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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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    Primary biliary cirrhosis-specific autoantibodies in first degree relatives of Greek primary biliary cirrhosis patients

    Theodoros A ZografosNikolaos GatselisKalliopi ZachouChristos Liaskos...
    4721-4728页
    查看更多>>摘要：AIM:To determine the prevalence and significance of primary biliary cirrhosis (PBC)-specific autoantibodies in first-degree relatives (FDRs) of Greek PBC patients.METHODS:The presence of antimitochondrial antibodies (AMA) and PBC-specific antinuclear antibodies (ANA) were determined using indirect immunofluorescence assays,dot-blot assays,and molecularly based enzyme-linked immunosorbent assays in 101 asymptomatic for liver-related symptoms FDRs of 44 PBC patients.In order to specify our results,the same investigation was performed in 40 healthy controls and in a disease control group consisting of 40 asy.mptomatic for liver-related symptoms FDRs of patients with other autoimmune liver diseases namely,autoimmune hepatitis-1 or primary sclerosing cholangitJs (AIH-1/PSC).RESULTS:AMA positivity was observed in 19 (only 4 with abnormal liver function tests) FDRs of PBC patients and none of the healthy controls.The prevalence of AMA was significantly higher in FDRs of PBC patients than in AIH-1/PSC FDRs and healthy controls [18.8％,95％ confidence interval (CI):12％-28.1％ vs 2.5％,95％ CI:0.1％-14.7％,P =0.01; 18.8％,95％ CI:12％-28.1％ vs 0％,95％ CI:0％-10.9％,P =0.003,respectively].PBC-specific ANA positivity was observed in only one FDR from a PSC patient.Multivariate analysis showed that having a proband with PBC independently associated with AMA positivity (odds ratio:11.24,95％ CI:1.27-25.34,P =0.03) whereas among the investigated comorbidities and risk factors,a positive past history for urinary tract infections (UTI)was also independently associated with AMA detection in FDRs of PBC patients (odds ratio:3.92,95％ CI:1.25-12.35,P =0.02).CONCLUSION:In FDRs of Greek PBC patients,AMA prevalence is significantly increased and independently associated with past UTI.PBC-specific ANA were not detected in anyone of PBC FDRs.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Titanium dioxide induced inflammation in the small intestine

    Carolina Maciel NogueiraWalter Mendes de AzevedoMaria Lucia Zaidan DagliSérgio Hiroshi Toma...
    4729-4735页
    查看更多>>摘要：AIM:To investigate the effects of titanium dioxide (TiO2)nanoparticles (NPTiO2) and microparticles (MPTiO2)on the inflammatory response in the small intestine of mice.METHODS:BI 57/6 male mice received distilled water suspensions containing TiO2 (100 mg/kg body weight)as NPTiO2 (66 nm),or MPTiO2 (260 nm) by gavage for 10 d,once a day; the control group received only distilled water.At the end of the treatment the duodenum,jejunum and ileum were extracted for assessment of cytokines,inflammatory cells and titanium content.The cytokines interleukin (IL)-1b,IL-4,IL-6,IL-8,IL-IO,IL-12,IL-13,IL-17,IL-23,tumor necrosis factor-α (TNF-α),intracellular interferon-γ (IFN-γ) and transforming growth factor-β (TGF-β) were evaluated by enzyme-linked immunosorbent assay in segments of jejunum and ileum (mucosa and underlying muscular tissue).CD4+ and CD8+ T cells,natural killer cells,and dendritic cells were evaluated in duodenum,jejunum and ileum samples fixed in 10％ formalin by immunohistochemistry.The titanium content was determined by inductively coupled plasma atomic emission spectrometry.RESULTS:We found increased levels of T CD4+ cells (cells/mm2) in duodenum:NP 1240 ± 139.4,MP 1070 ± 154.7 vs 458 ±-50.39 (P ＜ 0.01); jejunum:NP 908.4 ± 130.3,MP 813.8 ± 103.8 vs 526.6 ±-61.43 (P ＜ 0.05);and ileum:NP 818.60 ± 123.0,MP 640.1 ± 32.75 vs 466.9 ± 22.4 (P ＜ 0.05).In comparison to the control group,the groups receiving TiO2 showed a statistically significant increase in the levels of the inflammatory cytokines IL-12,IL-4,IL-23,TNF-α,IFN-γ,and TGF-β.The cytokine production was more pronounced in the ileum (mean ± SE):IL-12:NP 33.98 ±-11.76,MP 74.11 ± 25.65 vs 19.06 ± 3.92 (P ＜ 0.05); IL-4:NP 17.36 ± 9.96,MP 22.94 ±-7.47 vs 2.19 ± 0.65 (P ＜ 0.05); IL-23:NP 157.20 ± 75.80,MP 134.50 ±-38.31 vs 22.34 ±-5.81 (P ＜ 0.05); TNFα:NP 3.71 ± 1.33,MP 5.44 ± 1.67 vs 0.99± 019 (P ＜ 0.05); IFNy:NP 15.85± 9.99,MP 34.08 ± 11.44 vs 2.81 ± 0.69 (P ＜ 0.05); and TGF-α:NP 780.70 ± 318.50,MP 1409.00 ± 502.20 vs 205.50 ± 63.93 (P ＜ 0.05).CONCLUSION:Our findings indicate that TiO2 particles induce a Thl-mediated inflammatory response in the small bowel in mice.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    "Extended" radical cholecystectomy for gallbladder cancer:Long-term outcomes, indications and limitations

