期刊,世界胃肠病学杂志（英文版） 2012年卷41期_国家学术搜索

期刊信息/Journal information

世界胃肠病学杂志（英文版）

主　　编：潘伯荣

出版周期：周刊

国际刊号：1007-9327

电子邮箱：wjg@wjgnet.com

电　　话：010-85381901-628

邮政编码：100025

地　　址：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。

正式出版

收录年代

Steroid-sparing strategies in the management of ulcerative colitis: Efficacy of leukocytapheresis

Manabu ShirakiTakayuki Yamamoto

5833-5838页

查看更多>>摘要：Active ulcerative colitis (UC) is frequently associated with infiltration of a large number of leukocytes into the bowel mucosa.Leukocytapheresis is a novel nonpharmacologic approach for active UC,in which leukocytes are mechanically removed from the circulatory system.Current data indicate that leukocytapheresis is efficacious in improving response and remission rates with excellent tolerability and safety in patients with UC.Corticosteroid therapy remains a mainstay in the treatment of active UC; however,long-term,high doses of corticosteroids usually produce predictable and potentially serious side effects.If leukocytapheresis can spare patients from exposure to corticosteroids,the risk of steroid-induced adverse events should be minimized.This may be of great benefit to patients because severe side effects of steroids seriously impair healthrelated quality of life.In this article,we reviewed cur rent evidence on whether leukocytapheresis can avoid or reduce the use of corticosteroids in the management of patients with UC.Several studies have shown that leukocytapheresis was effective for steroid-na(i)ve patients with active UC.Furthermore,both short-term and long-term studies have demonstrated the steroidsparing effects of leukocytapheresis therapy in patients with UC.Although the evidence level is not striking,the available data suggest that leukocytapheresis can avoid or reduce the use of corticosteroids in the management of UC.Large,well-designed clinical trials are necessary to more accurately evaluate the steroid-sparing effects of leukocytapheresis in the management of UC.

原文链接:

NETL
NSTL
万方数据
维普

Omega-3 fatty acids for the treatment of non-alcoholic fatty liver disease

Matteo Nicola Dario Di MinnoAnna RussolilloRoberta LupoliPasquale Ambrosino...

5839-5847页

查看更多>>摘要：Non-alcoholic fatty liver disease (NAFLD) has been recognized as a major health burden.It is the most important cause of chronic liver disease and a major independent cardiovascular risk factor.Lacking a definite treatment for NAFLD,a specific diet and an increase in physical activity represent the most commonly used therapeutic approaches.In this review,major literature data about the use of omega-3 polyunsaturated fatty acids (n-3 PUFAs) as a potential treatment of NAFLD have been described.n-3 PUFAs,besides having a beneficial impact on most of the cardio-metabolic risk factors (hypertension,hyperlipidemia,endothelial dysfunction and atherosclerosis) by regulating gene transcription factors [i.e.,peroxisome proliferator-activated receptor (PPAR)α,PPARγ,sterol regulatory element-binding protein-1,carbohydrate responsive element-binding protein],impacts both lipid metabolism and on insulin sensitivity.In addition to an enhancement of hepatic beta oxidation and a decrease of the endogenous lipid production,n-3 PUFAs are able to determine a significant reduction of the expression of pro-inflammatory molecules (tumor necrosis factor-α and interleukin-6) and of oxygen reactive species.Further strengthening the results of the in vitro studies,both animal models and human intervention trials,showed a beneficial effect of n-3 PUFAs on the severity of NAFLD as expressed by laboratory parameters and imaging measurements.Despite available results provided encouraging data about the efficacy of n-3 PUFAs as a treatment of NAFLD in humans,well-designed randomized controlled trials of adequate size and duration,with histological endpoints,are needed to assess the long-term safety and efficacy of PUFA,as well as other therapies,for the treatment of NAFLD and non-alcoholic steatohepatitis patients.It is worthwhile to consider that n-3 PUFAs cannot be synthesized by the human body and must be derived from exogenous sources (fish oil,flaxseeds,olive oil) which are typical foods of the Mediterranean diet,known for its beneficial effects in preventing obesity,diabetes and,in turn,cardiovascular events.According to these data,it is important to consider that most of the beneficial effects of n-3 PUFAs can also be obtained by an equilibrate nutrition program.

