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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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    Two-stage resection for malignant colonic obstructions: The timing of early resection and possible predictive factors

    Hsiang-Yu YangChang-Chieh WuShu-Wen JaoKuo-Feng Hsu...
    3267-3271页
    查看更多>>摘要：AIM:To study potential predictive factors for early radical resection in two-stage resection for left malignant colonic obstruction.METHODS:Thirty-eight cases of left-sided obstructive colon cancer undergoing two-stage operations were reviewed between January 1998 and August 2008.Patients were classified into two groups (n =19 each):early radical resection (interval ≤ 10 d) and late radical resection (interval ＞ 10 d).Baseline demographics,post-diversion outcome,perioperative data,tumor characteristics,outcome and complications were analyzed.RESULTS:The baseline demographics revealed no differences except for less pre-diversion sepsis in the early group (P ＜ 0.001) and more obstruction days in the late group (P =0.009).The mean intervals of early and late radical resections were 7.9 ± 1.3 d and 17.8 ± 5.5 d,respectively (P ＜ 0.001).After diversion,the presence of bowel sounds,flatus,removal of the nasogastric tube and the resumption of oral feeding occurred earlier in the early group.The operation time and duration of hospital stay were both significant reduced in the early group.Complication rates did not differ between groups.CONCLUSION:The earlier recovery of bowel function seems to be predictive of early radical resection.In contrast,pre-diversion sepsis and more obstruction days were predictive of delayed radical resection.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Preoperative predictors of short-term survival after hepatectomy for multinodular hepatocellular carcinoma

    Wen-Chao ZhaoHai-Bin ZhangNing YangYong Fu...
    3272-3281页
    查看更多>>摘要：AIM:To investigate preoperative factors associated with poor short-term outcome after resection for multinodular hepatocellular carcinoma (HCC) and to assess the contraindication of patients for surgery.METHODS:We retrospectively analyzed 162 multinodular HCC patients with Child-Pugh A liver function who underwent surgical resection.The prognostic significance of preoperative factors was investigated by univariate analysis using the log-rank test and by multivariate analysis using the Cox proportional hazards model.Each independent risk factor was then assigned points to construct a scoring model to evaluate the indication for surgical intervention.A receiver operating characteristics (ROC) curve was constructed to assess the predictive ability of this system.RESULTS:The median overall survival was 38.3 mo (range:3-80 mo),while the median disease-free survival was 18.6 mo (range:1-79 mo).The 1-year mortality was 14％.Independent prognostic risk factors of 1-year death included prealbumin ＜ 170 mg/L [hazard ratio (HR):5.531,P ＜ 0.001],alkaline phosphatase ＞129 U/L (HR:3.252,P =0.005),α fetoprotein ＞ 20 μg/L (HR:7.477,P =0.011),total tumor size ＞ 8 cm (HR:10.543; P ＜ 0.001),platelet count ＜ 100 × 109/L(HR:9.937,P ＜ 0.001),and γ-glutamyl transpeptidase ＞ 64 U/L (HR:3.791,P ＜ 0.001).The scoring model had a strong ability to predict 1-year survival (area under ROC:0.925,P ＜ 0.001).Patients with a score ≥ 5 had significantly poorer short-term outcome than those with a score ＜ 5 (1-year mortality:62％ vs 5％,P ＜ 0.001; 1-year recurrence rate:86％ vs 33％,P ＜0.001).Patients with score ≥ 5 had greater possibility of microvascular invasion (P ＜ 0.001),poor tumor differentiation (P =0.003),liver cirrhosis with small nodules (P ＜ 0.001),and intraoperative blood transfusion (P =0.010).CONCLUSION:A composite preoperative scoring model can be used as an indication of prognosis of HCC patients after surgical resection.Resection should be considered with caution in patients with a score ≥ 5,which indicates a contraindication for surgery.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Electrical bioimpedance gastric motility measurement based on an electrical-mechanical composite mechanism

