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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

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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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    Genetically modified mouse models for the study of nonalcoholic fatty liver disease

    Perumal NagarajanM Jerald Mahesh KumarRamasamy VenkatesanSubeer S Majundar...
    1141-1153页
    查看更多>>摘要：Nonalcoholic fatty liver disease (NAFLD) is associated with obesity,insulin resistance,and type 2 diabetes.NAFLD represents a large spectrum of diseases ranging from (1) fatty liver (hepatic steatosis); (2) steatosis with inflammation and necrosis; to (3) cirrhosis.The animal models to study NAFLD/nonalcoholic steatohepatitis (NASH) are extremely useful,as there are still many events to be elucidated in the pathology of NASH.The study of the established animal models has provided many clues in the pathogenesis of steatosis and steatohepatitis,but these remain incompletely understood.The different mouse models can be classified in two large groups.The first one includes genetically modified (transgenic or knockout) mice that spontaneously develop liver disease,and the second one includes mice that acquire the disease after dietary or pharmacological manipulation.Although the molecular mechanism leading to the development of hepatic steatosis in the pathogenesis of NAFLD is complex,genetically modified animal models may be a key for the treatment of NAFLD.Ideal animal models for NASH should closely resemble the pathological characteristics observed in humans.To date,no single animal model has encompassed the full spectrum of human disease progression,but they can imitate particular characteristics of human disease.Therefore,it is important that the researchers choose the appropriate animal model.This review discusses various genetically modified animal models developed and used in research on NAFLD.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Trends on gastrointestinal bleeding and mortality: Where are we standing?

    Ahmed Mahmoud EI-Tawil
    1154-1158页
    查看更多>>摘要：Bleeding from the gastrointestinal tract and its management are associated with significant morbidity and mortality.The predisposing factors that led to the occurrence of these hemorrhagic instances are largely linked to the life style of the affected persons.Designing a new strategy aimed at educating the publics and improving their awareness of the problem could effectively help in eradicating this problem with no associated risks and in bringing the mortality rates down to almost zero.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Management of non-variceal upper gastrointestinal tract hemorrhage: Controversies and areas of uncertainty

    Eric P TrawickPatrick S Yachimski
    1159-1165页
    查看更多>>摘要：Upper gastrointestinal tract hemorrhage (UGIH) remains a common presentation requiring urgent evaluation and treatment.Accurate assessment,appropriate intervention and apt clinical skills are needed for proper management from time of presentation to discharge.The advent of pharmacologic acid suppression,endoscopic hemostatic techniques,and recognition of Helicobacter pylori as an etiologic agent in peptic ulcer disease (PUD)has revolutionized the treatment of UGIH.Despite this,acute UGIH still carries considerable rates of morbidity and mortality.This review aims to discuss current areas of uncertainty and controversy in the management of UGIH.Neoadjuvant proton pump inhibitor (PPI) therapy has become standard empiric treatment for UGIH given that PUD is the leading cause of non-variceal UGIH,and PPIs are extremely effective at promoting ulcer healing.However,neoadjuvant PPI administration has not been shown to affect hard clinical outcomes such as rebleeding or mortality.The optimal timing of upper endoscopy in UGIH is often debated.Upon completion of volume resuscitation and hemodynamic stabilization,upper endoscopy should be performed within 24 h in all patients with evidence of UGIH for both diagnostic and therapeutic purposes.With rising healthcare cost paramount in today's medical landscape,the ability to appropriately triage UGIH patients is of increasing value.Upper endoscopy in conjunction with the clinical scenario allows for accurate decision making concerning early discharge home in low-risk lesions or admission for further monitoring and treatment in higher-risk lesions.Concomitant pharmacotherapy with non-steroidal anti-inflammatory drugs (NSAIDs) and antiplatelet agents,such as clopidogrel,has a major impact on the etiology,severity,and potential treatment of UGIH.Long-term PPI use in patients taking chronic NSAIDs or clopidogrel is discussed thoroughly in this review.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Treatment of portal hypertension

