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Wu JM, Liu JN. [Surgical treatment of gastroesophageal reflux-related cough]. Zhonghua Jie He He Hu Xi Za Zhi 2023; 46:961-964. [PMID: 37752038 DOI: 10.3760/cma.j.cn112147-20230320-00142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 09/28/2023]
Abstract
Gastroesophageal reflux-related cough (GERC) is an extra-esophageal manifestation of gastroesophageal reflux disease (GERD) and a common cause of chronic cough. GERC is the most difficult of the chronic cough to diagnose and treat because of its lack of specificity and its multidisciplinary nature. In recent years, research into GERC has led to a consensus on many key issues. The 2021 edition of the Guidelines for the Diagnosis and Treatment of Cough (Cough guidelines) provides important guidance on the diagnosis and treatment of GERC. However, the surgical treatment of GERC is not well covered in the Cough guidelines. This article summarizes the surgical treatment of GERC in terms of surgical methods, current situation, indications for operation and curative effects.
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Affiliation(s)
- J M Wu
- Department of Gastroesophageal Reflux Disease, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
| | - J N Liu
- Department of Gastroesophageal Reflux Disease, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
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2
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Wu JM, Yang H, Li Q, Luo TF, Yang P, Huang WC. [Clinical efficacy of local injection of platelet-rich plasma combined with double-layer artificial dermis in treating wounds with exposed tendon on extremity]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2023; 39:849-856. [PMID: 37805801 DOI: 10.3760/cma.j.cn501225-20230420-00134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 10/09/2023]
Abstract
Objective: To investigate the clinical efficacy of local injection of platelet-rich plasma (PRP) combined with double-layer artificial dermis in treating wounds with exposed tendon on extremity. Methods: A retrospective observational study was conducted. From December 2017 to October 2022, 16 patients were admitted to Department of Orthopaedic Trauma of the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, and 32 patients were admitted to Department of Burns and Plastic Surgery of Guiyang Steel Factory Staff Hospital. All the patients had wounds with exposed tendon on extremity caused by various reasons and met the inclusion criteria. There were 39 males and 9 females, aged 26 to 58 years. The patients were divided into PRP alone group, artificial dermis alone group, and PRP+artificial dermis group, with 16 patients in each group. The wounds were treated with autologous PRP, double-layer artificial dermis, or thei combination of autologous PRP and double-layer artificial dermis, followed by autologous split-thickness scalp grafting after good growth of granulation tissue. On the 7th day after the secondary surgery, the autograft survival was observed, and the survival rate was calculated. The wound healing time and length of hospital stay of patients were recorded. At 3 and 6 months after wound healing, the Vancouver scar scale (VSS) was used to score the pigmentation, height, vascularity, and pliability of scars, and the total score was calculated. Adverse reactions during the entire treatment process were recorded. Data were statistically analyzed with chi-square test, Fisher's exact probability test, one-way analysis of variance, least significant difference test, Kruskal-Wallis H test, Nemenyi test, and Bonferroni correction. Results: On the 7th day after the secondary surgery, there was no statistically significant difference in the autograft survival rate of patients among PRP alone group, artificial dermis alone group, and PRP+artificial dermis group (P>0.05). The wound healing time and length of hospital stay of patients in PRP+artificial dermis group were (20.1±3.0) and (24±4) d, respectively, which were significantly shorter than (24.4±5.5) and (30±8) d in PRP alone group (P<0.05) and (24.8±4.9) and (32±8) d in artificial dermis alone group (P<0.05). At 3 and 6 months after wound healing, the pliability scores of patients in PRP+artificial dermis group were significantly lower than those in PRP alone group (with Z values of 12.91 and 15.69, respectively, P<0.05) and artificial dermis alone group (with Z values of 12.50 and 12.91, respectively, P<0.05). There were no statistically significant differences in pigmentation, vascularity, height scores, and total score of scar of patients among the three groups (P>0.05). In artificial dermis alone group, one patient experienced partial liquefaction and detachment of the double-layer artificial dermis due to local infection of Staphylococcus epidermidis, which received wound dressing change, second artificial dermis transplantation, and subsequent treatment as before. No adverse reactions occurred in the remaining patients during the whole treatment process. Conclusions: Local injection of PRP combined with double-layer artificial dermis is effective in treating wounds with exposed tendon on extremity, which can not only significantly shorten wound healing time and length of hospital stay, but also improve scar pliability after wound healing to some extent in the long term. It is a clinically valuable treatment technique that is worth promoting and applying.
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Affiliation(s)
- J M Wu
- Department of Burns and Plastic Surgery, the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang 550001, China Department of Burns and Plastic Surgery, Guiyang Steel Factory Staff Hospital, Guiyang 550005, China
| | - H Yang
- Department of Burns and Plastic Surgery, Guiyang Steel Factory Staff Hospital, Guiyang 550005, China
| | - Q Li
- Department of Burns and Plastic Surgery, Guiyang Steel Factory Staff Hospital, Guiyang 550005, China
| | - T F Luo
- Department of Burns and Plastic Surgery, Guiyang Steel Factory Staff Hospital, Guiyang 550005, China
| | - P Yang
- Department of Orthopaedic Trauma, the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang 550001, China
| | - W C Huang
- Department of Orthopaedic Trauma, the Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang 550001, China
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Gu RQ, Qiu JY, Zheng CY, Wu JM, Nie ZJ, Zhang LF, Chen Z, Wang X, Hu Z, Song YX, Zhang DD, Shan WP, Cao X, Tian YX, Shao L, Tian Y, Pan XB, Wang ZW. [Long-term mortality risk of valvular heart disease adults over 35 years old in Chinese communities]. Zhonghua Yi Xue Za Zhi 2023; 103:1818-1823. [PMID: 37357186 DOI: 10.3760/cma.j.cn112137-20221118-02430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Objective: To investigate the risk and influencing factors of long-term mortality of valvular heart disease (VHD) adults aged 35 years and over in Chinese communities. Methods: A cohort study was carried out. The data of the subjects who underwent echocardiography were collected from the Chinese Hypertension Survey between 2012 and 2015 and survival outcomes were followed up between 2018 and 2019. Kaplan-Meier survival curves were plotted and compared using log-rank test. Cox proportional hazards models were used to analyze the influence of VHD on mortality. Results: During an average follow-up time of (4.6±0.9) years, a total of 23 237 participants (10 881 males and 12 356 females) were pooled into the final analysis from 5 eastern, 5 central, and 4 western provinces, cities and autonomous regions in China, with a mean age of (56.9±13.2) years. Among the included participants, 1 004 had VHD (467 males and 537 females), with a mean age was of (68.1±12.6) years. In the Kaplan-Meier analysis, participants with VHD had a significantly increased risk of all-cause mortality (log-rank χ2=351.82, P<0.001) and cardiovascular mortality (log-rank χ2=284.14, P<0.001) compared with those without VHD. Multivariate Cox regression analysis showed that compared with those without VHD, the participants with rheumatic VHD had a 45% increased risk of all-cause mortality (HR=1.45, 95%CI: 1.12-1.89) and degenerative VHD increased the risk of cardiovascular mortality by 69% (HR=1.69, 95%CI: 1.19-2.38). The risk factors of cardiovascular mortality for VHD were age 55 years and over (55-<75 years: HR=4.93, 95%CI: 1.17-20.85;≥75 years: HR=11.92, 95%CI: 2.85-49.80) and diabetes mellitus (HR=1.71, 95%CI: 1.00-2.93). Conclusions: VHD is a risk factor of all-cause mortality and cardiovascular mortality among adults aged 35 years and over. Age 55 years and over and diabetes mellitus are adverse prognostic factors for patients with VHD.
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Affiliation(s)
- R Q Gu
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 102308, China
| | - J Y Qiu
- School of Public Health, Medical College of Soochow University, Suzhou 215006, China
| | - C Y Zheng
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 102308, China
| | - J M Wu
- School of Management, Beijing University of Chinese Medicine, Beijing 100029, China
| | - Z J Nie
- School of Public Health, Medical College of Soochow University, Suzhou 215006, China
| | - L F Zhang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 102308, China
| | - Z Chen
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 102308, China
| | - X Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 102308, China
| | - Z Hu
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 102308, China
| | - Y X Song
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 102308, China
| | - D D Zhang
- School of Public Health, Medical College of Soochow University, Suzhou 215006, China
| | - W P Shan
- School of Public Health, Medical College of Soochow University, Suzhou 215006, China
| | - X Cao
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 102308, China
| | - Y X Tian
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 102308, China
| | - L Shao
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 102308, China
| | - Y Tian
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 102308, China
| | - X B Pan
- Department of Structural Heart Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences, Beijing 100037, China
| | - Z W Wang
- Division of Prevention and Community Health, National Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 102308, China
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Wang SX, Feng YN, Feng S, Wu JM, Zhang M, Xu WL, Zhang YY, Zhu HB, Xiao H, Dong ED. IMM-H007 attenuates isoprenaline-induced cardiac fibrosis through targeting TGFβ1 signaling pathway. Acta Pharmacol Sin 2022; 43:2542-2549. [PMID: 35354962 PMCID: PMC9525664 DOI: 10.1038/s41401-022-00899-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 03/07/2022] [Indexed: 11/08/2022] Open
Abstract
Upon chronic stress, β-adrenergic receptor activation induces cardiac fibrosis and leads to heart failure. The small molecule compound IMM-H007 has demonstrated protective effects in cardiovascular diseases via activation of AMP-activated protein kinase (AMPK). This study aimed to investigate IMM-H007 effects on cardiac fibrosis induced by β-adrenergic receptor activation. Because adenosine analogs also exert AMPK-independent effects, we assessed AMPK-dependent and -independent IMM-H007 effects in murine models of cardiac fibrosis. Continual subcutaneous injection of isoprenaline for 7 days caused cardiac fibrosis and cardiac dysfunction in mice in vivo. IMM-H007 attenuated isoprenaline-induced cardiac fibrosis, diastolic dysfunction, α-smooth muscle actin expression, and collagen I deposition in both wild-type and AMPKα2-/- mice. Moreover, IMM-H007 inhibited transforming growth factor β1 (TGFβ1) expression in wild-type, but not AMPKα2-/- mice. By contrast, IMM-H007 inhibited Smad2/3 signaling downstream of TGFβ1 in both wild-type and AMPKα2-/- mice. Surface plasmon resonance and molecular docking experiments showed that IMM-H007 directly interacts with TGFβ1, inhibits its binding to TGFβ type II receptors, and downregulates the Smad2/3 signaling pathway downstream of TGFβ1. These findings suggest that IMM-H007 inhibits isoprenaline-induced cardiac fibrosis via both AMPKα2-dependent and -independent mechanisms. IMM-H007 may be useful as a novel TGFβ1 antagonist.
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Affiliation(s)
- Shuai-Xing Wang
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing, 100191, China
| | - Ye-Nan Feng
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing, 100191, China
| | - Shan Feng
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing, 100191, China
| | - Ji-Min Wu
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing, 100191, China
| | - Mi Zhang
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing, 100191, China
| | - Wen-Li Xu
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing, 100191, China
| | - You-Yi Zhang
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing, 100191, China
| | - Hai-Bo Zhu
- State Key Laboratory for Bioactive Substances and Functions of Natural Medicines, Beijing Key Laboratory of New Drug Mechanisms and Pharmacological Evaluation Study, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100050, China.
| | - Han Xiao
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing, 100191, China.
| | - Er-Dan Dong
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Key Laboratory of Molecular Cardiovascular Science, Ministry of Education, Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing, 100191, China
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5
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Mao SL, Zhang YH, Wu JM, Ye CJ, Ni LF, Wang XG, Wang RJ, Zhang JF. [Research advances on the treatment of hydrofluoric acid burns]. Zhonghua Shao Shang Yu Chuang Mian Xiu Fu Za Zhi 2022; 38:878-882. [PMID: 36177595 DOI: 10.3760/cma.j.cn501120-20210623-00224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Hydrofluoric acid is a highly dangerous and toxic inorganic acid, which is widely used in industrial fields and daily life. The risk of hydrofluoric acid burns is related to hydrofluoric acid mass fraction, duration of exposure to hydrofluoric acid, burn area, burn depth, and burn site, etc. Hydrofluoric acid has strong toxicity and tissue penetration ability. A small area of hydrofluoric acid burns can cause death in a short time. Therefore, improving the understanding of the mechanism of hydrofluoric acid burns and learning how to treat hydrofluoric acid burns in different sites can further improve the cure rate of hydrofluoric acid burns.