    Yoshio ShiraiJun SakataToshifumi WakaiTaku Ohashi...
    4736-4743页
    查看更多>>摘要：AIM:To delineate indications and limitations for "extended" radical cholecystectomy for gallbladder cancer:a procedure which was instituted in our department in 1982.METHODS:Of 145 patients who underwent a radical resection for gallbladder cancer from 1982 through 2006,52 (36％) had an extended radical cholecystectomy,which involved en bloc resection of the gallbladder,gallbladder fossa,extrahepatic bile duct,and the regional lymph nodes (first-and second-echelon node groups).A retrospective analysis of the 52 patients was conducted including at least 5 years of follow up.Residual tumor status was judged as no residual tumor (R0) or microscopic/macroscopic residual tumor (R1-2).Pathological findings were documented according to the American Joint Committee on Cancer Cancer Staging Manual (7th edition).RESULTS:The primary tumor was classified as pathological T1 (pT1) in 3 patients,pT2 in 36,pT3 in 12,and pT4 in 1.Twenty-three patients had lymph node metastases; 11 had a single positive node,4 had two positive nodes,and 8 had three or more positive nodes.None of the three patients with pT1 tumors had nodal disease,whereas 23 of 49 (47％) with pT2 or more advanced tumors had nodal disease.One patient died during the hospital stay for definitive resection,giving an in-hospital mortality rate of 2％.Overall survival (OS) after extended radical cholecystectomy was 65％ at 5 years and 53％ at 10 years in all 52 patients.OS differed according to the pT classification (P ＜ 0.001)and the nodal status (P =0.010).All of 3 patients with pT1 tumors and most (29 of 36) patients with pT2 tumors survived for more than 5 years.Of 12 patients with pT3 tumors,8 who had an R1-2 resection,distant metastasis,or extensive extrahepatic organ involvement died soon after resection.Of the remaining four pT3 patients who had localized hepatic spread through the gallbladder fossa and underwent an R0 resection,2 survived for more than 5 years and another survived for 4 years and 2 mo.The only patient with pT4 tumor died of disease soon after resection.Among 23 nodepositive patients,11 survived for more than 5 years,and of these,10 had a modest degree of nodal disease (one or two positive nodes).CONCLUSION:Extended radical cholecystectomy is indicated for pT2 tumors and some pT3 tumors with localized hepatic invasion,provided that the regional nodal disease is limited to a modest degree (up to two positive nodes).Extensive pT3 disease,pT4 disease,or marked nodal disease appears to be beyond the scope of this radical procedure.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    Clinicopathologic significance of expression of nuclear factor-κB RelA and its target gene products in gastric cancer patients

    Hyuk-Chan KwonSung-Hyun KimSung Yong OhSuee Lee...
    4744-4750页
    查看更多>>摘要：AIM:To assess the prognostic significance of nuclear factor-κB (NF-κB) and its target genes in gastric cancer.METHODS:The tumor tissues of 115 patients with gastric cancer were immunohistochemically evaluated using monoclonal antibodies against NF-κB RelA.Preoperative serum levels of vascular endothelial growth factor (VEGF),interleukin-6 (IL-6) were assessed via enzyme-linked immuno-sorbent assay.C-reactive protein (CRP) and serum amyloid A (SAA) were measured via immunotrubidimetry.RESULTS:Positive rate of NF-κB RelA was 42.6％.NF-κB RelA expression in tumor tissues was also related to serum levels of IL-6 (P =0.044) and CRP (P =0.010).IL-6,SAA,CRP were related to depth of invasion,VEGF and SAA were correlated with lymph node metastasis.IL-6,VEGF,SAA and CRP were related to the stage.Univariate analysis demonstrated that immunostaining of NF-κB RelA,levels of IL-6,VEGF,SAA were significantly related with both disease free survival and overall survival (OS).Multivariate analysis verified that NF-κB RelA [hazard ratio (HR):3.40,P =0.024] and SAA (HR:3.39,P =0.045) were independently associated with OS.CONCLUSION:Increased expression of NF-κB RelA and high levels of serum SAA were associated with poor OS in gastric cancer patients.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Prognosis of hepatocellular carcinoma expressing cytokeratin 19: Comparison with other liver cancers

