PubMed Health⌕ Search

Biomedical subjects

Guo-ming Xu

Publications and source records attributed to Guo-ming Xu.

10 recordsLinked to original sources
PubMed2006

Role of duodenogastroesophageal reflux in the pathogenesis of esophageal mucosal injury and gastroesophageal reflux symptoms.

BACKGROUND AND AIM: Patients with gastroesophageal reflux disease (GERD) usually suffer from acid reflux and duodenogastroesophageal reflux (DGER) simultaneously. The question of whether DGER has an important effect on the development of GERD remains controversial. The aim of the present study was to investigate the role of DGER in the pathogenesis of GERD and its value for the diagnosis of nonerosive reflux disease (NERD). METHODS: GERD was initially diagnosed using the reflux disease questionnaire. For further diagnosis, results of the upper gastrointestinal endoscopy (excluding a diagnosis of Barrett's esophagus) were considered in conjunction with simultaneous 24 h esophageal pH and bilirubin monitoring. RESULTS: According to endoscopic findings, 95 patients (43 men, 50+/-10 years of age) were divided into two groups: the reflux esophagitis (RE) group (n=51) and the NERD group (n=44). Three DGER parameters, the percentage of time with absorbance greater than 0.14, the total number of reflux episodes and the number of bile reflux episodes lasting longer than 5 min, were evaluated in the study. For the RE group, the values of the DGER parameters (19.05%+/-23.44%, 30.56+/-34.04 and 5.90+/-6.37, respectively) were significantly higher than those of the NERD group (7.26%+/-11.08%, 15.68+/-20.92 and 2.59+/-3.57, respectively, P<0.05 for all) but no significant difference was found in acid reflux. Of NERD patients, 18.5% were diagnosed with simple DGER. The positive diagnosis rate of NERD could be significantly elevated from 65.9% to 84.1% (P<0.05), if bilirubin monitoring was employed in diagnosis. CONCLUSIONS: DGER may occur independently but plays an important role in the development of RE and GERD symptoms. Simultaneous 24 h esophageal pH and bilirubin monitoring is superior to simple pH monitoring in helping identify patients at risk for NERD.

Adult↗
PubMed2005

[A study of cerebral evoked potentials response to esophageal distention in non-erosive gastroesophageal reflux disease].

OBJECTIVE: To study the mechanism of visceral hypersensitivity in patients with non-erosive gastroesophageal reflux disease (NERD) and to get further objective evidence in the abnormal alteration of the afferents involved in mediating esophageal sensation by cerebral evoked potentials (CEP). METHODS: We recruited 21 NERD patients and 10 normal healthy volunteers for the study. Mechanical distention stimulation was performed using a balloon-affixed polyvinyl multilumen catheter. First, maximally tolerated pain threshold of all subjects were recorded, then esophageal mechanical stimulation at an intensity of 75% maximum tolerated intensity and a frequency of 0.2 Hz was inflated in a total of 64 times by means of a computer-controlled barostat. The alternation of esophageal CEP was recorded before and after acid perfusion with a multi-channel international 10-20 system of electroencephalograph. RESULTS: Esophageal mucosal distention may evoke recognizable and reproducible multi-peak CEP. CEP morphology of the NERD patients was characterized by randomly distributed patterns and the peak latencies for N1, P1, and N2 were significantly shorter for mechanical stimulation as compared with the control group (respectively, P = 0.016, 0.003, 0.031), and the amplitude of the P1-N2 components was significantly increased in NERD patients (P = 0.03). CONCLUSIONS: Characterization and alternation of CEP morphology and peak latencies and P1-N2 amplitudes elicited by esophageal distention in NERD patients provides evidence for defective hypersensitivity of afferent neural pathways and cortical processing.

Adult↗
PubMed2004

[Treatment of refractory malignant biliary obstraction: comparing results of percutaneous transhepatic biliary drainage with external catheters or endoscopic metallic stenting].

