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ObjectiveTo investigate the efficacy and safety of endoscopic retrograde cholangiopancreatography （ERCP） during pregnancy and puerperium through a comparative analysis. MethodsA retrospective analysis was performed for the clinical data of 22 patients in pregnancy and 39 patients in puerperium who received ERCP in Digestive Endoscopy Center of The First Affiliated Hospital of Nanchang University from January 2007 to August 2022. The two groups of patients were compared in terms of baseline data， diagnosis during ERCP， interventions， laboratory results before and after ERCP， post-ERCP complications， and delivery and fetal outcomes. The independent-samples t test was used for comparison of continuous data between two groups， and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups. ResultsThere were no significant differences between the patients in pregnancy and those in puerperium in all baseline data （all P>0.05） except the rate of CT examination （22.73% vs 58.97%， χ2=7.44， P=0.006）. During the ERCP procedure， compared with the patients in puerperium， the patients in pregnancy had a significantly lower proportion of the patients who underwent biliary stone extraction or endoscopic papillary balloon dilation （χ2=4.007 and 4.315， both P<0.05） and a significantly higher proportion of the patients who did not receive X-ray fluoroscopy （χ2=12.103， P=0.001）. After ERCP， both groups had significant improvements in white blood cell count， total bilirubin， direct bilirubin， alanine aminotransferase， and aspartate aminotransferase （all P<0.05）. The overall incidence rate of post-ERCP complications was 7.04% （5/71） for all patients， with post-ERCP biliary infection as the most common complication （3/71，4.23%）， and there was no significant difference in the incidence rate of post-ERCP complications between the two groups （P>0.05）. As for delivery and fetal outcomes， compared with the patients in puerperium， the patients in pregnancy had a significantly higher proportion of patients with early termination of pregnancy （50.00% vs 0，χ2=20.528， P<0.001） and a significantly lower proportion of patients with cesarean section （36.36% vs 76.92%， χ2=4.756， P=0.029）. There were no significant differences in the incidence rates of adverse events such as abnormal fetal development and stillbirth between the two groups （P>0.05）. ConclusionWith strict control of ERCP indications and timing， ERCP is effective and relatively safe in both pregnancy and puerperium and has a comparable incidence rate of post-ERCP complications to that in the general population， with relatively good delivery and fetal outcomes.
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Objective:To explore the reasons of the proximal migration of pancreatic stents and the endoscopic management.Methods:From April 2007 to January 2015, of all 967 patients with biliopancreatic diseases implanted with pancreatic duct plastic stents at the First Affiliated Hospital of Nanchang University, proximal migration occurred in 10 cases. Migrated rates and endoscopic retrieval methods of pancreatic straight stents and single pigtail stents were compared.Results:Pancreatic straight stents showed a higher migration rate than those single pigtail ones [3.23% (7/217) VS 0.40% (3/750)]. For 3 migrated single pigtail pancreatic stents: 2 were directly removed with biopsy forceps. Another failed in retrieval, and the same stent then was implanted. There was no discomfort after the operation. For 7 migrated pancreatic straight stents: 2 were pulled out of duodenum papilla incision under wire-guided balloon and basket. Five others were pulled out of papilla under wire-guided balloon, and then the stents were removed by a snare.Conclusion:Pancreatic straight stents are more likely to migrate compared with single pigtail stents. Migrated pancreatic straight stents can be removed with wire-guided balloon or basket and snare, while migrated single pigtail stents can be directly retrieved with biopsy forceps.
