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Changes of gastric ulcer bleeding in the metropolitan area of Japan

World Journal of Gastroenterology 2019年第42期25卷 6342-6353页

作者： Yoko Kubosawa Hideki Mori Satoshi Kinoshita Yoshihiro Nakazato Ai Fujimoto Masahiro kikuchi toshihiro Nishizawa Masayuki Suzuki Hidekazu Suzuki Department of Gastroenterology National Hospital Organization Tokyo Medical CenterMeguroTokyo 152-8902Japan Division of Gastroenterology and Hepatology Department of Internal MedicineKeio University School of MedicineShinjukuTokyo 160-0016Japan Department of Clinical and Experimental Medicine Translational Research Center for Gastrointestinal Diseases(TARGID)University of LeuvenLeuven 3000Belgium Department of Gastroenterology Digestive Disease CenterInternational University of Health and WelfareMita HospitalMinatoTokyo 108-8329Japan Division of Gastroenterology and Hepatology Department of Internal MedicineTokai University School of MedicineIseharaKanagawa 259-1193Japan

BACKGROUND The two main causes of gastric ulcer bleeding are Helicobacter pylori(***)infection and ulcerogenic medicines,although the number of cases caused by each may vary with *** Japan,the rate of *** infection has fallen over the last decade and the number of prescriptions for non-steroidal anti-inflammatory drugs(NSAIDs)and antithrombotic drugs is increasing as the population *** of treatment for gastric ulcer bleeding have advanced with the advent of hemostatic forceps and potassium-competitive acid blocker(P-CAB).Thus,causes and treatments for gastric ulcer bleeding have changed over the last *** To examine the trends of gastric ulcer bleeding over 10 years in the metropolitan area of *** This is a single-center retrospective study.A total of 564 patients were enrolled from inpatients admitted to our hospital with gastric ulcer bleeding between 2006 and ***,medication history,*** infection,method of treatment,rate of rebleeding,and the length of hospitalization were *** associated with gastric ulcer bleeding were evaluated using Fisher’s exact test,Pearson’s Chi-squared test or Student’s t-test as *** Jonckheere-Terpstra test was used to evaluate trends.A per-protocol analysis was used to examine the rate of *** *** There was a significant increase in the mean age over time(P<0.01).The rate of *** infection tended to decrease over the study period(P=0.10),whereas the proportion of patients taking antithrombotic agents or NSAIDs tended to increase(P=0.07).Over time,the use of NSAIDs and antithrombotic drugs increased with *** contrast,the rate of *** infection during the study period fell with ***-induced ulcers accounted for the majority of cases in younger patients(<70 years old);however,the rate decreased with age(P<0.01).The method of treatment trend has changed significantly over *** main method of endoscopic hemostasis has changed from

关键词： Helicobacter pylori infection Gastric ulcer bleeding Non-steroidal antiinflammatory drugs Antithrombotic agents

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Efficacy of mucosa-submucosa clip closure method after gastric endoscopic submucosal dissection

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World Journal of Gastrointestinal Endoscopy 2020年第1期12卷 17-22页

作者： Satoshi Kinoshita toshihiro Nishizawa Ai Fujimoto Hideki Mori Yoshihiro Nakazato Masahiro kikuchi Toshio Uraoka Department of Gastroenterology National Hospital Organization Tokyo Medical CenterTokyo 152-8902Japan Division of Research and Development for Minimally Invasive Treatment Cancer CenterKeio University School of MedicineTokyo 160-8582Japan Department of Gastroenterology and Hepatology International University of Health and Welfare Mita HospitalTokyo 108-8329Japan Department of Internal Medicine Division of Gastroenterology and HepatologyGunma UniversityMaebashi 371-8511Japan

