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Rysbekov K, Abrakhmanova S, Satybaeva R, Starosvetova Y, Kushugulova A. Helicobacter pylori eradication therapy for children. Drug Metab Pers Ther 2024; 39:59-67. [PMID: 38997154 DOI: 10.1515/dmpt-2024-0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 06/17/2024] [Indexed: 07/14/2024]
Abstract
OBJECTIVES The research aims to investigate the effect of vitamin D supplementation on the efficacy of Helicobacter pylori eradication therapy and to find new drug combinations for the eradication of the bacterium. METHODS A total of 128 children participated in the research. They were distributed under the following criteria: group A were children who tested positive for H. pylori and were treated with the standard so-called triple therapy including vitamin D; group B were children who tested positive for H. pylori and received the standard triple therapy without including vitamin D in the treatment; and group C were children who tested negative for H. pylori. After endoscopic examination, additional venous blood samples were taken from the children to determine vitamin D levels. A controlled study was carried out 45 days after the initial treatment. RESULTS The overall success rate of eradication therapy was 84.1 %. In group A, the success rate of treatment was 93.5 %, contrary to group B, where the success rate was 75 %. Although there was a difference in the percentage of H. pylori eradication therapy in the main group compared to the control group, there was no significant difference in group B. The success rate of eradication is p=0.082. CONCLUSIONS Following the research results, the addition of vitamin D to the standard triple therapy regimen for H. pylori had no effect. It can therefore be concluded that vitamin D does not significantly increase the efficacy of eradication therapy.
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Affiliation(s)
- Kairat Rysbekov
- Department of Pediatric Diseases with Courses Cardio-Rheumatology and Gastroenterology, 217968 Astana Medical University , Astana, Kazakhstan
| | - Sagira Abrakhmanova
- Department of Pediatric Diseases with Courses Cardio-Rheumatology and Gastroenterology, 217968 Astana Medical University , Astana, Kazakhstan
| | - Rashida Satybaeva
- Department of Pediatric Diseases with Courses Cardio-Rheumatology and Gastroenterology, 217968 Astana Medical University , Astana, Kazakhstan
| | - Yekaterina Starosvetova
- Department of Pediatric Diseases with Courses Cardio-Rheumatology and Gastroenterology, 217968 Astana Medical University , Astana, Kazakhstan
| | - Almagul Kushugulova
- Laboratory of Human Microbiome and Longevity, National Laboratory Astana, Astana, Kazakhstan
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2
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Ma PF, Zhuo L, Yuan LP, Qi XH. Recent Advances in Vitamin D3 Intervention to Eradicate Helicobacter pylori Infection. J Multidiscip Healthc 2024; 17:825-832. [PMID: 38434485 PMCID: PMC10906669 DOI: 10.2147/jmdh.s454605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Accepted: 02/13/2024] [Indexed: 03/05/2024] Open
Abstract
Helicobacter pylori (HP) infections affect approximately one-third of children worldwide. In China, the incidence of HP infection in children ranges from approximately 30% to 60%. In addition to damaging the gastrointestinal tract mucosa, HP infection in children can negatively affect their growth and development, hematology, respiratory and hepatobiliary system, skin, nutritional metabolism, and autoimmune system. However, the rate of HP eradication also fell considerably from the previous rate due to the presence of drug-resistant HP strains and the limited types of antibiotics that can be used in young patients. Vitamin D3 (VitD3) is a steroid hormone that can reduce inflammation in the stomach mucosa induced by HP and can alleviate and eradicate HP through a variety of pathways and mechanisms, including immune regulation and the stimulation of antimicrobial peptide (AMP) secretion and Ca2+ influx, to reestablish lysosomal acidification; thus, these results provide new strategies and ideas for the eradication of drug-resistant HP strains.
