首页期刊导航|世界胃肠病学杂志（英文版）
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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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    Inhibition of gastric perception of mild distention by omeprazole in volunteers

    Akihito IidaHiroshi KanekoToshihiro KonagayaYasushi Funaki...
    5576-5580页
    查看更多>>摘要：To evaluate the effects of omeprazole on gastric mechanosensitivity in humans.METHODS:A double lumen polyvinyl tube with a plastic bag was introduced into the stomach of healthy volunteers under fluorography and connected to a barostat device.Subjects were then positioned so they were sitting comfortably,and the minimal distending pressure (MDP) was determined after a 30-min adaptation period.Isobaric distensions were performed in stepwise increments of 2 mmHg (2 min each) starting from the MDP.Subjects were instructed to score feelings at the end of every step using a graphic rating scale:0,no perception; 1,weak/vague; 2,weak but significant; 3,moderate/vague; 4,moderate but significant; 5,severe discomfort; and 6,unbearable pain.After this first test,subjects received omeprazole (20 mg,after dinner) once daily for 1 wk.A second test was performed on the last day of treatment.RESULTS:No adverse effects were observed.Mean MDP before and after treatment was 6.3 ± 0.3 mmHg and 6.2 ± 0.5 mmHg,respectively.One subject before and 2 after treatment did not reach a score of 6 at the maximum bag volume of 750 mL.After omeprazole,there was a significant increase in the distension pressure required to reach scores of 1 (P =0.019) and 2(P =0.017) as compared to baseline.There were no changes in pressure required to reach the other scores after treatment.Two subjects before and one after omeprazole rated their abdominal feeling ＜ 1 at MDP,and mean (± SE) abdominal discomfort scores at MDP were 0.13 ±± 0.09 and 0.04 ±± 0.04,respectively.Mean scores induced by each MDP + 2,4,6,8,10,12,14,16,18 and 20 (mmHg) were 1.1 ± 0.3,2.0 ± 0.4,2.9± 0.5,3.3 ± 0.4,4.6 ± 0.3,5.2 ± 0.3,5.5 ± 0.2,5.5± 0.3,5.7 ± 0.3,and 5.4,respectively.After omeprazole,abdominal feeling scores for the same incremental pressures over MDP were 0.3 ± 0.1,0.8 ± 0.1,2.0±-0.4,2.8-0.4,3.8 ±± 0.4,4.6 ±± 0.4,4.9 ± 0.3,5.4± 0.4,5.2 ±± 0.6,and 5.0 ±± 1.0,respectively.A significant decrease in feeling score was observed at intrabag pressures of MDP + 2 mmHg (P =0.028) and +4 mmHg (P =0.013),respectively,after omeprazole.No significant score changes were observed at pressures ≥ MDP + 6 mmHg.CONCLUSION:Although the precise mechanisms are undetermined,the present study demonstrated that omeprazole decreases mechanosensitivity to mild gastric distension.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Thioredoxin and thioredoxin-interacting protein as prognostic markers for gastric cancer recurrence

    Jae Yun LimSun Och YoonSoon Won HongJong Won Kim...
    5581-5588页
    查看更多>>摘要：To evaluate the potential of thioredoxin (TXN)and thioredoxin-interacting protein (TXNIP) expression as biomarkers for predicting gastric cancer recurrence.METHODS:TXN and TXNIP expression levels were acquired from gene expression microarray data for 65human gastric cancer tissues.We determined whether each gene expression level was associated with cancer recurrence and investigated the relationship between the two genes.For validation,the expression levels of TXN and TXNIP were measured by quantitative realtime reverse transcription polymerase chain reaction in 68 independent stage Ⅲ gastric cancer patients.The correlation between gene expression and cancer prognosis was evaluated.Immunohistochemical staining was performed to investigate the protein expression levels of TXN and TXNIP and to characterize the expression patterns of each protein.RESULTS:TXN was a prognosis-related gene (P =0.009),whereas TXNIP,a TXN inhibitor,demonstrated a negative correlation with TXN in the gene expression microarray data.In the 68 stage Ⅲ patients,the expression levels of both TXN and TXNIP had a statistically significant effect on recurrence-free survival (RFS,P =0.008 and P =0.036,respectively).The low TXN and high TXNIP expression group exhibited a better prognosis than the other groups,and the high TXN and low TXNIP expression group exhibited a poorer prognosis (P ＜ 0.001 for RFS and P =0.001 for overall survival).More than half of the patients in the simultaneously high TXN and low TXNIP expression group experienced a recurrence within 1 year after curative surgery,and the 5-year survival rate of the patients in this group was 29％,compared with 89％ in the low TXN and high TXNIP expression group.The TXN protein was overexpressed in 65％ of the gastric cancer tissues,whereas the TXNIP protein was underexpressed in 85％ of the cancer cells.In a correlation analysis,TXN and TXNIP were highly correlated with many oncogenes and tumor suppressors as well as with genes related to energy,protein synthesis and autophagy.CONCLUSION:TXN and TXNIP are promising prognostic markers for gastric cancer,and performing personalized adjuvant treatment based on TXN and TXNIP expression levels would be an effective practice in the treatment of gastric cancer.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Photodynamic therapy prolongs metal stent patency in patients with unresectable hilar cholangiocarcinoma

