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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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    Consensus statement AIGO/SICCR: Diagnosis and treatment of chronic constipation and obstructed defecation (part Ⅰ :Diagnosis)

    Antonio BoveFilippo PuccianiMassimo BelliniEdda Battaglia...
    1555-1564页
    查看更多>>摘要：Chronic constipation is a common and extremely troublesome disorder that significantly reduces the quality of life,and this fact is consistent with the high rate at which health care is sought for this condition.The aim of this project was to develop a consensus for the diagnosis and treatment of chronic constipation and obstructed defecation.The commission presents its results in a "Question-Answer" format,including a set of graded recommendations based on a systematic review of the literature and evidence-based medicine.This section represents the consensus for the diagnosis.The history includes information relating to the onset and duration of symptoms and may reveal secondary causes of constipation.The presence of alarm symptoms and risk factors requires investigation.The physical examination should assess the presence of lesions in the anal and perianal region.The evidence does not support the routine use of blood testing and colonoscopy or barium enema for constipation.Variousscoring systems are available to quantify the severity of constipation; the Constipation Severity Instrument for constipation and the obstructed defecation syndrome score for obstructed defecation are the most reliable.The Constipation-Related Quality of Life is an excellent tool for evaluating the patient's quality of life.No single test provides a pathophysiological basis for constipation.Colonic transit and anorectal manometry define the pathophysiologic subtypes.Balloon expulsion is a simple screening test for defecatory disorders,but it does not define the mechanisms.Defecography detects structural abnormalities and assesses functional parameters.Magnetic resonance imaging and/or pelvic floor sonography can further complement defecography by providing information on the movement of the pelvic floor and the organs that it supports.All these investigations are indicated to differentiate between slow transit constipation and obstructed defecation because the treatments differ between these conditions.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    Adjuvant and neoadjuvant treatment in pancreatic cancer

    Marta Herreros-VillanuevaElizabeth HijonaAngel CosmeLuis Bujanda...
    1565-1572页
    查看更多>>摘要：Pancreatic adenocarcinoma is one of the most aggressive human malignancies,ranking 4th among causes for cancer-related death in the Western world including the United States.Surgical resection offers the only chance of cure,but only 15 to 20 percent of cases are potentially resectable at presentation.Different studies demonstrate and confirm that advanced pancreatic cancer is among the most complex cancers to treat and that these tumors are relatively resistant to chemotherapy and radiotherapy.Currently there is no consensus around the world on what constitutes "standard"adjuvant therapy for pancreatic cancer.This controversy derives from several studies,each fraught with its own limitations.Standards of care also vary somewhat with regard to geography and economy,for instance chemo-radiotherapy followed by chemotherapy or vice versa is considered the optimal therapy in North America while chemotherapy alone is the current standard in Europe.Regardless of the efforts in adjuvant and neoadjuvant improved therapy,the major goal to combat pancreatic cancer is to find diagnostic markers,identifying the disease in a pre-metastatic stage and making a curative treatment accessible to more patients.In this review,authors examined the different therapy options for advanced pancreatic patients in recent years and the future directions in adjuvant and neoadjuvant treatments for these patients.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    2011 update on esophageal achalasia

    Seng-Kee ChuahPin-I HsuKeng-Liang WuDeng-Chyang Wu...
    1573-1578页
    查看更多>>摘要：There have been some breakthroughs in the diagnosis and treatment of esophageal achalasia in the past few years.First,the introduction of high-resolution manometry with pressure topography plotting as a new diagnostic tool has made it possible to classify achalasia into three subtyPes.The most favorable outcome is predicted for patients receiving treatment for type Ⅱ achalasia (achalasia with compression).Patients with type I (classic achalasia) and type Ⅲ achalasia (spastic achalasia) experience a less favorable outcome.Second,the first multicenter randomized controlled trial published by the European Achalasia Trial group reported 2-year follow-up results indicating that laparoscopic Heller myotomy was not superior to endoscopic pneumatic dilation (PD).Although the follow-up period was not long enough to reach a convincing conclusion,it merits the continued use of PD as a generally available technique in gastroenterology.Third,the novel endoscopic technique peroral endoscopic myotomy is a promising option for treating achalasia,but it requires increased experience and cautious evaluation.Despite all this good news,the bottom line is a real breakthrough from the basic studies to identify the actual cause of achalasia that may impede treatment success is still anticipated.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Dual regulatory role for phosphatase and tensin homolog in specification of intestinal endocrine cell subtypes

