Esophageal Baseline Impedance Reflects Mucosal Integrity and Predicts Symptomatic Outcome With Proton Pump Inhibitor Treatment

( Chenxi Xie ),( Daniel Sifrim ),( Yuwen Li ),( Minhu Chen ),( Yinglian Xiao ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2018 Journal of Neurogastroenterology and Motility (JNM Vol.24 No.1

Background/Aims Esophageal baseline impedance, which is decreased in gastroesophageal reflux disease (GERD) patients, is related to the severity of acid reflux and the integrity of the esophageal mucosa. The study aims to compare the baseline impedance and the dilated intercellular spaces (DIS) within patients with typical reflux symptoms and to evaluate the correlation of baseline impedance with DIS, esophageal acid exposure, as well as the efficacy of proton pump inhibitor (PPI) treatment. Methods Ninety-two patients and 10 healthy controls were included in the study. Erosive esophagitis (EE) was defined by esophageal mucosal erosion under upper endoscopy. Patients without mucosa erosion were divided into groups with pathologic acid reflux (non-erosive reflux disease [NERD]) or with hypersensitive esophagus. The biopsies of esophageal mucosa were taken 2-4 cm above the gastroesophageal junction Z-line during upper endoscopy for DIS measurement. All the patients received esomeprazole 20 mg twice-daily treatment for 8 weeks. The efficacy of esomeprazole was evaluated among all patients. Results The intercellular spaces were dilated in both EE and NERD patients (P < 0.05). The value 0.73 mm could be used as the cut-off DIS value to distinguish patients from controls (area under the curve [AUC] = 0.849, P < 0.01). One thousand seven hundred sixty-four ohms could be used as the cut-off impedance values to distinguish patients from controls (AUC = 0.794, P < 0.01). The baseline impedance was decreased in both EE patients and NERD patients, and negatively correlated to the acid exposure time (r = -0.527, P < 0.05). There was a weak correlation between DIS and baseline impedance (r = -0.230, P < 0.05). “Baseline impedance > 1764 Ω” was an independent predictor for PPI failure (OR, 11.9; 95% CI, 2.4-58.9; P < 0.01). Conclusions The DIS and decreased baseline impedance was observed in patients with mucosa erosion or pathological acid reflux. The baseline impedance reflected the mucosal integrity, it was more sensitive to esophageal acid exposure. Patients with high impedance might not benefit from the PPI treatment. (J Neurogastroenterol Motil 2018;24:43-50)

Esophagogastric Junction Contractility Integral Reflect the Anti-reflux Barrier Dysfunction in Patients with Gastroesophageal Reflux Disease

( Chenxi Xie ),( Jinhui Wang ),( Yuwen Li ),( Niandi Tan ),( Yi Cui ),( Minhu Chen ),( Yinglian Xiao ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2017 Journal of Neurogastroenterology and Motility (JNM Vol.23 No.1

Background/Aims Anti-reflux barrier dysfunction is one of the primary mechanisms in gastroesophageal reflux disease (GERD) pathogenesis. The esophagogastric junction contractile integral (EGJ-CI) is a new metric adopted to evaluate the EGJ contractility, which implies the antireflux barrier function. The aim of the current study was to validate this new metric in patients with GERD and its correlation with the esophageal acid exposure, as well as the efficacy of proton pump inhibitor treatment. Methods Ninety-eight patients with GERD and 21 healthy controls were included in the study. Upper endoscopy, high-resolution manometry (HRM) and 24-hour multichannel intraluminal impedance-pH monitoring were performed in all patients. Three respiration cycles were chosen at the initial HRM resting frame and the value computed with distal contractile integral tool was then divided by the duration of the cycles to yield EGJ-CI. All the patients were treated with esomeprazole 20 mg twice-daily for 8 weeks. Results EGJ-CI was lower in the patients with GERD than that of the controls (P < 0.05). For patients with GERD, EGJ-CI was lower in those with hiatal hernia (P < 0.05). The new metric correlated with esophageal acid exposure in the supine position (P < 0.05), and it also negatively correlated to the total reflux episodes (P < 0.05). There was no significant difference on EGJ-CI between patients with and without response to the esomeprazole treatment (P = 0.627). Conclusions EGJ-CI reflected the dysfunction of the anti-reflux barrier in patients with GERD, but it had little impact on the esomeprazole response. (J Neurogastroenterol Motil 2017;23:27-33)

Detection of Water Cloud Microphysical Properties Using Multi-scattering Polarization Lidar

