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Gao Y, Ye LS, Li X, Yu B, Liao K, Xie J, Du J, Zhang QY, Hu B. Effect of vinegar supplementation on patients with esophageal lesions lightly stained with Lugol’s iodine solution: Prospective single-centre trial. World J Gastrointest Endosc 2024; 16:259-272. [DOI: 10.4253/wjge.v16.i5.259] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 03/12/2024] [Accepted: 04/22/2024] [Indexed: 05/14/2024] Open
Abstract
BACKGROUND Esophageal chromoendoscopy with iodine solution is important for detecting early esophageal cancer. The effect of routine treatment for lesions lightly stained with Lugol’s iodine solution is limited, and the addition of natural substances to a regular diet is becoming increasingly common. Vinegar has antitumor effects as reported in previous studies.
AIM To evaluate whether vinegar supplementation could improve the prognosis of patients with lightly stained esophageal lesions.
METHODS This prospective single-centre trial included consecutive patients with lightly stained lesions between June 2020 and April 2022. Patients in the experimental group received increased amounts of vinegar for 6 months. The primary outcome of the study was the clinical therapeutic effect. Complications related to vinegar ingestion and adverse events were also recorded in detail.
RESULTS A total of 166 patients were included in the final analysis. There was no significant difference in the baseline data between the two groups. Intention-to-treat (ITT) analysis demonstrated that the rates at which endoscopic characteristics improved were 33.72% in the experimental group and 20.00% in the conventional group (P = 0.007); and the rates at which biopsy pathology improved were 19.77% and 8.75%, respectively (P = 0.011). Additional vinegar consumption had a statistically protective effect on the rate at which endoscopic characteristics improved [hazard ratio (HR) ITT = 2.183, 95%CI: 1.183-4.028; HRper-protocol (PP) = 2.307, 95%CI: 1.202-4.426] and biopsy pathology improved (HRITT = 2.931, 95%CI: 1.212-7.089; HRPP = 3.320, 95%CI: 1.295-8.507). No statistically significant effect of increased vinegar consumption on preventing high-grade intraepithelial neoplasia or early cancer was observed (HRITT = 0.382, 95%CI: 0.079-1.846; HRPP = 0.382, 95%CI: 0.079-1.846). The subgroup analyses indicated that the overall therapeutic improvement of endoscopic characteristics and biopsy pathology seemed more obvious in older (age > 60) male patients with small lesions (lesion size ≤ 0.5 cm). Three patients in the experimental group reported acid regurgitation and heartburn. No adverse event during gastroscopy were recorded during follow-up.
CONCLUSION A moderately increased ingestion of vinegar could not directly reduce the risk of esophageal cancer in the mucosa dysplasia population, but it improved the endoscopic characteristics and ameliorated the biopsy pathology to a certain extent. Further research is needed to verify the effect of nutritional intervention on precancerous esophageal lesions.
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Affiliation(s)
- Yuan Gao
- Department of Gastroenterology and Hepatology, Digestive Endoscopy Medical Engineering Research Laboratory, West China Hospital, Med-X Center for Materials, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Lian-Song Ye
- Department of Gastroenterology and Hepatology, Digestive Endoscopy Medical Engineering Research Laboratory, West China Hospital, Med-X Center for Materials, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xu Li
- Center of Biostatistics, Design, Measurement and Evaluation (CBDME), Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bin Yu
- Institute for Disaster Management and Reconstruction, Sichuan University-The Hong Kong Polytechnic University, Chengdu 610065, Sichuan Province, China
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu 610044, Sichuan Province, China
| | - Ke Liao
- Precision Medicine Research Center, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jia Xie
- Department of Gastroenterology and Hepatology, Digestive Endoscopy Medical Engineering Research Laboratory, West China Hospital, Med-X Center for Materials, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jiang Du
- Department of Gastroenterology and Hepatology, Digestive Endoscopy Medical Engineering Research Laboratory, West China Hospital, Med-X Center for Materials, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Qiong-Ying Zhang
- Department of Gastroenterology and Hepatology, Digestive Endoscopy Medical Engineering Research Laboratory, West China Hospital, Med-X Center for Materials, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bing Hu
- Department of Gastroenterology and Hepatology, Digestive Endoscopy Medical Engineering Research Laboratory, West China Hospital, Med-X Center for Materials, Sichuan University, Chengdu 610041, Sichuan Province, China
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Zhu YN, Yuan XL, Liu W, Zhang YH, Mou Y, Hu B, Ye LS. Exploring non-curative endoscopic submucosal dissection: Current treatment optimization and future indication expansion. World J Gastroenterol 2024; 30:1257-1260. [PMID: 38577178 PMCID: PMC10989481 DOI: 10.3748/wjg.v30.i9.1257] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 01/17/2024] [Accepted: 02/18/2024] [Indexed: 03/06/2024] Open
Abstract
The increasing popularity of endoscopic submucosal dissection (ESD) as a treatment for early gastric cancer has highlighted the importance of quality assessment in achieving curative resections. This article emphasizes the significance of evaluating ESD quality, not only for curative cases but also for non-curative ones. Postoperative assessment relies on the endoscopic curability (eCura) classification, but management strategies for eCuraC-1 tumour with a positive horizontal margin are unclear. Current research primarily focuses on comparing additional surgical procedures in high-risk patients, while studies specifically targeting eCuraC-1 patients are limited. Exploring management strategies and follow-up outcomes for such cases could provide valuable insights. Furthermore, the application of molecular imaging using near-infrared fluorescent tracers holds promise for precise tumour diagnosis and navigation, potentially impacting the management of early-stage gastric cancer patients. Advancing research in these areas is essential for improving the overall efficacy of endoscopic techniques and refining treatment indications.
