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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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    High-fibre diet and Lactobacillus paracasei B21060 in symptomatic uncomplicated diverticular disease

    Edith LahnerGianluca EspositoAngelo ZulloCesare Hassan...
    5918-5924页
    查看更多>>摘要：AIM:TO investigate in symptomatic uncomplicated diverticular disease the efficacy of symbiotics associated with a high-fibre diet on abdominal symptoms.METHODS:This study was a multicentre,6-mo randomized,controlled,parallel-group intervention with a preceding 4-wk washout period.Consecutive outpatients with symptomatic uncomplicated diverticular disease,aged 40-80 years,evaluated in 4 Gastroenterology Units,were enrolled.Symptomatic uncomplicated diverticular disease patients were randomized to two treatment arms A or B.Treatment A (n =24 patients)received 1 symbiotic sachet Flortec(c) (Lactobacillus paracasei B21060) once daily plus high-fibre diet for 6 mo.Treatment B (n =21 patients) received high-fibre diet alone for 6 mo.The primary endpoint was regression of abdominal symptoms and change of symptom severity after 3 and 6 mo of treatment.RESULTS:In group A,the proportion of patients with abdominal pain ＜ 24 h decreased from 100％ at baseline to 35％ and 25％ after 3 and 6 mo,respectively (P＜ 0.001).In group B the proportion of patients with this symptom decreased from 90.5％ at baseline to 61.9％ and 38.1％ after 3 and 6 mo,respectively (P =0.001).Symptom improvement became statistically significant at 3 and 6 mo in group A and B,respectively.The proportion of patients with abdominal pain ＞24h decreased from 60％ to 20％ then 5％ after 3 and 6 mo,respectively in group A (P ＜ 0.001) and from 33.3％ to 9.5％ at both 3 and 6 mo in group B (P =0.03).In group A the proportion of patients with abdominal bloating significantly decreased from 95％ to 60％ after 3 mo,and remained stable (65％) at 6-mo follow-up (P =0.005) while in group B,no significant changes in abdominal bloating was observed (P =0.11).After 6 mo of treatment,the mean visual analogic scale (VAS) values of both short-lasting abdominal pain (VAS,mean ± SD,group A:4.6 ± 2.1 vs 2.2 ± 0.8,P =0.02;group B:4.6±2.9 vs 2.0 ± 1.9,P =0.03) and abdominal bloating (VAS,mean ± SD,group A:5.3 ± 2.2 vs 3.0± 1.7,P =0.005; group B:5.3 ± 3.2 vs 2.3 ± 1.9,P =0.006) decreased in both groups,whilst the VAS values of prolonged abdominal pain decreased in the Flortec(c)group,but remained unchanged in the high-fibre dietgroup (VAS,mean ± SD,group A:6.5 ± 1.5 vs 4.5 ±2.1,P =0.052; group B:4.5 ± 3.8 vs 5.5 ± 3.5).CONCLUSION:A high-fibre diet is effective in relieving abdominal symptoms in symptomatic uncomplicated diverticular disease.This treatment may be implemented by combining the high-fibre diet with Flortec(c).
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Effects of the viability of Lactobacillus rhamnosus GG on rotavirus infection in neonatal rats

