Duowu Zou - Academia.edu (original) (raw)
Papers by Duowu Zou
Zhonghua Nei Ke Za Zhi Chinese Journal of Internal Medicine, May 1, 2004
To investigate the role of duodenogastroesophageal reflux (DGER) in the pathogenesis of gastroeso... more To investigate the role of duodenogastroesophageal reflux (DGER) in the pathogenesis of gastroesophageal reflux disease (GERD) and its value for the diagnosis of non-erosive reflux disease (NERD). 95 cases of GERD were divided into two groups according to endoscopic findings: reflux esophagitis (RE) (n = 51) and NERD (n = 44). Simultaneous 24-hour esophageal pH and bilirubin monitoring were performed. The index values of DGER in RE group such as percent of time with Abs > 0.14, total reflux time and time with reflux > 5 min were 19.05 +/- 23.44, 30.56 +/- 34.04 and 5.90 +/- 6.37 respectively, they were significantly higher than those of NERD, 7.26 +/- 11.08, 15.68 +/- 20.92 and 2.59 +/- 3.57, respectively (P < 0.05), but no significant difference was found in acid reflux. The occurrence of DGER was more common in more severe esophagitis. Isolated DGER were found in 18.2% of NERD, and combined bilirubin monitoring could elevate the positive diagnosis rate of NERD from 65.9% to 84.1%. DGER could be present isolatedly and played an obvious role in the genesis of RE and GERD symptoms. Simultaneous 24-hour esophageal pH and bilirubin monitoring were helpful for the diagnosis of NERD.
Gastroenterology, 2009
Background: Gastroesophageal reflux disease imposes a significant burden of illness in Western po... more Background: Gastroesophageal reflux disease imposes a significant burden of illness in Western populations. However, data on the impact of reflux symptoms on daily life in Asian populations are scarce. The current study aimed to evaluate the impact of GERD (defined on the basis of symptoms) on health-related quality-of-life (HRQoL) in individuals from five regions in China, as part of the Systematic Investigation of Gastrointestinal Diseases in China (SILC) study. Methods: In total, 18 000 residents were randomly selected from across five regions of China and asked to complete a general information questionnaire and a Chinese version of the Reflux Disease Questionnaire (RDQ). A randomly selected subsample of one-fifth of subjects (20% from each region) completed Chinese versions of the 36-item self-administered (SF-36) questionnaire and Epworth Sleepiness Scale (ESS) questionnaire. Reflux symptoms were defined as the presence of heartburn and/or regurgitation. Symptom-defined GERD was diagnosed as mild heartburn and/or regurgitation ≥2 days per week, or moderate/severe heartburn and/or regurgitation ≥1 day a week, based on the Montreal Definition of GERD for population-based studies.
Zhonghua Nei Ke Za Zhi Chinese Journal of Internal Medicine, Sep 1, 2003
To investigate the changes of the mast cells (MCs) and substance P (SP), and to elucidate their p... more To investigate the changes of the mast cells (MCs) and substance P (SP), and to elucidate their possible roles in visceral hypersensitivity in patients with irritable bowel syndrome (IBS). In 22 diarrhea-predominant IBS, 20 constipation-predominant IBS and 19 controls, the biopsies were carried out from the terminal ileum, the ileocecal junction, the ascending colon, and the sigmoid colon. The MCs and the SP-ergic nerve terminals, SP receptor (SPR) cells were stained by histochemistry and immunohistochemistry respectively, and the results were investigated qualitatively and quantitatively by color image analyzer. The biopsies of the ICJ and the sigmoid colon were measured by radioimmunoassay. The structure relation between the MCs and SP-ergic terminals, SPR-ergic cells were studied through an ultramicroscopy using in situ embedding technique and a light microscopic study in serial sections respectively. The number of MCs in the terminal ileum, the ileocecal junction, and the ascending colon were significantly elevated in IBS patients (P < 0.01), and the MCs in IBS have great variations. Significantly increased the SP-ergic nerve terminals were found in patients with IBS of intestine compared with the control. The correlation between mucosal MC and the SP-ergic nerve terminals was found, and MCs were close to these terminals in lamina propria, which were demonstrated SP-ergic nerve terminals. Some MCs were demonstrated to be SPR-positive cells. The MCs and SP of intestinal mucosa may play a central role in the gut hypersensitivity in both motor response and visceral perception in IBS.
2011 International Conference on Internet Technology and Applications, 2011
... In Proceedings of the Sixth International Web Conference, Santa Clara, California 1997 [5] Hu... more ... In Proceedings of the Sixth International Web Conference, Santa Clara, California 1997 [5] Huang Lian'en, “On the Technologies for Building and Accessing a Web Archive”, PhD thesis, Peking University, 2008(Ch) [6] Schleimer.S, DSWilkerson, and A ... [13] C.Basile,G.Cristadoro ...
