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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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    Adjuvant treatment in biliary tract cancer: To treat or not to treat?

    Stefano CeredaCarmen BelliMichele Reni
    2591-2596页
    查看更多>>摘要：Biliary tract cancer is a rare malignant tumor.There is limited knowledge about biology and natural history of this disease and considerable uncertainty remains regarding its optimal diagnostic and therapeutic management.The role of adjuvant therapy is object of debate and controversy.Although resection is identified as the most effective and the only potentially curative treatment,there is no consensus on the impact of adjuvant chemotherapy and/or radiotherapy on the high incidence of disease recurrence and on survival.This is mainly due to the rarity of this disease and the consequent difficulty in performing randomized trials.The only two prospectively controlled trials concluded that adjuvant chemotherapy did not improve survival.Most of the retrospective trials,which had limited sample size and included heterogeneous patients population and non-standardized therapies,suggested a marginal benefit of chemoradiotherapy in reducing locoregional recurrence and an uncertain impact on survival.Welldesigned multi-institutional randomized trials are necessary to clarify the role of adjuvant therapy.Two ongoing phase Ⅲ trials may provide relevant information.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Motor vehicle accidents: How should cirrhotic patients be managed?

    Takumi KawaguchiEitaro TaniguchiMichio Sata
    2597-2599页
    查看更多>>摘要：Motor vehicle accidents (MVAs) are serious social issues worldwide and driver illness is an important cause of MVAs.Minimal hepatic encephalopathy (MHE) is a complex cognitive dysfunction with attention deficit,which frequently occurs in cirrhotic patients independent of severity of liver disease.Although MHE is known as a risk factor for MVAs,the impact of diagnosis and treatment of MHE on MVA-related societal costs is largely unknown.Recently,Bajaj et al demonstrated valuable findings that the diagnosis of MHE by rapid screening using the inhibitory control test (ICT),and subsequent treatment with lactulose could substantially reduce the societal costs by preventing MVAs,Besides the ICT and lactulose,there are various diagnostic tools and therapeutic strategies for MHE.In this commentary,we discussed a current issue of diagnostic tools for MHE,including neuropsychological tests.We also discussed the advantages of the other therapeutic strategies for MHE,such as intake of a regular breakfast and coffee,and supplementation with zinc and branched chain amino acids,on the MVA-related societal costs.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Pregnancy related issues in inflammatory bowel disease:Evidence base and patients' perspective

    Christian P SelingerRupert WL LeongSimon Lal
    2600-2608页
    查看更多>>摘要：Inflammatory bowel disease (IBD) affects women of childbearing age and can influence fertility,pregnancy and decisions regarding breastfeeding.Women with IBD need to consider the possible course of disease during pregnancy,the benefits and risks associated with medications required for disease management during pregnancy and breastfeeding and the effects of mode of delivery on their disease.When indicated,aminosalicylates and thiopurines can be safely used during pregnancy.Infliximab and Adalimumab are considered probably safe during the first two trimesters.During the third trimester the placenta can be crossed and caution should be applied.Methotrexate is associated with severe teratogenicity due to its folate antagonism and is strictly contraindicated.Women with IBD tend to deliver earlier than healthy women,but can have a vaginal delivery in most cases.Caesarean sections are generally recommended for women with active perianal disease or after ileo-anal pouch surgery.While the impact of disease activity and medication has been addressed in several studies,there are minimal studies evaluating patients' perspective on these issues.Women's attitudes may influence their decision to have children and can positively or negatively influence the chance of conceiving,and their beliefs regarding therapies may impact on the course of their disease during pregnancy and/or breastfeeding.This review article outlines the impact of IBD and its treatment on pregnancy,and examines the available data on patients' views on this subject.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    Leaky gut and the liver: A role for bacterial translocation in nonalcoholic steatohepatitis

    Yaron Ilan
    2609-2618页
    查看更多>>摘要：Gut flora and bacterial translocation (BT) play important roles in the pathogenesis of chronic liver disease,including cirrhosis and its complications.Intestinal bacterial overgrowth and increased bacterial translocation of gut flora from the intestinal lumen predispose patients to bacterial infections,major complications and also play a role in the pathogenesis of chronic liver disorders.Levels of bacterial lipopolysaccharide,a component of gram-negative bacteria,are increased in the portal and/or systemic circulation in several types of chronic liver disease.Impaired gut epithelial integrity due to alterations in tight junction proteins may be the pathological mechanism underlying bacterial translocation.Preclinical and clinical studies over the last decade have suggested a role for BT in the pathogenesis of nonalcoholic steatohepatitis (NASH).Bacterial overgrowth,immune dysfunction,alteration of the luminal factors,and altered intestinal permeability are all involved in the pathogenesis of NASH and its complications.A better understanding of the cell-specific recognition and intracellular signaling events involved in sensing gut-derived microbes will help in the development of means to achieve an optimal balance in the gut-liver axis and ameliorate liver diseases.These may suggest new targets for potential therapeutic interventions for the treatment of NASH.Here,we review some of the mechanisms connecting BT and NASH and potential therapeutic developments.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Juvenile ferric iron prevents microbiota dysbiosis and colitis in adult rodents