    Hanna VentolaLiisa LehtorantaMari MadetojaMarja-Leena Simonen-Tikka...
    5925-5931页
    查看更多>>摘要：AIM:To study the effects of live and dead Lactobacillus rhamnosus GG (GG) on rotavirus infection in a neonatal rat model.METHODS:At the age of 2 d,suckling Lewis rat pups were supplemented with either live or dead GG and the treatment was continued daily throughout the experiment.At the age of 5 and 6 d the pups received oral rotavirus (RV) SA-11 strain.The pups were sacrificed at the age of 7 or 8 d by decapitation.The gastrointestinal tract was removed and macroscopic observations were done.The consistency of feces in the colon was classified using a four-tier system.RV was detected from the plasma,small intestine,colon and feces by real-time quantitative polymerase chain reaction (PCR).RESULTS:In this neonatal rat model,RV induced a mild-to-moderate diarrhea in all except one pup of the RV-inoculated rats.RV moderately reduced body weight development from day 6 onwards.On day 7,after 2 d of RV infection,live and dead GG groups gained significantly more weight than the RV group without probiotics [36％ (P =0.001) and 28％ (P =0.031),respectively].In addition,when compared with the RV control group,both live and dead GG reduced the weight ratio of colon/animal body weight to the same level as in the healthy control group,with reductions of 22％ (P=0.002) and 28％ (P ＜ 0.001),respectively.Diarrhea increased moderately in both GG groups.However,the diarrhea incidence and severity in the GG groups were not statistically significantly different as compared with the RV control group.Moreover,observed diarrhea did not provoke weight loss or death.The RV control group had the largest amount of RV PCR-positive samples among the RV-infected groups,and the live GG group had the smallest amount.Rats receiving live GG had significantly less RV in the colon (P =0.027) when compared with the RV control group.Live GG was also more effective over dead GG in reducing the quantity of RV from plasma (P =0.047).CONCLUSION:Both live and dead GG have beneficial effects in RV infection.GG may increase RV clearance from the body and reduce colon swelling.
      原文链接:
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    Methane production and small intestinal bacterial overgrowth in children living in a slum

    Carolina Santos MelloSoraia TahanLígia Cristina FL MelliMirian Silva do Carmo Rodrigues...
    5932-5939页
    查看更多>>摘要：AIM:To analyze small intestinal bacterial overgrowth in school-aged children and the relationship between hydrogen and methane production in breath tests.METHODS:This transversal study included 85 children residing in a slum and 43 children from a private school,all aged between 6 and 10 years,in Osasco,Brazil.For characterization of the groups,data regarding the socioeconomic status and basic housing sanitary conditions were collected.Anthropometric data was obtained in children from both groups.All children completed the hydrogen (H2) and methane (CH4) breath test in order to assess small intestinal bacterial overgrowth (SIBO).SIBO was diagnosed when there was an increase in H2 ≥ 20 ppm or CH4 ≥ 10 ppm with regard to the fasting value until 60 min after lactulose ingestion.RESULTS:Children from the slum group had worse living conditions and lower nutritional indices than children from the private school.SIBO was found in 30.9％ (26/84) of the children from the slum group and in 2.4％ (1/41) from the private school group (P =0.0007).Greater hydrogen production in the small intestine was observed in children from the slum group when compared to children from the private school (P =0.007).A higher concentration of hydrogen in the small intestine (P ＜ 0.001) and in the colon (P ＜ 0.001) was observed among the children from the slum group with SIBO when compared to children from the slum group without SIBO.Methane production was observed in 63.1％ (53/84) of the children from the slum group and in 19.5％ (8/41) of the children from the private school group (P ＜ 0.0001).Methane production was observed in 38/58 (65.5％) of the children without SIBO and in 15/26 (57.7％) of the children with SIBO from the slum.Colonic production of hydrogen was lower in methaneproducing children (P =0.017).CONCLUSION:Children who live in inadequate environmental conditions are at risk of bacterial overgrowth and methane production.Hydrogen is a substrate for methane production in the colon.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Efficacy of endoluminal gastroplication in Japanese patients with proton pump inhibitor-resistant, non-erosive esophagitis

