Search Results (30)

(1) Backgroud Astragalus, a traditional Chinese medicine, demonstrates therapeutic effectiveness in acute pancreatitis (AP). Nevertheless, its precise pharmacological mechanism remains unclear, and clinical guidelines have not been established. This study aims to systematically elucidate the active compounds and molecular mechanisms underlying Astragalus’ therapeutic effects in AP, and provide clinical evidence supporting its efficacy. (2) Methods: TCMSP and Swiss Target Prediction identified drug targets; GeneCards, DrugBank, and OMIM provided disease targets. Venny determined the therapeutic targets, while STRING constructed a protein–protein interaction network. Cytoscape 3.10.3 validated core targets. DAVID was used to conduct GO and KEGG pathway analyses, visualized via Bioinformatic platform. Cytoscape 3.10.3 was used to build a “drug–ingredients–targets–pathways–disease” network. AutoDock Vina 1.1.2 and AutoDockTools 1.5.7 was used to performed molecular docking, with PyMOL 3.0 visualizing the results. PubMed, Embase, Cochrane, Web of Science, CNKI, Wanfang, VIP, and CBMdisc were searched. The literature was screened, extracted, and evaluated, followed by a meta-analysis, using RevMan 5.4.1 and Stata 18. (3) Results: We identified 539 targets for the active ingredients of astragalus. Among 1974 disease-related targets, 232 were found to be therapeutic targets. The GO analysis yielded 589 entries, while the KEGG pathway enrichment analysis identified 147 relevant pathways. The top five active ingredients were quercetin, kaempferol, isorhamnetin, formononetin, and calycosin. Molecular docking analysis revealed potential synergistic effects between these components and core targets. The meta-analysis, comprising six randomized controlled trials, demonstrated a significantly higher total effective rate of clinical efficacy in the astragalus group compared to the control group. (4) Conclusions: Astragalus treats AP through the synergistic action of its components, targets, and pathways. Key active compounds, such as quercetin, kaempferol, isorhamnetin, formononetin, and calycosin, engage with pivotal targets, including TP53, AKT1, TNF, IL6, EGFR, CASP3, MYC, and HIF1A, within primary pathways, such as pathways in cancer, PI3K-Akt signaling pathway, and lipid metabolism, and atherosclerosis. Astragalus effectively treats AP and alleviates clinical symptoms by reducing the time for gas or defecation passage, the disappearance time of abdominal pain or distension, and the recovery time of bowel sounds. Full article

This study proposes an innovative health management solution to address the defecation care needs of the elderly population. Traditional post-defecation care methods have significant limitations, particularly imposing a considerable psychological burden on patients. By leveraging the rich physiological information contained in bowel sounds, in this work, we designed and implemented a wearable defecation warning monitor based on scandium aluminum nitride (ScAlN) piezoelectric thin films and piezoelectric micromachined ultrasonic transducers (PMUTs). The proposed device mainly incorporates two core components: a bowel sound signal acquisition module and a real-time signal display graphical user interface (GUI) developed using the MATLAB R2023a platform. The research focuses on the systematic characterization and comparative analysis of the sound pressure sensitivity of three different signal readout structures. Experimental results demonstrate that the differential readout structure exhibits superior sensitivity. By continuously monitoring bowel sounds in healthy subjects both with and without the urge to defecate using the defecation warning monitor and a modified stethoscope, and conducting a comparative analysis of the experimental data, it is verified that the defecation warning monitor has significant advantages in clinical applications and demonstrates promising potential for defecation warning monitoring. Full article

Bowel sounds, produced by intestinal peristalsis, are essential for diagnosing gastrointestinal disorders. However, acquiring and analyzing bowel sounds is challenging due to their unpredictable nature and individual variability. Biological tissues can affect bowel sounds during propagation, resulting in varying degrees of signal attenuation between the sound source and the transducer. This study aims to develop a numerical model of bowel sound propagation in the abdominal cavity, focusing on the impact of different biological layers on signal attenuation. Validation of the model demonstrated strong consistency between simulated and actual bowel sound signals, confirming the model’s accuracy and reliability. The model accounted for adipose tissue thickness, ranging from 5 to 20 mm across individuals, while muscle and skin thicknesses remained constant. Results indicated that signal attenuation increases with both the propagation distance and adipose tissue thickness. These findings provide insights into how tissue layers influence bowel sound propagation, offering a theoretical foundation for developing personalized and precise monitoring devices. Full article

