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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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    Loss of fragile histidine triad and amplification of 1p36.22 and 11p15.5 in primary gastric adenocarcinomas

    Yuan-Yuan LiuHai-Ying ChenMan-Li ZhangDan Tian...
    4522-4532页
    查看更多>>摘要：AIM:To investigate the genomic copy number alterations that may harbor key driver genes in gastric tumorigenesis.METHODS:Using high-resolution array comparative genomic hybridization (CGH),we investigated the genomic alterations of 20 advanced primary gastric adenocarcinomas (seventeen tubular and three mucinous)of Chinese patients from the Jilin province.Ten matching adjacent normal regions from the same patients were also studied.RESULTS:The most frequent imbalances detected in these cancer samples were gains of 3q26.31-q27.2,5p,8q,11p,18p,19q and 20q and losses of 3p,4p,18q and 21q.The use of high-resolution array CGH increased the resolution and sensitivity of the observed genomic changes and identified focal genetic imbalances,which included 54 gains and 16 losses that were smaller than 1 Mb in size.The most interesting focal imbalances were the intergenic loss/homozygous deletion of the fragile histidine triad gene and the amplicons 11q13,18q11.2 and 19q12,as well as the novel amplicons 1p36.22 and 11p15.5.CONCLUSION:These regions,especially the focal amplicons,may harbor key driver genes that will serve as biomarkers for either the diagnosis or the prognosis of gastric cancer,and therefore,a large-scale investigation is recommended.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    FOLFIRI regimen in metastatic pancreatic adenocarcinoma resistant to gemcitabine and platinum-salts

    Cindy NeuzilletOlivia HenticBeno(i)t RousseauVinciane Rebours...
    4533-4541页
    查看更多>>摘要：AIM:To evaluate the efficacy and safety of the FOLFIRI regimen in patients with metastatic pancreatic adenocarcinoma (PAC) after the failure of gemcitabine and platinum salts.METHODS:All consecutive patients with histologically confirmed,metastatic PAC and World Health Organization performance status (PS) ≤ 2 received FOLFIRI-1 [irinotecan 180 mg/m2 on day 1 and leucovorin 400 mg/m2 followed by 5-fluorouracil (5-FU) 400 mg/m2 bolus,then 5-FU 2400 mg/m2 as a 46-h infusion,biweekly] or FOLFIRI-3 (irinotecan 100 mg/m2 on day 1 and leucovorin 400 mg/m2,then 5-FU 2400 mg/m2 as a 46-h infusion and irinotecan 100 mg/m2 repeated on day 3,biweekly) after failure of gemcitabine and platinum-based chemotherapies as a systematic policy in two institutions between January 2005 and May 2010.Tumor response,time to progression (TTP),overall survival rate (OS) and grade 3-4 toxicities were retrospectively studied.Subgroup analyses were performed to search for prognostic factors.RESULTS:Sixty-three patients (52.4％ male,median age 59 years) were analyzed.Among them,42.9％ were PS 0,38.1％ were PS 1 and 19.0％ were PS 2.Fifty one patients (81.0％) had liver metastases.Before the FOLFIRI regimen,patients had received 1 line (n =19),2 lines (n =39) or 3 lines (n =5) of chemotherapy.Median TTP obtained with the line before FOLFIRI was 3.9 mo (95％ CI:3.4-5.3 mo).A total of 480 cycles was completed (median:6 cycles,range:1-51 cycles).The main reason for discontinuing FOLFIRI was tumor progression (90.3％).Tumor control was achieved in 25 patients (39.7％) (partial response:n =5,stable disease:n =20) with FOLFIRI.Median TTP was 3.0 mo (95％ CI:2.1-3.9 mo) and median OS was 6.6 mo (95％ CI:5.3-8.1 mo).Dose adaptation was required in 36 patients (57.1％).Fifteen patients (23.8％) had grade 3-4 toxicities,mainly hematological (n =11) or digestive (n =4).Febrile neutropenia occurred in 3 patients.There was no toxic death.PS 2 was significantly associated with poor TTP [hazard ratio (HR):16.036,P ＜ 0.0001) and OS (HR:4.003,P =0.004].CONCLUSION:The FOLFIRI regimen had an acceptable toxicity and an interesting efficacy in our study,limited to patients in good condition (PS 0-1).
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Efficacy of a therapeutic strategy for eradication of Helicobacter pylori infection

