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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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    Significant decrease in prevalence of Helicobacter pylori in the Czech Republic

    Jan Bure(s)Marcela Kopá(c)ováIlona KoupilBohumil Seifert...
    4412-4418页
    查看更多>>摘要：AIM:To study possible decrease in prevalence of Helicobacter pylori (H.pylori) infection in the Czech Republic within a 10-year period.METHODS:A total of 22 centres entered the study.The catchment areas of these centres covered cities and towns with more than 20 000 inhabitants,smaller towns (≤ 20 000 inhabitants) with surrounding villages and rural areas,and were spread over the whole country,corresponding well to the geographical distribution of the Czech population.A total of 1 837 subjects (aged 5-98 years) took part in the study,randomly selected out of 38 147 people from the general population.H.pylori infection was investigated by means of a 13C-urea breath test.Breath samples in duplicates were analysed using isotope ratio mass spectrometry.The cut-off point was 3.5.Social and demographic characteristics were based on data from self-completed questionnaires.RESULTS:The overall prevalence of H.pylori infection was 23.5％ (430/1826),and 4.8％ (20/420) in children aged 15 or less.There was no statistically significant difference in prevalence between males (24.3％; 208/857) and females (22.9％,222/969,P =0.494).H.pylori infection was strongly associated with higher age,among subjects aged 55+ years,prevalence of H.pylori infection was 39.8％ (252/633,P ＜0.001).The highest prevalence of H.pylori infection was found among persons aged 55-64 years (43.9％,97/221) and 75+ years (37.9％,58/153).Among study subjects aged 15+ years,prevalence of H.pylori infection was significantly increased in those with lowest education (odds risk 3.19,95％ CI 1.87-5.47).Compared to never married (14.1％),the prevalence of H.pylori infection was statistically significantly higher among married (35.4％,246/694,P ＜ 0.001),divorced (36.8％,49/133,P ＜ 0.001) and widowed study subjects (40.2％,45/112,P ＜ 0.001),both in minimally and fully adjusted analysis.There was no significant difference in the prevalence of H.pylori infection between married and widowed subjects (35.4％,246/694 vs 40.2％,45/112,P =0.389).There was little variation in smoking prevalence across categories of smoking and there was no evidence of an increased risk of H.pylori infection among current or past smokers in our data (odds risk 1.04 with 95％ CI 0.78-1.40 for current smokers; odds ratio 0.83 with 95％ CI 0.60-1.16 for former smokers).The current prevalence of H.pylori in 2011 was significantly lower compared to the prevalence reported from identical geographical areas in 2001 (23.5％ vs 41.7％,P ＜ 0.001).CONCLUSION:The overall prevalence of H.pylori infection in the general population has fallen substantially in the Czech Republic over the past 10 years.
      原文链接:
    • NETL
    • NSTL
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    Development of a quantum-dot-labelled magnetic immunoassay method for circulating colorectal cancer cell detection

    Maria GazouliAnna LyberopoulouPericles PericleousSpyros Rizos...
    4419-4426页
    查看更多>>摘要：AIM:To detect of colorectal cancer (CRC) circulating tumour cells (CTCs) surface antigens,we present an assay incorporating cadmium selenide quantum dots (QDs) in these paper.METHODS:The principle of the assay is the immunomagnetic separation of CTCs from body fluids in conjunction with QDs,using specific antibody biomarkers:epithelial cell adhesion molecule antibody,and monoclonal cytokeratin 19 antibody.The detection signal was acquired from the fluorescence signal of QDs.For the evaluation of the performance,the method under study was used to isolate the human colon adenocarcinoma cell line (DLD-1) and CTCs from CRC patients' peripheral blood.RESULTS:The minimum detection limit of the assay was defined to 10 DLD-1 CRC cells/mL as fluorescence was measured with a spectrofluorometer.Fluorescenceactivated cell sorting analysis and Real Time RT-PCR,they both have also been used to evaluate the performance of the described method.In conclusion,we developed a simple,sensitive,efficient and of lower cost (than the existing ones) method for the detection of CRC CTCs in human samples.We have accomplished these results by using magnetic bead isolation and subsequent QD fluorescence detection.CONCLUSION:The method described here can be easily adjusted for any other protein target of either the CTC or the host.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Contrast-enhanced ultrasonography parameters in neural network diagnosis of liver tumors