OBJECTIVE: To compare the initial results and adverse events of percutaneous transhepatic biliary drainage with external catheters or metallic stents for refractory malignant biliary obstruction. METHODS: To review the data of those patients with refractory malignant biliary obstruction treated with external catheters or metallic stents in Changhai hospital from Sept. 1999 to Aug. 2002. Liver function tests were determined 2 to 4 days prior to and 5 to 7 days after the procedures and adverse events were recorded. A total of 13 metallic stents were implanted in 13 patients (9 men, 4 women, mean age, 62.5 years) and 16 external catheters were implanted in 15 patients (9 men, 6 women, mean age, 60.8 years). RESULTS: The mean serum total bilirubin concentration prior to and after the procedures were (279.19 +/- 108.15) micro mol/L and (158.02 +/- 99.97) micro mol/L in the metallic stents group, (261.09 +/- 106.48) micro mol/L and (172.81 +/- 106.48) micro mol/L in the external catheters group. The mean serum direct bilirubin concentration were (226.83 +/- 84.03) micro mol/L and (132.57 +/- 80.16) micro mol/L, (208.03 +/- 95.03) micro mol/L and (142.61 +/- 83.74) micro mol/L in the two groups. There is no significant difference of the mean serum total and direct bilirubin concentrations between the two groups prior to the procedures (P > 0.05), but either the mean serum total or direct bilirubin concentration after the procedures in the two groups was significantly lower than that prior to the procedures (P < 0.01). The percentage of changes was significantly greater in the metallic stents group than that in the external catheters group (P < 0.01). Two patients with 3 complications occurred in the metallic stents group, including bile leakage and bleeding (1) and duodenal obstruction (1). Five complications occurred in the external catheters group, including catheter migration (2), catheter occlusion (1), bile leakage (1) and bleeding (1). CONCLUSIONS: Percutaneous transhepatic biliary drainage is a reliable and safe therapy for refractory malignant biliary obstruction. The initial results suggest that the potential patency of percutaneous transhepatic biliary drainage with self-expandable metal stent is more rapid and effective than that with external catheters.

Adult↗
PubMed2004

[The role of duodenogastroesophageal reflux in gastroesophageal reflux disease].

OBJECTIVE: To investigate the role of duodenogastroesophageal reflux (DGER) in the pathogenesis of gastroesophageal reflux disease (GERD) and its value for the diagnosis of non-erosive reflux disease (NERD). METHODS: 95 cases of GERD were divided into two groups according to endoscopic findings: reflux esophagitis (RE) (n = 51) and NERD (n = 44). Simultaneous 24-hour esophageal pH and bilirubin monitoring were performed. RESULTS: The index values of DGER in RE group such as percent of time with Abs > 0.14, total reflux time and time with reflux > 5 min were 19.05 +/- 23.44, 30.56 +/- 34.04 and 5.90 +/- 6.37 respectively, they were significantly higher than those of NERD, 7.26 +/- 11.08, 15.68 +/- 20.92 and 2.59 +/- 3.57, respectively (P < 0.05), but no significant difference was found in acid reflux. The occurrence of DGER was more common in more severe esophagitis. Isolated DGER were found in 18.2% of NERD, and combined bilirubin monitoring could elevate the positive diagnosis rate of NERD from 65.9% to 84.1%. CONCLUSIONS: DGER could be present isolatedly and played an obvious role in the genesis of RE and GERD symptoms. Simultaneous 24-hour esophageal pH and bilirubin monitoring were helpful for the diagnosis of NERD.

Adult↗
PubMed2003

[The changes of mucosal mast cells and substance P in patients with irritable bowel syndrome].

OBJECTIVE: To investigate the changes of the mast cells (MCs) and substance P (SP), and to elucidate their possible roles in visceral hypersensitivity in patients with irritable bowel syndrome (IBS). METHODS: In 22 diarrhea-predominant IBS, 20 constipation-predominant IBS and 19 controls, the biopsies were carried out from the terminal ileum, the ileocecal junction, the ascending colon, and the sigmoid colon. The MCs and the SP-ergic nerve terminals, SP receptor (SPR) cells were stained by histochemistry and immunohistochemistry respectively, and the results were investigated qualitatively and quantitatively by color image analyzer. The biopsies of the ICJ and the sigmoid colon were measured by radioimmunoassay. The structure relation between the MCs and SP-ergic terminals, SPR-ergic cells were studied through an ultramicroscopy using in situ embedding technique and a light microscopic study in serial sections respectively. RESULTS: The number of MCs in the terminal ileum, the ileocecal junction, and the ascending colon were significantly elevated in IBS patients (P < 0.01), and the MCs in IBS have great variations. Significantly increased the SP-ergic nerve terminals were found in patients with IBS of intestine compared with the control. The correlation between mucosal MC and the SP-ergic nerve terminals was found, and MCs were close to these terminals in lamina propria, which were demonstrated SP-ergic nerve terminals. Some MCs were demonstrated to be SPR-positive cells. CONCLUSIONS: The MCs and SP of intestinal mucosa may play a central role in the gut hypersensitivity in both motor response and visceral perception in IBS.

Adult↗