    Sébastien AB RoyMarie-Josée LangloisJulie C CarrierFran(c)ois Boudreau...
    1579-1589页
    查看更多>>摘要：AIM:To investigate the impact of phosphatase and tensin homolog (Pten) in the specification of intestinal enteroendocrine subpopulations.METHODS:Using the Cre/IoxP system,a mouse with conditional intestinal epithelial Pten deficiency was generated.Pten mutant mice and controls were sacrificed and small intestines collected for immunofluorescence and quantitative real-time polymerase chain reaction.Blood was collected on 16 h fasted mice by cardiac puncture.Enzyme-linked immunosorbent assay was used to measure blood circulating ghrelin,somatostatin (SST) and glucose-dependent insulinotropic peptide (GIP) levels.RESULTS:Results show an unexpected dual regulatory role for epithelial Pten signalling in the specification/differentiation of enteroendocrine cell subpopulations in the small intestine.Our data indicate that Pten positively regulates chromogranin A (CgA) expressing subpopulations,including cells expressing secretin,ghrelin,gastrin and cholecystokinin (CCK).In contrast,Pten negatively regulates the enteroendocrine subtype specification of non-expressing CgA cells such as GIP and SST expressing cells.CONCLUSION:The present results demonstrate that Pten signalling favours the enteroendocrine progenitor to specify into cells expressing CgA including those producing CCK,gastrin and ghrelin.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Overexpression of Dickkopf-3 induces apoptosis through mitochondrial pathway in human colon cancer

    Zi-Rong YangWei-Guo DongXiao-Fei LeiMeng Liu...
    1590-1601页
    查看更多>>摘要：AIM:To investigate the mechanisms of the biological roles of Dickkopf-3 (Dkk-3) in cell invasion,survival and apoptosis in colon cancer cells.METHODS:Three human colon cancer cell lines,i.e.,HT-29,LoVo and SW480,were used.Overexpression of Dkk-3 induced by pEGFP-N1-Dkk-3-GFP plasmid in LoVo cells was performed using Lipofectamine 2000reagent.Reverse transcription polymerase chain reaction and Western blotting were performed to determine the mRNA and protein expression levels of Dkk-3,respectively.Cell proliferation assay,cell cycle analysis,hoechst 33258 assay and Matrigel invasion assay were performed on Dkk-3 overexpressing transfectants.RESULTS:The mRNA and protein expressions of Dkk-3 in HT-29 (mRNA:0.06 ± 0.02,protein:0.06 ±0.01) and LoVo (mRNA:0.07 ± 0.02,protein:0.07 ±0.02) cells were significantly lower than that in SW480 cells (mRNA:0.92 ± 0.04,protein:0.69 ± 0.13; all P ＜ 0.05),and the greatest levels of invasiveness was in LoVo cells.Dkk-3 overexpression inhibited the proliferation and invasion of LoVo cells and induced cell cycle arrest at G0/G1 phase and subsequent apoptosis,as indicated by increased chromatin condensation and fragments,upregulated Bax and cytochrome c protein,downregulated survivin and Bcl-2 protein,and the activation of caspase-3 and caspase-9.Furthermore,Dkk-3 overexpression reduced the accumulation of cytosolic fraction of β-catenin.CONCLUSION:Dkk-3 overexpression induced apoptosis in human colon cancer possibly through the mitochondrial pathway.Dkk-3 may be involved in the Wnt/β-catenin signaling pathways in colon cancer.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Toxicarioside A inhibits SGC-7901 proliferation, migration and invasion via NF-κB/bFGF signaling

