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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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    Knockdown of liver-intestine cadherin decreases BGC823 cell invasiveness and metastasis in vivo

    YU XuJin ZhangQi-Sheng LiuWei-Guo Dong...
    3129-3137页
    查看更多>>摘要：AIM:To assess BGC823 gastric cancer (GC) cell metastasis after knockdown of liver-intestine cadherin (CDH17) and the therapeutic value of CDH17-RNAilentivirus in vivo.METHODS:We evaluated primary tumor growth and assessed local infiltration and systemic tumor dissemination using an orthotopic implantation technique.The therapeutic value of CDH17 knockdown was examined by intratumoral administration of CDH17-RNA interference (RNAi)-lentivirus in an established GC tumor xenograft mouse model.Furthermore,a comparative proteomic approach was utilized to identify differentially expressed proteins in BGC823 and lenti-CDH17-miRneg cells following CDH17 knockdown.RESULTS:Metastases in the liver and lung appeared earlier and more frequently in animals with tumors derived from BGC823 or lenti-CDH17-miR-neg cells than in tumors derived from lenti-CDH17-miR-B cells.Average tumor weight and volume in the CDH17-RNAi-lentivirus-treated group were significantly lower than those in the control group (tumor volume:0.89 ± 0.04 cm3 vs 1.16 ± 0.06 cm3,P ＜ 0.05; tumor weight:1.15 ±0.58 g vs 2.09 ± 0.08 g,P ＜ 0.05).Fifteen differentially expressed proteins were identified after CDH17 silencing in BGC823 cells,including a variety of cytoskeletal and chaperone proteins as well as proteins involved in metabolism,immunity/defense,cell proliferation and differentiation,cell cycle,and signal transduction.CONCLUSION:Our data establish a foundation for future studies of the comprehensive protein expression patterns and effects of CDH17 in GC.
      原文链接:
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    Comparison of total splenic artery embolization and partial splenic embolization for hypersplenism

    Xin-Hong HeJian-Jian GuWen-Tao LiWei-Jun Peng...
    3138-3144页
    查看更多>>摘要：AIM:To evaluate whether total splenic artery embolization (TSAE) for patients with hypersplenism delivers better long-term outcomes than partial splenic embolization (PSE).METHODS:Sixty-one patients with hypersplenism eligible for TSAE (n =27,group A) or PSE (n =34,group B) were enrolled into the trial,which included clinical and computed tomography follow-up.Data on technical success,length of hospital stay,white blood cell (WBC)and platelet (PLT) counts,splenic volume and complications were collected at 2 wk,6 mo,and 1,2,3,4 years postoperatively.RESULTS:Both TSAE and PSE were technically successful in all patients.Complications were significantly fewer (P =0.001),and hospital stay significantly shorter (P =0.007),in group A than in group B.Postprocedure WBC and PLT counts in group A were significantly higher than those in group B from 6 mo to 4 years (P =0.001),and post-procedure residual splenic volume in group A was significantly less than that observed in group B at 1,2,3 and 4 years post-procedure (P =0.001).No significant differences were observed in red blood cell counts and liver function parameters between the two groups following the procedure.CONCLUSION:Our results indicate that TSAE for patients with hypersplenism not only delivers a better longterm outcome,but is also associated with lower complication rates and a shorter hospital stay than PSE.
      原文链接:
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    Gastric mucosal damage in water immersion stress:Mechanism and prevention with GHRP-6

