Mosapride Research Articles

Comparison and Determination of the Content of Mosapride Citrate by Different qNMR Methods.

As a salt-type compound, mosapride citrate's metabolism and side effects are correlated with its salt-forming ratio. Several techniques were developed in this work to compare various quantitative nuclear magnetic resonance (qNMR) methodologies and to quantitatively examine the content of raw materials. Among the qNMR techniques, methods for 1H NMR and 19F NMR were developed. Appropriate solvents were chosen, and temperature, number of scans, acquisition time, and relaxation delay parameter settings were optimized. Maleic acid was chosen as the internal standard in 1H NMR, and the respective characteristic signals of mosapride and citrate were selected as quantitative peaks. The internal standard in 19F NMR analysis was 4,4'-difluoro diphenylmethanone, and the distinctive signal peak at -116.15 ppm was utilized to quantify mosapride citrate. The precision, repeatability, linearity, stability, accuracy, and robustness of the qNMR methods were all validated according to the ICH guidelines. By contrasting the outcomes with those from high-performance liquid chromatography (HPLC), the accuracy of qNMR was assessed. As a result, we created a quicker and easier qNMR approach to measure the amount of mosapride citrate and evaluated several qNMR techniques to establish a foundation for choosing quantitative peaks for the qNMR method. Concurrently, it is anticipated that various selections of distinct quantitative objects will yield the mosapride citrate salt-forming ratio.

Effect of thumbtack needle on functional constipation: A pragmatic randomized controlled trial

ObjectiveThumbtack Needling (TN) has been employed in the treatment of functional constipation (FC), although the existing evidence supporting its effectiveness is limited. This study is to evaluate the efficacy of TN in ameliorating FC. MethodA total of 482 eligible patients were recruited and randomly assigned to the TN group or the Mosapride Citrate (MC) group. The TN was buried once for three days, rest for one day after two consecutive burials, followed by a 4-week follow-up. The primary outcome measure was the score for Complete and spontaneous bowel movement score (CSBMs). Secondary outcome measures included the Bristol Stool Form Scale (BSFS), Cleveland Clinic Score (CCS), and the Patient Assessment of Constipation Quality of Life Questionnaire (PAC-QOL). ResultsOut of the 482 patients randomized, 241 were allocated to each group. Of these, 216 patients (89.6 %) in both groups completed the intervention and follow-up. Compared with the baseline, the differences of CSBMs in TN group [1.76(95 % CI, 1.61 to 1.91)] and MC group [1.35(95 % CI, 1.20 to 1.50)] at week 4 meet the threshold for minimal clinically important difference (MCID). However, there were no clinical difference from baseline at week 2 and week 8 in both groups. Mean CSBMs at week 4 was 3.35 ± 0.99 in the TN group and 3 ± 1.03 in the MC group (adjusted difference between groups, 0.37 points [95 % CI, 0.18 to 0.55]; P < 0.001), although differences between the two groups did not meet the MCID threshold. ConclusionCompared with mosapride citrate, thumbtack needling produced a greater improvement in CSBMs, although the difference from control was not clinically significant. ClinicalTrials.gov identifierChiCTR2100043684

A randomized controlled study to assess the effect of mosapride citrate on intestinal recovery following gastrectomy

The enhanced recovery after surgery (ERAS) protocol, including prokinetic medications, is commonly used to prevent postoperative ileus. Prospective studies evaluating the effectiveness of mosapride citrate, a prokinetic 5-hydroxytryptamine 4 receptor agonist, in patients undergoing gastrectomy within the ERAS framework are lacking. This double-blind randomized trial included patients who were scheduled for laparoscopic or robotic gastrectomy for gastric cancer. Participants were randomly assigned to either a control (placebo) or experimental (mosapride citrate) group, with drugs administered on postoperative days 1–5. Bowel motility was evaluated based on bowel transit time measured using radiopaque markers, first-flatus time, and amount of food intake. No significant differences were observed in baseline characteristics between the two groups. On postoperative day 3, no significant difference was observed in the number of radiopaque markers visible in the colon between the groups. All factors associated with bowel recovery, including the time of first flatus, length of hospital stay, amount of food intake, and severity of abdominal discomfort, were similar between the two groups. Mosapride citrate does not benefit the recovery of intestinal motility after minimally invasive gastrectomy in patients with gastric cancer. Therefore, routine postoperative use of mosapride citrate is not recommended in such patients.