    Costin Teodor StrebaMihaela IonescuDan Ionut GheoneaLarisa Sandulescu...
    4427-4434页
    查看更多>>摘要：AIM:To study the role of time-intensity curve (TIC) analysis parameters in a complex system of neural networks designed to classify liver tumors.METHODS:We prospectively included 112 patients with hepatocellular carcinoma (HCC) (n =41),hypervascular (n =20) and hypovascular (n =12) liver metastases,hepatic hemangiomas (n =16) or focal fatty changes (n =23) who underwent contrast-enhanced ultrasonography in the Research Center of Gastroenterology and Hepatology,Craiova,Romania.We recorded full length movies of all contrast uptake phases and post-processed them offline by selecting two areas of interest (one for the tumor and one for the healthy surrounding parenchyma) and consecutive TIC analysis.The difference in maximum intensities,the time to reaching them and the aspect of the late/portal phase,as quantified by the neural network and a ratio between median intensities of the central and peripheral areas were analyzed by a feed forward back propagation multi-layer neural network which was trained to classify data into five distinct classes,corresponding to each type of liver lesion.RESULTS:The neural network had 94.45％ training accuracy (95％ CI:89.31％-97.21％) and 87.12％ testing accuracy (95％ CI:86.83％-93.17％).The automatic classification process registered 93.2％ sensitivity,89.7％ specificity,94.42％ positive predictive value and 87.57％ negative predictive value.The artificial neural networks (ANN) incorrectly classified as hemangyomas three HCC cases and two hypervascular metastases,while in turn misclassifying four liver hemangyomas as HCC (one case) and hypervascular metastases (three cases).Comparatively,human interpretation of TICs showed 94.1％ sensitivity,90.7％ specificity,95.11％ positive predictive value and 88.89％ negative predictive value.The accuracy and specificity of the ANN diagnosis system was similar to that of human interpretation of the TICs (P =0.225 and P =0.451,respectively).Hepatocellular carcinoma cases showed contrast uptake during the arterial phase followed by wash-out in the portal and first seconds of the late phases.For the hypovascular metastases did not show significant contrast uptake during the arterial phase,which resulted in negative differences between the maximum intensities.We registered wash-out in the late phase for most of the hypervascular metastases.Liver hemangiomas had contrast uptake in the arterial phase without agent wash-out in the portallate phases.The focal fatty changes did not show any differences from surrounding liver parenchyma,resulting in similar TIC patterns and extracted parameters.CONCLUSION:Neural network analysis of contrastenhanced ultrasonography-obtained TICs seems a promising field of development for future techniques,providing fast and reliable diagnostic aid for the clinician.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Endoscopic ultrasound-guided choledochoduodenostomies with fully covered self-expandable metallic stents