The American Journal of Gastroenterology, 2008
The American journal of gastroenterology, 2010
Complications of peptic ulcer disease (PUD) are common in China. Population-based estimates of th... more Complications of peptic ulcer disease (PUD) are common in China. Population-based estimates of the prevalence of PUD are needed to quantify and characterize the population at risk of these complications. As part of a large epidemiological study, 3,600 randomly selected residents of Shanghai (aged 18-80 years) were asked to undergo endoscopy and to provide blood samples for Helicobacter pylori serology. All participants also completed a general information questionnaire and Chinese versions of the reflux disease questionnaire (RDQ) and Rome II questionnaire. Associations between PUD and other factors were analyzed using a multiple logistic regression model. In total, 3,153 individuals (87.6%) completed the survey. All underwent blood tests, and 1,030 patients (32.7%) agreed to undergo endoscopy. Results from 1,022 patients were suitable for analysis. In all, 176 participants (17.2%) had PUD (62 with gastric ulcer; 136 with duodenal ulcer). The prevalence of H. pylori infection was 73...
Case reports in gastroenterology, 2010
The diagnosis of neuroendocrine malignant tumor in the small bowel is difficult [J Oncol 2008;200... more The diagnosis of neuroendocrine malignant tumor in the small bowel is difficult [J Oncol 2008;2008:212067]. It is usually found intraoperatively during intestinal resection and confirmed by subsequent histological examination. We reported a case of jejunum neoplasm which was misdiagnosed as Crohn's disease by capsule endoscopy. Capsule endoscopy was stuck in the jejunum stricture and was removed with a snare under double-balloon enteroscopy. The pathology of the biopsy was jejunum small cell malignant carcinoma tending to neuroendocrine malignant tumor. The immunohistochemical result revealed that CD99 and Ki-67 were positive. The patient underwent intestinal resection and the diagnosis of neuroendocrine malignant tumor was confirmed.
Gastroenterology research and practice, 2014
Aims. We attempted to establish some guidelines for the selection of transmural stents during end... more Aims. We attempted to establish some guidelines for the selection of transmural stents during endoscopic drainage of PFCs by retrospective review of the clinical data obtained from three tertiary hospitals. Patients and Methods. Clinical data of 93 patients with attempted endoscopic drainage of symptomatic PFCs were obtained through chart review and prospective follow-up. Results. Treatment success for acute pseudocyst (n = 67), chronic pseudocyst (n = 9), and WOPN (n = 17) was 95.3%, 100%, and 88.2%, respectively (P = 0.309). Clinical success for single-stent drainage was 93.9% (46/49) versus 97.4% (37/38) for multiple-stent drainage (P = 0.799). Secondary infection for single-stent drainage was 18.4% (9/49) versus 5.3% (2/38) for multiple-stent drainage (P = 0.134). Secondary infection for stent diameter less than or equal to 8.5 F was 3.4% (1/29) versus 17.2% (10/58) for stent diameter larger than or equal to 10 F (P = 0.138). Conclusion. EUS-guided transmural drainage is an effe...
Journal of digestive diseases, Jan 15, 2014
To evaluate the efficacy of prucalopride (2 mg/day), a novel selective high-affinity 5-hydroxytry... more To evaluate the efficacy of prucalopride (2 mg/day), a novel selective high-affinity 5-hydroxytryptamine type-4 receptor agonist, in relieving chronic constipation-associated symptoms in Asians and non-Asians. This integrated analysis included pooled data from 4 phase-III, multicenter, randomized, double-blind, placebo-controlled studies (NCT00488137, NCT00483886, NCT00485940, NCT01116206) of patients treated with prucalopride 2 mg and placebo. Efficacy in relieving chronic constipation-associated symptoms was evaluated based on improvements in the 'Patient Assessment of Constipation Symptoms' scores. Change from baseline in each symptom score was analyzed using an analysis of covariance model, with treatment, study, and baseline spontaneous bowel movement frequency as factors, and baseline value for each symptom score as covariates for each subgroup of interest: Asian and non-Asian. Overall, 1782 patients (26.7% Asians; 73.3% non-Asians), predominantly women (89.3%), were i...
Gut and Liver, 2014
This is an Open Access article distributed under the terms of the Creative Commons Attribution No... more This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Journal of Neurogastroenterology and Motility, 2014
Journal of interventional gastroenterology, 2013
Iodine 125 radioactive seeds implanted by endoscopic ultrasonography (EUS) represent a novel stra... more Iodine 125 radioactive seeds implanted by endoscopic ultrasonography (EUS) represent a novel strategy for the treatment of pancreatic cancer. However, its long-term effects still remain unknown. The aim was to provide reliable data of long-term effects. Moreover, whether chemotherapy affects the result of EUS-guided implantation was also determined. The present study prospectively observed 100 cases of unresectable pancreatic cancer underwent EUS-guided interstitial implantation of 125(I) radioactive seeds. Mean age was 60.9 years and 75% patients were staged III or IV. Eighty-five patients received routine gemcitabine-based chemotherapy one week after brachytherapy. The overall survival (OS) and progress-free survival (PFS) rates were evaluated for long-term effects. The mean follow-up time was 7.80±6.10 months (0.3-36 months), and the estimated median PFS and OS were 4.5 months (95% CI 3.1-5.9) and 7.0 months (95% CI 5.3-8.8), respectively. The estimated one-year and two-year surv...