    Giuliana SereniFrancesco AzzoliniLorenzo CamelliniDebora Formisano...
    4542-4548页
    查看更多>>摘要：AIM:To determine the efficacy of our therapeutic strategy for Helicobacter pylori (H.pylori) eradication and to identify predictive factors for successful eradication.METHODS:From April 2006 to June 2010,we retrospectively assessed 2428 consecutive patients (1025 men,1403 women; mean age 55 years,age range 18-92 years) with gastric histology positive for H.pylori infection referred to our unit for 13-C urea breath test (UBT),after first-line therapy with proton pump inhibitor (PPI) b.i.d.+ amoxicillin 1 g b.i.d.+ clarithromycin 500 mg b.i.d.for 7 d.Patients who were still positive to UBT were recommended a second-line therapy (PPI b.i.d.+amoxicillin 1 g b.i.d.+ tinidazole 500 mg b.i.d.for 14 d).Third choice treatment was empirical with PPI b.i.d.+amoxicillin 1 g b.i.d.+ levofloxacin 250 mg b.i.d.for 14 d.RESULTS:Out of 614 patients,still H.pylori-positive after first-line therapy,only 326 and 19 patients respectively rechecked their H.pylori status by UBT after the suggested second and third-line regimens."Per protocol" eradication rates for first,second and thirdline therapy were 74.7％ (95％ CI:72.7％-76.4％),85.3％ (95％ CI:81.1％-89.1％) and 89.5％ (95％ CI:74.9％-103％) respectively.The overall percentage of patients with H.pylori eradicated after two treatments was 97.8％ (95％ CI:97.1％-98.4％),vs 99.9％ (95％CI:99.8％-100％) after three treatments.The study found that eradication therapy was most effective in patients with ulcer disease (P ＜ 0.05,P =0.028),especially in those with duodenal ulcer.Smoking habits did not significantly affect the eradication rate.CONCLUSION:First-line therapy with amoxicillin and clarithromycin produces an H.pylori eradication rate comparable or superior to other studies and secondline treatment can still be triple therapy with amoxicillin and tinidazole.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Lack of CD44 variant 6 expression in rectal cancer invasive front associates with early recurrence

    Suvi Tuulia AvorantaEija Annika KorkeilaKari Juhani Syrj(a)nenSeppo Olavi Pyrh(o)nen...
    4549-4556页
    查看更多>>摘要：AIM:To investigate the prognostic value of CD44 variant 6 (CD44v6),a membranous adhesion molecule,in rectal cancer.METHODS:Altogether,210 rectal cancer samples from 214 patients treated with short-course radiotherapy (RT,n =90),long-course (chemo) RT (n =53) or surgery alone (n =71) were studied with immunohistochemistry for CD44v6.The extent and intensity of membranous and cytoplasmic CD44v6 staining,and the intratumoral membranous staining pattern,were analyzed.RESULTS:Membranous CD44v6 expression was seen in 84％ and cytoplasmic expression in 81％ of the cases.In 59％ of the tumors with membranous CD44v6 expression,the staining pattern in the invasive front was determined as "front-positive" and in 41％ as "front-negative".The latter pattern was associated with narrower circumferential margin (P =0.01),infiltrative growth pattern (P ＜ 0.001),and shorter disease-free survival in univariate survival analysis (P =0.022) when compared to the "front-positive" tumors.CONCLUSION:The lack of membranous CD44v6 in the rectal cancer invasive front could be used as a method to identify patients at increased risk for recurrent disease.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Characteristics of intestinal pseudo-obstruction in patients with mitochondrial diseases