    Shu GuoQian GaoQing JiaoWei Hao...
    3145-3155页
    查看更多>>摘要：AIM:To investigate the mechanism of gastric mucosal demage induced by water immersion restraint stress (WRS) and its prevention by growth hormone releasing peptide-6 (GHRP-6).METHODS:Male Wistar rats were subjected to conscious or unconscious (anesthetized) WRS,simple restraint (SR),free swimming (FS),non-water fluid immersion,immersion without water contact,or rats were placed in a cage surrounded by sand.To explore the sensitivity structures that influence the stress reaction besides skin stimuli,a group the rats had their eyes occluded.Cervical bilateral trunk vagotomy or atropine injection was performed in some rats to assess the parasympathetic role in mucosal damage.Gastric mucosal lesions,acid output and heart rate variability were measured.Plasma renin,endothelin-1 and thromboxane B2 and gastric heat shock protein 70 were also assayed.GHRP-6 was injected [intraperitoneal (IP) or intracerebroventricular (ICV)]2 h before the onset of stress to observe its potential prevention of the mucosal lesion.RESULTS:WRS for 6 h induced serious gastric mucosal lesion [lesion area,WRS 81.8 ± 6.4 mm2 vs normal control 0.0 ± 0.0 mm2,P ＜ 0.01],decreased the heart rate,and increased the heart rate variability and gastric acid secretion,suggesting an increase in vagal nervecarrying stimuli.The mucosal injury was inversely correlated with water temperature (lesion area,WRS at 35 ℃ 56.4 ± 5.2 mm2 vs WRS at 23 ℃ 81.8 ± 6.4 mm2,P ＜ 0.01) and was consciousness-dependent.The injury could not be prevented by eye occlusion,but could be prevented by avoiding contact of the rat body with the water by dressing it in an impermeable plastic suit.When water was replaced by vegetable oil or liquid paraffin,there were gastric lesions in the same grade of water immersion.When rat were placed in a cage surrounded by sand,there were no gastric lesions.All these data point to a remarkable importance of cutenuous information transmitted to the high neural center that by vagal nerves reaching the gastric mucosa.FS alone also induced serious gastric injury,but SR could not induce gastric injury.Bilateral vagotomy or atropine prevented the WRS-induced mucosal lesion,indicating that increased outflow from the vagal center is a decisive factor in WRS-induced gastric injury.The mucosal lesions were prevented by prior injection of GHRP-6 via IP did,but not via ICV,suggesting that the protection is peripheral,although a sudden injection is not equivalent to a physiological release and uptake,which eventually may affect the vagal center.CONCLUSION:From the central nervous system,vagal nerves carry the cutaneous stimuli brought about by the immersion restraint,an experimental model for inducing acute gastric erosions.GHRP-6 prevents the occurrence of these lesions.
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    Two-stage vs single-stage management for concomitant gallstones and common bile duct stones

    Jiong LuYao ChengXian-Ze XiongYi-Xin Lin...
    3156-3166页
    查看更多>>摘要：AIM:To evaluate the safety and effectiveness of two-stage vs single-stage management for concomitant gallstones and common bile duct stones.METHODS:Four databases,including PubMed,Embase,the Cochrane Central Register of Controlled Trials and the Science Citation Index up to September 2011,were searched to identify all randomized controlled trials (RCTs).Data were extracted from the studies by two independent reviewers.The primary outcomes were stone clearance from the common bile duct,postoperative morbidity and mortality.The secondary outcomes were conversion to other procedures,number of procedures per patient,length of hospital stay,total operative time,hospitalization charges,patient acceptance and quality of life scores.RESULTS:Seven eligible RCTs [five trials (n =621)comparing preoperative endoscopic retrograde cholangiopancreatography (ERCP)/endoscopic sphincterotomy (EST) + laparoscopic cholecystectomy (LC) with LC +laparoscopic common bile duct exploration (LCBDE);two trials (n =166) comparing postoperative ERCP/EST + LC with LC + LCBDE],composed of 787 patients in total,were included in the final analysis.The metaanalysis detected no statistically significant difference between the two groups in stone clearance from the common bile duct [risk ratios (RR) =-0.10,95％ confidence intervals (CI):-0.24 to 0.04,P =0.17],postoperative morbidity (RR =0.79,95％ CI:0.58 to 1.10,P =0.16),mortality (RR =2.19,95％ CI:0.33 to 14.67,P =0.42),conversion to other procedures (RR =1.21,95％ CI:0.54 to 2.70,P =0.39),length of hospital stay (MD =0.99,95％ CI:-1.59 to 3.57,P =0.45),total operative time (MD =12.14,95％ CI:-1.83 to 26.10,P =0.09).Two-stage (LC + ERCP/EST) management clearly required more procedures per patient than single-stage (LC + LCBDE) management.CONCLUSION:Single-stage management is equivalent to two-stage management but requires fewer procedures.However,patient's condition,operator's expertise and local resources should be taken into account in making treatment decisions.
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    Poor awareness of preventing aspirin-induced gastrointestinal injury with combined protective medications

