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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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    Age, smoking and overweight contribute to the development of intestinal metaplasia of the cardia

    Christian FelleyHanifa BouzoureneMarianne Bründler G VanMelleAntoine Hadengue...
    2076-2083页
    查看更多>>摘要：AIM:To assess the role of Helicobacterpylori (H.pylori),gastroesophageal reflux disease (GERD),age,smoking and body weight on the development of intestinal metaplasia of the gastric cardia (IMC).METHODS:Two hundred and seventeen patients scheduled for esophagogastroduodenoscopy were enrolled in this study.Endoscopic biopsies from the esophagus,gastroesophageal junction and stomach were evaluated for inflammation,the presence of H.pylori and intestinal metaplasia.The correlation of these factors with the presence of IMC was assessed using logistic regression.RESULTS:IMC was observed in 42％ of the patients.Patient age,smoking habit and body mass index (BMI)were found as potential contributors to IMC.The risk of developing IMC can be predicted in theory by combining these factors according to the following formula:Risk of IMC =a + s-2B where a =2,...6 decade of age,s =0for non-smokers or ex-smokers,1 for ＜ 10 cigarettes/d,2 for ＞ 10 cigarettes/d and B =0 for BMI ＜ 25 kg/m2 (BMI ＜ 27 kg/m2 in females),1 for BMI ＞ 25 kg/m2 (BMI ＞ 27 kg/m2 in females).Among potential factors associated with IMC,H.pylori had borderline significance (P =0.07),while GERD showed no significance.CONCLUSION:Age,smoking and BMI are potential factors associated with IMC,whileH.pylori and GERDshow no significant association.IMC can be predicted in theory by logistic regression analysis.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    Rifaximin, but not growth factor 1, reduces brain edema in cirrhotic rats

    Gemma (ò)denaMireia MiquelAnna SerafínAmparo Galan...
    2084-2091页
    查看更多>>摘要：AIM:To compare rifaximin and insulin-like growth factor (IGF)-1 treatment of hyperammonemia and brain edema in cirrhotic rats with portal occlusion.METHODS:Rats with CCl4-induced cirrhosis with ascites plus portal vein occlusion and controls were randomized into six groups:Cirrhosis; Cirrhosis + IGF-1;Cirrhosis + rifaximin; Controls; Controls + IGF-1; and Controls + rifaximin.An oral glutamine-challenge test was performed,and plasma and cerebral ammonia,glucose,bilirubin,transaminases,endotoxemia,brain water content and ileocecal cultures were measured and liver histology was assessed.RESULTS:Rifaximin treatment significantly reduced bacterial overgrowth and endotoxemia compared with cirrhosis groups,and improved some liver function parameters (bilirubin,alanine aminotransferase and aspartate aminotransferase).These effects were associated with a significant reduction in cerebral water content.Blood and cerebral ammonia levels,and area-underthe-curve values for oral glutamine-challenge tests were similar in rifaximin-treated cirrhotic rats and control group animals.By contrast,IGF-1 administration failed to improve most alterations observed in cirrhosis.CONCLUSION:By reducing gut bacterial overgrowth,only rifaximin was capable of normalizing plasma and brain ammonia and thereby abolishing low-grade brain edema,alterations associated with hepatic encephalopathy.
      原文链接:
    • NETL
    • NSTL
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    New reduced volume preparation regimen in colon capsule endoscopy

