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世界胃肠病学杂志（英文版）
世界胃肠病学杂志（英文版）

潘伯荣

周刊

1007-9327

wjg@wjgnet.com

010-85381901-628

100025

北京市朝阳区东四环中路62号楼远洋国际中心D座903室

世界胃肠病学杂志（英文版）/Journal World Journal of GastroenterologyCSCDCSTPCDSCI
查看更多>>主要报道和刊登国内外、特别是我国消化病学者具有创造性的、有较高学术水平的基础和临床研究论文、研究快报等. 对具有中国特色的研究论文, 如食管癌、胃癌、肝癌、大肠癌、病毒性肝炎、幽门螺杆菌、中医中药、中西医结合和基于作者自己研究工作为主的综述性论文, 将优先发表. 读者对象为基础研究或临床研究的消化专业工作者。
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    Framework for assessing quality of care for inflammatory bowel disease in Sweden

    Martin RejlerJ(o)rgen TholstrupMattias ElgAnna Sp(a)ngéus...
    1085-1092页
    查看更多>>摘要：AIM:To create and apply a framework for quality assessment and improvement in care for inflammatory bowel disease (IBD) patients.METHODS A framework for quality assessment and improvement was created for IBD based on two generally acknowledged quality models.The model of Donabedian (Df) offers a logistical and productive perspective and the Clinical Value Compass (CVC) model adds a management and service perspective.The framework creates a pedagogical tool to understand the balance between the dimensions of clinical care (CVC) and the components of clinical outcome (Df).The merged models create a framework of the care process dimensions as a whole,reflecting important parts of the IBD care delivery system in a local setting.Clinical and organizational quality measures were adopted from clinical experience and the literature and were integrated into the framework.Data were collected at the yearly check-up for 481 IBD patients during 2008.The application of the quality assessment framework was tested and evaluated in a local clinical IBD care setting in J(o)nk(o)ping County,Sweden.RESULTS:The main outcome was the presentation of how locally-selected clinical quality measures,integrated into two complementary models to develop a framework,could be instrumental in assessing the quality of care delivered to patients with IBD.The selected quality measures of the framework noted less anemia in the population than previously reported,provided information about hospitalization rates and the few surgical procedures reported,and noted good access to the clinic.CONCLUSION:The applied local quality framework was feasible and useful for assessing the quality of care delivered to IBD patients in a local setting.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Autoimmune thyroid diseases and Helicobacter pylori: The correlation is present only in Graves's disease

    Vincenzo BassiGennaro MarinoAlba IengoOlimpia Fattoruso...
    1093-1097页
    查看更多>>摘要：AIM:To investigate the correlation between autoimmune thyroid diseases (ATDs) and the prevalence of Cag-A positive strains of Helicobacter pylori (H.pylon)in stool samples.METHODS:Authors investigated 112 consecutive Caucasian patients (48 females and 4 males with Graves' disease and 54 females and 6 males with Hashimoto's thyroiditis HT),at their first diagnosis of ATDs.Authors tested for H.pylori in stool samples using an amplified enzyme immunoassay and Cag-A in serum samples using an enzyme-linked immunoassay method (ELISA).The results were analyzed using the two-sided Fisher's exact test and the respective odds ratio (OR) was calculated.RESULTS:A marked correlation was found between the presence of H.pylori (P ≤ 0.0001,OR 6.3) and,in particular,Cag-A positive strains (P ≤ 0.005,OR 5.3)in Graves' disease,but not in Hashimoto's thyroiditis,where authors found only a correlation with Cag-A strains (P ≤ 0.005,OR 8.73) but not when H.pylori was present.CONCLUSION:The marked correlation between H.pylori and Cag-A,found in ATDs,could be dependent on the different expression of adhesion molecules in the gastric mucosa.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    Predictability of outcome of caustic ingestion by esophagogastroduodenoscopy in children