Temporomandibular disorders (TMDs) encompass various clinical conditions associated with the temporomandibular joint (TMJ) and the masticatory muscles. TMD symptoms include pain in the orofacial region, restricted or altered mandibular movement, and sounds associated with the temporomandibular joint (TMJ). This condition adversely affects quality of life, social functioning, and daily activities, and may also contribute to widespread pain syndromes and comorbidities, including irritable bowel syndrome (IBS). IBS is a common chronic functional disorder of the lower gastrointestinal tract, characterized by recurrent abdominal pain associated with impaired bowel symptoms. Previous studies indicate an association between TMD and IBS. This scoping review examined the correlation between TMD and IBS concerning their pathology, frequency, and severity, and the potential similarities in how the nervous and endocrine systems influence them. PubMed, SCOPUS, Web of Science, and Google Scholar search engines were utilized to identify suitable studies for this article. Following the application of selection criteria, a total of 58 clinical papers met the eligibility requirements for inclusion in the systematic review. Research showed that both conditions significantly enhance the development of one another and have mutual comorbidities. Both ailments were proven to modify central nervous system processing, leading to high comorbidity in patients. Combining dental and gastroenterological treatments, including a simultaneous therapeutic approach, can significantly enhance patients’ quality of life, but further research is needed for a holistic approach. Full article

Background: Chewing gum, considered a form of sham feeding, has been shown to improve intestinal motor and secretory function in various types of abdominal surgery. We conducted this systematic review to evaluate the effects of postoperative gum chewing on the recovery of gastrointestinal function after laparoscopic gynecologic surgery. Methods: We performed a comprehensive literature review of all randomized controlled trials (RCTs) in PubMed, Embase, and a reference list of relevant studies from the inception to 11 March 2024, comparing postoperative gum chewing versus no gum chewing following laparoscopic gynecologic surgery regardless of indications and setting without language restriction. The primary outcome was the time to the presence of bowel sounds and the time to the first passage of flatus. Cochrane’s risk of bias tool was used to assess the risk of bias in included studies. Results: Nine RCTs with a total of 1011 patients were included. Overall, three studies were categorized as having a low risk of bias, three had some concerns, and three exhibited a high risk of bias. The time to the presence of bowel sounds (mean difference [MD] −2.66 h, 95% confidence interval [CI] −3.68 to −1.64, p < 0.00001) and time to the first passage of flatus (MD −4.20 h, 95% CI −5.79 to −2.61, p < 0.00001) was significantly shorter in the gum-chewing group. There was no statistical difference between the two groups with regard to the time to the first defecation (MD −6.52 h, 95% CI −15.70 to 2.66, p = 0.16), time to the first postoperative mobilization (MD 24.05 min, 95% CI −38.16 to 86.26, p = 0.45), postoperative ileus (MD 0.68, 95% CI 0.39 to 1.19, p = 0.17), and length of hospital stay (MD −0.05 day, 95% CI −0.14 to 0.04, p = 0.28). Conclusions: Gum chewing following laparoscopic gynecologic surgery appears to promote the recovery of gastrointestinal function, as evidenced by a reduced time to the presence of bowel sounds and the first passage of flatus. Full article

Constipation is a common gastrointestinal disorder that impairs quality of life. Evaluating bowel motility via traditional methods, such as MRI and radiography, is expensive and inconvenient. Bowel sound (BS) analysis has been proposed as an alternative, with BS-time-domain acoustic features (BSTDAFs) being effective for evaluating bowel motility via several food and drink consumption tests. However, the effect of BSTDAFs before drink consumption on those after drink consumption is yet to be investigated. This study used BS-based stimulus–response plots (BSSRPs) to investigate this effect on 20 participants who underwent drinking tests. A strong negative correlation was observed between the number of BSs per minute before carbonated water consumption and the ratio of that before and after carbonated water consumption. However, a similar trend was not observed when the participants drank cold water. These findings suggest that when carbonated water is drunk, bowel motility before ingestion affects motor response to ingestion. This study provides a non-invasive BS-based approach for evaluating motor response to food and drink, offering a new research window for investigators in this field. Full article

Auscultation is a fundamental diagnostic technique that provides valuable diagnostic information about different parts of the body. With the increasing prevalence of digital stethoscopes and telehealth applications, there is a growing trend towards digitizing the capture of bodily sounds, thereby enabling subsequent analysis using machine learning algorithms. This study introduces the SonicGuard sensor, which is a multichannel acoustic sensor designed for long-term recordings of bodily sounds. We conducted a series of qualification tests, with a specific focus on bowel sounds ranging from controlled experimental environments to phantom measurements and real patient recordings. These tests demonstrate the effectiveness of the proposed sensor setup. The results show that the SonicGuard sensor is comparable to commercially available digital stethoscopes, which are considered the gold standard in the field. This development opens up possibilities for collecting and analyzing bodily sound datasets using machine learning techniques in the future. Full article