    Yasuo KakugawaYutaka SaitoShoichi SaitoKenji Watanabe...
    2092-2098页
    查看更多>>摘要：AIM:To evaluate the effectiveness of our proposed bowel preparation method for colon capsule endoscopy.METHODS:A pilot,multicenter,randomized controlled trial compared our proposed "reduced volume method" (group A) with the "conventional volume method" (group B) preparation regimens.Group A did not drink polyethylene glycol electrolyte lavage solution (PEGELS) the day before the capsule procedure,while group B drank 2 L.During the procedure day,groups A and B drank 2 L and 1 L of PEG-ELS,respectively,and swallowed the colon capsule (PillCam COLON(R) capsule).Two hours later the first booster of 100 g magnesium citrate mixed with 900 mL water was administered to both groups,and the second booster was administered six hours post capsule ingestion as long as the capsule had not been excreted by that time.Capsule videos were reviewed for grading of cleansing level.RESULTS:Sixty-four subjects were enrolled,with results from 60 analyzed.Groups A and B included 31 and 29 subjects,respectively.Twenty-nine (94％) subjects in group A and 25 (86％) subjects in group B had adequate bowel preparation (ns).Twenty-two (71％) of the 31 subjects in group A excreted the capsule within its battery life compared to 16 (55％) of the 29 subjects in group B (ns).Of the remaining 22 subjects whose capsules were not excreted within the battery life,all of the capsules reached the left side colon before they stopped functioning.A single adverse event was reported in one subject who had mild symptoms of nausea and vomiting one hour after starting to drink PEG-ELS,due to ingesting the PEG-ELS faster than recommended.CONCLUSION:Our proposed reduced volume bowel preparation method for colon capsule without PEG-ELS during the days before the procedure was as effective as the conventional volume method.
      原文链接:
    • NETL
    • NSTL
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    Differences between diffuse and focal autoimmune pancreatitis

    Taku TabataTerumi KamisawaKensuke TakumaSeiichi Hara...
    2099-2104页
    查看更多>>摘要：AIM:To investigate differences in clinical features between diffuse-and focal-type autoimmune pancreatitis (AIP).METHODS:Based on radiological findings by computed tomography and/or magnetic resonance imaging,we divided 67 AIP patients into diffuse type (D type)and focal type (F type).We further divided F type into head type (H type) and body and/or tail type (B/T type)according to the location of enlargement.Finally,we classified the 67 AIP patients into three groups:D type,H type and B/F type.We compared the three types of AIP in terms of clinical,laboratory,radiological,functional and histological findings and clinical course.RESULTS:There were 34 patients with D-type,19 with H-type and 14 with B/T-type AIP.Although obstructive jaundice was frequently detected in D-type patients (88％) and H-type patients (68％),no B/T-type patients showed jaundice as an initial symptom (P ＜ 0.001).There were no differences in frequency of abdominal pain,but acute pancreatitis was associated more frequently in B/T-type patients (36％) than in D-type patients (3％) (P =0.017).Serum immunoglobulin G (IgG)4 levels were significantly higher in D-type patients (median 309 mg/dL) than in B/T-type patients (133.5 mg/dL) (P =0.042).Serum amylase levels in B/T-type patients (median:114 IU/L) were significantly greater than in H-type patients (72 IU/L) (P =0.049).Lymphoplasmacytic sclerosing pancreatitis (LPSP) was histologically confirmed in 6 D-type,7 H-type and 4 B/T-type patients; idiopathic duct-centric pancreatitis was observed in no patients.Marked fibrosis and abundant infiltration of CD20-positive B lymphocytes with few IgG4-positive plasma cells were detected in 2 B/T-type patients.Steroid therapy was effective in all 50 patients (31 D type,13 H type and 6 B/T type).Although AIP relapsed during tapering or after stopping steroids in 3 D-type and 3 H-type patients,no patients relapsed in B/T type.During follow-up,radiological features of 6 B/T-type patients were not changed and 1 B/T-type patient improved naturally.CONCLUSION:Clinical features of H-type AIP were similar to those of D-type,but B/T-type differed from D and H types.B/T-type may involve diseases other than LPSP.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Study of Helicobacter pylori genotype status in saliva,dental plaques, stool and gastric biopsy samples

