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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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    T cell immunopathogenesis and immunotherapeutic strategies for chronic hepatitis B virus infection

    Yukihiro Shimizu
    2443-2451页
    查看更多>>摘要：Hepatitis B is caused by the host immune response and T cells play a major role in the immunopathogenesis.More importantly,T cells not only destroy hepatocytes infected by hepatitis B virus (HBV),but also control HBV replication or eradicate HBV in a noncytolytic manner.Therefore,analysis of T cell immune response during acute and chronic HBV infection is important to develop a strategy for successful viral control,which could lead to immunotherapy for terminating persistent HBV infection.There have been many attempts at immunotherapy for chronic HBV infection,and some have shown promising results.High viral load has been shown to suppress antiviral immune responses and immunoinhibitory signals have been recently elucidated,therefore,viral suppression by nucleos(t)ide analogs,stimulation of antiviral immune response,and suppression of the immunoinhibitory signals must be combined to achieve desirable antiviral effects.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Serrated polyposis syndrome: Molecular, pathological and clinical aspects

    Carla GuarinosCristina Sánchez-FortúnMaría Rodríguez-SolerCristina Alenda...
    2452-2461页
    查看更多>>摘要：Hyperplastic polyps have traditionally been considered not to have malignant potential.New pathological classification of serrated polyps and recent discoveries about the serrated pathway of carcinogenesis have revolutionized the concepts and revitalized the research in this area.Until recently,it has been thought that most colorectal cancers arise from conventional adenomas via the traditional tumor suppressor pathway initiated by a mutation of the APC gene,but it has been found that this pathway accounts for only approximately 70％-80％of colorectal cancer (CRC) cases.The majority of the remaining colorectal cancer cases follow an alternative pathway leading to CpG island methylator phenotype carcinoma with BRAF mutation and with or without microsatellite instability.The mechanism of carcinomas arising from this alternative pathway seems to begin with an activating mutation of the BRAF oncogene.Serrated polyposis syndrome is a relatively rare condition characterized by multiple and/or large serrated polyps of the colon.Clinical characteristics,etiology and relationship of serrated polyposis syndrome to CRC have not been clarified yet.Patients with this syndrome show a high risk of CRC and both sporadic and hereditary cases have been described.Clinical criteria have been used for diagnosis and frequent colonoscopy surveillance should be performed in order to prevent colorectal cancer.In this review,we try to gather new insights into the molecular pathogenesis of serrated polyps in order to understand their possible clinical implications and to make an approach to the management of this syndrome.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    Globus pharyngeus: A review of its etiology, diagnosis and treatment

    Bong Eun LeeGwang Ha Kim
    2462-2471页
    查看更多>>摘要：Globus is a persistent or intermittent non-painful sensation of a lump or foreign body in the throat.It is a commonly encountered clinical condition that is usually long-lasting,difficult to treat,and has a tendency to recur.Furthermore,due to the uncertain etiology of globus,it remains difficult to establish standard investigation and treatment strategies for affected patients.As a first step for managing globus,careful history taking and nasolaryngoscopy are essential.Given the benign nature of the condition and the recent notion that gastroesophageal reflux disease is a major cause of globus,empirical therapy with a high dose of proton pump inhibitors is reasonable for patients with typical globus.If patients are nonresponsive to this therapy,definitive assessments such as endoscopy,multichannel intraluminal impedance/pH monitoring,and manometry should be considered.Speech and language therapy,anti-depressants,and cognitive-behavioral therapy can be helpful in patients whose symptoms persist despite negative investigations.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    Lactobacillus plantarum B7 inhibits Helicobacter pylori growth and attenuates gastric inflammation