    Abdulkerim TemizPelin OguzkurtSemire Serin EzerEmine Ince...
    1098-1103页
    查看更多>>摘要：AIM:To assess the necessity of esophagogastroduodenoscopy (EGD) to predict the outcome of caustic ingestion in children.METHODS:The study included 206 children who underwent EGD because of ingestion of caustic substances between January 2005 and August 2010.Retrospective analysis of data of the patients was performed.RESULTS:The male/female ratio was 1.6 and mean age was 38.1 ± 28.8 mo.The caustic substances were acidic in 72 (34.9％) cases,alkaline in 56 (27.2％),liquid household bleach in 62 (30.1％),and unknown in 16 (7.8％).Fifty-seven (27.7％) patients were symptom-free.Significant clinical findings were observed in 149 (72.3％) patients.Upper gastrointestinal endoscopy findings of esophageal injury were grade 0 in 86 (41.7％) patients,grade 1 in 49 (23.8％),grade 2a in 42 (20.4％),grade 2b in 28 (13.6％),and grade 3a in 1 (0.5％) patient.35 patients with grade 2a,2b,and 3a injuries underwent esophageal dilation at second week of ingestion.Esophageal stricture,which necessitated a regular dilation program developed in 13 of the aforementioned 35 patients.There is no statistically significant difference in the rate of development of esophageal stricture between the patients who ingested acidic (15.3％) and alkaline (8.9％) substances (P =0.32).Severe gastric injury was detected in 38 (18.5％)patients.The rate of development of gastric injury was significantly higher in the acidic group (14％) than in the alkaline group (2.9％) (P =0.001).Out of 149 patients with clinical findings,49 (32.9％) patients had no esophageal injury and 117 (78.5％) patients had no gastric lesion.Esophageal and severe gastric injuries were detected in 20 (35.1％) and 8 (14％) of patients with no clinical findings respectively.Pyloric stenosis developed in 6 patients.Pyloric obstruction improved with balloon dilation in 2 patients.Mean hospitalization time were 1.2±0.5 d for grade 0 and 2.3 ± 5 d for grade 1 and 6.3 ± 6.2 d for grade 2a and 15.8 ± 18.6d for grade 2b.It was significantly longer for patients with grade 2a and 2b injuries (P =0.000).CONCLUSION:Endoscopy is an effective technique for determining the presence of esophageal and gastric damage and to avoid unnecessary treatment in patients with no or mild injury.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Bevacizumab as a second-or later-line of treatment for metastatic colorectal cancer

    Lee Chun ParkHo Sup LeeSeong Hoon ShinSeun Ja Park...
    1104-1109页
    查看更多>>摘要：AIM:To determine the efficacy of bevacizumab in patients with metastatic colorectal cancer (MCRC) who have failed prior chemotherapy without bevacizumab.METHODS:Between March 2002 and June 2010,40 patients in South Korea with MCRC who were treated with bevacizumab plus chemotherapy as a second or later-line treatment were analyzed retrospectively for their overall response rate (ORR),overall survival (OS),and progression-free survival (PFS).The tumor responses were assessed using the Response Evaluation Criteria in Solid Tumors guidelines.RESULTS:All of the patients had progressed under prior chemotherapy without bevacizumab.Three patients (7.5％) exhibited an ORR,twenty one patients (52.5％)exhibited stable disease (SD),and fifteen patients (37.5％) exhibited disease progression.The median duration of the OS and PFS were 14.0 mo and 6.13 mo respectively.The median OSs were 16.60,14.07 and 13.00 mo for second-line,third-line and fourth-or later-line treatments,respectively.The median PFSs were 7.23,7.30 and 3.87 mo for the second-line,third-line and fourth-or later-line treatments,respectively.CONCLUSION:In patients with MCRC,bevacizumab combined chemotherapy may be beneficial during second-or later-line treatment.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    Is hepatic neoplasm-related pyogenic liver abscess a distinct clinical entity?