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Affiliation(s)
- Yi-Nong Zhu
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xiang-Lei Yuan
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Wei Liu
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yu-Hang Zhang
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yi Mou
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bing Hu
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Lian-Song Ye
- Department of Gastroenterology and Hepatology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Yuan XL, Liu W, Liu Y, Zeng XH, Mou Y, Wu CC, Ye LS, Zhang YH, He L, Feng J, Zhang WH, Wang J, Chen X, Hu YX, Zhang KH, Hu B. Artificial intelligence for diagnosing microvessels of precancerous lesions and superficial esophageal squamous cell carcinomas: a multicenter study. Surg Endosc 2022; 36:8651-8662. [PMID: 35705757 PMCID: PMC9613556 DOI: 10.1007/s00464-022-09353-0] [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] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 05/20/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Intrapapillary capillary loop (IPCL) is an important factor for predicting invasion depth of esophageal squamous cell carcinoma (ESCC). The invasion depth is closely related to the selection of treatment strategy. However, diagnosis of IPCLs is complicated and subject to interobserver variability. This study aimed to develop an artificial intelligence (AI) system to predict IPCLs subtypes of precancerous lesions and superficial ESCC. METHODS Images of magnifying endoscopy with narrow band imaging from three hospitals were collected retrospectively. IPCLs subtypes were annotated on images by expert endoscopists according to Japanese Endoscopic Society classification. The performance of the AI system was evaluated using internal and external validation datasets (IVD and EVD) and compared with that of the 11 endoscopists. RESULTS A total of 7094 images from 685 patients were used to train and validate the AI system. The combined accuracy of the AI system for diagnosing IPCLs subtypes in IVD and EVD was 91.3% and 89.8%, respectively. The AI system achieved better performance than endoscopists in predicting IPCLs subtypes and invasion depth. The ability of junior endoscopists to diagnose IPCLs subtypes (combined accuracy: 84.7% vs 78.2%, P < 0.0001) and invasion depth (combined accuracy: 74.4% vs 67.9%, P < 0.0001) were significantly improved with AI system assistance. Although there was no significant differences, the performance of senior endoscopists was slightly elevated. CONCLUSIONS The proposed AI system could improve the diagnostic ability of endoscopists to predict IPCLs classification of precancerous lesions and superficial ESCC.
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Affiliation(s)
- Xiang-Lei Yuan
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wu Hou District, Chengdu, 610041, China
| | - Wei Liu
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wu Hou District, Chengdu, 610041, China
| | - Yan Liu
- School of Automation, Nanjing University of Information Science and Technology, Nanjing, China
| | - Xian-Hui Zeng
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wu Hou District, Chengdu, 610041, China
| | - Yi Mou
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wu Hou District, Chengdu, 610041, China
| | - Chun-Cheng Wu
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wu Hou District, Chengdu, 610041, China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wu Hou District, Chengdu, 610041, China
| | - Yu-Hang Zhang
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wu Hou District, Chengdu, 610041, China
| | - Long He
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wu Hou District, Chengdu, 610041, China
| | - Jing Feng
- Department of Gastroenterology, Zhongshan Hospital, Xiamen University, Xiamen, China
| | - Wan-Hong Zhang
- Department of Gastroenterology, Cangxi People's Hospital, Guangyuan, China
| | - Jun Wang
- Department of Gastroenterology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Xin Chen
- The First People's Hospital of Shuangliu District, Chengdu, China
| | - Yan-Xing Hu
- Xiamen Innovision Medical Technology Co, Ltd., Xiamen, China
| | - Kai-Hua Zhang
- ERCDF, Ministry of Education and School of Computing and Software, Nanjing University of Information Science and Technology, Nanjing, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wu Hou District, Chengdu, 610041, China.
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Luo Q, Yuan XL, Ye LS, Hu B. Feasibility of 3-dimensional-printed model assisting endoscopic resection of gastrointestinal submucosal tumors. Dig Liver Dis 2022; 54:845-848. [PMID: 35430164 DOI: 10.1016/j.dld.2022.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/16/2022] [Accepted: 03/17/2022] [Indexed: 02/07/2023]
Affiliation(s)
- Qi Luo
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiang-Lei Yuan
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China.
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Yuan XL, Ye LS, Chen Z, Hu B. Mixed reality technology in the guidance of endoscopic resection for a giant submucosal tumor in the esophagus. Dig Liver Dis 2022; 54:836-837. [PMID: 33737007 DOI: 10.1016/j.dld.2021.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/15/2021] [Accepted: 01/28/2021] [Indexed: 02/07/2023]
Affiliation(s)
- Xiang-Lei Yuan
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wu Hou District, Chengdu 610041, China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wu Hou District, Chengdu 610041, China
| | | | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Alley, Wu Hou District, Chengdu 610041, China.
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Zhang YY, Ye LS, Mou Y, Wu CC, Tan QH, Liao K, Hu B. Endoscopic ultrasound-guided rendezvous recanalization of a completely obstructed esophagogastric anastomosis. Endoscopy 2022; 54:E137-E138. [PMID: 33878795 DOI: 10.1055/a-1443-3943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Yu-Yan Zhang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yi Mou
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chun-Cheng Wu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qing-Hua Tan
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ke Liao
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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Duan WX, Ye LS, Du H, Liu C, Duan Y, Mao LC. [Analysis of the detection of metals and metalloids in the bronchoalveolar lavage fluid for the etiological diagnosis value of pneumoconiosis]. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 2021; 39:844-848. [PMID: 34886645 DOI: 10.3760/cma.j.cn121094-20201207-00672] [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: 06/13/2023]
Abstract
Objective: To analyze the differences of the concentrations of metals and metalloids in bronchoalveolar lavage fluid (BALF) of patients with pneumoconiosis, so as to provide reference for the etiological diagnosis of pneumoconiosis. Methods: From September 2019 to August 2020, 47 pneumoconiosis patients hospitalized in Chongqing Prevention and Treatment Center for Occupational Diseases and undergoing bronchoalveolar lavage were selected as the research objects using cluster sampling method. The general situation and occupational history of patients were investigated by questionnaire, The BALF of 47 pneumoconiosis patients was collected, and the concentrations of metals and metalloids in BALF were detected by inductively coupled plasma mass spectrometry (ICP-MS) , the differences among patients with different types of pneumoconiosis, different stages of silicosis and different occupational history were analyzed by one-way ANOVA. Results: The concentrations of 50 metals and metalloids in BALF were detected, and 21 of them were analyzed. Compared with different types of pneumoconiosis, the concentrations of Zn, Mn and Sn in BALF were statistically significant (F=9.959, 3.635, 9.488, P<0.05) . The concentrations of K, Mg, Fe, Zn, Cu and Ni in BALF were significantly different in different stages of silicosis (F=4.271, 4.334, 3.588, 5.120, 7.340, 3.905, P<0.05) . The concentrations of Zn and Sn in pneumoconiosis patients with different types of work and types of exposed dust were significantly different (P<0.05) . Conclusion: The detection of Zn, Mn, Sn, and other metals in BALF can provide reference basis for the etiological diagnosis of pneumoconiosis and provide a new idea for the diagnostic method of pneumoconiosis.