    Chompoonut SunanliganonDuangporn Thong-NgamSomying TumwasornNaruemon Klaikeaw...
    2472-2480页
    查看更多>>摘要：AIM:To determine the anti-Helicobacter property of Lactobacillus plantarum B7 (L.plantarum) B7 supernatants in vitro and the protective effects of L.plantarum B7 on serum tumor necrosis factor-alpha (TNF-α),gastric malondialdehyde (MDA) level,apoptosis,and histopathology in Helicobacter pylori (H.pylorl)-induced gastric inflammation in rats.METHODS:In vitro,the inhibition of H,pylori growth was examined using L.plantarum B7 supernatants at pH 4 and pH 7 and at the concentration of 1×,5× and 10× on plates inoculated with H.pylori.The inhibitory effect of H.pylori was interpreted by the size of the inhibition zone.In vitro,male Sprague-Dawley rats were randomly divided into four groups including group 1 (control group),group 2 (H.pylori infected group),group 3 (H.pylori infected with L.plantarum B7 10é CFUs/mL treated group) and group 4 (H.pylori infected with L.plantarum B7 1010 CFUs/mL treated group).One week after H.pylori inoculation,L.plantarum B7 106 CFUs/mL or 1010 CFUs/mL were fed once daily to group 3 and group 4,respectively,for one week.Blood and gastric samples were collected at the end of the study.RESULTS:In vitro,at intact pH 4,mean inhibitory zone diameters of 8.5 mm and 13 mm were noted at concentrations of 5× and 10× of L.plantarum B7supernatant disks,respectively.At adjusted pH 7,L.plantarum B7 supernatants at concentrations of 5 × and 10× yielded mean inhibitory zone diameters of 6.5 mm and 11 mm,respectively.In the in vitro study,in group 2,stomach histopathology revealed mild to moderate H.pylori colonization and inflammation.The level of gastric MDA and epithelial cell apoptosis were significantly increased compared with group 1.The serum TNF-α level was significant decreased in group 3compared with group 2 (P ＜ 0.05).In addition,L.plantarum B7 treatments resulted in a significant improvement in stomach pathology,and decreased gastric MDA level and apoptotic epithelial cells.CONCLUSION:L.plantarum B7 supernatant inhibits H.pylori growth.This inhibition was dose-dependent and greater at pH 4.Moreover,L.plantarum B7 attenuated H.pylori-induced gastric inflammation.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Key factors in developing the trinitrobenzene sulfonic acid-induced post-inflammatory irritable bowel syndrome model in rats

    Hong-Yan QinHai-Tao XiaoJustin CY WuBrian M Berman...
    2481-2492页
    查看更多>>摘要：AIM:To investigate the key factors in developing the trinitrobenzene sulfonic acid (TNBS)-induced postinflammatory irritable bowel syndrome (PI-IBS) model in rats.METHODS:TNBS was administered to rats at the following conditions:(1) with different doses (20,10,5mg/0.8 mL per rat); (2) with same dose in different concentrations (20 mg/rat,25,50 mg/mL); (3) in different ethanol percentage (25％,50％); and (4) at depth either 4 cm or 8 cm from anus.At 5 d and 4 wk after TNBS administration,inflammation severity and inflammation resolution were evaluated.At 4 and 8 wk after TNBS application,visceral hyperalgesia and enterochromaffin (EC) cell hyperplasia were assayed by abdominal withdrawal reflex test,silver staining and capillary electrophoresis.RESULTS:Our results showed that:(1) TNBS induced dose-dependent acute inflammation and inflammation resolution.At 5 d post TNBS,the pathological score and myeloperoxidase (MPO) activity in all TNBS treated rats were significantly elevated compared to that of the control (9.48 ± 1.86,8.18 ± 0.67,5.78 ±0.77 vs 0,and 3.55 ± 1.11,1.80 ± 0.82,0.97 ± 0.08unit/mg vs 0.14 ± 0.01 unit/mg,P ＜ 0.05).At 4 wk post TNBS,the pathological score in high and median dose TNBS-treated rats were still significantly higher than that of the control (1.52 ± 0.38 and 0.80 ± 0.35vs 0,P ＜ 0.05); (2) Intracolonic TNBS administration position affected the persistence of visceral hyperalgesia.At 4 wk post TNBS,abdominal withdrawal reflex (AWR) threshold pressure in all TNBS-treated groups were decreased compared to that of the control (21.52± 1.73 and 27.10 ± 1.94 mmHg vs 34.44 ± 1.89mmHg,P ＜ 0.05).At 8 wk post TNBS,AWR threshold pressure in 8 cm administration group was still significantly decreased (23.33 ± 1.33 mmHg vs 36.79 ± 2.29mmHg,P ＜ 0.05); (3) Ethanol percentage affected the TNBS-induced inflammation severity and visceral hyperalgesia.In TNBS-25％ ethanol-treated group,the pathological score and MPO activity were significantly lowered compared to that of the TNBS-50％ ethanoltreated group,while AWR threshold pressure were significantly elevated (36.33 ± 0.61 mmHg vs 23.33 ± 1.33mmHg,P ＜ 0.05); and (4) TNBS (5 mg/0.8 mL per rat,in 50％ ethanol,8 cm from anus)-treated rats recovered completely from the inflammation with acquired visceral hyperalgesia and EC cell hyperplasia at 4 wk after TNBS administration.CONCLUSION:TNBS dosage,concentration,intracoIonic administration position,and ethanol percentage play important roles in developing visceral hyperalgesia and EC cell hyperplasia of TNBS-induced PI-IBS rats.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Cost-benefit analysis of esophageal cancer endoscopic screening in high-risk areas of China