    Siu-Tong LawKi Kong Li
    1110-1116页
    查看更多>>摘要：AIM:To compare the clinical characteristics of pyogenic liver abscess (PLA) in patients with and without hepatic neoplasm (HN).METHODS:Authors performed a retrospective analysis involving patients with PLA.The demographic,clinical features,laboratory and imaging findings,management and outcome of patients with and without HN were studied.RESULTS:From January 2000 to December 2009 inclusive,318 patients (35 with HN) had PLA,and mean age and comorbidity were comparable between the two groups.More patients with HN experienced right upper quadrant pain (68.6％ vs 52.7％,P ＜ 0.04),developed jaundice (14.3％ vs 5.7％,P ＜ 0.03) and hepatomegaly (17.1％ vs 3.9％,P ＜ 0.01),and had higher serum total bilirubin level (43.3 μmol/L vs 30.0 μmol/L,P =0.05).Most patients in both groups had PLAs in the right hepatic lobe,and biliary tract disorder was the most common underlying cause (71.4％ and 61.8％).However,more PLAs in the HN group were associated with thicker abscess wall (37.1％ vs 19.4％,P ＜ 0.01),septal lobulation (77.1％ vs 58％,P ＜ 0.02),gaseous cavitation (17％ vs 7.8％,P =0.03),portal thrombophlebitis (11.4％ vs 1.8％,P ＜ 0.01) and aerobilia (25.9％ vs 5.5％,P ＜ 0.01).Mixed bacterial growth (40％ vs 15.2％,P ＜ 0.01) and Gram-negative bacilli (22.8％ vs 60.4％,P ＜ 0.01) were dominant isolates in PLAs with and without HN,respectively.Although incidence of the complications was comparable between the two groups,patients with HN had a higher mortality rate than those without (71.4％ vs 8.8％,P ＜ 0.01).Multivariate logistic regression analysis revealed underlying active malignancy [odds ratio (OR):40.45,95％ CI:14.76-111.65],hypoalbuminemia (OR:1.22,95％ CI:1.14-1.38),disseminated intravascular coagulation (OR:3.32,95％CI:1.19-9.69) and acute coronary syndrome (OR:4.48,95％ CI:1.08-17.8) were independent risk factors associated with mortality.However,several HN cases,presented concurrently with PLAs,were found to have curative resectable tumors and had good prognosis after surgery.CONCLUSION:PLA associated with HN tends to form a distinct clinical syndrome with a different extent of clinical manifestations,radiological and microbiological features and complications.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Association between gastric cancer and-1993 polymorphism of TBX21 gene

    Le-Hui ZhangQin LiPeng LiSheng-Tao Zhu...
    1117-1122页
    查看更多>>摘要：AIM:To investigate the association between the polymorphism of TBX21 gene and the risk of gastric cancer in a Chinese population.METHODS:The-1993 polymorphism located in TBX21 gene promoter region was identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) method.The risk between TBX21 gene genotype and gastric cancer was determined by multivariate logistic regression analysis in 220 gastric cancer patients and 262 cancer-free controls matched by age,sex and ethnicity.RESULTS:Compared with the TBX21-1993TT genotype,the-1993CC genotype exhibited a significantly elevated risk for gastric cancer [Odds ratio (OR) =3.42,95％ confidence interval (CI):1.41-8.31].The relationship between the-1993 polymorphic genotype and the invasive status such as lymph node and distant metastasis was found among the gastric cancer patients (OR =4.02,95％ CI:1.87-8.66; OR =7.02,95％ CI:3.44-14.34,respectively).CONCLUSION:TBX21-1993 polymorphism might contribute to the risk of gastric cancer,especially to the distant metastasis.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    Interleukin-8, a promising predictor for prognosis of pancreatic cancer

    Ying ChenMin ShiGuan-Zhen YuXiao-Ran Qin...
    1123-1129页
    查看更多>>摘要：AIM:To investigate the value of interleukin-8 (IL-8),a pro-inflammatory chemokine,in predicting the prognosis of pancreatic cancer.METHODS:Expression of IL-8 and its receptor CXCR1 was assessed by immunohistochemistry in pancreatic cancer and chronic pancreatitis samples.Enzyme-linked immunosorbent assay was used to detect the serum IL-8 levels in pancreatic cancer patients.Human pancreatic cancer tissues were heterotopically transplanted to the immune-deficiency mice to evaluate the effect of serum IL-8 on the tumorigenesis of the cancer samples.RESULTS:IL-8 and CXCR1 proteins were both overexpressed in pancreatic adenocarcinoma samples (55.6％ and 65.4％,respectively) compared with the matched para-cancer tissues (25.9％ and 12.3％,P ＜ 0.01),or chronic pancreatitis (0％ and 25％,P ＜0.05).Serum IL-8 levels in pancreatic cancer patients (271.1 ± 187.7 ng/mL) were higher than in other digestive system tumors,such as gastric cancer (41.77 ±9.11 ng/mL,P =0.025),colorectal carcinoma (78.72 ±80.60 ng/mL,P =0.032) and hepatocellular carcinoma (59.60 ± 19.80 ng/mL,P =0.016).In vivo tumorigenesis analysis further proved that tumor tissues from patients with higher serum IL-8 levels grew faster than those with lower IL-8 levels.CONCLUSION:IL-8 can be a fine serum marker for predicting the prognosis pancreatic cancer.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Quantification of choline concentration following liver cell apoptosis using 1H magnetic resonance spectroscopy