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Affiliation(s)
- Peng-Fei Ma
- Department of Gastroenterology, Children’s Hospital of Fudan University at Anhui (Anhui Provincial Children’s Hospital), Hefei, Anhui, People’s Republic of China
| | - Lin Zhuo
- Department of Gastroenterology, Children’s Hospital of Fudan University at Anhui (Anhui Provincial Children’s Hospital), Hefei, Anhui, People’s Republic of China
| | - Li-Ping Yuan
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People’s Republic of China
| | - Xiao-Hui Qi
- Department of Pediatrics, Children’s Hospital of Fudan University at Anhui (Anhui Provincial Children’s Hospital), Hefei, Anhui, People’s Republic of China
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3
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Săsăran MO, Mărginean CO, Lupu A, Koller AM. Vitamin D and Its Association with H. pylori Prevalence and Eradication: A Comprehensive Review. Nutrients 2023; 15:3549. [PMID: 37630738 PMCID: PMC10459106 DOI: 10.3390/nu15163549] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/08/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Taking into account previous data that sustain a relationship between vitamin D deficiency and higher H. pylori infection positivity rates, this review aims to assess the influence of vitamin D deficiency and/or insufficiency upon the prevalence of H. pylori infection and its eradication success. Three major databases were searched for articles that analyzed a relationship between vitamin D status and H. pylori infection. The literature search retrieved a total of 37 reports, after the article selection process. Hypovitaminosis D emerged as a potential risk factor for H. pylori infection, given the higher prevalence of vitamin D deficiency and/or insufficiency among H. pylori-positive subjects. Furthermore, the same type of micronutrient deficiency has been directly linked to H. pylori eradication failure. An inverse linear relationship between vitamin D status and gastric cancer risk exists, but the additional involvement of H. pylori in this correlation is still in question. The potential benefit of oral supplements in enhancing the success of classical therapeutic regimens of H. pylori still requires future research. Future population-based studies from larger geographical areas are warranted to address this subject in more depth.
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Affiliation(s)
- Maria Oana Săsăran
- Department of Pediatrics 3, University of Medicine, Pharmacy, Sciences and Technology George Emil Palade from Târgu Mureș, Gheorghe Marinescu Street No. 38, 540136 Târgu Mureș, Romania;
| | - Cristina Oana Mărginean
- Department of Pediatrics 1, University of Medicine, Pharmacy, Sciences and Technology George Emil Palade from Târgu Mureș, Gheorghe Marinescu Street No. 38, 540136 Târgu Mureș, Romania
| | - Ancuta Lupu
- Department of Pediatrics, University of Medicine and Pharmacy Gr. T. Popa Iași, Universității Street No. 16, 700115 Iași, Romania;
| | - Ana Maria Koller
- Clinics of Pediatrics, Emergency County Clinical Hospital, Gheorghe Marinescu Street No. 50, 540136 Târgu Mureș, Romania;
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Kountouras J. Concentrating on the Long Topic of Empirical or Not Conventional Helicobacter pylori Eradication Regimens. Clin Gastroenterol Hepatol 2023; 21:2433-2434. [PMID: 36343844 DOI: 10.1016/j.cgh.2022.10.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Jannis Kountouras
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
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5
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Kountouras J. Considering the Long-Conflicting Topic of Empirical or Nonconventional Helicobacter pylori Eradication Regimens. Gut Liver 2023; 17:659-660. [PMID: 36916038 PMCID: PMC10352069 DOI: 10.5009/gnl220450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 12/28/2022] [Accepted: 01/12/2023] [Indexed: 03/16/2023] Open
Affiliation(s)
- Jannis Kountouras
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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6