Integration of sustainable chemistry frameworks with a single-pot, on-off fluorescence approach for enabling the facile quantification of mosapride; Application to pharmaceutical tablets and content uniformity

The twelve green chemistry concepts were considered for designing two new feasible, sensitive and selective spectroscopic approaches for the estimation of mosapride (MSP) in pure powder and tablet dosages. These approaches were derived from the reaction of the drug with erythrosine B in buffered acidic medium. The reaction yielded a binary complex, and its absorbance can be measured at its λmax (556 nm) while the incorporation of erythrosine B in the complexation reaction caused quantitative quenching of its native fluorescence that could be measured at 554 nm after excitation at 529 nm. The reaction parameters were carefully optimized for the two methods then the calibration curves were plotted. The absorbance and fluorescence quenching were directly proportional to MSP concentration in the ranges of 1.0–12.0 and 0.15–2.0 μg/mL, respectively. Limits of detection and quantitation were estimated giving values of 0.30 and 0.92 μg/mL for spectrophotometric method and 0.047 and 0.143 μg/mL for spectrofluorimetric method. In accordance with the International Council for Harmonization (ICH) guiding rules, the new methods were assessed proving their high accuracy, precision, and robustness. The methods were adopted for the determination of the cited drug in pharmaceutical tablets. Moreover, the uniformity of tablet contents was successfully tested according to USP utilizing the suggested approaches. Furthermore, the greenness of the suggested procedure was confirmed using three different approaches.

Therapeutic effects of curcumin on constipation-predominant irritable bowel syndrome is associated with modulating gut microbiota and neurotransmitters.

Constipation-predominant irritable bowel syndrome (IBS-C) is a functional bowel disease that affects 10-20% of the population worldwide. Curcumin (CUR) is widely used in traditional Chinese medicine to treat IBS, but its mechanism of action needs further investigation. In this study, we used mosapride (MOS) as a positive control to evaluate the changes in gut microbiota in IBS-C rat models after treatment with CUR or MOS by analyzing 16S rDNA variation. In addition, we used enzyme immunoassay kits and immunohistochemical analysis to investigate whether CUR or MOS influenced serotonin (5-HT), substance P (SP), and vasoactive intestinal peptide (VIP) levels in the serum and colon of IBS-C rats. The study showed that rats supplemented with CUR showed significantly increased fecal weight, fecal water content, small intestine transit rate and significantly decreased serum levels of 5-HT, VIP and SP compared to the IBS group (p < 0.05). In addition, treatment with CUR changed the relative abundance of Blautia, Sutterella, Acetanaerobacterium and Ruminococcus2 in the gut microbiota. This study showed that the efficacy of CUR on IBS-C was possibly by modulating the microbiota and lowering the serum levels of HT, SP, and VIP.

Efficacy and safety of Bifidobacterium quadruple viable tablets combined with mosapride citrate in the treatment of constipation in China: a systematic review and meta-analysis

AimTo analyze the efficacy and safety of Bifidobacterium quadruple viable tablets combined with mosapride citrate for the treatment of constipation.MethodsA systematic review was performed on studies published until July 2022 in PubMed, Embase, China National Knowledge Infrastructure, and Wanfang. The efficacy rate, adverse reaction rate, recurrence rate, and clinical symptoms were included in the measured outcomes.ResultsThe efficacy of Bifidobacterium quadruple viable tablets combined with mosapride citrate in the treatment of constipation was higher than that of mosapride citrate alone (OR = 4.75, 95% CI (3.27, 6.90), Z = 8.19, P < 0.001; I2 = 0.0%, P = 0.645). There was no significant difference in the incidence of adverse reactions between the two groups (OR = 0.97, 95% CI (0.61,1.57), Z = 0.11, P = 0.911; I2 = 0.0%, P = 0.958). The recurrence rate of constipation in patients receiving the combination treatment was lower than that of patients treated with mosapride citrate alone (OR = 0.48, 95%CI (0.31, 0.73), Z = 3.38, P = 0.001; I2 = 29.8%, P = 0.200).ConclusionsBifidobacterium quadruple viable tablets combined with mosapride citrate demonstrated efficacy and safety in treating constipation. Probiotics have the potential to positively influence gut health and microbial profiles in patients with functional constipation.