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Affiliation(s)
- S L Mao
- Department of Burns and Plastic Surgery, Zhejiang Quhua Hospital, Quzhou 324004, China
| | - Y H Zhang
- Department of Burns and Plastic Surgery, Zhejiang Quhua Hospital, Quzhou 324004, China
| | - J M Wu
- Department of Burns and Plastic Surgery, Zhejiang Quhua Hospital, Quzhou 324004, China
| | - C J Ye
- Department of Burns and Plastic Surgery, Zhejiang Quhua Hospital, Quzhou 324004, China
| | - L F Ni
- Department of Burns and Plastic Surgery, Zhejiang Quhua Hospital, Quzhou 324004, China
| | - X G Wang
- Department of Burns & Wound Repair, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
| | - R J Wang
- Department of Burns and Plastic Surgery, Zhejiang Quhua Hospital, Quzhou 324004, China
| | - J F Zhang
- Department of Burns and Plastic Surgery, Zhejiang Quhua Hospital, Quzhou 324004, China
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Yang SM, Wu SB, Wu JM, Huang JB, Huang MJ, Xiong DL, Hao Y, Sun WP, Xiao LZ. [The molecular mechanism of oxaliplatin-induced peripheral neuropathic pain]. Zhonghua Yi Xue Za Zhi 2021; 101:3581-3587. [PMID: 34808752 DOI: 10.3760/cma.j.cn112137-20210513-01127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the molecular mechanism of oxaliplatin-induced chemotherapy-induced peripheral neuropathic pain (CIPNP). Methods: A total of 16 male Sprague-Dawley rats of specific pathogen-free grade were randomly divided into two groups: oxaliplatin experimental group (2.4 mg/kg oxaliplatin dissolved in 5.0% glucose solution, n=8) and control group (equal volume 5% glucose solution, n=8). The rat model of CIPNP was established by continuous administration with oxaliplatin. In addition, mechanical allodynia, thermal hyperalgesia and cold hyperalgesia were measured and compared between the two groups. To explore the molecular mechanism of oxaliplatin-induced CIPNP, the gene expression of dorsal root ganglia (DRG) from the rat model of CIPNP was analyzed using RNA sequencing (RNA-Seq). Results: Mechanical and thermal hypersensitivity was exhibited on day 7 and a stronger hypersensitivity was observed on day 14. A total of 20 152 genes were quantified by RNA-Seq, and 379 differentially expressed genes (DEGs) were obtained with absolute fold change cut-offs ≥ 2 and P value<0.05. There were 7 genes (Npy, Car3, Cdkn1a, Nts, Prc1, Ms4a7 and Ecel1) that were involved in peripheral nerve injury-related neuropathic pain. Gene ontology (GO) functional enrichment analyses indicated that the DEGs induced by oxaliplatin were involved in oxygen transport, cell division, intermediate, centromere, oxygen transporter activity, oxygen binding. Moreover, the result of Kyoto Encyclopedia of genes and genomes (KEGG) analyses highlighted that the DEGs induced by oxaliplatin were involved in malaria, African trypanosomiasis, primary immunodeficiency, peroxisome proliferator activated receptor (PPAR) signaling pathway. Conclusion: Oxaliplatin induces CIPNP via pain-related genes and signaling pathways.
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Affiliation(s)
- S M Yang
- Department of Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital), Shenzhen Municipal Key Laboratory for Pain Medicine, Shenzhen 518052, China
| | - S B Wu
- Department of Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital), Shenzhen Municipal Key Laboratory for Pain Medicine, Shenzhen 518052, China
| | - J M Wu
- School of Pharmaceutical Sciences, Health Science Center, Shenzhen University, Shenzhen 518060, China
| | - J B Huang
- Department of Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital), Shenzhen Municipal Key Laboratory for Pain Medicine, Shenzhen 518052, China
| | - M J Huang
- Department of Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital), Shenzhen Municipal Key Laboratory for Pain Medicine, Shenzhen 518052, China
| | - D L Xiong
- Department of Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital), Shenzhen Municipal Key Laboratory for Pain Medicine, Shenzhen 518052, China
| | - Y Hao
- School of Pharmaceutical Sciences, Health Science Center, Shenzhen University, Shenzhen 518060, China
| | - W P Sun
- Department of Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital), Shenzhen Municipal Key Laboratory for Pain Medicine, Shenzhen 518052, China
| | - L Z Xiao
- Department of Pain Medicine, Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital), Shenzhen Municipal Key Laboratory for Pain Medicine, Shenzhen 518052, China
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7
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Wu T, Gao YY, Su J, Tang XN, Chen Q, Ma LW, Zhang JJ, Wu JM, Wang SX. Three-dimensional bioprinting of artificial ovaries by an extrusion-based method using gelatin-methacryloyl bioink. Climacteric 2021; 25:170-178. [PMID: 33993814 DOI: 10.1080/13697137.2021.1921726] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE The aim of this study was to design and fabricate a three-dimensional (3D) printed artificial ovary. METHODS We first compared the printability of gelatin-methacryloyl (GelMA), alginate and GelMA-alginate bioinks, of which GelMA was selected for further investigation. The swelling properties, degradation kinetics and shape fidelity of GelMA scaffolds were characterized by equilibrium swelling/lyophilization, collagenase processing and micro-computed tomography evaluation. Commercial ovarian tumor cell lines (COV434, KGN, ID8) and primary culture ovarian somatic cells were utilized to perform cell-laden 3D printing, and the results were evaluated by live/dead assays and TUNEL detection. Murine ovarian follicles were seeded in the ovarian scaffold and their diameters were recorded every day. Finally, in vitro maturation was performed, and the ovulated oocytes were collected and observed. RESULTS Our results indicated that GelMA was suitable for 3D printing fabrication. Its scaffolds performed well in terms of hygroscopicity, degradation kinetics and shape fidelity. The viability of ovarian somatic cells was lower than that of commercial cell lines, suggesting that extrusion-based 3D culture fabrication is not suitable for primary ovarian cells. Nevertheless, the GelMA-based 3D printing system provided an appropriate microenvironment for ovarian follicles, which successfully grew and ovulated in the scaffolds. Metaphase II oocytes were also observed after in vitro maturation. CONCLUSIONS The GelMA-based 3D printing culture system is a viable alternative option for follicular growth, development and transfer. Accordingly, it shows promise for clinical application in the treatment of female endocrine and reproductive conditions.
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Affiliation(s)
- T Wu
- National Clinical Research Center for Obstetrical and Gynecological Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Cancer Invasion and Metastasis, Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Y Y Gao
- National Clinical Research Center for Obstetrical and Gynecological Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Cancer Invasion and Metastasis, Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - J Su
- State Key Laboratory of Materials Processing and Die & Mould Technology, School of Materials Science and Engineering, Huazhong University of Science and Technology, Wuhan, China
| | - X N Tang
- National Clinical Research Center for Obstetrical and Gynecological Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Cancer Invasion and Metastasis, Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Q Chen
- National Clinical Research Center for Obstetrical and Gynecological Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Cancer Invasion and Metastasis, Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - L W Ma
- National Clinical Research Center for Obstetrical and Gynecological Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Cancer Invasion and Metastasis, Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - J J Zhang
- National Clinical Research Center for Obstetrical and Gynecological Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Cancer Invasion and Metastasis, Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - J M Wu
- State Key Laboratory of Materials Processing and Die & Mould Technology, School of Materials Science and Engineering, Huazhong University of Science and Technology, Wuhan, China
| | - S X Wang
- National Clinical Research Center for Obstetrical and Gynecological Diseases, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Cancer Invasion and Metastasis, Ministry of Education, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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8
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Hu ZW, Wu JM, Wang ZG, Li R, Deng CR, Zhang Y, Zhan XL, Ji T, Wang F, Tian SR, Chen D. [Effect of laparoscopic novel W-H fundoplication in patients with proton pump inhibitor dependent gastroesophageal reflux disease]. Zhonghua Yi Xue Za Zhi 2021; 101:737-743. [PMID: 33721954 DOI: 10.3760/cma.j.cn112137-20200622-01920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To investigate the effect of a novel laparoscopic W-H fundoplication in the treatment of proton pump inhibitor (PPI) dependent gastroesophageal reflux disease (GERD). Methods: The clinical data of PPI dependent GERD patients who underwent laparoscopic W-H fundoplication in PLA Rocket Force Characteristic Medical Center from October 1st, 2018 to April 30th, 2019 were analyzed retrospectively. The GERD symptom score, subjective symptom relief, PPI withdrawal, efficacy satisfaction and postoperative complications were followed up and analyzed by a questionnaire. Results: A total of 80 GERD patients were included in this study, and 49 were male and 31 were female, with a median age of 58 years. Among all patients, 85% (68/80) are with esophagitis and 77.5% (62/80) with hiatal hernia. The operation time was 67 (52, 73) minutes, without intraoperative complications and conversion to laparotomy. The postoperative follow-up period was 16 (14, 18) months. The postoperative GERD symptom scores were significantly lower than those before surgery, with an statistical difference (all P<0.05). The subjective remission degree of the overall digestive and respiratory symptoms were 100 (90, 100)% and 100 (80, 100)%, respectively. During the follow-up period, the PPI discontinuation rate was 83% (69/80), and the satisfactory rate was 93% (75/80). Postoperative complications included dysphagia, flatulence, increased exhaust and diarrhea, and the incidence was 61% (49/80), 8% (6/80), 5% (4/80) and 4% (3/80), respectively, and 16% (13/80) of the patients had prolonged occasional mild dysphagia. There was no death, symptomatic recurrence or reoperation. Conclusions: The novel W-H fundoplication has a good medium-term efficacy, with significant GERD symptom control rate and PPI discontinuation rate. The postoperative dysphagia is common, but it is self-limiting and does not affect the satisfaction of the surgical effect.
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Affiliation(s)
- Z W Hu
- Department of Gastroesophageal Surgery, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
| | - J M Wu
- Department of Gastroesophageal Surgery, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
| | - Z G Wang
- Department of Gastroesophageal Surgery, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
| | - R Li
- Department of Gastroesophageal Surgery, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
| | - C R Deng
- Department of Gastroesophageal Surgery, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
| | - Y Zhang
- Department of Gastroesophageal Surgery, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
| | - X L Zhan
- Department of Gastroesophageal Surgery, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
| | - T Ji
- Department of Gastroesophageal Surgery, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
| | - F Wang
- Department of Gastroesophageal Surgery, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
| | - S R Tian
- Department of Gastroesophageal Surgery, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
| | - D Chen
- Department of Gastroesophageal Surgery, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
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9
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Qu SL, Wang AL, Wu JM, He D, Peng J, Wang XY, Luo HM, Pan XP, Zhang T. [Analysis of the catastrophic health expenditure of HIV-positive maternal households in high AIDS endemic areas in Liangshan prefecture]. Zhonghua Yu Fang Yi Xue Za Zhi 2021; 55:189-193. [PMID: 34645178 DOI: 10.3760/cma.j.cn112150-20200827-01161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To analysis the income and expenditure of HIV-positive pregnant women and the catastrophic health expenditure of their households in high AIDS endemic areas in Liangshan prefecture. Methods: From December 2018 to January 2019, a total of 250 pregnant women were recruited from 2 of 17 counties in Liangshan Prefecture, including 133 HIV-positive pregnant women and 117 HIV-negative pregnant women. The data, including basic information of pregnant women, basic information of the family, annual family income in 2017, annual family health expenditure in 2017, and maternal and child-related expenditure in 2017, were collected for analyzing the incidence of catastrophic health expenditure in the family. Results: The average annual income and average annual health expenditure of HIV-positive pregnant women households were 7 000 CNY and 2 000 CNY, while those of HIV-negative pregnant women households were 10 000 CNY and 3 000 CNY, respectively. Based on the criteria of 15%, 25% and 40%, the incidence of catastrophic health expenditure of HIV-positive pregnant households was 39.10%, 33.83% and 27.82%, with average differences of 34.84%, 31.17% and 26.65%, respectively, while that of HIV-negative pregnant women households was 38.46%, 33.33% and 23.93%, with average differences of 31.68%, 28.35% and 24.22%, respectively. Conclusion: The incidence of catastrophic health expenditure of pregnant households in high AIDS endemic areas in Liangshan prefecture is high. The incidence of HIV-positive families is slightly higher than that of HIV-negative families. We suggest that medical insurance compensation in Liangshan prefecture should be improved to reduce the impact of catastrophic health expenditure.
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Affiliation(s)
- S L Qu
- Chinese Center for Disease Control and Prevention,Beijing 102206, China
| | - A L Wang
- National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing 100081, China
| | - J M Wu
- Liangshan Maternal and Child Health Care Family Planning Service Center, Liangshan 615000, China
| | - D He
- Sichuan Maternal and Child Health Hospital, Chengdu 610000, China
| | - J Peng
- Liangshan Maternal and Child Health Care Family Planning Service Center, Liangshan 615000, China
| | - X Y Wang
- National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing 100081, China
| | - H M Luo
- Chinese Center for Disease Control and Prevention,Beijing 102206, China
| | - X P Pan
- National Center for Women and Children's Health Chinese Center for Disease Control and Prevention, Beijing 100081, China
| | - T Zhang
- Capital Institute of Pediatrics, Beijing 100020, China
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10
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Fang Y, Jin CY, Zheng R, Wu JM, Zhang BR, Pu JL. Asymmetric, multifocal musculoskeletal pain preceding the onset of progressive supranuclear palsy: A case report. CNS Neurosci Ther 2020; 27:256-258. [PMID: 33274849 PMCID: PMC7816200 DOI: 10.1111/cns.13527] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/01/2020] [Accepted: 11/01/2020] [Indexed: 11/30/2022] Open
Affiliation(s)
- Yi Fang
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Chong-Yao Jin
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Ran Zheng
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Ji-Min Wu
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Bao-Rong Zhang
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jia-Li Pu
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
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Han HL, Zhang JF, Yan EF, Shen MM, Wu JM, Gan ZD, Wei CH, Zhang LL, Wang T. Effects of taurine on growth performance, antioxidant capacity, and lipid metabolism in broiler chickens. Poult Sci 2020; 99:5707-5717. [PMID: 33142488 PMCID: PMC7647726 DOI: 10.1016/j.psj.2020.07.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 07/07/2020] [Accepted: 07/23/2020] [Indexed: 10/31/2022] Open
Abstract
To investigate the effects of dietary taurine supplementation on growth performance, antioxidant status, and lipid metabolism in broilers, 384 male broilers (Arbor Acres, 1 D of age) were randomly allocated into 4 groups with 8 replicates of 8 birds. Dietary treatments were supplemented with taurine at the level of 0.00, 2.50, 5.00, and 7.50 g/kg of the diet (denoted as CON, TAU1, TAU2, TAU3, respectively). The BW gain from 1 to 21 D and from 22 to 42 D were all increased linearly (linear, P < 0.001) by taurine supplementation. Throughout the trial period, the highest BW gain and favorable gain-to-feed ratio were observed in the TAU2 group. Taurine supplementation increased the antioxidant enzyme activities and decreased (linear, P < 0.001) the content of malondialdehyde in both serum and the liver of broilers and alleviated oxidative damage through enhancing (P < 0.05) the hepatic genes expression of nuclear factor erythroid-2-related factor 2 (NRF2), glutathione peroxidase (GPX), and heme oxygenase-1 (HO-1). Correspondingly, in serum, the activities of hepatic lipase and total lipase were decreased linearly and quadratically (linear and quadratic, P < 0.001) with the increasing inclusion of taurine in the diet. Meanwhile, in serum, the content of triglycerides was significantly decreased (P < 0.05), and except for TAU3, the total cholesterol content was also significantly decreased (P < 0.05) by taurine supplementation. In addition, the hepatic content of triglycerides was significantly decreased (P < 0.05) in the TAU1 and TAU2 groups. Compared with the CON group, the hepatic genes expression of adenosine monophosphate-activated protein kinase alpha (AMPKα), silent 1, (SIRT1) and carnitine palmitoyltransferase 1 (CPT-1) were all increased (P < 0.05), and sterol regulatory element-binding protein-1 (SREBP-1) expression was decreased (P < 0.05) in the TAU2 group. These results indicated that taurine supplementation improved the growth performance, antioxidant capacity, and lipid metabolism of broilers.