    Yusuke SekinoMasahiko InamoriEiji YamadaHidenori Ohkubo...
    4557-4562页
    查看更多>>摘要：AIM:To reveal the frequency,characteristics and prognosis of chronic intestinal pseudo-obstruction (CIP) in mitochondrial disease patients.METHODS:Between January 2000 and December 2010,31 patients (13 males and 18 females) were diagnosed with mitochondrial diseases at our hospital.We conducted a retrospective review of the patients'sex,subclass of mitochondrial disease,age at onset of mitochondrial disease,frequency of CIP and the age at its onset,and the duration of survival.The age at onset or at the first diagnosis of the disorder that led to the clinical suspicion of mitochondrial disease was also examined.RESULTS:Twenty patients were sub-classified with mitochondrial encephalopathy with lactic acidosis and stroke-like episodes (MELAS),8 with' chronic progressive external ophthalmoplegia (CPEO),and 3 with myoclonus epilepsy associated with ragged-red fibers (MERRF).Nine patients were diagnosed with CIP,8 of the 20 (40.0％) patients with MELAS,0 of the 8 (0.0％)patients with CPEO,and 1 of the 3 (33.3％) patients with MERRF.The median age (range) at the diagnosis and the median age at onset of mitochondrial disease were 40 (17-69) and 25 (12-63) years in patients with CIP,and 49 (17-81) and 40 (11-71) years in patients without CIP.During the survey period,5 patients (4 patients with MELAS and 1 with CPEO) died.The cause of death was cardiomyopathy in 2 patients with MELAS,cerebral infarction in 1 patient with MELAS,epilepsy and aspiration pneumonia in 1 patient with MELAS,and multiple metastases from gastric cancer and aspiration pneumonia in 1 patient with CPEO.CONCLUSION:Patients with CIP tend to have disorders that are suspected to be related to mitochondrial diseases at younger ages than are patients without CIP.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Effect of composite yogurt enriched with acacia fiber and Bifidobacterium lactis

    Yang Won MinSang Un ParkYeon Sil JangYoung-Ho Kim...
    4563-4569页
    查看更多>>摘要：AIM:To investigate whether composite yogurt with acacia dietary fiber and Bifidobacterium lactis (B.lactis)has additive effects in irritable bowel syndrome (IBS).METHODS:A total of 130 patients were randomly allocated to consume,twice daily for 8 wk,either the composite yogurt or the control product.The composite yogurt contained acacia dietary fiber and high-dose B.lactis together with two classic yogurt starter cultures.Patients were evaluated using the visual analog scale via a structured questionnaire administered at baseline and after treatment.RESULTS:Improvements in bowel habit satisfaction and overall IBS symptoms from baseline were significantly higher in the test group than in the control group (27.16 vs 15.51,P =0.010,64.2 ± 17.0 vs 50.4 ± 20.5,P ＜ 0.001; respectively).In constipation-predominant IBS,improvement in overall IBS symptoms was significantly higher in the test group than in the control group (72.4 ± 18.4 vs 50.0 ± 21.8,P ＜ 0.001).In patients with diarrhea-predominant IBS,improvement in bowel habit satisfaction from baseline was significantly higher in the test group than in the control group (32.90 vs 7.81,P =0.006).CONCLUSION:Our data suggest that composite yogurt enriched with acacia fiber and B.lactis has greater therapeutic effects in patients with IBS than standard yogurt.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Reduction of gastrointestinal motility by unilateral thyroparathyroidectomy plus subdiaphragmatic vagotomy in rats

