Pub Date : 2006-01-01DOI: 10.1111/j.1443-9573.2006.00244.x
De Rong Xie, Han Lin Liang, Yu Wang, Shuang Shuang Guo
Objectives: To compare the therapeutic effects of gemcitabine (GEM) monotherapy with GEM-cisplatin (DDP) combination chemotherapy in patients with advanced stage pancreatic cancer (APCa) through meta-analysis.
Methods: MEDLINE and EMBASE searches were supplemented by information from trial registers of randomized controlled trials (RCTs) for GEM-DDP combination chemotherapy and GEM alone in APCa. A quantitative meta-analysis using updated information based on inclusion criteria from all available RCTs was carried out by two reviewers. The primary meta-analysis involved the overall survival (OS), objective remission rate (ORR) and toxicity.
Results: The meta-analysis included six RCTs. There was no significant advantage for the GEM-DDP combination group in 6-month survival rate (P = 0.24) or clinical benefit rate (P = 0.58). There was a marginal significant improvement for the GEM-DDP combination group in ORR (RD = 6%, P = 0.05; RD, risk difference = risk in the GEM-DDP combination group - risk in the GEM alone group). Moreover, there was a significant improvement for the combination group in 6-month TTP/TTF (RD = 9%, P = 0.02). WHO grade 3-4 toxicity was higher for the GEM-DDP combination group in terms of neutropenia (RD = 6%, P = 0.08), thrombocytopenia (RD = 8%, P = 0.17) and vomiting/nausea (RD = 11%, P = 0.07); none reached significant difference.
Conclusion: GEM-DDP combination should not be recommended and GEM monotherapy remains the standard treatment for patients with APCa.
目的:通过meta分析比较吉西他滨(GEM)单药治疗与GEM-顺铂(DDP)联合化疗治疗晚期胰腺癌(APCa)的疗效。方法:MEDLINE和EMBASE检索补充了GEM- ddp联合化疗和GEM单独治疗APCa的随机对照试验(rct)的试验注册信息。使用基于所有可用rct纳入标准的最新信息进行定量荟萃分析，由两名评论者进行。主要荟萃分析包括总生存期(OS)、客观缓解率(ORR)和毒性。结果:meta分析包括6项随机对照试验。GEM-DDP联合治疗组在6个月生存率(P = 0.24)和临床获益率(P = 0.58)方面无显著优势。GEM-DDP联合用药组的ORR有显著改善(RD = 6%， P = 0.05;RD，风险差异= GEM- ddp联合组风险- GEM单独组风险)。此外，联合治疗组在6个月TTP/TTF方面有显著改善(RD = 9%， P = 0.02)。GEM-DDP联合组在中性粒细胞减少(RD = 6%， P = 0.08)、血小板减少(RD = 8%， P = 0.17)和呕吐/恶心(RD = 11%， P = 0.07)方面的WHO 3-4级毒性更高;没有达到显著差异。结论:不推荐GEM- ddp联合治疗，GEM单药治疗仍是APCa患者的标准治疗方法。
{"title":"Meta-analysis of inoperable pancreatic cancer: gemcitabine combined with cisplatin versus gemcitabine alone.","authors":"De Rong Xie, Han Lin Liang, Yu Wang, Shuang Shuang Guo","doi":"10.1111/j.1443-9573.2006.00244.x","DOIUrl":"https://doi.org/10.1111/j.1443-9573.2006.00244.x","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the therapeutic effects of gemcitabine (GEM) monotherapy with GEM-cisplatin (DDP) combination chemotherapy in patients with advanced stage pancreatic cancer (APCa) through meta-analysis.</p><p><strong>Methods: </strong>MEDLINE and EMBASE searches were supplemented by information from trial registers of randomized controlled trials (RCTs) for GEM-DDP combination chemotherapy and GEM alone in APCa. A quantitative meta-analysis using updated information based on inclusion criteria from all available RCTs was carried out by two reviewers. The primary meta-analysis involved the overall survival (OS), objective remission rate (ORR) and toxicity.</p><p><strong>Results: </strong>The meta-analysis included six RCTs. There was no significant advantage for the GEM-DDP combination group in 6-month survival rate (P = 0.24) or clinical benefit rate (P = 0.58). There was a marginal significant improvement for the GEM-DDP combination group in ORR (RD = 6%, P = 0.05; RD, risk difference = risk in the GEM-DDP combination group - risk in the GEM alone group). Moreover, there was a significant improvement for the combination group in 6-month TTP/TTF (RD = 9%, P = 0.02). WHO grade 3-4 toxicity was higher for the GEM-DDP combination group in terms of neutropenia (RD = 6%, P = 0.08), thrombocytopenia (RD = 8%, P = 0.17) and vomiting/nausea (RD = 11%, P = 0.07); none reached significant difference.</p><p><strong>Conclusion: </strong>GEM-DDP combination should not be recommended and GEM monotherapy remains the standard treatment for patients with APCa.</p>","PeriodicalId":10082,"journal":{"name":"Chinese journal of digestive diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2006-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1443-9573.2006.00244.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25800139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2003-12-01DOI: 10.1046/J.1443-9573.2003..X
I. Maier, George Y Wu
Normal propulsion of luminal contents through the gastrointestinal (GI) tract requires complex, coordinated neural and motor activity. Abnormalities can occur at a number of different levels, and there are numerous etiologies. Several drugs are proven to be effective in stimulating the motility of the GI tract. The most common medications used in the USA are erythromycin, metoclopramide, and neostigmine. A new prokinetic agent, tegaserod, has been recently approved, and other serotonin agonist agents are currently undergoing clinical studies. Cisapride has been withdrawn from the market because of its side-effects. Other prokinetics, such as domperidone, are not yet approved in the USA, although it is used in other countries. This review summarizes current knowledge of the mechanisms of GI motility disorders, as well as new agents that show promise as therapy.