European journal of gastroenterology & hepatology, 2014
Endoscopic placement of a iodine-125 radioactive stent is useful to treat obstructive jaundice wi... more Endoscopic placement of a iodine-125 radioactive stent is useful to treat obstructive jaundice with unresectable periampullary tumors. This study aimed to retrospectively evaluate the obstructive component of biliary radioactive stents and discuss the different obstructive mechanism with common plastic stents. Twenty consecutive patients with malignant obstruction underwent insertion of stents into the common bile duct, including 10 radioactive stents and 10 polyethylene stents. The radioactive stents were withdrawn after ∼3 months or earlier if clinical signs suggested stent clogging. Polyethylene stents were withdrawn after physical signs suggested stent clogging. Bacteriologic analyses included identification of aerobic and anaerobic bacteria. Stent surfaces were observed by scanning electron microscopy. Stent deposition was identified by Fourier-transformed infrared spectroscopy and pyrolysis derivatization/gas chromatography/mass spectrometry. Radioactive stent group and polyet...
Digestive diseases and sciences, Jan 20, 2015
Population-based endoscopic studies of esophageal eosinophilia and eosinophilic esophagitis are l... more Population-based endoscopic studies of esophageal eosinophilia and eosinophilic esophagitis are limited in the world. This study was aiming to describe features of esophageal eosinophilia and eosinophilic esophagitis in a representative sample of the adult in Shanghai, China. As part of a large epidemiological study, 3,600 individuals (aged 18-80 years) were randomly selected in Shanghai, China. They were asked to undergo endoscopy and have at least four esophageal biopsies taken from 0.5 cm above the Z-line and any abnormal areas. Any eosinophil infiltration of the epithelium was defined as esophageal eosinophilia. Eosinophilic esophagitis was defined as ≥15 eosinophils/high-power field in esophageal biopsies. A total of 1,030 individuals accepted to have endoscopy and 1,021 individuals with biopsy results were suitable for analysis. Esophageal eosinophilia was present in 67 subjects (6.6 %). Eosinophilic esophagitis was present in four cases (0.4 %). No significant association was...
Surgery, 2011
Background. Small intestinal motility is impaired in acute necrotizing pancreatitis (ANP). The pr... more Background. Small intestinal motility is impaired in acute necrotizing pancreatitis (ANP). The present study was designed to detect the impairment in small intestinal motility and to assess the role of interstitial cells of Cajal (ICC), myenteric neurons and the associated mechanism in the pathogenesis of ileus during experimentally induced acute pancreatitis. Methods. ANP was induced by intraperitoneal injections of 30% L-ornithine at a dose of 3 g/kg at hourly intervals. The alterations of small intestine electrical activity---migrating myoelectric complexes (MMCs), and slow waves---were measured 24 hr after ANP induction. The spontaneous mechanical activity and the contractile response to ACh, KCl, tetrodotoxin (TTX) and the nitric oxide synthase (NOS) inhibitor NG-nitro-L-arginine (L-NNA) were evaluated by organ bath technique, and the morphologic alterations of the network of ICC, myenteric neurons and neuronal nitric oxide synthase (nNOS) immunoreactive cells were evaluated using the markers of c-Kit, PGP9.5, and nNOS, respectively. To demonstrate the deficiencies in enteric neuronal origin, we also measured nNOS expression in the muscular layer of ileum. Results. L-ornithine--induced necrotizing pancreatitis manifests with multiple symptoms, including decreased amplitude of spontaneous contractions in small intestinal smooth muscle, declined contractile response to ACh, TTX, and L-NNA in vitro, disrupted MMC cycle length, decreased dominant frequency and dominant power of slow waves in vivo. Furthermore, the morphologic studies demonstrated the damage of ICC (ANP group versus control; P = .000), myenteric neurons (ANP group versus control; P = .001) and nNOS immunoreactive neurons (ANP group versus control; P = .000). We also observed a substantial loss in the expression of nNOS protein in muscular layer of the small intestine (ANP group versus control; P = .032). Conclusion. Our results suggest that the pathogenesis of the small intestinal paralysis in ANP may be related to the deficiencies in ICC and nNOS neurons. (Surgery
Scandinavian Journal of Gastroenterology, 2011
Gastroesophageal reflux disease (GERD) is thought to be less prevalent in China than in Western c... more Gastroesophageal reflux disease (GERD) is thought to be less prevalent in China than in Western countries. However, essential population-based endoscopy data are lacking for this country. As part of a wider study, 3600 individuals selected randomly from the Shanghai region were asked to undergo endoscopy. Participants completed a general information questionnaire and a Chinese version of the Reflux Disease Questionnaire. When sufficient numbers were available, associations were assessed using multiple logistic regression or the Wilcoxon rank-sum test. Of 3153 (87.6%) individuals who completed the survey, 1030 (32.7%) agreed to endoscopy and 1029 endoscopies were suitable for analysis. Symptom-defined GERD was more prevalent in the endoscopy group (4.7%) than in the non-endoscopy group (1.7%). Prevalence estimates were 6.4% for reflux esophagitis, 1.8% for endoscopically suspected esophageal metaplasia and 0.7% for hiatus hernia. Reflux esophagitis was more prevalent in patients with symptom-defined GERD than in those without (12.5% [6/48] vs. 6.1% [60/981]), and was significantly associated with reflux symptoms of any frequency or severity (OR = 2.10, 95% CI 1.13-3.89) and with negative Helicobacter pylori infection (OR = 0.44, 95% CI 0.25-0.80). Only 28.8% of participants with reflux esophagitis had heartburn and/or regurgitation symptoms. Epigastric burning was significantly more severe and frequent in participants with reflux esophagitis than in those without (p = 0.05). Reflux esophagitis is less prevalent in China than reported in Western countries. Further work is needed to establish why reflux esophagitis appears less symptomatic in China than in Western countries.