    Tae Yoon LeeYoung Koog CheonChan Sup ShimYoung Deok Cho...
    5589-5594页
    查看更多>>摘要：To evaluate the effect of photodynamic therapy (PDT) on metal stent patency in patients with unresectable hilar cholangiocarcinoma (CC).METHODS:This was a retrospective analysis of patients with hilar CC referred to our institution from December,1999 to January,2011.Out of 232 patients,thirty-three patients with unresectable hilar CC were treated.Eighteen patients in the PDT group were treated with uncovered metal stents after one session of PDT.Fifteen patients in the control group were treated with metal stents alone.Porfimer sodium (2 mg/kg)was administered intravenously to PDT patients.Fortyeight hours later,PDT was administered using a diffusing fiber that was advanced across the tumor by either endoscopic retrograde cholangiopancreatography or percutaneous cholangiography.After performance of PDT,uncovered metal stents were inserted to ensure adequate decompression and bile drainage.Patient survival rates and cumulative stent patency were calculated using Kaplan-Meier analysis with the log-rank test.RESULTS:The PDT and control patients were comparable with respect to age,gender,health status,pretreatment bilirubin,and hilar CC stage.When compared to control,the PDT group was associated with significantly prolonged stent patency (median 244 ±66 and 177 ± 45 d,respectively,P =0.002) and longer patient survival (median 356 ± 213 and 230 ± 73 d,respectively,P =0.006).Early complication rates were similar between the groups (PDT group 17％,control group 13％) and all patients were treated conservatively.Stent malfunctions occurred in 14 PDT patients (78％) and 12 control patients (80％).Of these 26patients,twenty-two were treated endoscopically and four were treated with external drainage.CONCLUSION:Metal stenting after one session of PDT may be safe with acceptable complication rates.The PDT group was associated with a significantly longer stent patency than the control group in patients with unresectable hilar CC.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Surgical outcome of pancreatic cancer using radical antegrade modular pancreatosplenectomy procedure

    Ye Rim ChangSung-Sik HanSang-Jae ParkSeung Duk Lee...
    5595-5600页
    查看更多>>摘要：To evaluate the surgical outcomes following radical antegrade modular pancreatosplenectomy (RAMPS)for pancreatic cancer.METHODS:Twenty-four patients underwent RAMPS with curative intent between January 2005 and June 2009 at the National Cancer Center,South Korea.Clinicopathologic data,including age,sex,operative findings,pathologic results,adjuvant therapy,postoperative clinical course and follow-up data were retrospectively collected and analyzed for this study.RESULTS:Twenty-one patients (87.5％) underwent distal pancreatectomy and 3 patients (12.5％) underwent total pancreatectomy using RAMPS.Nine patients (37.5％) underwent combined vessel resection,including 8 superior mesenteric-portal vein resections and 1 celiac axis resection.Two patients (8.3％) underwent combined resection of other organs,including the colon,stomach or duodenum.Negative tangential margins were achieved in 22 patients (91.7％).The mean tumor diameter for all patients was 4.09 ± 2.15 cm.The 2 patients with positive margins had a mean diameter of 7.25 cm.The mean number of retrieved lymph nodes was 20.92 ± 11.24 and the node positivity rate was 70.8％.The median survival of the 24 patients was 18.23 ± 6.02 mo.Patients with negative margins had a median survival of 21.80 ± 5.30 mo and those with positive margins had a median survival of 6.47 mo (P =0.021).Nine patients (37.5％) had postoperative complications,but there were no postoperative mortalities.Pancreatic fistula occurred in 4 patients (16.7％):2 patients had a grade A fistula and 2 had a grade B fistula.On univariate analysis,histologic grade,positive tangential margin,pancreatic fistula and adjuvant therapy were significant prognostic factors for survival.CONCLUSION:RAMPS is a feasible procedure for achieving negative tangential margins in patients with carcinoma of the body and tail of the pancreas.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Biochemical characteristics of neonatal cholestasis induced by citrin deficiency