    Zhi-Wei ShenZhen CaoKe-Zeng YouZhong-Xian Yang...
    1130-1136页
    查看更多>>摘要：AIM:To evaluate the feasibility of quantifying liver choline concentrations in both normal and apoptotic rabbit livers in vivo,using 1H magnetic resonance spectroscopy (1H-MRS).METHODS:1H-MRS was performed in 18 rabbits using a 1.5T GE MR system with an eight-channel head/neck receiving coil.Fifteen rabbits were injected with sodium selenite at a dose of 10 μmol/kg to induce the liver cell apoptosis.Point-resolved spectroscopy sequencelocalized spectra were obtained from 10 livers once before and once 24 h after sodium selenite injection in vivo.T1 and T2 relaxation time of water and choline was measured separately in the livers of three healthy rabbits and three selenite-treated rabbits.Hematoxylin and eosin and dUTP-biotin nick end labeling (TUNEL) staining was used to detect and confirm apoptosis.Choline peak areas were measured relative to unsuppressed water using LCModel.Relaxation attenuation was corrected using the average of T1 and T2 relaxation time.The choline concentration was quantified using a formula,which was tested by a phantom with a known concentration.RESULTS:Apoptosis of hepatic cells was confirmed by TUNEL assay.In phantom experiment,the choline concentration (3.01 mmol/L),measured by 1H-MRS,was in good agreement with the actual concentration (3 mmol/L).The average T1 and T2 relaxation time of choline was 612 ± 15 ms and 74 ± 4 ms in the control group and 670 ± 27 ms and 78 ± 5 ms in apoptotic livers in vivo,respectively.Choline was quantified in 10 rabbits,once before and once after the injection with sodium selenite.The choline concentration decreased from 14.5 ± 7.57 mmol/L before sodium selenite injection to 10.8 ± 6.58 mmol/L (mean ± SD,n =10) after treatment (Z =-2.395,P ＜ 0.05,two-sample paired Wilcoxon test).CONCLUSION:1H-MRS can be used to quantify liver choline in vivo using unsuppressed water as an internal reference.Decreased liver choline concentrations are found in sodium selenite-treated rabbits undergoing liver cell apoptosis.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Large-vessel thrombosis in intestinal Beh(c)et's disease complicated with myelodysplastic syndrome and trisomy 8

    Huang-Chi ChenYing-Ming Chiu
    1137-1140页
    查看更多>>摘要：Beh(c)et's disease is characterized by recurrent oral ulcers,genital ulcers,uveitis and skin lesions.Myelodysplastic syndrome (MDS) is characterized by problems due to ineffective hematopoiesis.Several studies have identified a relationship between MDS and Beh(c)et's disease,especially intestinal Beh(c)et's disease.Trisomy 8 seems to play an important role in these disorders as well.The present case was a 24-year-old woman who had a huge tonsil ulcer with initial symptoms of odynophagia and intermittent fever.We also noted folliculitis on her upper back.Five days later,she began to experience diarrhea and abdominal pain.Abdominal computed tomography and subsequent surgery revealed ileum perforation and enterocolitis with multiple ulcers.Later,she was admitted again for a vulvar suppurative ulcer and suspicious Bartholin's cyst infection.The patient's clinical presentations met the criteria for Beh(c)et's disease.Six months after the bowel perforation event,we noted the development of pancytopenia in a routine laboratory examination.All the examinations led to the diagnosis of MDS with trisomy 8.The most unusual finding was that multiple large vessel thrombi developed during follow-up.Previous studies have suggested that trisomy 8 in MDS leads to concurrent intestinal Beh(c)et's disease.Moreover,the inflammatory and immune genes related to thrombus formation are overexpressed in cases of MDS with trisomy 8.Trisomy 8 must play a role in thrombosis.Further studies are needed to help clarify the pathophysiology and pathogenesis of these disorders.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

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      原文链接:
    • NETL
    • NSTL
    • 万方数据