    Chourouk EttreikiPascale Gadonna-WidehemIrène ManginMo(i)se Co(e)ffier...
    2619-2629页
    查看更多>>摘要：AIM:To assess whether juvenile chronic ferric iron ingestion limit colitis and dysbiosis at adulthood in rats and mice.METHODS:Two sets of experiments were designed.In the first set,recently weaned mice were either orally administered ferrous (Fe2+) iron salt or ferric (Fe3+) microencapsulated iron for 6 wk.The last week of experiments trinitrobenzene sulfonic acid (TNBS) colitis was induced.In the second set,juvenile rats received the microencapsulated ferric iron for 6 wk and were also submitted to TNBS colitis during the last week of experiments.In both sets of experiments,animals were sacrificed 7 d after TNBS instillation.Severity of the inflammation was assessed by scoring macroscopic lesions and quantifying colonic myeloperoxidase (MPO) activity.Alteration of the microflora profile was estimated using quantitative polymerase chain reaction (qPCR) by measuring the evolution of total caecal microflora,Bacteroidetes,Firmicutes and enterobacteria.RESULTS:Neither ferrous nor ferric iron daily exposures at the juvenile period result in any effect in control animals at adulthood although ferrous iron repeated administration in infancy limited weight gain.Ferrous iron was unable to limit the experimental colitis (1.71 ± 0.27MPO U/mg protein vs 2.47 ± 0.22 MPO U/mg protein in colitic mice).In contrast,ferric iron significantly prevented the increase of MPO activity (1.64 ± 0.14 MPO U/mg protein) in TNBS-induced colitis.Moreover,this positive effect was observed at both the doses of ferric iron used (75 and 150 mg/kg per day po-6 wk).In the study we also compared,in both rats and mice,the consequences of chronic repeated low level exposure to ferric iron (75 mg/kg per day po-6 wk) on TNBS-induced colitis and its related dysbiosis.We confirmed that ferric iron limited the TNBS-induced increase of MPO activity in both the rodent species.Furthermore,we assessed the ferric iron incidence on TNBS-induced intestinal microbiota dysbiosis.At first,we needed to optimize the isolation and quantify DNA copy numbers using standard curves to perform by qPCR this interspecies comparison.Using this approach,we determined that total microflora was similar in control rats and mice and was mainly composed of Firmicutes and Bacteroidetes at a ratio of 10/1.Ferric juvenile administration did not modify the microflora profile in control animals.Total microflora numbers remained unchanged whichever experimental conditions studied.Following TNBS-induced colitis,the Firmicutes/Bacteroidetes ratio was altered resulting in a decrease of the Firmicutes numbers and an increase of the Bacteroidetes numbers typical of a gut inflammatory reaction.In parallel,the subdominant population,the enterobacteria was also increased.However,ferric iron supplementation for the juvenile period prevented the increase of Bacteroidetes and of enterobacteria numbers consecutive to the colitis in both the studied species at adulthood.CONCLUSION:Rats and mice juvenile chronic ferric iron ingestion prevents colitis and dysbiosis at adulthood as assessed by the first interspecies comparison.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    High dose glargine alters the expression profiles of microRNAs in pancreatic cancer cells