    Juan YangWen-Qiang WeiJin NiuZhi-Cai Liu...
    2493-2501页
    查看更多>>摘要：AIM:To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer (EC) in high-risk areas of China.METHODS:Markov model-based analyses were conducted to compare the net present values (NPVs) and the benefit-cost ratios (BCRs) of 12 EC endoscopic screening strategies.Strategies varied according to the targeted screening age,screening frequencies,and follow-up intervals.Model parameters were collected from population-based studies in China,published literatures,and surveillance data.RESULTS:Compared with non-screening outcomes,all strategies with hypothetical 100 000 subjects saved life years.Among five dominant strategies determined by the incremental cost-effectiveness analysis,screening once at age 50 years incurred the lowest NPV (international dollar-I＄55 million) and BCR (2.52).Screening six times between 40-70 years at a 5-year interval [i.e.,six times(40)f-strategy] yielded the highest NPV (I＄99 million) and BCR (3.06).Compared with six times(40)fstrategy,screening thrice between 40-70 years at a 10-year interval resulted in relatively lower NPV,but the same BCR.CONCLUSION:EC endoscopic screening is cost-beneficial in high-risk areas of China.Policy-makers should consider the cost-benefit,population acceptance,and local economic status when choosing suitable screening strategies.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Cervical inlet patch-optical coherence tomography imaging and clinical significance

    Chao ZhouTejas KirtaneTsung-Han TsaiHsiang-Chieh Lee...
    2502-2510页
    查看更多>>摘要：AIM:To demonstrate the feasibility of optical coherence tomography (OCT) imaging in differentiating cervical inlet patch (CIP) from normal esophagus,Barrett's esophagus (BE),normal stomach and duodenum.METHODS:This study was conducted at the Veterans Affairs Boston Healthcare System (VABHS).Patients undergoing standard esophagogastroduodenoscopy at VABHS,including one patient with CIP,one representative patient with BE and three representative normal subjects were included.White light video endoscopy was performed and endoscopic 3D-OCT images were obtained in each patient using a prototype OCT system.The OCT imaging probe passes through the working channel of the endoscope to enable simultaneous video endoscopy and 3D-OCT examination of the human gastrointestinal (GI) tract.Standard hematoxylin and eosin (H and E) histology was performed on biopsy or endoscopic mucosal resection specimens in order to compare and validate the 3D-OCT data.RESULTS:CIP was observed from a 68-year old male with gastroesophageal reflux disease.The CIP region appeared as a pink circular lesion in the upper esophagus under white light endoscopy.OCT imaging over the CIP region showed columnar epithelium structure,which clearly contrasted the squamous epithelium structure from adjacent normal esophagus.3D-OCT images obtained from other representative patients demonstrated distinctive patterns of the normal esophagus,BE,normal stomach,and normal duodenum bulb.Microstructures,such as squamous epithelium,lamina propria,muscularis mucosa,muscularis propria,esophageal glands,Barrett's glands,gastric mucosa,gastric glands,and intestinal mucosal villi were clearly observed with OCT and matched with H and E histology.These results demonstrated the feasibility of using OCT to evaluate GI tissue morphology in situ and in real-time.CONCLUSION:We demonstrate in situ evaluation of CIP microstructures using 3D-OCT,which may be a useful tool for future diagnosis and follow-up of patients with CIP.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Endomysial antibodies predict celiac disease irrespective of the titers or clinical presentation