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Ma PF, Dai Q, Chu J, Zhuo L, Chen Y, Cheng R, Wu C, Yuan LP. 25-hydroxyvitamin D levels in children of different ages and with varying degrees of Helicobacter pylori infection and immunological features. Front Pediatr 2023; 11:1157777. [PMID: 37138564 PMCID: PMC10149923 DOI: 10.3389/fped.2023.1157777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 03/30/2023] [Indexed: 05/05/2023] Open
Abstract
Background Helicobacter pylori (HP) is a major cause of upper digestive tract diseases. However, the relationship between HP infection and 25-hydroxyvitamin D [25(OH)D] levels in children has not been fully elucidated. This study investigated the levels of 25(OH)D in children of different ages and with varying degrees of HP infection and immunological features as well as the correlations between 25(OH)D levels in children infected with HP and their ages and degrees of infection. Materials and methods Ninety-four children who underwent upper digestive endoscopy were divided into an HP-positive group without peptic ulcers (Group A), an HP-positive group with peptic ulcers (Group B) and an HP-negative control group (Group C). The serum levels of 25(OH)D and immunoglobulin and the percentages of lymphocyte subsets were determined. HP colonization, the degree of inflammation, and the degree of activity were further evaluated by HE staining and immunohistochemical staining in gastric mucosal biopsy. Results The 25(OH)D level of the HP-positive groups (50.93 ± 16.51 nmol/L) was significantly lower than that of the HP-negative group (62.89 ± 19.18 nmol/L). The 25(OH)D level of Group B (47.79 ± 14.79 nmol/L) was lower than that of Group A (51.53 ± 17.05 nmol/L) and was significantly lower than that of Group C (62.89 ± 19.18 nmol/L). The 25(OH)D level decreased with increasing age, and there was a significant difference between Group C subjects who were ≤5 years old and those who were aged 6-9 years and ≥10 years. The 25(OH)D level was negatively correlated with HP colonization (r = -0.411, P < 0.01) and the degree of inflammation (r = -0.456, P < 0.01). The percentages of lymphocyte subsets and immunoglobulin levels among Groups A, B and C were not significantly different. Conclusions The 25(OH)D level was negatively correlated with HP colonization and the degree of inflammation. As the age of the children increased, the level of 25(OH)D decreased, and the susceptibility to HP infection increased.
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Affiliation(s)
- Peng-fei Ma
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Department of Gastroenterology, Children's Hospital of Fudan University at Anhui (Anhui Provincial Children's Hospital), Hefei, China
| | - Qun Dai
- Department of Pathology, The Third People's Hospital of Hefei, Anhui Medical University Hefei Third Clinical College, Hefei, China
| | - Jing Chu
- Department of Pathology, Children'sHospital of Fudan University at Anhui (Anhui Provincial Children's Hospital), Hefei, China
| | - Lin Zhuo
- Department of Gastroenterology, Children's Hospital of Fudan University at Anhui (Anhui Provincial Children's Hospital), Hefei, China
| | - Yi Chen
- Department of Gastroenterology, Children's Hospital of Fudan University at Anhui (Anhui Provincial Children's Hospital), Hefei, China
| | - Rong Cheng
- Department of Gastroenterology, Children's Hospital of Fudan University at Anhui (Anhui Provincial Children's Hospital), Hefei, China
| | - Cheng Wu
- Department of Gastroenterology, Children's Hospital of Fudan University at Anhui (Anhui Provincial Children's Hospital), Hefei, China
| | - Li-Ping Yuan
- Department of Pediatrics, The First Affiliated Hospital of Anhui Medical University, Hefei, China
- Correspondence: Li-Ping Yuan
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Mărginean CO, Meliț LE, Borka Balas R, Văsieșiu AM, Fleșeriu T. The Crosstalk between Vitamin D and Pediatric Digestive Disorders. Diagnostics (Basel) 2022; 12:diagnostics12102328. [PMID: 36292016 PMCID: PMC9600444 DOI: 10.3390/diagnostics12102328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/18/2022] [Accepted: 09/23/2022] [Indexed: 11/22/2022] Open
Abstract