    Khurram BariGuadalupe Garcia-Tsao
    1166-1175页
    查看更多>>摘要：Portal hypertension is the main complication of cirrhosis and is defined as an hepatic venous pressure gradient (HVPG) of more than 5 mmHg.Clinically significant portal hypertension is defined as HVPG of 10 mmHg or more.Development of gastroesophageal varices and variceal hemorrhage are the most direct consequence of portal hypertension.Over the last decades significant advancements in the field have led to standard treatment options.These clinical recommendations have evolved mostly as a result of randomized controlled trials and consensus conferences among experts where existing evidence has been reviewed and future goals for research and practice guidelines have been proposed.Management of varices/variceal hemorrhage is based on the clinical stage of portal hypertension.No specific treatment has shown to prevent the formation of varices.Prevention of first variceal hemorrhage depends on the size/characteristics of varices.In patients with small varices and high risk of bleeding,nonselective β-blockers are recommended,while patients with medium/large varices can be treated with either β-blockers or esophageal band ligation.Standard of care for acute variceal hemorrhage consists of vasoactive drugs,endoscopic band ligation and antibiotics prophylaxis.Transjugular intrahepatic portosystemic shunt (TIPS) is reserved for those who fail standard of care or for patients who are likely to fail ("early TIPS").Prevention of recurrent variceal hemorrhage consists of the combination of β-blockers and endoscopic band ligation.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Management of portal hypertension in children

    Roberto GugigPhilip Rosenthal
    1176-1184页
    查看更多>>摘要：Portal hypertension can be caused by a wide variety of conditions.It frequently presents with bleeding from esophageal varices.The approach to acute variceal hemorrhage in children is a stepwise progression from least invasive to most invasive.Management of acute variceal bleeding is straightforward.But data on primary prophylaxis and long term management prevention of recurrent variceal bleeding in children is scarce,therefore prospective multicenter trials are needed to establish best practices.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Pros and cons of colonoscopy in management of acute lower gastrointestinal bleeding

    Dekey Y LhewaLisa L Strate
    1185-1190页
    查看更多>>摘要：Acute lower gastrointestinal bleeding (LGIB) is a frequent gastrointestinal cause of hospitalization,particularly in the elderly,and its incidence appears to be on the rise.Endoscopic and radiographic measures are available for the evaluation and treatment of LGIB including flexible sigmoidoscopy,colonoscopy,angiography,radionuclide scintigraphy and multi-detector row computed tomography.Although no modality has emerged as the gold standard in the management of LGIB,colonoscopy is the current preferred initial test for the majority of the patients presenting with hematochezia felt to be from a colon source.Colonoscopy has the ability to diagnose all sources of bleeding from the colon and,unlike the radiologic modalities,does not require active bleeding at the time of the examination.In addition,therapeutic interventions such as cautery and endoclips can be applied to achieve hemostasis and prevent recurrent bleeding.Studies suggest that colonoscopy,particularly when performed early in the hospitalization,can decrease hospital length of stay,rebleeding and the need for surgery.However,results from available small trials are conflicting and larger,multicenter studies are needed.Compared to other management options,colonoscopy is a safe procedure with complications reported in less than 2％ of patients,including those undergoing urgent examinations.The requirement of bowel preparation (typically 4 or more liters of polyethylene glycol),the logistical complexity of coordinating after-hours colonoscopy,and the low prevalence of stigmata of hemorrhage complicate the use of colonoscopy for LGIB,particularly in urgent situations.This review discusses the above advantages and disadvantages of colonoscopy in the management of acute lower gastrointestinal bleeding in further detail.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Angiographic evaluation and management of acute gastrointestinal hemorrhage

    T Gregory WalkerGloria M SalazarArthur C Waltman
    1191-1201页
    查看更多>>摘要：Although most cases of acute nonvariceal gastrointestinal hemorrhage either spontaneously resolve or respond to medical management or endoscopic treatment,there are still a significant number of patients who require emergency angiography and transcatheter treatment.Evaluation with noninvasive imaging such as nuclear scintigraphy or computed tomography may localize the bleeding source and/or confirm active hemorrhage prior to angiography.Any angiographic evaluation should begin with selective catheterization of the artery supplying the most likely site of bleeding,as determined by the available clinical,endoscopic and imaging data.If a hemorrhage source is identified,superselective catheterization followed by transcatheter microcoil embolization is usually the most effective means of successfully controlling hemorrhage while minimizing potential complications.This is now wellrecognized as a viable and safe alternative to emergency surgery.In selected situations transcatheter intra-arterial infusion of vasopressin may also be useful in controlling acute gastrointestinal bleeding.One must be aware of the various side effects and potential complications associated with this treatment,however,and recognize the high re-bleeding rate.In this article we review the current role of angiography,transcatheter arterial embolization and infusion therapy in the evaluation and management of nonvariceal gastrointestinal hemorrhage.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Management of acute nonvariceal upper gastrointestinal bleeding: Current policies and future perspectives