PLoS ONE, 2012
Amelioration of intestinal dysmotility and stasis during the early period of acute necrotizing pa... more Amelioration of intestinal dysmotility and stasis during the early period of acute necrotizing pancreatitis (ANP) appears to be important to reduce the risks of secondary pancreatic infection. We aimed to characterize the association between the neuropathy of the enteric nervous system and gut dysfunction and to examine the effect of octreotide on motor innervation in the early stage of ANP. The rats were randomly divided into eight groups: control+saline; control+octreotide; ANP+saline and ANP+octreotide (24 h, 48 h, 72 h). The spontaneous activity of ileal segments and the response to ACh, l-NNA were recorded. The alterations of myenteric neuronal nitric oxide synthase (nNOS), choline acetyltransferase (CHAT), PGP9.5 and somatostatin receptor 2 (SSTR(2)) immunoreactive cells were evaluated by immunofluorescence and the protein expression of nNOS and CHAT were evaluated by western blot. We found the amplitude of spontaneous contractions at 48 h and the response to ACh at 24 h declined in the ANP+saline rats. A higher contractile response to both ACh and to l-NNA was observed in the ANP+octreotide group, compared with the ANP+saline rats at 24 h. A significant reduction in the nNOS and cholinergic neurons was observed in ANP+saline rats at the three time points. However, this reduction was greatly ameliorated in the presence of octreotide at 24 h and 48 h. The protein expression of CHAT neurons at 24 h and the nNOS neurons at 48 h in the ANP+octreotide rats was much higher than the ANP+saline rats. The pathogenesis of ileus in the early stage of ANP may be related to the neuropathy of the enteric nervous system. Octreotide may reduce the severity of ileus by lessening the damage to enteric motor innervation.
Pancreatology, 2008
Data regarding the use of corticosteroids for the prevention of post-endoscopic retrograde cholan... more Data regarding the use of corticosteroids for the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis are conflicting. The aim of this meta-analysis was to compare corticosteroids with placebo for prevention of post-ERCP pancreatitis. Multiple databases including MEDLINE, EMBASE, Cochrane controlled trials register, the Cochrane Library, Science Citation Index, Google Scholar and Google updated to June 2007 were searched to retrieve the relevant randomized controlled trials. Primary outcome measure was post-ERCP pancreatitis. Six randomized controlled trials involving 2,448 patients were identified. The analysis showed that corticosteroids did not prevent post-ERCP pancreatitis (OR 1.13: 95% CI [0.88, 1.46]). Subsequent sensitivity and subgroup analyses according to different criteria all confirmed these results. Based on available evidence, prophylactic corticosteroids do not reduce the incidence of post-ERCP pancreatitis.
Pancreas, 2011
Intestinal motility is impaired in acute necrotizing pancreatitis (ANP). The aim of present study... more Intestinal motility is impaired in acute necrotizing pancreatitis (ANP). The aim of present study was to investigate the effects of octreotide on the small intestinal motor function during experimentally induced ANP. L-Ornithine was intraperitoneally injected to induce ANP. Octreotide was administrated subcutaneously every 8 hours. The small intestine migrating myoelectrical complexes and slow waves in vivo were recorded before and after (24, 48, and 72 hours) ANP induction. The morphological alterations of interstitial cells of Cajal (ICCs) in deep muscular plexus were evaluated by immunohistochemistry and Western blots. Disturbed migrating myoelectrical complex cycle length and decreased dominant frequency of slow waves exacerbated gradually with time. The bolus applications of octreotide per 8 hours attenuated these functional abnormalities. The result of morphological study suggested that octreotide might ameliorate the damage of ICCs at 48 and 72 hours after ANP induction. Decreased expression of c-Kit protein at 72 hours was also attenuated by octreotide. The pathogenesis of the ileus in ANP may be related to the sustained deficiencies in ICCs. Octreotide may ameliorate the severity of ileus by minimizing the injury of ICCs.