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Objective To study the diagnostic value of Spyglass visual impression and Spybite targeted biopsies for biliary strictures of unknown reasons. Methods Several Chinese and English databases were electronically searched for studies on biliary strictures diagnosed with Spyglass visual impression and Spybite targeted biopsies compared with golden standard ( pathological biopsy, autopsy and long-term clinical follow-up) . The methodological quality of the included studies was assessed according to QUADAS-2 items. The software Meta-DiSc ( version 1. 4 ) was used to conduct pooling on sensitivity, specificity, positive likelihood radio, negative likelihood radio and diagnostic odds ratio ( DOR ) . Heterogeneity test was performed and the summary receiver operating characteristic curve ( SROC ) was drawn for area under the curve ( AUC) . Results A total of 12 studies met the inclusion criteria, involving 532 patients who received Spyglass visual impression and 525 who received Spybite targeted biopsies. The combined specificity, sensitivity, positive likelihood ratio, negative likelihood ratio and DOR were 0. 90 (95％CI:0. 85-0. 94), 0. 89 (95％CI:0. 85-0. 93), 7. 12 (95％CI: 4. 36-11. 64), 0. 12 (95％CI:0. 07-0. 22)and 82. 40 (95％CI:33. 73-201. 28)for Spyglass visual impression, and 0. 98 (95％CI:0. 96-1. 00), 0. 66 (95％CI:0. 60-0. 71), 13. 29 (95％CI:6. 92-25. 53), 0. 37 (95％CI:0. 28-0. 47)and 51. 05 (95％CI:23. 58-110. 53) for Spybite targeted biopsies, respectively. The AUC on the SROC of Spyglass visual impression and Spybite targeted biopsies were 0. 9574 and 0. 9398, respectively. Conclusion Spyglass visual impression is useful for detecting malignant lesion, whereas Spybite targeted biopsies is better at confirming malignant diagnosis, which indicates combination of the two methods have good diagnostic value for indeterminate biliary strictures, but their negative results are not perfect in excluding biliary cancer.
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Objective Dieulafoy's lesion is a rare cause of upper gastrointestinal bleeding. The purpose of this study was to recognize the clinical characteristics of gastric Dieulafoy and to identify possible predictive factors of rebleeding. Methods Retrospective study of patients with gastrointestinal bleeding secondary to Dieulafoy's lesion from January 2009 to June 2016. We analyzed the clinical data and endoscopic findings and the correlated with rebleeding risk factors with Dieulafoy's lesion. Results 111 patients were included in the study, 97 (87.4%) patients were male; the most common location of the bleeding lesions were Proximal stomach of 53 cases (47.7%); According to the Forrest type, 46.8% of the cases were arterial (spurting), 52.3% of the cases were arterial (oozing), there were 101 (91.0%) patients treated by endoscopic combined drug therapy. The success rate of Endoscopic hemostatic treatment was 84.2%, endoscopic hemostatic treatment success rate was as follows: single endoscopic, 85.0%; two endoscopic, 84.8%; three endoscopic, 75.0%. The hemostatic treatment success rate of 101 patients with endoscopic combined drug was as follows: Proximal stomach, 83.7%; mid-stomach, 82.1%; and distal stomach, 88.9%. Age (P = 0.002) and blood transfusion (P = 0.004) were risk factors for rebleeding in the study. Blood transfusion was associated with a higher recurrence rate for bleeding (P = 0.018, OR=37.77, 95% CI = 1.86~766.47) for 101 patients with endoscopic in combination with drug. Conclusion Endoscopic therapy is effective for treating Dieulafoy's lesion. The blood transfusion was associated with a high rate of bleeding recurrence. There were no significant differences between the rebleeding and non-rebleeding groups with respect to bleeding location or hemostatic methods.
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Objective To evaluate the safety of anesthesia endoscopic retrograde cholangio pancreatography (ERCP) under general anesthesia.Methods From January 1st,2008 to June 30th,2016,patients underwent ERCP under general anesthesia were enrolled as anesthesia group and from January 1st,2005 to December 31st,2007,patients accepted ERCP without anesthesia were enrolled as control group.Chi-square test was performed to analyze disease composition,conditions during operation,success rate of operation and complications in these two groups.Results A total of 14 724 patients with ERCP under general anesthesia and 2 102 patients received ERCP without anesthesia were enrolled.In 14 724 patients with ERCP under general anesthesia,1 799 cases had malignant biliary and pancreatic diseases and 12 925 cases with biliary and pancreatic diseases.During the operation,transient hypoxemia occurred in 441 cases (3.00％) and relieved by increasing oxygen flow,lower anesthetic dose or lifting lower jaw.The success rate of ERCP in the anesthesia group (98.41 ％,14 490/14 724) was higher than that in the control group (97.34％,2 046/2 102),and the difference was statistically significant (x2 =11.500,P=0.001).The incidence rate of post-ERCP pancreatitis in the anesthesia group was 2.35％ (346/14 724),which was lower than that in the control group (3.85％,81/2 102),and the difference was statistically significant (x2 =16.813,P＜0.01).Conclusion ERCP under general anesthesia is safe,which could increase the success rate of operation and reduce the incidence rate of post-ERCP pancreatitis.
