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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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    Time to detoxify medical literature from guideline overdose

    Dinesh VyasArpita K Vyas
    3331-3335页
    查看更多>>摘要：The current financial turmoil in the United States has been attributed to multiple reasons including healthcare expenditure.Health care spending has increased from 5.7 percent of the gross domestic product (GDP)in 1965 to 16 percent of the GDP in 2004.Healthcare is driven with a goal to provide best possible care available at that period of time.Guidelines are generally assumed to have the high level of certainty and security as conclusions generated by the conventional scientific method leading many clinicians to use guidelines as the final arbiters of care.To provide the standard of care,physicians follow guidelines,proposed by either groups of physicians or various medical societies or government organizations like National Comprehensive Cancer Network.This has lead to multiple tests for the patient and has not survived the test of time.This independence leads to lacunae in the standardization of guidelines,hence flooding of literature with multiple guidelines and confusion to patients and physicians and eventually overtreatment,inefficiency,and patient inconvenience.There is an urgent need to restrict articles with Guidelines and develop some strategy like have an intermediate stage of pre-guidelines and after 5-10 years of trials,a systematic launch of the Guidelines.There can be better ways than this for putting together guidelines as has been suggested by multiple authors and researchers.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Recent advances in small bowel diseases: Part Ⅰ

    Alan BR ThomsonAngeli ChopraMichael Tom ClandininHugh Freeman...
    3336-3352页
    查看更多>>摘要：As is the case in all parts of gastroenterology and hepatology,there have been many advances in our knowledge and understanding of small intestinal diseases.Over 1000 publications were reviewed for 2008 and 2009,and the important advances in basic science as well as clinical applications were considered.In Part Ⅰ of this Editorial Review,seven topics are considered:intestinal development; proliferation and repair;intestinal permeability; microbiotica,infectious diarrhea and probiotics; diarrhea; salt and water absorption; necrotizing enterocolitis; and immunology/allergy.These topics were chosen because of their importance to the practicing physician.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    Recent advances in small bowel diseases: PartⅡ

    Alan BR ThomsonAngeli ChopraMichael Tom ClandininHugh Freeman...
    3353-3374页
    查看更多>>摘要：As is the case in all areas of gastroenterology and hepatology,in 2009 and 2010 there were many advances in our knowledge and understanding of small intestinal diseases.Over 1000 publications were reviewed,and the important advances in basic science as well as clinical applications were considered.In Part Ⅱ we review six topics:absorption,short bowel syndrome,smooth muscle function and intestinal motility,tumors,diagnostic imaging,and cystic fibrosis.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    How can portal vein cavernous transformation cause chronic incomplete biliary obstruction?

    Ozgur HarmanciYusuf Bayraktar
    3375-3378页
    查看更多>>摘要：Biliary disease in the setting of non-cirrhotic portal vein thrombosis (and similarly in portal vein cavernous transformation) can become a serious problem during the evolution of disease.This is mostly due to portal biliary ductopathy.There are several mechanisms that play a role in the development of portal biliany ductopathy,such as induction of fibrosis in the biliary tract (due to direct action of dilated peribiliary collaterals and/or recurrent cholangitis),loss of biliary motility,chronic cholestasis (due to fibrosis or choledocholithiasis) and increased formation of cholelithiasis (due to various factors).The management of cholelithiasis in cases with portal vein cavernous transformation merits special attention.Because of a heterogeneous clinical presentation and concomitant pathophysiological changes that take place in biliary anatomy,diagnosis and therapy can become very complicated.Due to increased incidence and complications of cholelithiasis,standard treatment modalities like sphincterotomy or balloon sweeping of bile ducts can cause serious problems.Cholangitis,biliary strictures and hemobilia are the most common complications that occur during management of these patients.In this review,we specifically discuss important issues about bile stones related to bile duct obstruction in non-cirrhotic portal vein thrombosis and present evidence in the current literature.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Acute pancreatitis in aging animals: Loss of pancreatitis-associated protein protection?