    Tae Jun SongYil Sik HyunSang Soo LeeDo Hyun Park...
    4435-4440页
    查看更多>>摘要：AIM:To investigate the long-term outcomes of endoscopic ultrasound-guided choledochoduodenostomy (EUS-CDS) with a fully covered self-expandable metallic stent (FCSEMS).METHODS:From April 2009 to August 2010,15 patients with distal malignant biliary obstructions who were candidates for alternative techniques for biliary decompression due to a failed endoscopic retrograde cholangiopancreatography (ERCP) were included.These 15 patients consisted of 8 men and 7 women and had a median age of 61 years (range:30-91 years).The underlying causes of the distal malignant biliary obstruction were pancreatic cancer (n =9),ampulla of Vater cancer (n =2),renal cell carcinoma (n =1),advanced gastric cancer (n =1),lymphoma (n =1),and duodenal cancer (n =1).RESULTS:The technical success rate of EUS-CDS with an FCSEMS was 86.7％ (13/15),and functional success was achieved in 100％ (13/13) of those cases.In two patients,the EUS-CDS failed because an FCSEMS with a delivery device could not be passed into the common bile duct.The mean duration of stent patency was 264 d.Early adverse events developed in three patients (3/13,23.1％),including self-limited pneumoperitoneum in two patients and cholangitis requiring stent reposition in one patient.During the follow-up period (median:186 d,range:52-388 d),distal stent migration occurred in four patients (4/13,30.8％).In 3 patients,the FCSEMS could be reinserted through the existing choledochoduodenal fistula tract.CONCLUSION:EUS-CDS with an FCSEMS is technically feasible and can lead to effective palliation of distal malignant biliary obstructions after failed ERCP.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Favorable surgical treatment outcomes for chronic constipation with features of colonic pseudo-obstruction

    Eon Chul HanHeung-Kwon OhHeon-Kyun HaEun Kyung Choe...
    4441-4446页
    查看更多>>摘要：AIM:To determine long-term outcomes of surgical treatments for patients with constipation and features of colonic pseudo-obstruction.METHODS:Consecutive 42 patients who underwent surgery for chronic constipation within the last 13 years were prospectively collected.We identified a subgroup with colonic pseudo-obstruction (CPO) features,with dilatation of the colon proximal to the narrowed transitional zone,in contrast to typical slowtransit constipation (STC),without any dilated colonic segments.The outcomes of surgical treatments for chronic constipation with features of CPO were analyzed and compared with outcomes for STC.RESULTS:Of the 42 patients who underwent surgery for constipation,33 patients had CPO with dilatation of the colon proximal to the narrowed transitional zone.There were 16 males and 17 females with a mean age of 51.2 ± 16.1 years.All had symptoms of chronic intestinal obstruction,including abdominal distension,pain,nausea,or vomiting,and the mean duration of symptoms was 67 mo (range:6-252 mo).Preoperative defecation frequency was 1.5 ± 0.6 times/wk (range:1-2 times/wk).Thirty-two patients underwent total colectomy,and one patient underwent diverting transverse colostomy.There was no surgery-related mortality.Postoperative histologic examination showed hypoganglionosis or agangliosis in 23 patients and hypoganglionosis combined with visceral neuropathy or myopathy in 10 patients.In contrast,histology of STC group revealed intestinal neuronal dysplasia type B (n =6) and visceral myopathy (n =3).Early postoperative complications developed in six patients with CPO;wound infection (n =3),paralytic ileus (n =2),and intraabdominal abscess (n =1).Defecation frequencies 3 mo after surgery improved to 4.2 ± 3.2 times/d (range:1-15 times/d).Long-term follow-up (median:39.7 mo) was available in 32 patients; all patients had improvements in constipation symptoms,but two patients needed intermittent medication for management of diarrhea.All 32 patients had distinct improvements in constipation symptoms (with a mean bowel frequency of 3.3 ± 1.3 times/d),social activities,and body mass index (20.5 kg/m2 to 22.1 kg/m2) and were satisfied with the results of their surgical treatment.In comparison with nine patients who underwent colectomy for STC without colon dilatation,those in the CPO group had a lower incidence of small bowel obstructions (0％ vs 55.6％,P ＜ 0.01) and less difficulty with long-distance travel (6.7％ vs 66.7％,P =0.007)on long-term follow-up.CONCLUSION:Chronic constipation patients with features of CPO caused by narrowed transitional zone in the left colon had favorable outcomes after total colectomy.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    In vivo detection of mucosal healing-involved histiocytes by confocal laser endomicroscopy