    Kentaro TokudomeYasushi FunakiMakoto SasakiShinya Izawa...
    5940-5947页
    查看更多>>摘要：AIM:To evaluate the efficacy,safety,and long-term outcomes of endoluminal gastroplication (ELGP) in patients with proton pump inhibitor (PPI)-resistant,nonerosive reflux disease (NERD).METHODS:The subjects were NERD patients,diagnosed by upper endoscopy before PPI use,who had symptoms such as heartburn or reflux sensations two or more times a week even after 8 wk of full-dose PPI treatment.Prior to ELGP,while continuing full-dose PPI medication,patients' symptoms and quality of life (QOL)were assessed using the questionnaire for the diagnosis of reflux disease,the frequency scale for symptoms of gastro-esophageal reflux disease (FSSG),gastrointestinal symptoms rating scale,a 36-item short-form.In addition,24-h esophageal pH monitoring or 24-h intraesophageal pH/impedance (MII-pH) monitoring was performed.The Bard EndoCinchTM was used for ELGP,and 2 or 3 plications were made.After ELGP,all acid reducers were temporarily discontinued,and medication was resumed depending on the development and severity of symptoms.Three mo after ELGP,symptoms,QOL,pH or MII-pH monitoring,number of plications,and PPI medication were evaluated.Further,symptoms,number of plications,and PPI medication were evaluated 12 mo after ELGP to investigate long-term effects.RESULTS:The mean FSSG score decreased significantly from before ELGP to 3 and 12 mo after ELGP (19.1 ± 10.5 to 10.3 ± 7.4 and 9.3 ± 9.9,P ＜ 0.05,respectively).The total number of plications decreased gradually at 3 and 12 mo after ELGP (2.4 ± 0.8 to 1.2 ± 0.8 and 0.8 ± 1.0,P ＜ 0.05,respectively).The FSSG scores in cases with no remaining plications and in cases with one or more remaining plications were 4.4 and 2.7,respectively,after 3 mo,and 2.0 and 2.8,respectively,after 12 mo,showing no correlation to plication loss.On pH monitoring,there was no difference in the percent time pH ＜ 4 from before ELGP to 3 mo after.Impedance monitoring revealed no changes in the number of reflux episodes or the symptom index for reflux events from before ELGP to 3 mo after,but the symptom sensitivity index decreased significantly 3 mo after ELGP (16.1±12.9 to 3.9 ± 8.3,P ＜ 0.01).At 3 mo after ELGP,6 patients (31.6％) had reduced their PPI medication by 50％ or more,and 11 patients (57.9％) were able to discontinue PPI medication altogether.After 12 mo,3 patients (16.7％) were able to reduce the amount of PPI medication by 50％ or more,and 12 patients (66.7％) were able to discontinue PPI medication altogether.A high percentage of cases with remaining plications had discontinued PPIs medication after 3 mo,but there was no difference after 12 mo.No serious complications were observed in this study.CONCLUSION:ELGP was safe,resulted in significant improvement in subjective symptoms,and allowed less medication to be used over the long term in patients with PPI-refractory NERD.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Electrogastrography associated with symptomatic changes after prokinetic drug treatment for functional dyspepsia

    Hyun Chul LimSang In LeeJiande DZ ChenHyojin Park...
    5948-5956页
    查看更多>>摘要：AIM:To evaluate the effect of prokinetic drugs on electrogastrography (EGG) parameters according to symptomatic changes in patients with functional dyspepsia (FD).METHODS:Seventy-four patients with FD were prospectively enrolled in this study between December 2006 and December 2010.We surveyed the patients using a questionnaire on dyspeptic symptoms before and after an 8-wk course of prokinetic drug treatment.We also measured cutaneous pre-prandial and postprandial EGG recordings including percentage of gastric waves (normogastria,bradygastria,tachygastria),dominant frequency (DF),dominant power (DP),dominant frequency instability coefficient (DFIC),dominant power instability coefficient (DPIC),and the ratio of post-prandial to fasting in DP before and after the 8-wk course of prokinetic drug treatment.RESULTS:Fifty-two patients (70％) achieved symptomatic improvement after prokinetic drug treatment.Patients who had normal gastric slow waves showed symptom improvement group after treatment.Postprandial DF showed a downward trend in the symptom improvement group,especially in the itopride group.Post-prandial DP was increased regardless of symptom improvement,especially in the itopride group and mosapride group.Post-prandial DFIC and DPIC in the symptom improvement group were significantly increased after the treatment.The EGG power ratio was increased after treatment in the symptom improvement group (0.50 ± 0.70 vs 0.93 ± 1.77,P =0.002),especially in the itopride and levosulpiride groups.CONCLUSION:Prokinetics could improve the symptoms of FD by regulating gastric myoelectrical activity,and EGG could be a useful tool in evaluating the effects of various prokinetics.
      原文链接:
    • NETL
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    • 维普

    Comparative study of rendezvous techniques in post-liver transplant biliary stricture