    Jun-Li GuoShao-Jiang ZhengYue-Nan LiWei Jie...
    1602-1609页
    查看更多>>摘要：AIM:To investigate the inhibitory role of toxicarioside A on the gastric cancer cell line human gastric cancer cell line (SGC-7901) and determine the underlying molecular mechanism.METHODS:After SGC-7901 cells were treated with toxicarioside A at various concentrations (0.5,1.5,4.5,9.0 μg/mL) for 24 h or 48 h,cell viability was determined by 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyl-2H-tetrazolium bromide assay,and the motility and invasion of tumor cells were assessed by the Transwell chamber assay.Immunofluorescence staining,reverse transcription polymerase chain reaction and Western blotting were performed to detect the expression of basic fibroblast growth factor (bFGF) and fibroblast growth factor receptor-1 (FGFR1),and nuclear factorkappa B (NF-κB) activation was examined by electrophoretic mobility shift assay.RESULTS:The results showed that toxicarioside A was capable of reducing cell viability,inhibiting cell growth,and suppressing cell migration and invasion activities in a time-and dose-dependent manner in SGC-7901cells.Further analysis revealed that not only the expression of bFGF and its high-affinity receptor FGFR1 but also the NF-κB-DNA binding activity were effectively blocked by toxicarioside A in a dose-dependent manner compared with the control group (P ＜ 0.05 or P ＜ 0.01).Interestingly,application of the NF-κB specific inhibitor,pyrrolidinedithiocarbamate (PDTC),to SGC-7901 cells significantly potentized the toxicarioside A-induced down-regulation of bFGF compared with the control group (P ＜ 0.05).CONCLUSION:These findings suggest that toxicarioside A has an anti-gastric cancer activity and this effect may be achieved partly through down-regulation of NF-κB and bFGF/FGFR1 signaling.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    Medical treatment for sphincter of oddi dysfunction: Can it replace endoscopic sphincterotomy?

    Véronique VittonSalah EzzedineJean-Michel GonzalezMohamed Gasmi...
    1610-1615页
    查看更多>>摘要：AIM:To report the results of a medical management of sphincter of oddi dysfunction (SOD) after an intermediate follow-up period.METHODS:A total of 59 patients with SOD (2 men and 57 women,mean age 51 years old) were included in this prospective study.After medical treatment for one year,the patients were clinically re-evaluated after an average period of 30 mo.RESULTS:The distribution of the patients according to the Milwaukee's classification was the following:11patients were type 1,34 were type 2 and 14 were type 3.Fourteen patients underwent an endoscopic sphincterotomy (ES) after one year of medical treatment.The median intermediate follow-up period was 29.8 ±3 mo (3-72 mo).The initial effectiveness of the medical treatment was complete,partial and poor among 50.8％,13.5％ and 35％,respectively,of the patients.At the end of the follow-up period,37 patients (62.7％)showed more than 50％ improvement.The rate of improvement in patients who required ES was not significantly different compared with the patients treated conservatively (64.2％ vs 62.2％,respectively).CONCLUSION:Our study confirms that conservative medical treatment could be an alternative to endoscopic sphincterotomy because,after an intermediate follow-up period,the two treatments show the same success rates.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    Impact of comorbidities on the severity of chronic hepatitis B at presentation

    Evangelista SagnelliTommaso StroffoliniAlfonso MeleMichele Imparato...
    1616-1621页
    查看更多>>摘要：AIM:To evaluate the clinical relevance of each cofactor on clinical presentation of chronic hepatitis B.METHODS:Out of 1366 hepatitis B surface antigen (HBsAg) positive subjects consecutively observed in 79Italian hospitals,53 (4.3％) showed as the only cofactor hepatitis D virus (HDV) infection [hepatitis B virus (HBV)/HDV group],130 (9.5％) hepatitis C virus (HCV)(group HBV/HCV),6 (0.4％) human immunodeficiency virus (HIV) (group HBWHIV),138 (10.2％) alcohol abuse (group HBV/alcohol); 109 (8.0％) subjects had at least two cofactors and 924 were in the cofactor-free (CF) group.RESULTS:Compared with patients in group CF those in group HBV/alcohol were older and more frequently had cirrhosis (P ＜ 0.001),those in group HBV/HDV were younger (P ＜ 0.001),more frequently resided in the south of the country and had cirrhosis (P ＜0.001),those in group HBV/HCV were older (P ＜ 0.001) and more frequently had cirrhosis (P ＜ 0.001).These cofactors were all independent predictors of liver cirrhosis in HBsAg positive patients.Multivariate analysis showed that an older age [odds ratio (OR) 1.06,95％ CI:1.05-1.08],alcohol abuse with more than 8 drinks daily (OR 2.89,95％ CI:1.81-4.62) and anti-HDV positivity (OR 3.48,95％ CI:2.16-5.58) are all independently associated with liver cirrhosis.This association was found also for anti-HCV positivity in univariate analysis,but it was no longer associated (OR 1.23,95％ CI:0.84-1.80)at multivariate analysis.CONCLUSION:Older age,HDV infection and alcohol abuse are the major determinants of severe liver disease in chronic HBV infection,while HCV replication plays a lesser role in the severity of hepatic damage.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    No evidence of circulating autoantibodies against osteoprotegerin in patients with celiac disease