    Shu ZhaoHong ShaZhang-Yong LiChao-Shi Ren...
    3282-3287页
    查看更多>>摘要：AIM:To introduce a bioimpedance gastric motility measurement method based on an electrical-mechanical composite concept and a preliminary clinical application.METHODS:A noninvasive gastric motility measurement method combining electrogastrogram (EGG) and impedance gastric motility (IGM) test was used.Preliminary clinical application studies of patients with functional dyspepsia (FD) and gastritis,as well as healthy controls,were carried out.Twenty-eight FD patients (mean age 40.9 ± 9.7 years) and 40 healthy volunteers (mean age 30.9 ± 7.9 years) were involved.IGM spectrum was measured for both the healthy subjects and FD patients,and outcomes were compared in the FD patients before treatment and 1 wk and 3 wk after treatment.IGM parameters were obtained from 30 erosive gastritis patients (mean age 50.5 ± 13.0 years)and 40 healthy adults,and IGM and EGG results were compared in the gastritis patients before treatment and 1 wk after treatment.RESULTS:There were significant differences in the IGM parameters between the FD patients and healthy subjects,and FD patients had a poorer gastric motility [percentage of normal frequency (PNF) 70.8 ± 25.5 in healthy subjects and 28.3 ± 16.9 in FD patients,P ＜ 0.01].After 1 wk administration of domperidone 10 mg,tid,the gastric motility of FD patients was not improved,although the EGG of the patients had returned to normal.After 3 wk of treatment,the IGM rhythm of the FD patients became normal.There was a significant difference in IGN parameters between the two groups (PNF 70.4 ± 25.5 for healthy subjects and 36.1 ± 21.8 for gastritis patients,P ＜ 0.05).The EGG rhythm of the gastritis patients returned to normal (frequency instability coefficient 2.22 ± 0.43 before treatment and 1.77± 0.19 one wk after treatment,P ＜ 0.05) after 1 wk of treatment with sodium rabeprazole tablets,10 mg,qd,po,qm,while some IGM parameters showed a tendency toward improvement but had not reached statistical significance.CONCLUSION:The electrical-mechanical composite measurement method showed an attractive clinical application prospect in gastric motility research and evaluation.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Omega-3 polyunsaturated fatty acids promote liver regeneration after 90％ hepatectomy in rats

    Yu-Dong QiuSheng WangYue YangXiao-Peng Yan...
    3288-3295页
    查看更多>>摘要：AIM:To evaluate the effectiveness of omega-3 polyunsaturated fatty acid (ω-3 PUFA) administration on liver regeneration after 90％ partial hepatectomy (PH) in METHODS:ω-3 PUFAs were intravenously injected in the ω-3 PUFA group before PH surgery.PH,sparing only the caudate lobe,was performed in both the control and the ω-3 PUFA group.Survival rates,liver weight/body weight ratios,liver weights,HE staining,transmission electron microscope imaging,nuclearassociated antigen Ki-67,enzyme-linked immunosorbent assay and signal transduction were evaluated to analyze liver regeneration.RESULTS:All rats in the control group died within 30 h after hepatectomy.Survival rates in the ω-3 PUFA group were 20/20 at 30 h and 4/20 1 wk after PH.Liver weight/body weight ratios and liver weights increased significantly in the ω-3 PUFA group.The structure of sinusoidal endothelial cells and space of Disse was greatly restored in the ω-3 PUFA group compared to the control group after PH.In the ω-3 PUFA group,interleukin (IL)-4 and IL-10 levels were significantly increased whereas IL-6 and tumor necrosis factor-α levels were dramatically decreased.In addition,activation of protein kinase B (Akt) and of signal transducer and activator of transcription 3 signaling pathway were identified at an earlier time after PH in the ω-3 PUFA group.CONCLUSION:Omega-3 polyunsaturated fatty acids may prevent acute liver failure and promote liver regeneration after 90％ hepatectomy in rats.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Expression and significance of homeodomain protein Cdx2 in gastric carcinoma and precancerous lesions

    Rong QinNa-Na WangJing ChuXian Wang...
    3296-3302页
    查看更多>>摘要：AIM:To investigate the expression and significance of caudal-related homeobox transcription factor (Cdx2) in gastric carcinoma (GC) and precancerous lesions.METHODS:The expression of Cdx2 in GC,precancerous lesions and normal gastric mucosa were detected using immunohistochemical method.Hematoxylin and eosin staining,alcian blue/periodic acid-schiff and high iron diamine/alcian blue staining were used to classify intestinal metaplasia (IM) and GC.RESULTS:Cdx2 was not detected in normal gastric mucosa.Cdx2 expression was detected in 87.1％(101/116) of IM,50％ (36/72) of dysplasia and 48.2％(41/85) of GC.The Cdx2-expressing cells in IM were more prevalent than in dysplasia and carcinoma (P ＜0.05).There was no relationship between Cdx2 expression and the classification of IM or the degree of dysplasia.Expression of Cdx2 was significantly higher in intestinal-type carcinoma than in diffuse and mixedtype carcinoma (P ＜ 0.05).Positive expression of Cdx2 was mainly found in moderately to well differentiated GC.There was a negative association between nuclear Cdx2 expression and lymph node metastasis and tumor,nodes,metastasis stage of GC (P ＜ 0.05).The patients with Cdx2-positive expression showed a higher survival rate than those with Cdx2-negative expression (P =0.038).Multivariate analysis revealed that the expression of Cdx2 and lymph node metastasis were independent prognostic indicators of GC (P ＜ 0.05).CONCLUSION:Cdx2 may be closely related to IM and the intestinal-type GC and implicate better biological behavior and outcome.Cdx2 is useful for predicting the prognosis of GC.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Increased frequency and clinical significance of myeloidderived suppressor cells in human colorectal carcinoma

