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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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    Cyclooxygenase-2 expression as a predictor of outcome in colorectal carcinoma

    Jaudah AI-MaghrabiAbdelbaset BuhrneidaEman EmamKari Syrj(a)nen...
    1793-1799页
    查看更多>>摘要：AIM:To correlate cyclooxygenase-2 (COX-2) expression profile with clinical and pathological variables to assess their prognostic/predictive value in colorectal carcinoma (CRC).METHODS:Archival tumor samples were analyzed using immunohistochemistry for COX-2 expression in 94patients with CRC.Patients were diagnosed and treated at the Departments of Surgery and Oncology,King Abdulaziz University Hospital,Saudi Arabia.RESULTS:Fifty-six percent of the tumors showed positive cytoplasmic COX-2 expression,whereas 44％ of cases were completely COX-2-negative.There were no significant correlations between COX-2 expression and sex,age,grade or tumor location.However,COX-2 expression revealed a significant correlation with tumor stage (P =0.01) and distant metastasis (P =0.02),and a borderline association with lymph node involvement (P=0.07).Tumors with high COX-2 expression showed a higher recurrence rate than tumors with no expression (P ＜ 0.009).In univariate Kaplan-Meier survival analysis,there was a significant (P =0.026) difference in disease-free survival between COX-2-positive and negative tumors in favor of the latter.COX-2 expression did not significantly predict disease-specific survival,which was much shorter for COX-2-positive tumors.In multivariate (COX) models,COX-2 did not appear among the independent predictors of disease-free survival or disease-specific survival.CONCLUSION:COX-2 expression seems to provide useful prognostic information in CRC,while predicting the patients at high risk for recurrent disease.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Patient and physician perception of natural orifice transluminal endoscopic appendectomy

    Tomas HuclAdela SaglovaMarek BenesMatej Kocik...
    1800-1805页
    查看更多>>摘要：AIM:To investigate perception of natural orifice transluminal endoscopic surgery (NOTES) as a potential technique for appendectomy.METHODS:One hundred patients undergoing endoscopy and 100 physicians were given a questionnaire describing in detail the techniques of NOTES and laparoscopic appendectomy.They were asked about the reasons for their preference,choice of orifice,and extent of complication risk they were willing to accept.RESULTS:Fifty patients (50％) and only 21 physicians (21％) preferred NOTES (P ＜ 0.001).Patients had previously heard of NOTES less frequently (7％ vs 73％,P ＜ 0.001) and had undergone endoscopy more frequently (88％ vs 36％,P ＜ 0.001) than physicians.Absence of hernia was the most common reason for NOTES preference in physicians (80％ vs 44％,P =0.003),whereas reduced pain was the most common reason in patients (66％ vs 52％).Physicians were more likely to refuse NOTES as a novel and unsure technique (P ＜ 0.001) and having an increased risk of infection (P ＜ 0.001).The preferred access site in both groups was colon followed by stomach,with vagina being rarely preferred.In multivariable modeling,those with high-school education [odds ratio (OR):2.68,95％confidence interval (CI):1.23-5.83] and prior colonoscopy (OR:2.10,95％ CI:1.05-4.19) were more likely to prefer NOTES over laparoscopic appendectomy.There was a steep decline in NOTES preference with increased rate of procedural complications.Male patients were more likely to consent to their wives vaginal NOTES appendectomy than male physicians (P =0.02).CONCLUSION:The preference of NOTES for appendectomy was greater in patients than physicians and was related to reduced pain and absence of hernia rather than lack of scarring.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Differential expression of Rab27A/B correlates with clinical outcome in hepatocellular carcinoma

