简介：摘要Functional dyspepsia (FD) and gastroparesis are two common functional gastrointestinal diseases, affecting millions of people in both China and around the world. However, treatment options are limited and difficult due to multiple factors involved in their pathophysiologies. Therefore it is critically important to assess and understand pathophysiologies of these diseases before a treatment is given. In this minireview we provide updates on recent development in the pathophysiologies and treatments of FD and gastroparesis. In addition to common abnormalities in gastric accommodation, antral hypomotility and visceral hypersensitivity, FD has recently been reported to display a number of impairment in duodenal functions, such as low-grade inflammation and increased permeability. For gastroparesis, macrophages have recently been reported to play an important role in its pathophysiology. A brief overview on the assessment of pathophysiologies of FD and gastroparesis is also provided; pros and cons of clinically available methodologies as well as emerging methods are discussed. Finally, available treatment options for FD and gastroparesis are presented in this minireview, including authors′ opinions on the advantages and disadvantages of each therapy. Potential novel therapies for FD and gastroparesis, especially those associated with Traditional Chinese Medicine, are also introduced and discussed.

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简介：AbstractBackground:Functional dyspepsia (FD) has rarely been investigated in areas with a high prevalence of esophageal squamous cell carcinoma (ESCC). This study aims to reveal the epidemiological and clinical features of FD and organic dyspepsia (OD) in such a population.Methods:A middle-aged and elderly population-based study was conducted in a region with a high incidence of ESCC. All participants completed the Gastroesophageal Reflux Disease Questionnaire and Functional Gastrointestinal Disease Rome III Diagnostic Questionnaire, and they underwent gastroscopy. After exclusion of gastroesophageal reflux disease, uninvestigated dyspepsia (UID) was divided into OD and FD for further analyses.Results:A total of 2916 participants were enrolled from July 2013 to March 2014 in China. We detected 166 UID cases with questionnaires, in which 17 patients with OD and 149 with FD were diagnosed via gastroscopy. OD cases presented as reflux esophagitis (RE), ESCC, and duodenal ulcer. Heartburn (52.94%) and reflux (29.41%) were common in OD, but no symptomatic differences were found between FD and OD. Male sex, low education level, and liquid food were the risk factors for OD, while frequent fresh vegetable consumption was a protective factor. FD included 56 (37.58%) cases of postprandial distress syndrome (PDS), 52 (34.89%) of epigastric pain syndrome (EPS), nine (6.04%) of PDS + EPS, and 32 (21.48%) of FD + functional esophageal disorders. The Helicobacter pylori infection rate in FD patients was not higher than that in the control group (34.23% vs. 42.26%, P = 0.240). Frequent spicy food consumption was associated with PDS (odds ratio [OR]: 2.088, 95% confidence interval [CI]: 1.028-4.243), while consumption of deep well water was protective for PDS (OR: 0.431, 95% CI: 0.251-0.741).Conclusions:The prevalence of FD was 5.11% in the studied population. Gastroscopy should be prescribed for dyspepsia patients in case that ESCC and RE would be missed in UID cases diagnosed solely by the Rome III questionnaire.Trial Registration:ClinicalTrials.gov, NCT01688908; https://clinicaltrials.gov/ct2/show/record/NCT01688908.

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简介：Acupunctureiswidelyusedtotreatfunctionaldyspepsiawithsatisfactoryoutcomes.CombinationoftheHeandMuacupointsiscommonlyusedandhasasynergisticeffectonfunctionaldyspepsia;however,itsunderlyingmechanismsremainunclear.Therefore,arandomizedcontrolledparallelclinicaltrialiscurrentlyunderwayatChengduUniversityofTraditionalChineseMedicine,China.ThistrialisdesignedtoexploretheefficacyofandcentralresponsestotheHe-Mupointcombinationinpatientswithfunctionaldyspepsiausingfunctionalmagneticresonanceimaging.Atotalof105patientswithfunctionaldyspepsiawillbeallocatedinto3groups:thelow-Hepointgroup(puncturingatZusanli(ST36)),Mupointgroup(puncturingatZhongwan(CV12)),andHe-Mupointcombinationgroup(puncturingatST36andCV12).Everyparticipantwillreceive20sessionsofmanualacupuncturefor4weeks.Theneedleswillbeinsertedperpendicularlytoadepthof1to2cun.Theangleofrotationandtwistingwillrangefrom90to180degrees,whileliftingandthrustingwillrangefrom0.3to0.5cm.Thevariousmanipulationswillbeperformed60to90timesperminute.Theneedleswillremaininplacefor30minutes,duringwhichmanipulationwillbeappliedevery10minutes.Magneticresonanceimagingwillbeperformedbeforeandafter20sessionsofacupuncture.TheprimaryoutcomeissymptomimprovementaccordingtotheChineseversionoftheNepeanDyspepsiaIndex.SecondaryoutcomesincludetheLeedsdyspepsiaquestionnaire,Self-RatingAnxietyScale,Self-RatingDepressionScale,BeckAnxietyInventory,BeckDepressionInventory,andvisualanaloguescalescoresbeforeandafter10and20sessionsofacupuncture.Needlesensationandadverseeventswillbeusedtoassessthetherapeuticeffects.ThisstudywillpromotemorewidespreadawarenessofthebenefitsofacupointcombinationintheclinicalsettingandprovideafurtherexplanationoftheneuromechanismbywhichacupunctureattheHe-Mupointcombinationforfunctio