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Objective To investigate the effects of antibiotic prophylaxis on post-operation complications after endoscopic retrograde cholangio-pancreatography (ERCP).Methods From January 1st,2011 to December 31st,2013,1 951 patients undergoing ERCP were enrolled and divided into postoperative antibiotic prophylaxis group (antibiotics group,630 cases) and postoperative non-antibiotic treatment group (non-antibiotics group,1 321 cases).Complications after ERCP were compared between the two groups.Chi square test,single factor analysis and multiple factor analysis were performed for statistical analysis.Results Among the 1 951 patients,277 patients had postoperative complications:101 patients (5.18％) with post-endoscopic retrograde cholangio-pancreatography pancreatitis (PEP),54 patients (2.77％) with hyperamylasemia,134 patients (6.87％) with biliary infection,eight patients (0.41％) with hemorrhage,one patient (0.05％) with intestinal obstruction and one patient (0.05％) with perforation.The incidence of postoperative biliary infection of antibiotics group was 4.44％ (28/630),which was lower than that of non-antibiotics group (8.02％,106/1 321),and the difference was statistically significant (x2 =8.546,P =0.030).The incidences of PEP of antibiotics group and nonantibiotics group were 4.92％ (31/630) and 5.30％ (70/1 321),respectively.The incidences of postoperative hyperamylasemia of antibiotics group and non-antibiotics group were 3.02％oo (19/630) and 2.65％ (35/1 321),respectively.The incidences of upper gastrointestinal hemorrhage were 3.02％ (19/630) and 2.65％ (35/1 321),respectively.The incidences of intestinal obstruction were 0 (0/630) and 0.08％ (1/1 321),respectively,while the incidences of perforation post-operation were 0.16％ (1/630) and 0 (0/1 321),respectively,and the differences were not statistically significant (all P＞0.05).Cholangiocarcinoma (odd ratios (OR)=2.93,95％ confidence interval (CI) 1.88 to 4.56,P＜0.01) and repeated ERCP during hospitalization (OR=2.53,95 ％ CI 1.63 to 3.93,P＜0.01) were the independent risk factors of cholangitis after operation.However,endoscopic sphincterotomy (OR=0.65,95 ％ CI 0.44 to 0.97,P =0.030) and antibiotics prophylaxis (OR =0.64,95％ CI 0.39 to 0.95,P =0.030) were the protective factors.Conclusions Antibiotic prophylaxis after ERCP can reduce the occurrence of postoperative cholangitis.Paitents with cholangiocarcinoma,repeated ERCP procedures during hospitalization or without endoscopic sphincterotomy should be recommended for antibiotic prophylaxis.