原文链接:

NETL
NSTL
万方数据
维普

Changes of the cytokine profile in inflammatory bowel diseases

Gy(o)rgyi MüzesBéla MolnárZsolt TulassayFerenc Sipos...

5848-5861页

查看更多>>摘要：Cytokines are indispensable signals of the mucosaassociated immune system for maintaining normal gut homeostasis.An imbalance of their profile in favour of inflammation initiation may lead to disease states,such as that is observed in inflammatory bowel diseases (IBD).Although Crohn's disease (CD) is often described as a prototype of T-helper 1-type diseases,and ulcerative colitis (UC) is traditionally viewed as a T-helper 2-mediated condition,the classic paradigm,which categorises cytokines into pro-and anti-inflammatory groups,has recently been changed.The inflammation regulatory pathways may not be mutually exclusive as individual cytokines can have diverse and even opposing functions in various clinical and immunological settings.None the less there are many common immunological responses in IBD that are mediated by cytokines.Although they regulate and influence the development,course and recurrence of the inflammatory process,the concrete pathogenic role of these small signaling molecules is sometimes not unambiguous in the subtypes of the disease.Our aim is to review the current information about pro-and anti-inflammatory effects of traditionally studied and recently discovered cytokines in the pathogenesis of UC and CD.The better understanding of their production and functional activity may lead to the development of new therapeutic modalities.

原文链接:

NETL
NSTL
万方数据
维普

Crohn's and colitis in children and adolescents

Andrew S DayOren LedderSteven T LeachDaniel A Lemberg...

5862-5869页

查看更多>>摘要：Crohn's disease and ulcerative colitis can be grouped as the inflammatory bowel diseases (IBD).These conditions have become increasingly common in recent years,including in children and young people.Although much is known about aspects of the pathogenesis of these diseases,the precise aetiology is not yet understood,and there remains no cure.Recent data has illustrated the importance of a number of genes-several of these are important in the onset of IBD in early life,including in infancy.Pain,diarrhoea and weight loss are typical symptoms of paediatric Crohn's disease whereas bloody diarrhoea is more typical of colitis in children.However,atypical symptoms may occur in both conditions:these include isolated impairment of linear growth or presentation with extra-intestinal manifestations such as erythèma nodosum.Growth and nutrition are commonly compromised at diagnosis in both Crohn's disease and colitis.Consideration of possible IBD and completion of appropriate investigations are essential to ensure prompt diagnosis,thereby avoiding the consequences of diagnostic delay.Patterns of disease including location and progression of IBD in childhood differ substantially from adultonset disease.Various treatment options are available for children and adolescents with IBD.Exclusive enteral nutrition plays a central role in the induction of remission of active Crohn's disease.Medical and surgical therapies need to considered within the context of a growing and developing child.The overall management of these chronic conditions in children should include multi-disciplinary expertise,with focus upon maintaining control of gut inflammation,optimising nutrition,growth and quality of life,whilst preventing disease or treatment-related complications.

原文链接:

NETL
NSTL
万方数据
维普

Effectiveness of impedance monitoring during radiofrequency ablation for predicting popping

Hiroya IidaTsukasa AiharaShinichi IkutaNaoki Yamanaka...

5870-5878页

查看更多>>摘要：AIM:To retrospectively evaluate the effectiveness of impedance monitoring for predicting popping during radiofrequency ablation (RFA) using internally cooled electrodes.METHODS:We reviewed 140 patients (94 males,46females; age range 73.0 4± 11.1 year) who underwent RFA between February 2006 and November 2008 with a modified protocol using a limited power delivery rather than a conventional one to avoid popping.All the patients provided their written informed consent,and the study was approved by the institutional review board.Intraprocedural impedances were measured for the study subjects,and the tumors were classified into three types according to the characteristics of their impedance curves:increasing,flat,or decreasing.The tumors were further sorted into seven subtypes (A-G)depending on the curvature of the impedance curve' s increase or decrease.Relative popping rates were determined for the three types and seven subtypes.A chi-square test was performed to estimate statistical significance.RESULTS:A total of 148 nodules treated by RFA were analyzed.The study samples included 132 nodules of hepatocellular carcinoma,14 nodules of metastatic liver cancer,and two nodules of intrahepatic cholangiocarcinoma.The numbers of nodules with each impedance curve type were as follows:37 increasing-type nodules,43 fiat-type nodules,and 68 decreasing-type nodules.Popping occurrence rates were 24.3％,46.5％ and 64.7％,respectively.Flat-type nodules exhibited a significantly higher rate of popping compared to increasing-type nodules (P =0.039).Decreasing-type nodules exhibited a significantly higher rate of popping compared to increasing-type nodules (P ＜ 0.0001).Notably,nodules that showed a sharp decrease in impedance in the latter ablation period (subtype E) exhibited a significantly higher rate of popping compared to other subtypes.CONCLUSION:Intraprocedural impedance monitoring can be a useful tool to predict the occurrence of popping during liver tumor RFA performed with internally cooled electrodes.