{"title":"Prokinetic therapy for gastroenterological diseases","authors":"I. Maier, George Y Wu","doi":"10.1046/J.1443-9573.2003..X","DOIUrl":"https://doi.org/10.1046/J.1443-9573.2003..X","url":null,"abstract":"Normal propulsion of luminal contents through the gastrointestinal (GI) tract requires complex, coordinated neural and motor activity. Abnormalities can occur at a number of different levels, and there are numerous etiologies. Several drugs are proven to be effective in stimulating the motility of the GI tract. The most common medications used in the USA are erythromycin, metoclopramide, and neostigmine. A new prokinetic agent, tegaserod, has been recently approved, and other serotonin agonist agents are currently undergoing clinical studies. Cisapride has been withdrawn from the market because of its side-effects. Other prokinetics, such as domperidone, are not yet approved in the USA, although it is used in other countries. This review summarizes current knowledge of the mechanisms of GI motility disorders, as well as new agents that show promise as therapy.","PeriodicalId":10082,"journal":{"name":"Chinese journal of digestive diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75423663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2003-12-01DOI: 10.1046/J.1443-9573.2003.T01-1-.X
Yi Liu, G. Tytgat, S. Xiao, F. Kate
{"title":"Gastric endocrine cells","authors":"Yi Liu, G. Tytgat, S. Xiao, F. Kate","doi":"10.1046/J.1443-9573.2003.T01-1-.X","DOIUrl":"https://doi.org/10.1046/J.1443-9573.2003.T01-1-.X","url":null,"abstract":"","PeriodicalId":10082,"journal":{"name":"Chinese journal of digestive diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72736075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2003-12-01DOI: 10.1046/J.1443-9611.2003.00137.X
F. Zhi, Lan Zhang, Xiu Peng, Xiangming Wu, D. Pan, Tian-mo Wan, Si-De Liu, Zhen Shu Zhang, Dian-yuan Zhou
OBJECTIVE: At present, there are few materials available for esophagus reconstruction anywhere in the world. The reported survival rate in animals during the perioperative period is comparatively low. The present study assessed the feasibility of using a biotype artificial esophagus in the reconstruction of a dog's esophagus. METHODS: In 30 mongrel dogs, a portion of the thoracic esophagus was resected and an 8 cm section of artificial esophagus was transplanted to reconstruct the organ. The survival rate, food intake and process of healing were observed. RESULTS: Of the 30 dogs, 28 survived the perioperative period (93.3% survival). Two dogs (6.7%) developed an anastomotic fistula; 19 dogs survived for 1 year, a survival rate of 79.2% (19/24) with the remaining six dogs were killed according to the experimental protocol. Detachment of the artificial esophagus occurred on average 28.8 days after operation and the dogs suffered from varying degrees of dysphagia 23−45 days after operation. Gradual remission occurred after 4 months. The histological study revealed that the regenerated esophagus was composed of fibrous and connective tissues and the luminal surface was covered with squamous epithelium in 3−6 months. CONCLUSION: The transplanted artificial esophagus detached after the surrounding ‘regenerated esophagus’ had formed, and the squamous epithelium gradually covered the luminal surface. Continuous remodeling of the ‘regenerated esophagus’ gradually relieved the stenosis. Whether detachment of the implant and the postoperative stenosis can be solved is the key problem restricting the use of the biotype artificial esophagus in clinical practice.