An Intragastric Delivery Device Employing FDM Technology: 3D-Printed Tablet Containing Green Developed Mosapride-Saccharin Co-crystals

Mosapride citrate (MC) is a poorly soluble short half-life drug with more pronounced absorption in the stomach. The present study aimed to incorporate MC co-crystals with enhanced solubility into 3D-printed floating tablets. MC co-crystals were prepared via the green method using Saccharin sod. as a co-former at a (1:1) molar ratio. The prepared co-crystals were assessed for solubility, FTIR, thermal behavior, and SEM. Then, it was incorporated into zero % infill 3D-printed tablets of different configurations at two thickness levels by the FDM printing technique. Printed tablets were evaluated for dimensions, weight deviation, friability, and in vitro floating behavior. Drug release and kinetic of the MC release were also assessed. Solubility study of the co-crystals showed a significant (p value < 0.05) increased solubility over pure MC. FTIR and thermal behavior confirmed hydrogen bonding formation during co-crystallization. The obstructed particles had an erratic protrusion form, similar to a nodule, as illustrated by SEM. The printed tablets showed acceptable physicochemical properties. Tablets floated for about ≥ 12 h without floating lag time. In vitro drug release exhibited variable extended release profiles with different lag times depending on the configuration indicating that the tablet’s wall thickness and surface area were the factors manipulated to control drug release. Kinetic analysis of the release data displayed intermediate kinetics between zero-order and diffusional kinetics. The intragastric extended release profile for MC co-crystals of improved solubility could be successfully, economically, and quickly developed utilizing the 3D printing technique.Graphical

Electroacupuncture for acute exacerbation of chronic obstructive pulmonary disease complicated with gastrointestinal dysfunction: a randomized controlled trial

To observe the clinical effect of electroacupuncture (EA) for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated with gastrointestinal dysfunction.A total of 100 patients with AECOPD complicated with gastrointestinal dysfunction were randomly divided into an EA group (50 cases, 2 cases dropped off, 1 case excluded) and a medication group (50 cases). Both groups were treated with symptomatic and supportive treatment such as low flow oxygen, nebulized inhalation of short-acting β2 agonist (SABA) or short-acting muscarinic antagonist (SAMA) combined with inhaled corticosteroid (ICS). The EA group was treated with EA at Zusanli (ST 36), Yinlingquan (SP 9), Zhongwan (CV 12), Shuifen (CV 9), Tianshu (ST 25), Chize (LU 5) and Lieque (LU 7), with discontinuous wave, 2 Hz in frequency, 30 min each time, once a day. In the medication group, oral mosapride citrate tablets were given, 3 times a day, 5 mg each time. Both groups were treated for 5 d. Before and after treatment, the gastrointestinal symptom rating scale (GSRS) score was observe, serum procalcitonin (PCT), C-reactive protein (CRP), and plasma oxygenation index (PaO2/FiO2) were detected, and patient satisfaction degree was evaluated in the two groups.Compared with before treatment, except for diarrhea dimension in the medication group, the total scores and each dimension scores of GSRS were decreased (P<0.05), serum PCT and CRP were decreased (P<0.05), plasma PaO2/FiO2 was increased (P<0.05) in the two groups after treatment. After treatment, in the EA group, the total score and abdominal pain, dyspepsia, constipation and diarrhea scores of GSRS were lower than those in the medication group (P<0.05), meanwhile serum PCT and CRP were lower and plasma PaO2/FiO2 was higher than those in the medication group (P<0.05). The improvement of gastrointestinal symptoms, life quality and overall satisfaction degree in the EA group were superior to those in the medication group (P<0.05).EA could improve the symptoms of patients with AECOPD complicated with gastrointestinal dysfunction, reduce inflammatory response, improve oxygenation and patient satisfaction degree.目的：探讨电针干预慢性阻塞性肺疾病急性发作期（AECOPD）合并胃肠功能障碍的临床疗效。方法：将100例AECOPD合并胃肠功能障碍患者随机分为电针组（50例，脱落2例、剔除1例）和药物组（50例）。两组均予低流量吸氧、短效β2激动剂（SABA）或短效胆碱受体拮抗剂（SAMA）联合吸入型糖皮质激素（ICS）雾化吸入等对症及支持治疗。电针组予电针刺激足三里、阴陵泉、中脘、水分、天枢、尺泽、列缺，予断续波，频率2 Hz，每次30 min，每日1次；药物组予口服枸橼酸莫沙必利片，每日3次，每次5 mg。两组均治疗5 d。观察两组患者治疗前后胃肠道症状评定量表（GSRS）评分，检测两组患者治疗前后降钙素原（PCT）、C反应蛋白（CRP）、氧合指数（PaO2/FiO2），并评价患者满意度。结果：与治疗前比较，除药物组腹泻维度，两组治疗后GSRS总分及各个维度评分均降低（P<0.05），PCT、CRP降低（P<0.05），PaO2/FiO2升高（P<0.05）；治疗后，电针组GSRS总分及腹痛、消化不良、便秘、腹泻评分均低于药物组（P<0.05），PCT、CRP低于药物组（P<0.05），PaO2/FiO2高于药物组（P<0.05）。电针组患者胃肠道症状改善、生活质量改善及总体满意度优于药物组（P<0.05）。结论：电针可改善AECOPD合并胃肠功能障碍患者症状，降低机体炎性反应，改善氧合情况，提升患者满意度。.