    Jun Ho LeeOh Deog KwonSeon Ho AhnKeun Han Choi...
    4570-4577页
    查看更多>>摘要：AIM:To investigate whether the combined methods of unilateral thyroparathyroidectomy (TPX) and subdiaphragmatic vagotomy (VAX) can be adapted for rats and used as a reliable method to produce a rat model of long-term reduction of gastrointestinal (GI) motor function.METHODS:Male Sprague-Dawley rats were randomly divided into 3 groups,normal,sham-operated and unilateral TPX plus VAX.The TPX plus VAX rats received VAX 7 d after application of TPX,and dietary intake and fecal output were then measured daily for 1 wk.After completion of the experiments,gastric emptying and small bowel transit were measured in vivo,and the contractile responses of colonic strips to excitatory and inhibitory neurotransmitters were estimated using isometric force transducers in vitro.RESULTS:In comparison with normal and sham-operated rats,rats which received unilateral TPX plus VAX showed a significant decrease in body weight and in fecal pellet number and weight throughout the entire week.Application of TPX plus VAX to rats markedly delayed gastric emptying and small bowel transit.In TPX plus VAX rats,the longitudinal muscles of the proximal colon showed a significant reduction in contractile responses to acetylcholine (5 x 10-6 mol/L),and a dramatic attenuation of contractile responses was also observed in both the longitudinal and circular muscles of the distal colon.However,the spontaneous contractility of the colonic strips from TPX plus VAX rats was not significantly affected by treatment with/V-nitro-L-arginine-methyl ester (0.1 mol/L).CONCLUSION:The results indicate that unilateral TPX plus VAX reduced the motor function of the GI tract in rats,and the reduced gut motility is likely mediated,at least in part,by inhibition of the excitatory neurotransmitter system.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Does immunohistochemical staining have a clinical impact in early gastric cancer conducted endoscopic submucosal dissection?

    Seong Ran JeonJoo Young ChoGene Hyun BokTae Hee Lee...
    4578-4584页
    查看更多>>摘要：AIM:To evaluate clinicopathologic parameters and the clinical significance related lymphovascular invasion (LVI) by immunohistochemical staining (IHCS) in endoscopic submucosal dissection (ESD).METHODS:Between May 2005 and May 2010,a total of 348 lesions from 321 patients (mean age 63 ± 10 years,men 74.6％) with early gastric cancer (EGC)who met indication criteria after ESD were analyzed retrospectively.The 348 lesions were divided into the absolute (n =100,differentiated mucosal cancer without ulcer ≤ 20 mm) and expanded (n =248) indication groups after ESD.The 248 lesions were divided into four subgroups according to the expanded ESD indication.The presence of LVI was determined by factor Ⅷ-related antigen and D2-40 assessment.We compared LVI IHCS-negative group with LVI IHCS-positive in each group.RESULTS:LVI by hematoxylin-eosin staining (HES)and IHCS were all negative in the absolute group,while was observed in only the expanded groups.The positive rate of LVI by IHCS was higher than that of LVI by HES (n =1,0.4％ vsn =11,4.4％,P =0.044).LVI IHCS-positivity was observed when the cancer invaded to the mucosa 3 (M3) or submucosa 1 (SM1)levels,with a predominance of 63.6％ in the subgroup that included only SM1 cancer (P ＜ 0.01).In a univariate analysis,M3 or SM1 invasion by the tumor was significantly associated with a higher rate of LVI by IHCS,but no factor was significant in a multivariate analysis.There were no cases of tumor recurrence or metastasis during the median 26 mo follow-up.CONCLUSION:EGCs of the absolute group are immunohistochemically stable.The presence of LVI may be carefully examined by IHCS in an ESD expanded indication group with an invasion depth of M3 or greater.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Spectral analysis of bowel sounds in intestinal obstruction using an electronic stethoscope