    Tiziana LarussaEvelina SuraciImmacolata NazionaleIsabella Leone...
    1622-1627页
    查看更多>>摘要：AIM:To investigate risk factors for low bone mineral density (BMD) in celiac disease (CD) patients,focusing on circulating autoantibodies against osteoprotegerin (OPG).METHODS:Seventy asymptomatic CD adult patients on gluten-free diet (GFD) and harbouring persistent negative CD-related serology were recruited.Conventional risk factors for osteoporosis (e.g.,age,sex,menopausal status,history of fractures,smoke,and body mass index) were checked and BMD was assessed by dual energy X ray absorptiometry.Serum calcium and parathyroid hormone (PTH) levels were evaluated.Thirty-eight patients underwent repeat duodenal biopsy.Serum samples from a selected sub-group of 30 patients,who were also typed for human leukocyte antigen (HLA) DQ2 and DQ8 haplotype,were incubated with homodimeric recombinant human OPG and tested by western blotting with an anti-OPG antibody after immunoprecipitation.RESULTS:Despite persistent negative CD-related serology and strict adherence to GFD,49 out of the 70 (74％) patients displayed low BMD.Among these patients,13 (24％) showed osteoporosis and 36 (76％)osteopenia.With the exception of age,conventional risk factors for osteoporosis did not differ between patients with normal and low BMD.Circulating serum calcium and PTH levels were normal in all patients.Duodenal mucosa healing was found in 31 (82％) out of 38 patients who underwent repeat duodenal biopsy with 20 (64％) still displaying low BMD.The remaining 7 patients had an incomplete normalization of duodenal mucosa with 6 (84％) showing low BMD.No evidence of circulating antibodies against OPG was found in the serum of 30 celiac patients who were tested for,independent of BMD,duodenal histology,and HLA status.CONCLUSION:If any,the role of circulating autoantibodies against OPG in the pathogenesis of bone derangement in patients with CD is not a major one.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Mucosa-associated bacteria in two middle-aged women diagnosed with collagenous colitis

    Rita J GustafssonBodil OhlssonCecilia BenoniBengt Jeppsson...
    1628-1634页
    查看更多>>摘要：AIM:To characterize the colon microbiota in two women histologically diagnosed with collagenous colitis using a culture-independent method.METHODS:Biopsies were taken from the ascending colon and the total DNA was extracted.Universal bacterial primers were used to amplify the bacterial 16S rRNA genes.The amplicons were then cloned into competent Escherichia coli cells.The clones were sequenced and identified by comparison to known sequences.RESULTS:The clones could be divided into 44 different phylotypes.The microbiota was dominated by Firmicutes and Bacteroidetes.Seven phylotypes were found in both patients and constituted 47.5％ of the total number of clones.Of these,the most dominating were clones similar to Bacteroides cellulosilyticus,Bacteroides caccae,Bacteroides thetaiotaomicron,Bacteroides uniformis and Bacteroides dorei within Bacteroidetes.Sequences similar to Faecalibacterium prausnitzii and C/ostridium citroniae were also found in both patients.CONCLUSION:A predominance of potentially pathogenic Bacteroidesspp.,and the presence of clones showing similarity to Clostridium clostridioforme were found but the overall colon microbiota showed similarities to a healthy one.Etiologies for collagenous colitis other than an adverse bacterial flora must also be considered.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普