    Hassan MomtazNegar SouodHossein DabiriMeysam Sarshar...
    2105-2111页
    查看更多>>摘要：AIM:To compare genotype of Helicobacter pylori (H.pylori) isolated from saliva,dental plaques,gastric biopsy,and stool of each patient in order to evaluate the mode of transmission ofH.pylori infection.METHODS:This cross-sectional descriptive study was performed on 300 antral gastric biopsy,saliva,dental plaque and stool samples which were obtained from patients undergoing upper gastrointestinal tract endoscopy referred to endoscopy centre of Hajar hospital of Shahrekord,Iran from March 2010 to February 2011.Initially,H.pylori strains were identified by rapid urease test (RUT) and polymerase chain reaction (PCR)were applied to determine the presence of H.pylori (ureC) and for genotyping of voculating cytotoxin gene A (vacA) and cytotoxin associated gene A (cagA) genes in each specimen.Finally the data were analyzed by using statistical formulas such as Chi-square and Fisher's exact tests to find any significant relationship between these genes and patient's diseases.P ＜ 0.05 was considered statistically significant.RESULTS:Of 300 gastric biopsy samples,77.66％were confirmed to be H.pylori positive by PCR assay while this bacterium were detected in 10.72％ of saliva,71.67％ of stool samples.We were not able to find it in dental plaque specimens.The prevalence of H.pylori was 90.47％ among patients with peptic ulcer disease (PUD),80％ among patients with gastric cancer,and 74.13％ among patients with none ulcer dyspepsia (NUD) by PCR assay.The evaluation of vacA and cagA genes showed 6 differences between gastric biopsy and saliva specimens and 11 differences between gastric and stool specimens.94.42％ ofH.pylori positive specimens were cagA positive and all samples had amplified band both for vacA s and m regions.There was significant relationship between vacA s1a/m1a and PUD diseases (P =0.04),s2/m2 genotype and NUD diseases (P =0.05).No statically significant relationship was found between cagA status with clinical outcomes and vacA genotypes (P =0.65).The evaluation of vacA and cagA genes showed 6 differences between gastric biopsy and saliva specimens and 11 differences between gastric and stool specimens.CONCLUSION:Regard to high similarity in genotype ofH.pylori isolates from saliva,stomach and stool,this study support the idea which fecal-oral is the main route of H.pylori transmission and oral cavity may serve as a reservoir for H.pylori,however,remarkable genotype diversity among stomach,saliva and stool samples showed that more than one H.pylori genotype may exist in a same patient.
      原文链接:
    • NETL
    • NSTL
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    Association of NOD1 and NOD2 genes polymorphisms with Helicobacter pylori related gastric cancer in a Chinese population

    Peng WangLi ZhangJian-Ming JiangDan Ma...
    2112-2120页
    查看更多>>摘要：AIM:To investigate the association between the tag single nucleotide polymorphisms (TagSNPs) of NOD1 and NOD2 and the risk of developing gastric cancer.METHODS:We conducted a hospital-based case-control study including 296 incident gastric cancer patients and 160 gastritis controls.Eight TagSNPs in the NOD1 and NOD2 genes were selected from the Hapmap database using the haploview software and genotyped by the Sequenom MassArray system.The serum levels of anti-Helicobacter pylori (H.pylori) IgG were measured by enzyme-linked immunosorbent assay to indicate H.pylori infection.The odds ratios (OR) and 95％ confidence intervals (CI) were calculated by unconditional logistic regression,including sex and age as confounding factors.RESULTS:The NOD1 rs2907749 GG genotype showed a decreased risk for gastric cancer (OR 0.50,95％ CI:0.26-0.95,P =0.04) while the rs7789045 TT genotype showed an increased risk (OR 2.14,95％ CI:1.20-3.82,P =0.01).An elevated susceptibility to gastric cancer was observed in the subjects with H.pylori infection and the NaOD1 rs7789045 TT genotype (OR 2.05,95％ CI:1.07-3.94,P =0.03) or the NOD2 rs7205423 GC genotype (OR 2.52,95％ CI:1.05-6.04,P =0.04).Haplotype analysis suggested that the distribution of AGT (rs2907749,rs2075820 and rs7789045) in NOD1 between the cases and control groups was significantly different (P corrected:0.04),and the diplotype AGT/AGT was associated with an elevated gastric cancer risk (OR 1.98,95％CI:1.04-3.79,P =0.04).The association of the NOD1 rs7789045 Tr genotype and the diplotype AGT/AGT was significant with H.pylori-related diffuse-type gastric cancer (OR 3.00,95％ CI:1.38-6.53,P =0.01; OR 4.02,95％ CI:1.61-10.05,P ＜ 0.01,respectively).CONCLUSION:Genetic polymorphisms in NOD1 and NOD2 may interact with H.pylori infection and may play important roles in promoting the development of gastric cancer in the Chinese population.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Role of serum carcinoembryonic antigen in the detection of colorectal cancer before and after surgical resection