    Jian-She WangXiao-Hong WangYing-Jie ZhengHai-Yan Fu...
    5601-5607页
    查看更多>>摘要：AIM:To explore differences in biochemical indices between neonatal intrahepatic cholestasis caused by citrin deficiency (NICCD) and that with other etiologies.METHODS:Patients under 6 mo of age who were referred for investigation of conjugated hyperbilirubinaemia from June 2003 to December 2010 were eligible for this study.After excluding diseases affecting the extrahepatic biliary system,all patients were screened for the two most common SLC25A13 mutations; the coding exons of the entire SLC25A13 gene was sequenced and Western blotting of citrin protein performed in selected cases.Patients in whom homozygous or compound heterozygous SLC25A13 mutation and/or absence of normal citrin protein was detected were defined as having NICCD.Cases in which no specific etiological factor could be ascertained after a comprehensive conjugated hyperbilirubinaemia work-up were defined as idiopathic neonatal cholestasis (INC).Thirty-two NICCD patients,250 INC patients,and 39infants with cholangiography-confirmed biliary atresia (BA) were enrolled.Laboratory values at their first visit were abstracted from medical files and compared.RESULTS:Compared with BA and INC patients,the NICCD patients had significantly higher levels of total bile acid (TBA) [all measures are expressed as median (inter-quartile range):178.0 (111.2-236.4) μtmol/L in NICCD vs 112.0 (84.9-153.9) μmol/L in BA and 103.0 (70.9-135.3) μmol/L in INC,P =0.0001].The NICCD patients had significantly lower direct bilirubin [D-Bil 59.6 (43.1-90.9) μmol/L in NICCD vs 134.0(115.9-151.2) μmol/L in BA and 87.3 (63.0-123.6)μmol/L in INC,P =0.0001]; alanine aminotransferase [ALT 34.0 (23.0-55.0) U/L in NICCD vs 108.0(62.0-199.0) U/L in BA and 84.5 (46.0-166.0) U/L in INC,P =0.0001]; aspartate aminotransferase [AST 74.0 (53.5-150.0) U/L in NICCD vs 153.0 (115.0-239.0)U/L in BA and 130.5 (81.0-223.0) U/L in INC,P =0.0006]; albumin [34.9 (30.7-38.2) g/L in NICCD vs 38.4 (36.3-42.2) g/L in BA and 39.9 (37.0-42.3) g/L in INC,P =0.0001]; glucose [3.2 (2.0-4.4) mmol/L in NICCD vs 4.1 (3.4-5.1) mmol/L in BA and 4.0 (3.4-4.6)mmol/L in INC,P =0.0014] and total cholesterol [TCH 3.33 (2.97-4.00) mmol/L in NICCD vs 4.57 (3.81-5.26)mmol/L in BA and 4.00 (3.24-4.74) mmol/L in INC,P =0.0155] levels.The D-Bil to total bilirubin (T-Bil) ratio was significantly lower in NICCD patients [all measures are expressed as median (inter-quartile range):0.54(0.40-0.74)] than that in BA patients [0.77 (0.72-0.81),P =0.001] and that in INC patients [0.74 (0.59-0.80),P =0.0045].A much higher AST/ALT ratio was found in NICCD patients [2.46 (1.95-3.63)] compared to BA patients [1.38 (0.94-1.97),P =0.0001] and INC patients [1.48 (1.10-2.26),P =0.0001].NICCD patients had significantly higher TBA/D-Bil ratio [3.36(1.98-4.43) vs 0.85 (0.72-1.09) in BA patients and 1.04(0.92-1.14) in INC patients,P =0.0001],and TBA/TCH ratio [60.7 (32.4-70.9) vs 24.7 (19.8-30.2) in BA patients and 24.2 (21.4-26.9) in INC patients,P =0.0001]compared to the BA and INC groups.CONCLUSION:NICCD has significantly different biochemical indices from BA or INC.TBA excretion in NICCD appeared to be more severely disturbed than that of bilirubin and cholesterol.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Colonic stenting vs emergent surgery for acute left-sided malignant colonic obstruction: A systematic review and meta-analysis