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Affiliation(s)
- H L Han
- College of Animal Science and Technology, Nanjing Agricultural University, Jiangsu 210095, Nanjing, People's Republic of China
| | - J F Zhang
- College of Animal Science and Technology, Nanjing Agricultural University, Jiangsu 210095, Nanjing, People's Republic of China
| | - E F Yan
- College of Animal Science and Technology, Nanjing Agricultural University, Jiangsu 210095, Nanjing, People's Republic of China
| | - M M Shen
- College of Animal Science and Technology, Nanjing Agricultural University, Jiangsu 210095, Nanjing, People's Republic of China
| | - J M Wu
- College of Animal Science and Technology, Nanjing Agricultural University, Jiangsu 210095, Nanjing, People's Republic of China
| | - Z D Gan
- College of Animal Science and Technology, Nanjing Agricultural University, Jiangsu 210095, Nanjing, People's Republic of China
| | - C H Wei
- College of Animal Science and Technology, Nanjing Agricultural University, Jiangsu 210095, Nanjing, People's Republic of China
| | - L L Zhang
- College of Animal Science and Technology, Nanjing Agricultural University, Jiangsu 210095, Nanjing, People's Republic of China
| | - T Wang
- College of Animal Science and Technology, Nanjing Agricultural University, Jiangsu 210095, Nanjing, People's Republic of China.
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12
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Gao X, Liu DG, Wang F, Zhang C, Du X, Wu JM, Wang ZG, Li F. Efficacy evaluation of pepsin in laparoscopic antireflux surgery for gastroesophageal reflux disease. Technol Health Care 2020; 29:91-97. [PMID: 32741794 DOI: 10.3233/thc-192090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The false positive rate of the PPI test for the diagnosis of typical symptoms of gastroesophageal reflux disease (GERD) is extremely high. OBJECTIVE This study aims to investigate the effect of the pepsin test on GERD and laparoscopy-assisted anti-reflux surgery for GERD. METHODS A total of 30 GERD patients were enrolled into this study, and the pre-diagnosis of GERD was determined by symptom evaluation, impedance-pH examination, gastroscopy and pepsin test. All patients underwent surgery. RESULTS Among the 30 GERD patients, 18 patients were male and 12 were female, and their average age was 58.2 + 12.6 years old. The patients were treated with laparoscopic fundoplication and hiatus hernia repair after preoperative assessment. A total of 28 patients were followed up, one patient developed recurrent symptoms, and one patient developed postoperative dysphagia and received non-operative treatment. Furthermore, the symptom scores were significantly lower at postoperative pepsin detection when compared to the scores before the operation (pepsin: preoperative: 148.8 ± 82.6, postoperative: 30.7 ± 24.6; t= 4.848, P= 0.000). CONCLUSIONS Laparoscopic fundoplication and hiatus hernia repair may effectively control the symptoms of GERD. Furthermore, the detection of pepsin is non-invasive and easy to operate.
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Affiliation(s)
- Xiang Gao
- Department of General Surgery, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Dian-Gang Liu
- Department of General Surgery, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Feng Wang
- Department of Gastroesophageal Reflux Disease, PLA Rocket Force General Hospital, Beijing, China
| | - Chao Zhang
- Department of General Surgery, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Xing Du
- Department of General Surgery, Xuanwu Hospital of Capital Medical University, Beijing, China
| | - Ji-Min Wu
- Department of Gastroesophageal Reflux Disease, PLA Rocket Force General Hospital, Beijing, China
| | - Zhong-Gao Wang
- Department of General Surgery, Xuanwu Hospital of Capital Medical University, Beijing, China.,Department of Gastroesophageal Reflux Disease, PLA Rocket Force General Hospital, Beijing, China
| | - Fei Li
- Department of General Surgery, Xuanwu Hospital of Capital Medical University, Beijing, China
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13
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Zhu YL, Guo XM, Qin ZB, Zhou ZJ, Cao J, Wu JM, Pu JL. Reversible Parkinsonism caused by Influenza B-associated encephalitis affecting bilateral basal ganglia: A case report. CNS Neurosci Ther 2020; 26:396-398. [PMID: 31823469 PMCID: PMC7052805 DOI: 10.1111/cns.13278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 11/14/2019] [Accepted: 11/22/2019] [Indexed: 11/28/2022] Open
Affiliation(s)
- Yue-Li Zhu
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiao-Ming Guo
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Zun-Bo Qin
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Department of Neurology, Hengdian Wenrong Hospital, Jinhua, China
| | - Zhi-Jian Zhou
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Department of Neurology, Affiliated Shaoxing Hospital of Traditional Chinese Medicine, Zhejiang Chinese Medical University, Shaoxing, China
| | - Jin Cao
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Ji-Min Wu
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jia-Li Pu
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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14
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Wang YJ, Lang XQ, Wu D, He YQ, Lan CH, Xiao X, Wang B, Zou DW, Wu JM, Zhao YB, Dettmar PW, Chen DF, Yang M. Salivary Pepsin as an Intrinsic Marker for Diagnosis of Sub-types of Gastroesophageal Reflux Disease and Gastroesophageal Reflux Disease-related Disorders. J Neurogastroenterol Motil 2020; 26:74-84. [PMID: 31650768 PMCID: PMC6955190 DOI: 10.5056/jnm19032] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 06/14/2019] [Accepted: 07/23/2019] [Indexed: 12/13/2022] Open
Abstract
Background/Aims To determine the value of salivary pepsin in discriminating sub-types of gastroesophageal reflux disease (GERD) and GERD-related disorders. Methods Overall, 322 patients with different sub-types of GERD and 45 healthy controls (HC) were studied. All patients took Gastroesophageal Reflux Disease Questionnaire (GerdQ) and underwent endoscopy and 24-hour esophageal pH monitoring and manometry. Salivary pepsin concentration (SPC) was detected by using colloidal gold double-antibody immunological sandwich assay. Oral esomeprazole treatment was administrated in the patients with non-erosive reflux disease (NERD) and extra-esophageal symptoms (EES). Results Compared to HC, patients with erosive esophagitis, NERD, EES, EES plus typical GERD symptoms, or Barrett’s esophagus had a higher prevalence of saliva and SPC (all P < 0.001). There was no significant difference in the positive rate for pepsin in patients with functional heartburn or GERD with anxiety and depression, compared to HC. After esomeprazole treatment, the positive rate and SPC were significantly reduced in NERD (both P < 0.001) and in EES (P = 0.001 and P = 0.002, respectively). Of the 64 NERD patients, 71.9% (n = 46) were positive for salivary pepsin, which was significantly higher than the rate (43.8%, n = 28) of pathological acid reflux as detected by 24-hour esophageal pH monitoring (P = 0.002). Conclusions Salivary pepsin has an important significance for the diagnosis of GERD and GERD-related disorders. Salivary pepsin and 24-hour esophageal pH monitoring may complement with each other to improve the diagnostic efficiency.
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Affiliation(s)
- Yan-Jun Wang
- Department of Gastroenterology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
| | - Xiu-Qiong Lang
- Department of Gastroenterology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
| | - Dan Wu
- Department of Gastroenterology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
| | - Yu-Qin He
- Department of Gastroenterology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
| | - Chun-Hui Lan
- Department of Gastroenterology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
| | - Xiao Xiao
- Department of Gastroenterology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
| | - Bin Wang
- Department of Gastroenterology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
| | - Duo-Wu Zou
- Department of Gastroenterology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Ji-Min Wu
- Department of Gastroenterology, Department of Gastroesophageal Reflux Disease, PLA Rocket Force General Hospital, Beijing, China
| | - Yong-Bin Zhao
- Department of Gastroenterology, Xinqiao Hospital, Chongqing, China
| | | | - Dong-Feng Chen
- Department of Gastroenterology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
| | - Min Yang
- Department of Gastroenterology, Daping Hospital, Army Medical Center of PLA, Army Medical University, Chongqing, China
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15
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Hu ZW, Xu H, Zhan Y, Xin RH, Sun CY, Tian SR, Zhan XL, Chen D, Wang ZG, Wu JM. [The relationship between acid reflux and esophageal motility, esophagitis and cardiac morphology in gastroesophageal reflux disease]. Zhonghua Yi Xue Za Zhi 2019; 99:3494-3499. [PMID: 31826568 DOI: 10.3760/cma.j.issn.0376-2491.2019.44.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Objective: To analyze the relationship between the severity of esophageal acid reflux and esophageal motility, esophageal mucosal injury and morphological anatomy of gastroesophageal junction (GEJ) in patients with gastroesophageal reflux disease (GERD). Methods: The clinicaldata of GERD patients who underwent 24 h pH-impedance monitoring, gastroscopy and high-resolution manometry (HRM) from January 2016 to January 2019 in the Gastroesophageal Surgery Department of PLA Rocket Force Characteristic Medical Center were retrospectively analyzed. The patients were divided into non-pathological acid reflux group, mild pathological acid reflux group and moderate to severe pathological acid reflux group according to the DeMeester score. The gender and age of each group were matched, with 60 cases in each group. Statistical analysiswas performed to analyze thedifferences in upper esophageal sphincter pressure, lower esophageal sphincter pressure (LES), LES length, length of ventral LES, percentage of ineffective swallowing, esophagitis, Hill grade of GEJ, and hiatus hernia (HH) in each group. The comparison and correlation analysis are also carried out between the groups. Results: The male-female ratio was 33/27, and the age was (57±13) years in each group. Non-parametric analysis showed that the LES pressure and the length of the ventral LES decreased with the severity of acid reflux, and there was a statistical difference (P= 0.033, P=0.015). The detection rate of HH by HRM increased significantly (χ(2)=0.001) as well. Esophagitis score increased with the severity of acid reflux and there was statistical difference (P<0.001).The detection rate of esophagitis increased significantly (χ(2)<0.001) as well. Hill grading score of GEJ increased with the severity of acid reflux, and there was statistical difference (P<0.001).The detection rate of HH by endoscopy increased significantly (χ(2)<0.001) as well. The correlation between DeMeester score and LES pressure, length of ventral LES, percentage of ineffective swallowing, esophagitis score, and Hill grade score were statistically significant (P<0.05). Conclusions: The esophageal low motility (such as low LES pressure) and anatomical abnormalities (abdominal esophageal shortening, GEJ flabbiness, and even HH formation) of the GEJ regionare significantly associated with the severity of acid reflux. These factors may be important causes of increased acid reflux. In addition, the aggravation of acid reflux can also increase the incidence and severity of esophagitis.
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Affiliation(s)
- Z W Hu
- Gastroesophageal Surgery Department, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
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16
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Shao YL, Zhang SC, Wu JM, Guo FC, Liu LG, Ye CY, Yan T, Cao Q, Zhang F, Wang J, Mao YH, Fan JG. [Relationship between liver controlled attenuation parameters and body fat mass and its distribution]. Zhonghua Gan Zang Bing Za Zhi 2019; 27:754-759. [PMID: 31734988 DOI: 10.3760/cma.j.issn.1007-3418.2019.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Objective: To explore the relationship between liver controlled attenuation parameters (CAP) and body fat mass and its distribution. Methods: From May to December 2018, 978 adult patients visited at the fatty liver center of the Third People's Hospital of Changzhou were treated. The patient's liver controlled attenuation parameters were measured by transient elastography and the body fat mass and its distribution were measured by bioelectrical impedance technology. Pearson's correlation coefficient was adopted to describe the correlation between liver CAP value and body mass index (BMI), body fat mass index (BFMI), trunk fat mass index (TFMI), limbs fat mass index (LFMI) and visceral fat area (VFA). Receiver operating characteristic curve (ROC) and area under the curve (AUC) were used to evaluate BMI, BFMI, TFMI, LFMI and VFA to differentiate the cut-off points and efficacy of CAP for diagnosing grading of fatty liver changes in S0-1 and S2-3. Results: In 653 cases of male, S0 ~ S3 accounted for 4.90%, 3.37%, 22.36% and 69.37%, respectively, and in 325 cases of females, S0 ~ S3 accounted for 7.38%, 6.46%, 13.23% and 72.92%, respectively. Female patients had more visceral, trunk and limbs fat than male (P < 0.01). Body mass, body fat mass, body fat percentage, BMI, BFMI, TFMI, LFMI, and VFA were increased in male and female patients with increasing liver fat grade (P < 0.01). CAP values of male and female patients were positively correlated with BMI, BFMI, TFMI, LFMI and VFA. Percentage of body fat mass increased with increasing liver fat grade (male: F = 13.42, P < 0.001; female: F = 3.22, P = 0.023); while limb fat mass percentage did not increase with liver fat grade (Male: F = 1.13, P = 0.34; female: F = 1.05, P = 0.37). Hepatic steatosis grading (S0 ~ 1 or S2 ~ 3) diagnosed with CAP were distinguished through BMI, BFMI, TFMI, LFMI and VFA. AUC was 0.80 ~ 0.82 in males (P < 0.01), and 0.75 ~ 0.78 in females (P < 0.01). Conclusion: The liver CAP value is positively correlated with the body's limbs, trunk and visceral fat, and has a strong correlation with trunk and visceral fat. BMI, BFMI, TFMI, LFMI and VFA up to some extent can identify the CAP diagnosis of grading of fatty liver changes in S0-1 and S2-3.