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Affiliation(s)
- W X Duan
- Center of Laboratory Medicine, Chongqing Prevention and Treatment Center for Occupational Diseases, Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, the First Affiliated Hospital of Chongqing Medical and Pharmaceutical College, Chongqing 400060, China
| | - L S Ye
- Department of Occupational Disease and Poisoning, Chongqing Prevention and Treatment Center for Occupational Diseases, Chongqing 400060, China
| | - H Du
- Center of Laboratory Medicine, Chongqing Prevention and Treatment Center for Occupational Diseases, Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, the First Affiliated Hospital of Chongqing Medical and Pharmaceutical College, Chongqing 400060, China
| | - C Liu
- Center of Laboratory Medicine, Chongqing Prevention and Treatment Center for Occupational Diseases, Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, the First Affiliated Hospital of Chongqing Medical and Pharmaceutical College, Chongqing 400060, China
| | - Y Duan
- Center of Laboratory Medicine, Chongqing Prevention and Treatment Center for Occupational Diseases, Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, the First Affiliated Hospital of Chongqing Medical and Pharmaceutical College, Chongqing 400060, China
| | - L C Mao
- Center of Laboratory Medicine, Chongqing Prevention and Treatment Center for Occupational Diseases, Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, the First Affiliated Hospital of Chongqing Medical and Pharmaceutical College, Chongqing 400060, China
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Li Y, Ye LS, Hu B. Synchronous multiple primary malignancies of the esophagus, stomach, and jejunum: A case report. World J Clin Cases 2021; 9:9889-9895. [PMID: 34877327 PMCID: PMC8610897 DOI: 10.12998/wjcc.v9.i32.9889] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 06/26/2021] [Accepted: 09/08/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Treatment of synchronous multiple primary malignancies is quite often very challenging. Herein, we report on a rare case of synchronous multiple primary malignancies in the esophagus, stomach, and jejunum.
CASE SUMMARY A 50-year-old man who was a heavy drinker and smoker with a poor diet, and had a family history of cancer sought treatment due to dysphagia lasting for 4 mo. He was finally diagnosed with lower esophageal squamous cell carcinoma (pT3N2M0, G2, stage IIIB), gastric angular adenocarcinoma (pT3N2M0, G2-G3, stage IIIA) with greater omental lymph node metastasis, and jejunal stromal tumor (high risk). The high-risk jejunal stromal tumor was found during surgery. In spite of radical resection and adjuvant chemotherapy, lymph node metastasis occurred 21 mo later. The patient responded poorly to additional chemotherapy and refused further examination and therapy. He died of widespread metastases 33 mo after surgery.
CONCLUSION This case indicates a poor prognosis of synchronous multiple advanced primary malignancies and the importance of comprehensive assessment in the population at high risk for cancer.
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Affiliation(s)
- Yan Li
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Yuan XL, Ye LS, Zeng XH, Tan QH, Mou Y, Liu W, Wu CC, Yang H, Hu B. New anti-reflux plastic stent to reduce the risk of stent-related cholangitis in the treatment of biliary strictures. World J Gastroenterol 2021; 27:4697-4709. [PMID: 34366630 PMCID: PMC8326253 DOI: 10.3748/wjg.v27.i28.4697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Revised: 06/08/2021] [Accepted: 07/07/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND There is little data available on the role of new anti-reflux plastic stents (ARPSs).
AIM To compare the use of ARPSs with that of traditional plastic stents (TPSs) for patients with biliary strictures.
METHODS Consecutive patients with biliary strictures who underwent first endoscopic biliary stenting between February 2016 and May 2019 were included. The onset of stent-related cholangitis, stent patency, clinical success, and other adverse events were evaluated.
RESULTS Sixty-seven patients in the ARPS group and 66 patients in the TPS group were included in the final analyses. Fewer patients experienced stent-related cholangitis in the ARPS group than that in the TPS group (8 patients vs 18 patients; P = 0.030). The median time till the onset of first stent-related cholangitis was later in the ARPS group than that in the TPS group (128.5 d vs 76 d; P = 0.039). The cumulative median stent patency in the ARPS group was 185 d, which was significantly longer than that in the TPS group (133 d; P = 0.001). The clinical success rates and other adverse events did not significantly differ between both groups.
CONCLUSION Placement of new ARPS might be a safe and effective optional therapeutic strategy to reduce the risk of stent-related cholangitis and prolong stent patency.
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Affiliation(s)
- Xiang-Lei Yuan
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xian-Hui Zeng
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Qing-Hua Tan
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yi Mou
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Wei Liu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Chun-Cheng Wu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Hang Yang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Gao Y, Xie J, Ye LS, Du J, Zhang QY, Hu B. Negative-Pressure Isolation Mask for Endoscopic Examination During the Coronavirus Disease 2019 Pandemic: A Randomized Controlled Trial. Clin Transl Gastroenterol 2021; 12:e00314. [PMID: 33620880 PMCID: PMC8345917 DOI: 10.14309/ctg.0000000000000314] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 12/29/2020] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION During the coronavirus disease 2019 (COVID-19) pandemic, endoscopists have high risks of exposure to exhaled air from patients during gastroscopy. To minimize this risk, we transformed the oxygen mask into a fully closed negative-pressure gastroscope isolation mask. This study aimed to evaluate the effectiveness, safety, and feasibility of use of this mask during gastroscopy. METHODS From February 28, 2020, to March 10, 2020, 320 patients undergoing gastroscopy were randomly assigned into the mask group (n = 160) or conventional group (n = 160). Patients in the mask group wore the isolation mask during gastroscopy, whereas patients in the conventional group did not wear the mask. The adenosine triphosphate fluorescence and carbon dioxide (CO2) concentration in patients' exhaled air were measured to reflect the degree of environmental pollution by exhaled air. Patients' vital signs, operation time, and adverse events during endoscopy were also evaluated. RESULTS Four patients were excluded because of noncooperation or incomplete data. A total of 316 patients were included in the final analysis. The difference between the highest CO2 concentration around patients' mouth and CO2 concentration in the environment was significantly decreased in the mask group compared with the conventional group. There was no significant difference in the adenosine triphosphate fluorescence, vital signs, and operation time between the 2 groups. No severe adverse events related to the isolation mask, endoscopy failure, or new coronavirus infection during follow-up were recorded. DISCUSSION This new isolation mask showed excellent feasibility of use and safety compared with routine gastroscopy during the COVID-19 pandemic.
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Affiliation(s)
- Yuan Gao
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China;
| | - Jia Xie
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China;
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China;
| | - Jiang Du
- Department of Endoscopy Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
| | - Qiong-Ying Zhang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China;
- Department of Endoscopy Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China;
- Department of Endoscopy Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China.