    Bin-Bin SuHui ShiJun Wan
    2121-2126页
    查看更多>>摘要：AIM:To determine whether serum levels of carcinoembryonic antigen (CEA) correlate with the presence of primary colorectal cancer (CRC),and/or recurrent CRC following radical resection.METHODS:A total of 413 patients with CRC underwent radical surgery between January 1998 and December 2002 in our department and were enrolled in this study.The median follow-up period was 69 mo (range,3-118 mo),and CRC recurrence was experienced by 90/413 (21.8％) patients.Serum levels of CEA were assayed preoperatively,and using a cutoff value of 5 ng/mL,patients were divided into two groups,those with normal serum CEA levels (e.g.,≤ 5 ng/mL)and those with elevated CEA levels (＞ 5 ng/mL).RESULTS:The overall sensitivity of CEA for the detection of primary CRC was 37.0％.The sensitivity of CEA according to stage,was 21.4％,38.9％,and 41.7％ for stages Ⅰ-Ⅲ,respectively.Moreover,for stage Ⅱ and stage Ⅲ cases,the 5-year disease-free survival rates were reduced for patients with elevated preoperative serum CEA levels (P ＜ 0.05).The overall sensitivity of CEA for detecting recurrent CRC was 54.4％,and sensitivity rates of 36.6％,66.7％,and 75.0％ were associted with cases of local recurrence,single metastasis,and multiple metastases,respectively.In patients with normal serum levels of CEA preoperatively,the sensitivity of CEA for detecting recurrence was reduced compared with patients having a history of elevated CEA prior to radical resection (32.6％ vs 77.3％,respectively,P ＜ 0.05).CONCLUSION:CRC patients with normal serum CEA levels prior to resection maintained these levels during CRC recurrence,especially in cases of local recurrence vs cases of metastasis.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Stress-induced intestinal necrosis resulting from severe trauma of an earthquake

    Jia-Qing GongGuo-Hu ZhangFu-Zhou TianYong-Hua Wang...
    2127-2131页
    查看更多>>摘要：AIM:To investigate the possible reasons and suggest therapeutic plan of stress-induced intestinal necrosis resulting from the severe trauma.METHODS:Three patients in our study were trapped inside collapsed structures for 22,21 and 37 h,respectively.The patients underwent 3-4 operations after sustaining their injuries.Mechanical ventilation,intermittent hemodialysis and other treatments were also provided.The patients showed signs of peritoneal irritation on postoperative days 10-38.Small intestinal necrosis was confirmed by emergency laparotomy,and for each patient,part of the small bowel was removed.RESULTS:Two patients who all performed 3 operations died of respiratory complications on the first and second postoperative days respectively.The third patient who performed 4 operations was discharged and made a full recovery.Three patients had the following common characteristics:(1) Multiple severe trauma events with no direct penetrating gastrointestinal injury; (2) Multiple surgeries with impaired renal function and intermittent hemodialysis treatment; (3) Progressive abdominal pain and tenderness,and peritoneal irritation was present on post-traumatic days 10-38; (4)Abdominal operations confirmed segment ulcer,necrosis of the small intestine,hyperplasia and stiffness of the intestinal wall; and (5) Pathological examinations suggested submucosal hemorrhage,necrosis,fibrosis and hyalinization of the vascular wall.Pathological examinations of all 3 patients suggested intestinal necrosis with fistulas.CONCLUSION:Intestinal necrosis is strongly associated with stress from trauma and post-traumatic complications; timely exploratory laparotomy maybe an effective method for preventing and treating stressinduced intestinal necrosis.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Emodin promoted pancreatic claudin-5 and occludin expression in experimental acute pancreatitis rats