Zhonghua Nei Ke Za Zhi Chinese Journal of Internal Medicine, May 1, 2004
To investigate the role of duodenogastroesophageal reflux (DGER) in the pathogenesis of gastroeso... more To investigate the role of duodenogastroesophageal reflux (DGER) in the pathogenesis of gastroesophageal reflux disease (GERD) and its value for the diagnosis of non-erosive reflux disease (NERD). 95 cases of GERD were divided into two groups according to endoscopic findings: reflux esophagitis (RE) (n = 51) and NERD (n = 44). Simultaneous 24-hour esophageal pH and bilirubin monitoring were performed. The index values of DGER in RE group such as percent of time with Abs > 0.14, total reflux time and time with reflux > 5 min were 19.05 +/- 23.44, 30.56 +/- 34.04 and 5.90 +/- 6.37 respectively, they were significantly higher than those of NERD, 7.26 +/- 11.08, 15.68 +/- 20.92 and 2.59 +/- 3.57, respectively (P < 0.05), but no significant difference was found in acid reflux. The occurrence of DGER was more common in more severe esophagitis. Isolated DGER were found in 18.2% of NERD, and combined bilirubin monitoring could elevate the positive diagnosis rate of NERD from 65.9% to 84.1%. DGER could be present isolatedly and played an obvious role in the genesis of RE and GERD symptoms. Simultaneous 24-hour esophageal pH and bilirubin monitoring were helpful for the diagnosis of NERD.
Gastroenterology, 2009
Background: Gastroesophageal reflux disease imposes a significant burden of illness in Western po... more Background: Gastroesophageal reflux disease imposes a significant burden of illness in Western populations. However, data on the impact of reflux symptoms on daily life in Asian populations are scarce. The current study aimed to evaluate the impact of GERD (defined on the basis of symptoms) on health-related quality-of-life (HRQoL) in individuals from five regions in China, as part of the Systematic Investigation of Gastrointestinal Diseases in China (SILC) study. Methods: In total, 18 000 residents were randomly selected from across five regions of China and asked to complete a general information questionnaire and a Chinese version of the Reflux Disease Questionnaire (RDQ). A randomly selected subsample of one-fifth of subjects (20% from each region) completed Chinese versions of the 36-item self-administered (SF-36) questionnaire and Epworth Sleepiness Scale (ESS) questionnaire. Reflux symptoms were defined as the presence of heartburn and/or regurgitation. Symptom-defined GERD was diagnosed as mild heartburn and/or regurgitation ≥2 days per week, or moderate/severe heartburn and/or regurgitation ≥1 day a week, based on the Montreal Definition of GERD for population-based studies.
Zhonghua Nei Ke Za Zhi Chinese Journal of Internal Medicine, Sep 1, 2003
To investigate the changes of the mast cells (MCs) and substance P (SP), and to elucidate their p... more To investigate the changes of the mast cells (MCs) and substance P (SP), and to elucidate their possible roles in visceral hypersensitivity in patients with irritable bowel syndrome (IBS). In 22 diarrhea-predominant IBS, 20 constipation-predominant IBS and 19 controls, the biopsies were carried out from the terminal ileum, the ileocecal junction, the ascending colon, and the sigmoid colon. The MCs and the SP-ergic nerve terminals, SP receptor (SPR) cells were stained by histochemistry and immunohistochemistry respectively, and the results were investigated qualitatively and quantitatively by color image analyzer. The biopsies of the ICJ and the sigmoid colon were measured by radioimmunoassay. The structure relation between the MCs and SP-ergic terminals, SPR-ergic cells were studied through an ultramicroscopy using in situ embedding technique and a light microscopic study in serial sections respectively. The number of MCs in the terminal ileum, the ileocecal junction, and the ascending colon were significantly elevated in IBS patients (P < 0.01), and the MCs in IBS have great variations. Significantly increased the SP-ergic nerve terminals were found in patients with IBS of intestine compared with the control. The correlation between mucosal MC and the SP-ergic nerve terminals was found, and MCs were close to these terminals in lamina propria, which were demonstrated SP-ergic nerve terminals. Some MCs were demonstrated to be SPR-positive cells. The MCs and SP of intestinal mucosa may play a central role in the gut hypersensitivity in both motor response and visceral perception in IBS.
2011 International Conference on Internet Technology and Applications, 2011
... In Proceedings of the Sixth International Web Conference, Santa Clara, California 1997 [5] Hu... more ... In Proceedings of the Sixth International Web Conference, Santa Clara, California 1997 [5] Huang Lian'en, “On the Technologies for Building and Accessing a Web Archive”, PhD thesis, Peking University, 2008(Ch) [6] Schleimer.S, DSWilkerson, and A ... [13] C.Basile,G.Cristadoro ...