{"title":"Experimental reconstruction of dog's esophagus with biotype artificial esophagus","authors":"F. Zhi, Lan Zhang, Xiu Peng, Xiangming Wu, D. Pan, Tian-mo Wan, Si-De Liu, Zhen Shu Zhang, Dian-yuan Zhou","doi":"10.1046/J.1443-9611.2003.00137.X","DOIUrl":"https://doi.org/10.1046/J.1443-9611.2003.00137.X","url":null,"abstract":"OBJECTIVE: At present, there are few materials available for esophagus reconstruction anywhere in the world. The reported survival rate in animals during the perioperative period is comparatively low. The present study assessed the feasibility of using a biotype artificial esophagus in the reconstruction of a dog's esophagus. \u0000 \u0000 \u0000 \u0000METHODS: In 30 mongrel dogs, a portion of the thoracic esophagus was resected and an 8 cm section of artificial esophagus was transplanted to reconstruct the organ. The survival rate, food intake and process of healing were observed. \u0000 \u0000 \u0000 \u0000RESULTS: Of the 30 dogs, 28 survived the perioperative period (93.3% survival). Two dogs (6.7%) developed an anastomotic fistula; 19 dogs survived for 1 year, a survival rate of 79.2% (19/24) with the remaining six dogs were killed according to the experimental protocol. Detachment of the artificial esophagus occurred on average 28.8 days after operation and the dogs suffered from varying degrees of dysphagia 23−45 days after operation. Gradual remission occurred after 4 months. The histological study revealed that the regenerated esophagus was composed of fibrous and connective tissues and the luminal surface was covered with squamous epithelium in 3−6 months. \u0000 \u0000 \u0000 \u0000CONCLUSION: The transplanted artificial esophagus detached after the surrounding ‘regenerated esophagus’ had formed, and the squamous epithelium gradually covered the luminal surface. Continuous remodeling of the ‘regenerated esophagus’ gradually relieved the stenosis. Whether detachment of the implant and the postoperative stenosis can be solved is the key problem restricting the use of the biotype artificial esophagus in clinical practice.","PeriodicalId":10082,"journal":{"name":"Chinese journal of digestive diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73142271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2003-12-01DOI: 10.1046/J.1443-9611.2003.00138.X
Z. Ran, Jiong Liu, Ying Feng, Jian Zou, S. Xiao
OBJECTIVE: To investigate the cell cytotoxicity induced by the antineoplastic parvovirus H-1 in gastric carcinoma cells. METHODS: The cytotoxicity of the H-1 virus in the gastric cancer cell strain HGC27 was measured by MTT test and FACS analysis. The mRNA expressions of genes related to the mitogen-activated protein kinase (MAPK) signaling transduction pathway were measured by RT-PCR in HGC27 cells infected by the H-1 virus. RESULTS: HGC27 cells were sensitive to the cytotoxicity of the H-1 virus, although the cell cycle distribution was not significantly changed. The RT-PCR results showed that 48 h after H-1 virus infection of HGC27 cells the expression of creb was increased and that of erk1, stat2, p38-γ, mek2, B-raf and mtk1 was remarkably decreased. However, the expression of each of jnk2, ets and erk2 was unchanged. CONCLUSIONS: The mechanism of the cytotoxic effect of parvovirus H-1 in HGC27 cells might be interference with specific cellular signaling transduction pathways, which would induce cell death. A modified and reconstructed parvovirus H-1 could be a very useful tool for antitumor biochemical therapy.
{"title":"Impact of parvovirus H‐1 infection on the expression of genes related to the MAPK signaling pathway in gastric cancer cells","authors":"Z. Ran, Jiong Liu, Ying Feng, Jian Zou, S. Xiao","doi":"10.1046/J.1443-9611.2003.00138.X","DOIUrl":"https://doi.org/10.1046/J.1443-9611.2003.00138.X","url":null,"abstract":"OBJECTIVE: To investigate the cell cytotoxicity induced by the antineoplastic parvovirus H-1 in gastric carcinoma cells. \u0000 \u0000 \u0000 \u0000METHODS: The cytotoxicity of the H-1 virus in the gastric cancer cell strain HGC27 was measured by MTT test and FACS analysis. The mRNA expressions of genes related to the mitogen-activated protein kinase (MAPK) signaling transduction pathway were measured by RT-PCR in HGC27 cells infected by the H-1 virus. \u0000 \u0000 \u0000 \u0000RESULTS: HGC27 cells were sensitive to the cytotoxicity of the H-1 virus, although the cell cycle distribution was not significantly changed. The