Zhao-Shen Li

Changhai Hospital, Shanghai, Shanghai, Shanghai Shi, China

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Publications (174)541.82 Total impact

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    ABSTRACT: Background and study aim: Post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) remains the most common complication of ERCP. Somatostatin may inhibit pancreatic secretion and has been tested for PEP prophylaxis. However, the results of previous studies are inconsistent. The aim of the current study was to investigate whether somatostatin can reduce the incidence of PEP. Patients and methods: The study was a multicenter, open-label, randomized controlled trial. A total of 908 patients with normal amylase levels who were undergoing ERCP were randomized to receive somatostatin 250 μg bolus injection before ERCP and 250 μg/hour intravenous infusion for 11 hours after ERCP (somatostatin group) or no somatostatin treatments (control group). The incidences of PEP and hyperamylasemia were compared in the two groups. Results: The full analysis set included 900 patients (445 in the somatostatin group, 455 in the control group). PEP developed in 34 patients (7.5 %) in the control group (95 % confidence interval [CI] 5.4 % - 10.3 %) and in 18 patients (4.0 %) in the somatostatin group (95 %CI 2.6 % - 6.3 %; P = 0.03). Hyperamylasemia occurred in 46 patients (10.1 %) in the control group (95 %CI 7.7 % - 13.2 %) and in 27 patients (6.1 %) in the somatostatin group (95 %CI 4.2 % - 8.7 %; P = 0.03). No perforation or death occurred during the study. Conclusions: This study showed that somatostatin was effective and safe for the prevention of PEP and hyperamylasemia in ERCP patients.(ClinicalTrials.gov number, NCT01431781). © Georg Thieme Verlag KG Stuttgart · New York.
    Endoscopy 01/2015; DOI:10.1055/s-0034-1391227 · 5.20 Impact Factor
  • Endoscopy 01/2015; DOI:10.1055/s-0034-1391123 · 5.20 Impact Factor
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    ABSTRACT: Autoimmune pancreatitis (AIP) is increasingly recognized as a unique subtype of pancreatitis. This study aimed to analyze the diagnosis and treatment of AIP patients from a tertiary care center in China. One hundred patients with AIP who had been treated from January 2005 to December 2012 in our hospital were enrolled in this study. We retrospectively reviewed the data of clinical manifestations, laboratory tests, imaging examinations, pathological examinations, treatment and outcomes of the patients. The median age of the patients at onset was 57 years (range 23-82) with a male to female ratio of 8.1:1. The common manifestations of the patients included obstructive jaundice (49 patients, 49.0%), abdominal pain (30, 30.0%), and acute pancreatitis (11, 11.0%). Biliary involvement was one of the most extrapancreatic manifestations (64, 64.0%). Fifty-six (56.0%) and 43 (43.0%) patients were classified into focal-type and diffuse-type respectively according to the imaging examinations. The levels of serum IgG and IgG4 were elevated in 69.4% (43/62) and 92.0% (69/75) patients. Pathological analysis of specimens from 27 patients supported the diagnosis of lymphoplasmacytic sclerosing pancreatitis, and marked (>10 cells/HPF) IgG4 positive cells were found in 20 (74.1%) patients. Steroid treatment and surgery as the main initial treatments were given to 41 (41.0%) and 28 (28.0%) patients, respectively. The remission rate after the initial treatment was 85.0%. Steroid was given as the treatment after relapse in most of the patients and the total remission rate at the end of follow-up was 96.0%. Clinical manifestations, laboratory tests, imaging and pathology examinations in combination could increase the diagnostic accuracy of AIP. Steroid treatment with an initial dose of 30 or 40 mg prednisone is effective and safe in most patients with AIP.