    Gheorghe HundorfeanAbbas AgaimyMircea T ChiriacWalter Geiβd(o)rfer...
    4447-4449页
    查看更多>>摘要：Histiocytes have a pivotal role in wound repair and intestinal epithelial recovery-the most important goal to sustain gut functionality.Yet,an in vivo description of colonic histiocytes by confocal laser endomicroscopy (CLE) is missing.Here,we report the case of a 45-yearsold male patient who was referred to our clinic with weight loss and a history of two consecutive Clostridium difficile colitis episodes,the latter cured 3 wk before present admission.Stool microbiology was negative.Conventional colonoscopy showed atrophy and a light mucosal oedema in the distal colon.During on-going endoscopy,we performed a fluorescein-aided CLE which revealed large polygonal (histiocytes-like) cells with copious cytoplasm and large nuclei in the lamina propria of the sigmoid colon as well as regenerative epithelial changes.Histopathological assessment of biopsies from the same areas confirmed the endomicroscopical findings:Periodic acid-Schiff-and CD68-positive foamy histiocytes in the colonic lamina propria and an advanced epithelial recovery.Since stool microbiology was repeatedly negative and polymerase chain reaction-analysis from colonic biopsies could not detect any mRNA for Thropheryma whippleii and common pathogens,we interpreted this particular setting as a mucosal healing process after consecutive Clostridium difficile infections.In conclusion,by describing these colonic histiocytes,we highlight the clinical usefulness of CLE in describing the entity of histiocytes in vivo and in real-time during the process of post-infectious mucosal healing in the colon.
      原文链接:
    • NETL
    • NSTL
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    • 维普

    Candida-associated gastric ulcer relapsing in a different position with a different appearance

    Kenji Sasaki
    4450-4453页
    查看更多>>摘要：An 87-year-old,Japanese woman was shown to have a submucosal tumor-like lesion with a deep,central ulceration covered with thick,whitish exudate in the stomach.Biopsy showed Candida tropicalis but not Helicobacter pylori (H.pylori).She had no predisposing factors or history of peptic ulcers nor had taken non-steroidal anti-inflammatory drugs (NSAIDs),diagnosed with Candida-associated gastric ulcer.Though cured of the lesion,she developed another ulcer in a different position,in which Candida was demonstrated but H.pylori was undetectable.This is the first case of recurrent Candida-associated gastric ulcer in the world.Detected in both the original and recurrent lesions in an H.pylori-negative patient with no antecedent ulcers who had not taken NSAIDs,Candida is considered,contrary to the prevailing opinion,to play an etiologic role in ulcer formation.
      原文链接:
    • NETL
    • NSTL
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    • 维普

    "Passive-bending colonoscope" significantly improves cecal intubation in difficult cases

    Takeshi MizukamiHaruhiko OgataToshihumi Hibi
    4454-4456页
    查看更多>>摘要：Colonoscopy sometimes causes pain during insertion,especially in difficult cases.Over-insufflation of air causes elongation or acute angulations of the colon,making passage of the scope difficult and causing pain.We previously reported a sedative-risk-free colonoscopy insertion technique,namely,"Water Navigation Colonoscopy".Complete air suction after water infusion not only improves the vision,but also makes water flow down to the descending colon,while the sigmoid colon collapses and shortens.While non-sedative colonoscopy can be carried out without pain in most cases,some patients do complain of pain.Most of these patients have abnormal colon morphology,and the pain is caused while negotiating the "hairpin" bends of the colon.The "hairpin" bends of the colon should be negotiated by gently pushing the full-angled colonoscope.The proximal 10-20 cm from the angulated part of the conventional colonoscope is stiff,with a wide turning radius,therefore,a conventional colonoscope cannot be negotiated through the "hairpin" bends of the colon without stretching them and causing pain.The "passive-bending colonoscope" has a flexible tip with a narrow turning radius,so that the scope can be negotiated through the "hairpin" bends of the colon with a minimum turning radius and minimal discomfort.Therefore,the intubation and pain-reducing performance of the "passive-bending colonoscope" was assessed in difficult cases.
      原文链接:
    • NETL
    • NSTL
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      原文链接:
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    • NSTL
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