    Wei-Wei DongQuan MouJian ChenJian-Tao Cui...
    1806-1813页
    查看更多>>摘要：AIM:To investigate the association of Rab27A and Rab27B expression with clinicopathological characteristics and prognosis of hepatocellular carcinoma (HCC).METHODS:We used reverse transcription polymerase chain reaction (RT-PCR),real-time PCR,and Western blotting to detect Rab27A and Rab27B mRNA and protein expression in 5 human HCC lines and the immortalized hepatic HL-7702 cell line.We further examined 148 primary HCC samples matched with adjacent normal tissue and 80 non-HCC specimens by immunohistochemistry to evaluate the correlation of Rab27A and Rab27B expression with clinicopathological features and prognosis.RESULTS:Our data showed that Rab27A and Rab27Bwere differentially expressed in cell lines and primary HCC tumors.Rab27A mRNA and protein were detected in 67％ (4/6) of human cell lines and 80％ (4/5) of HCC cell lines,while Rab27B was found in 50％ (3/6) of human lines and 40％ (2/5) of HCC lines.Rab27A expression was higher in primary HCC (46.2％,66/143) than in matched adjacent tissue (24.3％,33/136,P ＜ 0.001),whereas immunopositivity for Rab27B was lower in primary HCC (57.4％,81/141) than in matched adjacent tissue (87.5％,119/136,P ＜ 0.001).Analysis of clinicopathological characteristics of 148 HCC specimens revealed significant correlations between Rab27A and Rab27B expression and tumor tumor-node-metastasis (TNM) classification (P =0.046 and P =0.027,respectively),and between strong Rab27A expression and tumor differentiation grade (P =0.008).Survival analyses revealed that patients with Rab27A+ or Rab27B+ tumors had significantly reduced overall survival compared with that of patients with Rab27A or Rab27B tumors (P =0.015 and P =0.005,respectively).Risk analyses revealed that Rab27B+ and TNM Ⅲ-Ⅳ were independent poor prognosis factors associated with a 3.36-and 3.37-fold higher relative risk of death,respectively.CONCLUSION:Rab27A and Rab27B expression were closely correlated with tumor progression and can be valuable prognostic indicators for HCC patients.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Propofol vs midazolam plus fentanyl for upper gastrointestinal endomicroscopy: A randomized trial

    Xiu-Li ZuoZhen LiXiao-Ping LiuChang-Qing Li...
    1814-1821页
    查看更多>>摘要：AIM:To compare the endomicroscopic image quality of integrated confocal laser endomicroscopy (iCLE) and sedation efficacy of propofol vs midazolam plus fentanyl (M/F).METHODS:Consecutive outpatients undergoing iCLE were prospectively recruited and randomized to the propofol group (P group) or M/F group.The patient,performing endoscopist and endoscopic assistant were blinded to the randomization.The quality of endomicro<scopic images and anesthetic efficacy outcomes were blindly evaluated after iCLE examination.RESULTS:There were significantly more good quality endomicroscopic images in the propofol group than in the M/F group (72.75％ vs 52.89％,P ＜ 0.001).The diagnostic accuracy for upper gastrointestinal mucosal lesions using confocal laser endomicroscopy favors the P group,although this did not reach statistical significance.Adverse events and patient assessment were not significantly different for M/F vs propofol except for more frequent intraprocedural recall with M/F.Procedure duration and sedation times were significantly longer in the M/F group,while the scores of endoscopist,anesthetist and assistant assessment were all significantly better in the P group.CONCLUSION:Sedation with propofol might increase the proportion of good quality endomicroscopic images,and may result in improved procedural efficacy and diagnostic accuracy during iCLE examination.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    Decompression of the small bowel by endoscopic long-tube placement

    Shi-Bin GuoZhi-Jun Duan
    1822-1826页
    查看更多>>摘要：AIM:To investigate and compare the decompression effect on small bowel obstruction of a long tube inserted using either endoscopic or fluoroscopic placement.METHODS:Seventy-eight patients with small bowel obstruction requiring decompression were enrolled in the study and divided into two groups.Intubation of a long tube was guided by fluoroscopy in one group and by endoscopy in the other.The duration of the procedure and the success rate for each group were evaluated.RESULTS:A statistically significant difference in the mean duration of the procedure was found between the fluoroscopic group (32.6 ± 14.6 min) and the endoscopic group (16.5 ± 7.8 min) among the cases classified as successful (P ＜ 0.05).The success rate was significantly different between the groups:88.6％ in the fluoroscopic group and 100％ in the endoscopic group (P＜ 0.05).CONCLUSION:For patients with adhesive small bowel obstruction,long-tube decompression is recommended and long-tube insertion by endoscopy was superior to fluoroscopic placement.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    KISS-1 inhibits the proliferation and invasion of gastric carcinoma cells