    Sophia FuAlbert StanekCathy M MuellerNefertti A Brown...
    3379-3388页
    查看更多>>摘要：AIM:To investigate the effect of age on severity of acute pancreatitis (AP) using biochemical markers,histology and expression of the protective pancreatitisassociated proteins (PAPs).METHODS:AP was induced via intraductal injection of 4％ sodium taurocholate in young and old rats.Sera and pancreata were assayed at 24 h for the parameters listed above; we also employed a novel molecular technique to assess bacterial infiltration using polymerase chain reaction to measure bacterial genomic ribosomal RNA.RESULTS:At 24 h after induction of AP,the pancreata of older animals had less edema (mean ± SE histologic score of young vs old:3.11 ± 0.16 vs 2.50 ±-0.11,P ＜0.05),decreased local inflammatory response (histologic score of stromal infiltrate:3.11 ± 0.27 vs 2.00 ± 0.17,P ＜ 0.05) and increased bacterial infiltration (174％ ±52％ increase from sham vs 377％ ± 4％,P ＜ 0.05).A decreased expression of PAP1 and PAP2 was demonstrated by Western blotting analysis and immunohistochemical staining.There were no differences in serum amylase and lipase activity,or tissue myeloperoxidase or monocyte chemotactic protein-1 levels.However,in the most-aged group,serum C-reactive protein levels were higher (young vs old:0.249 ± 0.04 mg/dL vs 2.45± 0.68 mg/dL,P ＜ 0.05).CONCLUSION:In older animals,there is depressed PAP expression related to a blunted inflammatory response in AP which is associated with worsened bacterial infiltration and higher C-reactive protein level; this may explain the more aggressive clinical course.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    Osteopontin increases hepatocellular carcinoma cell growth in a CD44 dependant manner

    Renee J PhillipsKarla J HelbigKylie H Van der HoekDevanshi Seth...
    3389-3399页
    查看更多>>摘要：AIM:To investigate the role of osteopontin (OPN) and its splice variants in the proliferation of hepatocellular carcinoma (HCC).METHODS:The expression of OPN variants in HCC cell lines as well as HCC tissue samples and nontumour tissue was studied using polymerase chain reaction.OPN variant cDNAs were cloned into a mammalian expression vector allowing both transient expression and the production of stable OPN expressing cell lines.OPN expression was studied in these cells using Western blotting,immunofluoresnce and enzyme linked immunosorbent assay.A CD44 blocking antibody and siRNA targeting of CD44 were used to examine the role of this receptor in the OPN stimulated cell growth observed in culture.Huh-7 cells stably expressing either OPN-A,-B or-C were injected subcutaneously into the flanks of nude mice to observe in vivo tumour growth.Expression of OPN mRNA and protein in these tumours was examined using reverse transcriptionpolymerase chain reaction and immunohistochemistry.RESULTS:OPN is expressed in HCC in 3 forms,the full length OPN-A and 2 splice variants OPN-B and-C.OPN variant expression was noted in HCC tissue as well as cognate surrounding cirrhotic liver tissue.Expression of these OPN variants in the HCC derived cell line Huh-7resulted in secretion of OPN into the culture medium.Transfer of OPN conditioned media to naive Huh-7 and HepG2 cells resulted in significant cell growth suggesting that all OPN variants can modulate cell proliferation in a paracrine manner.Furthermore the OPN mediated increase in cellular proliferation was dependent on CD44 as only CD44 positive cell lines responded to OPN conditioned media while siRNA knockdown of CD44 blocked the proliferative effect.OPN expression also increased the proliferation of Huh-7 cells in a subcutaneous nude mouse tumour model,with Huh-7 cells expressing OPN-A showing the greatest proliferative effect.CONCLUSION:This study demonstrates that OPN plays a significant role in the proliferation of HCC through interaction with the cell surface receptor CD44.Modulation of this interaction could represent a novel strategy for the control of HCC.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Retrograde-viewing device improves adenoma detection rate in colonoscopies for surveillance and diagnostic workup