The American Journal of Gastroenterology, 2008
The American journal of gastroenterology, 2010
Complications of peptic ulcer disease (PUD) are common in China. Population-based estimates of th... more Complications of peptic ulcer disease (PUD) are common in China. Population-based estimates of the prevalence of PUD are needed to quantify and characterize the population at risk of these complications. As part of a large epidemiological study, 3,600 randomly selected residents of Shanghai (aged 18-80 years) were asked to undergo endoscopy and to provide blood samples for Helicobacter pylori serology. All participants also completed a general information questionnaire and Chinese versions of the reflux disease questionnaire (RDQ) and Rome II questionnaire. Associations between PUD and other factors were analyzed using a multiple logistic regression model. In total, 3,153 individuals (87.6%) completed the survey. All underwent blood tests, and 1,030 patients (32.7%) agreed to undergo endoscopy. Results from 1,022 patients were suitable for analysis. In all, 176 participants (17.2%) had PUD (62 with gastric ulcer; 136 with duodenal ulcer). The prevalence of H. pylori infection was 73...
Case reports in gastroenterology, 2010
The diagnosis of neuroendocrine malignant tumor in the small bowel is difficult [J Oncol 2008;200... more The diagnosis of neuroendocrine malignant tumor in the small bowel is difficult [J Oncol 2008;2008:212067]. It is usually found intraoperatively during intestinal resection and confirmed by subsequent histological examination. We reported a case of jejunum neoplasm which was misdiagnosed as Crohn's disease by capsule endoscopy. Capsule endoscopy was stuck in the jejunum stricture and was removed with a snare under double-balloon enteroscopy. The pathology of the biopsy was jejunum small cell malignant carcinoma tending to neuroendocrine malignant tumor. The immunohistochemical result revealed that CD99 and Ki-67 were positive. The patient underwent intestinal resection and the diagnosis of neuroendocrine malignant tumor was confirmed.
Gastroenterology research and practice, 2014
Aims. We attempted to establish some guidelines for the selection of transmural stents during end... more Aims. We attempted to establish some guidelines for the selection of transmural stents during endoscopic drainage of PFCs by retrospective review of the clinical data obtained from three tertiary hospitals. Patients and Methods. Clinical data of 93 patients with attempted endoscopic drainage of symptomatic PFCs were obtained through chart review and prospective follow-up. Results. Treatment success for acute pseudocyst (n = 67), chronic pseudocyst (n = 9), and WOPN (n = 17) was 95.3%, 100%, and 88.2%, respectively (P = 0.309). Clinical success for single-stent drainage was 93.9% (46/49) versus 97.4% (37/38) for multiple-stent drainage (P = 0.799). Secondary infection for single-stent drainage was 18.4% (9/49) versus 5.3% (2/38) for multiple-stent drainage (P = 0.134). Secondary infection for stent diameter less than or equal to 8.5 F was 3.4% (1/29) versus 17.2% (10/58) for stent diameter larger than or equal to 10 F (P = 0.138). Conclusion. EUS-guided transmural drainage is an effe...
Journal of digestive diseases, Jan 15, 2014
To evaluate the efficacy of prucalopride (2 mg/day), a novel selective high-affinity 5-hydroxytry... more To evaluate the efficacy of prucalopride (2 mg/day), a novel selective high-affinity 5-hydroxytryptamine type-4 receptor agonist, in relieving chronic constipation-associated symptoms in Asians and non-Asians. This integrated analysis included pooled data from 4 phase-III, multicenter, randomized, double-blind, placebo-controlled studies (NCT00488137, NCT00483886, NCT00485940, NCT01116206) of patients treated with prucalopride 2 mg and placebo. Efficacy in relieving chronic constipation-associated symptoms was evaluated based on improvements in the 'Patient Assessment of Constipation Symptoms' scores. Change from baseline in each symptom score was analyzed using an analysis of covariance model, with treatment, study, and baseline spontaneous bowel movement frequency as factors, and baseline value for each symptom score as covariates for each subgroup of interest: Asian and non-Asian. Overall, 1782 patients (26.7% Asians; 73.3% non-Asians), predominantly women (89.3%), were i...
Gut and Liver, 2014
This is an Open Access article distributed under the terms of the Creative Commons Attribution No... more This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Journal of Neurogastroenterology and Motility, 2014
Journal of interventional gastroenterology, 2013
Iodine 125 radioactive seeds implanted by endoscopic ultrasonography (EUS) represent a novel stra... more Iodine 125 radioactive seeds implanted by endoscopic ultrasonography (EUS) represent a novel strategy for the treatment of pancreatic cancer. However, its long-term effects still remain unknown. The aim was to provide reliable data of long-term effects. Moreover, whether chemotherapy affects the result of EUS-guided implantation was also determined. The present study prospectively observed 100 cases of unresectable pancreatic cancer underwent EUS-guided interstitial implantation of 125(I) radioactive seeds. Mean age was 60.9 years and 75% patients were staged III or IV. Eighty-five patients received routine gemcitabine-based chemotherapy one week after brachytherapy. The overall survival (OS) and progress-free survival (PFS) rates were evaluated for long-term effects. The mean follow-up time was 7.80±6.10 months (0.3-36 months), and the estimated median PFS and OS were 4.5 months (95% CI 3.1-5.9) and 7.0 months (95% CI 5.3-8.8), respectively. The estimated one-year and two-year surv...