Vitamin D is a cyclopentane polyhydrophenanthrene compound involved mainly in bone health and calcium metabolism but also autophagy, modulation of the gut microbiota, cell proliferation, immune functions and intestinal barrier integrity. The sources of vitamin D include sunlight, diet and vitamin D supplements. Vitamin D3, the most effective vitamin D isoform is produced in the human epidermis as a result of sunlight exposure. Vitamin D undergoes two hydroxylation reactions in the liver and kidney to reach its active form, 1,25-dihydroxyvitamin D. Recent studies highlighted a complex spectrum of roles regarding the wellbeing of the gastrointestinal tract. Based on its antimicrobial effect, it was recently indicated that vitamin D supplementation in addition to standard eradication therapy might enhance H. pylori eradication rates. Moreover, it was suggested that low levels of vitamin D might also be involved in the acquisition of H. pylori infection. In terms of celiac disease, the negative effects of vitamin D deficiency might begin even during intrauterine life in the setting of maternal deficiency. Moreover, vitamin D is strongly related to the integrity of the gut barrier, which represents the core of the pathophysiology of celiac disease onset, in addition to being correlated with the histological findings of disease severity. The relationship between vitamin D and cystic fibrosis is supported by the involvement of this micronutrient in preserving lung function by clearing airway inflammation and preventing pathogen airway colonization. Moreover, this micronutrient might exert anticatabolic effects in CF patients. Inflammatory bowel disease patients also experience major benefits if they have a sufficient level of circulating vitamin D, proving its involvement in both induction and remission in these patients. The findings regarding the relationship between vitamin D, food allergies, diarrhea and constipation remain controversial, but vitamin D levels should be monitored in these patients in order to avoid hypo- and hypervitaminosis. Further studies are required to fill the remaining gaps in term of the complex impact of vitamin D on gastrointestinal homeostasis.
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Affiliation(s)
- Cristina Oana Mărginean
- Department of Pediatrics I, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No 38, 540136 Târgu Mureș, Romania
| | - Lorena Elena Meliț
- Department of Pediatrics I, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No 38, 540136 Târgu Mureș, Romania
- Correspondence:
| | - Reka Borka Balas
- Department of Pediatrics I, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No 38, 540136 Târgu Mureș, Romania
| | - Anca Meda Văsieșiu
- Department of Infectious Disease, “George Emil Palade” University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, Gheorghe Marinescu Street No 38, 540136 Târgu Mureș, Romania
| | - Tudor Fleșeriu
- Department of Infectious Disease, County Clinical Hospital Târgu Mureș, Gheorghe Doja Street No 89, 540394 Târgu Mureș, Romania
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Kountouras J, Doulberis M, Polyzos SA, Kazakos E, Vardaka E, Tzitiridou-Chatzopoulou M, Chatzopoulos D, Liatsos C, Kyriakopoulos A, Papaefthymiou A. Emerging parameters relevant to the management of antimicrobial-resistant Helicobacter pylori infection. Intern Med J 2022; 52:1654-1655. [PMID: 36100561 DOI: 10.1111/imj.15872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 02/24/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Jannis Kountouras
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
| | - Michael Doulberis
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece.,Division of Gastroenterology and Hepatology, Medical University Department, Kantonsspital Aarau, Aarau, Switzerland.,First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
| | - Stergios A Polyzos
- First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
| | - Evangelos Kazakos
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
| | - Elisabeth Vardaka
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece.,Department of Nutritional Sciences and Dietetics, School of Health Sciences, International Hellenic University, Thessaloniki, Macedonia, Greece
| | - Maria Tzitiridou-Chatzopoulou
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece.,School of Healthcare Sciences, Midwifery Department, University of West Macedonia, Kozani, Macedonia, Greece
| | - Dimitrios Chatzopoulos
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece
| | - Christos Liatsos
- Department of Gastroenterology, 401 General Military Hospital of Athens, Attiki, Greece
| | - Antony Kyriakopoulos
- Department of Research and Development, Nasco AD Biotechnology Laboratory, Piraeus, Greece
| | - Apostolis Papaefthymiou
- Second Medical Clinic, School of Medicine, Ippokration Hospital, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece.,First Laboratory of Pharmacology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Macedonia, Greece.,Department of Gastroenterology, University Hospital of Larisa, Larisa, Thessaly, Greece
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9
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Lan QL, Sun HY, Ye Y, Wang Y, Liu Y, Weng XJ. Factors Affect the Eradication Rate of Helicobacter pylori by Modified Quadruple Therapy: A Prospective Cohort Study. Infect Drug Resist 2022; 15:2339-2345. [PMID: 35517896 PMCID: PMC9063792 DOI: 10.2147/idr.s358464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/22/2022] [Indexed: 11/23/2022] Open
Abstract
Objective This study aimed to investigate related factors affecting the eradication rate of Helicobacter pylori (Hp) by modified quadruple therapy. Methods Between September 2020 and March 2021, 341 patients who were diagnosed with Hp infection and whose infections were confirmed by gastroscopy, a histological examination, and a C13-UBT without culturing and antimicrobial susceptibility studies received a two-week anti-Hp treatment, a modified quadruple therapy, in our department. The result of C13-UBT was rechecked 4 weeks after the drug withdrawal, and the patients were divided into two groups-a success group and a failure group-according to the final breath result. The general clinical information and related laboratory indexes of each patient were collected, and the factors affecting the eradication rate were analyzed. Results The total clinical eradication rate was 80.06% (273/341), and the failure rate was 19.94% (68/341), correspondingly. Univariate analysis identified statistically significant differences between the two groups in serum 25-hydroxyvitamin D levels, presence of oral diseases, positive cytotoxin-associated gene A (CagA), and medical compliance (P < 0.05). Meanwhile, the use of a proton pump inhibitor (PPIs) and antibiotics was statistically different (P < 0.05). Logistic regression analysis revealed that vitamin D level (<20 ng/mL) [OR = 98.56, 95% CI (29.01-334.83), P < 0.001] and medical compliance [OR = 148.18, 95% CI (37.64-583.33), P < 0.001] were independent effecting factors for eradication rate. Conclusion Serum 25-hydroxyvitamin D level lower than 20 ng/mL may affect the success of eradication of Hp and is an independent risk factor for eradication failure.
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Affiliation(s)
- Qiao-Li Lan
- Department of Digestive System, Wenzhou People’s Hospital, The Third Affiliated Hospital of Shanghai University, The Wenzhou Third Clinical College of Wenzhou Medical University, Wenzhou, 325000, People’s Republic of China
| | - Hao-Yue Sun
- Department of Digestive System, Wenzhou People’s Hospital, The Third Affiliated Hospital of Shanghai University, The Wenzhou Third Clinical College of Wenzhou Medical University, Wenzhou, 325000, People’s Republic of China
| | - Yi Ye
- Department of Digestive System, Wenzhou People’s Hospital, The Third Affiliated Hospital of Shanghai University, The Wenzhou Third Clinical College of Wenzhou Medical University, Wenzhou, 325000, People’s Republic of China
| | - Ying Wang
- Department of Digestive System, Wenzhou People’s Hospital, The Third Affiliated Hospital of Shanghai University, The Wenzhou Third Clinical College of Wenzhou Medical University, Wenzhou, 325000, People’s Republic of China
| | - Ya Liu
- Department of Digestive System, Wenzhou People’s Hospital, The Third Affiliated Hospital of Shanghai University, The Wenzhou Third Clinical College of Wenzhou Medical University, Wenzhou, 325000, People’s Republic of China
| | - Xue-Jian Weng
- Department of Digestive System, Wenzhou People’s Hospital, The Third Affiliated Hospital of Shanghai University, The Wenzhou Third Clinical College of Wenzhou Medical University, Wenzhou, 325000, People’s Republic of China
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