RT-PCR results showed that 48 h after H-1 virus infection of HGC27 cells the expression of creb was increased and that of erk1, stat2, p38-γ, mek2, B-raf and mtk1 was remarkably decreased. However, the expression of each of jnk2, ets and erk2 was unchanged. \u0000 \u0000 \u0000 \u0000CONCLUSIONS: The mechanism of the cytotoxic effect of parvovirus H-1 in HGC27 cells might be interference with specific cellular signaling transduction pathways, which would induce cell death. A modified and reconstructed parvovirus H-1 could be a very useful tool for antitumor biochemical therapy.","PeriodicalId":10082,"journal":{"name":"Chinese journal of digestive diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85029384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2003-07-01DOI: 10.1046/J.1443-9573.2003.T01-1-00122.X
F. Marotta, Y. Naito, A. Helmy, E. Oliva, E. Minelli, M. Yoshioka, C. Min
OBJECTIVE: The aim of this investigation was to assess the role of different therapeutic options aimed at modifying the gut microecology in experimental liver cirrhosis in view of the cytokine cascade and splanchnic and systemic hemodynamics. METHODS: Cirrhosis was induced in male Sprague-Dawley rats by carbon tetrachloride (CCL4). After the 6th week of CCL4 administration rats were divided into 5 groups for the remaining 6 weeks: (A) saline b.i.d; (B) lactulose 0.5 g b.i.d.; (C) rifaximine 1 mg b.i.d; (D) 2 mL b.i.d of a probiotic mixture and (E) 1 week of rifaximine followed by 5 weeks of probiotic. RESULTS: Rats with cirrhosis and ascites showed a significantly high concentration of either portal, splanchnic and systemic endotoxin, as well as plasma TNF-α concentration (P < 0.05). Rifaximine alone, rifaximine plus probiotic or probiotic alone significantly decreased the plasma endotoxin concentration at each of the three tested sites, as well as the plasma concentration of TNF-α (P < 0.01). Total Gram-negative aerobic bacteria count in the stool markedly decreased together with a significant increase of the enterococcal population in the rifaximine plus probiotic group and, to a lesser extent, in the other treatment groups. Treated rats showed a significantly decreased occurrence of bacterial peritonitis and the rifaximine plus probiotic treatment was the most effective regimen. Each of the treatments significantly reduced the percentage of positive culture of either mesenteric lymph node or portal vein samples, rifaximine plus probiotic being the most effective. As compared with healthy control rats, those with cirrhosis showed a significantly lower mean arterial pressure and systemic vascular resistance, but a higher cardiac index and portal pressure. Spontaneous bacterial peritonitis further worsened the systemic vascular resistance, but this was partly improved by the rifaximine plus probiotic treatment. CONCLUSION: These data suggest that the association of a nonabsorbable antibiotic with a probiotic beneficially affects the abnormal systemic vasodilatory response in the course of severe liver cirrhosis, probably through the effects on endotoxin and indirect inhibition of TNF−α release.
{"title":"Spontaneous bacterial peritonitis associated with experimental cirrhosis: Comparative effect of different therapeutic options on endotoxinemia and hemodynamic derangement","authors":"F. Marotta, Y. Naito, A. Helmy, E. Oliva, E. Minelli, M. Yoshioka, C. Min","doi":"10.1046/J.1443-9573.2003.T01-1-00122.X","DOIUrl":"https://doi.org/10.1046/J.1443-9573.2003.T01-1-00122.X","url":null,"abstract":"OBJECTIVE: The aim of this investigation was to assess the role of different therapeutic options aimed at modifying the gut microecology in experimental liver cirrhosis in view of the cytokine cascade and splanchnic and systemic hemodynamics. \u0000 \u0000 \u0000 \u0000METHODS: Cirrhosis was induced in male Sprague-Dawley rats by carbon tetrachloride (CCL4). After the 6th week of CCL4 administration rats were divided into 5 groups for the remaining 6 weeks: (A) saline b.i.d; (B) lactulose 0.5 g b.i.d.; (C) rifaximine 1 mg b.i.d; (D) 2 mL b.i.d of a probiotic mixture and (E) 1 week of rifaximine followed by 5 weeks of probiotic. \u0000 \u0000 \u0000 \u0000RESULTS: Rats with cirrhosis and ascites showed a significantly high concentration of either portal, splanchnic and systemic endotoxin, as well as plasma TNF-α concentration (P < 0.05). Rifaximine alone, rifaximine plus probiotic or probiotic alone