    Jae Hyuck ChangIn Seok LeeHo Jong ChunJong Young Choi...
    5957-5964页
    查看更多>>摘要：AIM:To investigate the usefulness of a new rendezvous technique for placing stents using the Kumpe (KMP) catheter in angulated or twisted biliary strictures.METHODS:The rendezvous technique was performed in patients with a biiiary stricture after living donor liver transplantation (LDLT) who required the exchange of percutaneous transhepatic biliary drainage catheters for inside stents.The rendezvous technique was performed using a guidewire in 19 patients (guidewire group) and using a KMP catheter in another 19 (KMP catheter group).We compared the two groups retrospectively.RESULTS:The baseline characteristics did not differ between the groups.The success rate for placing inside stents was 100％ in both groups.A KMP catheter was easier to manipulate than a guidewire.The mean procedure time in the KMP catheter group (1012 s,range:301-2006 s) was shorter than that in the guidewire group (2037 s,range:251-6758 s,P =0.022).The cumulative probabilities corresponding to the procedure time of the two groups were significantly different (P =0.008).The factors related to procedure time were the rendezvous technique method,the number of inside stents,the operator,and balloon dilation of the stricture (P ＜ 0.05).In a multivariate analysis,the rendezvous technique method was the only significant factor related to procedure time (P =0.010).The procedural complications observed included one case of mild acute pancreatitis and one case of acute cholangitis in the guidewire group,and two cases of mild acute pancreatitis in the KMP catheter group.CONCLUSION:The rendezvous technique involving use of the KMP catheter was a fast and safe method for placing inside stents in patients with LDLT biliary stricture that represents a viable alternative to the guidewire rendezvous technique.
      原文链接:
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    • NSTL
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    • 维普

    Correlation between mitochondrial TRAP-1 expression and lymph node metastasis in colorectal cancer

    Jing-Yan GaoBao-Rong SongJun-Jie PengYuan-Ming Lu...
    5965-5971页
    查看更多>>摘要：AIM:To evaluate the effect of mitochondrial tumor necrosis factor receptor-associated protein-1 (TRAP-1) on the lymph node metastasis (LNM) in Chinese colorectal cancer (CRC) patients,and develop potential LNM-associated biomarkers for CRC using quantitative realtime polymerase chain reaction (RT-PCR) analysis.METHODS:Differences in mitochondrial TRAP-1 gene expression between primary CRC with LNM (LNM CRC) and without LNM (non-LNM CRC) were assessed in 96 Chinese colorectal carcinoma samples using quantitative RT-PCR analysis,Western blotting,and confirmed with immunohistochemical assay.The relationship between clinicopathological parameters and potential diagnostic biomarkers was also examined.RESULTS:TRAP-1 was significantly upregulated in LNM CRC compared with non-LNM CRC,which was confirmed by RT-PCR,Western blotting and immunohistochemical assay.The expression of TRAP-1 in two different metastatic potential human colorectal cancer cell lines,LoVo and HT29,was analyzed with Western blotting.The expression level of TRAP-1 was dramatically higher in LoVo than in HT29.Overexpression of TRAP-1 was significantly associated with LNM (90.2％ in LNM group vs 22％ in non-LNM group,P ＜ 0.001),the advanced tumor node metastasis stage (89.1％ in LNM group vs 26.9％ in non-LNM group,P ＜ 0.001),the increased 5-year recurrence rate (82.7％ in LNM group vs 22.6％ in non-LNM group,P ＜ 0.001) and the decreased 5-year overall survival rate (48.4％ in LNM vs 83.2％ in non-LNM group,P ＜ 0.001).Univariate and multivariate analyses indicated that TRAP-1 expression was an independent prognostic factor for recurrence and survival of CRC patients (Hazard ratio of 2.445 in recurrence,P =0.017; 2.867 in survival,P =0.028).CONCLUSION:Mitochondria TRAP-1 affects the lymph node metastasis in CRC,and may be a potential biomarker for LNM and a prognostic factor in CRC.Over-expression of TRAP-1 is a predictive factor for the poor outcome of colorectal cancer patients.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Drug-induced liver injury in hospitalized patients with notably elevated alanine aminotransferase

