP696 and DMP904 have favorable pharmacokinetic profiles with good oral bioavailabilities. The overall pharmacological properties suggest that both compounds may be effective anxiolytics with low behavioral side effect liabilities. [ABSTRACT FROM AUTHOR]