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Gao Y, Ye LS, Du J, Zhang QY, Hu B. Management of an endoscopy center during the outbreak of COVID-19: Experience from West China Hospital. World J Gastroenterol 2020; 26:5749-5758. [PMID: 33132632 PMCID: PMC7579759 DOI: 10.3748/wjg.v26.i38.5749] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/27/2020] [Accepted: 09/08/2020] [Indexed: 02/06/2023] Open
Abstract
Since the outbreak of the coronavirus disease 2019 (COVID-19), various measures have been taken to protect against the infection. As droplet and contact transmission are the main routes of COVID-19 infection, endoscopy centers are considered to be high-risk areas for exposure to COVID-19. We have undertaken several countermeasures in our endoscopic center during the pandemic, and have gained significant experience in terms of prevention and control of COVID-19. We here present our experience and strategies adopted for preventing hospital infection in our endoscopy center during the COVID-19 pandemic. We describe our management of the environment, endoscope, patients, and medical staff, and our self-made masks.
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Affiliation(s)
- Yuan Gao
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jiang Du
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Qiong-Ying Zhang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Li Y, Guo LJ, Ma YC, Ye LS, Hu B. Endoscopic palliative resection of a giant 26-cm esophageal tumor: A case report. World J Clin Cases 2020; 8:4624-4632. [PMID: 33083427 PMCID: PMC7559645 DOI: 10.12998/wjcc.v8.i19.4624] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/28/2020] [Accepted: 09/04/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Esophageal carcinosarcoma, usually presenting as a pedunculated polypoid mass, is a rare malignancy with coexisting sarcomatoid and carcinomatous components. Its imaging and endoscopic characteristics are similar to those of leiomyosarcoma, liposarcoma and so forth. The diagnosis needs histological confirmation. Surgical resection is the traditional therapy. Endoscopic resection is minimally invasive but still controversial. This paper reports the case of a patient with a giant esophageal carsinosarcoma who underwent a palliative endoscopic resection.
CASE SUMMARY A 55-year-old male patient presented with dysphagia and weight loss for 1 mo. Imaging and endoscopy showed a gray-white, polypoid, stalk-like mass, with a bulky pedicle located in the middle and lower esophagus. The mass almost filled the whole esophageal lumen, but the endoscope could still pass through. Despite the suspicion of a malignancy, repeated biopsies indicated necrosis and inflammation. After multidisciplinary team consultation, an endoscopic resection to diagnose and relieve the obstruction was recommended. The pedicle of the mass was cut off, the bleeding was stopped, and the mass was cut into pieces and pulled out. The mass was 26 cm × 5 cm × 4 cm in size. The final diagnosis was esophageal carcinosarcoma. No postoperative complications occurred. After 1 mo, the patient gained 6 kg and endoscopic reexamination revealed no obstruction. Radical surgery with lymph node dissection was carried out successfully. This lesion was the largest endoscopically resected esophageal carcinosarcoma reported to date.
CONCLUSION Endoscopic palliative resection can help obtain adequate tissue for diagnosis and relieve obstructions in patients with giant esophageal carcinosarcoma.
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Affiliation(s)
- Yan Li
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Lin-Jie Guo
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Ying-Cai Ma
- Department of Digestion, Qinghai Provincial People's Hospital, Xining 810007, Qinghai Province, China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Feng YL, Li J, Ye LS, Zeng XH, Hu B. Combined endoscopy/laparoscopy/percutaneous transhepatic biliary drainage, hybrid techniques in gastrointestinal and biliary diseases. World J Meta-Anal 2020; 8:210-219. [DOI: 10.13105/wjma.v8.i3.210] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 06/10/2020] [Accepted: 06/16/2020] [Indexed: 02/06/2023] Open
Abstract
In recent years, a wide range of gastrointestinal endoscopy techniques have been developed, such as endoscopic submucosal dissection (ESD) and endoscopic retrograde cholangiopancreatography (ERCP). Although ESD and ERCP have an important role in gastrointestinal and biliary diseases, each technique has its limitations. Hybrid techniques that combine endoscopic and surgical procedures have emerged that have the advantages of different procedures and negate their limitations at the same time. Laparoscopic endoscopic cooperative surgery and modified laparoscopic endoscopic cooperative surgery combine ESD and laparoscopic techniques to resect submucosal tumors with minimum resection area. Air leak test by intraoperative endoscopy can effectively identify a mechanically insufficient anastomosis and decrease the complication rate. The rendezvous technique that combines percutaneous transhepatic biliary drainage and endoscopy can be performed as a rescue approach for the treatment of biliary obstruction, stenosis and bile duct injuries. For patients with simultaneous presence of stones in the gallbladder and the common bile duct, the laparo-endoscopic rendezvous technique can perform ERCP and laparoscopic cholecystectomy at the same time and reduces the risk of pancreatic injury caused by ERCP. Biliobiliary and bilioenteric anastomosis using magnetic compression anastomosis is another choice for biliary obstruction. The most common used approach to deliver the magnets is by percutaneous-peroral tract. Laparoscopic-assisted ERCP is a safe and highly effective therapy for patients who develop biliary diseases after Roux-en-Y gastric bypass surgery.
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Affiliation(s)
- Yi-Long Feng
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jing Li
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xian-Hui Zeng
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Feng Z, Liu ZM, Yuan XL, Ye LS, Wu CC, Tan QH, Hu B. Peroral endoscopic myotomy for management of gastrointestinal motility disorder. World J Clin Cases 2020; 8:2116-2126. [PMID: 32548141 PMCID: PMC7281049 DOI: 10.12998/wjcc.v8.i11.2116] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/27/2020] [Accepted: 04/27/2020] [Indexed: 02/05/2023] Open
Abstract
Achalasia is a type of esophageal motility disorder, consisting of relaxation dysfunction of the lower esophagus and disturbed esophageal peristalsis. Related clinical symptoms include dysphagia, regurgitation, chest pain, and weight loss. Traditional treatment options include endoscopic botulinum toxin injection, endoscopic pneumatic dilation, and laparoscopic Heller’s myotomy. These therapies mainly relieve symptoms by reducing the pressure on the lower esophageal sphincter and reducing blood flow resistance at the esophagogastric junction. Based on endoscopic submucosal dissection and natural orifice transluminal endoscopic surgery, peroral endoscopic myotomy (POEM) is a purely endoscopic method of myotomy with minimal invasiveness and a low rate of adverse events when performed by experienced operators. Since then, numerous studies have shown the significant clinical efficacy and safety of POEM. The purpose of this article is to introduce different modified POEMs, special indications for different POEMs, and their advantages as well as disadvantages.