    Jung Il LeeJin-Woo LeeJoon Mee KimJa Kyung Kim...
    4751-4757页
    查看更多>>摘要：AIM:To investigate whether expressing biliary phenotype predicted poor outcome after the surgical treatment in primary liver cancers.METHODS:Out of 204 patients that underwent liver resection due to hepatocellular carcinoma (HCC),liver specimens of 70 patients with HCC were evaluated for biliary components by cytokeratin (CK) 19 immunostain (CK19-HCC and CK19+ HCC).CK19 positivity was defined as membranous and/or cytoplasmic expression in ≥ 5％ of tumor cells with moderate or strong intensity.Patients with other primary liver cancers,such as combined HCC and cholangiocarcinoma (cHCC-CC),intrahepatic cholangiocarcinoma (ICC) who received curative liver resection,were also included in the study.Clinical characteristics of CK19 HCC and CK19+ HCC patients,including survival outcome after curative liver resection,were compared with that of cHCC-CC and ICC patients.RESULTS:The overall survival (OS) rate of CK19 HCC (n =49) after the curative surgical treatment was 90.7％,and 80.4％ at 1 and 5 years after the resection.OS rate of CK19+ HCC (n =21) was 74.3％,28.9％ and OS rate of cHCC-CC (n =22) was 66.7％,32.2％ at 1 and 5 years after the surgery.For ICC (n =19),1 and 5-year-OS rate was 50.2％ and 14.3％ after the curative resection.The OS rates of CK19+ HCC and cHCC-CC were significantly lower than that of CK19 HCC,but higher than the OS rate of IcC (P =0.000).There was no statistically significant difference in OS rate between CK19+ HCC and cHCC-CC.The disease free survival (DFS) rate of CK19 HCC was 72.0％ and 54.5％ at 1 and 3 years after the surgical treatment.DFS rate of CK19+ HCC was 53.3％,34.3％ and DFS rate of cHCC-CC was 51.5％,39.2％ at I and 3 years after the resection.For ICC,1 and 3-year-DFS rate was 28.0％ and 14.0％ after the curative resection.DFS rate of CK19 HCC was significantly higher than that of ICC (P =0.017),but marginally higher than DFS rate of either CK19+ HCC or cHCC-CC (P =0.097,P =0.089,respectively).Predictors of outcome after the surgery of primary liver cancer were pathology of the resected mass,existence of microvascular invasion and accompanying satellite nodule.CONCLUSION:Primary liver cancers with biliary components tended to show poorer surgical outcome.This suggested that immuno-phenotype of liver cancers was as important as their morphological classification.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Association of fucosyltransferase 2 gene variants with ulcerative colitis in Han and Uyghur patients in China