Intracolonic Administration of Mosapride Citrate Significantly Increases Colonic Motility Compared With Oral Administration

Intracolonic Administration of Mosapride Citrate Significantly Increases Colonic Motility Compared With Oral Administration

Bowls-unblocking and mind-regulating acupuncture therapy for constipation-predominant irritable bowel syndrome: An exploratory randomized clinical trial 通腑调神针法治疗便秘型肠易激综合征:随机对照试验

ObjectiveTo observe the effects of bowls-unblocking and mind-regulating acupuncture therapy on constipation, anxiety, depression and serum neuropeptide Y (NPY) content for the patients with constipation-predominant irritable bowel syndrome (IBS-C). MethodsForty-two IBS-C patients were randomly assigned either into a bowls-unblocking and mind-regulating acupuncture group (acupuncture group) or a mosapride citrate group (medication group) with 21 cases in each group. During the treatment, one patient in the medication group was excluded and 20 patients were included in final statistical analysis; while 21 patients completed the trial in the acupuncture group. Before treatment, after treatment and in follow-up (1 month after the whole treatment), the scores of the Cleveland clinical constipation scoring system (CCS), the self-rating anxiety scale (SAS), and the self-rating depression scale (SDS) were assessed in both groups. The changes in NPY content were compared before and after treatment. Results① Total score of CCS: after treatment, the total score in the acupuncture group and the medication group were (4.76 ± 2.10) points and (5.60 ± 1.88) points, respectively, which were significantly lower than those before treatment in both groups (both P < 0.05); and the difference in the score was not significant for the between-group comparison (P > 0.05). In the follow-up, the total scores were (4.19 ± 1.69) points in the acupuncture group, and was (6.35 ± 2.06) points in the medication group. The score in the medication group was higher than that after treatment in the same group (P < 0.05), but there was no significant difference between acupuncture group and the medication group (P > 0.05). ② SAS score: after treatment, the SAS scores were (50.24 ± 2.19) points and (53.45 ± 2.46) points in the acupuncture group and the medication group, respectively, which was lower than that before treatment in the two groups (both P < 0.05); and the difference in the score was significant between two groups (P < 0.05). In the follow-up, the scores were (51.95 ± 2.27) points and (54.55 ± 1.67) points in the acupuncture group and the medication group, respectively; which was lower than that before treatment in the two groups (both P < 0.05), and the difference in the score was significant between two groups (P < 0.05). ③SDS score: after treatment, the SDS scores were (50.71 ± 2.70) points and (53.15 ± 2.25) points in the acupuncture group and the medication group, respectively, which was significantly lower than that before treatment in the two groups (both P < 0.05); and the difference in the score was significant between the two group (P < 0.05). In the follow-up, the score of the acupuncture group was (52.57 ± 3.72) points and it was (56.60 ± 2.42) points in the medication group, which was significantly lower than that before treatment in the two groups (both P < 0.05); and the difference in the score was significant between the two groups (P < 0.05). ④Comparison of serum NPY content: after treatment, the serum NPY content of the acupuncture group and the medication group were (7.08 ± 3.02) mmol/L and (9.89 ± 3.82) mmol/L, respectively, which was significantly lower than that before treatment within each group (both P < 0.05). The difference was significant between the two groups (P < 0.05). ⑤ Effective rate: after treatment, the total effective rate was 95.24% in the acupuncture group and 90.00% in the medication group, without statistically significant difference (P > 0.05). Conclusionsbowls-unblocking and mind-regulating acupuncture therapy relieved the defecation-related symptoms, anxiety, and depression in IBS-C patients; and it was more effective on abdominal pain compared with mosapride citrate. Acupuncture therapy also had some long-term effect, which may be related to its regulatory effect on the serum NPY content.

Comparison of the laxative effects of Korean Gochujang containing different microbiota on loperamide-induced constipation in ICR mice.