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Affiliation(s)
- Y L Shao
- Department of Hepatology and Center of Fatty Liver, Changzhou Third People's Hospital, Changzhou 213001, China
| | - S C Zhang
- Department of Hepatology and Center of Fatty Liver, Changzhou Third People's Hospital, Changzhou 213001, China
| | - J M Wu
- Department of Hepatology and Center of Fatty Liver, Changzhou Third People's Hospital, Changzhou 213001, China
| | - F C Guo
- Department of Hepatology and Center of Fatty Liver, Changzhou Third People's Hospital, Changzhou 213001, China
| | - L G Liu
- Department of Hepatology and Center of Fatty Liver, Changzhou Third People's Hospital, Changzhou 213001, China
| | - C Y Ye
- Department of Hepatology and Center of Fatty Liver, Changzhou Third People's Hospital, Changzhou 213001, China
| | - T Yan
- Department of Hepatology and Center of Fatty Liver, Changzhou Third People's Hospital, Changzhou 213001, China
| | - Q Cao
- Department of Hepatology and Center of Fatty Liver, Changzhou Third People's Hospital, Changzhou 213001, China
| | - F Zhang
- Department of Endocrinology and Center of Fatty Liver, Changzhou Third People's Hospital, Changzhou 213001, China
| | - J Wang
- Department of Cardiology and Center of Fatty Liver, Changzhou Third People's Hospital, Changzhou 213001, China
| | - Y H Mao
- Department of Nutrition and Center of Fatty Liver, Changzhou Third People's Hospital, Changzhou 213001, China
| | - J G Fan
- Department of Gastroenterology and Center of Fatty Liver, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200092, China
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Wu JM, Zhao LY, Chen T, Hu YF, Yu J, Li GX. [Vascular injury and anatomy during laparoscopy - assisted distal gastrectomy with D2 lymphadenectomy for gastric cancer]. Zhonghua Wei Chang Wai Ke Za Zhi 2019; 22:955-960. [PMID: 31630493 DOI: 10.3760/cma.j.issn.1671-0274.2019.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To evaluate the incidence of intraoperative vascular injury (IVI) and associated anatomical features during laparoscopy - assisted distal gastrectomy (LADG) with D2 lymphadenectomy for gastric cancer. Methods: A descriptive cohort study was performed. Clinical data and operational videos of 278 consecutive gastric cancer patients who underwent LADG with D2 lymphadenectomy for gastric cancer at Department of General Surgery of Nanfang Hospital between January 2010 and December 2017 were retrospectively analyzed. IVI and vascular anatomy during lymphadenectomy were observed and recorded in the following four scenes: scene I: No. 4sb and No.4d of lower left (tail of pancreas) area; scene II: No.6 of lower right (subpyloric) area; scene III: No.5 and No.12a of upper right (suprapyloric) area; scene IV: No. 7, No. 8a, No. 9, No. 11p of central area posterior to the gastric body. IVI was defined as the injury of main perigastric vessel requiring additional procedure for hemostasis such as electrocauterization, gauze compression, clipping or suture. Results: Among 278 patients, 125 (45.0%) had IVI. Two cases of IVI required conversion to open operation and the injuried vascular was left gastric artery (LGA) and right gastric artery (RGA), respectively. Higher incidence of IVI was found in scene II (92/278, 33.1%) and scene IV(39/278, 14.0%). More common IVI was observed in right gastroepiploic vein (RGeV, 57/278, 20.5%) and left gastric vein (LGV, 33/278, 11.9%). The right gastroepiploic vessels were observed in all 278 patients, including 3 (1.1%) cases with 2 RGeVs, and 2 cases with 2 right gastroepiploic arteries (RGeA). RGA was observed clearly in 265 (95.3%) patients, whose ramification pattern was as follows: from proper hepatic artery (PHA, 223/265, 84.2%), from gastroduodenal artery (GDA, 16/265, 6.0%), from left hepatic artery (LHA, 12/265,4.5%), from the crossing of PHA and GDA (8/265, 3.0%), and 6 (2.3%) patients with 2 RGAs simultaneously from PHA and GDA, respectively. The most common injury of RGA (4/12) occurred in LHA. Excluding 2 cases of conversion to open surgery due to intraoperative hemorrhage, among 276 patients, LGV was observed in 270 patients (97.1%), whose drainage pattern was as follows: into the portal vein (PV, 148/270, 54.8%), into the spleen vein (SV, 56/270, 20.7%), into the junction of these two veins (52/270, 19.3%), into left portal vein (LPV, 8/270, 3.0%), meanwhile 6 patients had 2 LGVs simultaneously, including LGVs of 5 cases into PV and SV, and of 1 case into PV-SV junction and SV. The most common IVI was found in those patients with two LGVs (4/6). Conclusions: IVI during LADG with D2 lymphadenectomy is common. The highest risk of IVI is found in scene II and scene IV. Attentions should be paid to anatomic variation of vessels, especially the RGeV, LGV and RGA.
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Affiliation(s)
- J M Wu
- Department of General Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China (is now working on Department of Gastrointestinal Surgery, the First Hospital of Jiaxing, Zhejiang Jiaxing 314000, China)
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Liang WT, Li T, Wu JM, Hu ZW, Yan C, Qian YJ. Medical Image Analysis Based on Endoscopic Radiofrequency Ablation Catheter System on the Treatment of Gastroesophageal Reflux Disease Related Extra-Esophageal Symptoms. j med imaging hlth inform 2019. [DOI: 10.1166/jmihi.2019.2796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective: Gastroesophageal reflux disease is easily missed on X-ray or even computer tomography. This study was to evaluate the endoscopic imaging for the radiofrequency ablation (RA) on the diagnosis and management of gastroesophageal reflux disease related extra-esophageal
symptoms. Methods: From January 2011, to January 2012, we allocated 51 patients to LTF and 47 to RA procedure. Primary outcome measures, including symptom scores of globus hysterics, chest pain, belching, hiccup, cough and asthma as well as proton pump inhibitors (PPIs) use, were analyzed
after 5-year follow-up. Results: There were 90 patients following RA procedure (N = 40) or LTF (N = 50) that completed the designated 5-year follow-up and were included in the final analysis. At the end of 5-year follow-up, the symptom scores were all significantly decreased
as compared with the corresponding values before the two procedures in both groups (p < 0.05). Moreover, the improvement in symptom scores between the two groups did not achieve statistical significance. After RA procedure and LTF, 18 (45%) and 32 (64%) patients in each group achieved
complete PPIs therapy independence (p = 0.071). Comparing with LTF, however, the RA procedure had a higher risk of reoperation (17.5% vs. 0, p = 0.002). Conclusion: Comparing with LTF in controlling GERD-related extra-esophageal symptoms, RA procedure can offer equivalent
relief on symptoms and PPIs independence. However, it has a higher risk of reoperation during the 5 years follow-up.
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Feng Y, Zhu R, Shen J, Wu J, Lu W, Zhang J, Zhang J, Liu K. Human Bone Marrow Mesenchymal Stem Cells Rescue Endothelial Cells Experiencing Chemotherapy Stress by Mitochondrial Transfer Via Tunneling Nanotubes. Stem Cells Dev 2019; 28:674-682. [PMID: 30808254 DOI: 10.1089/scd.2018.0248] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Tunneling nanotubes (TNTs) are newly discovered tubular structures between two distant cells that facilitate the intercellular exchange of signals and components. Recent reports show that mesenchymal stem cells (MSCs) can rescue injured target cells and promote recovery from a variety of stresses via TNT-mediated mitochondrial transfer. In this study, we explored how TNTs form between bone marrow MSCs and endothelial cells (ECs) by using a human umbilical cord vein endothelial cell (HUVEC) model. TNT formation between MSCs and HUVECs could be induced by treating HUVECs with cytarabine (Ara-C), and human bone marrow mesenchymal stem cells (hBMMSCs) could transfer mitochondria to injured HUVECs through TNTs. Mitochondrial transfer from hBMMSCs to HUVECs via TNTs rescued the injured HUVECs by reducing apoptosis, promoting proliferation and restoring the transmembrane migration ability as well as the capillary angiogenic capacity of HUVECs. This study provides novel insights into the cell-cell communication between MSCs and ECs and supports the results of prior studies indicating that ECs promote hematopoietic regeneration. An improved understanding of MSC-EC cross-talk will promote the development of MSC-directed strategies for improving EC function and hematopoietic system regeneration following myelosuppressive and myeloablative injuries.
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Affiliation(s)
- Yonghuai Feng
- 1 Beijing Key Laboratory of Haematopoietic Stem Cell Transplantation, Institute of Haematology, Peking University People's Hospital, Beijing, China.,2 Institute of Haematology, Affiliated Hospital of Zunyi Medical College, Zunyi, China
| | - Rongjia Zhu
- 3 Chinese Academy of Medical Science and Peking Union Medical College, Institute of Basic Medical Sciences and School of Basic Medicine, Beijing, China
| | - Jing Shen
- 4 Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, China
| | - JiMin Wu
- 4 Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, Beijing, China
| | - Wenyi Lu
- 1 Beijing Key Laboratory of Haematopoietic Stem Cell Transplantation, Institute of Haematology, Peking University People's Hospital, Beijing, China
| | - JiaMin Zhang
- 1 Beijing Key Laboratory of Haematopoietic Stem Cell Transplantation, Institute of Haematology, Peking University People's Hospital, Beijing, China
| | - Jing Zhang
- 1 Beijing Key Laboratory of Haematopoietic Stem Cell Transplantation, Institute of Haematology, Peking University People's Hospital, Beijing, China
| | - Kaiyan Liu
- 1 Beijing Key Laboratory of Haematopoietic Stem Cell Transplantation, Institute of Haematology, Peking University People's Hospital, Beijing, China
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Liang WT, Li T, Wang ZG, Wu JM, Hu ZW, Yan C, Qian YJ. Medical Image Analysis Based on Endoscopic Radiofrequency Ablation Catheter System on the Treatment of Gastroesophageal Reflux Disease. j med imaging hlth inform 2019. [DOI: 10.1166/jmihi.2019.2625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objective: Gastroesophagel reflux disease is not readily diagnosed using X-ray or even computer tomography. This study was to evaluate the endoscopic imaging for the radiofrequency ablation (RA) on the diagnosis and management of gastroesophageal reflux disease. Methods:
We allocated 85 to mechanical RA and 80 patients to LTF. Primary outcome measures, including symptom scores of heartburn, regurgitation, chest pain, belching, hiccup, cough and asthma as well as proton pump inhibitors (PPIs) use, were analyzed. Results: There were 125 patients following
mechanical radiofrequency ablation procedure (N = 60) or LTF (N = 65) included in the final analysis. The symptom scores were all significantly decreased as compared with the corresponding values before the two procedures in both groups (p < 0.05). After mechanical
RA procedure and LTF, 30 (50%) and 45 (69.2%) patients in each group achieved complete PPIs therapy independence (p = 0.028). Comparing with LTF, the mechanical RA procedure had less effect on improving typical symptoms of heartburn and chest pain and the rate of reoperation (13% vs.
0, p = 0.003). Conclusions: Comparing with LTF in controlling GERD symptoms, the mechanical radiofrequency ablation procedure can offer equivalent relief on atypical symptoms. However, it has less effect on improving PPIs independence and avoiding reoperation.
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Shao YL, Zhang SC, Wu JM, Guo FC, Huang ZY, Liu LG. [Clinical features of drug-induced liver injury rechallenge with polygonum multiflorum]. Zhonghua Gan Zang Bing Za Zhi 2018; 26:686-689. [PMID: 30481867 DOI: 10.3760/cma.j.issn.1007-3418.2018.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Y L Shao
- Department of Hepatology, Changzhou Third People's Hospital, Changzhou 213001, Jiangsu Province, China
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Hu ZW, Wang ZG, Wu JM, Tian SR, Zhang Y, Zhan XL, Du X, Wang F, Xin RH, Xu H. [Relationship between the severity of reflux esophagitis and the esophageal motility features on high resolution manometry]. Zhonghua Yi Xue Za Zhi 2017; 97:3306-3311. [PMID: 29141375 DOI: 10.3760/cma.j.issn.0376-2491.2017.42.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Objective: To analyze esophageal motility dysfunction in gastroesophageal reflux disease (GERD) with different severity of esophagitis, and the relationship between the esophageal motility dysfunction and the severity of esophagitis. Methods: GERD patients simultaneously undergone endoscopy and high-resolution manometry were divided into four groups: Non-esophagitis (Non-erosive gastroesophageal reflux disease, NERD) group, mild esophagitis group, moderate esophagitis group and severe esophagitis group. The gender and age were matched for each group, and every group consisted of 80 cases. Nonparametric test was used to analyze the differences in HRM parameters, such as upper esophageal sphincter (UES) pressure, lower esophageal sphincter (LES) pressure, LES length, LES-CD (crural diaphragm) separation distance, and the percentage of failed peristalsis of the four groups, and the differences between each two of the groups were also analyzed. Results: Nonparametric test showed that the LES pressure and length decreased with the severity of esophagitis, and there were statistical differences (P<0.001, P=0.030). The failed peristalsis percentage increased with the severity of esophagitis and the difference was statistically significant (P<0.001). The LES-CD separation distance was increased with the severity of esophagitis and had statistically significance (P<0.001). When comparing the differences between each two of the groups, there were significant differences (P<0.001, P=0.012, P<0.001, P<0.001) between NERD group and severe esophagitis group in the HRM parameters of the lower esophageal sphincter pressure, the LES length, the LES-CD separation distance, and the percentage of ineffective swallowing in the NERD and severe esophagitis group. The detection rate of HH was significantly increased from NERD to severe esophagitis, the detection rate of HH was 6.3% to 82.5% in gastoracopy and 16.3% to 45.0% in HRM, and the diagnostic consistency was fair (Kappa Value: 0.31). Conclusions: Hypo-dynamic state of esophageal and HH are the main motility characteristics of erosive gastroesophageal reflux disease, Esophageal motility abnormalities increase in parallel with the severity of GERD from NERD to severe esophagitis, these motility disorders may also play important roles in causing esophagitis.