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Objective To analyze the diagnostic value of endoscopic ultrasonography(EUS)for staging of early gastric cancer(EGC)and its influential factors. Methods Clinical information of 120 EGC patients admitted from February 2009 to January 2016 was reviewed. Diagnostic accuracy and the influencing factors of EUS for the invasive depth were analyzed by comparing the results of preoperative EUS and the pathology. Results Thirty-six patients were over-staged by EUS,and 10 patients were under-staged among 120 EGC patients. The accuracy, sensitivity, specificity of EUS for the submucosal invasion were 61.67%(74/120),58.33%(14/24),62.50%(60/96)respectively. The accuracy, sensitivity and specificity for protruded EGCs(Type I)diagnosis were 74.36%(29/39), 50.00%(6/12), 85.19%(23/27) respectively;these three variables were 59.02%(36/61),83.33%(5/6),56.36%(31/55)respectively for flat EGCs(Type Ⅱ), and 45.00%(9/20), 50.00%(3/6), 42.86%(6/14)respectively for excavated EGCs(Type Ⅲ). The univariate factor results showed that differentiated degree, location and endoscopic morphology of the tumor were possible influential factors for over-stage. Multivariate factor results showed that flat type(OR=3.667,95%CI:1.086-12.386,P<0.05)and excavated type(OR=6.552,95%CI:1.421-30.218,P<0.05)were independent risk factors. Gender,age and tumor maximum diameter were not factors influencing the diagnostic accuracy of EUS. Conclusion The EUS shows higher clinical value for diagnosing the invasive depth in EGC. Tumor differentiated degree, location and endoscopic morphology may be the influencing factors for diagnostic accuracy of EUS. Flat type and excavated type may lead to over-staging.
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Objective To investigate the risk factors for post-ERCP complications. Methods Data of the patients who underwent ERCP in the First Affiliated Hospital of Nanchang University from 1 January 2011 to 31 December 2013 were retrospectively analyzed. Post-ERCP complications were analyzed by univariate and multivariate analyses. Results A total of 277 patients out of 1 951 developed complications, 101(5.18%)pancreatitis, 54(2.77%)hyperamylasemia(not including pancreatitis), 134(6.87%) biliary infection,8(0.41%)hemorrhage,1(0.05%)obstruction and 1(0.05%)perforation.Multivariate analyses showed cholangiocarcinoma(P=0.002,OR=2.39, 95% CI:1.38-4.14), long operation time(>60 min)(P=0.020,OR=3.77,95%CI:1.23-11.53)and endoscopic sphincterotomy(EST)(P=0.008, OR=2.56,95% CI:1.28-5.14)and entrance of guidewire to pancreatic duct(P=0.012,OR=1.43, 95%CI:1.08-1.87)were independent risk factors for PEP. Cholangiocarcinoma(P<0.01, OR=2.93, 95%CI:1.88-4.56),multiple times of ERCP during the period of hospitalization(P<0.01, OR=2.53, 95%CI:1.63-3.93)were independent risk factors for post-cholangitis. However, EST(P=0.03, OR=0.65,95%CI:0.44-0.97)and antibiotics prophylaxis after ERCP(P=0.03, OR=0.64, 95% CI:0.39-0.95)were protective factors for post-cholangitis. ConclusionCholangiocarcinoma, endoscopic sphincterotomy, long operation time(> 60 min)and entrance of guidewire to pancreatic duct were independent risk factors for PEP. Cholangiocarcinoma and multiple ERCP during the period of hospitalization are independent risk factors for post-cholangitis.EST and antibiotics prophylaxis after ERCP might reduce the occurrence of cholangitis.
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Objective To compare the difference of the effects and safety of endoscopic submucosal dissection (ESD) and surgery for early gastric cancer. Methods We searched the Pubmed, CBM, Embase, Cochrane Library, CNKI, CQVIP and WanFang data from January 1990 to June 2016 studies comparing endoscopic resection with gastrectomy for treatment of early gastric cancer. We selected the eligible studies according the including and excluding criteria. The quality of the included studies was assess using the Newcastle-Ottawa Scale (NOS), then using Revman 5.3 to make the Meta analysis. Result The meta-analysis enrolled 12 studies with 4331 patients, all of the studies were retrospectively analyzed. The result of the meta-analysis showed that there were no significant difference regarding the recurrence rate [(22/2586, 0.85%) vs (6/1134, 0.53%), P = 0.370] and five-year survival rate [(852/909, 93.72%) vs (707/746, 94.77%), P = 0.340] between endoscopic resection and gastrectomy. Gastrectomy was associated with higher en bloc resection rate, which were 100.00% and 92.23% respectively. However, gastrectomy was also related to longer operative time (SMD = -3.04, 95%CI: -3.64 ~ -2.45, P = 0.000) and hospital stay (SMD = -2.53, 95%CI: -3.73 ~ -1.32, P = 0.000). The postoperative complication was also higher than endoscopic, which were (45/816, 5.50%) vs (101/686, 14.72%) respectively. Conclusion There were no significant difference regarding recurrence rate and five-year survival rate between endoscopic and gastrectomy. While the en bloc resection rate was lower than gastrectomy, endoscopic offers a shorter hospital stay, shorter operative time with minimal invasive and fewer operating and postoperative complications than gastrectomy. Endoscopic should be recommended as a standard treatment for early gastric cancer with indications.