    Ayinuer AhemanHe-Sheng LuoFeng Gao
    4758-4764页
    查看更多>>摘要：AIM:To investigate the contribution of fucosyltransferase 2 (FUT2) variants to the genetic susceptibility and clinical heterogeneity of ulcerative colitis (UC) between Han and Uyghur patients in Xinjiang,China.METHODS:A total of 102 UC patients (53 Han patients including 22 men and 31 women,and 49 Uyghur patients including 25 men and 24 women; aged 48 ± 16 years) and 310 age-and sex-matched healthy controis were enrolled from January 2010 to May 2011 in Xinjiang People's Hospital of China.UC was diagnosed based on the clinical,endoscopic and histological findings following Lennard-Jones criteria.Blood samples were collected and genomic DNA was extracted by the routine laboratory methods.Polymerase chain reactionsequence-based typing method was used to identify FUT2 variants rs281377,rs1047781,rs601338 and rs602662.Genotypic and allelic frequencies were documented and compared between the UC patients and the healthy controls.Genotypic frequencies were also compared between Han and Uyghur patients.Potential association of genetic variation and UC between Han and Uyghur patients was examined.RESULTS:rs281377 was found significantly associated with UC in the Han population as compared with the controls (P =0.011) while rs281377 was not associated with UC in the Uyghur population (P =0.06).TT homozygous rs281377 frequencies were higher in the UC groups than in the controls (88.7％ vs 68.7％ and 55.1％ vs 50.3％).rs1047781 was specifically associated with UC in the Uyghur population (P =0.001),but not associated with UC in the Han population (P =0.13).Tr homozygous rs1047781 frequencies were lower in the UC groups than in the controls (9.5％ vs 11.8％ and 4.0％ vs 6.7％).rs601338 was statistically related to UC in both populations (Han,P =0.025; Uyghur,P =8.33x 10s).AA homozygous rs601338 frequencies were lower in the UC groups than in the controls (0％ vs 1.8％ and 12.2％ vs 13.4％).No association was found between rs602662 and UC in both Han and the Uyghur populations.Allelic analysis showed that rs281377 allele was significantly associated with UC in the Han population as compared with the controls [P =0.001,odd ratio (OR) =0.26],however,it was not associated with UC in the Uyghur population (P =0.603,OR =1.14),and rs1047781 allele was associated with UC in the Uyghur population (P =0.001,OR =0.029) while it was not associated with UC in the Han population (P =0.074,OR =0.62).Moreover,rs601338 was associated with UC in both Han (P =0.005,OR =0.1) and Uyghur populations (P =0.002,OR =0.43).Meta analysis showed that rs1047781 and rs601338 conferred risk of UC as compared with the controls [P =0.005,OR =0.47; P =0.0003,OR =0.35; 95％ confidence interval (CI) =0.31-0.72 and 0.21-0.58],but rs281377 and rs602662 showed no statistically significant differences between patients with UC and controls (P =0.10,OR =0.71; P =0.68,OR =0.09; 95％ CI =0.47-1.07 and 0.56-1.47).CONCLUSION:Functionally relevant FUT2 gene variants are associated with UC,suggesting that they play a potential role in the pathogenesis of UC and may contribute to the clinical heterogeneity of UC between Han and Uyghur patients.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Emergency transcatheter arterial embolization for patients with acute massive duodenal ulcer hemorrhage

    Yong-Li WangYing-Sheng ChengLi-Zhen LiuZhong-Hui He...
    4765-4770页
    查看更多>>摘要：AIM:To evaluate the efficacy and safety of emergency transcatheter arterial embolization (ETAE) for patients with acute massive duodenal ulcer hemorrhage.METHODS:Twenty-nine consecutive patients with acute massive bleeding of duodenal ulcer were admitted to our hospital from 2006 to 2011.Superselective angiography of the celiac and gastroduodenal arteries was performed to find out the bleeding sites before ETAE,then,embolotherapy was done with gelatin sponge particles or microstrips via a 5 French angiographic catheter or 3 French microcatheter.After ETAE,further superior mesenteric arteriography was undertaken in case collateral circulation supplied areas of the duodenal ulcer.Technical and clinical success rates were analyzed.Changes in the mucous membrane were observed using endoscopy following ETAE.RESULTS:Angiography showed active bleeding with extravasation of contrast medium in seven cases with a 24％ positive rate of celiac artery bleeding,and in 19 cases with a 65.5％ rate of gastroduodenal artery bleeding.There were no angiographic signs of bleeding in three patients who underwent endoscopy prior to ETAE.Twenty-six patients achieved immediate hemostasis and technical success rate reached 90％.No hemostasis was observed in 27 patients within 30 d after ETAE and clinical success rate was 93％.Recurrent hemorrhage occurred in two patients who drank a lot of wine who were treated by a second embolotherapy in the same way.Five patients underwent transient ischem with light abdominal pain under xiphoid,spontaneous restoration without special treatment.No mucous necrosis happened to 29 cases for ischem of gastroduodenal arteries embolized.CONCLUSION:ETAE is an effective and safe measure to control acute massive bleeding of duodenal ulcer.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Diagnosis of gastric intraepithelial neoplasia by narrowband imaging and confocal laser endomicroscopy