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Affiliation(s)
- Z W Hu
- Department of Gastroesophageal Reflux Disease, Rocket Force General Hospital PLA, Beijing 100088, China
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Du X, Wu JM, Hu ZW, Wang F, Wang ZG, Zhang C, Yan C, Chen MP. Laparoscopic Nissen (total) versus anterior 180° fundoplication for gastro-esophageal reflux disease: A meta-analysis and systematic review. Medicine (Baltimore) 2017; 96:e8085. [PMID: 28906412 PMCID: PMC5604681 DOI: 10.1097/md.0000000000008085] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Laparoscopic Nissen fundoplication (LNF) has been the gold standard for the surgical management of Gastro-esophageal reflux disease (GERD). Laparoscopic anterior 180° fundoplication (180° LAF) is reported to reduce the incidence of postoperative complications while obtaining similar control of reflux. The present meta-analysis was conducted to confirm the value of the 2 techniques. METHODS PubMed, Medline, Embase, Cochrane Library, Springerlink, and China National Knowledge Infrastructure Platform databases were searched for randomized controlled trials (RCTs) comparing LNF and 180° LAF. Data regarding the benefits and adverse results of 2 techniques were extracted and compared using a meta-analysis. RESULTS Six eligible RCTs comparing LNF (n = 266) and 180° LAF (n = 265) were identified. There were no significant differences between LNF and 180° LAF with regard to operating time, perioperative complications, length of hospital stay, patient satisfaction, willingness to undergo surgery again, quality of life, postoperative heartburn, proton pump inhibitor (PPI) use, postoperative DeMeester scores, postoperative lower esophageal sphincter (LES) pressure, postoperative gas-bloating, unable to belch, diarrhea, or overall reoperation. LNF was associated with a higher prevalence of postoperative dysphagia compared with 180° LAF, while 180° LAF was followed by more reoperation for recurrent reflux symptoms. CONCLUSION LNF and 180° LAF are equally effective in controlling reflux symptoms and obtain a comparable prevalence of patient satisfaction. 180° LAF can reduce the incidence of postoperative dysphagia while this is offset by a higher risk of reoperation for recurrent symptoms. The risk of recurrent symptoms should need to be balanced against the risk of dysphagia when surgeons choose surgical procedures for each individual with GERD.
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Affiliation(s)
- Xing Du
- Department of Vascular Surgery, Xuan Wu Hospital, Capital Medical University
| | - Ji-Min Wu
- Department of Gastroesophageal Reflux Disease, PLA Rocket Force General Hospital
| | - Zhi-Wei Hu
- Department of Gastroesophageal Reflux Disease, PLA Rocket Force General Hospital
| | - Feng Wang
- Department of Gastroesophageal Reflux Disease, PLA Rocket Force General Hospital
| | - Zhong-Gao Wang
- Department of Vascular Surgery, Xuan Wu Hospital, Capital Medical University
| | - Chao Zhang
- Department of General Surgery, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Chao Yan
- Department of Vascular Surgery, Xuan Wu Hospital, Capital Medical University
| | - Mei-Ping Chen
- Department of Gastroesophageal Reflux Disease, PLA Rocket Force General Hospital
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Xiao H, Li H, Wang JJ, Zhang JS, Shen J, An XB, Zhang CC, Wu JM, Song Y, Wang XY, Yu HY, Deng XN, Li ZJ, Xu M, Lu ZZ, Du J, Gao W, Zhang AH, Feng Y, Zhang YY. IL-18 cleavage triggers cardiac inflammation and fibrosis upon β-adrenergic insult. Eur Heart J 2017; 39:60-69. [DOI: 10.1093/eurheartj/ehx261] [Citation(s) in RCA: 140] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 05/02/2017] [Indexed: 12/16/2022] Open
Affiliation(s)
- Han Xiao
- Institute of Vascular Medicine, Cardiology Department, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, and Beijing Key Laboratory of Cardiovascular Receptors Research, No. 49, Huayuan Bei Road, Haidian District, Beijing 100191, China
| | - Hao Li
- Institute of Vascular Medicine, Cardiology Department, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, and Beijing Key Laboratory of Cardiovascular Receptors Research, No. 49, Huayuan Bei Road, Haidian District, Beijing 100191, China
| | - Jing-Jing Wang
- Institute of Vascular Medicine, Cardiology Department, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, and Beijing Key Laboratory of Cardiovascular Receptors Research, No. 49, Huayuan Bei Road, Haidian District, Beijing 100191, China
| | - Jian-Shu Zhang
- Institute of Vascular Medicine, Cardiology Department, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, and Beijing Key Laboratory of Cardiovascular Receptors Research, No. 49, Huayuan Bei Road, Haidian District, Beijing 100191, China
| | - Jing Shen
- Institute of Vascular Medicine, Cardiology Department, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, and Beijing Key Laboratory of Cardiovascular Receptors Research, No. 49, Huayuan Bei Road, Haidian District, Beijing 100191, China
| | - Xiang-Bo An
- Institute of Vascular Medicine, Cardiology Department, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, and Beijing Key Laboratory of Cardiovascular Receptors Research, No. 49, Huayuan Bei Road, Haidian District, Beijing 100191, China
| | - Cong-Cong Zhang
- Vascular Biology Department, Beijing AnZhen Hospital, Capital Medical University, the Key Laboratory of Remodeling-related Cardiovascular Diseases, Ministry of Education, Beijing Institute of Heart, Lung and Blood Vessel Diseases, No.2, Anzhen Road, Chaoyang District, Beijing 100029, China
| | - Ji-Min Wu
- Institute of Vascular Medicine, Cardiology Department, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, and Beijing Key Laboratory of Cardiovascular Receptors Research, No. 49, Huayuan Bei Road, Haidian District, Beijing 100191, China
| | - Yao Song
- Institute of Vascular Medicine, Cardiology Department, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, and Beijing Key Laboratory of Cardiovascular Receptors Research, No. 49, Huayuan Bei Road, Haidian District, Beijing 100191, China
| | - Xin-Yu Wang
- Institute of Vascular Medicine, Cardiology Department, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, and Beijing Key Laboratory of Cardiovascular Receptors Research, No. 49, Huayuan Bei Road, Haidian District, Beijing 100191, China
| | - Hai-Yi Yu
- Institute of Vascular Medicine, Cardiology Department, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, and Beijing Key Laboratory of Cardiovascular Receptors Research, No. 49, Huayuan Bei Road, Haidian District, Beijing 100191, China
| | - Xiang-Ning Deng
- Institute of Vascular Medicine, Cardiology Department, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, and Beijing Key Laboratory of Cardiovascular Receptors Research, No. 49, Huayuan Bei Road, Haidian District, Beijing 100191, China
| | - Zi-Jian Li
- Institute of Vascular Medicine, Cardiology Department, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, and Beijing Key Laboratory of Cardiovascular Receptors Research, No. 49, Huayuan Bei Road, Haidian District, Beijing 100191, China
| | - Ming Xu
- Institute of Vascular Medicine, Cardiology Department, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, and Beijing Key Laboratory of Cardiovascular Receptors Research, No. 49, Huayuan Bei Road, Haidian District, Beijing 100191, China
| | - Zhi-Zhen Lu
- Institute of Vascular Medicine, Cardiology Department, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, and Beijing Key Laboratory of Cardiovascular Receptors Research, No. 49, Huayuan Bei Road, Haidian District, Beijing 100191, China
| | - Jie Du
- Vascular Biology Department, Beijing AnZhen Hospital, Capital Medical University, the Key Laboratory of Remodeling-related Cardiovascular Diseases, Ministry of Education, Beijing Institute of Heart, Lung and Blood Vessel Diseases, No.2, Anzhen Road, Chaoyang District, Beijing 100029, China
| | - Wei Gao
- Institute of Vascular Medicine, Cardiology Department, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, and Beijing Key Laboratory of Cardiovascular Receptors Research, No. 49, Huayuan Bei Road, Haidian District, Beijing 100191, China
| | - Ai-Hua Zhang
- Department of Nephrology, Jiangsu Key Laboratory of Pediatrics, Children's Hospital of Nanjing Medical University, No.140, Hanzhong Road, Nanjing, Jiangsu Province 210008, China
| | - Yue Feng
- Department of Pharmacology, Emory University School of Medicine, 5029 Rollins Research Center, 1510 Clifton Road, Atlanta, GA 30322, USA
| | - You-Yi Zhang
- Institute of Vascular Medicine, Cardiology Department, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptide, Ministry of Health, and Beijing Key Laboratory of Cardiovascular Receptors Research, No. 49, Huayuan Bei Road, Haidian District, Beijing 100191, China
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Zhang C, Hu ZW, Yan C, Wu Q, Wu JM, Du X, Liu DG, Luo T, Li F, Wang ZG. Nissen fundoplication vs proton pump inhibitors for laryngopharyngeal reflux based on pH-monitoring and symptom-scale. World J Gastroenterol 2017; 23:3546-3555. [PMID: 28596691 PMCID: PMC5442091 DOI: 10.3748/wjg.v23.i19.3546] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 01/21/2017] [Accepted: 02/17/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To compare the outcomes between laparoscopic Nissen fundoplication (LNF) and proton pump inhibitors (PPIs) therapy in patients with laryngopharyngeal reflux (LPR) and type I hiatal hernia diagnosed by oropharyngeal pH-monitoring and symptom-scale assessment.
METHODS From February 2014 to January 2015, 70 patients who were diagnosed with LPR and type I hiatal hernia and referred for symptomatic assessment, oropharyngeal pH-monitoring, manometry, and gastrointestinal endoscopy were enrolled in this study. All of the patients met the inclusion criteria. All of the patients underwent LNF or PPIs administration, and completed a 2-year follow-up. Patients’ baseline characteristics and primary outcome measures, including comprehensive and single symptoms of LPR, PPIs independence, and satisfaction, and postoperative complications were assessed. The outcomes of LNF and PPIs therapy were analyzed and compared.
RESULTS There were 31 patients in the LNF group and 39 patients in the PPI group. Fifty-three patients (25 in the LNF group and 28 in the PPI group) completed reviews and follow-up. Oropharyngeal pH-monitoring parameters were all abnormal with high acid exposure, a large amount of reflux, and a high Ryan score, associated reflux symptom index (RSI) score. There was a significant improvement in the RSI and LPR symptom scores after the 2-year follow-up in both groups (P < 0.05), as well as typical symptoms of gastroesophageal reflux disease. Improvement in the RSI (P < 0.005) and symptom scores of cough (P = 0.032), mucus (P = 0.011), and throat clearing (P = 0.022) was significantly superior in the LNF group to that in the PPI group. After LNF and PPIs therapy, 13 and 53 patients achieved independence from PPIs therapy (LNF: 44.0% vs PPI: 7.14%, P < 0.001) during follow-up, respectively. Patients in the LNF group were more satisfied with their quality of life than those in the PPI group (LNF: 62.49 ± 28.68 vs PPI: 44.36 ± 32.77, P = 0.004). Body mass index was significantly lower in the LNF group than in the PPI group (LNF: 22.2 ± 3.1 kg/m2vs PPI: 25.1 ± 2.9 kg/m2, P = 0.001).
CONCLUSION Diagnosis of LPR should be assessed with oropharyngeal pH-monitoring, manometry, and the symptom-scale. LNF achieves better improvement than PPIs for LPR with type I hiatal hernia.
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Yan C, Hu ZW, Wu JM, Zhang C, Yan L, Wang ZG. Laparoscopic Toupet fundoplication with duodenojejunostomy for the management of superior mesenteric artery syndrome with reflux symptoms. Medicine (Baltimore) 2017; 96:e5771. [PMID: 28099334 PMCID: PMC5279079 DOI: 10.1097/md.0000000000005771] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
RATIONALE The patient had symptoms of GERD and the reflux even caused the symptom of cough. Gaining weight is a risk factor for the treatment of reflux as it could exacerbated symptoms of reflux and the drug treatment is not effective. Surgical intervention becomes necessary when there is failure following conservative medical therapy or the patient. PATIENT CONCERNS The patient was not satisfied with the drug treatment. DIAGNOSES Superior mesenteric artery syndrome, gastroesophageal reflux disease. INTERVENTIONS Laparoscopic Toupet fundoplication with duodenojejunostomy. OUTCOMES The patient discharged from hospital 10 days after surgery without any postoperative complication. The patient achieved complete relief of symptoms and discontinuation of drug. LESSONS SUBSECTIONS Superior mesenteric artery (SMA) syndrome may manifest the symptoms of GERD such as heartburn, acid reflux and cough. It is necessary to complete examination to exclude superior mesenteric artery syndrome for these patients. Laparoscopic fundoplication with duodenojejunostomy provided an effective treatment for patients who failed drug treatment.