    Na LiHong-Xing WangJie ZhangYa-Ping Ye...
    1827-1833页
    查看更多>>摘要：AIM:To investigate the function of the KISS-1 gene in gastric carcinoma cells and to explore its potential mechanism.METHODS:A KISS-1 eukaryotic expression vector was constructed and transfected into BGC-823 cells.Resistant clones were obtained through G418 selection.reverse transcription-polymerase chain reaction and western blotting were used to detect KISS-1 and matrix metalloproteinase-9 (MMP-9) expression in transfected cells.The growth of transfected cells was investigated by 3-(4,5-dimethylthiazolyl-2)-2,5-diphenyltetrazolium bromide (MTT) proliferation assays,and the cells' invasive potential was analyzed by basement membrane (Matrigel) invasion assays.The anti-tumor effects of KISS-1 were tested in vivo using allografts in nude mice.RESULTS:The expression level of KISS-1 mRNA and protein in BGC-823/KISS-1 transfected cells were significantly higher than in BGC-823/pcDNA3.1 transfected cells (P ＜ 0.05) or the parental BGC-823 cell line (P ＜0.05).The expression level of MMP-9 mRNA and protein in BGC-823/KISS-1 were significantly less than in BGC-823/pcDNA3.1 (P ＜ 0.05) or BGC-823 cells (P ＜0.05).MlT growth assays show the proliferation of BGC-823/KISS-1 cells at 48 h (0.642 ± 0.130) and 72h (0.530 ± 0.164) were significantly reduced compared to BGC-823/pcDNA3.1 (0.750 ± 0.163,0.645 ± 0.140)(P ＜ 0.05) and BGC-823 cells (0.782 ± 0.137,0.685 ±0.111) (P ＜ 0.05).Invasion assays indicate the invasive potential of BGC-823/KISS-1 cells (16.50 ± 14.88) is significantly reduced compared to BGC-823/pcDNA3.1(20.22 ± 14.87) (P ＜ 0.05) and BGC-823 cells after 24h (22.12 ± 16.12) (P ＜ 0.05).In vivo studies demonstrate the rate of pcDNA3.1-KISS-1 tumor growth is significantly slower than pcDNA3.1 and control cell tumor growth in nude mice.Furthermore,tumor volume of pcDNA3.1-KISS-1 tumors (939.38 ± 82.08 mm3) was significantly less than pcDNA3.1 (1250.46±44.36 mm3)and control tumors (1284.36 ± 55.26 mm3) (P ＜ 0.05).Moreover,the tumor mass of pcDNA3.1-KISS-1 tumors (0.494 ± 0.84 g) was significantly less than pcDNA3.1(0.668 ± 0.55 g) and control tumors (0.682 ± 0.38 g) (P＜ 0.05).CONCLUSION:KISS-1 may inhibit the proliferation and invasion of gastric carcinoma cells in vitro and in vivo through the downregulation of MMP-9.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Preoperative predictors of portal vein thrombosis after splenectomy with periesophagogastric devascularization

    Yu ZhangTian-Fu WenLu-Nan YanHong-Ji Yang...
    1834-1839页
    查看更多>>摘要：AIM:To evaluate the predictive value of preoperative predictors for portal vein thrombosis (PVT) after splenectomy with periesophagogastric devascularization.METHODS:In this prospective study,69 continuous patients with portal hypertension caused by hepatitis B cirrhosis underwent splenectomy with periesophagogastric devascularization in West China Hospital of Sichuan University from January 2007 to August 2010.The portal vein flow velocity and the diameter of portal vein were measured by Doppler sonography.The hepatic congestion index and the ratio of velocity and diameter were calculated before operation.The prothrombin time (PT) and platelet (PLT) levels were measured before and after operation.The patients' spleens were weighed postoperatively.RESULTS:The diameter of portal vein was negatively correlated with the portal vein flow velocity (P ＜ 0.05).Thirty-three cases (47.83％) suffered from postoperative PVT.There was no statistically significant difference in the Child-Pugh score,the spleen weights,the PT,or PLT levels between patients with PVT and without PVT.Receiver operating characteristic curves showed four variables (portal vein flow velocity,the ratio of velocity and diameter,hepatic congestion index and diameter of portal vein) could be used as preoperative predictors of postoperative portal vein thrombosis.The respective values of the area under the curve were 0.865,0.893,0.884 and 0.742,and the respective cut-off values (24.45 cm/s,19.4333/s,0.1138 cm/s-1 and 13.5 mm)were of diagnostically efficient,generating sensitivity values of 87.9％,93.9％,87.9％ and 81.8％,respectively,specificities of 75％,77.8％,86.1％ and 63.9％,respectively.CONCLUSION:The ratio of velocity and diameter was the most accurate preoperative predictor of portal vein thrombosis after splenectomy with periesophagogastric devascularization in hepatitis B cirrhosis-related portal hypertension.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Gastric angiodysplasia in a hereditary hemorrhagic telangiectasia type 2 patient