原文链接:

NETL
NSTL
万方数据
维普

Several factors including ITPA polymorphism influence ribavirin-induced anemia in chronic hepatitis C

Akihito TsubotaNoritomo ShimadaHiroshi AbeKai Yoshizawa...

5879-5888页

查看更多>>摘要：AIM:To construct formulae for predicting the likelihood of ribavirin-induced anemia in pegylated interferon α plus ribavirin for chronic hepatitis C.METHODS:Five hundred and sixty-one Japanese patients with hepatitis C virus genotype 1b who had received combination treatment were enrolled and assigned randomly to the derivation and confirmatory groups.Single nucleotide polymorphisms at or nearby ITPA were genotyped by real-time detection polymerase chain reaction.Factors influencing significant anemia (hemoglobin concentration ＜ 10.0 g/dL at week 4 of treatment) and significant hemoglobin decline (declining concentrations ＞ 3.0 g/dL at week 4) were analyzed using multiple regression analyses.Prediction formulae were constructed by significantly independent factors.RESULTS:Multivariate analysis for the derivation group identified four independent factors associated with significant hemoglobin decline:hemoglobin decline at week 2 [P =3.29 × 10-17,odds ratio (OR) =7.54(g/dL)],estimated glomerular filtration rate [P =2.16 × 10-4,OR =0.962 (mL/min/1.73 m2)],rs1127354 (P=5.75 x 10-4,OR =10.94) and baseline hemoglobin [P =7.86 x 10-4,OR =1.50 (g/dL)].Using the model constructed by these factors,positive and negative predictive values and predictive accuracy were 79.8％,88.8％ and 86.2％,respectively.For the confirmatory group,they were 83.3％,91.0％ and 88.3％.These factors were closely correlated with significant anemia.However,the model could not be constructed,because no patients with rs1127354 minor genotype CA/AA had significant anemia.CONCLUSION:Reliable formulae for predicting the likelihood of ribavirin-induced anemia were constructed.Such modeling may be useful in developing individual tailoring and optimization of ribavirin dosage.

原文链接:

NETL
NSTL
万方数据
维普

Characteristics of deslanoside-induced modulation on jejunal contractility

Da-Peng ChenYong-Jian XiongZe-Yao TangQi-Ying Yao...

5889-5896页

查看更多>>摘要：AIM:TO characterize the dual effects of deslanoside on the contractility of jejunal smooth muscle.METHODS:Eight pairs of different low and high contractile states of isolated jejunal smooth muscle fragment (JSMF) were established.Contractile amplitude of JSMF in different low and high contractile states was selected to determine the effects of deslanoside,and Western blotting analysis was performed to measure the effects of deslanoside on myosin phosphorylation of jejunal smooth muscle.RESULTS:Stimulatory effects on the contractility of JSMF were induced (45.3％ ± 4.0％ vs 87.0％ ± 7.8％,P ＜ 0.01) by deslanoside in 8 low contractile states,and inhibitory effects were induced (180.6％ ± 17.8％vs 109.9％ ± 10.8％,P ＜ 0.01) on the contractility of JSMF in 8 high contractile states.The effect of deslanoside on the phosphorylation of myosin light chain ofJSMF in low (78.1％ ± 4.1％ vs 96.0％ ± 8.1％,P ＜0.01) and high contractile state (139.2％ ± 8.5％ vs 105.5 ± 7.34,P ＜ 0.01) was also bidirectional.Bidirectional regulation (BR) was abolished in the presence of tetrodotoxin.Deslanoside did not affect jejunal contractility pretreated with the Ca2+ channel blocker verapamil or in a Ca2+-free assay condition.The stimulatory effect of deslanoside on JSMF in a low contractile state (low Ca2+ induced) was abolished by atropine.The inhibitory effect of deslanoside on jejunal contractility in a high contractile state (high Ca2+ induced) was blocked by phentolamine,propranolol and L-NG-nitroarginine,respectively.CONCLUSION:Deslanoside-induced BR is Ca2+ dependent and is related to cholinergic and adrenergic systems when JSMF is in low or high contractile states.

