期刊,世界胃肠病学杂志（英文版） 2012年卷14期_国家学术搜索

期刊信息/Journal information

世界胃肠病学杂志（英文版）

主　　编：潘伯荣

出版周期：周刊

国际刊号：1007-9327

电子邮箱：wjg@wjgnet.com

电　　话：010-85381901-628

邮政编码：100025

地　　址：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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Randomized controlled trial of pancreatic stenting to prevent pancreatitis after endoscopic retrograde cholangiopancreatography

Yoshiaki KawaguchiMasami OgawaFumio OmataHiroyuki Ito...

1635-1641页

查看更多>>摘要：AIM:To determine the effectiveness of pancreatic duct (PD) stent placement for the prevention of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP) in high risk patients.METHODS:Authors conducted a single-blind,randomized controlled trial to evaluate the effectiveness of a pancreatic spontaneous dislodgement stent against post-ERCP pancreatitis,including rates of spontaneous dislodgement and complications.Authors defined high risk patients as having any of the following:sphincter of Oddi dysfunction,difficult cannulation,prior history of post-ERCP pancreatitis,pre-cut sphincterotomy,pancreatic ductal biopsy,pancreatic sphincterotomy,intraductal ultrasonography,or a procedure time of more than 30 min.Patients were randomized to a stent group (n =60) or to a non-stent group (n =60).An abdominal radiograph was obtained daily to assess spontaneous stent dislodgement.Post-ERCP pancreatitis was diagnosed according to consensus criteria.RESULTS:The mean age (± standard deviation) was 67.4 ± 13.8 years and the male:female ratio was 68:52.In the stent group,the mean age was 66 ± 13years and the male:female ratio was 33:27,and in the non-stent group,the mean age was 68 ± 14 years and the male:female ratio was 35:25.There were no significant differences between groups with respect to age,gender,final diagnosis,or type of endoscopic intervention.The frequency of post-ERCP pancreatitis in PD stent and non-stent groups was 1.7％ (1/60) and 13.3％ (8/60),respectively.The severity of pancreatitis was mild in all cases.The frequency of post-ERCP pancreatitis in the stent group was significantly lower than in the non-stent group (P =0.032,Fisher's exact test).The rate of hyperamylasemia were 30％ (18/60) and 38.3％ (23 of 60) in the stent and non-stent groups,respectively (P =0.05,x2 test).The placement of a PD stent was successful in all 60 patients.The rate of spontaneous dislodgement by the third day was 96.7％ (58/60),and the median (range) time to dislodgement was 2.1 (2-3) d.The rates of stent migration,hemorrhage,perforation,infection (cholangitis or cholecystitis) or other complicationss were 0％ (0/60),0％ (0/60),0％ (0/60),0％ (0/60),0％ (0/60),respectively,in the stent group.Univariate analysis revealed no significant differences in high risk factors between the two groups.The pancreatic spontaneous dislodgement stent safely prevented post-ERCP pancreatitis in high risk patients.CONCLUSION:Pancreatic stent placement is a safe and effective technique to prevent post-ERCP pancreatitis.Therefore authors recommend pancreatic stent placement after ERCP in high risk patients.

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Relationship between hepatitis C virus infection and type 2 diabetes mellitus: Meta-analysis

Cho NaingJoon Wah MakSyed Imran AhmedMala Maung...