Jiaming Xie,Xingyou Huang,Lingbing Bu,Hengheng Zhang,Farhan Mustafa,Chenxi Chu 한국광학회 2020 Current Optics and Photonics Vol.4 No.3

Multiscattering occurs when a laser transmits into dense atmosphere targets (e.g. fogs, smoke or clouds), which can cause depolarization effects even though the scattering particles are spherical. In addition, multiscattering effects have additional information about microphysical properties of scatterers. Thus, multiscattering can be utilized to study the microphysical properties of the liquid water cloud. In this paper, a Monte Carlo method was used to simulate multi-scattering transmission properties of Lidar signals in the cloud. The results showed the slope of the degree of linear polarization (SLDLP) can be used to invert the extinction coefficient, and then the cloud effective size (CES) and the liquid water content (LWC) may be easily obtained by using the extinction coefficient and saturation of the degree of linear polarization (SADLP). Based on calculation results, a microphysical properties inversion method for a liquid cloud was presented. An innovative multiscattering polarization Lidar (MSPL) system was constructed to measure the LWC and CES of the liquid cloud, and a new method based on the polarization splitting ratio of the Polarization Beam Splitter (PBS) was developed to calibrate the polarization channels of MSPL. By analyzing the typical observation data of MSPL observation in the northern suburbs of Nanjing, China, the LWC and CES of the liquid water cloud were obtained. Comparisons between the results from the MSPL, MODIS and the Microwave radar data showed that, the microphysical properties of liquid cloud could be retrieved by combining our MSPL and the inversion method.

Relationship Between Salivary Pepsin Concentration and Esophageal Mucosal Integrity in Patients With Gastroesophageal Reflux Disease

( Yu-wen Li ),( Daniel Sifrim ),( Chenxi Xie ),( Minhu Chen ),( Ying-lian Xiao ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2017 Journal of Neurogastroenterology and Motility (JNM Vol.23 No.4

Background/Aims Increased salivary pepsin could indicate an increase in gastro-esophageal reflux, however, previous studies failed to demonstrate a correlation between salivary pepsin concentrations and 24-hour esophageal acid exposure. This study aims to detect the salivary pepsin and to evaluate the relationship between salivary pepsin concentrations and intercellular spaces (IS) in different gastroesophageal reflux disease phenotypes in patients. Methods A total of 45 patients and 11 healthy volunteers were included in this study. All subjects underwent upper gastrointestinal endoscopy, 24-hour ambulatory multichannel impedance-pH (MII-pH) monitoring, and salivary sampling at 3-time points during the 24-hour MII-pH monitoring. IS were measured by transmission electron microscopy, and salivary pepsin concentrations were determined by enzyme-linked immunosorbent assay. Results The IS measurements were greater in the esophagitis (EE), non-erosive reflux disease (NERD), and hypersensitive esophagus (HO) groups than in the functional heartburn (FH) and healthy volunteer groups, and significant differences were indicated. Patients with NERD and HO had higher average pepsin concentrations compared with FH patients. A weak correlation was determined between IS and salivary pepsin among patients with NERD (r = 0.669, P = 0.035). Conclusions We confirmed the presence of a higher level of salivary pepsin in patients with NERD than in patients with FH. Salivary pepsin concentrations correlated with severity of mucosal integrity impairment in the NERD group. We suggest that in patients with NERD, low levels of salivary pepsin can help identify patients with FH, in addition the higher the pepsin concentration, the more likely the severity of dilated IS. (J Neurogastroenterol Motil 2017;23:517-525)

Fundamental effects in nanoscale thermocapillary flow

Hun Jin, Sung,Song, Jizhou,Uk Chung, Ha,Zhang, Chenxi,Dunham, Simon N.,Xie, Xu,Du, Frank,Kim, Tae-il,Lee, Jong-Ho,Huang, Yonggang,Rogers, John A. American Institute of Physics 2014 Journal of Applied Physics Vol.115 No.5

When implemented on the nanoscale, material flows driven by gradients in temperature, sometimes known as thermocapillary flows, can be exploited for various purposes, including nanopatterning, device fabrication, and purification of arrays of single walled carbon nanotubes (SWNTs). Systematic experimental and theoretical studies on thermocapillary flow in thin polymer films driven by heating in individual metallic SWNT over a range of conditions and molecular weights reveal the underlying physics of this process. The findings suggest that the zero-shear viscosity is a critical parameter that dominates the dependence on substrate temperature and heating power. The experimentally validated analytical models in this study allow assessment of sensitivity to other parameters, such as the temperature coefficient of surface tension, the thermal interface conductance, and the characteristic length scale of the heated zone. (c) 2014 AIP Publishing LLC.