原文链接:

NETL
NSTL
万方数据
维普

Expression characteristics and diagnostic value of annexin A2 in hepatocellular carcinoma

Hai-Jian ZhangDeng-Fu YaoMin YaoHua Huang...

5897-5904页

查看更多>>摘要：AIM:To investigate the characteristics and diagnostic value of annexin A2 (ANXA2) expression in cancerous tissues and sera of patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).METHODS:Levels of liver ANXA2 gene transcription or protein expression were analyzed in HCC-,their self-controlled precancerous-,and distant cancerous-tissues from 30 HCC.Serum levels of ANXA2 expression in 115 patients with HCC,25 with metastatic liver cancer,35 with chronic hepatitis,28 with acute hepatitis,38 with cirrhosis,and 30 healthy controls were determined.Clinicopathological characteristics of circulating ANXA2 expression were analyzed,and its diagnostic efficiency and clinical values in HCC were evaluated.RESULTS:ANXA2 expression was localized in both cell membrane and cytoplasm in HCC tissue,mainly in the cytoplasm of matched adjacent cancerous tissue,and there was almost no positive staining in matched distant cancerous tissue.Abnormal expression of liver ANXA2 was present in HCC tissues compared with self-controlled adjacent-and distant-cancerous tissues at prorein or mRNA level.Circulating ANXA2 in HCC patients was significantly higher than that of other liver diseases (P ＜ 0.01) except metastatic liver cancer.If the diagnostic cutoff value of ANXA2 level was more than 18 ng/mL,the incidence of serum ANXA2 was 86.96％ in the HCC group,80％ in the metastatic liver cancer group,31.58％ in the liver cirrhosis group,none in the chronic hepatitis or acute hepatitis or normal control group,respectively.Serum ANXA2 expression in HCC patients was correlated with HBV infection (27.38 ± 5.67 ng/mL vs 18.58 ± 7.83 ng/mL,P ＜ 0.01),extrahepatic metastasis (26.11 ± 5.43 ng/mL vs 22.79 ± 5.64 ng/mL,P ＜0.01),and portal vein thrombus (26.03 ± 5.99 ng/mL vs 23.06 ± 5.03 ng/mL,P ＜ 0.01),and was significantly higher (P ＜ 0.01) in the moderately-(26.19 ± 5.34 ng/mL) or the poorly-differentiated group (27.05 ± 5.13ng/mL) than in the well differentiated group (20.43 ± 4.97 ng/mL),and in the tumor node metastasis stages Ⅲ-Ⅳ (P ＜ 0.01) than in stages Ⅰ-Ⅱ.ANXA2 was not correlated with patient sex,age,size or α-fetoprotein (AFP) level.Area under the receiver operating characteristic curve for the whole range of sensitivities and specificities was 0.796 for ANXA2 and 0.782 for AFR Combining detection of serum ANXA2 and AFP substantially improved the diagnostic efficiency (96.52％) and the negative predictive value (96.61％) for HCC.CONCLUSION:The characteristics and distribution of ANXA2 expression has good diagnostic potential for HCC diagnosis.

原文链接:

NETL
NSTL
万方数据
维普

Comparative effectiveness of i-SCANTM and high-definition white light characterizing small colonic polyps

Johanna L ChanLi LinMichael FeilerAndrew I Wolf...