significantly decreased the plasma endotoxin concentration at each of the three tested sites, as well as the plasma concentration of TNF-α (P < 0.01). Total Gram-negative aerobic bacteria count in the stool markedly decreased together with a significant increase of the enterococcal population in the rifaximine plus probiotic group and, to a lesser extent, in the other treatment groups. Treated rats showed a significantly decreased occurrence of bacterial peritonitis and the rifaximine plus probiotic treatment was the most effective regimen. Each of the treatments significantly reduced the percentage of positive culture of either mesenteric lymph node or portal vein samples, rifaximine plus probiotic being the most effective. As compared with healthy control rats, those with cirrhosis showed a significantly lower mean arterial pressure and systemic vascular resistance, but a higher cardiac index and portal pressure. Spontaneous bacterial peritonitis further worsened the systemic vascular resistance, but this was partly improved by the rifaximine plus probiotic treatment. \u0000 \u0000 \u0000 \u0000CONCLUSION: These data suggest that the association of a nonabsorbable antibiotic with a probiotic beneficially affects the abnormal systemic vasodilatory response in the course of severe liver cirrhosis, probably through the effects on endotoxin and indirect inhibition of TNF−α release.","PeriodicalId":10082,"journal":{"name":"Chinese journal of digestive diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76701174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2003-07-01DOI: 10.1046/J.1443-9573.2003.T01-1-00120.X
Z. Ge, Yun-biao Hu, Yun-jie Gao, S. Xiao
BACKGROUND: Diagnostic modalities for identifying lesions within the small bowel have been quite limited. Wireless capsule endoscopy (WCE) is a new, innovative technique that can detect very small mucosal lesions in the entire small bowel and can be used in the outpatient setting. The present study explored the diagnostic value, tolerance and safety of WCE in the identification of small bowel pathology that was not detected with conventional small bowel imaging studies. METHODS: From May through September 2002, 15 patients with suspected small bowel diseases were prospectively examined, Of them, 12 presented with persistent obscure gastrointestinal bleeding and negative findings on upper endoscopy, colonoscopy, small bowel radiography, and bleeding-scan scintig-raphy or mesenteric angiography. RESULTS: Wireless capsule endoscopy identified pathologic small bowel findings in 11 of the 15 patients (73%): angioectasias, Dieulafoy's lesion, polypoid lesion, submucosal mass, Crohn's disease, carcinoid tumor, lipoma, aphthous ulcer, and hemorrhagic gastritis; four of the patients had two lesions. The images displayed were considered to be good. The capsule endoscopes remained in the stomach for an average of 82 min (range 6−311 min) and the mean transit time in the small bowel was 248 min (range 104−396 min). The mean time of recording was 7 h 29 min (from 5 h to 8 h 30 min). The mean time to reach the cecum was 336 min (180−470 min). The average number of the images transmitted by the capsule was 57 919 and the average time the physician took to review the images transmitted by the capsule was 82 min (range 30−120 min). The average time of elimination of the capsule was 33 h (range 24−48 h). All 15 patients reported that the capsule was easy to swallow, painless, and preferable to conventional endoscopy. No complications were observed. CONCLUSIONS: Wireless capsule endoscopy is safe, well tolerated, and useful for identifying occult lesions of the small bowel, especially in patients who present with obscure gastrointestinal bleeding.
背景:鉴别小肠内病变的诊断方法相当有限。无线胶囊内窥镜(WCE)是一种新的创新技术，可以检测整个小肠非常小的粘膜病变，可用于门诊。本研究探讨了WCE在常规小肠影像学检查未检测到的小肠病理诊断中的价值、耐受性和安全性。方法:2002年5 ~ 9月，对15例疑似小肠疾病的患者进行前瞻性检查，其中12例表现为持续性消化道隐蔽性出血，上肠镜、结肠镜、小肠x线摄影、出血扫描或肠系膜血管造影均阴性。结果:无线胶囊内镜在15例患者中发现了11例(73%)的病理小肠表现:血管扩张、Dieulafoy病变、息肉样病变、粘膜下肿块、克罗恩病、类癌、脂肪瘤、阿弗顿溃疡和出血性胃炎;其中四名患者有两处病变。显示的图像被认为是好的。胶囊内窥镜在胃内的平均停留时间为82分钟(6 - 311分钟)，在小肠内的平均穿越时间为248分钟(104 - 396分钟)。平均记录时间为7 h 29 min (5 h ~ 8 h 30 min)。平均到达盲肠时间为336 min (180 ~ 470 min)。胶囊传输图像的平均数量为57919张，医生检查胶囊传输图像的平均时间为82分钟(范围30 - 120分钟)。胶囊消除的平均时间为33小时(24 - 48小时)。所有15例患者报告胶囊易于吞咽，无痛，优于常规内镜检查。无并发症发生。结论:无线胶囊内镜是一种安全、耐受性良好的方法，可用于识别小肠隐匿性病变，特别是对伴有隐蔽性消化道出血的患者。