The prevalence of constipation, one of the common gastrointestinal (GI) diseases, has been gradually increasing. Gochujang, a traditional Korean fermented paste, has various microbiota and exerts diverse health beneficial effects. However, the ameliorative effect of Gochujang on constipation is unexplored. Seven-week-old ICR mice were divided into five groups: the normal group, the loperamide (LOP) group, the LOP + mosapride citrate (3 mg per kg BW, MOSA) treated group, the LOP + BMG Gochujang (2 g per kg BW) group, and the LOP + VMG Gochujang (2 g per kg BW) group. Gochujang alleviated constipation by increasing defecation frequency and water content in feces by reducing AQP3 mRNA expression. Additionally, Gochujang increased GI transit time and excitatory neurotransmitter levels and decreased inhibitory neurotransmitter levels. Moreover, Gochujang reduced mitogen-activated protein kinase (MAPK) activation and increased the c-Kit/SCF signaling pathway, suggesting that Gochujang regulates the enteric nervous system (ENS). Interestingly, BMG and VMG differently influenced the gut microbiota composition. Both Gochujang groups significantly decreased the Bacteroidetes and Firmicutes ratio compared to the LOP group. However, among Firmicutes genera, Acetatifactor was only reduced in BMG, and VMG only decreased Caproiciproducens and Acutalibacter. In summary, Gochujang effectively alleviated LOP-induced constipation outcomes regardless of their different microbial communities by ameliorating GI motility and changing the gut microbiota composition.

Effect of Massa Medicata Fermentata on the intestinal flora of rats with functional dyspepsia.

Massa Medicata Fermentata (MMF) is one of the most commonly used traditional fermented Chinese medicines. MMF is widely used for the treatment of digestive diseases such as dyspepsia and flatulence in traditional Chinese medicine (TCM). However, the therapeutic mechanism of MMF is not well understood. In this study, SD rats received 0.1% iodoacetamide either alone or in combination with water platform sleep deprivation to induce functional dyspepsia and were administered MMF (1 or 3g/kg/d, ig), mosapride citrate (Mosa., 2mg/kg/d, ig) or saline for 21 days. After treatment, the sucrose preferences and gastric emptying rates of the rats were assessed; HE staining was used to detect the pathological changes in the rat duodenum; ELISA kits were used to detect motilin (MTL) in the rat duodenum and the serum contents of Interferon-λ (IFN-λ), Interleukin 6 (IL-6), and Tumor Necrosis Factor-α (TNF-α). An approach based on 16S rDNA amplicon sequencing was utilized to explore the intestinal microflora in the colon contents of rats and the metabolism of the microflora to assess the potential mechanisms of MMF in ameliorating functional dyspepsia (FD). In addition, gas chromatography-mass spectrometry (GC/MS) was used to detect changes in short fatty acids (SCFAs) in the colon contents of rats. MMF reduced the serum levels of TNF-α, and IFN-λ, improved the morphology of duodenal intestinal villi and ameliorated intestinal mucosal lamina propria injury in FD rats, and the sucrose preference increased and the gastric emptying rate decreased in FD rats. MMF alleviated intestinal microflora disturbance and exerted a regulatory effect on Bacteroidetes, Proteobacteria, and Firmicutes, reduced total SCAFs, Butyric Acid, Propionic acid-2-methyl, Butanoic Acid-3-methyl, and Hexanoic acid. These results showed that the effect of MMF on the intestinal flora and its metabolites may provide a new treatment strategy for FD.

Effect of Electroacupuncture with Different Current Intensities on the Serum Metabolomics of Functional Constipation.

The aim of the study is to investigate the serum metabolomics of electroacupuncture (EA) with different current intensities in the treatment of functional constipation (FC). The total number of FC patients was 19, (7, 6, 6, in the low current intensity group (LCI), high current intensity group (HCI), and mosapride citrate tablet control group (MC), respectively). Patients in the EA groups received 16 sessions of acupuncture treatments. Patients in the MC group were orally administered 5 mg mosapride citrate tablets 3 times daily, and serum samples were collected from the patients before and after treatment. Orthogonal partial least square-discriminant analysis (OPLS-DA) was used to assess the metabolic data. The significant differences before and after FC treatment are shown in the OPLS-DA score plot. Variable importance plots (VIPs) and T tests were used to identify significant metabolites. Among the three groups, the number of metabolites with VIP > 1 was 11, 7, and 21 (in LCI, HCI and MC groups, respectively). Compared with those before treatment, the serum metabolites of patients were characterized by increased levels of L-ornithine (p < 0.05) and glyceric acid in the LCI group (p < 0.05), increased levels of vanillic acid in the MC group (p < 0.05), and decreased levels of arabinonic acid in the MC group (p < 0.05). The effects of EA treatment on the serum metabolomics of FC may involve fatty acid and amino acid metabolism.