    Hepatobiliary & pancreatic diseases international: HBPD INT 12/2014; 13(6):642-8. DOI:10.1016/S1499-3872(14)60263-0 · 1.17 Impact Factor
  • Digestive and Liver Disease 11/2014; 47(2). DOI:10.1016/j.dld.2014.10.012 · 2.89 Impact Factor
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    ABSTRACT: To determine the existence of a potential relationship between the methylation state of the Vimentin gene and its prognostic value in pancreatic cancer.
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    ABSTRACT: Background and study aims: Extracorporeal shock wave lithotripsy is recommended as treatment for stones in chronic pancreatitis. The aim of this study was to investigate the risk factors for complications of pancreatic extracorporeal shock wave lithotripsy (P-ESWL). Patients and methods: Patients with painful chronic pancreatitis and pancreatic stones (> 5 mm diameter) who were treated with P-ESWL between March 2011 and June 2013 were prospectively included. Adverse events after P-ESWL were classified as complications and transient adverse events, depending on severity. The major complications of P-ESWL included post-ESWL pancreatitis, bleeding, infection, steinstrasse, and perforation. Multivariate analyses based on univariate analysis were performed to detect risk factors of overall and moderate-to-severe complications. Results: A total of 634 patients underwent 1470 P-ESWL procedures. The overall complication rate was 6.7 % of all procedures. Complications occurred in 62 patients (9.8 %) after the first ESWL procedure. The risk factors for complications were pancreas divisum (odds ratio [OR] 1.28) and the interval between diagnosis of chronic pancreatitis and P-ESWL (OR 1.28). Protective factors were male sex (OR 0.50), diabetes (OR 0.45), and steatorrhea (OR 0.43). Male sex, the only identified predictor for moderate-to-severe complications, was a protective factor (OR 0.19). For the second P-ESWL procedure, complications occurred in 22/409 patients (5.4 %). Complication and asymptomatic hyperamylasemia after the first ESWL session were significantly associated with higher risk for complications after the second ESWL session (P < 0.05). Conclusions: Patient-related factors were important in determining a high risk of P-ESWL complications when no procedure-related factors were identified. Patients suffering from complications after the first ESWL session were also likely to experience complications in subsequent P-ESWL sessions.
    Endoscopy 09/2014; 46(12). DOI:10.1055/s-0034-1377753 · 5.20 Impact Factor
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    ABSTRACT: Background: The association between gastroesophageal reflux disease (GERD) and hemodialysis (HD) is unclear. We aimed to determine the prevalence of GERD in HD patients and to identify the risk factors and effects of GERD in this patient population. Methods: This retrospective study involved 432 HD patients who completed a questionnaire including a GERD symptom assessment scale (QUEST). Clinical data were obtained by interviewing the patients and/or reviewing their medical records. Results: GERD was diagnosed in 141 (32.64%) of the 432 HD patients by using a structured questionnaire scoring system. Multivariate logistic regression analysis revealed that low urine volume (odds ratio [OR]: 1.619, 95% confidence interval [CI]: 1.046–2.505; P = 0.031), high serum creatinine level (OR: 1.694, 95% CI: 1.011–2.839; P = 0.045), angiotensin receptor blocker (ARB)/angiotensin-converting enzyme inhibitor (ACEI) administration (OR: 1.767, 95% CI: 1.13–2.746; P = 0.011) and the intradialytic complications of excessive hunger (OR: 1.652, 95% CI: 1.067–2.559; P = 0.024), heartburn (OR: 6.235, 95% CI: 2.606–14.920; P = 0.000) and tinnitus (OR: 1.606, 95% CI: 1.029–2.507; P = 0.037) were independent predictors of GERD, as detected using QUEST. The Spearman rank correlation analysis showed that sodium bicarbonate consumption was positively correlated with serum total carbon dioxide level (r = 0.127, P = 0.008), interdialytic weight gain (IDWG; r = 0.189, P = 0.000) and IDWG% (IDWG/estimated dry weight; r = 0.166, P = 0.001). Conclusions: The prevalence of GERD is higher in patients undergoing HD in our center than in the general population. The risk factors for GERD in hemodialysis patients were low urine volume (9 mg/dl), ARB/ACEI administration and intradialytic hunger, heartburn and tinnitus. HD patients with GERD may take excessive sodium bicarbonate, which increases IDWG%. Awareness of GERD and administration of PPIs were low in HD patients. Routine PPI treatment would provide clinical benefits by reducing GERD symptoms, sodium bicarbonate consumption and IDWG%.