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Affiliation(s)
- Chao Yan
- Department of Vascular Surgery, Xuan Wu Hospital, Capital Medical University
| | - Zhi-Wei Hu
- Department of Gastroesophageal Reflux Disease, The General Hospital of the PLA Rocket, Beijing, China
| | - Ji-Min Wu
- Department of Gastroesophageal Reflux Disease, The General Hospital of the PLA Rocket, Beijing, China
| | - Chao Zhang
- Department of Vascular Surgery, Xuan Wu Hospital, Capital Medical University
| | - Liang Yan
- Department of Gastroesophageal Reflux Disease, The General Hospital of the PLA Rocket, Beijing, China
| | - Zhong-Gao Wang
- Department of Vascular Surgery, Xuan Wu Hospital, Capital Medical University
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Siedhoff MT, Doll KM, Rutstein SE, Wheeler SB, Geller EJ, Wu JM, Clarke-Pearson DL. Laparoscopic Hysterectomy with Morcellation versus Abdominal Hysterectomy for Presumed Uterine Leiomyomata: An Updated Decision Analysis. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Siedhoff MT, Rutstein SE, Wheeler SB, Geller EJ, Doll KM, Wu JM, Clarke-Pearson DL. Cost-Effectiveness of Laparoscopic Hysterectomy With Morcellation Compared to Abdominal Hysterectomy for Presumed Benign Leiomyomata. J Minim Invasive Gynecol 2016; 22:S78. [PMID: 27679339 DOI: 10.1016/j.jmig.2015.08.209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- M T Siedhoff
- Minimally Invasive Gynecologic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - S E Rutstein
- Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - S B Wheeler
- Gillings School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - E J Geller
- Female Pelvic Medicine and Reconstructive Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - K M Doll
- Gynecologic Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - J M Wu
- Female Pelvic Medicine and Reconstructive Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - D L Clarke-Pearson
- Gynecologic Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Hu ZW, Wu JM, Wang ZG, Wang F, Chen MP, Dong YY, Zhan XL, Zhang Y, Ma SS, Zhang C, Yan C. [Laparoscopic reoperation for recurred antireflux surgery of gastroesophageal reflux disease]. Zhonghua Wai Ke Za Zhi 2016; 54:498-503. [PMID: 27373474 DOI: 10.3760/cma.j.issn.0529-5815.2016.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate the safety and effectiveness of laparoscopic reoperation for patients with gastroesophageal reflux disease (GERD) recurred form previous anti-reflux surgery. METHODS Totally 19 patients received laparoscopic reoperation for symptomatic and anatomic recurred GERD in Department of Gastroesophageal Reflux Disease, Rocket Force General Hospital from January 2008 to September 2015 were retrospectively analyzed. There were 12 male and 7 female patients. The average reoperation age was (48±14) years, the average duration of reoperation from original ones was (43±38) months. The patients underwent preoperative barium, endoscopy, manometry and 24-hour pH studies. Laparoscopic hiatal hernia repair plus fundoplication was carried out for reoperation. Gastroesophageal reflux related symptoms (reflux, heartburn, chest pain, chough, wheezing, chest tightness and globus sensation) before and after surgery were compared by a questionnaire. The patients' medication consumption, complications and satisfaction of the reoperation were investigated as well. The repeated measures analysis of variance was used for statistical comparison of data preoperatively and postoperatively. RESULTS No major complication and death occurred. Six cases (32%) had complications such as diarrhea, increased passing wind, flatulence, dysphagia and abdominal pain. The GERD related symptom score of reflux, heartburn, chest pain, chough, wheezing, chest tightness and globus sensation all significantly decreased (F: 25.0 to 56.7; P: 0.000 to 0.001) after the reoperation, with 68% good outcome of all the patients. After a follow-up of (33±22) months after reoperation, 1 case had partial recurrence at the 3(rd) month after reoperation. For all the patients, 12 cases felt very satisfied or satisfied with the reoperation. CONCLUSION Laparoscopic reoperation is generally effective with acceptable morbidity rates for patients with esophageal and extraesophageal symptoms recurred form previous hiatal repair and (or) fundoplication.
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Affiliation(s)
- Z W Hu
- Department of Gastroesophageal Reflux Disease, Rocket Force General Hospital, Beijing 100088, China
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Liang WT, Yan C, Wang ZG, Wu JM, Hu ZW, Zhan XL, Wang F, Ma SS, Chen MP. Early and Midterm Outcome After Laparoscopic Fundoplication and a Minimally Invasive Endoscopic Procedure in Patients with Gastroesophageal Reflux Disease: A Prospective Observational Study. J Laparoendosc Adv Surg Tech A 2016; 25:657-61. [PMID: 26258269 DOI: 10.1089/lap.2015.0188] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND AND AIMS Although the minimally invasive endoscopic Stretta procedure is being increasingly used as an alternative strategy to manage gastroesophageal reflux disease (GERD), the benefits of this procedure have to be further evaluated in clinical settings. This prospective observational study assessed the short-term and midterm outcomes associated with laparoscopic Toupet fundoplication (LTF) and the Stretta procedure. PATIENTS AND METHODS From January 2011 to January 2012, we allocated 80 patients to LTF and 85 to the Stretta procedure. Primary outcome measures, including symptom scores of heartburn, regurgitation, chest pain, belching, hiccup, cough, and asthma, as well as proton pump inhibitor (PPI) use, were analyzed at midterm follow-up (1-3 years). RESULTS Of the 165 patients, 125 patients following LTF (n=65) or the Stretta procedure (n=60) completed the designated 3-year follow-up and were included in the final analysis. At the end of the 3-year follow-up, the symptom scores were all significantly decreased compared with the corresponding values before the two procedures in both groups (P<.05). After LTF and the Stretta procedure, 47/65 (72.3%) and 41/60 (68.3%) patients, respectively, achieved complete PPI therapy independence (72.3% versus 68.3%, P=.627). Comparing with LTF, however, the Stretta procedure had less effect on improving typical symptoms of heartburn, regurgitation, and chest pain and reducing the rate of re-operation (11.8% versus 0%, P=.006). CONCLUSIONS LTF and the Stretta procedure were equally effective in controlling GERD symptoms and reducing PPI use. However, LTF can achieve more improvement on typical symptoms and has a lower rate of re-operation.
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Affiliation(s)
- Wei-Tao Liang
- 1 Department of Vascular Surgery, Xuan Wu Hospital, Capital Medical University , Beijing, China
| | - Chao Yan
- 1 Department of Vascular Surgery, Xuan Wu Hospital, Capital Medical University , Beijing, China
| | - Zhong-Gao Wang
- 1 Department of Vascular Surgery, Xuan Wu Hospital, Capital Medical University , Beijing, China
| | - Ji-Min Wu
- 2 Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of Chinese People's Liberation Army , Beijing, China
| | - Zhi-Wei Hu
- 2 Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of Chinese People's Liberation Army , Beijing, China
| | - Xiu-Lan Zhan
- 2 Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of Chinese People's Liberation Army , Beijing, China
| | - Feng Wang
- 2 Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of Chinese People's Liberation Army , Beijing, China
| | - Song-Song Ma
- 2 Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of Chinese People's Liberation Army , Beijing, China
| | - Mei-Ping Chen
- 2 Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of Chinese People's Liberation Army , Beijing, China
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Yan C, Liang WT, Wang ZG, Hu ZW, Wu JM, Zhang C, Chen MP. Comparison of Stretta procedure and toupet fundoplication for gastroesophageal reflux disease-related extra-esophageal symptoms. World J Gastroenterol 2015; 21:12882-12887. [PMID: 26668513 PMCID: PMC4671044 DOI: 10.3748/wjg.v21.i45.12882] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 08/09/2015] [Accepted: 09/30/2015] [Indexed: 02/06/2023] Open
Abstract
AIM: To compare the outcomes between the Stretta procedure and laparoscopic toupet fundoplication (LTF) in patients with gastroesophageal reflux disease (GERD)-related extra-esophageal symptoms.
METHODS: From January 2011 to February 2012, a total of 98 patients diagnosed with GERD-related extra-esophageal symptoms who met the inclusion criteria were enrolled in this study. All patients who either underwent the Stretta procedure or LTF treatment have now completed the 3-year follow-up. Primary outcome measures, including frequency and severity of extra-esophageal symptoms, proton pump inhibitor (PPI) use, satisfaction, and postoperative complications, were assessed. The results of the Stretta procedure and LTF therapy were analyzed and compared.
RESULTS: There were 47 patients in the Stretta group and 51 patients in the LTF group. Ninety patients were available at the 3-year follow-up. The total of the frequency and severity scores for every symptom improved in both groups (P < 0.05). Improvement in symptom scores of cough, sputum, and wheezing did not achieve statistical significance between the two groups (P > 0.05). However, the score for globus hysterics was different between the Stretta group and the LTF group (4.9 ± 2.24 vs 3.2 ± 2.63, P < 0.05). After the Stretta procedure and LTF treatment, 29 and 33 patients in each group achieved PPI therapy independence (61.7% vs 64.7%, P = 0.835). The patients in the LTF group were more satisfied with their quality of life than those in the Stretta procedure group (P < 0.05). Most complications resolved without intervention within two weeks; however, two patients in the LTF group still suffered from severe dysphagia 2 wk after the operation, and it improved after bougie dilation treatment in both patients.
CONCLUSION: The Stretta procedure and LTF were both safe and effective for the control of GERD-related extra-esophageal symptoms and the reduction of PPI use.
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Castelijns B, Ponten JEH, Van de Poll MCG, Nienhuijs SW, Smulders JF, Hu ZW, Wu JM, Wang ZG, Idani H, Asami S, Nakano K, Miyake S, Harano M, Miyoshi H, Araki H, Ogawa T, Takahashi K, Shiozaki S, Ninomiya M, Prasad A, Todkar J, Asti E, Lovece A, Sironi A, Bonavina L, Wright R, Wurst H, Zhang C, Li HL, Ke LM, Loi K, Hua R, Yao QY, Chen H, Okinyi W, Odende K, Ndungu B, Ndonga A, Kiragu P, Kelimu A, Alimujiang M, Tian W, Bing M. Hiatal Hernia. Hernia 2015; 19 Suppl 1:S13-7. [PMID: 26518789 DOI: 10.1007/bf03355320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
| | | | | | | | | | | | - J M Wu
- Gastroesophageal Reflux Disease Department, Second Artillery General Hospital PLA, 2. Xuanwu Hospital, Capital Medic, Beijing, China
| | | | - H Idani
- Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - S Asami
- Fukuyama City Hospital, Fukuyama, Japan
| | - K Nakano
- Fukuyama City Hospital, Fukuyama, Japan
| | - S Miyake
- Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - M Harano
- Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - H Miyoshi
- Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - H Araki
- Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - T Ogawa
- Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - K Takahashi
- Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - S Shiozaki
- Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - M Ninomiya
- Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan
| | - A Prasad
- Apollo Hospital, New Delhi, India
| | - J Todkar
- Hiranandani Hospital, Mumbai, India
| | - E Asti
- IRCCS Policlinico San Donato, Milan, Italy
| | - A Lovece
- IRCCS Policlinico San Donato, Milan, Italy
| | - A Sironi
- IRCCS Policlinico San Donato, Milan, Italy
| | - L Bonavina
- IRCCS Policlinico San Donato, Milan, Italy
| | - R Wright
- Cascade Hernia Institute, Puyallup, USA
| | - H Wurst
- Meridian Surgery Center, Puyallup, USA
| | - C Zhang
- Department of Minimally Invasive Surgery, Xinjiang people Hospital, Urumqi, China
| | | | | | - K Loi
- St George Private Hospital, Sydney, Australia
| | | | - Q Y Yao
- Department of General Surgery, Hernia Center, Shanghai Medical College, Fudan University, Shanghai, China
| | | | - W Okinyi
- The University of Nairobi, Nairobi, Kenya
| | - K Odende
- Kenyatta National Hospital, Nairobi, Kenya
| | - B Ndungu
- The University of Nairobi, Nairobi, Kenya
| | - A Ndonga
- The Mater Hospital, Nairobi, Kenya
| | - P Kiragu
- Maralal County Hospital, Maralal, Kenya
| | - A Kelimu
- Department of Minimally Invasive Surgery, hernias and abdominal wall surgery, People's Hospital of Xinjiang Uyghur Auton, Urumqi, China
| | | | - W Tian
- Department of General Surgery, 1st affiliated hospital of PLA general hospital, Beijing, China
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Hu ZW, Wu JM, Liang WT, Wang ZG. Gastroesophageal reflux disease related asthma: From preliminary studies to clinical practice. World J Respirol 2015; 5:58-64. [DOI: 10.5320/wjr.v5.i1.58] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2014] [Revised: 01/16/2015] [Accepted: 02/11/2015] [Indexed: 02/06/2023] Open
Abstract
The diagnosis of asthma requires the presence of episodic respiratory difficulties characterized by variable and reversible airway obstruction. It has a high prevalence worldwide and is traditionally considered to be an allergic disease. Most cases are responsive to treatment with bronchodilators and anti-inflammatories, as recommended by national and international guidelines; however, approximately 10% of asthmatic patients are refractory even to optimal therapy. Gastroesophageal reflux disease (GERD) is a common disorder in asthmatic patients and the two disorders may be linked pathophysiologically. Here we review data from preliminary studies that suggest asthma could be induced or exacerbated by gastroesophageal reflux. The optimal strategies for the diagnosis of GERD-related asthma and its therapy are still debated. However, there is evidence to suggest that antireflux treatment is effective and practical for asthmatic patients with well-defined reflux disease.