Point-of-care critical ultrasound (POC-CUS) screening plays an increasingly important role in the treatment of critically ill infants. Without POC-CUS, the lives of many infants would not be saved in time and correctly. A premature infant with systemic multiple organ system dysfunction caused by fungal sepsis was treated and nursed under the guidance of POC-CUS monitoring, and the infant was ultimately cured. This premature infant had systemic multiple organ system dysfunction and disseminated intravascular coagulation (DIC) caused by fungal sepsis. In the hypercoagulable state of early-stage DIC, cardiac thrombosis could be found using ultrasound screening. For this case, right renal artery thrombosis was found via renal artery Doppler ultrasound examination. Due to the severity of this disease, ultrasound-guided peripherally inserted central catheter (PICC) insertion and ultrasound checks of the PICC tip’s position were performed, which ensured the success of this one-time catheterization and shortened the catheterization time. Lung ultrasound is used for the diagnosis and differential diagnosis of pulmonary diseases, and to guide the application of mechanical ventilation. Because the abdominal circumference of the patient’s markedly enlarged abdominal circumference, bloody stool, and absence of bowel sounds, abdominal ultrasonography was performed, which revealed a markedly enlarged liver, significant peritoneal effusion, and necrotizing enterocolitis. Guided by POC-CUS monitoring, we had the opportunity to implement timely and effective treatment that ultimately saved this critically ill patient’s life. The successful treatment of this newborn infant fully reflects the importance of carrying out POC-CUS screening. Full article

Irritable bowel syndrome (IBS) has a global prevalence of around 4.1% and is associated with a low quality of life and increased healthcare costs. Current guidelines recommend that IBS is diagnosed using the symptom-based Rome IV criteria. Despite this, when patients seek medical attention, they are usually over-investigated. This issue might be resolved by novel technologies in medicine, such as the use of Artificial Intelligence (AI). In this context, this paper aims to review AI applications in IBS. AI in colonoscopy proved to be useful in organic lesion detection and diagnosis and in objectively assessing the quality of the procedure. Only a recently published study talked about the potential of AI-colonoscopy in IBS. AI was also used to study biofilm characteristics in the large bowel and establish a potential relationship with IBS. Moreover, an AI algorithm was developed in order to correlate specific bowel sounds with IBS. In addition to that, AI-based smartphone applications have been developed to facilitate the monitoring of IBS symptoms. From a therapeutic standpoint, an AI system was created to recommend specific diets based on an individual’s microbiota. In conclusion, future IBS diagnosis and treatment may benefit from AI. Full article

Stethoscopes were originally designed for the auscultation of a patient’s chest for the purpose of listening to lung and heart sounds. These aid medical professionals in their evaluation of the cardiovascular and respiratory systems, as well as in other applications, such as listening to bowel sounds in the gastrointestinal system or assessing for vascular bruits. Listening to internal sounds during chest auscultation aids healthcare professionals in their diagnosis of a patient’s illness. We performed an extensive literature review on the currently available stethoscopes specifically for use in chest auscultation. By understanding the specificities of the different stethoscopes available, healthcare professionals can capitalize on their beneficial features, to serve both clinical and educational purposes. Additionally, the ongoing COVID-19 pandemic has also highlighted the unique application of digital stethoscopes for telemedicine. Thus, the advantages and limitations of digital stethoscopes are reviewed. Lastly, to determine the best available stethoscopes in the healthcare industry, this literature review explored various benchmarking methods that can be used to identify areas of improvement for existing stethoscopes, as well as to serve as a standard for the general comparison of stethoscope quality. The potential use of digital stethoscopes for telemedicine amidst ongoing technological advancements in wearable sensors and modern communication facilities such as 5G are also discussed. Based on the ongoing trend in advancements in wearable technology, telemedicine, and smart hospitals, understanding the benefits and limitations of the digital stethoscope is an essential consideration for potential equipment deployment, especially during the height of the current COVID-19 pandemic and, more importantly, for future healthcare crises when human and resource mobility is restricted. Full article

Objective: To explore the surgical risk variables in patients with necrotizing enterocolitis (NEC) and develop a nomogram model for predicting the surgical intervention timing of NEC. Methods: Infants diagnosed with NEC were enrolled in our study. We gathered information from clinical data, laboratory examinations, and radiological manifestations. Using LASSO (least absolute shrinkage and selection operator) regression analysis and multivariate logistic regression analysis, a clinical prediction model based on the logistic nomogram was developed. The performance of the nomogram model was evaluated using the receiver operating characteristic (ROC) curve, calibration curves, and decision curve analysis (DCA). Results: A surgical intervention risk nomogram based on hypothermia, absent bowel sounds, WBC > 20 × 10⁹/L or < 5 × 10⁹/L, CRP > 50 mg/L, pneumatosis intestinalis, and ascites was practical, had a moderate predictive value (AUC > 0.8), improved calibration, and enhanced clinical benefit. Conclusions: This simple and reliable clinical prediction nomogram model can help physicians evaluate children with NEC in a fast and effective manner, enabling the early identification and diagnosis of children at risk for surgery. It offers clinical revolutionary value for the development of medical or surgical treatment plans for children with NEC. Full article