European journal of gastroenterology & hepatology, 2014
Endoscopic placement of a iodine-125 radioactive stent is useful to treat obstructive jaundice wi... more Endoscopic placement of a iodine-125 radioactive stent is useful to treat obstructive jaundice with unresectable periampullary tumors. This study aimed to retrospectively evaluate the obstructive component of biliary radioactive stents and discuss the different obstructive mechanism with common plastic stents. Twenty consecutive patients with malignant obstruction underwent insertion of stents into the common bile duct, including 10 radioactive stents and 10 polyethylene stents. The radioactive stents were withdrawn after ∼3 months or earlier if clinical signs suggested stent clogging. Polyethylene stents were withdrawn after physical signs suggested stent clogging. Bacteriologic analyses included identification of aerobic and anaerobic bacteria. Stent surfaces were observed by scanning electron microscopy. Stent deposition was identified by Fourier-transformed infrared spectroscopy and pyrolysis derivatization/gas chromatography/mass spectrometry. Radioactive stent group and polyet...
Digestive diseases and sciences, Jan 20, 2015
Population-based endoscopic studies of esophageal eosinophilia and eosinophilic esophagitis are l... more Population-based endoscopic studies of esophageal eosinophilia and eosinophilic esophagitis are limited in the world. This study was aiming to describe features of esophageal eosinophilia and eosinophilic esophagitis in a representative sample of the adult in Shanghai, China. As part of a large epidemiological study, 3,600 individuals (aged 18-80 years) were randomly selected in Shanghai, China. They were asked to undergo endoscopy and have at least four esophageal biopsies taken from 0.5 cm above the Z-line and any abnormal areas. Any eosinophil infiltration of the epithelium was defined as esophageal eosinophilia. Eosinophilic esophagitis was defined as ≥15 eosinophils/high-power field in esophageal biopsies. A total of 1,030 individuals accepted to have endoscopy and 1,021 individuals with biopsy results were suitable for analysis. Esophageal eosinophilia was present in 67 subjects (6.6 %). Eosinophilic esophagitis was present in four cases (0.4 %). No significant association was...
Surgery, 2011
Background. Small intestinal motility is impaired in acute necrotizing pancreatitis (ANP). The pr... more Background. Small intestinal motility is impaired in acute necrotizing pancreatitis (ANP). The present study was designed to detect the impairment in small intestinal motility and to assess the role of interstitial cells of Cajal (ICC), myenteric neurons and the associated mechanism in the pathogenesis of ileus during experimentally induced acute pancreatitis. Methods. ANP was induced by intraperitoneal injections of 30% L-ornithine at a dose of 3 g/kg at hourly intervals. The alterations of small intestine electrical activity---migrating myoelectric complexes (MMCs), and slow waves---were measured 24 hr after ANP induction. The spontaneous mechanical activity and the contractile response to ACh, KCl, tetrodotoxin (TTX) and the nitric oxide synthase (NOS) inhibitor NG-nitro-L-arginine (L-NNA) were evaluated by organ bath technique, and the morphologic alterations of the network of ICC, myenteric neurons and neuronal nitric oxide synthase (nNOS) immunoreactive cells were evaluated using the markers of c-Kit, PGP9.5, and nNOS, respectively. To demonstrate the deficiencies in enteric neuronal origin, we also measured nNOS expression in the muscular layer of ileum. Results. L-ornithine--induced necrotizing pancreatitis manifests with multiple symptoms, including decreased amplitude of spontaneous contractions in small intestinal smooth muscle, declined contractile response to ACh, TTX, and L-NNA in vitro, disrupted MMC cycle length, decreased dominant frequency and dominant power of slow waves in vivo. Furthermore, the morphologic studies demonstrated the damage of ICC (ANP group versus control; P = .000), myenteric neurons (ANP group versus control; P = .001) and nNOS immunoreactive neurons (ANP group versus control; P = .000). We also observed a substantial loss in the expression of nNOS protein in muscular layer of the small intestine (ANP group versus control; P = .032). Conclusion. Our results suggest that the pathogenesis of the small intestinal paralysis in ANP may be related to the deficiencies in ICC and nNOS neurons. (Surgery
Scandinavian Journal of Gastroenterology, 2011
Gastroesophageal reflux disease (GERD) is thought to be less prevalent in China than in Western c... more Gastroesophageal reflux disease (GERD) is thought to be less prevalent in China than in Western countries. However, essential population-based endoscopy data are lacking for this country. As part of a wider study, 3600 individuals selected randomly from the Shanghai region were asked to undergo endoscopy. Participants completed a general information questionnaire and a Chinese version of the Reflux Disease Questionnaire. When sufficient numbers were available, associations were assessed using multiple logistic regression or the Wilcoxon rank-sum test. Of 3153 (87.6%) individuals who completed the survey, 1030 (32.7%) agreed to endoscopy and 1029 endoscopies were suitable for analysis. Symptom-defined GERD was more prevalent in the endoscopy group (4.7%) than in the non-endoscopy group (1.7%). Prevalence estimates were 6.4% for reflux esophagitis, 1.8% for endoscopically suspected esophageal metaplasia and 0.7% for hiatus hernia. Reflux esophagitis was more prevalent in patients with symptom-defined GERD than in those without (12.5% [6/48] vs. 6.1% [60/981]), and was significantly associated with reflux symptoms of any frequency or severity (OR = 2.10, 95% CI 1.13-3.89) and with negative Helicobacter pylori infection (OR = 0.44, 95% CI 0.25-0.80). Only 28.8% of participants with reflux esophagitis had heartburn and/or regurgitation symptoms. Epigastric burning was significantly more severe and frequent in participants with reflux esophagitis than in those without (p = 0.05). Reflux esophagitis is less prevalent in China than reported in Western countries. Further work is needed to establish why reflux esophagitis appears less symptomatic in China than in Western countries.