    Guang-Yao YeZhe CuiLu ChenMing Zhong...
    5608-5615页
    查看更多>>摘要：To investigate the effects of emergent preoperative self-expandable metallic stent (SEMS) vs emergent surgery for acute left-sided malignant colonic obstruction.METHODS:Two investigators independently searched the MEDLINE,EMBASE and Cochrane Central Register of Controlled Trials,as well as references of included studies to identify randomized controlled trials (RCTs)that compared two or more surgical approaches for acute colonic obstruction.Summary risk ratios (RR)and 95％ CI for colonic stenting and emergent surgery were calculated.RESULTS:Eight studies met the selection criteria,involving 444 patients,of whom 219 underwent SEMS and 225 underwent emergent surgery.Seven studies reported difference of the one-stage stoma rates between the two groups (RR,0.60; 95％ CI:0.48-0.76;P ＜ 0.0001).Only three RCTs described the follow-up stoma rates,which showed no significant difference between the two groups (RR,0.80; 95％ CI:0.59-1.08;P =0.14).Difference was not significant in the mortality between the two groups (RR,0.91; 95％ CI:0.50-1.66; P =0.77),but there was significant difference (RR,0.57; 95％ CI:0.44-0.74; P ＜ 0.0001) in the overall morbidity.There were no significant differences between the two groups in the anastomotic leak rate (RR,0.60; 95％ CI:0.28-1.28; P =0.19),occurrence of abscesses,including peristomal abscess,intraperitoneal abscess and parietal abscess (RR,0.83; 95％ CI:0.36-1.95; P =0.68),and other abdominal complications (RR:0.67; 95％ CI:0.40-1.12; P =0.13).CONCLUSION:SEMS is not obviously more advantageous than emergent surgery for patients with acute left-sided malignant colonic obstruction.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Comparison between different reconstruction routes in esophageal squamous cell carcinoma

    Yu-Zhen ZhengShu-Qin DaiWei LiXun Cao...
    5616-5621页
    查看更多>>摘要：To compare postoperative complications and prognosis of esophageal squamous cell carcinoma patients treated with different routes of reconstruction.METHODS:After obtaining approval from the Medical Ethics Committee of the Sun Yat-Sen University Cancer Center,we retrospectively reviewed data from 306 consecutive patients with histologically diagnosed esophageal squamous cell carcinoma who were treated between 2001 and 2011.All patients underwent radical McKeown-type esophagectomy with at least two-field lymphadenectomy.Regular follow-up was performed in our outpatient department.Postoperative complications and long-term survival were analyzed by treatment modality,baseline patient characteristics,and operative procedure.Data from patients treated via the retrosternal and posterior mediastinal routes were compared.RESULTS:The posterior mediastinal and retrosternal reconstruction routes were employed in 120 and 186patients,respectively.Pulmonary complications were the most common complications experienced during the postoperative period (46.1％ of all patients;141/306).Compared to the retrosternal route,the posterior mediastinal reconstruction route was associated with a lower incidence of anastomotic stricture (15.8％vs 27.4％,P =0.018) and less surgical bleeding (242.8± 114.2 mL vs 308.2 ± 168.4 mL,P ＜ 0.001).The median survival time was 26.8 mo (range:1.6-116.1mo).Upon uni/multivariate analysis,a lower preoperative albumin level (P =0.009) and a more advanced pathological stage (pT; P =0.006; pN; P ＜ 0.001)were identified as independent factors predicting poor prognosis.The reconstruction route did not influence prognosis (P =0.477).CONCLUSION:The posterior mediastinal route of reconstruction reduces incidence of postoperative complications but does not affect survival.This route is recommended for resectable esophageal squamous cell carcinoma.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Carbon dioxide insufflation for endoscopic retrograde cholangiopancreatography: A meta-analysis and systematic review