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Objective To evaluate the safety of endoscopic retrograde cholangiopancreatography (ERCP) for elder patients (age more than or equal to 80 years).Methods Data of 464 patients (age ≥ 80 years) who underwent ERCP procedures from June 2008 to June 2014 in the First Affiliated Hospital of Nanchang University were compared with those of patients less than or equal to 60 years old,randomly chosen at 1∶4,for comorbidity,feature of disease distribution,intraoperative situation and postoperative complications of ERCP.Results The comorbidity rates of coronary heart disease,hypertension,chronic pulmonary disease and type 2 diabetes in observation group were significantly higher than those in the control group(P＜0.05),but there was no significant difference between two groups regarding to the comorbidity rate of arrhythmia(P =0.111).The main feature of disease distribution in two groups was choledocholithiasis,but the rate of malignant tumor in observation group was higher than that in the control group(P＜0.05).The success rate of ERCP showed no significant difference in two groups (98.92％ VS 99.35％,P=0.358).There was no significant difference between the two groups in the complication rates of acute pancreatitis (4.96％ VS 3.18％,P =0.064),infection (0.43％ VS 0.54％,P =1.000) and hemorrhage (1.08％ VS 0.59％,P=0.259).However the rate of perforation in observation group was lower than that in the control group (0.43％ VS 0.05％,P =0.043).Conclusion ERCP is safe and effective for elder patients.
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Objective To investigate the clinical features of gastric stump ulcer (GSU)after partial gastrectomy due to gastroduodenal ulcer.Methods From January 1st 2007 to October 31th 2013,272 patients with partial gastrectomy for gastroduodenal ulcer underwent gastroscopy due to upper gastrointestinal symptoms were collected.Among them,there were 237 male patients and 35 female patients with the average age (55 .4 ± 13.0 )years.The lesion location,symptoms and pathological changes of GSU were analyzed.Chi-square test and Fisher exact probability analysis were used for count data comparison.The t test was performed for measurement data comparison.Results There was no significant difference between patients with GSU after Billroth Ⅰ gastrectomy and Billroth Ⅱ gastrectomy in the incidence of dysphagia,nausea and vomiting,retrosternal pain,retrosternal buring sensation,upper abdominal pain, abdominal distention, acid regurgitation and (or) epigastric buring sensation, hematemesis and (or)melena (all P >0.05 ).The proportion of ulcer located in remnant stomach and anastomotic stoma of patients with Billroth Ⅰ gastrectomy (24.7%,18/73 and 72.6%,53/73 )was higher than those of patients with Billroth Ⅱ gastrectomy (10.1 %,20/199 and 58.3%,116/199 )and the difference was statistically significant (OR=2.929 and 1 .896,95 %CI :1 .448 to 5 .927 and 1 .055 to 3.409,χ2 =9.482 and 4.649,P =0.002 and 0.031 ).There was no significant difference between the proportion of afferent loop and efferent loop ulcer in patients with Billroth Ⅱ gastrectomy and the proportion of duodenal ulcer in patients with Billroth Ⅰ gastrectomy (P =0.619).The diameter of GSU of patients with BillrothⅠ((1.1±0.7)cm)was larger than that of ulcer of patients with BillrothⅡ((0.8±0.6)cm) and the difference was statistically significant (t = 3.591 ,P = 0.007 ).The incidence of intestinal metaplasia and atypic hyperplasia of GSU was 8.1 % (22/272),and there was no significant difference in gastric ulcer,stoma ulcer,nek ulcer,afferent loop and efferent loop ulcer (all P >0.05).The incidence of gastric stump cancer of GSU was 4.0% (11/272)and that of gastric ulcer,stoma ulcer,nek ulcer,afferent loop and efferent loop ulcer was 13.2% (5/38 ),2.4% (4/169 ),1.8% (1/55 )and 1/10,respectively.The incidence of gastric stump cancer of gastric ulcer was significantly higher than that of stoma ulcer and nek ulcer, the differences were