Retracted: Mosapride Citrate Combined with Divine Qu Disinfectant Oral Liquid for Children Function Dyspepsia and the Influence of Serum Factors.

[This retracts the article DOI: 10.1155/2022/3053277.].

Effect of electroacupuncture combined with Zhuang-medicine-thread moxibustion on expression of apoptosis-related factors in gastric antrum of diabetic gastroparesis rats

To observe the effect of electroacupuncture (EA) combined with Zhuang-medicine-thread moxibustion on expression of apoptosis-related factors in gastric antrum of diabetic gastroparesis (DGP) rats, so as to explore its mechanism underlying improvement of DGP. Male SD rats were randomly divided into normal, model, medication, EA, Zhuang-medicine-thread moxibustion (moxibustion) and EA+moxibustion (combination) groups (12 rats in each group). The DGP model was established by intraperitoneal injection of streptozotocin (STZ). Rats of the medication group were treated by gavage of 0.15 mg/mL mosapride citrate suspension （10 mL/kg）. EA (10 Hz/50 Hz, 2 mA, 20 min) or Zhuang-medicine-thread moxibustion (3 cones) was applied to "Zhongwan" (CV12), bilateral "Neiguan" (PC6) and bilateral "Sanyinjiao" (SP6) of the related groups, once a day for 3 weeks. The blood glucose, gastric emptying rate and intestinal propulsion rate of rats were measured. The apoptosis index of gastric antrum cells were observed by TUNEL staining. The protein and mRNA expressions of Caspase-3, B-cell lymphoma/leukemia-2 (Bcl-2) and Bcl-2 associated X protein (Bax) in gastric antrum were detected by Wes-tern blot and real-time quantitative PCR, respectively. Compared with the normal group, the blood glucose, the apoptosis index, the protein and gene expressions of Caspase-3 and Bax were significantly increased (P<0.01), and the gastric emptying rate, intestinal propulsive rate, the protein and gene expressions of Bcl-2 were considerably decreased (P<0.01) in the model group. In contrast to the model group, the blood glucose in the EA, moxibustion and combination groups, the apoptosis index in the 4 treatment groups, as well as Caspase-3 protein, Bax protein and mRNA expressions in the medication, EA and combination groups, Caspase-3 protein and mRNA, Bax mRNA expressions in the moxibustion group were significantly decreased (P<0.01, P<0.05); while the gastric emptying rate and intestinal propulsive rate in the 4 treatment groups, and Bcl-2 protein and mRNA expressions in the medication and combination groups, Bcl-2 mRNA expressions in the EA and moxibustion groups were obviously increased (P<0.01). The effects of EA+moxibustion were significantly superior to those of simple EA, moxibustion or medication in increasing gastric emptying rate and intestinal propulsive rate, and in lowering blood glucose (P<0.05, P<0.01). And the effects of the combination treatment were better than those of EA in lowering Caspase-3 protein and Bax mRNA expressions (P<0.01), and in increasing Bcl-2 protein and mRNA expressions (P<0.05, P<0.01). Also the effects of the combination treatment were better than those of moxibustion in lowering the apoptosis index, Caspase-3 protein, and Bax protein and mRNA expressions (P<0.01, P<0.05), and in increasing Bcl-2 protein expression (P<0.05). EA combined with Zhuang-medicine-thread moxibustion can reduce blood glucose and improve gastrointestinal motility in DGP rats, which may be related to its effect in regulating of Caspase-3, Bax and Bcl-2 expression.

Effect of electroacupuncture combined with Zhuang-medicine-thread moxibustion on oxidative stress in gastric antrum of diabetic gastroparesis rats