    Current Signal Transduction Therapy 08/2014; 9(2). · 0.45 Impact Factor
  • Jun Pan, Lei Xin, Zhao-Shen Li
    Gastroenterology 07/2014; 147(3). DOI:10.1053/j.gastro.2013.11.054 · 12.82 Impact Factor
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    ABSTRACT: Hereditary pancreatitis (HP) has been rarely investigated in China. We aimed to describe clinical features and mutation frequency of Chinese patients with HP and to evaluate outcomes of endoscopic treatments.
    Pancreas 07/2014; DOI:10.1097/MPA.0000000000000198 · 3.01 Impact Factor
  • Bai-Rong Li, Liang-Hao Hu, Zhao-Shen Li
    Gastroenterology 06/2014; 147(2). DOI:10.1053/j.gastro.2014.03.054 · 12.82 Impact Factor
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    Pancreas 05/2014; 43(4):659-60. DOI:10.1097/MPA.0000000000000071 · 3.01 Impact Factor
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    ABSTRACT: To analyze the activation of sonic hedgehog (SHh) signaling pathways in a rat model of chronic pancreatitis. Forty Wistar rats were randomly divided into 2 groups: experimental group and control group (20 rats in each group). Dibutyltin dichloride was infused into the tail vein of the rats to induce chronic pancreatitis in the experimental group. The same volume of ethanol and glycerol mixture was infused in the control group. The expression of Ptch, Smo and Gli were analyzed using immunohistochemistry, and real-time reverse transcription polymerase chain reaction (RT-PCR). Compared with the control group, significant histological changes in terms of the areas of abnormal architecture, glandular atrophy, fibrosis, pseudo tubular complexes, and edema were observed at week 4 in the experimental group. The expression of Ptch1, Smo and Gli1 in the pancreatic tissue increased significantly in the experimental group. Using RT-PCR, mRNA levels of Ptch, Smo and Gli in the experimental group increased significantly compared with the control group. The SHh signaling pathway is aberrantly activated in rats with chronic pancreatitis. The SHh signaling pathway plays an important role in the development of chronic pancreatitis. These results may be helpful in studies focusing on the relationship between chronic pancreatitis and pancreatic cancer.
    World Journal of Gastroenterology 04/2014; 20(16):4712-4717. DOI:10.3748/wjg.v20.i16.4712 · 2.43 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate the M-ANNHEIM classification system to categorize patients with chronic pancreatitis (CP). All symptomatic patients recruited from the gastroenterology outpatient clinic of Changhai Hospital (n = 89) were routinely evaluated by magnetic resonance cholangiopancreatography and contrast-enhanced computed tomography. M-ANNHEIM clinical staging was used to categorize patients. The primary outcome measure was pain during the 2-year follow-up period, expressed as mean Izbicki pain scores obtained before and after endotherapy. There was a significant improvement in mean (SD) Izbicki pain scores obtained at 24 months among patients receiving endoscopic therapy at stage 1a compared with those at stage 1b (4.9 [3.0] vs 14.5 [6.9], P = 0.012). Furthermore, significantly more patients receiving endoscopic therapy at stage 1a achieved complete + partial pain relief after 2-year follow-up than those at stage 1b (95.2% vs 78.0%, P = 0.021). There was no exocrine or endocrine insufficiency, but a significantly greater number of patients treated at stage 1a had post-endoscopic retrograde cholangiopancreatography pancreatitis compared with those at stage 1b (10.5% vs 2.7%, P = 0.025). We demonstrated that a sophisticated M-ANNHEIM classification system for CP will improve diagnosis by allowing for more timely intervention. Furthermore, prompt treatment of CP may achieve improved pain relief and patient outcomes.