statistically significant (OR =6.250 and 8.182,95%CI :1.593 to 24.519 and 0.915 to 73.126,χ2 =8.687 and 4.788,P =0.012 and 0.040).There was no statistically significant difference in the incidence of gastric stump cancer of GSU in other gastric parts (all P > 0.05 ).There was no statistically significant difference in the incidence of intestinal metaplasia,atypic hyperplasia and gastric stump cancer between case with BillrothⅠgastrectomy and case with Billroth Ⅱ gastrectomy (P =0.650 and 0.733).Among the 11 gastric stump cancers,the number of cases with the onset time with 20 years,20-30 years and beyond 30 years after gastrectomy were one,three,seven,respectively.Conclusion The incidence of intestinal metaplasia, atypic hyperplasia and gastric stump cancer of patients with GSU was high,and the predilection site of GSU was the remnant stomach.
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Objective To observe the efficacy and safety of endoscopic variceal ligation (EVL) and esophageal variceal sclerotherapy (EVS) with different hardeners for esophageal variceal bleeding (EVB).Methods Clinical data of 314 patients with EVB were retrospectively reviewed.The patients were divided into 5 groups according to the endoscopic treatments they have received,i.e.,endoscopic variceal ligation (EVL) group (n =112),sodium morrhuate sclerotherapy (EVS1) group (n =48),lauromacrogol sclerotherapy (EVS2) group (n =40),EVL plus sodium morrhuate sclerotherapy (EVLS1) group (n =26) and EVL plus lauromacrogol sclerotherapy (EVLS2) group (n =88).The efficacy,variceal recurrence rate and complication rate were evaluated.Results There was no significant difference in efficacy of stop bleeding among 5 groups,which was 85.7％ (96/112) in EVL group,83.3％ (40/48) in EVS1 group,92.5％(37/40) in EVS2 group,92.3％ (24/26) in EVLS1 group and 94.3％ (83/88) in EVLS2 group (P ＞0.05).The complete cure rates in EVLS1 group (88.5％,23/26) and EVLS2 group (87.5％,77/88)were significantly higher than those in 3 other groups (P ＜ 0.05).Rebleeding rates in EVS1 group (18.8％,9/48) and EVL group (11.6％,13/112) were significantly higher than those in other 3 groups (P ＜0.05).The patients were followed up for 6-18 months,and the varices recurrence rate was highest in group EVL (23.2％,26/112) and lowest in EVLS2 (10.2％,9/88,P ＜0.05).The complication rate in group EVS1 (32.2％,49/152) was significantly higher than that in other 4 groups (P ＜0.05).Conclusion EVL plus EVS,either with sodium morrhuate or lauromacrogol EVS is safe and effective for EVB,especially EVL plus Lauromacrogol EVS,may become an optimal therapy to control esophageal variceal bleeding and rebleeding.
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Objective To study the safety and efficacy of endoscopic sphincterotomy (EST) and endoscopic papillary balloon dilation (EPBD) in the treatment for extrahepatic bile duct stones.Methods A total of 164 patients underwent endoscopic treatment for extrahepatic bile duct stones.Seventy eight underwent EST and EPBD (the EST + EPBD group),86 others underwent EST only (the EST group).The complication rate,complete stone clearance rate and gravel incidence rate were compared between the two groups.Results Hyperamylasemia occurred in 3 cases,mild acute pancreatitis in 2 cases of the EST and EPBD group,while hyperamylasemia occurred in 5 cases,mild acute pancreatitis in 3 and hemorrhage in 2 of the EST group.There were no severe complications like severe acute pancreatitis or intestinal perforation.The complication rate of the EST + EPBD group ( 6.4％,5/78 ) was slightly lower than that of the EST group ( 11.6％,10/86),(x2 =1.340,P =0.288),so was gravel incidence (33.3％ vs.60.5％,x2 =12.073,P =0.001 ).While complete stone clearance rate of this group was obviously higher than that of the EST group (100.0％ vs.93.0％ ),(x2 =5.649,P=0.030).Conclusion EST combined with EPBD is safe and effective for extrahepatic bile duct stone removal,especially for large stones or poor duodenal papilla.