1642-1651页

查看更多>>摘要：AIM:To investigate the association between hepatitis C infection and type 2 diabetes mellitus.METHODS:Observational studies assessing the relationship between hepatitis C infection and type 2 diabetes mellitus were identified via electronic and hand searches.Studies published between 1988 to March 2011 were screened,according to the inclusion criteria set for the present analysis.Authors performed separate analyses for the comparisons between hepatitis C virus (HCV) infected and not infected,and HCV infected and hepatitis B virus infected.The included studies were further subgrouped according to the study design.Heterogenity was assessed using I2 statistics.The summary odds ratios with their corresponding 95％ CIs were calculated based on a random-effects model.The included studies were subgrouped according to the study design.To assess any factor that could potentially affect the outcome,results were further stratified by age group (proportion of ≥ 40 years),gender (proportion of male gender),body mass index (BMI) (proportion of BMI ≥ 27),and family history of diabetes (i.e.,self reported).For stability of results,a sensitivity analysis was conducted including only prospective studies.RESULTS:Combining the electronic database and hand searches,a total of 35 observational studies (in 31 articles) were identified for the final analysis.Based on random-effects model,17 studies (n =286 084)compared hepatitis C-infected patients with those who were uninfected [summary odds ratio (OR):1.68,95％ CI:1.15-2.45].Of these 17 studies,7 were both a cross-sectional design (41.2％) and cohort design (41.2％),while 3 were case-control studies (17.6％).Nineteen studies (n =51 156) compared hepatitis C-infected participants with hepatitis B-infected (summary OR:1.92,95％ CI:1.41-2.62).Of these 19 studies,4(21.1％),6 (31.6％) and 9 (47.4％) were cross-sectional,cohort and case-control studies,respectively.A sensitivity analysis with 3 prospective studies indicated that hepatitis C-infected patients had a higher risk of developing type 2 diabetes compared with uninfected controls (summary odds ratio:1.41,95％ CI:1.17-1.7;I2 =0％).Among hepatitis C-infected patients,male patients (OR:1.26,95％ CI:1.03-1.54) with age over 40 years (summary OR:7.39,95％ CI:3.82-9.38) had an increased frequency of type 2 diabetes.Some caution must be taken in the interpretation of these resuits because there may be unmeasured confounding factors which may introduce bias.CONCLUSION:The findings support the association between hepatitis C infection and type 2 diabetes mellitus.The direction of association remains to be determined,however.Prospective studies with adequate sample sizes are recommended.

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A population-based cohort study of symptomatic gallstone disease in diabetic patients

Chi-Ming LiuChung-Te HsuChung-Yi LiChu-Chieh Chen...

1652-1659页

查看更多>>摘要：AIM:To investigate the prevalence of gallstone disease (GSD) and to evaluate the risk of symptomatic GSD among diabetic patients.METHODS:The study was conducted by analyzing the National Health Research Institutes (NHRI) dataset of ambulatory care patients,inpatient claims,and the updated registry of beneficiaries from 2000 to 2008.A total of 615 532 diabetic patients without a prior history of hospital treatment or ambulatory care visits for symptomatic GSD were identified in the year 2000.Age-and gender-matched control individuals free from both GSD and diabetes from 1997 to 1999 were randomly selected from the NHIR database (n =614 871).The incidence densities of symptomatic GSD were estimated according to the subjects' diabetic status.The distributions of age,gender,occupation,income,and residential area urbanization were compared between diabetic patients and control subjects using Cox proportion hazards models.Differences between the rates of selected comorbidities were also assessed in the two groups.RESULTS:Overall,60 734 diabetic patients and 48 116control patients developed symptomatic GSD and underwent operations,resulting in cumulative operation rates of 9.87％ and 7.83％,respectively.The age and gender distributions of both groups were similar,with a mean age of 60 years and a predominance of females.The diabetic group had a significantly higher prevalence of all comorbidities of interest.A higher incidence of symptomatic GSD was observed in females than in males in both groups.In the control group,females under the age of 64 had a significantly higher incidence of GSD than the corresponding males,but this difference was reduced with increasing age.The cumulative incidences of operations for symptomatic GSD in the diabetic and control groups were 13.06 and 9.52 cases per 1000 person-years,respectively.Diabetic men exhibited a higher incidence of operations for symptomatic GSD than did their counterparts in the control group (12.35vs 8.75 cases per 1000 person-years).CONCLUSION:The association of diabetes with increased symptomatic GSD may provide insight to thetreatment or management of diabetes in clinical settings.