    Pancreas 04/2014; DOI:10.1097/MPA.0000000000000140 · 3.01 Impact Factor
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    ABSTRACT: Abstract Anastomotic dehiscence (AD) requiring reoperation is the most severe complication following anterior rectal resection. We performed a systematic review on studies that describe AD requiring reoperation and its subsequent mortality after anterior resection for rectal carcinoma. A systematic search was performed on published literature. Data on the definition and rate of AD, the number of ADs requiring reoperation, the mortality caused by AD, and the overall postoperative mortality were pooled and analyzed. A total of 39 studies with 24,232 patients were analyzed. The studies varied in incidence and definition of AD. Systematic review of the data showed that the overall rate of AD was 8.6%, and the rate of AD requiring reoperation was 5.4%. The postoperative mortality caused by AD was 0.4%, and the overall postoperative mortality was 1.3%. We found considerable risk and mortality for AD requiring reoperation, which largely contributed to the overall postoperative mortality.
    International surgery 03/2014; 99(2):112-9. DOI:10.9738/INTSURG-D-13-00059 · 0.25 Impact Factor
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    ABSTRACT: Chronic gastritis is one of the most common findings at upper endoscopy in the general population, and chronic atrophic gastritis is epidemiologically associated with the occurrence of gastric cancer. However, the current status of diagnosis and treatment of chronic gastritis in China is unclear. A multi-center national study was performed; all patients who underwent diagnostic upper endoscopy for evaluation of gastrointestinal symptoms from 33 centers were enrolled. Data including sex, age, symptoms and endoscopic findings were prospectively recorded. Totally 8892 patients were included. At endoscopy, 4389, 3760 and 1573 patients were diagnosed to have superficial gastritis, erosive gastritis, and atrophic gastritis, respectively. After pathologic examination, it is found that atrophic gastritis, intestinal metaplasia and dysplasia were prevalent, which accounted for 25.8%, 23.6% and 7.3% of this patient population. Endoscopic features were useful for predicting pathologic atrophy (PLR = 4.78), but it was not useful for predicting erosive gastritis. Mucosal-protective agents and PPI were most commonly used medications for chronic gastritis. The present study suggests non-atrophic gastritis is the most common endoscopic finding in Chinese patients with upper GI symptoms. Precancerous lesions, including atrophy, intestinal metaplasia and dysplasia are prevalent in Chinese patients with chronic gastritis, and endoscopic features are useful for predicting pathologic atrophy.
    BMC Gastroenterology 02/2014; 14(1):21. DOI:10.1186/1471-230X-14-21 · 2.11 Impact Factor
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    ABSTRACT: Respiratory disease remains one of the leading causes of morbidity and mortality in China. However, little is known about the research status of respirology in three major regions of China-Mainland (ML), Hong Kong (HK) and Taiwan (TW). A 10-year survey of literature was conducted to compare the three regions' outputs in the research of respirology. A bibliometric study. China. A literature search in PubMed database, updated as of September 2012, led to the identification of the related articles from 2000 to 2009. The number of total articles, randomised controlled trials, case reports, meta-analysis, impact factors (IF), citations and articles published in top general medicine journals was collected for quantity and quality comparisons. 2208 articles were collected, 814 from ML, 909 from TW and 485 from HK. The total number of articles from the three regions has increased significantly from 2000 to 2009. The number of articles published per year from ML has exceeded that from HK in 2005 and TW in 2008. The accumulated IF of articles from TW (3192.417) was much higher than that from ML (2409.956) and HK (1898.312). HK got the highest average IF of respirology articles and the majority of articles were published in top general medicine journals. The total number of published articles from the three major regions of China has increased notably from 2000 to 2009. The annual number of publications by ML researchers exceeded those from TW and HK. However, the quality of articles from TW and HK is better than that from ML.