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Affiliation(s)
- Zhe Feng
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Zi-Ming Liu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xiang-Lei Yuan
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Chun-Cheng Wu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Qing-Hua Tan
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Ye LS, Li Y, Liu W, Yao MH, Khan N, Hu B. Clinical course of suspected small gastrointestinal stromal tumors in the stomach. World J Gastrointest Surg 2020; 12:171-177. [PMID: 32426096 PMCID: PMC7215971 DOI: 10.4240/wjgs.v12.i4.171] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Revised: 02/24/2020] [Accepted: 03/26/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Gastric subepithelial lesions are frequently encountered during endoscopic examinations, and the majority of them are small and asymptomatic. Among these lesions, gastrointestinal stromal tumors (GISTs) are the major concern for patients and clinicians owing to their malignant potentials. Although previous guidelines suggested periodic surveillance for such small (≤ 20 mm) lesions, several patients and clinicians have still requested or prescribed repeated examinations or radical resection, posing extra medical burdens and risks.
AIM To describe the clinical course of suspected small gastric GISTs and provide further evidence for surveillance strategy for tumor therapy.
METHODS This single-center, retrospective study was conducted at West China Hospital, Sichuan University. Consecutive patients with suspected small gastric GISTs were reviewed from November 2004 to November 2018. GIST was suspected according to endoscopic ultrasonography features: hypoechoic lesions from muscularis propria or muscularis mucosa. Eligible patients with suspected small (≤ 20 mm) GISTs were included for analysis. Patients’ demographic data, lesions’ characteristics, and follow-up medical records were collected.
RESULTS A total of 383 patients (male/female, 121/262; mean age, 54 years) with 410 suspected small gastric GISTs (1 lesion in 362 patients, 2 lesions in 16, 3 lesions in 4, and 4 lesions in 1) were included for analysis. The most common location was gastric fundus (56.6%), followed by body (29.0%), cardia (12.2%), and antrum (2.2%). After a median follow-up of 28 mo (interquartile range, 16-48; range, 3-156), 402 lesions (98.0%) showed no changes in size, and size of 8 lesions (2.0%) was increased (mean increment, 10 mm). Of the 8 lesions with size increment, endoscopic or surgical resection was performed in 6 patients (5 GISTs and 1 leiomyoma). For other 2 remaining patients, unroofing biopsy or endoscopic ultrasound-guided fine-needle aspiration was carried out (2 GISTs), while no further change in size was noted over a period of 62-64 mo.
CONCLUSION The majority of suspected small (≤ 20 mm) gastric GISTs had no size increment during follow-up. Regular endoscopic follow-up without pathological diagnosis may be highly helpful for such small gastric subepithelial lesions.
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Affiliation(s)
- Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yan Li
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Wei Liu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Ming-Hong Yao
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Naveed Khan
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Yuan XL, Ye LS, Liu Q, Wu CC, Liu W, Zeng XH, Zhang YH, Guo LJ, Zhang YY, Li Y, Zhou XY, Hu B. Risk factors for distal migration of biliary plastic stents and related duodenal injury. Surg Endosc 2020; 34:1722-1728. [PMID: 31321537 PMCID: PMC7093356 DOI: 10.1007/s00464-019-06957-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 07/01/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND The risk factors of duodenal injury from distal migrated biliary plastic stents remain uncertain. The aim of this study was to determine the risk factors of distal migration and its related duodenal injury in patients who underwent placement of a single biliary plastic stent for biliary strictures. METHODS We retrospectively reviewed all patients with biliary strictures who underwent endoscopic placement of a single biliary plastic stent from January 2006 to October 2017. RESULTS Two hundred forty-eight patients with 402 endoscopic retrograde cholangiopancreatography procedures were included. The incidence of distal migration was 6.2%. The frequency of duodenal injury was 2.2% in all cases and 36% in cases with distal migration. Benign biliary strictures (BBS), length of the stent above the proximal end of the stricture (> 2 cm), and duration of stent retention (< 3 months) were independently associated with distal migration (p = 0.018, p = 0.009, and p = 0.016, respectively). Duodenal injury occurred more commonly in cases with larger angle (≥ 30°) between the distal end of the stent and the centerline of the patient's body (p = 0.018) or in cases with stent retention < 3 months (p = 0.031). CONCLUSIONS The risk factors of distal migration are BBS and the length of the stent above the proximal end of the stricture. The risk factor of duodenal injury due to distal migration is large angle (≥ 30°) between the distal end of the stent and the centerline of the patient's body. Distal migration and related duodenal injury are more likely to present during the early period after biliary stenting.
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Affiliation(s)
- Xiang-Lei Yuan
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Qin Liu
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Chun-Cheng Wu
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Wei Liu
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Xian-Hui Zeng
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Yu-Hang Zhang
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Lin-Jie Guo
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Yu-Yan Zhang
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Yan Li
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Xin-Yue Zhou
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
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Feng Z, Liu ZM, Ye LS, Yang WJ, Guo LJ, Li J, Hu B. Balloon-assisted endoscopic extraction of a lamp bulb stuck in the rectosigmoid junction: an inspiration from ERCP. Endoscopy 2020; 52:E124-E125. [PMID: 31652468 DOI: 10.1055/a-1022-4387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Zhe Feng
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Zi-Ming Liu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Wen-Juan Yang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Lin-Jie Guo
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Li
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
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Ye LS, Yuan XL, Wu CC, Liu W, Du J, Yao MH, Tan QH, Hu B. Biliary spontaneous dislodgement spiral stent for patients who underwent mechanical lithotripsy. World J Gastroenterol 2020; 26:740-748. [PMID: 32116421 PMCID: PMC7039826 DOI: 10.3748/wjg.v26.i7.740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 12/05/2019] [Accepted: 01/11/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) cholangitis (PEC) in patients who underwent mechanical lithotripsy (ML) for large stone removal is high (up to 13.3%). One of the main causes is remaining small fragments or sludge that can impair normal biliary drainage. Endoscopic placement of a nasobiliary tube or a conventional plastic biliary stent has been commonly used under such conditions, but the patient may suffer from significant discomfort after the placement of a nasobiliary tube, while additional endoscopy is required for stent removal. We developed a biliary spontaneous dislodgement spiral stent (BSDSS) to overcome those shortcomings. AIM To evaluate the feasibility, safety, and effectiveness of inserting a BSDSS for patients who underwent ML for large stone removal. METHODS We conducted a single-center, retrospective, cohort study at West China Hospital, Sichuan University. A total of 91 consecutive patients with large biliary stones (≥ 10 mm) in the common bile duct who underwent ML between November 2017 and July 2018 were included. The 49 eligible patients were divided into the BSDSS group and the nasobiliary tube group. Technical success, post-ERCP adverse events (including PEC, post-ERCP pancreatitis, stone recurrence, BSDSS retention, self-extraction and dislocation of the nasobiliary tube), drainage time, and postoperative stay were measured and compared. RESULTS Twenty-one patients in the BSDSS group and 28 patients in the nasobiliary tube group were included in the analyses. The baseline characteristics and clinical information were similar in the two groups. Insertions of BSDSS and nasobiliary tube were technically successful in all 49 patients. There was no significant difference in the incidence of overall post-ERCP adverse events between the two groups (4.8% in the BSDSS group vs 17.9% in the nasobiliary tube group, P = 0.219). The median duration of drainage time (3 d in the BSDSS group vs 4 d in the nasobiliary tube group) and length of postoperative stay (4 d in the BSDSS group vs 5 d in the nasobiliary tube group) also did not differ (P = 0.934, and P = 0.223, respectively). CONCLUSION Endoscopic placement of a BSDSS appears to be feasible, safe and effective for patients who underwent ML for large stone removal.