    Kalle KurppaTiia R(a)s(a)nenPekka CollinSari Iltanen...
    2511-2516页
    查看更多>>摘要：AIM:To investigate the association between serum antibody levels and a subsequent celiac disease diagnosis in a large series of children and adults.METHODS:Besides subjects with classical gastrointestinal presentation of celiac disease,the study cohort included a substantial number of individuals with extraintestinal symptoms and those found by screening in at-risk groups.Altogether 405 patients underwent clinical,serological and histological evaluations.After collection of data,the antibody values were further graded as low [endomysial (EmA) 1:5-200,transglutaminase 2 antibodies (TG2-ab) 5.0-30.0 U/L] and high (EmA 1:≥ 500,TG2-ab ≥ 30.0 U/L),and the serological results were compared with the small intestinal mucosal histology and clinical presentation.RESULTS:In total,79％ of the subjects with low and 94％ of those with high serum EmA titers showed small-bowel mucosal villous atrophy.Furthermore,96％ of the 47 EmA positive subjects who had normal mucosal villi and remained on follow-up either subsequently developed mucosal atrophy while on a glutencontaining diet,or responded positively to a glutenfree diet.CONCLUSION:Irrespective of the initial serum titers or clinical presentation,EmA positivity as such is a very strong predictor of a subsequent celiac disease diagnosis.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Efficacy of mosapride citrate with polyethylene glycol solution for colonoscopy preparation

    Masahiro TajikaYasumasa NiwaVikram BhatiaHiroki Kawai...
    2517-2525页
    查看更多>>摘要：AIM:To evaluate the efficacy and safety of adjunctive mosapride citrate for bowel preparation before colonoscopy.METHODS:We conducted a randomized,double-blind,placebo-controlled study with mosapride in addition to polyethylene glycol (PEG)-electrolyte solution.Of 250 patients undergoing colonoscopy,124 were randomized to receive 2 L PEG plus 15 mg of mosapride citrate (mosapride group),and 126 received 2 L PEG plus placebo (placebo group).Patients completed a questionnaire reporting the acceptability and tolerability of the bowel preparation process.The efficacy of bowel preparation was assessed by colonoscopists using a 5-point scale based on Aronchick's criteria.The primary end point was optimal bowel preparation rates (scores of excellent/good/fair vs poor/inadequate).RESULTS:A total of 249 patients were included in the analysis.In the mosapride group,optimal bowel preparation rates were significantly higher in the left colon compared with the placebo group (78.2％ vs 65.6％,P ＜ 0.05),but not in the right colon (76.5％ vs 66.4％,P =0.08).After excluding patients with severe constipation,there was a significant difference in bowel preparation in both the left and right colon (82.4％ vs 66.7％,80.8％ vs 67.5％,P ＜ 0.05,P ＜ 0.01).The incidence of adverse events was similar in both groups.Among the subgroup who had previous colonoscopy experience,a significantly higher number of patients in the mosapride group felt that the current preparation was easier compared with patients in the placebo group (34/72 patients vs 24/74 patients,P ＜ 0.05).CONCLUSION:Mosapride citrate may be an effective and safe adjunct to PEG-electrolyte solution that leads to improved quality of bowel preparation,especially in patients without severe constipation.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Endoscopic ultrasound-guided biliary drainage with placement of a fully covered metal stent for malignant biliary obstruction

    Tae Hyeon KimSeong Hun KimHyo Jeong OhYoung Woo Sohn...
    2526-2532页
    查看更多>>摘要：AIM:To determine the utility of endoscopic ultrasoundguided biliary drainage (EUS-BD) with a fully covered self-expandable metal stent for managing malignant biliary stricture.METHODS:We collected data from 13 patients who presented with malignant biliary obstruction and underwent EUS-BD with a nitinol fully covered selfexpandable metal stent when endoscopic retrograde cholangiopancreatography (ERCP) fails.EUS-guided choledochoduodenostomy (EUS-CD) and EUS-guided hepaticogastrostomy (EUS-HG) was performed in 9 patients and 4 patients,respectively.RESULTS:The technical and functional success rate was 92.3％ (12/13) and 91.7％ (11/12),respectively.Using an intrahepatic approach (EUS-HG,n =4),there was mild peritonitis (n =1) and migration of the metal stent to the stomach (n =1).With an extrahepatic approach (EUS-CD,n =10),there was pneumoperitoneum (n =2),migration (n =2),and mild peritonitis (n =1).All patients were managed conservatively with antibiotics.During follow-up (range,1-12 mo),there was re-intervention (4/13 cases,30.7％) necessitated by stent migration (n =2) and stent occlusion (n =2).CONCLUSION:EUS-BD with a nitinol fully covered self-expandable metal stent may be a feasible and effective treatment option in patients with malignant biliary obstruction when ERCP fails.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普