    Siok Siong ChingYih Kai Tan
    4585-4592页
    查看更多>>摘要：AIM:To determine the value of bowel sounds analysis using an electronic stethoscope to support a clinical diagnosis of intestinal obstruction.METHODS:Subjects were patients who presented with a diagnosis of possible intestinal obstruction based on symptoms,signs,and radiological findings.A 3MTM Littmann(R) Model 4100 electronic stethoscope was used in this study.With the patients lying supine,six 8-second recordings of bowel sounds were taken from each patient from the lower abdomen.The recordings were analysed for sound duration,soundto-sound interval,dominant frequency,and peak frequency.Clinical and radiological data were reviewed and the patients were classified as having either acute,subacute,or no bowel obstruction.Comparison of bowel sound characteristics was made between these subgroups of patients.In the presence of an obstruction,the site of obstruction was identified and bowel calibre was also measured to correlate with bowel sounds.RESULTS:A total of 71 patients were studied during the period July 2009 to January 2011.Forty patients had acute bowel obstruction (27 small bowel obstruction and 13 large bowel obstruction),11 had subacute bowel obstruction (eight in the small bowel and three in large bowel) and 20 had no bowel obstruction (diagnoses of other conditions were made).Twenty-five patients received surgical intervention (35.2％) during the same admission for acute abdominal conditions.A total of 426 recordings were made and 420 recordings were used for analysis.There was no significant difference in sound-to-sound interval,dominant frequency,and peak frequency among patients with acute bowel obstruction,subacute bowel obstruction,and no bowel obstruction.In acute large bowel obstruction,the sound duration was significantly longer (median 0.81 s vs 0.55 s,P =0.021) and the dominant frequency was significantly higher (median 440 Hz vs 288 Hz,P =0.003) when compared to acute small bowel obstruction.No significant difference was seen between acute large bowel obstruction and large bowel pseudoobstruction.For patients with small bowel obstruction,the sound-to-sound interval was significantly longer in those who subsequently underwent surgery compared with those treated non-operatively (median 1.29 s vs 0.63 s,P ＜ 0.001).There was no correlation between bowel calibre and bowel sound characteristics in both acute small bowel obstruction and acute large bowel obstruction.CONCLUSION:Auscultation of bowel sounds is nonspecific for diagnosing bowel obstruction.Differences in sound characteristics between large bowel and small bowel obstruction may help determine the likely site of obstruction.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Stopping or reducing dietary fiber intake reduces constipation and its associated symptoms

    Kok-Sun HoCharmaine You Mei TanMuhd Ashik Mohd DaudFrancis Seow-Choen...
    4593-4596页
    查看更多>>摘要：AIM:To investigate the effect of reducing dietary fiber on patients with idiopathic constipation.METHODS:Sixty-three cases of idiopathic constipation presenting between May 2008 and May 2010 were enrolled into the study after colonoscopy excluded an organic cause of the constipation.Patients with previous colon surgery or a medical cause of their constipation were excluded.All patients were given an explanation on the role of fiber in the gastrointestinal tract.They were then asked to go on a no fiber diet for 2 wk.Thereafter,they were asked to reduce the amount of dietary fiber intake to a level that they found acceptable.Dietary fiber intake,symptoms of constipation,difficulty in evacuation of stools,anal bleeding,abdominal bloating or abdominal pain were recorded at 1 and 6 mo.RESULTS:The median age of the patients (16 male,47 female) was 47 years (range,20-80 years).At 6 mo,41 patients remained on a no fiber diet,16 on a reduced fiber diet,and 6 resumed their high fiber diet for religious or personal reasons.Patients who stopped or reduced dietary fiber had significant improvement in their symptoms while those who continued on a high fiber diet had no change.Of those who stopped fiber completely,the bowel frequency increased from one motion in 3.75 d (± 1.59 d) to one motion in 1.0 d (± 0.0 d) (P ＜ 0.001);those with reduced fiber intake had increased bowel frequency from a mean of one motion per 4.19 d (± 2.09 d)to one motion per 1.9 d (± 1.21 d) on a reduced fiber diet (P ＜ 0.001); those who remained on a high fiber diet continued to have a mean of one motion per 6.83 d (± 1.03 d) before and after consultation.For no fiber,reduced fiber and high fiber groups,respectively,symptoms of bloating were present in 0％,31.3％ and 100％ (P ＜ 0.001) and straining to pass stools occurred in 0％,43.8％ and 100％ (P ＜ 0.001).CONCLUSION:Idiopathic constipation and its associated symptoms can be effectively reduced by stopping or even lowering the intake of dietary fiber.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普