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Affiliation(s)
- Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xiang-Lei Yuan
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Chun-Cheng Wu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Wei Liu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Jiang Du
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Ming-Hong Yao
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Qing-Hua Tan
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Hu B, Ye LS. Endoscopic applications of magnets for the treatment of gastrointestinal diseases. World J Gastrointest Endosc 2019; 11:548-560. [PMID: 31839874 PMCID: PMC6885730 DOI: 10.4253/wjge.v11.i12.548] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 08/21/2019] [Accepted: 09/11/2019] [Indexed: 02/06/2023] Open
Abstract
Endoscopic treatment of gastrointestinal diseases has developed rapidly in recent years, due to its minimally invasive nature. One of the main contributing factors for this progress is the improvement of endoscopic instruments, which are essential for facilitating safe and effective endoscopic interventions. However, the slow learning curve required in the implementation of many advanced endoscopic procedures using standard devices is associated with a high risk of complications. Other routine procedures may also be complicated by unexpected difficulties. Based on the ferromagnetic properties of many objects, both internal and external magnetic devices have been developed and applied for multiple endoscopic interventions. The applications of magnets, mainly including compression, anchoring and traction, facilitate many difficult procedures and make it feasible to operate procedures that were previously impossible. Other novel endoscopic applications, such as magnetic nanoparticles, are also under development. In this article, we reviewed published studies of endoscopic applications of magnets for the treatment of gastrointestinal diseases such as precancerous lesions and cancer, obstruction, stricture, congenital and acquired malformations, motility disorders, and ingestion of foreign bodies. Since several endoscopic applications of magnets may also be relevant to surgery, we included them in this review.
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Affiliation(s)
- Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Affiliation(s)
- Xiang-Lei Yuan
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Onpan Cheung
- San Bernardino Gastroenterology Associates, Rialto, California, USA
| | - Jiang Du
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
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Zeng QS, Ye LS, Wu CC, Liu JR, Zhang QY, Bai S, Hu B. Pyloric gland adenoma in the duodenal bulb: case report of a giant laterally spreading tumor treated with endoscopic submucosal dissection. Endoscopy 2019; 51:E130-E131. [PMID: 30866018 DOI: 10.1055/a-0862-0098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Qi-Shan Zeng
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Chun-Cheng Wu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Jian-Rong Liu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Qiong-Ying Zhang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Shuai Bai
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
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Yuan XL, Wei B, Ye LS, Wu CC, Tan QH, Yao MH, Zhang YH, Zeng XH, Li Y, Zhang YY, Hu B. New antireflux plastic stent for patients with distal malignant biliary obstruction. World J Gastroenterol 2019; 25:2373-2382. [PMID: 31148908 PMCID: PMC6529883 DOI: 10.3748/wjg.v25.i19.2373] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 03/28/2019] [Accepted: 04/20/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Endoscopic biliary stenting is a well-established palliative treatment for patients with unresectable distal malignant biliary obstruction (MBO). However, the main problem with stent placement is the relatively short duration of stent patency. Although self-expanding metal stents (SEMSs) have a longer patency period than plastic stents (PSs), the higher costs limit the wide use of SEMSs. A PS with an antireflux valve is an attractive idea to prolong stent patency, but no ideal design for an antireflux PS (ARPS) has been proposed. We developed a new ARPS with a “duckbilled” valve attached to the duodenal end of the stent.
AIM To compare the patency of ARPSs with that of traditional PSs (TPSs) in patients with unresectable distal MBO.
METHODS We conducted a single-center, prospective, randomized, controlled, double-blind study. This study was conducted at the West China Hospital of Sichuan University. Consecutive patients with extrahepatic MBO were enrolled prospectively. Eligible patients were randomly assigned to receive either an ARPS or a TPS. Patients were followed by clinic visits or telephone interviews every 1-2 mo until stent exchange, death, or the final study follow-up in October 2018. The primary outcome was the duration of stent patency. Secondary outcomes included the rate of technical success, the rate of clinical success, adverse events, and patient survival.
RESULTS Between February 2016 and December 2017, 38 patients were randomly assigned to two groups, with 19 patients in each group, to receive ARPSs or TPSs. Stent insertion was technically successful in all patients. There were no significant differences between the two groups in the rates of clinical success or the rates of early or late adverse events (P = 0.660, 1.000, and 1.000, respectively). The median duration of stent patency in the ARPS group was 285 d [interquartile range (IQR), 170], which was significantly longer than that in the TPS group (median, 130 d; IQR, 90, P = 0.005). No significant difference in patient survival was noted between the two groups (P = 0.900).
CONCLUSION The new ARPS is safe and effective for the palliation of unresectable distal MBO, and has a significantly longer stent patency than a TPS.