    Wei-Guang LiYao-Zong YuanMin-Min QiaoYong-Ping Zhang...
    2630-2639页
    查看更多>>摘要：AIM:To investigate the effect of high dose glargine on the expression profiles of microRNAs in human pancreatic cancer cells.METHODS:Real-time polymerase chain reaction array (RT-PCR) was applied to investigate miRNAs differentially expressed in Sw1990 cells treated with or without 100 IU/L glargine.Stem-loop RT-PCR was used to confirm the results of the array assay in Sw1990 and Panc-1 cells.The effects of miR-95 on cell growth,apoptosis,invasion and migration abilities were respectively examined by CCK8 assay,apoptosis assay,Matrigel invasion and migration assay in Sw1990 and Panc-1 cells.Nude mice xenograft models with Sw1990 cells were built to investigate pancreatic cancer growth in vivo after transfection by the lentivirus pGLV3-GFP-miR-95.RESULTS:Ten miRNAs were significantly up-regulated and 2 miRNAs down-regulated in glargine treated Sw1990 cells when compared with non-treated cells (2.48-fold changes on average,P ＜ 0.01).miR-95,miR-134 and miR-34c-3p are the top three miRNAs regulated by glargine (3.65-fold,2.67-fold and 2.60-fold changes respectively,P ＜ 0.01) in Sw1990 cells.Stem-loop RT-PCR confirmed that high dose glargine up-regulated the expression of miR-95 and miR-134 in both Sw1990 and Panc-1 cells.The most obvious change is the apparent increase of miR-95.Forced expression of miR-95 significantly increased cell proliferation (Sw1990:2.510 ±0.129 vs 2.305 ± 0.187,P ＜ 0.05; Panc-1:2.439 ± 0.211vs 2.264 ± 0.117,P ＜ 0.05),invasion (Sw1990:67.90±12.33 vs 47.30 ± 5.89,P ＜ 0.01; Panc-1:37.80 ± 8.93 vs 30.20 ± 5.14,P ＜ 0.01),migration (Sw1990:101 ±6.00 vs 51.20 ± 8.34,P ＜ 0.01; Panc-1:91.80 ± 9.22 vs 81.50 ± 7.47,P ＜ 0.01) and inhibited cell apoptosis (Sw1990:22.05％ ± 1.92％ vs 40.32％ ± 1.93％,P ＜0.05; Panc-1:20.17％ ± 0.85％ vs 45.60％ ± 1.43％,P ＜ 0.05) when compared with paired negative controls,whereas knockdown of miR-95 obtained the opposite effect.Nude mice xenograft models confirmed that miR-95 promoted the growth of pancreatic cancer in vivo when compared with negative control (tumor volume:373.82± 23.67 mL vs 219.69 ± 17.82 mL,P ＜ 0.05).CONCLUSION:These observations suggested that modulation of miRNA expression may be an important mechanism underlying the biological effects of glargine.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Suppression of colorectal cancer metastasis by nigericin through inhibition of epithelial-mesenchymal transition

    Hou-Min ZhouTao-Tao DongLin-Lin WangBo Feng...
    2640-2648页
    查看更多>>摘要：AIM:To evaluate the effect of nigericin on colorectal cancer and to explore its possible mechanism.METHODS:The human colorectal cancer (CRC) cell lines HT29 and 5W480 were treated with nigericin or oxaliplatin under the conditions specified.Cell viability assay and invasion and metastasis assay were performed to evaluate the effect of nigericin on CRC cells.Sphereforming assay and soft agar colony-forming assay were implemented to assess the action of nigericin on the cancer stem cell properties of CRC cells undergone epithelial-mesenchymal transition (EMT).RESULTS:Compared with oxaliplatin,nigericin showed more toxicity for the HT29 cell line (IC50,12.92 ± 0.25μmol vs 37.68 ± 0.34 μmol).A similar result was also obtained with the SW116 cell line (IC50,15.86 ± 0.18 μmol vs 41.02 ± 0.23 μmol).A Boyden chamber assay indicated that a significant decrease in the number of HT29 cells migrating through polyvinylidene fluoride membrane was observed in the nigericin-treated group,relative to the vehicle-treated group [11 ± 2 cells per high-power field (HPF) vs 19.33 ± 1.52 cells per HPF,P ＜ 0.05].Compared to the control group,the numbers of HT29 cells invading through the Matrigel-coated membrane also decreased in the nigericin-treated group (6.66 ± 1.52 cells per HPF vs 14.66 ± 1.52 cells per HPF,P ＜ 0.05).Nigericin also reduced the proportion of CD133+ cells from 83.57％ to 63.93％,relative to the control group (P ＜ 0.05).Nigericin decreased the number of spheres relative to the control group (0.14 ± 0.01 vs 0.35 ± 0.01,P ＜ 0.05),while oxaliplatin increased the number of spheres relative to the control group (0.75 ± 0.02 vs 0.35 ± 0.01; P ＜ 0.05).Nigericin also showed a decreased ability to form colonies under anchorage-independent conditions in a standard soft agar assay after 14 d in culture,relative to the control group (1.66 ± 0.57 vs 7 ± 1.15,P ＜ 0.05),whereas the colony numbers were higher in the oxaliplatin group relative to the vehicle-treated controls (14.33 ± 0.57 vs 7 ± 1.15,P ＜ 0.05).We further detected the expression of E-cadherin and vimentin in cells treated with nigericin and oxaliplatin.The results showed that HT29 cells treated with nigericin induced an increase in E-cadherin expression and a decrease in the vimentin expression relative to vehicle controls.In contrast,oxaliplatin downregulated the expression of E-cadherin and upregulated the expression of vimentin in HT29 cells relative to vehicle controls.CONCLUSION:This study demonstrated that nigericin could partly reverse the EMT process during cell invasion and metastasis.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Association between autoimmune pancreatitis and systemic autoimmune diseases