{"title":"Clinical application of wireless capsule endoscopy","authors":"Z. Ge, Yun-biao Hu, Yun-jie Gao, S. Xiao","doi":"10.1046/J.1443-9573.2003.T01-1-00120.X","DOIUrl":"https://doi.org/10.1046/J.1443-9573.2003.T01-1-00120.X","url":null,"abstract":"BACKGROUND: Diagnostic modalities for identifying lesions within the small bowel have been quite limited. Wireless capsule endoscopy (WCE) is a new, innovative technique that can detect very small mucosal lesions in the entire small bowel and can be used in the outpatient setting. The present study explored the diagnostic value, tolerance and safety of WCE in the identification of small bowel pathology that was not detected with conventional small bowel imaging studies. \u0000 \u0000 \u0000 \u0000METHODS: From May through September 2002, 15 patients with suspected small bowel diseases were prospectively examined, Of them, 12 presented with persistent obscure gastrointestinal bleeding and negative findings on upper endoscopy, colonoscopy, small bowel radiography, and bleeding-scan scintig-raphy or mesenteric angiography. \u0000 \u0000 \u0000 \u0000RESULTS: Wireless capsule endoscopy identified pathologic small bowel findings in 11 of the 15 patients (73%): angioectasias, Dieulafoy's lesion, polypoid lesion, submucosal mass, Crohn's disease, carcinoid tumor, lipoma, aphthous ulcer, and hemorrhagic gastritis; four of the patients had two lesions. The images displayed were considered to be good. The capsule endoscopes remained in the stomach for an average of 82 min (range 6−311 min) and the mean transit time in the small bowel was 248 min (range 104−396 min). The mean time of recording was 7 h 29 min (from 5 h to 8 h 30 min). The mean time to reach the cecum was 336 min (180−470 min). The average number of the images transmitted by the capsule was 57 919 and the average time the physician took to review the images transmitted by the capsule was 82 min (range 30−120 min). The average time of elimination of the capsule was 33 h (range 24−48 h). All 15 patients reported that the capsule was easy to swallow, painless, and preferable to conventional endoscopy. No complications were observed. \u0000 \u0000 \u0000 \u0000CONCLUSIONS: Wireless capsule endoscopy is safe, well tolerated, and useful for identifying occult lesions of the small bowel, especially in patients who present with obscure gastrointestinal bleeding.","PeriodicalId":10082,"journal":{"name":"Chinese journal of digestive diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90387931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2003-07-01DOI: 10.1046/J.1443-9573.2003.T01-1-00118.X
Xue-song Yang, Y. Lu, Changyuan Yu, C. Wang
OBJECTIVE: To review the clinical and endoscopic features, and outcome of ischemic colitis. METHODS: Sixty cases with the diagnosis of ischemic colitis were retrospectively analyzed. All the patients were under observation in hospital and most of them underwent colonoscopy at least twice: once for diagnosis and then follow-up after treatment. The demographic data, presenting symptoms, endoscopic findings, laboratory tests, and treatment were reviewed. RESULTS: Fifty-two of the 60 cases were over 50 years old (87%; mean age, 59.9 years): 40 female, 20 male (2 : 1); 76.0% of these patients had a coexistent disease such as a cardio-cerebrovascular disorder, diabetes, hematologic diseases or a previous history of abdominal surgery. Abdominal pain (57/60, 95%), hematochezia (55/60, 91.7%), and diarrhea (26/60, 43.3%) were the main complaints. Lesions seen on colonoscopy were more commonly located in the left colon (46/60, 79.3%) and rectum (5/60, 8.6%), and were characteristically segment-distributed, including hemorrhagic edematous mucosa, erosions, ulcerations, pseudopolyps, and stricture. Ultrasonography revealed colonic wall thickening in 13 cases (13/55, 21.7%), and small to moderate ascites was detected in 4 cases (4/55, 7.3%). In this cohort, most of the patients recovered (49/60, 81.7%) or improved (10/60, 16.7%) after conservative treatment. Only one patient who had a myocardial infarction prior to the onset of the ischemic colitis, died from peritonitis complicated with septic shock. Progress and outcome were associated with the patient's age, severity of the lesions, clinical course, underlying diseases and the complications. CONCLUSION: Colonoscopy is safe and helpful in the early diagnosis of ischemic colitis. Nongangrenous colonic ischemia usually requires only medical management and is associated with a good prognosis.