    BMJ Open 01/2014; 4(2):e004201. DOI:10.1136/bmjopen-2013-004201 · 2.06 Impact Factor
  • Endoscopy 01/2014; 46(S 01):E332-E333. DOI:10.1055/s-0034-1377221 · 5.20 Impact Factor
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    ABSTRACT: Aims. We attempted to establish some guidelines for the selection of transmural stents during endoscopic drainage of PFCs by retrospective review of the clinical data obtained from three tertiary hospitals. Patients and Methods. Clinical data of 93 patients with attempted endoscopic drainage of symptomatic PFCs were obtained through chart review and prospective follow-up. Results. Treatment success for acute pseudocyst (n = 67), chronic pseudocyst (n = 9), and WOPN (n = 17) was 95.3%, 100%, and 88.2%, respectively (P = 0.309). Clinical success for single-stent drainage was 93.9% (46/49) versus 97.4% (37/38) for multiple-stent drainage (P = 0.799). Secondary infection for single-stent drainage was 18.4% (9/49) versus 5.3% (2/38) for multiple-stent drainage (P = 0.134). Secondary infection for stent diameter less than or equal to 8.5 F was 3.4% (1/29) versus 17.2% (10/58) for stent diameter larger than or equal to 10 F (P = 0.138). Conclusion. EUS-guided transmural drainage is an effective therapy for PFCs. Single-stent transmural drainage of PFCs is enough and does not seem to influence clinical success. The number or diameter of stents does not seem to be associated with secondary infection.
    Gastroenterology Research and Practice 01/2014; 2014:193562. DOI:10.1155/2014/193562 · 1.50 Impact Factor
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    Fan Yang, Dan Ma, Quan-Cai Cai, Zhao-Shen Li
    Journal of Gastroenterology and Hepatology 12/2013; 28(12):1795-1797. DOI:10.1111/jgh.12370 · 3.33 Impact Factor
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    ABSTRACT: The transpapillary approach can be used for draining pancreatic pseudocysts (PPs) with pancreatic-duct abnormalities. The purpose of this study was to analyze prognostic factors for clinical success of transpapillary drainage. Data for all patients who underwent transpapillary drainage between November 2000 and September 2009 were obtained by retrospective review and entered into a computerized database. Patient data were prospectively followed up to determine long-term outcomes. Seventy interventional ERCP procedures were performed for 43 patients. Technical success was 90.7 % (39/43). Overall clinical success was 79.5 % (31/39). Clinical success for pancreatic head pseudocyst was significantly different from that for body or tail pseudocyst (62.5 vs. 91.3 %, P = 0.043). Logistic regression analysis showed that location of the PPs predicted the success of endoscopic transpapillary pseudocyst drainage (P = 0.025). Transpapillary drainage is the least traumatic approach for drainage of PPs, and is also effective for patients with no communicating pseudocysts. Clinical success for pancreatic body or tail pseudocyst drainage was higher than that for pancreatic head pseudocyst drainage. It was found that the location of PPs predicted the success of transpapillary pseudocyst drainage. None of the other factors tested was a significant predictor of clinical success.
    Digestive Diseases and Sciences 11/2013; 59(2). DOI:10.1007/s10620-013-2924-2 · 2.26 Impact Factor

Publication Stats

1k Citations
541.82 Total Impact Points


  • 2000–2015
    • Changhai Hospital, Shanghai
      Shanghai, Shanghai Shi, China
  • 2014
    • Hangzhou First People's Hospital
      Hang-hsien, Zhejiang Sheng, China
  • 2007–2014
    • Second Military Medical University, Shanghai
      Shanghai, Shanghai Shi, China
  • 2013
    • Xinqiao Hospital
      Ch’ung-ch’ing-shih, Chongqing Shi, China