    Peter D SiersemaAmit RastogiAnke M LeufkensPaul A Akerman...
    3400-3408页
    查看更多>>摘要：AIM:To determine which patients might benefit most from retrograde viewing during colonoscopy through subset analysis of randomized,controlled trial data.METHODS:The Third Eye(R) Retroscope(R) Randomized Clinical Evaluation (TERRACE) was a randomized,controlled,multicenter trial designed to evaluate the efficacy of a retrograde-viewing auxiliary imaging device that is used during colonoscopy to provide a second video image which allows viewing of areas on the proximal aspect of haustral folds and flexures that are difficult to see with the colonoscope's forward view.We performed a post-hoc analysis of the TER-RACE data to determine whether certain subsets of the patient population would gain more benefit than others from use of the device.Subjects were patients scheduled for colonoscopy for screening,surveillance or diagnostic workup,and each underwent same-day tandem examinations with standard colonoscopy (SC)and Third Eye colonoscopy (TEC),randomized to SC followed by TEC or vice versa.RESULTS:Indication for colonoscopy was screening in 176/345 subjects (51.0％),surveillance after previous polypectomy in 87 (25.2％) and diagnostic workup in 82 (23.8％).In 4 subjects no indication was specified.Previously reported overall results had shown a net additional adenoma detection rate (ADR) with TEC of 23.2％ compared to SC.Relative risk (RR) of missing adenomas with SC vs TEC as the initial procedure was 1.92 (P =0.029).Post-hoc subset analysis shows additional ADRs for TEC compared to SC were 4.4％ for screening,35.7％ for surveillance,55.4％ for diagnostic and 40.7％ for surveillance and diagnostic combined.The RR of missing adenomas with SC vs TEC was 1.11 (P =0.815) for screening,3.15 (P =0.014) for surveillance,8.64 (P =0.039) for diagnostic and 3.34(P =0.003) for surveillance and diagnostic combined.Although a multivariate Poisson regression suggested gender as a possibly significant factor,subset analysis showed that the difference between genders was not statistically significant.Age,bowel prep quality and withdrawal time did not significantly affect the RR of missing adenomas with SC vs TEC.Mean sizes of adenomas detected with TEC and SC were similar at 0.59cm and 0.56 cm,respectively (P =NS).CONCLUSION:TEC allows detection of significantly more adenomas compared to SC in patients undergoing surveillance or diagnostic workup,but not in screening patients (ClinicalTrials.gov Identifier:NCT01044732).
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Importance of early diagnosis of pancreaticobiliary maljunction without biliary dilatation

    Kensuke TakumaTerumi KamisawaTaku TabataSeiichi Hara...
    3409-3414页
    查看更多>>摘要：AIM:To clarify the strategy for early diagnosis of pancreaticobiliary maljunction (PBM) without biliary dilatation and to pathologically examine gallbladder before cancer develops.METHODS:The anatomy of the union of the pancreatic and bile ducts was assessed by using endoscopic retrograde cholangiopancreatography (ERCP).Patients with a long common channel in which communication between the pancreatic and bile ducts was maintained even during sphincter contraction were diagnosed as having PBM.Of these,patients in which the maximal diameter of the bile duct was less than 10 mm were diagnosed with PBM without biliary dilatation.The process of diagnosing 54 patients with PBM without biliary dilatation was retrospectively investigated.Histopathological analysis of resected gallbladder specimens from 8 patients with PBM without biliary dilatation or cancer was conducted.RESULTS:Thirty-six PBM patients without biliary dilatation were diagnosed with gallbladder cancer after showing clinical symptoms such as abdominal or back pain (n =16) or jaundice (n =12).Radical surgery for gallbladder cancer was only possible in 11 patients (31％)and only 4 patients (11％) survived for 5 years.Eight patients were suspected as having PBM without biliary dilatation from the finding of gallbladder wall thickening on ultrasound and the diagnosis was confirmed by ERCP and/or magnetic resonance cholangiopancreatography (MRCP).The median age of these 8 patients was younger by a decade than PBM patients with gallbladder cancer.All 8 patients underwent prophylactic cholecystectomy and bile duct cancer has not occurred.Wall thickness and mucosal height of the 8 resected gallbladders were significantly greater than controls,and hyperplastic changes,hypertrophic muscular layer,subserosal fibrosis,and adenomyomatosis were detected in 7 (88％),5 (63％),7 (88％) and 5 (63％) patients,respectively.Ki-67 labeling index was high and K-ras mutation was detected in 3 of 6 patients.CONCLUSION:To detect PBM without biliary dilatation before onset of gallbladder cancer,we should perform MRCP for individuals showing increased gallbladder wall thickness on ultrasound.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Effect of sumatriptan on gastric emptying: A crossover study using the BreathID system