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Swab culture monitoring of automated endoscope reprocessors after high-level disinfection

Lung-Sheng LuKeng-Liang WuYi-Chun ChiuMing-Tzung Lin...

1660-1663页

查看更多>>摘要：AIM:To conduct a bacterial culture study for monitoring decontamination of automated endoscope reprocessors (AERs) after high-level disinfection (HLD).METHODS:From February 2006 to January 2011,authors conducted randomized consecutive sampling each month for 7 AERs.Authors collected a total of 420 swab cultures,including 300 cultures from 5 gastroscope AERs,and 120 cultures from 2 colonoscope AERs.Swab cultures were obtained from the residual water from the AERs after a full reprocessing cycle.Samples were cultured to test for aerobic bacteria,anaerobic bacteria,and mycobacterium tuberculosis.RESULTS:The positive culture rate of the AERs was 2.0％ (6/300) for gastroscope AERs and 0.8％ (1/120)for colonoscope AERs.All the positive cultures,including 6 from gastroscope and 1 from colonoscope AERs,showed monofloral colonization.Of the gastroscope AER samples,50％ (3/6) were colonized by aerobic bacterial and 50％ (3/6) by fungal contaminations.CONCLUSION:A full reprocessing cycle of an AER with HLD is adequate for disinfection of the machine.Swab culture is a useful method for monitoring AER decontamination after each reprocessing cycle.Fungal contamination of AERs after reprocessing should also be kept in mind.

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Prognostic significance of PTEN, Ki-67 and CD44s expression patterns in gastrointestinal stromal tumors

Yu-Mei LiangXiang-Hong LiWen-Mei LiYou-Yong Lu...

1664-1671页

查看更多>>摘要：AIM:To develop a prognostic approach for gastrointestinal stromal tumors (GISTs) using a cluster of indicators and follow-up information.METHODS:One hundred and four GISTs that had not been subjected to targeted therapies were collected and classified by NIH risk assessment and anatomic location.By immunohistochemistry,the expressions of PTEN,Ki-67,CD44s matrix metalloproteinase (MMP)-9 and TIMP-1 were detected on tissue microarray.Univariate and multimarker survival analyses were performed and then a COX hazard proportion model was constructed to evaluate a cluster of predictors of GIST.RESULTS:Our data showed small intestinal GIST are more aggressive than gastric GIST.The NIH risk assessment correlated with disease-free survival for either gastric GIST or small intestinal GIST.Immunohistochemical analysis revealed that Ki-67 labeling indexes (LIs) ＜ 5％ predicted higher disease-specific survival (DSS) in gastric and small intestinal GIST.CD44s positivity and PTEN LIs ≥ 50％ correlated with higher DSS in gastric GIST.MMP-9 and TIMP-1 had no correlation with survival.Multimarker analysis revealed that the expression pattern of PTEN LIs ≥ 50％ combined with Ki-67 LIs ＜ 5％ and CD44s positivity reliably predicted favorable outcomes for gastric GIST (P =0.009),as did the combination of PTEN LIs ≥ 50％ and Ki-67 LIs ＜5％ for small intestinal GIST (P =0.011).Authors also found that high NIH risk grade was correlated with DSS in patients with gastric GIST and disease-free survival in patients with small intestinal GIST.CONCLUSION:PTEN LIs ≥ 50％,Ki-67 LIs ＜ 5％ and CD44s positivity provides an accurate,favorable prognosis for gastric GIST.PTEN LIs ≥ 50％ and Ki-67 LIs ＜ 5％ does the same for small intestinal GIST.Ki-67 LIs enhances the NIH assessment.

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Vitamin D receptor gene polymorphisms and colorectal cancer risk: A systematic meta-analysis

Yong-Heng BaiHong LuDan HongCheng-Cheng Lin...