    Shu-Fang WangYun-Sheng YangLi-Xin WeiZhong-Sheng Lu...
    4771-4780页
    查看更多>>摘要：AIM:To evaluate the diagnosis of different differentiated gastric intraepithelial neoplasia (IN) by magnification endoscopy combined with narrow-band imaging (ME-NBI) and confocal laser endomicroscopy (CLE).METIHIODS:Eligible patients with suspected gastric IN lesions previously diagnosed by endoscopy in secondary hospitals and scheduled for further diagnosis and treatment were recruited for this study.Excluded from the study were patients who had liver cirrhosis,impaired renal function,acute gastrointestinal (GI) bleeding,coagulopathy,esophageal varices,jaundice,and GI post-surgery.Also excluded were those who were pregnant,breastfeeding,were younger than 18 years old,or were unable to provide informed consent.All patients had all mucus and bile cleared from their stomachs.They then received upper GI endoscopy.When a mucosal lesion is found during observation with whitelight imaging,the lesion is visualized using maximal magnification,employing gradual movement of the tip of the endoscope to bring the image into focus.Saved images are analyzed.Confocal images were evaluated by two endoscopists (Huang J and Li MY),who were familiar with CLE,blinded to the related information about the lesions,and asked to classify each lesion as either a low grade dysplasia (LGD) or high grade dysplasia (HGD) according to given criteria.The results were compared with the final histopathologic diagnosis.ME-NBI images were evaluated by two endoscopists (Lu ZS and Ling-Hu EQ) who were familiar with NBI,blinded to the related information about the lesions and CLE images,and were asked to classify each lesion as a LGD or HGD according to the "microvascular pattern and surface pattern" classification system.The results were compared with the final histopathologic diagnosis.RESULTS:The study included 32 pathology-proven low grade gastric IN and 26 pathology-proven high grade gastric IN that were detected with any of the modalities.CLE and ME-NBI enabled clear visualization of the vascular microsurface patterns and microvascular structures of the gastric mucosa.The accuracy of the CLE and the ME-NBI diagnosis was 88％ (95％ CI:78％-98％) and 81％ (95％ CI:69％-93％),respectively.The kappa coefficient of agreement between the histopathology and the in vivo CLE imaging was 0.755;between the histopathology and the in vivo CLE imaging was 0.615.McNemar's test (binomial distribution used) indicated that the agreement was significant (P ＜0.05).When patients were diagnosed by ME-NBI with CLE,the overall accuracy of the diagnosis was 86.21％ (95％ CI:73％-96％),and the kappa coefficient of agreement was 0.713,according to McNemar's test (P ＜ 0.05).CONCLUSION:Higher diagnostic accuracy,sensitivity and specificity of CLE over ME-NBI indicate the feasibility of these two techniques for the efficacious diagnostic classification of gastric IN.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    Hyperthermia inhibits hypoxia-induced epithelial-mesenchymal transition in HepG2 hepatocellular carcinoma cells

    Guang-Jin YuanQian-wen LiShun-Lin ShanWu-Ming Wang...
    4781-4786页
    查看更多>>摘要：AIM:TO investigate the effect of hyperthermia on hypoxia-induced epithelial-mesenchymal transition (EMT)in HepG2 hepatocellular carcinoma (HCC) cells,and its mechanism.METHODS:Cells were treated with hyperthermia at 43 ℃ for 0.5 h,followed by incubation under hypoxic or normoxic conditions for 72 h.Cell morphology was observed.Expressions of E-cadherin and vimentin were determined by immunofluorescence assay or Western blot.The protein and mRNA expressions of Snail were also determined by Western blot and reverse transcription-polymerase chain reaction.Cell migratory capacity was evaluated.RESULTS:Hypoxia induced EMT in HepG2 cells,which was evidenced by morphological,molecular and functional changes,including the formation of a spindle shape and the loss of cell contact.The expression of E-cadherin was decreased but the expression of vimentin was increased; also,the migratory capability was increased by 2.2 ± 0.20-fold as compared with normoxia.However,those effects were inhibited by hyperthermia pretreatment.Furthermore,protein synthesis and mRNA expression of Snail in the cells were enhanced by hypoxia as compared with normoxia,and also significantly inhibited by hyperthermia pretreatment.CONCLUSION:Hyperthermia may inhibit hypoxiainduced EMT in HepG2 HCC cells,and the mechanism may involve inhibition of induced expression of Snail.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Angioedema associated with Crohn's disease: Response to biologics

    Flavio HabalVivian Huang
    4787-4790页
    查看更多>>摘要：A 46-year-old female patient with terminal ileum Crohn's disease and ankylosing spondylitis presented with recurrent angioedema and urticaria.Investigations ruled out hereditary angioedema,and environmental or food allergen triggers.She was diagnosed with chronic idiopathic urticaria with angioedema,and was treated with a trial of intravenous immunoglobulin immunotherapy,danazol,prednisone and hydroxyzine.Due to ongoing bowel and arthritic complaints,she was started on infliximab infusions and within 2 treatments,she had complete resolution of the angioedema and urticaria,as well as of the bowel and arthritic symptoms.Unfortunately she developed allergic reactions to the infliximab and was switched to another anti-tumor necrosis factor (TNF)-α agent,adalimumab.Since then,she has had no further angioedema or urticaria,and her Crohn's disease has been quiescent.This is the first known case report of chronic idiopathic urticaria with angioedema coexistent with Crohn's disease that was successfully treated with anti-TNF-α agents.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普