    Hong-Li SunXin ZhouYi-Feng XueKe Wang...
    3303-3309页
    查看更多>>摘要：AIM:To investigate the frequency and clinical significance of the myeloid-derived suppressor cells (MDSC) in human colorectal carcinoma (CRC).METHODS:Samples of peripheral blood and tumor tissue from 49 CRC patients were analyzed.Mononuclear cells were isolated by Ficoll-Hypaque density gradient centrifugation and were subjected to a flow cytometrybased immunophenotypic analysis.RESULTS:A considerable increase in the percentage of CD33+HLA-DR MDSCs was observed in the peripheral blood (1.89％ ± 0.75％) and tumor tissues (2.99％± 1.29％) of CRC patients as compared with that in the peripheral blood of healthy controls (0.54％ ± 0.35％).This expanded CD33+HLA-DR-subset exhibited immature myeloid cell markers,but not lineage markers,and showed up-regulation of CD18/CD11b expression as compared with the MDSCs from healthy donors.Further studies showed that the MDSC proportion in CRC peripheral blood was correlated with nodal metastasis (P =0.023),whereas that in tumor tissues was correlated with nodal/distant metastasis (P =0.016/P =0.047) and tumor stage (P =0.028),suggesting the involvement of MDSCs in CRC tumor development.CONCLUSION:Characterization of MDSCs in CRC suggests the clinical significance of circulating and tumorinfiltrating MDSCs and may provide new insights into the CRC immunotherapy targeting MDSCs.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    Protective effect of nitric oxide on hepatopulmonary syndrome from ischemia-reperfusion injury

    Tong-Jin DiaoXin ChenLi-Hua DengHan-Xiang Chen...
    3310-3316页
    查看更多>>摘要：AIM:To evaluate immunological protection of nitric oxide (NO) in hepatopulmonary syndrome and probable mechanisms of ischemia-reperfusion (IR) injury in rat liver transplantation.METHODS:Sixty-six healthy male Wistar rats were randomly divided into three groups (11 donor/recipient pairs).In group Ⅱ,organ preservation solution was lactated Ringer's solution with heparin 10 000/μL at 4 ℃.In groups Ⅰ and Ⅲ,the preservation solution added,respectively,L-arginine or NG-L-arginine methyl ester (L-NAME) (1 mmol/L) based on group Ⅱ,and recipients were injected with L-arginine or L-NAME (50 mg/kg) in the anhepatic phase.Grafted livers in each group were stored for 6 h and implanted into recipients.Five rats were used for observation of postoperative survival in each group.The other six rats in each group were used to obtain tissue samples,and executed at 3 h and 24 h after transplantation.The levels of alanine aminotransferase (ALT),tumor necrosis factor (TNF)-α and NO metabolites (NOx) were detected,and expression of NO synthase,TNF-α and intercellular adhesion molecule 1 (ICAM-1) was examined by triphosphopyridine nucleotide diaphorase histochemical and immunohistochemical staining.RESULTS:By supplementing L-arginine to strengthen the NO pathway,a high survival rate was achieved and hepatic function was improved.One-week survival rate of grafted liver recipients in group Ⅰ was significantly increased (28.8 ± 36.6 d vs 4 ± 1.7 d,P＜ 0.01) as compared with groups Ⅱ and Ⅲ.Serum levels of ALT in group Ⅰ were 2-7 times less than those in groups Ⅱ and Ⅲ (p ＜ 0.01).The cyclic guanosine monophosphate (cGMP) levels in liver tissue and NOx in group Ⅰ were 3-4 times higher than those of group Ⅱ after 3 h and 24 h reperfusion,while in group Ⅲ,they were significantly reduced as compared with those in group Ⅱ (P ＜ 0.01).The levels of TNF-α in group Ⅰ were significantly lower than in group Ⅱ after 3 h and 24 h reperfusion (P ＜ 0.01),while being significantly higher in group Ⅲ than group Ⅱ (P ＜ 0.01).Histopathology revealed more severe tissue damage in graft liver and lung tissues,and a more severe inflammatory response of the recipient after using NO synthase inhibitor,while the pathological damage to grafted liver and the recipient's lung tissues was signifcantly reduced in group Ⅰ after 3 h and 24 h reperfusion.A small amount of constitutive NO synthase (cNOS) was expressed in liver endothelial cells after 6 h cold storage,but there was no expression of inducible NO synthase (iNOS).Expression of cNOS was particularly significant in vascular endothelial cells and liver cells at 3 h and 24 h after reperfusion in group Ⅱ,but expression of iNOS and ICAM-1 was low in group Ⅰ.There was diffuse strong expression of ICAM-1 and TNF-α in group Ⅲ at 3 h after reperfusion.CONCLUSION:The NO/cGMP pathway may be critical in successful organ transplantation,especially in treating hepatopulmonary syndrome during cold IR injury in rat orthotopic liver transplantation.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Lymphogranuloma venereum proctosigmoiditis is a mimicker of inflammatory bowel disease