PLoS ONE, 2012
Amelioration of intestinal dysmotility and stasis during the early period of acute necrotizing pa... more Amelioration of intestinal dysmotility and stasis during the early period of acute necrotizing pancreatitis (ANP) appears to be important to reduce the risks of secondary pancreatic infection. We aimed to characterize the association between the neuropathy of the enteric nervous system and gut dysfunction and to examine the effect of octreotide on motor innervation in the early stage of ANP. The rats were randomly divided into eight groups: control+saline; control+octreotide; ANP+saline and ANP+octreotide (24 h, 48 h, 72 h). The spontaneous activity of ileal segments and the response to ACh, l-NNA were recorded. The alterations of myenteric neuronal nitric oxide synthase (nNOS), choline acetyltransferase (CHAT), PGP9.5 and somatostatin receptor 2 (SSTR(2)) immunoreactive cells were evaluated by immunofluorescence and the protein expression of nNOS and CHAT were evaluated by western blot. We found the amplitude of spontaneous contractions at 48 h and the response to ACh at 24 h declined in the ANP+saline rats. A higher contractile response to both ACh and to l-NNA was observed in the ANP+octreotide group, compared with the ANP+saline rats at 24 h. A significant reduction in the nNOS and cholinergic neurons was observed in ANP+saline rats at the three time points. However, this reduction was greatly ameliorated in the presence of octreotide at 24 h and 48 h. The protein expression of CHAT neurons at 24 h and the nNOS neurons at 48 h in the ANP+octreotide rats was much higher than the ANP+saline rats. The pathogenesis of ileus in the early stage of ANP may be related to the neuropathy of the enteric nervous system. Octreotide may reduce the severity of ileus by lessening the damage to enteric motor innervation.
Pancreatology, 2008
Data regarding the use of corticosteroids for the prevention of post-endoscopic retrograde cholan... more Data regarding the use of corticosteroids for the prevention of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis are conflicting. The aim of this meta-analysis was to compare corticosteroids with placebo for prevention of post-ERCP pancreatitis. Multiple databases including MEDLINE, EMBASE, Cochrane controlled trials register, the Cochrane Library, Science Citation Index, Google Scholar and Google updated to June 2007 were searched to retrieve the relevant randomized controlled trials. Primary outcome measure was post-ERCP pancreatitis. Six randomized controlled trials involving 2,448 patients were identified. The analysis showed that corticosteroids did not prevent post-ERCP pancreatitis (OR 1.13: 95% CI [0.88, 1.46]). Subsequent sensitivity and subgroup analyses according to different criteria all confirmed these results. Based on available evidence, prophylactic corticosteroids do not reduce the incidence of post-ERCP pancreatitis.
Pancreas, 2011
Intestinal motility is impaired in acute necrotizing pancreatitis (ANP). The aim of present study... more Intestinal motility is impaired in acute necrotizing pancreatitis (ANP). The aim of present study was to investigate the effects of octreotide on the small intestinal motor function during experimentally induced ANP. L-Ornithine was intraperitoneally injected to induce ANP. Octreotide was administrated subcutaneously every 8 hours. The small intestine migrating myoelectrical complexes and slow waves in vivo were recorded before and after (24, 48, and 72 hours) ANP induction. The morphological alterations of interstitial cells of Cajal (ICCs) in deep muscular plexus were evaluated by immunohistochemistry and Western blots. Disturbed migrating myoelectrical complex cycle length and decreased dominant frequency of slow waves exacerbated gradually with time. The bolus applications of octreotide per 8 hours attenuated these functional abnormalities. The result of morphological study suggested that octreotide might ameliorate the damage of ICCs at 48 and 72 hours after ANP induction. Decreased expression of c-Kit protein at 72 hours was also attenuated by octreotide. The pathogenesis of the ileus in ANP may be related to the sustained deficiencies in ICCs. Octreotide may ameliorate the severity of ileus by minimizing the injury of ICCs.