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Affiliation(s)
- Xiang-Lei Yuan
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bin Wei
- Department of Gastroenterology, the First Hospital of Xi’an City, Xi’an 710002, Shaanxi Province, China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Chun-Cheng Wu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Qing-Hua Tan
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Ming-Hong Yao
- Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yu-Hang Zhang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Xian-Hui Zeng
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yan Li
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Yu-Yan Zhang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China
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Zeng QS, Wu CC, Liu W, Ye LS, Jiang S, Zhang YH, Hu B. Correction: Endoscopic Placement of a U-Shaped Plastic Stent in Patients With Recurrent Acute Pancreatitis and Incomplete Pancreas Divisum. Am J Gastroenterol 2019; 114:695. [PMID: 30807295 DOI: 10.14309/ajg.0000000000000195] [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: 02/07/2023]
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24
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Zeng QS, Yang J, Wu CC, Ye LS, Liu W, Zeng HZ, Jiang S, Zhang YH, Yuan XL, Zeng XH, Luo YH, Hu B. Short-term effect of a negative colonoscopy in patients with functional constipation. Proc AMIA Symp 2019; 32:18-21. [PMID: 30956573 PMCID: PMC6442907 DOI: 10.1080/08998280.2018.1502510] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 04/09/2018] [Revised: 07/07/2018] [Accepted: 07/17/2018] [Indexed: 02/07/2023] Open
Abstract
The yield of colonoscopy for neoplasia among patients with chronic constipation is very low. However, a negative colonoscopy may benefit these patients by decreasing anxiety and thereby alleviating constipation symptoms. We performed a prospective study to characterize the effect of a negative colonoscopy in patients with functional constipation. Seventy-five patients with chronic constipation were enrolled, and 69 patients were diagnosed with functional constipation through the Rome III criteria. After excluding patients whose constipation symptoms were affected by medications (e.g., laxatives, prokinetics), 45 patients were included in the study. Among the 45 patients, the average health-related anxiety score decreased from 21.0 to 15.6 at 1 week after colonoscopy (P < 0.01). Sustained improvement was observed in anxiety scores at 1 month (14.0), 2 months (12.4), and 6 months (11.2). Mean constipation symptom score was also decreased at 1 week (8.7), 1 month (8.0), 2 months (7.6), and 6 months (6.8) compared with the precolonoscopy period (11.5; P < 0.01). These results suggest that a negative colonoscopy in patients with functional constipation is associated with a decline in health-related anxiety and constipation symptom scores. (Registration number: ChiCTR-OOh-16008488).
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Affiliation(s)
- Qi-Shan Zeng
- Department of Gastroenterology, West China Hospital of Sichuan UniversityChengduSichuan, China
| | - Juliana Yang
- Division of Digestive and Liver Diseases, University of Texas Southwestern Medical CenterDallasTexas
| | - Chun-Cheng Wu
- Department of Gastroenterology, West China Hospital of Sichuan UniversityChengduSichuan, China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital of Sichuan UniversityChengduSichuan, China
| | - Wei Liu
- Department of Gastroenterology, West China Hospital of Sichuan UniversityChengduSichuan, China
| | - Hong-Ze Zeng
- Department of Gastroenterology, West China Hospital of Sichuan UniversityChengduSichuan, China
| | - Shan Jiang
- Department of Gastroenterology, West China Hospital of Sichuan UniversityChengduSichuan, China
| | - Yu-Hang Zhang
- Department of Gastroenterology, West China Hospital of Sichuan UniversityChengduSichuan, China
| | - Xiang-Lei Yuan
- Department of Gastroenterology, West China Hospital of Sichuan UniversityChengduSichuan, China
| | - Xian-Hui Zeng
- Department of Gastroenterology, West China Hospital of Sichuan UniversityChengduSichuan, China
| | - Yong-Hong Luo
- Department of Gastroenterology, West China Hospital of Sichuan UniversityChengduSichuan, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital of Sichuan UniversityChengduSichuan, China
- Corresponding author: Bing Hu, MD,Department of Gastroenterology, West China Hospital of Sichuan UniversityNo. 37 Guo Xue XiangChengduSichuan 610041, China (e-mail:)
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25
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Fan H, Li M, Qin TJ, Qu SH, Ye LS, Li FT, Lin GS, Liang YQ. [Expression of eosinophils and IL-33 levels in peripheral blood of patients with allergic rhinitis]. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2018; 31:1427-1430. [PMID: 29797999 DOI: 10.13201/j.issn.1001-1781.2017.18.012] [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] [Received: 06/22/2017] [Indexed: 11/12/2022]
Abstract
Objective:To investigate the relationship between the count of eosinophils(EOS) in peripheral blood and the serum levels of IL-33, and to discuss the relations among serum levels of IL-33, the count of EOS, visual analog scale (VAS) in different groups.Method:According to different treatments, the patients are divided into three groups: the untreated allergic rhinitis (AR) group (group A), the AR group who had been treated subcutaneous imunotherapy (SCIT) for at least a year (group B) and the AR complicated with allergic asthma group who had been treated subcutaneous imunotherapy (SCIT) for at least a year (gourp C). All subjects were conducted blood cell analysis, and EOS were counted. The serum levels of IL-33 were measured by enzyme linked immune (ELISA), and the obtained date were analysed by GraphPad.Prism 5.0 and SPSS 22.0.AR patients were asked to fill out VAS and were assessed nasal symptoms.Result:The serum levels of IL-33 in the group A were higher than that in other subjects (P<0.05).The serum levels of IL-33 in the group B showed no significant difference between the group B and the group C (P> 0.05).The serum levels of IL-33 in the group B were higher than that in the control group (P<0.05).The serum levels of IL-33 in the group C were higher than that in the control group (P<0.05).The count of EOS in the group A were higher than that in other subjects, and there is no difference between with each other (P> 0.05).The VAS in the group A were higher than that in the group B (P<0.05) and there is no significant difference between the group A and the group C (P<0.05).There is no difference between the group B and the group C(P<0.05).After at least one-year SCIT, the symptoms of AR patients were obviously relieved, such as consciously rhinobyon, rhinorrhea, sneezing and so on. Spearman test showed the serum levels of IL-33 in the AR patients has a weak correlation with the count of eosinophils (P> 0.05, r=0.287).Conclusion:SCIT is an effective treatment for AR patients. role on AR, which can alleviate the symptoms of patients, also can reduce the levels of IL-33 and the count of EOS in peripheral blood.