    Minsu HaYoon Jae KimKwang An KwonKi Baik Hahm...
    1840-1844页
    查看更多>>摘要：Hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal-dominantly inherited disease that occurs in approximately one in 5000 to 8000 people.Clinical diagnosis of HHT is made when a person presents three of the following four criteria:family history,recurrent nosebleeds,mucocutaneous telangiectasis,and arteriovenous malformations (AVM) in the brain,lung,liver and gastrointestinal (GI) tract.Although epistaxis is the most common presenting symptom,AVMs affecting the lungs,brain and GI tract provoke a more serious outcome.Heterozygous mutations in endoglin,activin receptor-like kinase 1 (ACVRL1; ALK1),and SMAD4,the genes involved in the transforming growth factor-β family signaling cascade,cause HHT.We report here the case of a 63 year-old male patient who presented melena and GI bleeding episodes,proven to be caused by bleeding from multiple gastric angiodysplasia.Esophagogastroduodenoscopy revealed multiple angiodysplasia throughout the stomach.Endoscopic argon plasma coagulation was performed to control bleeding from a gastric angiodysplasia.The patient has been admitted several times with episodes of hemoptysis and hematochezia.One year ago,the patient was hospitalized due to right-sided weakness,which was caused by left basal ganglia hemorrhage as the part of HHT presentation.In family history,the patient's mother and elder sister had died,due to intracranial hemorrhage,and his eldest son has been suffered from recurrent epistaxis for 20 years.A genetic study revealed a mutation in exon 3 of ALK1 (c.199C ＞ T; p.Arg67Trp) in the proband and his eldest son presenting epistaxis.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Solitary gastric Peutz-Jeghers type stomach polyp mimicking a malignant gastric tumor

    Jong-Shiaw JinJi-Kuen YuTang-Yi TsaoLien-Fu Lin...
    1845-1848页
    查看更多>>摘要：Most cases of Peutz-Jeghers type polyps of the stomach are associated with mucocutaneous pigmentation and multiple intestinal polyposis.A solitary PeutzJeghers type polyp of the stomach is rare.We here report a case of a 71-year-old woman with a solitary Peutz-Jeghers type polyp of the stomach who presented with intolerable epigastric pain and weight loss of 5 kg over the prior two months.During the hospital treatment course for this patient,endoscopic examination revealed a bulging lesion with a central hole,mucosal ulceration,an asymmetrical wall thickness and a narrowing of the gastric lumen.A gastric biopsy further revealed ulceration with moderate dysplasia.The patient received endoscopic ultrasonography which showed a second subepithelial lesion that measured 4 cm × 3 cm.Computed tomography of the abdomen subsequently showed a thickened gastric wall with three visibly enlarged lymph nodes,all greater than 1 cm.The suspected diagnosis was malignant gastric cancer with lymph node metastases.The other lesion,which measured 2 cm × 2 cm × 1 cm was noted in the submucosa of the jejunum during surgery.The patient was treated using a subtotal gastrectomy and partial resection of the jejunal tumor.The final pathological report indicated a gastric Peutz-Jeghers type polyp with proliferation of smooth muscle bundles in the submucosal layer,and hyperplastic glands in the mucosal layer and ectopic pancreas of the jejunum.This is the first reported clinical case of a solitary Peutz-Jeghers type polyp of the stomach accompanying a lymph node enlargement and ectopic pancreas in the jejunum that simulates stomach cancer with lymph node metastases.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    What is the optimal treatment for appendiceal mass formed after acute perforated appendicitis?

    Enver ZeremGoran Imamovi(c)Farid LjucaJasmina Alid(z)anovi(c)...
    1849-1850页
    查看更多>>摘要：We read with great interest the editorial article by Meshikhes AWN published in issue 25 of World J Gastroenterol 2011.The article described the advantages of emergency laparoscopic appendectomy compared with interval appendectomy as a new safe treatment modality for the appendiceal mass.The author concluded that the emergency laparoscopic appendectomy was a safe treatment modality for the appendiceal mass,and might prove to be more cost-effective than conservative treatment,with no need for interval appendectomy.However,we would like to highlight certain issues regarding the possibility of percutaneous catheter drainage to successfully treat the appendiceal mass,with no need for appendectomy,too.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普