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Improved control of hypertension following laparoscopic fundoplication for gastroesophageal reflux disease

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《医学前沿（英文）》 2017年 第11卷 第1期   页码 68-73 doi: 10.1007/s11684-016-0490-7

摘要：

This study aims to determine whether successful laparoscopic fundoplication for gastroesophageal reflux disease (GERD) can improve the control of hypertension. We conducted an observational study of GERD patients with hypertension. The esophageal and gastroesophageal symptoms of these patients were successfully treated with laparoscopic fundoplication, as measured by the reduced GERD symptoms and proton pump inhibitor consumption. A hypertension control scale was used to classify the use of antihypertensive medications and the quality of blood pressure control before and after anti-reflux surgery. Wilcoxon signed-ranks test was used for the statistical analyses. Seventy GERD patients were included in the analysis and followed up for a mean period of 3.5±1.4 years. Prior to surgery, all participating patients were taking at least one class of antihypertensive medication, and 56 patients (80%) had intermittently high blood pressure. After surgery, the mean number of antihypertensive medication classes per patient was significantly reduced from 1.61±0.77 pre-procedure to 1.27±0.88 post-procedure (P?<?0.001). The blood pressure of 48 of the 56 cases (86%) with preoperative intermittent high blood pressure returned to normal post procedure. A total of 50 patients (71%) recorded improvements on the hypertension control scale, with the overall mean score decreasing from 3.1±1.0 pre-procedure to 1.4±1.0 post-procedure (P?<?0.001). Therefore, successful laparoscopic fundoplication may result in better blood pressure control in some hypertensive GERD patients. This result suggests a possible connection between gastroesophageal reflux and hypertension.

关键词： gastroesophageal reflux disease     hypertension     blood pressure     laparoscopic fundoplication    

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A belated revelation: from gastroesophageal reflux derived asthma to laryngotracheal irritation even

WANG Zhonggao

《医学前沿（英文）》 2008年 第2卷 第2期   页码 127-129 doi: 10.1007/s11684-008-0023-0

摘要： The author has been inspired by the Global Evidence-Based Consensus for gastroesophageal reflux (GER), which put forward four extra-esophageal syndromes: reflux cough syndrome, reflux laryngitis syndrome, reflux dental erosion syndrome and the reflux asthma syndrome. The author himself happened to receive five emergency rescue treatments following apparent “bronchial asthma”, which was to be diagnosed as GER at his own insistence. PPI resulted in some relief. After being rescued again from suffocation, he had a fundaplication, which was performed at the Englewood Hospital & Medical Center, Englewood, USA in March 2006. The procedure immediately cleared up his “asthma”. A month later he brought forth a Center for GER in an army hospital in Beijing, China. Up to now, 601 patients with mainly respiratory distress (84%) were treated by Stretta Radiofrequency, 58 by surgery and more by PPI. The GER Center is now complete with a ward. GER patients with respiratory distresses turned out to fare better than those with acid regurgitation. A nozzle-shaped pharynx was found in patients with the reflux. Animal study revealed that the refluxate entered into trachea and even lungs. Gradually a hypothesis of a gastro-oesophago-laryngo-tracheal reflux took shape.Our modest effort to treat GER-derived respiratory distresses has got off to an encouraging start amid relative shortage of experience and facilities. We would like to share two thoughts with scholars and experts at home and abroad:1. The GER-derived asthma is not asthma, but GER pure and simple;2. The pathogenesis of “asthma” is not asthma, but laryngotracheal irritation/spasm and its sequence.

关键词： laryngotracheal irritation/spasm     gastro-oesophago-laryngo-tracheal     sequence     fundaplication     encouraging    

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Insult of gastroesophageal reflux on airway: clinical significance of pharyngeal nozzle

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《医学前沿（英文）》 2015年 第9卷 第1期   页码 117-122 doi: 10.1007/s11684-014-0343-1

摘要：

At the very time of global paying the highest attention to the worst insults of smoking as well as haze on the airway, everybody knows both are exogenous and noticeable. However, people mostly, including many medical personnel, do not know how badly the gastroesophageal reflux (GER) insults on our own airway. Symptoms of GER are commonly seen as heartburn and regurgitation, which can be mostly tolerated. However, when the up going gastric content reversely passes the esophagus and then the distal pharynx, where it appears a beak like stricture, serving as a nozzle, so as to produce numerous micro-particles and reach the oro-nasal cavity and also the airway causing allergic rhinitis and asthmatic attacks, even pulmonary parenchyma lesions. It will reduce life quality or even jeopardize life. The point that the endogenous insult appears in the respiratory system, but originates from the digestive tract is not well known and often undiagnosed and not correctly treated. The GER induced airway challenge is a treatable and preventive entity, as soon as a diagnosis is made, a good relief could be expected by means of life style adjustment, medicine, or fixation of the patulous cardia through radiofrequency or fundoplication. The author Dr. Zhonggao Wang had suffered it for long and symptoms disappeared for 8 years after anti-reflux surgery. Here is a presentation of Dr. Zhonggao Wang and his team’s work and would call attention to the public so as to recognize this relatively unknown entity — a treatable condition occurring from human itself, but not from outside surroundings as smoking or haze does.