    Yasunari SakamotoYusuke SekinoEiji YamadaTakuma Higurashi...
    3415-3419页
    查看更多>>摘要：AIM:To determine the effect of oral sumatriptan on gastric emptying using a continuous 13C breath test (BreathID system).METHODS:Ten healthy male volunteers participated in this randomized,2-way crossover study.The subjects fasted overnight and were randomly assigned to receive a test meal (200 kcal/200 mL) 30 min after pre-medication with sumatriptan 50 mg (sumatriptan condition),or the test meal alone (control condition).Gastric emptying was monitored for 4 h after administration of the test meal by the 13C-acetic acid breath test performed continually using the BreathID system.Then,using Oridion Research Software (β version),the time taken for emptying of 50％ of the labeled meal (T1/2) similar to the scintigraphy lag time for 10％emptying of the labeled meal (Tlag),the gastric emptying coefficient (GEC),and the regression-estimated constants (β and κ) were calculated.The statistical significance of any differences in the parameters were analyzed using Wilcoxon's signed-rank test.RESULTS:In the sumatdptan condition,significant differences compared with the control condition were found in T1/2 [median 131.84 min (range,103.13-168.70) vs 120.27 min (89.61-138.25); P =0.0016],Tlag [median 80.085 min (59.23-125.89) vs 61.11 min (39.86-87.05);P =0.0125],and β [median 2.3374 (1.6407-3.8209)vs 2.0847 (1.4755-2.9269); P =0.0284].There were no significant differences in the GEC or κ between the 2 conditions.CONCLUSION:This study showed that oral sumatriptan significantly delayed gastric emptying of a liquid meal.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Safety and effectiveness of propofol sedation during and after outpatient colonoscopy

    Akira HoriuchiYoshiko NakayamaMasashi KajiyamaNaoyuki Kato...
    3420-3425页
    查看更多>>摘要：AIM:To study the safety and effectiveness of propofol sedation for outpatient colonoscopy.METHODS:Propofol was given by bolus injection with an age-adjusted standard protocol consisting of 60 mg for patients ＜ 70 years old,40 mg for patients age 70-89 years,and 20 mg for those ≥ 90 years,and additional injections of 20 mg propofol were given up to a maximum of 200 mg.The principal parameters were the occurrence of adverse events within 24 h after colonoscopy and overall satisfaction for this procedure.Secondary parameters included successful procedure,respiratory depression,and other complications.RESULTS:Consecutive patients were entered prospectively and all 2101 entered successfully completed outpatient colonoscopy.The mean dose of propofol used was 96.4 mg (range 40-200 mg).Younger patients required higher doses of propofol than older patients (20-40 years vs ≥ 61 years:115.3±32 mg vs 89.7 ± 21 mg,P ＜ 0.001).Transient supplemental oxygen supply was needed by five patients (0.2％);no other complications occurred.The questionnaires were completed by 1820 (87％) of 2101 patients and most rated their overall satisfaction as excellent (80％)or good (17％).The majority (65％) of patients drove home or to their office after their colonoscopy.Most (99％) were willing,to repeat the same procedure.No incidents occurred within 24 h after colonoscopy.CONCLUSION:Propofol sedation using a dose ＜ 200 mg proved both safe and practical for outpatient colonoscopy.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普