Please select the eligibility criteria that correspond to the clinical trial below.
Title: Oral vs Intravenous Proton Pump Inhibitor（PPI） in Patients With Peptic Ulcer Bleeding After Successful Endoscopic Therapy- a Prospective Randomized Comparative Trial
Brief Summary: A bleeding peptic ulcer remains a serious medical problem with significant morbidity and mortality. Endoscopic therapy significantly reduces further bleeding, surgery, and mortality in patients with bleeding peptic ulcers and is now recommended as the first hemostatic modality for these patients.

In the past few years, adjuvant use of a high-dose proton pump inhibitor (PPI) after endoscopic therapy has been endorsed in some studies. Laine and Javid et al found that oral PPI and IV PPI had a similar intragastric pH response in the past two years. Therefore, whether oral can replace IV in the management of peptic ulcer bleeding is the objective in this study.

The investigators enrolled 130 patients with active bleeding or nonbleeding visible vessels（NBVV） in this study. They are randomly assigned as oral lansoprazole or IV nexium group. All patients receive successful endoscopic therapy with heater probe or hemoclip placement.

In the lansoprazole group (N=65), 30 mg four times daily is given orally for three days. Thereafter, the patients receive 30 mg lansoprazole orally daily for two months. In the nexium group, 160 mg/day continuous infusion is given for three days. Thereafter, the patients receive 40 mg nexium orally daily for two months.

The primary end point is recurrent bleeding before discharge and within 14 days. At day 14, volume of blood transfused, number of surgeries performed, and the mortality rates of the two groups are compared as well.


Options:
A: Inclusion Criteria:

* A peptic ulcer with active bleeding,a non-bleeding visible vessel (NBVV) or an adherent blood clot at the ulcer base is observed within 24 hours of hospital admission

Exclusion Criteria:

* Patients are excluded from the study if they are pregnant,
* Do not obtain initial hemostasis with endoscopic injection of epinephrine
* Do not give written informed consent
* Have bleeding tendency (platelet count \<50×109/L,serum prothrombin \<30% of normal,or were taking anticoagulants)
* Uremia.
B: Inclusion Criteria:

* Patients with overt signs of upper GIB; fresh hematemesis and/or melena with or with circulatory compromise

Exclusion Criteria:

* Chronic aspirin user,
* Pregnancy,
* Age\<16,
* Allergy to PPI,
* No consent
C: Inclusion Criteria:

1. Above 21 year old
2. OGD done within 48 hrs of admission
3. No recent upper GIT surgery past one month
4. Forrest Type I, IIa \& IIb ulcer (Type Ia: Spurting, Ib:Oozing, IIa: Visible vessel, IIb: Clot)
5. Non-malignant ulcer
6. Informed consent taken

Exclusion Criteria:

1. Impaired hepatic function
2. Pregnancy
3. Lactation
4. Concomitant medication (warfarin, diazepam, phenytoin, chlarithromycin, cimetidine and digoxin)
5. Underlying malignancy
D: Inclusion Criteria:

* adults aged above 16 years old with acute nonvariceal upper gastrointestinal bleeding
* read, agree to attend the study, and signed informed consent indicated to receive esophagogastroduodenoscopy(EGD)
* peptic ulcers with high risk lesions (active bleeding: spurting, oozing peptic ulcers. Ulcers with NBVV: nonbleeding visible vessel)

Exclusion Criteria:

* unable to receive EGD (unable to open mouth, upper gastrointestinal obstruction)
* bleeding tendency (platelet \< 50x109/L, prothrombin time INR \>2, ongoing use of heparin or coumadin)
* gastric malignancy
* myocardial infarction within recent one week
* recent cerebrovascular event within recent one week
* pregnancy
* refuse to attend the study
* known allergy history to epinephrine or pantoprazole

Answer: A