1672-1679页

查看更多>>摘要：AIM:To investigate the relationship between polymorphisms present in the vitamin D receptor (VDR) gene and colorectal cancer risk,a systematic meta-analysis of population-based studies was performed.METHODS:A total of 38 relevant reports published between January 1990 and August 2010 were identified,of which only 23 qualified for this meta-analysis based on our selection criteria.Five polymorphic variants of the VDR gene,including Cdx-2 (intron 1e) and FokI (exon 2) present in the 5' region of the gene,and BsmI (intron 8),ApaI (intron 8),and TaqI (exon 9) sites present in the 3' untranslated region (UTR),were evaluated for possible associations with colorectalcancer risk.Review manager 4.2 was used to perform statistical analyses.RESULTS:In the meta-analysis performed,only the BsmI polymorphism was found to be associated with colorectal cancer risk.In particular,the BsmI B genotype was found to be related to an overall decrease in the risk for colorectal cancer [BB vs bb:odds ratio (OR) =0.87,95％ CI:0.80-0.94,P =3 x 10-4; BB vs Bb + bb:OR =0.90,95％ CI:0.84-0.97,P =5 x 10-4].Moreover,in subgroup analyses,the BsmI B genotype was significantly associated with colon cancer,and not rectal cancer.An absence of between-study heterogeneity was also observed.CONCLUSION:A meta-analysis of 23 published studies identified the BsmI polymorphism of the VDR gene to be associated with an increased risk of colon cancer.

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Heme oxygenase-1 prevents liver fibrosis in rats by regulating the expression of PPARγ and NF-κB

Hui YangLong-Feng ZhaoZhong-Fu ZhaoYan Wang...

1680-1688页

查看更多>>摘要：AIM:To investigate the effects of heme oxygenase (HO)-1 on liver fibrosis and the expression of peroxisome proliferator-activated receptor gamma (PPARγ)and nuclear factor-kappa B (NF-κB) in rats.METHODS:Sixty Wistar rats were used to construct liver fibrosis models and were randomly divided into 5 groups:group A (normal,untreated),group B (model for 4 wk,untreated),group C (model for 6 wk,untreated),group D [model for 6 wk,treated with zinc protoporphyrin Ⅸ (ZnPP-Ⅸ) from week 4 to week 6],group E (model for 6 wk,treated with hemin from week 4 to week 6).Next,liver injury was assessed by measuring serum alanine aminotransferase (ALT),aspartate aminotransferase (AST) and albumin levels.The degree of hepatic fibrosis was evaluated by measuring serum hyaluronate acid (HA),type Ⅳ collagen (IV-C) and by histological examination.Hydroxyproline (Hyp) content in the liver homogenate was determined.The expression levels of alpha-smooth muscle actin (α-SMA) in liver tissue were measured by real-time quantitative polymerase chain reaction (RT-PCR).The expression levels of PPARγ,and NF-KB were determined by RT-PCR and Western blotting.RESULTS:The expression of HO-1 increased with the development of fibrosis.Induction of HO-1 by hemin significantly attenuated the severity of liver injury and the levels of liver fibrosis as compared with inhibition of HO-1 by ZnPP-Ⅸ.The concentrations of serum ALT,AST,HA and IV-C in group E decreased compared with group C and group D (P ＜ 0.01).Amount of Hyp and α-SMA in the liver tissues in group E decreased compared with group C (0.62 ± 0.14 vs 0.84 ± 0.07,1.42 ±0.17 vs 1.84 ± 0.17,respectively,P ＜ 0.01) and group D (0.62-0.14 vs 1.11 ± 0.16,1.42 ± 0.17 vs 2.56 ±0.37,respectively,P ＜ 0.01).The expression of PPARγ at levels of transcription and translation decreased with the development of fibrosis especially in group D; and it increased in group E compared with groups C and D (0.88 ± 0.15 vs 0.56 ± 0.19,0.88 ± 0.15 vs 0.41 ±0.11,respectively,P ＜ 0.01).The expression of NF-κB increased with the development of fibrosis especially in group D; and it decreased in group E compared with groups C and D (1.43 ± 0.31 vs 1.89 ± 0.29,1.43 ± 0.31vs 2.53 ± 0.54,respectively,P ＜ 0.01).CONCLUSION:Our data demonstrate a potential mechanism that HO-1 can prevent liver fibrosis by enhancing the expression of PPARγ,and decreasing the expression of NF-κB in liver tissues.