{"title":"Clinical and endoscopic features of ischemic colitis","authors":"Xue-song Yang, Y. Lu, Changyuan Yu, C. Wang","doi":"10.1046/J.1443-9573.2003.T01-1-00118.X","DOIUrl":"https://doi.org/10.1046/J.1443-9573.2003.T01-1-00118.X","url":null,"abstract":"OBJECTIVE: To review the clinical and endoscopic features, and outcome of ischemic colitis. \u0000 \u0000 \u0000 \u0000METHODS: Sixty cases with the diagnosis of ischemic colitis were retrospectively analyzed. All the patients were under observation in hospital and most of them underwent colonoscopy at least twice: once for diagnosis and then follow-up after treatment. The demographic data, presenting symptoms, endoscopic findings, laboratory tests, and treatment were reviewed. \u0000 \u0000 \u0000 \u0000RESULTS: Fifty-two of the 60 cases were over 50 years old (87%; mean age, 59.9 years): 40 female, 20 male (2 : 1); 76.0% of these patients had a coexistent disease such as a cardio-cerebrovascular disorder, diabetes, hematologic diseases or a previous history of abdominal surgery. Abdominal pain (57/60, 95%), hematochezia (55/60, 91.7%), and diarrhea (26/60, 43.3%) were the main complaints. Lesions seen on colonoscopy were more commonly located in the left colon (46/60, 79.3%) and rectum (5/60, 8.6%), and were characteristically segment-distributed, including hemorrhagic edematous mucosa, erosions, ulcerations, pseudopolyps, and stricture. Ultrasonography revealed colonic wall thickening in 13 cases (13/55, 21.7%), and small to moderate ascites was detected in 4 cases (4/55, 7.3%). In this cohort, most of the patients recovered (49/60, 81.7%) or improved (10/60, 16.7%) after conservative treatment. Only one patient who had a myocardial infarction prior to the onset of the ischemic colitis, died from peritonitis complicated with septic shock. Progress and outcome were associated with the patient's age, severity of the lesions, clinical course, underlying diseases and the complications. \u0000 \u0000 \u0000 \u0000CONCLUSION: Colonoscopy is safe and helpful in the early diagnosis of ischemic colitis. Nongangrenous colonic ischemia usually requires only medical management and is associated with a good prognosis.","PeriodicalId":10082,"journal":{"name":"Chinese journal of digestive diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89681924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2003-07-01DOI: 10.1046/J.1443-9573.2003.T01-1-00115.X
Jun Ting Li, Z. Li, X. Zhan, Z. Cui, Shinan Nie
OBJECTIVE: To compare the gastric mucosal damage induced by a COX-2 inhibitor, celecoxib, and a conventional NSAID, indomethacin. METHODS: A rat model of NSAID-induced gastric mucosal damage was prepared for indomethacin and celecoxib separately (n = 8). After gastric damage was induced by 100% ethanol, celecoxib was administered by gastric gavage (n = 8). Gastric mucosal concentrations of 6-keto-PGF1α and TXB2 and the lesion index (LI) were measured. Morphological changes of the gastric mucosa were assessed under light and scanning electron microscopy. RESULTS: Indomethacin caused marked gastric damage (LI: 13.38 ± 2.06) and significant reduction of the concentrations of 6-keto-PGF1α and TXB2 (P < 0.01), Celecoxib did not produce necrotic injuries on healthy gastric mucosa (LI: 0), but the mucosal injuries previously induced by ethanol worsened after its administration (LI: 37.19 ± 3.34 vs 19.90 ± 2.28, P < 0.01). CONCLUSIONS: Inhibition of COX-1 is the major mechanism of NSAIDs in producing gastric mucosal damage. As a selective COX-2 inhibitor, celecoxib does not produce toxic injuries of the healthy gastric mucosa, and is thus safer than conventional NSAID. However, when administered in the presence of an altered gastric mucosa, gastric injuries were worsened.
{"title":"Experimental study of the safety of the selective COX‐2 inhibitor, celecoxib, for gastric mucosa","authors":"Jun Ting Li, Z. Li, X. Zhan, Z. Cui, Shinan Nie","doi":"10.1046/J.1443-9573.2003.T01-1-00115.X","DOIUrl":"https://doi.org/10.1046/J.1443-9573.2003.T01-1-00115.X","url":null,"abstract":"OBJECTIVE: To compare the gastric mucosal damage induced by a COX-2 inhibitor, celecoxib, and a conventional NSAID, indomethacin. \u0000 \u0000 \u0000 \u0000METHODS: A rat model of NSAID-induced gastric mucosal damage was prepared for indomethacin and celecoxib separately (n = 8). After gastric damage was induced by 100% ethanol, celecoxib was administered by gastric gavage (n = 8). Gastric mucosal concentrations of 6-keto-PGF1α and TXB2 and the lesion index (LI) were measured. Morphological changes of the gastric mucosa were assessed under light and scanning electron microscopy. \u0000 \u0000 \u0000 \u0000RESULTS: Indomethacin caused marked gastric damage (LI: 13.38 ± 2.06) and significant reduction of the concentrations of 6-keto-PGF1α and TXB2 (P < 0.01), Celecoxib did not produce necrotic injuries on healthy gastric mucosa (LI: 0), but the mucosal injuries previously induced by ethanol worsened after its administration (LI: 37.19 ± 3.34 vs 19.90 ± 2.28, P < 0.01). \u0000 \u0000 \u0000 \u0000CONCLUSIONS: Inhibition of COX-1 is the major mechanism of NSAIDs in producing gastric mucosal damage. As a selective COX-2 inhibitor, celecoxib does not produce toxic injuries of the healthy gastric mucosa, and is thus safer than conventional NSAID. However, when administered in the presence of an altered gastric mucosa, gastric injuries were worsened.","PeriodicalId":10082,"journal":{"name":"Chinese journal of digestive diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75369337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2003-07-01DOI: 10.1046/J.1443-9573.2003.T01-1-00114.X