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Yang CZ, Tian AJ, Meng ZH, Wu JM, Zhang YY, Guo LJ, Li ZJ. [Establishment of a FVB/N mouse model of cardiac hypertrophy by isoprenaline]. Beijing Da Xue Xue Bao Yi Xue Ban 2014; 46:906-910. [PMID: 25512281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To investigate the condition of isoprenaline (ISO)-induced cardiac hypertrophy in the FVB/N mouse. METHODS ISO (30 mg/kg/d) was administered either by daily subcutaneous injection, or by continuous infusion via an implanted osmotic minipump. The mice in each mode of administration were randomly divided into two groups. For subcutaneous injection: the mice received ISO or saline through daily subcutaneous injection for 2 weeks. The mice for minipump: the mice received continuous infusion of ISO via an implanted osmotic minipump for 2 weeks, or received sham operation as the control to mimipump. The ratio of heart weight to tibia length (HW/TI), the diastolic left ventricular posterior wall thickness (dLVPW) were used to indicate cardiac hypertrophy. Interstitial fibrosis was examined with picrosirius red staining. RESULTS ISO (30 mg/kg/d) administered by daily subcutaneous injection did not lead to cardiac hypertrophy or fibrosis in the FVB/N mice, and 50% of the mice died before the end point. The mice receiving ISO via minipumps showed significant increase in HW/TI [(10.60±0.40 ) mg/mm vs. (7.93±0.19) mg/mm,P<0.001] and dLVPW [(0.87±0.03) mm vs. (0.68±0.06)mm,P=0.0116]. ISO administered via minipumps did not induce cardiac fibrosis. All the mice in this group survived to the end point. CONCLUSION ISO (30 mg/kg/d) administered by continuous infusion via a minipump for 2 weeks can lead to significant cardiac hypertrophy.
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Affiliation(s)
- C Z Yang
- Institute of Vascular Medicine, Peking University Third Hospital; Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health; Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education; Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing 100191,China
| | - A J Tian
- Institute of Vascular Medicine, Peking University Third Hospital; Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health; Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education; Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing 100191,China
| | - Z H Meng
- Institute of Vascular Medicine, Peking University Third Hospital; Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health; Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education; Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing 100191,China
| | - J M Wu
- Institute of Vascular Medicine, Peking University Third Hospital; Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health; Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education; Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing 100191,China
| | - Y Y Zhang
- Institute of Vascular Medicine, Peking University Third Hospital; Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health; Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education; Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing 100191,China
| | - L J Guo
- Institute of Vascular Medicine, Peking University Third Hospital; Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health; Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education; Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing 100191,China
| | - Z J Li
- Institute of Vascular Medicine, Peking University Third Hospital; Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides, Ministry of Health; Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education; Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing 100191,China
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Liang WT, Wu JM, Wang ZG. Modification of Belsey (Mark IV) fundoplication in the management of hiatal hernia and gastroesophageal reflux disease after sleeve gastrectomy: a case report. Surg Obes Relat Dis 2014; 11:e19-20. [PMID: 25820076 DOI: 10.1016/j.soard.2014.11.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 11/21/2014] [Accepted: 11/23/2014] [Indexed: 01/02/2023]
Affiliation(s)
- Wei-Tao Liang
- Center for GERD, The Second Artillery General Hospital of Chinese People's Liberation Army, Beijing, P.R. China; Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, P.R. China
| | - Ji-Min Wu
- Center for GERD, The Second Artillery General Hospital of Chinese People's Liberation Army, Beijing, P.R. China.
| | - Zhong-Gao Wang
- Center for GERD, The Second Artillery General Hospital of Chinese People's Liberation Army, Beijing, P.R. China; Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, P.R. China
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Liang WT, Wang ZG, Wang F, Yang Y, Hu ZW, Liu JJ, Zhu GC, Zhang C, Wu JM. Long-term outcomes of patients with refractory gastroesophageal reflux disease following a minimally invasive endoscopic procedure: a prospective observational study. BMC Gastroenterol 2014. [PMID: 25304252 DOI: 10.1186/1471-230x-14-1781471-230x-14-178] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Gastroesophageal reflux disease (GERD) is the most common digestive disease, affecting one third of the world's population. The minimally invasive endoscopic Stretta procedure is being increasingly used as an alternative strategy to manage refractory GERD. However, long-term benefits of this procedure have to be further evaluated in clinical settings. This prospective observational study was therefore conducted to evaluate the outcome of patients with refractory GERD 5 years after the Stretta procedure. METHODS A total of 152 patients with refractory GERD underwent the Stretta procedure in our department between April 2007 and September 2008. They were followed up for 5 years, during which the primary outcome measures including symptom scores of heartburn, regurgitation, chest pain, cough and asthma and the secondary outcome measures including proton pump inhibitor (PPI) use and patients' satisfaction were analysed at 6, 12, 24, 36, 48 and 60 months respectively. RESULTS Of the 152 patients, 138 completed the designated 5-year follow-up and were included in the final analysis. At the end of the 5-year follow-up, the symptom scores of heartburn (2.47 ± 1.22 vs. 5.86 ± 1.52), regurgitation (2.23 ± 1.30 vs. 5.56 ± 1.65), chest pain (2.31 ± 0.76 vs. 4.79 ± 1.59), cough (3.14 ± 1.43 vs. 6.62 ± 1.73) and asthma (3.26 ± 1.53 vs. 6.83 ± 1.46) were all significantly decreased as compared with the corresponding values before the procedure (P < 0.001). After the Stretta procedure, 59 (42.8%) patients achieved complete PPI therapy independence and 104 (75.4%) patients were completely or partially satisfied with the GERD symptom control. Moreover, no severe complications were observed except for complaint of abdominal distention in 12 (8.7%) patients after the Stretta procedure. CONCLUSION The Stretta procedure may achieve an effective and satisfactory long-term symptom control and considerably reduce the reliance on medication without significant adverse effects in adult patients with refractory GERD, thereby having profound clinical implications.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Ji-Min Wu
- Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of the Chinese People's Liberation Army, 16 Xinwai Street, Xicheng District, Beijing 100088, China.
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Liang WT, Wang ZG, Wang F, Yang Y, Hu ZW, Liu JJ, Zhu GC, Zhang C, Wu JM. Long-term outcomes of patients with refractory gastroesophageal reflux disease following a minimally invasive endoscopic procedure: a prospective observational study. BMC Gastroenterol 2014; 14:178. [PMID: 25304252 PMCID: PMC4287567 DOI: 10.1186/1471-230x-14-178] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 09/29/2014] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Gastroesophageal reflux disease (GERD) is the most common digestive disease, affecting one third of the world's population. The minimally invasive endoscopic Stretta procedure is being increasingly used as an alternative strategy to manage refractory GERD. However, long-term benefits of this procedure have to be further evaluated in clinical settings. This prospective observational study was therefore conducted to evaluate the outcome of patients with refractory GERD 5 years after the Stretta procedure. METHODS A total of 152 patients with refractory GERD underwent the Stretta procedure in our department between April 2007 and September 2008. They were followed up for 5 years, during which the primary outcome measures including symptom scores of heartburn, regurgitation, chest pain, cough and asthma and the secondary outcome measures including proton pump inhibitor (PPI) use and patients' satisfaction were analysed at 6, 12, 24, 36, 48 and 60 months respectively. RESULTS Of the 152 patients, 138 completed the designated 5-year follow-up and were included in the final analysis. At the end of the 5-year follow-up, the symptom scores of heartburn (2.47 ± 1.22 vs. 5.86 ± 1.52), regurgitation (2.23 ± 1.30 vs. 5.56 ± 1.65), chest pain (2.31 ± 0.76 vs. 4.79 ± 1.59), cough (3.14 ± 1.43 vs. 6.62 ± 1.73) and asthma (3.26 ± 1.53 vs. 6.83 ± 1.46) were all significantly decreased as compared with the corresponding values before the procedure (P < 0.001). After the Stretta procedure, 59 (42.8%) patients achieved complete PPI therapy independence and 104 (75.4%) patients were completely or partially satisfied with the GERD symptom control. Moreover, no severe complications were observed except for complaint of abdominal distention in 12 (8.7%) patients after the Stretta procedure. CONCLUSION The Stretta procedure may achieve an effective and satisfactory long-term symptom control and considerably reduce the reliance on medication without significant adverse effects in adult patients with refractory GERD, thereby having profound clinical implications.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Ji-Min Wu
- Department of Gastroesophageal Reflux Disease, Second Artillery General Hospital of the Chinese People's Liberation Army, 16 Xinwai Street, Xicheng District, Beijing 100088, China.
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Liang WT, Wu JM, Wang F, Hu ZW, Wang ZG. Stretta radiofrequency for gastroesophageal reflux disease-related respiratory symptoms: a prospective 5-year study. MINERVA CHIR 2014; 69:293-299. [PMID: 25267020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
AIM The aim of the present study was to prospectively evaluate the Stretta radiofrequency (RF) treatment for gastroesophageal reflux disease (GERD) -related respiratory symptoms over a 5-years follow-up period. METHODS A total of 132 patients underwent the Stretta procedure between April 2007 and February 2009; 122 of the patients (92.4%) completed the 5-year follow-up. Symptom scores and PPI usage were evaluated at baseline, 6 months, 1 year, 3 years and 5 years after treatment. RESULTS A total of 122 patients (age, 51.7 ± 13.0 years, M:F, 52: 70) were followed up for 5 years and their outcomes were analyzed. At 5 years after treatment, the symptom scores were significantly reduced (heartburn score, from 5.67 ± 1.52 to 2.41 ± 1.13; regurgitation score, from 5.43 ± 1.66 to 2.27 ± 1.33; chest pain score, from 4.45 ± 1.47 to 2.40 ± 0.88; cough score, from 6.62 ± 1.73 to 3.14 ± 1.43; and asthma score, from 6.83 ± 1.46 to 3.26 ± 1.53, P<0.001). Moreover, 56.6% of the patients were completely off PPIs. CONCLUSION Stretta RF significantly improves the symptoms and reduces PPI usage at 5 years. Therefore, it is a viable, effective, and minimally invasive endoluminal procedure for patients with GERD-related respiratory symptoms.
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Affiliation(s)
- W T Liang
- Department of Thoracic Cardiovascular Surgery Xuanwu Hospital, Capital Medical University Xicheng District, Beijing, PR China -
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Wu QF, Wu JM, Bai XH, Wang ZH, Cai HY, Gong WL, Tian SR. [Response rules of pressing pain on back section in Governor Vessel in patients with gastroesophageal reflux disease]. Zhongguo Zhen Jiu 2014; 34:775-777. [PMID: 25335255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The response rules of pressing pain on the back section in the Governor Vessel in patients with gastro-esophageal reflux disease (GERD) were studied to provide references for the diagnosis and treatment of GERD. Seventy-six cases of GERD were included into an observation group while 30 healthy volunteers were recruited into a control group. A mechanical measurement device of pressing pain that could measure the pain threshold was adapted to observe the pressing pain on the back section in the Governor Vessel in GERD patients and healthy volunteers. The test area is from spinous process of the 1st thoracic vertebra to that of the 12th thoracic vertebra (T1 -T12), including acupoints and non-acupoints on the Governor Vessel. As a result, in the observation group the pain threshold of T5-T7 spinous process clearance, which was the location of Shendao (GV 11), Lingtai (GV 10) and Zhiyang (GV 9), was lower than that in the control group (all P < 0.05). This result indicated that there was significant pressing pain in T5-T7 spinous process clearance in patients with GERD, which could be taken as an important auxiliary diagnosis and a new thinking method in the treatment of GERD with acupuncture.
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Wang JN, Wong TK, Kan CD, Wu JM, Chiu WT, Chan HC. P345Isolation and identification of a new source of human stem cells expanded from pediatric congenital heart disease. Cardiovasc Res 2014. [DOI: 10.1093/cvr/cvu091.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Liang WT, Wu JM, Hu ZW, Wang ZG, Zhu GC, Zhang C. Laparoscopic Nissen fundoplication is more effective in treating patients with GERD-related chronic cough than Stretta radiofrequency. MINERVA CHIR 2014; 69:121-7. [PMID: 24970301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
AIM Chronic cough is the most common extra-esophageal manifestation of gastroesophageal reflux disease (GERD). This study aimed to retrospectively analyze outcomes in patients with GERD-related cough following laparoscopic Nissen fundoplication (LNF) and Stretta radiofrequency (RF) respectively. METHODS Medical charts of 83 patients with GERD-related cough that underwent LNF or Stretta RF between 2007 and 2012 were retrieved. Symptom scores (heartburn, regurgitation and cough) and proton pump inhibitors (PPIs) usages were evaluated. RESULTS A total of 83 patients with GERD-related cough underwent LNF (N.=35) and Stretta RF (N.=48), and were followed up 36.78 ± 16.12 months (range 13-55 months). During the follow-up, the post-treatment scores were statistically lower as compared with the pre-treatment scores in both groups, while the cough improvement after Stretta was significantly lower than that after LNF (P<0.001). Besides, 27 (77.1%) patients achieved complete PPI therapy independence after LNF, comparing with 27 (65.1%) after Stretta (P<0.05). No significant differences in post-treatment complications were observed except for the abdominal distention. CONCLUSION Even though laparoscopic Nissen fundoplication and Stretta are capable of controlling GERD-related cough effectively and safely in selected patients, laparoscopic Nissen fundoplication could improve more in symptoms and PPI elimination.
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Affiliation(s)
- W T Liang
- Department of Thoracic Cardiovascular Surgery Xuanwu Hospital, Capital Medical University No. 45 Changchun Street, Xicheng District, Beijing, P.R. China -
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Hu ZW, Wang ZG, Zhang Y, Tian SR, Wu JM, Zhu GC, Liang WT. Gastroesophageal reflux in chronic cough and cough syncope and the effect of antireflux treatment: case report and literature review. Ann Otol Rhinol Laryngol 2014; 123:719-25. [PMID: 24842868 DOI: 10.1177/0003489414534011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This study aimed to evaluate the efficacy of antireflux treatment on gastroesophageal reflux (GER)-related cough syncope. METHODS The method used was a retrospective review of the outcomes of antireflux treatment with proton pump inhibitor (PPI), Stretta radiofrequency (SRF), or laparoscopic fundoplication (LF) of 8 patients with chronic cough and cough syncope that was clinically evaluated to be GER related over a period of 2 to 5 years. RESULTS In the 8 selected cases, the typical GER symptoms disappeared in 7 cases and were significantly eased in 1 case. The chronic cough diminished to mild and occasional occurrence in 6 cases and was completely relieved in 2 cases. Meanwhile, the cough syncope disappeared in all cases. Seven of the patients resumed physical and social functions after the antireflux treatments, except for 1 person, who had a stroke due to other causes. CONCLUSION For chronic cough and cough syncope of unknown cause, the GER assessment could be valuable. In treating well-selected GER-related chronic cough and cough syncope, PPI, SRF, and LF can be considered. Moreover, satisfactory restoration of physical and social functions could be achieved after effective antireflux therapy.