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Treatment of cholecystitis with Chinese herbal medicines: A systematic review of the literature

Zhi-Yong DongGuan-Liang WangXing LiuJia Liu...

1689-1694页

查看更多>>摘要：AIM:To analyze the literature on the use of Chinese herbal medicines for the treatment of cholecystitis.METHODS:The literature on treatment of cholecystitis with traditional Chinese medicines (TCM) was analyzed based on the principles and methods described by evidence-based medicine (EBM).Eight databases including MEDLINE,EMbase,Cochrane Central (CCTR),four Chinese databases (China Biological Medicine Database,Chinese National Knowledge Infrastructure Database,Database of Chinese Science and Technology Periodicals,Database of Chinese Ministry of Science and Technology) and Chinese Clinical Registry Center,were searched.Full text articles or abstracts concerning TCM treatment of cholecystitis were selected,categorized according to study design,the strength of evidence,the first author's hospital type,and analyzed statistically.RESULTS:A search of the literature published from 1977 through 2009 yielded 1468 articles in Chinese and 9 in other languages; and 93.92％ of the articles focused on clinical studies.No article was of level I evidence,and 9.26％ were of level Ⅱ evidence.The literature cited by Science Citation Index (SCI),MEDLINE and core Chinese medical journals accounted for 0.41％,0.68％ and 7.29％,respectively.Typically,the articles featured in case reports of illness,examined from the perspective of EBM,were weak in both quality and evidence level,which inconsistently conflicted with the fact that most of the papers were by authors from Level-3 hospitals,the highest possible level evaluated based on their comprehensive quality and academic authenticity in China.CONCLUSION:The published literature on TCM treatment of cholecystitis is of low quality and based on low evidence,and cognitive medicine may functions as a useful supplementary framework for the evaluation.

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High resolution impedance manometric findings in dysphagia of Huntington's disease

Tae Hee LeeJoon Seong LeeWan Jung Kim

1695-1699页

查看更多>>摘要：Conventional manometry presents significant challenges,espedally in assessment of pharyngeal swallowing,because of the asymmetry and deglutitive movements of oropharyngeal structures.It only provides information about intraluminal pressure and thus it is difficult to study functional details of esophageal motility disorders.New technology of solid high resolution impedance manometry (HRIM),with 32 pressure sensors and 6 impedance sensors,is likely to provide better assessment of pharyngeal swallowing as well as more information about esophageal motility disorders.However,the clinical usefulness of application of HRIM in patients with oropharyngeal dysphagia or esophageal dysphagia is not known.We experienced a case of Huntington's disease presenting with both oropharyngeal and esophageal dysphagia,in which HRIM revealed the mechanism of oropharyngeal dysphagia and provided comprehensive information about esophageal dysphagia.

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Rifaximin for the prevention of spontaneous bacterial peritonitis

Georgios N KalambokisAthanasia MouzakiMaria RodiEpameinondas V Tsianos...

1700-1702页

查看更多>>摘要：According to a review article by Biecker etal published in a previous issue of World Journal of Gastroenterology in March 2011,intestinal decontamination with norfloxacin remains the mainstay of primary prophylaxis of spontaneous bacterial peritonitis (SBP) at the expense of development of quinolone-resistant bacteria after long-term use.In our research,the administration of a 4-wk regimen with rifaximin 1200 mg/d reduced significantly the ascitic neutrophil count in cirrhotic patients with sterile ascites in line with a significant decrease in plasma endotoxin levels.Our observations concur with recent findings,showing a significantly reduced 5-year probability of SBP in cirrhotic patients taking rifaximin.

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