关键词： gastroesophageal reflux     airway     pharyngeal nozzle     micro-aspiration     asthma    

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Effect of laparoscopic fundoplication treatment on gastroesophageal reflux disease-related respiratory

Zhong-Gao WANG MD, FACS, Feng JI MD, PhD, Yun-Gang LAI MD, PhD, Xiang GAO MD, PhD, Cheng-Chao ZHANG MD, PhD, Ji-Min WU MD, PhD, Xiu CHEN MD, PhD, Ibrahim M. IBRAHIM MD, FACS,

《医学前沿（英文）》 2010年 第4卷 第2期   页码 254-258 doi: 10.1007/s11684-010-0029-2

摘要： Gastroesophageal reflux disease (GERD) was diagnosed and fundoplication was performed, which relieved the symptoms. This paper explores the effect of fundoplication on GERD-related respiratory symptoms. From January 2007 to October 2008, 64 patients with respiratory symptoms related to GERD were consecutively enrolled for laparoscopic fundoplication. Of these, 60 patients had respiratory symptoms mainly combined with gastroesophageal reflux, while four had respiratory symptoms only. All patients had GERD confirmed, and medical treatment provided before surgery resulted in an insufficiently favorable effect or even producing further complications. All the patients were requested to fill a questionnaire form regarding the severity of symptoms and their medication so as to make an evaluation score for the follow-up. The outcome of respiratory symptoms after surgery was as follows: excellent in 23 cases (35.9%); good in 28 (43.8%); fair in 5 (7.8%); poor in 8 (12.5%). The mean respiratory symptom score decreased from 6.3±2.65 to 2.33±2.37. Laparoscopic fundoplication can be an effective treatment for the majority of patients with GERD-related respiratory symptoms.

关键词： gastroesophageal reflux disease     pH monitoring     laparoscopic fundoplication     respiratory symptom    

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Outcome of Stretta radiofrequency and fundoplication for GERD-related severe asthmatic symptoms

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《医学前沿（英文）》 2015年 第9卷 第4期   页码 437-443 doi: 10.1007/s11684-015-0422-y

摘要：

This study aimed to investigate the outcome of treatment with Stretta radiofrequency (SRF) or laparoscopic Nissen fundoplication (LNF). A total of 137 gastroesophageal reflux disease (GERD) patients with severe asthmatic symptoms who responded inadequately to medical treatment for asthma were investigated. The patients were followed up 1 year and 5 years after SRF (n = 82) or LNF (n = 55) treatment. A questionnaire covering 29 related symptoms and medication use was employed. Digestive, respiratory, and ear-nose-throat (ENT) symptom scores significantly decreased after antireflux treatment. Symptom scores respectively changed from 17.2±10.1, 31.9±6.6, and 21.1±11.8 to 5.0±6.2, 11.5±10.2, and 6.3±6.8 at 1 year and to 5.6±6.5, 13.1±10.1, and 7.8±7.2 at 5 years (P <0.001). The outcome of LNF was significantly better than that of SRF in terms of digestive (P <0.001, P = 0.001), respiratory (P = 0.006, P = 0.001), and ENT symptoms (P = 0.006, P = 0.003) at both 1 year and 5 years. SRF and LNF were both effective against the digestive symptoms of GERD as well as GERD-related severe asthmatic and ENT symptoms, with better outcomes exhibited by the LNF group. Severe asthmatic symptoms and GERD were closely associated, and this finding warrants further study.

关键词： asthma     gastroesophageal reflux     Stretta radiofrequency     laparoscopic Nissen fundoplication    

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The energy consumption in a batch stripper and a batch rectifier

Xianbao CUI, Tianyang FENG, Ying ZHANG, Zhicai YANG,

《化学科学与工程前沿（英文）》 2009年 第3卷 第4期   页码 443-452 doi: 10.1007/s11705-009-0266-6

摘要： The energy consumption in a batch rectifier and a batch stripper was investigated with a shortcut mathematical model. The minimum energy consumption of a batch stripper was compared to that of a batch rectifier under “general constant reflux” and “general constant distillate composition” with the ratio of minimum energy consumption /. When the feed contains a large amount of light component, the product purity specification is low and the relative volatility is small, the minimum energy consumption of a batch stripper is less than that of a batch rectifier under “general constant reflux” and “general constant distillate composition”. When the feed contains a small amount of light component, the product purity specification is very high and the relative volatility is low, a batch stripper can also consume less energy only in the “general constant distillate composition” operation mode. In other cases, a batch rectifier can consume less energy.

关键词： constant reflux     feed     energy consumption     general constant     product purity    

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标题 作者 时间 类型 操作

Improved control of hypertension following laparoscopic fundoplication for gastroesophageal reflux disease

null

期刊论文

A belated revelation: from gastroesophageal reflux derived asthma to laryngotracheal irritation even

WANG Zhonggao

期刊论文

Insult of gastroesophageal reflux on airway: clinical significance of pharyngeal nozzle

null

期刊论文

Effect of laparoscopic fundoplication treatment on gastroesophageal reflux disease-related respiratory

Zhong-Gao WANG MD, FACS, Feng JI MD, PhD, Yun-Gang LAI MD, PhD, Xiang GAO MD, PhD, Cheng-Chao ZHANG MD, PhD, Ji-Min WU MD, PhD, Xiu CHEN MD, PhD, Ibrahim M. IBRAHIM MD, FACS,

期刊论文

Outcome of Stretta radiofrequency and fundoplication for GERD-related severe asthmatic symptoms

null

期刊论文

The energy consumption in a batch stripper and a batch rectifier

Xianbao CUI, Tianyang FENG, Ying ZHANG, Zhicai YANG,

期刊论文