Zhao-Shen Li

Second Military Medical University, Shanghai, Shanghai, Shanghai Shi, China

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Publications (186)578.71 Total impact

  • Endoscopy 06/2015; 47(06). DOI:10.1055/s-0034-1391123 · 5.20 Impact Factor
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    ABSTRACT: The mechanisms associated with diabetes‑induced neuropathic pain are complex and poorly understood. In order to understand the involvement of spinal microglia activity in diabetic pain, the present study investigated whether minocycline treatment is able to attenuate diabetic pain using a rat model. Diabetes was induced using a single intraperitoneal injection of streptozotocin (STZ). Minocycline was then intrathecally administered to the rats. Paw withdrawal threshold (PWT) and paw withdrawal latency (PWL) were tested weekly. The expression of OX‑42, Iba‑1, phospho‑p38 mitogen‑activated protein kinase (MAPK), tumor necrosis factor‑α (TNF‑α), interleukin‑1β (IL‑1β) and inducible nitric oxide synthase (iNOS), were examined in the spinal cord in order to evaluate the activation of microglia. The present study demonstrated that rats with STZ‑induced diabetes exhibited increased mean plasma glucose concentration, decreased mean body weight and significant pain hypersensitivity compared with control rats. PWT and PWL values of rats with STZ‑induced diabetes increased following treatment with minocycline. No differences were observed in expression levels of the microglial activity markers (OX‑42, Iba‑1 and phospho‑p38 MAPK) between rats with STZ‑induced diabetes and control rats. However, TNF‑α, IL‑1β and iNOS expression levels were higher in rats with STZ‑induced diabetes compared with control rats. Following treatment with minocycline markers of microglial activation, including cytokines and iNOS, were downregulated in rats with STZ‑induced diabetes. The results of the present study indicated that minocycline treatment may inhibit spinal microglial activation and attenuate diabetic pain in rats with STZ‑induced diabetes.
    Molecular Medicine Reports 05/2015; DOI:10.3892/mmr.2015.3735 · 1.48 Impact Factor
  • The American Journal of Gastroenterology 05/2015; 110(5):773-774. DOI:10.1038/ajg.2015.107 · 9.21 Impact Factor
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    ABSTRACT: Vascular invasion is one of the most important prognostic factors for patients with hepatocellular carcinoma (HCC). The objective of the current, retrospective study was to determine the associations of ascites and hepatitis B viral factors (HBeAg and anti-HBe status and HBV DNA levels), as well as tumor-related factors (size, tumor number, grade, and location) with micro- or macroscopic vascular invasion in patients with HCC that developed as a result of hepatitis B virus (HBV)-related cirrhosis. A total of 336 consecutive patients were included. Potential factors associated with micro- or macroscopic vascular invasion were analyzed by logistic regression. Ascites were more commonly detected in patients with micro- or macroscopic vascular invasion, and the presence of ascites was independently associated with vascular invasion. Among patients with mild-to-moderate or severe ascites, the odds ratio for macroscopic vascular invasion was 4.83 (95 % confidence interval [CI] 2.29-10.16) and 11.87 (95 % CI 4.53-31.07), respectively. Similarly, the presence of ascites was associated with microscopic vascular invasion (OR 5.00; 95 % CI 1.23-20.31). In contrast, hepatitis B viral factors were not significantly associated with vascular invasion. The presence of ascites was associated with vascular invasion in patients with HBV-related cirrhotic HCC. Thus, patients with ascites, vascular invasion should be considered and more frequent surveillance should be performed after curative treatment.
    Tumor Biology 04/2015; DOI:10.1007/s13277-015-3311-8 · 2.84 Impact Factor
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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; 47(05). DOI:10.1055/s-0034-1391227 · 5.20 Impact Factor
  • Wen-Bin Zou, Fan Yang, Zhao-Shen Li
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    ABSTRACT: China has great burden of gastric cancer, and the diagnosis rate of early gastric cancer is relatively low (<10%). To perform screening, early endoscopic diagnosis and treatment of gastric cancer in high-risk population is a feasible and efficient way to change the current status. Therefore, the Chinese Society of Digestive Endoscopy recently issued Consensus on screening, ″Endoscopic diagnosis and treatment of early gastric cancer screening in China″. The consensus suggests a feasible and efficient strategy for early detection of gastric cancer: screening with non-invasive procedures, followed by intensive endoscopic examination for screened high-risk population. In this article, we also describe the current status, the causes, high-risk population and early diagnosis of gastric cancer in China; and review the new development of serology and endoscopic techniques for early diagnosis.
    Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences 01/2015; 44(1):9-14.
  • Chinese medical journal 01/2015; 128(8):995. DOI:10.4103/0366-6999.155049 · 1.02 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
  • Endoscopy 12/2014; 46(12). DOI:10.1055/s-0034-1391146 · 5.20 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 · 13.93 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 · 13.93 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 06/2014; 2014:193562. DOI:10.1155/2014/193562 · 1.50 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

Publication Stats

1k Citations
578.71 Total Impact Points


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