To observe the effect of electroacupuncture (EA) combined with Zhuang-medicine-thread moxibustion on oxidative stress-related indicators in diabetic gastroparesis (DGP) rats, so as to explore its mechanism underlying improvement of DGP. Male SD rats were randomly divided into normal, model, medication, EA, Zhuang-medicine-thread moxibustion (moxibustion) and EA+Zhuang-medicine-thread moxibustion (combination) groups (15 rats in each group). The DGP model was established by intraperitoneal injection of streptozotocin (STZ). Rats of the medication group were treated by gavage of 0.15 mg/mL mosapride citrate suspension（10 mL/kg）. EA (10 Hz/50 Hz, 2 mA, 20 min) or Zhuang-medicine-thread moxibustion (3 cones) was applied to "Zhongwan" (CV12), bilateral "Neiguan" (PC6) and bilateral "Sanyinjiao" (SP6) of the related groups, once a day for 3 weeks. The body weight, blood glucose, gastric emptying rate and intestinal propulsion rate of rats were measured. The serum malondialdehyde (MDA) content was measured by thiobarbituric acid method, the serum supero-xide dismutase (SOD) activity was measured by xanthine oxidase method, and the serum reactive oxygen species (ROS) activity was detected by ELISA. HE staining was used to observe the pathological changes of gastric antrum. The expression of heme oxygenase-1 (HO-1), nuclear factor erythroid 2-related factor 2 (Nrf2), nicotin-amide adenine dinucleotide phosphate oxidases (NOX4), peroxisome proliferators activated receptor-gamma coactivator 1α(PGC-1α) proteins and mRNAs in gastric antrum was detected by Western blot and real-time quantitative PCR, respectively. Compared with the normal group, the body weight, gastric emptying rate, intestinal propulsion rate, serum SOD activity, the expressions of HO-1, PGC-1α, total Nrf2 proteins and mRNAs, and Nrf2 nuclear translocation in gastric antrum were decreased (P<0.01), while the blood glucose, serum MDA content and ROS activity, NOX4 protein and mRNA expressions in gastric antrum were increased (P<0.01) in the model group. Compared with the model group, the blood glucose was decreased in the EA, moxibustion and combination groups (P<0.01); the body weight, gastric emptying rate, intestinal propulsion rate, and the expressions of HO-1 and PGC-1α mRNAs in gastric antrum were all increased in the four treatment groups (P<0.01, P<0.05), while the serum MDA content and ROS activity, NOX4 protein and mRNA expressions in gastric antrum were all decreased (P<0.01); the serum SOD activity and total Nrf2 protein expression in gastric antrum were increased in medication, moxibustion and combination groups (P<0.01, P<0.05); the expressions of HO-1 and PGC-1α proteins, and Nrf2 nuclear translocation in gastric antrum were increased in medication and combination groups (P<0.05, P<0.01); the expression of Nrf2 mRNA was increased in the medication, EA and combination groups (P<0.01, P<0.05). Compared with the combination group, the body weight, gastric emptying rate and intestine propulsion rate were decreased in the medication, EA and moxibustion groups(P<0.01, P<0.05), and the blood glucose increased (P<0.01); the serum MDA content and ROS activity, NOX4 protein and mRNA expressions in gastric antrum were increased (P<0.01, P<0.05), serum SOD activity, and the expressions of total Nrf2 protein, PGC-1α protein and mRNA, HO-1 mRNA in gastric antrum were decreased (P<0.01, P<0.05) in the EA and moxibustion groups; the expression of Nrf2 mRNA was decreased in the moxibustion group (P<0.05). HE staining showed a large number of inflammatory cell infiltration in the lamina propria and submucosa, and the gastric glands in the lamina propria were significantly expanded, the submucosa was severely edematous in the model group, which were relative milder in the four treatment groups. EA combined with Zhuang-medicine-thread moxibustion can effectively improve the activity of antioxidant enzymes, reduce the production of lipid peroxide, and regulate the expression of antioxidant related proteins and genes, which may be one of the mechanisms in treating DGP.

Effectiveness of Chinese herbal medicine Zhi Shi Xiao Pi Wan on adult diabetic gastroparesis: a systematic review and meta-analysis

Chinese herbal medicine formula Zhi Shi Xiao Pi Wan (ZSXPW) is commonly used for gastrointestinal diseases. Previous research showed ZSXPW also suggested for diabetic gastroparesis (DGP) treatment. The aim of this study is to evaluate the effectiveness and safety of ZSXPW in treating adult DGP. Six databases, including Pubmed, Cochrane Library, EMBASE, China Network Knowledge Infrastructure (CNKI), Wanfang, and Chinese Scientific Journals were searched from their inceptions to November 2021. Only randomized control trials (RCTs) evaluating ZSXPW for adult DGP were included in this review. Two investigators independently evaluated and extracted the data. Total 11 RCTs and 802 participants were included in the review. In these studies, ZSXPW was compared with oral cisapride, domperidone, and mosapride citrate tablets. The outcomes of effective rate, stomach emptying time, stomach emptying rate, motilin, gastrin, somatostatin, vasoactive intestinal peptide, and adverse events were analyzed. The effective rate of ZSXPW is higher than other pharmacotherapies (RR:1.24, 95% CI [1.16,1.32]). The results showed intervention group has better effect on gastric emptying time used (MD: -0.51, 95% CI [-0.81, -0.21]) and gastric emptying rate (MD: 19.32, 95% CI [12.82, 25.83]) than the comparison group. The meta-analysis results showed ZSXPW is effective on adult DGP.