BACKGROUND We recently developed a new endoscopic closure technique using only conventional endo-clips for colorectal *** is known about the feasibility of the endoscopic mucosa-submucosa clip closure method for gastric *** To elucidate the efficacy of the endoscopic mucosa-submucosa clip closure method after gastric endoscopic submucosal dissection(ESD).METHODS Twenty-two patients who underwent gastric ESD and mucosa-submucosa clip closure were included in this *** this method,endo-clips are placed at the edges of a mucosal *** endo-clips are then applied in the same way to facilitate reduction of the defect *** endo-clips are applied to both sides of the mucosal *** closure can be *** have also developed a“location score”and“closure difficulty index”for assessment *** Complete closure was achieved in 68.2%of the patients(15/22).The location score in the failure group was significantly larger than that in the complete closure group(P=0.023).The closure difficulty index in the failure group was significantly higher than that in the complete closure group(P=0.007).When the cutoff value of the closure difficulty index was set at 99,the high closure difficulty index predicted failure with a sensitivity of 57.1%,specificity of 100%,and accuracy of 86.3%.CONCLUSION The endoscopic mucosa-submucosa clip closure method was unreliable after gastric ESD,especially in cases with a high closure difficulty index.

关键词： Endoscopic submucosal dissection Stomach Endoscopic mucosa-submucosa clip closure method Colorectal

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尼可地尔降低非心脏手术过程中或术后心脏事件的发生率

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首都食品与医药 2015年第24期22卷 143-143页

作者： Satoshi Kashimoto Makoto Seki Toshihiko Ishiguro Hitoshi Yoshioka Osamu Nagata Kinya Nishimura toshihiro kikuchi Tatsuya Yamada Motoyo Iwade Akibumi Omi Osamu Honda Atsuhiro Sakamoto Yukihiko Ogihara Keiko Fujimoto Yasushi Nakaigawa Jitsu Kato Akio Watanabe Minoru Nomura Junzo Takeda 王青北京四环科宝制药有限公司 100079

（接11月下）组间无显著性差异。心脏事件的频率在附表2中显示,手术过程中心脏事件的每个风险因素的优势比在附表3中显示。在通过逐步回归分析得到的风险因素中,与尼可地尔联系最紧密的因素的优势比是0.15（95%置信区间,0.03~0.76;

关键词：尼可地尔心脏事件非心脏手术优势比逐步回归分析无显著性差异置信区间心肌衰竭患者例数心肌缺血患者

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尼可地尔降低非心脏手术过程中或术后心脏事件的发生率

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首都食品与医药 2015年第22期22卷 151-151页

作者： Satoshi Kashimoto Makoto Seki Toshihiko Ishiguro Hitoshi Yoshioka Osamu Nagata Kinya Nishimura toshihiro kikuchi Tatsuya Yamada Motoyo Iwade Akibumi Omi Osamu Honda Atsuhiro Sakamoto Yukihiko Ogihara Keiko Fujimoto Nakaigawa Jitsu Kato Akio Watanabe Minoru Nomura Junzo Takeda 王青北京四环科宝制药有限公司 100079

目的评估尼可地尔是否能减少危险手术进行过程中或术后心脏事件的发生。方案多中心研究。试验点日本的13家医院。患者通过心绞痛、心肌梗死病史、心脏衰竭、糖尿病和心电图异常等风险因素来评定的中危患者。给药方案在手术过程中给予这... 详细信息

目的评估尼可地尔是否能减少危险手术进行过程中或术后心脏事件的发生。方案多中心研究。试验点日本的13家医院。患者通过心绞痛、心肌梗死病史、心脏衰竭、糖尿病和心电图异常等风险因素来评定的中危患者。给药方案在手术过程中给予这些患者尼可地尔。试验方法和主要结果术中和术后连续5天监控心脏事件,比较尼可地尔治疗组患者与非治疗组患者心脏事件的发生率。其中,尼可地尔治疗组患者84例,常规治疗组患者237例。与常规治疗相比,术中和术后给予尼可地尔治疗的患者心脏事件发生率均显著降低（术中给予尼可地尔：比值比0.15;95%置信区间,0.03～0.76;P=0.02;术后给予尼可地尔：比值比0.24;95%置信区间,0.06～0.90;P=0.04）。结论在非心脏手术术中或术后给予尼可地尔,均能降低心脏事件的发生率。

关键词：心脏手术过程尼可地尔心脏事件发生率术后试验方法置信区间多中心研究

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