Production of bowel sounds, established in the 1900s, has limited application in existing patient-care regimes and diagnostic modalities. We review the physiology of bowel sound production, the developments in recording technologies and the clinical application in various scenarios, to understand the potential of a bowel sound recording and analysis device—the phonoenterogram in future gastroenterological practice. Bowel sound production depends on but is not entirely limited to the type of food consumed, amount of air ingested and the type of intestinal contractions. Recording technologies for extraction and analysis of these include the wavelet-based filtering, autoregressive moving average model, multivariate empirical mode decompression, radial basis function network, two-dimensional positional mapping, neural network model and acoustic biosensor technique. Prior studies evaluate the application of bowel sounds in conditions such as intestinal obstruction, acute appendicitis, large bowel disorders such as inflammatory bowel disease and bowel polyps, ascites, post-operative ileus, sepsis, irritable bowel syndrome, diabetes mellitus, neurodegenerative disorders such as Parkinson’s disease and neonatal conditions such as hypertrophic pyloric stenosis. Recording and analysis of bowel sounds using artificial intelligence is crucial for creating an accessible, inexpensive and safe device with a broad range of clinical applications. Microwave-based digital phonoenterography has huge potential for impacting GI practice and patient care. Full article

Many patients worldwide suffer from constipation, which reduces their quality of life (QOL) over the long term. Carbonated water intake is expected to improve constipation by improving intestinal motility. Conversely, carbonated water intake is believed to alter bowel status via the intestinal contents (gas and liquid) and intestinal distension, and these changes may be reflected in bowel sound (BS) peak-frequency histograms. In this study, to identify changes in intestinal conditions before and after the ingestion of liquid (i.e., water/carbonated water intake), we used a novel evaluation index, namely peak-frequency histogram similarity (PFHS), which measures the changes in the peak-frequency histogram before and after liquid intake. We considered 13 subjects who participated in a liquid intake test, and PFHS values before and after carbonated water intake were found to be significantly lower than those before and after cold water intake (p < 0.01). However, when using conventional frequency-domain features, this difference was not identified. The results obtained in this study suggest that PFHS can identify changes in bowel status (including intestinal gas and distension) that could not be found using conventional BS frequency domain features. Our findings provide a novel method of research for investigators to non-invasively monitor and evaluate intestinal conditions such as the intestinal gas volume and intestinal distention, which are associated with constipation, using a BS-based approach. Full article

Bowel sound (BS) is receiving more attention as an indicator of gut health since it can be acquired non-invasively. Current gut health diagnostic tests require special devices that are limited to hospital settings. This study aimed to develop a prototype smartphone application that can record BS using built-in microphones and automatically analyze the sounds. Using smartphones, we collected BSs from 100 participants (age 37.6 ± 9.7). During screening and annotation, we obtained 5929 BS segments. Based on the annotated recordings, we developed and compared two BS recognition models: CNN and LSTM. Our CNN model could detect BSs with an accuracy of 88.9% andan F measure of 72.3% using cross evaluation, thus displaying better performance than the LSTM model (82.4% accuracy and 65.8% F measure using cross validation). Furthermore, the BS to sound interval, which indicates a bowel motility, predicted by the CNN model correlated to over 98% with manual labels. Using built-in smartphone microphones, we constructed a CNN model that can recognize BSs with moderate accuracy, thus providing a putative non-invasive tool for conveniently determining gut health and demonstrating the potential of automated BS research. Full article

Bowel sounds contain some important human physiological parameters which can reflect information about intestinal function. In this work, in order to realize real-time monitoring of bowel sounds, a portable and wearable bowel sound electronic monitor based on piezoelectric micromachined ultrasonic transducers (PMUTs) is proposed. This prototype consists of a sensing module to collect bowel sounds and a GUI (graphical user interface) based on LabVIEW to display real-time bowel sound signals. The sensing module is composed of four PMUTs connected in parallel and a signal conditioning circuit. The sensitivity, noise resolution, and non-linearity of the bowel sound monitor are measured in this work. The result indicates that the designed prototype has high sensitivity (−142.69 dB), high noise resolution (50 dB at 100 Hz), and small non-linearity. To demonstrate the characteristic of the designed electronic monitor, continuous bowel sound monitoring is performed using the electronic monitor and a stethoscope on a healthy human before and after a meal. Through comparing the experimental results and analyzing the signals in the time domain and frequency domain, this bowel sound monitor is demonstrated to record bowel sounds from the human intestine. This work displays the potential of the sensor for the daily monitoring of bowel sounds. Full article