    Yao ChengXian-Ze XiongSi-Jia WuJiong Lu...
    5622-5631页
    查看更多>>摘要：AIM:To assess the safety and efficacy of carbon dioxide (CO2) insufflation during endoscopic retrograde cholangiopancreatography (ERCP).METHODS:The Cochrane Library,Medical Literature Analysis and Retrieval System Online,Excerpta Medica Database,Science Citation Index Expanded,Chinese Biomedical Literature Database,and references in relevant publications were searched up to December 2011 to identify randomized controlled trials (RCTs)comparing CO2 insufflation with air insufflation during ERCP.The trials were included in the review irrespective of sample size,publication status,or language.Study selection and data extraction were performed by two independent authors.The meta-analysis was performed using Review Manager 5.1.6.A randomeffects model was used to analyze various outcomes.Sensitivity and subgroup analyses were performed if necessary.RESULTS:Seven double-blind RCTs involving a total of 818 patients were identified that compared CO2insuftlation (n =404) with air insufflation (n =401)during ERCR There were a total of 13 post-randomization dropouts in four RCTs.Six RCTs had a high risk of bias and one had a low risk of bias.None of the RCTs reported any severe gas-related adverse events in either group.A meta-analysis of 5 RCTs (n =459)indicated that patients in the CO2 insufflation group had less post-ERCP abdominal pain and distension for at least 1 h compared with patients in the air insufflation group.There were no significant differences in mild cardiopulmonary complications [risk ratio (RR) =0.43,95％ CI:0.07-2.66,P =0.36],cardiopulmonary (e.g.,blood CO2 level) changes [standardized mean difference (SMD) =-0.97,95％ CI:-2.58-0.63,P =0.23],cost analysis (mean difference =3.14,95％ CI:-14.57-20.85,P =0.73),and total procedure time (SMD=-0.05,95％ CI:-0.26-0.17,P =0.67) between the two groups.CONCLUSION:CO2 insufflation during ERCP appears to be safe and reduces post-ERCP abdominal pain and discomfort.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Clostridium perfringens bacteremia caused by choledocholithiasis in the absence of gallbladder stones

    Antwan AtiaTejas RaiyaniPranav PatelRobert Patton...
    5632-5634页
    查看更多>>摘要：A 67-years-old male presented with periumbilical abdominal pain,fever and jaundice.His anaerobic blood culture was positive for clostridium perfringens.Computed tomogram scan of the abdomen and abdominal ultrasound showed normal gallbladder and common bile duct (CBD).Subsequently magnetic resonance cholangiopancreaticogram showed choledocholithiasis.Endoscopic retrograde cholangiopancreaticogramwith sphincterotomy and CBD stone extraction was performed.The patient progressively improved with antibiotic therapy Choledocholithiasis should be considered as a source of clostridium perfringens bacteremia especially in the setting of elevated liver enzymes with cholestatic pattern.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    A de novo germline MLH1 mutation in a Lynch syndrome patient with discordant immunohistochemical and molecular biology test results

    Fabrice AiraudSébastien KüryIsabelle ValoIngrid Maury...
    5635-5639页
    查看更多>>摘要：We describe a patient with a Homo sapiens mutL homolog 1 (MLH1)-associated Lynch syndrome with previous diagnoses of two distinct primary cancers:a sigmoid colon cancer at the age of 39 years,and a right colon cancer at the age of 50 years.The mutation identified in his blood and buccal cells,c.1771delG,p.Asp591Ilefs*25,appears to be a de novo event,as it was not transmitted by either of his parents.This type of de novo event is rare in MLH1 as only three cases have been reported in the literature so far.Furthermore,the discordant results observed between replication error phenotyping and immunohistochemistry highlight the importance of the systematic use of both pre-screening tests in the molecular diagnosis of Lynch syndrome.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普