    Ling-Ling ZhuLing-Cheng XuYan ChenQuan Zhou...
    3167-3172页
    查看更多>>摘要：AIM:To investigate prescribing pattern in low-dose aspirin users and physician awareness of preventing aspirin-induced gastrointestinal (GI) injury with combined protective medications.METHODS:A retrospective drug utilization study was conducted in the 2nd Affiliated Hospital,School of Medicine,Zhejiang University.The hospital has 2300 beds and 2.5 million outpatient visits annually.Data mining was performed on all aspirin prescriptions for outpatients and emergency patients admitted in 2011.Concomitant use of proton-pump inhibitors (PPIs),histamine 2-receptor antagonists (H2RA) and mucoprotective drugs (MPs) were analyzed.A defined daily dose (DDD) methodology was applied to each MP.A further investigation was performed in aspirin users on combination use of GI injurious medicines [non-steoid anti-inflammatory drugs (NSAIDs),corticosteroids and clopidogrel and warfarin] or intestinal protective drugs (misoprostol,rebamipide,teprenone and gefarnate).Data of major bleeding episodes were derived from medical records and adverse drug reaction monitoring records.The annual incidence of major GI bleeding due to low-dose aspirin was estimated for outpatients.RESULTS:Prescriptions for aspirin users receiving PPIs,H2RA and MPs (n =1039) accounted for only 3.46％of total aspirin prescriptions (n =30 015).The ratios of coadministration of aspirin/PPI,aspirin/H2RA,aspirin/MP and aspirin/PPI/MP to the total aspirin prescriptions were 2.82％,0.12％,0.40％ and 0.12％,respectively.No statistically significant difference was observed in age between patients not receiving any GI protective medications and patients receiving PPIs,H2RA or MPs.The combined medication of aspirin and PPI was used more frequently than that of aspirin and MPs (2.82％ vs 0.40％,P ＜ 0.05) and aspirin/H2RA (2.82％ vs 0.12％,P ＜ 0.05).The values of DDDs of MPs in descending order were as follows:gefarnate,hydrotalcite ＞ teprenone ＞ sucralfate oral suspension ＞ L-glutamine and sodium gualenate granules ＞ rebamipide ＞ sucralfate chewable tablets.The ratio of MP plus aspirin prescriptions to the total MP prescriptions was as follows:rebamipide (0.47％),teprenone (0.91％),L-glutamine and sodium gualenate granules (0.92％),gefarnate (0.31％),hydrotalcite (1.00％) and sucralfate oral suspension (0.13％).Percentages of prescriptions containing aspirin and intestinal protective drugs among the total aspirin prescriptions were:rebamipide (0.010％),PPI/rebamipide (0.027％),teprenone (0.11％),PPI/teprenone (0.037％),gefarnate (0.017％),and PPI/gefarnate (0.013％).No prescriptions were found containing coadministration of aspirin and other NSAIDs.Among the 3196 prescriptions containing aspirin/clopidogrel,3088 (96.6％) prescriptions did not contain any GI protective medicines.Of the 389 prescriptions containing aspirin/corticosteroids,236 (60.7％) contained no GI protective medicines.None of the prescriptions using aspirin/warfarin (n =22) contained GI protective medicines.Thirty-five patients were admitted to this hospital in 2011 because of acute hemorrhage of upper digestive tract induced by low-dose aspirin.The annual incidence rates of major GI bleeding were estimated at 0.25％ for outpatients taking aspirin and 0.5％ for out-patients taking aspirin/warfarin,respectively.CONCLUSION:The prescribing pattern of low-dose as-pirin revealed a poor awareness of preventing GI injury with combined protective medications.Actions should be taken to address this issue.
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    An unusual case of fatty liver in a patient with desmoid tumor