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Affiliation(s)
- Zhi-Wei Hu
- Center for GER, the Second Artillery General Hospital, Beijing Normal University, Beijing, China Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhong-Gao Wang
- Center for GER, the Second Artillery General Hospital, Beijing Normal University, Beijing, China Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Yu Zhang
- Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Shu-Rui Tian
- Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Ji-Min Wu
- Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Guang-Chang Zhu
- Center for GER, the Second Artillery General Hospital, Beijing Normal University, Beijing, China
| | - Wei-Tao Liang
- Center for GER, the Second Artillery General Hospital, Beijing Normal University, Beijing, China
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Jiang HH, Qin SY, Wang W, He B, Hu TS, Wu JM, Fan QS, Tu CC, Liu Q, Zhu XQ. Prevalence and genetic characterization of Toxoplasma gondii infection in bats in southern China. Vet Parasitol 2014; 203:318-21. [PMID: 24813744 DOI: 10.1016/j.vetpar.2014.04.016] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 04/08/2014] [Accepted: 04/14/2014] [Indexed: 11/25/2022]
Abstract
Toxoplasma gondii can infect a wide variety of warm-blooded animals, including bats. Limited information on T. gondii infection in bats is available in China. The objective of the present study was to determine prevalence and genetic diversity of T. gondii infection in bats in southern China. A total of 608 bats representing 12 species, including 120 Aselliscus stoliczkanus, 59 Myotis chinensis, 11 Miniopterus schreibersii, 53 Rhinolophus affinis, 32 Rhinolophus pusillus, 81 Hipposideros armiger, 28 Hipposideros fulvus, 32 Cynopterus brachyotis, 14 Cynopterus sphinx, 45 Eonycteris spelaea, 109 Hipposideros larvatus, and 24 Taphozous melanopogon, were collected from Yunnan and Guangxi provinces, southern China. They were examined for the presence of T. gondii DNA by amplification of the B1 gene using a nested PCR, and the positive samples were genotyped at 11 genetic loci (SAG1, 5'- and 3'-SAG2, alternative SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1 and Apico) using multilocus polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technology. Fifty-nine (9.7%) of these bats were detected positive by PCR but only five of these positive DNA samples were completely typed at all loci; of which 4 samples, 2 from A. stoliczkanus, and 2 from H. larvatus, belonged to ToxoDB Genotype #10, and the other one from H. larvatus was identified as ToxoDB Genotype #9 (http://toxodb.org/toxo/). To our knowledge, this is the first report of molecular detection and genetic characterization of T. gondii infection in bats in China. The results show that these bats are potential reservoirs for T. gondii transmission, which may pose a threat to human health.
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Affiliation(s)
- H H Jiang
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046, PR China
| | - S Y Qin
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046, PR China; College of Animal Science and Technology, Jilin Agricultural University, Changchun, Jilin Province 130118, PR China
| | - W Wang
- Military Veterinary Institute, Academy of Military Medical Sciences, Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun, Jilin Province 130122, PR China
| | - B He
- Military Veterinary Institute, Academy of Military Medical Sciences, Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun, Jilin Province 130122, PR China
| | - T S Hu
- Center for Disease Control and Prevention of Chengdu Military Region, Kunming, Yunnan Province 650032, PR China
| | - J M Wu
- Guangxi Veterinary Research Institute, Nanning, Guangxi Province 530001, PR China
| | - Q S Fan
- Center for Disease Control and Prevention of Chengdu Military Region, Kunming, Yunnan Province 650032, PR China
| | - C C Tu
- Military Veterinary Institute, Academy of Military Medical Sciences, Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun, Jilin Province 130122, PR China
| | - Q Liu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046, PR China; Military Veterinary Institute, Academy of Military Medical Sciences, Key Laboratory of Jilin Province for Zoonosis Prevention and Control, Changchun, Jilin Province 130122, PR China.
| | - X Q Zhu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province 730046, PR China; College of Animal Science and Technology, Jilin Agricultural University, Changchun, Jilin Province 130118, PR China.
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Liu RY, Wang JJ, Qiu X, Wu JM. Acute hyperglycemia together with hematoma of high-glucose blood exacerbates neurological injury in a rat model of intracerebral hemorrhage. Neurosci Bull 2014; 30:90-8. [PMID: 23884876 PMCID: PMC5561852 DOI: 10.1007/s12264-013-1371-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2013] [Accepted: 06/09/2013] [Indexed: 01/27/2023] Open
Abstract
Recent evidence suggests that admission hyperglycemia has deleterious effects on the survival and functional outcome of patients with intracerebral hemorrhage (ICH). In this study, we first induced acute hyperglycemia in male adult Sprague-Dawley rats by intraperitoneal injection of 50% glucose (6 mL/kg), and created the ICH model thereafter by delivering autologous whole blood or homologous normal-glucose blood into the right basal ganglia. Twenty-four hours later, we assessed the neurological injury, evaluated the hematoma and brain water content, and investigated autophagy. We found elevations of neurological deficit scores, brain water content, and microtubule-associated protein light chain-3 (LC3) and beclin-1 protein levels, and decreased SQSTM1/ p62 levels after ICH with normal-glucose blood (without hyperglycemia). Acute hyperglycemia with ICH of high-glucose blood hematoma was associated with significantly increased forelimb-use asymmetry test scores, brain water content and SQSTM1/p62 protein levels, and evident decreases in the ratio of LC3-II/LC3-I and beclin-1 protein levels. On the other hand, acute hyperglycemia and ICH with normal-glucose blood hematoma only slightly increased the neurological deficit scores and brain water content (P >0.05). In conclusion, the autophagy pathway was activated after ICH, and acute hyperglycemia with hematoma of high-glucose blood exacerbates the neurological injury, and reduces autophagy around the hematoma.
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Affiliation(s)
- Rong-Yi Liu
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310000 China
| | - Jun-Jun Wang
- Department of Neurology, Zhejiang Hospital, Hangzhou, 310000 China
| | - Xia Qiu
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310000 China
| | - Ji-Min Wu
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, 310000 China
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Hu ZW, Wang ZG, Zhang Y, Wu JM, Liu JJ, Lu FF, Zhu GC, Liang WT. Gastroesophageal reflux in bronchiectasis and the effect of anti-reflux treatment. BMC Pulm Med 2013; 13:34. [PMID: 23731838 PMCID: PMC3686605 DOI: 10.1186/1471-2466-13-34] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Accepted: 05/29/2013] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Bronchiectasis is a progressive and fatal disease despite the available treatment regimens. Gastroesophageal reflux (GER) may play an important role in the progression of bronchiectasis. However, active anti-reflux intervention such as Stretta radiofrequency (SRF) and/or laparoscopic fundoplication (LF) have rarely been used to treat Bronchiectasis. CASE PRESENTATION Seven patients' clinical outcomes for treating GER-related deteriorated bronchiectasis were retrospective reviewed. All patients were treated by SRF and/or LF, and had follow-up periods ranging from one to five years. Typical GER symptoms, respiratory symptoms, medication consumption and general health status were assessed during the follow-ups. At the latest follow-up all patients were alive. The typical GER symptoms disappeared in five people and were significantly improved in the other two. Two had complete remissions of both respiratory symptoms and bronchiectasis exacerbations; four had significantly improved respiratory symptoms to mild/moderate degrees as well as reduced or zero bronchiectasis exacerbations, which allowed them to resume the physical and social functions; one's respiratory symptoms and bronchiectasis exacerbations were not much improved, yet she was in stable condition and satisfied with the results. CONCLUSIONS Potentially, GER plays an important role in some patients with bronchiectasis, and active anti-reflux treatments can be beneficial. Future clinical studies are suggested to clarify GER's role in bronchiectasis and to further determine whether anti-reflux interventions for GER can improve the outcomes of patients with bronchiectasis.
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Affiliation(s)
- Zhi-Wei Hu
- Xuanwu Hospital of Capital Medical University, No. 45 Changchun Road, Xicheng District, Beijing 100053, China
- Center for GER, the Second Artillery General Hospital, Beijing Normal University, No. 16 Xinwai Road, Xicheng District, Beijing 100088, China
| | - Zhong-Gao Wang
- Xuanwu Hospital of Capital Medical University, No. 45 Changchun Road, Xicheng District, Beijing 100053, China
- Center for GER, the Second Artillery General Hospital, Beijing Normal University, No. 16 Xinwai Road, Xicheng District, Beijing 100088, China
| | - Yu Zhang
- Center for GER, the Second Artillery General Hospital, Beijing Normal University, No. 16 Xinwai Road, Xicheng District, Beijing 100088, China
| | - Ji-Min Wu
- Center for GER, the Second Artillery General Hospital, Beijing Normal University, No. 16 Xinwai Road, Xicheng District, Beijing 100088, China
| | - Jian-Jun Liu
- Center for GER, the Second Artillery General Hospital, Beijing Normal University, No. 16 Xinwai Road, Xicheng District, Beijing 100088, China
| | - Fang-Fang Lu
- Center for GER, the Second Artillery General Hospital, Beijing Normal University, No. 16 Xinwai Road, Xicheng District, Beijing 100088, China
| | - Guang-Chang Zhu
- Xuanwu Hospital of Capital Medical University, No. 45 Changchun Road, Xicheng District, Beijing 100053, China
| | - Wei-Tao Liang
- Xuanwu Hospital of Capital Medical University, No. 45 Changchun Road, Xicheng District, Beijing 100053, China
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Wu JM, Li ZJ. [G protein coupled recepters and signal transduction--introduction to the 2012 Nobel prize in chemistry]. Sheng Li Ke Xue Jin Zhan 2013; 44:75-81. [PMID: 23672009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Sun YD, Liang Y, Wu JM, Li YZ, Cui X, Qin L. Dynamic QTL analysis for fruit lycopene content and total soluble solid content in a Solanum lycopersicum x S. pimpinellifolium cross. Genet Mol Res 2012; 11:3696-710. [PMID: 22930431 DOI: 10.4238/2012.august.17.8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Fruit lycopene content and total soluble solid content are important factors determining fruit quality of tomatoes; however, the dynamic quantitative trait loci (QTL) controlling lycopene and soluble solid content have not been well studied. We mapped the chromosomal regions controlling these traits in different periods in F(2:3) families derived from a cross between the domestic and wild tomato species Solanum lycopersicum and S. pimpinellifolium. Fifteen QTLs for lycopene and soluble solid content and other related traits analyzed at three different fruit ripening stages were detected with a composite interval mapping method. These QTLs explained 7-33% of the individual phenotypic variation. QTLs detected in the color-changing period were different from those detected in the other two periods. On chromosome 1, the soluble solid content QTL was located in the same region during the color-changing and full-ripe periods. On chromosome 4, the same QTL for lycopene content was found during the color-changing and full-ripe periods. The QTL for lycopene content on chromosome 4 co-located with the QTL for soluble solid content during the full-ripe period. Co-location of lycopene content QTL and soluble solid content QTLs may be due to pleiotropic effects of a single gene or a cluster of genes via physiological relationships among traits. On chromosome 9, the same two QTLs for lycopene content at two different fruit ripening periods may reflect genes controlling lycopene content that are always expressed in tomato fruit development.
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Affiliation(s)
- Y D Sun
- Key Laboratory of Horticulture Plant Germplasm and Genetic Improvement, Ministry of Agriculture, College of Horticulture, Northwest A & F University, Yangling, Shaanxi, China
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Hu ZW, Wang ZG, Wu JM, Tan ST. Anti-reflux procedure for difficult-to-treat asthmatic children, case report and literature review. Multidiscip Respir Med 2012. [DOI: 10.4081/mrm.2012.615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Gastroesophageal reflux disease (GERD) is a commonly encountered condition in children, which at times causes respiratory distress, such as asthmatic symptoms, and results in serious morbidity and even mortality. The complexity is sometimes so obscure, that it can cause paradoxical diagnoses and treatment. Here we present two cases of children with difficult-to-treat asthmatic symptoms, which were eventually found to be related to GERD. The two children were treated with anti-reflux procedures and both became symptom free. Literature was also reviewed to shed a light into this complex disease.
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Hu ZW, Wang ZG, Wu JM, Tan ST. Anti-reflux procedure for difficult-to-treat asthmatic children, case report and literature review. Multidiscip Respir Med 2012; 7:28. [PMID: 22980911 PMCID: PMC3462718 DOI: 10.1186/2049-6958-7-28] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Accepted: 09/07/2012] [Indexed: 01/01/2023] Open
Abstract
Gastroesophageal reflux disease (GERD) is a commonly encountered condition in children, which at times causes respiratory distress, such as asthmatic symptoms, and results in serious morbidity and even mortality. The complexity is sometimes so obscure, that it can cause paradoxical diagnoses and treatment. Here we present two cases of children with difficult-to-treat asthmatic symptoms, which were eventually found to be related to GERD. The two children were treated with anti-reflux procedures and both became symptom free. Literature was also reviewed to shed a light into this complex disease.
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Affiliation(s)
- Zhi-Wei Hu
- Xuanwu Hospital of Capital Medical University, Beijing, China.
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