    Ingrid Lisanne HolsterErnst Johan Kuipers
    1202-1207页
    查看更多>>摘要：Acute upper gastrointestinal bleeding (UGIB) is a gastroenterological emergency with a mortality of 6％-13％.The vast majority of these bleeds are due to peptic ulcers.Nonsteroidal anti-inflammatory drugs and Helicobacter pylori are the main risk factors for peptic ulcer disease.Endoscopy has become the mainstay for diagnosis and treatment of acute UGIB,and is recommended within 24 h of presentation.Proton pump inhibitor (PPI) administration before endoscopy can downstage the bleeding lesion and reduce the need for endoscopic therapy,but has no effect on rebleeding,mortality and need for surgery.Endoscopic therapy should be undertaken for ulcers with high-risk stigmata,to reduce the risk of rebleeding.This can be done with a variety of modalities.High-dose PPI administration after endoscopy can prevent rebleeding and reduce the need for further intervention and mortality,particularly in patients with high-risk stigmata.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Expression of HER2 and bradykinin B1 receptors in precursor lesions of gallbladder carcinoma

    Cesar ToledoCarola E MatusXimena BarrazaPamela Arroyo...
    1208-1215页
    查看更多>>摘要：AIM:TO determine the expression of HER2 and bradykinin B1 receptors (B1R) in the two pathogenic models of gallbladder cancer:the metaplasia-dysplasia-carcinoma and the adenoma-carcinoma pathways.METHODS:Receptor proteins were visualized by immunohistochemistry on 5-μm sections of paraffin-embedded tissue.Expression of both receptors was studied in biopsy samples from 92 patients (6 males and 86 females; age ranging from 28 to 86 years,mean 56 years).High HER2 expression in specimens was additionally investigated by fluorescence in situ hybridization.Cell proliferation in each sample was assessed by using the Ki-67 proliferation marker.RESULTS:HER2 receptor protein was absent in adenomas and in normal gallbladder epithelium.On the contrary,there was intense staining for HER2 on the basolateral membrane of epithelial cells of intestinal metaplasia (22/24; 91.7％) and carcinoma in situ (9/10;90％),the lesions that displayed a significantly high proliferation index.Protein up-regulation of HER2 in the epithelium with metaplasia or carcinoma in situ was not accompanied by HER2 gene amplification.A similar result was observed in invasive carcinomas (0/12).The B1R distribution pattern mirrored that of HER2 except that B1R was additionally observed in the adenomas.The B1R appeared either as cytoplasmic dots or labelingon the apical cell membrane of the cells composing the epithelia with intestinal metaplasia (24/24; 100％) and carcinoma in situ (10/10; 100％) and in the epithelial cells of adenomas.In contrast,both HER2 (4/12; 33％)and B1R (1/12; 8.3％) showed a low expression in invasive gallbladder carcinomas.CONCLUSION:The up-regulation of HER2 and B1R in precursor lesions of gallbladder carcinoma suggests cross-talk between these two receptors that may be of importance in the modulation of cell proliferation in gallbladder carcinogenesis.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Proteomic analysis of gastric cancer and immunoblot validation of potential biomarkers

    Nina Ko(c)evarFederico OdremanAlessandro VindigniSnje(z)ana Frkovi(c) Grazio...
    1216-1228页
    查看更多>>摘要：AIM:To search for and validate differentially expressed proteins in patients with gastric adenocarcinoma.METHODS:We used two-dimensional gel electrophoresis and mass spectrometry to search for differentially expressed proteins in patients with gastric adenocarcinoma.A set of proteins was validated with immunoblotting.RESULTS:We identified 30 different proteins involved in various biological processes:metabolism,development,death,response to stress,cell cycle,cell communication,transport,and cell motility.Eight proteinswere chosen for further validation by immunoblotting.Our results show that gastrokine-1,39S ribosomal protein L12 (mitochondrial precursor),plasma cell-induced resident endoplasmic reticulum protein,and glutathione S-transferase mu 3 were significantly underexpressed in gastric adenocarcinoma relative to adjacent non-tumor tissue samples.On the other hand,septin-2,ubiquitin-conjugating enzyme E2 N,and transaldolase were significantly overexpressed.Translationally controlled tumor protein was shown to be differentially expressed only in patients with cancer of the gastric cardia/esophageal border.CONCLUSION:This work presents a set of possible diagnostic biomarkers,validated for the first time.It might contribute to the efforts of understanding gastric cancer carcinogenesis.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普