    Viktória TerzinImre F(o)ldesiLászló KovácsGyula Pokorny...
    2649-2653页
    查看更多>>摘要：AIM:To investigate the association between autoimmune pancreatitis (AIP) and systemic autoimmune diseases (SAIDs) by measurement of serum immunoglobulin G4 (IgG4).METHODS:The serum level of IgG4 was measured in 61 patients with SAIDs of different types who had not yet participated in glucocorticosteroid treatment.Patients with an elevated IgG4 level were examined by abdominal ultrasonography (US) and,in some cases,by computer tomography (CT).RESULTS:Elevated serum IgG4 levels (919 ± 996 mg/L) were detected in 17 (28％) of the 61 SAID patients.10 patients had Sj(o)gren's syndrome (SS) (IgG4:590 ±232 mg/L),2 of them in association with Hashimoto's thyroiditis,and 7 patients (IgG4:1388 ± 985.5 mg/L)had systemic lupus erythematosus (SLE).The IgG4 level in the SLE patients and that in patients with SS were not significantly different from that in AIP patients (783 ± 522 mg/L).Abdominal US and CT did not reveal any characteristic features of AIP among the SAID patients with an elevated IgG4 level.CONCLUSION:The serum IgG4 level may be elevated in SAIDs without the presence of AIP.The determination of serum IgG4 does not seem to be suitable for the differentiation between IgG4-related diseases and SAIDs.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Clinical course of sub-centimeter-sized nodules detected during surveillance for hepatocellular carcinoma

    Yang Won MinGeum-Youn GwakMin Woo LeeMoon Seok Choi...
    2654-2660页
    查看更多>>摘要：AIM:To evaluate the outcome of sub-centimeter-sized nodules (SCSNs) detected during surveillance for hepatocellular carcinoma (HCC) in patients at risk.METHODS:We retrospectively analyzed a total of 142 patients with liver cirrhosis or chronic hepatitis B or C without a prior history of HCC in whom a SCSN was detected during HCC surveillance.We calculated the rate of HCC development from SCSNs in the study population and analyzed the differences in the baseline clinical characteristics and imaging features between the patients with SCSNs that eventually developed into HCC and patients with SCSNs that did not develop into HCC.RESULTS:During 667 person-years of follow-up,HCC developed in 33 patients.The calculated HCC development rate was 4.9％ per year.The cumulative one-,two-,three-and five-year HCC development rates were 5.6％,10.6％,14.1％ and 20.4％,respectively.Upon baseline comparison,the HCC group was older (54.4± 8.3 years vs 48.9 ± 9.4 years; P =0.003) and had lower albumin levels (3.56 ± 0.58 g/dL vs 3.84 ± 0.55 g/dL; P =0.012) and higher baseline alpha-fetoprotein (AFP) levels (8.5 ng/mL vs 5.4 ng/mL; P =0.035) compared to the non-HCC group.Nodule pattern and initial radiologic diagnosis also differed between the two groups.Multivariate analysis revealed that age [P =0.012,odds ratio (OR) =1.075,95％ confidence interval (CI) =1.016-1.137],sex (P =0.009,OR =3.969,95％CI:1.403-11.226),and baseline AFP level (P =0.024,OR =1.039,95％ CI:1.005-1.073) were independent risk factors for developing HCC.CONCLUSION:The overall risk of HCC development in patients with SCSNs is similar to that in liver cirrhosis patients.Patients with these risk factors need to be closely monitored during follow-up.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Family history influences the early onset of hepatocellular carcinoma

    Chung-Hwa ParkSeung-Hee JeongHyeon-Woo YimJin Dong Kim...
    2661-2667页
    查看更多>>摘要：AIM:To evaluate the relationship between a positive family history of primary liver cancer and hepatocellular carcinoma (HCC) development in Korean HCC patients.METHODS:We studied a total of 2242 patients diagnosed with HCC between January 1990 and July 2008,whose family history of primary liver cancer was clearly described in the medical records.RESULTS:Of the 2242 patients,165 (7.4％) had a positive family history of HCC and 2077 (92.6％) did not.The male to female ratio was 3.6:1,and the major causes of HCC were chronic hepatitis B virus (HBV) infection in 75.1％,chronic hepatitis C virus infection in 13.2％ and alcohol in 3.1％.The median ages at diagnosis in the positive-and negative-history groups were 52 years (range:29-79 years) and 57 years (range:18-89 years),respectively (P ＜ 0.0001).Furthermore,among 1713 HCC patients with HBV infection,the number of patients under 45 years of age out of 136 patients with positive family history was 26 (19.1％),whereas those out of 1577 patients with negative family history was 197 (12.5％),suggesting that a positive family history may be associated with earlier development of HCC in the Korean population (P =0.0028).CONCLUSION:More intensive surveillance maybe recommended to those with a positive family history of HCC for earlier diagnosis and proper management especially when HBV infection is present.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普