    Xian-Ming XiaBang-Ku LiShi-Mei XingHai-Ling Ruan...
    2132-2139页
    查看更多>>摘要：AIM:To investigate the effect of emodin on pancreatic claudin-5 and occludin expression,and pancreatic paracellular permeability in acute pancreatitis (AP).METHODS:Experimental pancreatitis was induced by retrograde injection of 5％ sodium taurocholate into the biliopancreatic duct.Emodin was injected via the external jugular vein 0 or 6 h after induction of AP.Rats from sham operation and AP groups were injected with normal saline at the same time.Samples of pancreas were obtained 6 or 12 h after drug administration.Pancreatic morphology was examined with hematoxylin and eosin staining.Pancreatic edema was estimated by measuring tissue water content.Tumor necrosis factor (TNF)-α and interleukin (IL)-6 level were measured by enzyme-linked immunosorbent assay.Pancreatic paracellular permeability was assessed by tissue dye extravasation.Expression of pancreatic claudin-5 and occludin was examined by immunohistology,quantitative real-time reverse transcriptase polymerase chain reaction and western blotting.RESULTS:Pancreatic TNF-α and IL-6 levels,wet/dry ratio,dye extravasation,and histological score were significantly elevated at 3,6 and 12 h following sodium taurocholate infusion; treatment with emodin prevented these changes at all time points.Immunostaining of claudin-5 and occludin was detected in rat pancreas,which was distributed in pancreatic acinar cells,ductal cells and vascular endothelial cells,respectively.Sodium taurocholate infusion significantly decreased pancreatic claudin-5 and occludin mRNA and protein levels at 3,6 and 12 h,and that could be promoted by intravenous administration of emodin at all time points.CONCLUSION:These results demonstrate that emodin could promote pancreatic claudin-5 and occludin expression,and reduce pancreatic paracellular permeability.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Lymphomatoidgastropathy mimicking extranodal NK/T cell lymphoma, nasal type: A case report

    Tomohiro TeraiMitsushige SugimotoHiroki UozakiTetsushi Kitagawa...
    2140-2144页
    查看更多>>摘要：Extranodal natural killer (NK)/T-cell lymphoma,nasal type,exhibits aggressive tumor behavior and carries a poor prognosis.Recently,lymphomatoid gastropathy with NK/T cell infiltration into gastric mucosa has been recognized as a pseudo-malignant disease which regresses without treatment.Because the conventional immunohistochemical criteria of lymphomatoid gastropathy is similar to that of extranodal NK/T-cell lymphoma nasal type,it is difficult to distinguish between the two conditions by histopathological evaluation only.Here,we report a rare case of lymphomatoid gastropathy in a 57-year-old female.Gastroendoscopy on routine check-up revealed elevated reddish lesions ＜ 1 cm in diameter in the gastric fornix and body.Although repeat endoscopies at 1 and 6 mo later revealed no gastric lesions at any locations without any treatments,at 12 mo later gastric lymphomatoid lesions recurred at gastric fornix and body.Histological examination of endoscopic biopsy specimens at 12 mo showed atypical NK cell infiltration with CD3+,CD4-,CD5-,CD7+,CD8-,CD20-,CD30-,CD56+,CD79a-and T-cell-restricted intracellular antigen-1+ into gastric mucosa.After treatment for Helicobacter pylori (H.pylori) eradication,the lesions disappeared in all locations of the gastric fornix and body over the subsequent 12 mo.Here,we report a case of H.pylori-positive lymphomatoid gastropathy with massive NK-cell proliferation,and also review the literature concerning newly identified lymphomatoid gastropathy based on comparison of extra nodal NK/T-cell lymphoma nasal type.In any case,these lesions are evaluated with biopsy specimens,the possibility of this benign entity should be considered,and excessive treatment should be carefully avoided.Close follow-up for this case of lymphomatoid gastropathy is necessary to exclude any underlying malignancy.
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    • NETL
    • NSTL
    • 万方数据