5905-5911页

查看更多>>摘要：AIM:To evaluate accuracy of in vivo diagnosis of adenomatous vs non-adenomatous polyps using i-SCAN digital chromoendoscopy compared with high-definition white light.METHODS:This is a single-center comparative effectiveness pilot study.Polyps (n =103) from 75 averagerisk adult outpatients undergoing screening or surveillance colonoscopy between December 1,2010 and April 1,2011 were evaluated by two participating endoscopists in an academic outpatient endoscopy center.Polyps were evaluated both with high-definition white light and with i-SCAN to make an in vivo prediction of adenomatous vs non-adenomatous pathology.We determined diagnostic characteristics of i-SCAN and highdefinition white light,including sensitivity,specificity,and accuracy,with regards to identifying adenomatous vs non-adenomatous polyps.Histopathologic diagnosis was the gold standard comparison.RESULTS:One hundred and three small polyps,detected from forty-three patients,were included in the analysis.The average size of the polyps evaluated in the analysis was 3.7 mm (SD 1.3 mm,range 2 mm to 8 mm).Formal histopathology revealed that 54/103(52.4％) were adenomas,26/103 (25.2％) were hyperplastic,and 23/103 (22.3％) were other diagnoses include "lymphoid aggregates”,"non-specific colitis," and "no pathologic diagnosis." Overall,the combined accuracy of endoscopists for predicting adenomas was identical betweeni-SCAN (71.8％,95％CI:62.1％-80.3％)and high-definition white light (71.8％,95％CI:62.1％-80.3％).However,the accuracy of each endoscopist differed substantially,where endoscopist A demonstrated 63.0％ overall accuracy (95％CI:50.9％-74.0％)as compared with endoscopist B demonstrating 93.3％ overall accuracy (95％CI:77.9％-99.2％),irrespective of imaging modality.Neither endoscopist demonstrated a significant learning effect with i-SCAN during the study.Though endoscopist A increased accuracy using i-SCAN from 59％ (95％CI:42.1％-74.4％) in the first half to 67.6％ (95％CI:49.5％-82.6％) in the second half,and endoscopist B decreased accuracy using i-SCAN from 100％ (95％CI:80.5％-100.0％) in the first half to 84.6％ (95％CI:54.6％-98.1％) in the second half,neither of these differences were statistically significant.CONCLUSION:i-SCAN and high-definition white light had similar efficacy predicting polyp histology.Endoscopist training likely plays a critical role in diagnostic test characteristics and deserves further study.

原文链接:

NETL
NSTL
万方数据
维普

Human thrombin for the treatment of gastric and ectopic varices

Norma C McAvoyJohn N PlevrisPeter C Hayes

5912-5917页

查看更多>>摘要：AIM:To evaluate the efficacy of human thrombin in the treatment of bleeding gastric and ectopic varices.METHODS:Retrospective observational study in a Tertiary Referral Centre.Between January 1999-October 2005,we identified 37 patients who were endoscopically treated with human thrombin injection therapy for bleeding gastric and ectopic varices.Patient details including age,gender and aetiology of liver disease/ segmental portal hypertension were documented.The thrombin was obtained from the Scottish National Blood Transfusion Service and prepared to give a solution of 250 IU/mL which was injected via a standard injection needle.All patient case notes were reviewed and the total dose of thrombin given along with the number of endoscopy sessions was recorded.Initial haemostasis rates,rebleeding rates and mortality were catalogued along with the incidence of any immediate complications which could be attributable to the thrombin therapy.The duration of follow up was also listed.The study was conducted according to the United Kingdom research ethics guidelines.RESULTS:Thirty-seven patients were included.33 patients (89％) had thrombin (250 U/mL) for gastric varices,2 (5.4％) for duodenal varices,1 for rectal varices and 1 for gastric and rectal varices.(1) Gastric varices,an average of 15.2 mL of thrombin was used per patient.Re-bleeding occurred in 4 patients (10.8％),managed in 2 by a transjugular intrahepatic portosystemic shunt (TIPSS) (one unsuccessfully who died) and in other 2 by a distal splenorenal shunt; (2) Duodenal varices (or type 2 isolated gastric varices),an average of 12.5 mL was used per patient over 2-3 endoscopy sessions.Re-bleeding occurred in one patient,which was treated by TIPSS; and (3) Rectal varices,an average of 18.3 mL was used per patient over 3 endoscopy sessions.No re-bleeding occurred in this group.CONCLUSION:Human thrombin is a safe,easy to use and effective therapeutic option to control haemorrhage from gastric and ectopic varices.

原文链接:

NETL
NSTL
万方数据
维普