Impact of Helicobacter pylori Infection and Outcome of Anti-Helicobacter pylori Therapy in Patients with Reflux Laryngopharyngitis.

Objectives This study was designed to explore the relationship between Helicobacter pylori (Hp) infection and reflux laryngopharyngitis (RLP) and to evaluate the outcome of anti-Hp therapy in improving RLP symptoms. Methods A total of 410 patients with RLP were enrolled and tested for Hp infection. The association of Hp infection with reflux symptom index (RSI) and reflux finding score (RFS) was determined. Hp-positive patients received either a proton pump inhibitor (PPI) omeprazole alone (control group) or a combination regimen (experimental group) consisting of omeprazole, mosapride citrate, amoxicillin, and clarithromycin. Therapeutic outcomes were compared 4 weeks later. Results Of the 410 participants, 290 were Hp-positive and 120 Hp-negative. Both RSI and RFS were significantly higher in Hp-positive patients than in Hp-negative patients. Hp infection status was positively correlated with RSI (P < 0.05) and RFS (P < 0.05). The overall response rate was higher in the experimental group than in the control group. Both the groups had a significant reduction in RSI and RFS after therapy, with a greater improvement in the experimental group (P < 0.05). Conclusion Our findings establish a link between Hp infection and RLP. Anti-Hp therapy improves RSI and RFS in RLP patients. Therefore, Hp eradication drugs may be added to the PPI-based regimen in the treatment of RLP.

Mosapride Citrate Combined with Divine Qu Disinfectant Oral Liquid for Children Function Dyspepsia and the Influence of Serum Factors.

In order to investigate the efficacy of mosapril citrate combined with ShenQu Xiaoshi oral liquid in the treatment of children with functional dyspepsia and the effect on serum cytokines, 136 children with functional dyspepsia admitted from May 2017 to September 2020 were divided into 2 groups randomly, 68 cases in each group. The western medicine group was treated with mosapril citrate tablets, and the combined group was treated with Shenqu xiaoshi oral liquid on the basis of the western medicine group. The efficacy of patients was evaluated 14 days after treatment, and the safety, symptom score, and serum cytokines of the two groups were compared. The results showed that, after 14 days of treatment, the scores of abdominal distension and abdominal pain (ADAP), lack of food (LOF), nausea and vomiting (NAV), irregular stool (IS), and mental fatigue (MF) in the combined group were all lower than those in the western group (P < 0.05). There was no statistical significance in the incidence of diarrhea, abnormal liver and kidney, and allergic rash between the two groups (p > 0.05). In conclusion, mosapride citrate tablets combined with Shenqu Xiaoshi oral liquid can achieve good therapeutic effects in children with functional dyspepsia, reduce symptom scores, improve serum cytokine levels, and have high drug safety, which is worthy of promotion and application.

Application of analytical Eco-Scale and Complex-GAPI tools for green assessment of a new simple nanoparticle modified carbon paste electrode method for voltammetric determination of mosapride citrate in pharmaceutical dosage form and human plasma

A new, sensitive, eco-friendly and reliable electrochemical method was reported for determination of mosapride citrate (MOS). The method is based on the electrochemical oxidation of MOS after modification of carbon paste electrode (CPE) with 2% zirconium oxide (ZrO2) and cationic surfactant cetrimide using differential pulse voltammetry in 0.2 M phosphate buffer pH 5. Different instrumental and experimental parameters involved in the electrochemical determination were studied and optimized, including pH, buffer type and its concentration, and scan rate. The studied nanoparticles modified CPE showed high sensitivity and excellent anodic response with a linear relationship between the peak current and the molar concentration of the studied drug over the concentration range of 0.08–1.48 μM (equivalent to 0.05–0.91 μg mL−1). The limits of detection and quantification were found to be 0.01 and 0.08 μM, respectively. The proposed method was successfully applied for the determination of MOS in authentic drug, tablet dosage form and spiked human plasma. The proposed method was validated according to ICH guidelines showing high accuracy and precision with recovery100.04% and RSD 1.21%. The results of the analysis obtained showed a good agreement with those obtained from the reported method.