    Francesca De FeliceDaniela MusioRossella CaiazzoBartolomeo Dipalma...
    3173-3176页
    查看更多>>摘要：A desmoid tumor,also known as aggressive fibromatosis,is a rare benign neoplasm that arises from fascial or musculoaponeurotic tissues.It can occur in any anatomical location,most commonly the abdominal wall,shoulder girdle and retroperitoneum.The typical clinical presentation is a painless mass with a slow and progressive invasion of contiguous structures.It is associated with a high local recurrence rate after resection.Many issues regarding the optimal treatment of desmoid tumors remain controversial.Aggressive surgical resection with a wide margin (2-3 cm) remains the gold standard treatment with regard to preserving quality of life.Radiotherapy alone has been shown to be effective for the control of unresectable or recurrent lesions.Desmoid tumors tend to be locally infiltrative,therefore,the fields must be generous to prevent marginal recurrence.The radiation dose appropriate for treating desmoid tumors remains controversial.We present a 25-year-old Caucasian man with local recurrence of a desmoid tumor after repeated surgical resection,treated with radiotherapy.The patient achieved complete tumor regression at 4 mo after radiotherapy,and he is clinically free of disease at 12 mo after the end of treatment,with an acceptable quality of life.The patient developed short bowel syndrome as a complication of second surgical resection.Consequently,radiotherapy might have worsened an already present malabsorption and so led to steatohepatitis.
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    Rectal perforations and fistulae secondary to a glycerin enema: Closure by over-the-scope-clip

    Hirohito MoriHideki KobaraShintaro FujiharaNoriko Nishiyama...
    3177-3180页
    查看更多>>摘要：Rectal perforations due to glycerin enemas (GE) typically occur when the patient is in a seated or lordotic standing position.Once the perforation occurs and peritonitis results,death is usually inevitable.We describe two cases of rectal perforation and fistula caused by a GE.An 88-year-old woman presented with a large rectal perforation and a fistula just after receiving a GE.Her case was further complicated by an abscess in the right rectal wall.The second patient was a 78-year-old woman who suffered from a rectovesical fistula after a GE.In both cases,we performed direct endoscopic abscess lavage with a saline solution and closed the fistula using an over-the-scope-clip (OTSC) procedure.These procedures resulted in dramatic improvement in both patients.Direct endoscopic lavage and OTSC closure are very useful for pararectal abscess lavage and fistula closure,respectively,in elderly patients who are in poor general condition.Our two cases are the first reports of the successful endoscopic closure of fistulae using double OTSCs after endoscopic lavage of the debris and an abscess of the rectum secondary to a GE.
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    More attention should be paid on the interpretation of gene expression data

    Eric Verna
    3181-3182页
    查看更多>>摘要：Molecular profiling of gene expression is important for determining signatures in cancer progression and diagnosis.For this purpose,polymerase chain reactionbased techniques are preferentially used as a feasible and sensitive approach.Nevertheless,when relative quantitative analyses are performed on gene expression,the interpretation of mathematical equations must be carefully done.This letter to the editor is focused on recently published gene expression data in World Journal of Gastroenterology by Ozmen et al demonstrating increased levels of LYVE-1,VEGFR-3 and CD44 genes in gastric cancer samples compared to nonneoplastic gastric tissues.However,there are major concerns about misinterpretation of the gene expression data obtained with the 2-△△ct relative quantitative method.In the study,2-△△Ct values calculated for many samples were smaller than 1 (2-△△ct ＜ 1) which indicate decreased levels of LYVE-1,VEGFR-3 and CD44 gene expression in the gastric cancer tissues.This unfortunate mistake is an important example showing how a simple error in the interpretation of relative-quantitative gene expression data may result in misleading scientific conclusions.In this letter,a brief explanation of the 2-△△ct method is given.In addition,the importance of technical quality and interpretation in gene expression studies is discussed.
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      原文链接:
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