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Affiliation(s)
- H Fan
- Graduate School of Guangxi University of Chinese Medicine, Nanning, 530001, China
| | - M Li
- Department of Otorhinolaryngology, the People's Hospital of Guangxi Zhuang Autonomous Region
| | - T J Qin
- Graduate School of Guangxi University of Chinese Medicine, Nanning, 530001, China
| | - S H Qu
- Department of Otorhinolaryngology, the People's Hospital of Guangxi Zhuang Autonomous Region
| | - L S Ye
- Department of Otorhinolaryngology, the People's Hospital of Guangxi Zhuang Autonomous Region
| | - F T Li
- Department of Otorhinolaryngology, the People's Hospital of Guangxi Zhuang Autonomous Region
| | - G S Lin
- Department of Otorhinolaryngology, the People's Hospital of Guangxi Zhuang Autonomous Region
| | - Y Q Liang
- Department of Otorhinolaryngology, the People's Hospital of Guangxi Zhuang Autonomous Region
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26
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Affiliation(s)
- Xiang-Lei Yuan
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Shui-Fang Wang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Chun-Cheng Wu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Xian-Hui Zeng
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Naveed Khan
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
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27
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Affiliation(s)
- Xiang-Lei Yuan
- Department of Gastroenterology, West China Hospital, Sichuan University, Sichuan, China
| | - Wei Liu
- Department of Gastroenterology, West China Hospital, Sichuan University, Sichuan, China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Sichuan, China
| | - Ping Yan
- Department of Gastroenterology, West China Hospital, Sichuan University, Sichuan, China
| | - Yu Wang
- Department of Gastroenterology, West China Hospital, Sichuan University, Sichuan, China
| | - Naveed Khan
- Department of Gastroenterology, West China Hospital, Sichuan University, Sichuan, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Sichuan, China
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28
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Chen HL, Liu W, Jiang S, Ye LS, Zhang YH, Zeng HZ, Hu B. A Completely Occluded Colorectal Anastomotic Stenosis Treated Using an Endoscopic Incision Method. Am J Gastroenterol 2018; 113:174. [PMID: 29467532 DOI: 10.1038/ajg.2017.488] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Hong-Lin Chen
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Wei Liu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Shan Jiang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yu-Hang Zhang
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hong-Ze Zeng
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
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29
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Zeng QS, Wu CC, Liu W, Ye LS, Jiang S, Zhang YH, Hu B. Endoscopic Placement of a U-Shaped Plastic Stent in Patients With Recurrent Acute Pancreatitis and Incomplete Pancreas Divisum. Am J Gastroenterol 2017; 112:1777. [PMID: 29215619 DOI: 10.1038/ajg.2017.388] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Qi-Shan Zeng
- Department of Gastroenterology, West China Hospital, Sichuan University, Sichuan, P.R. China
| | - Chun-Cheng Wu
- Department of Gastroenterology, West China Hospital, Sichuan University, Sichuan, P.R. China
| | - Wei Liu
- Department of Gastroenterology, West China Hospital, Sichuan University, Sichuan, P.R. China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Sichuan, P.R. China
| | - Shan Jiang
- Department of Gastroenterology, West China Hospital, Sichuan University, Sichuan, P.R. China
| | - Yu-Hang Zhang
- Department of Gastroenterology, West China Hospital, Sichuan University, Sichuan, P.R. China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Sichuan, P.R. China
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30
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Affiliation(s)
- Wei Liu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Ling Liu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Hong-Lin Chen
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Hong-Ze Zeng
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Chun-Cheng Wu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Lian-Song Ye
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
| | - Bing Hu
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, Sichuan, P.R. China
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31
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Zhang B, Liang XL, Gao HY, Ye LS, Wang YG. Models of logistic regression analysis, support vector machine, and back-propagation neural network based on serum tumor markers in colorectal cancer diagnosis. Genet Mol Res 2016; 15:gmr8643. [PMID: 27323037 DOI: 10.4238/gmr.15028643] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
We evaluated the application of three machine learning algorithms, including logistic regression, support vector machine and back-propagation neural network, for diagnosing congenital heart disease and colorectal cancer. By inspecting related serum tumor marker levels in colorectal cancer patients and healthy subjects, early diagnosis models for colorectal cancer were built using three machine learning algorithms to assess their corresponding diagnostic values. Except for serum alpha-fetoprotein, the levels of 11 other serum markers of patients in the colorectal cancer group were higher than those in the benign colorectal cancer group (P < 0.05). The results of logistic regression analysis indicted that individual detection of serum carcinoembryonic antigens, CA199, CA242, CA125, and CA153 and their combined detection was effective for diagnosing colorectal cancer. Combined detection had a better diagnostic effect with a sensitivity of 94.2% and specificity of 97.7%; combining serum carcinoembryonic antigens, CA199, CA242, CA125, and CA153, with the support vector machine diagnosis model and back-propagation, a neural network diagnosis model was built with diagnostic accuracies of 82 and 75%, sensitivities of 85 and 80%, and specificities of 80 and 70%, respectively. Colorectal cancer diagnosis models based on the three machine learning algorithms showed high diagnostic value and can help obtain evidence for the early diagnosis of colorectal cancer.
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Affiliation(s)
- B Zhang
- Training Department, Third Military Medical University of Chinese PLA, Shapingba, Chongqing, China
| | - X L Liang
- Medical Department, Military General Hospital of Beijing PLA, Dongcheng, Beijing, China
| | - H Y Gao
- Medical Department, Military General Hospital of Beijing PLA, Dongcheng, Beijing, China
| | - L S Ye
- Medical Department, Military General Hospital of Beijing PLA, Dongcheng, Beijing, China
| | - Y G Wang
- Training Department, Third Military Medical University of Chinese PLA, Shapingba, Chongqing, China
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32
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Qian SG, Qiu SX, Ye LS. [The clinical observation of early neonatal pure breast-feeding]. Zhonghua Fu Chan Ke Za Zhi 1994; 29:138-40, 188-9. [PMID: 8082427] [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: 01/28/2023]
Abstract
Through observation on the rate of physiological body weight loss, the percentage of body weight regaining and the incidence of infection in hospital of 160 newborns with rooming in and pure breast-feeding after uneventful delivery or caesarean section. The average rates of physiological body weight loss were 6.70% and 6.47% in pure breast-feeding group with normal delivery and caesarean section respectively, whereas 5.03% and 5.57% in mix feeding group. The percentage of body weight regaining at discharge were 34.00% and 53.33% in pure breast-feeding group compared with 11.46% and 40.00% in mix feeding group. The incidence of neonatal infection in hospital were 2.00% and 13.33% in pure breast-feeding group, instead 14.00% and 13.33% in mix feeding group. The results showed advantages and feasible of pure breast-feeding.
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Affiliation(s)
- S G Qian
- Obstetrics and Gynecology Hospital, Shanghai Medical University
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