    Marlene GallegosDawn BradlyShriram JakateAli Keshavarzian...
    3317-3321页
    查看更多>>摘要：There has been an increasing prevalence of lymphogranuloma venereum (LGV) or Chlamydia trachomatis (C.trachomatis) cases among the men who have sex with men (MSM) population,particularly in Europe and North America.These cases may present with an incomplete or undisclosed history and proctosigmoiditis without characteristic adenopathy syndrome.During the initial evaluation and colonoscopy,there is a strong clinical and endoscopic suspicion of inflammatory bowel disease (IBD) by virtue of presentation and endoscopic and histological findings.The diagnosis of IBD is subsequently modified to LGV proctosigmoiditis when one or more of the following transpire:(1) there is failure of response to IBD therapy; (2) additional components of history (MSM/travel) may be identified; (3) return of initially performed Chlamydia antibody test is positive;and (4) response to antibiotics effective against Chlamydia.We describe three such cases initially suspected to be an inflammatory bowel disease and subsequently identified as C.trachomatis proctosigmoiditis.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Diagnosis in bile acid-CoA: Amino acid N-acyltransferase deficiency

    Nedim Had(z)i(c)Laura N BullPeter T ClaytonAS Knisely...
    3322-3326页
    查看更多>>摘要：Cholate-CoA ligase (CCL) and bile acid-CoA:amino acid N-acyltransferase (BAAT) sequentially mediate bile-acid amidation.Defects can cause intrahepatic cholestasis.Distinction has required gene sequencing.We assessed potential clinical utility of immunostaining of liver for CCL and BAAT.Using commercially available antibodies against BAAT and CCL,we immunostained liver from an infant with jaundice,deficiency of amidated bile acids,and transcription-terminating mutation in BAAT.CCL was normally expressed.BAAT expression was not detected.Immunostaining may facilitate diagnosis in bileacid amidation defects.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Giant choledocholithiasis treated by mechanical lithotripsy using a gastric bezoar basket

    Hyun Jung ChungSeok JeongDon Haeng LeeJung Il Lee...
    3327-3330页
    查看更多>>摘要：Mechanical lithotripsy (ML) is usually considered as a standard treatment option for large bile duct stones.However,it is impossible to retrieve oversized stones because the conventional lithotripsy basket may not be able to grasp the stone.However,there is no established endoscopic extraction method for such giant stone removal.We describe a case of successful extraction of a 4-cm large stone using a gastric bezoar basket.A 78-year-old woman had suffered from upper abdominal pain for 20 d.Contrast-enhanced computed tomogram revealed a 4-cm single stone in the distal common bile duct (CBD).Endoscopic stone retraction was decided upon and endoscopic papillary balloon dilation was performed using a large balloon.An attempt to capture the stone using a standard lithotripsy basket failed due to the large stone size.Subsequently,we used a gastric bezoar basket to successfully capture the stone.The stone was fragmented into small pieces and extracted.The stone was completely removed after two sessions of endoscopic retrograde cholangiopancreatography; each of which took 30 min.No complications occurred during or after the procedure.The patient was fully recovered and discharged on day 11 of hospitalization.ML using a gastric bezoar basket is a safe and effective retrieval method in select cases,and is considered as an alternative nonoperative option for the management of difficult CBD stones.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普