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Objectives To investigate the clinical characteristics and the regularity of seasonal changes that influence peptic ulcer (PU) in Nanehang area and to provide a theoretical basis for the treatment and prevention of PU.Methods Data collected from patients with PU diagnosed by clinic and gastroendoseopy between October 2003 to May 2008 were retrospectively analyzed.The PU was further divided into gastric ulcer,duodenal ulcer and complex ulcer.The lesion of gastric ulcer was calculated by five locations that were antral,angular,corporal,pyloric canal,fundic and cardia.The lesion of duodenal ulcer was calculated by five locations that were anterior wall of bulb,posterior wall,lesser curvature, greater curvature and postbulbar.The climate changes that influnced the incidence of PU disease were also observed.The detective rates of different types of PU were analyzed and its association with gender,age, lesion locations,seasons,Helicobacter pylori (Hp) infection and complications were also investigated. Results Among 83 888 patients who underwent endoscopy,PU was found in 21 308 patients (25.4%) including 66.33% duodenal ulcer,24.88% gastric ulcer and 8.79% complex ulcer.The male and femal ratio was 2.44 : 1 in PU,2.53 : 1 in duodenal ulcer,2.26 : 1 in gastric ulcer,and 2.33 : 1 in complex ulcer.The average age of patients with gastric ulcer was 48.0 years that was about 6.7 years higher than that of patients with duodenal ulcer.The prevalence of duodenal ulcer and gastric ulcer peaked in the 30- 39 years and 50-59 years,respectively.PU was more common from December to February (30.17%) and less common from June to August (22.54%) (P＜0.01) .The 57.43% of duodenal ulcer was found on anterior wall of bulb,18.26% on greater curvature,13.21% on lesser curvature,7.34% on posterior wall and 3.76% on postbulbar.The 45.69% of gastric ulcer was found on antral,20.54% on angular, 15.54% on corporal,9.36% on pyloric canal,and 8.87% on fundic and cardia.The 91.83% (12 318/ 13 414) of patients were positive for Hp infection.There was no significant difference of Hp infection among patients with different types of PU.The complications in patients with PU were bleeding (4.94%),pyloric obstruction (3.51%) and chronic perforation(0.04%).Conclusions The detective rate of PU in Nanchang area is 25.4%,which is higher than that in northern area of China.The incidence of PU is highly associated with sex,age,seasons and ulcer locations,with high Hp infections and a low incidence of complications.
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Objective To investigate the effects of basic fibroblast growth factor(bFGF)and sucralfate on healing of experimental gastic ulcer in rats. Methods Thirty-two famale Sprage-Dawley rats were divide into 4 groups,averagely.bFGF 100 ng?100 g -1 ?d -1 , sucralfate 40 mg?100 g -1 ?d -1 , bFGF 100 ng?100 g -1 ?d -1 + sucralfate 40 mg?100 g -1 ?d -1 and normal saline were used in experimental gastric ulcer rats induced by acetic acid for 21 days. Contents of gastric acid and pepsin were measured,and the healing rate and quality of gastric ulcer and the number of capillaries in ulcer bed were evaluated. Results The amount of gastric acid and pepsin in bFGF group had no different from those of normal saline group. The ulcer areas in bFGF group and sucralfate group were (2.9 ?0.8) mm 2 and (3.2?1.2) mm 2 respectively,which were significantly smaller than that of normal saline group (6.8? 1.4 ) mm 2, P