J. Sheng, S. Li, Lu-ping Wang, Lan-xiang Gao, Xiao-jun Zhao, Y. Tian, Y. Deng
OBJECTIVE: Numerous studies have demonstrated the role of Helicobacter pylori infection in the pathogenesis of gastric MALT lymphoma and the present study aimed to analyze this correlation in Chinese patients. METHODS: Thirty-five cases of primary gastrointestinal non-Hodgkin's lymphoma that had been surgically resected and pathologically examined during the past 20 years were collected. The tissue samples were re-examined by a physician from the pathology department. Immunohistochemical staining and H. pylori tests were conducted. The clinical diagnosis of gastric MALT lymphoma and the results of therapy were analyzed. RESULTS: According to the immunohistochemistry results, 21 cases were MALT lymphoma, and of these 16 were gastric MALT lymphoma, one was intestinal MALT lymphoma and four were colonic MALT lymphoma. Of the 16 samples of gastric MALT lymphoma, 13 were positive for H. pylori infection and three could not be evaluated because the sample was full of cancer cells. Of the cases of gastric MALT lymphoma, two were stage I1, five were stage II1, and nine were stage IIE. Eleven patients underwent endoscopy: three were misinterpreted as gastric carcinoma, one was diagnosed as Menetrier's disease, one as chronic atrophic gastritis, and only six cases were correctly diagnosed before surgery. Eradication of H. pylori in one patient with gastric MALT lymphoma resulted in regression of the lesion; that patient was followed up for 3 years without relapse. Fifteen cases underwent surgery and 10 were followed up for 5 years: four relapsed within 1−2 years after operation and six remained well. CONCLUSION: There is a close relationship between H. pylori infection and gastric MALT lymphoma. Early gastric MALT lymphoma can be cured after eradication of H. pylori. The depth of the lesion should be diagnosed by echoendoscopy and therapy should be chosen on the basis of the stage of the disease.
{"title":"Gastric mucosa‐associated lymphoid tissue lymphoma and Helicobacter pylori infection","authors":"J. Sheng, S. Li, Lu-ping Wang, Lan-xiang Gao, Xiao-jun Zhao, Y. Tian, Y. Deng","doi":"10.1046/J.1443-9573.2003.T01-1-00114.X","DOIUrl":"https://doi.org/10.1046/J.1443-9573.2003.T01-1-00114.X","url":null,"abstract":"OBJECTIVE: Numerous studies have demonstrated the role of Helicobacter pylori infection in the pathogenesis of gastric MALT lymphoma and the present study aimed to analyze this correlation in Chinese patients. \u0000 \u0000 \u0000 \u0000METHODS: Thirty-five cases of primary gastrointestinal non-Hodgkin's lymphoma that had been surgically resected and pathologically examined during the past 20 years were collected. The tissue samples were re-examined by a physician from the pathology department. Immunohistochemical staining and H. pylori tests were conducted. The clinical diagnosis of gastric MALT lymphoma and the results of therapy were analyzed. \u0000 \u0000 \u0000 \u0000RESULTS: According to the immunohistochemistry results, 21 cases were MALT lymphoma, and of these 16 were gastric MALT lymphoma, one was intestinal MALT lymphoma and four were colonic MALT lymphoma. Of the 16 samples of gastric MALT lymphoma, 13 were positive for H. pylori infection and three could not be evaluated because the sample was full of cancer cells. Of the cases of gastric MALT lymphoma, two were stage I1, five were stage II1, and nine were stage IIE. Eleven patients underwent endoscopy: three were misinterpreted as gastric carcinoma, one was diagnosed as Menetrier's disease, one as chronic atrophic gastritis, and only six cases were correctly diagnosed before surgery. Eradication of H. pylori in one patient with gastric MALT lymphoma resulted in regression of the lesion; that patient was followed up for 3 years without relapse. Fifteen cases underwent surgery and 10 were followed up for 5 years: four relapsed within 1−2 years after operation and six remained well. \u0000 \u0000 \u0000 \u0000CONCLUSION: There is a close relationship between H. pylori infection and gastric MALT lymphoma. Early gastric MALT lymphoma can be cured after eradication of H. pylori. The depth of the lesion should be diagnosed by echoendoscopy and therapy should be chosen on the basis of the stage of the disease.","PeriodicalId":10082,"journal":{"name":"Chinese journal of digestive diseases","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2003-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73821826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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