    Hui-Min XuYan ChenJie XuQuan Zhou...
    5972-5978页
    查看更多>>摘要：AIM:To identify the proportion,causes and the nature of drug-induced liver injury (DILI) in patients with notably elevated alanine aminotransferase (ALT).METHODS:All the inpatients with ALT levels above 10 times upper limit of normal range (ULN) were retrospectively identified from a computerized clinical laboratory database at our hospital covering a 12-mo period.Relevant clinical information was obtained from medical records.Alternative causes of ALT elevations were examined for each patient,including biliary abnormality,viral hepatitis,hemodynamic injury,malignancy,DILI or undetermined and other causes.All suspected DILI cases were causality assessed using the Council for International Organizations of Medical Sciences scale,and only the cases classified as highly probable,probable,or possible were diagnosed as DILI.Comments related to the diagnosis of DILI in the medical record and in the discharge letter for each case were also examined to evaluate DILI detection by the treating doctors.RESULTS:A total of 129 cases with ALT ＞ 10 ULN were identified.Hemodynamic injury (n =46,35.7％),DILI (n =25,19.4％) and malignancy (n =21,16.3％)were the top three causes of liver injury.Peak ALT values were lower in DILI patients than in patients with hemodynamic injury (14.5 t 5.6 ULN vs 32.5±30.7 ULN,P =0.001).Among DILI patients,one (4％) case was classified as definite,19 (76％) cases were classified as probable and 5 (20％) as possible according to the CIOMS scale.A hepatocellular pattern was observed in 23 (92％) cases and mixed in 2 (8％).The extent of severity of liver injury was mild in 21 (84％)patients and moderate in 4 (16％).Before discharge,10 (40％) patients were recovered and the other 15 (60％) were improved.The improved patients tended to have a higher peak ALT (808 ± 348 U/L vs 623 ± 118 U/L,P =0.016) and shorter treatment duration before discharge (8 ± 6 d vs 28 ± 12 d,P =0.008) compared with the recovered patients.Twenty-two drugs and 6 herbs were found associated with DILI.Antibacterials were the most common agents causing DILI in 8 (32％) cases,followed by glucocorticoids in 6 (24％) cases.Twenty-four (96％) cases received treatment of DILI with at least one adjunctive drug.Agents for treatment of DILI included anti-inflammatory drugs (e.g.,glycyrrhizinate),antioxidants (e.g.,glutathione,ademetionine 1,4-butanedisulfonate and tiopronin),polyene phosphatidyl choline and herbal extracts (e.g.,protoporphyrin disodium and silymarin).Diagnosis of DILI was not mentioned in the discharge letter in 60％ of the cases.Relative to prevalent cases and cases from wards of internal medicine,incident cases and cases from surgical wards had a higher risk of missed diagnosis in discharge letter [odds ratio (OR) 32.7,95％CI (2.8-374.1),and OR 58.5,95％CI (4.6-746.6),respectively].CONCLUSION:DILI is mostly caused by use of antibacterials and glucocorticoids,and constitutes about one fifth of hospitalized patients with ALT ＞ 10 ULN.DILI is underdiagnosed frequently.
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    Dedifferentiated liposarcoma of the rectum: A case report

    Atsushi TsurutaKenji NotoharaTaebum ParkTadashi Itoh...
    5979-5981页
    查看更多>>摘要：Liposarcoma is one of the most common soft tissue sarcomas found in adults,and it usually occurs in the retroperitoneum and the extremities.Here,we describe a case of dedifferentiated liposarcoma originating from a well-differentiated liposarcoma of the mesorectum that presented as a protruding mass in the rectal lumen.Hartmann's operation with total mesorectal excision was performed and the tumor was removed radically.No management guidelines are currently available for liposarcoma of the rectum.We propose that complete surgical resection be required for the treatment of rectal liposarcoma and that a long-term detailed follow up is necessary.
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    • 维普

    Synchronous double cancers of the common bile duct

    Tatsuaki SumiyoshiYasuo ShimaAkihito Kozuki
    5982-5985页
    查看更多>>摘要：We report an extremely rare case of synchronous double cancers of the common bile duct without pancreaticobiliary maljunction.Only two similar cases have been reported in the English literature.Endoscopic retrograde cholangiopancreatography showed a tuberous filling defect in the middle and superior parts of the common bile duct,and mild stenosis in the inferior duct.Computed tomography (CT) showed a well enhanced mass in the middle and superior parts of the common bile duct.A single cancer of the middle and superior bile duct was suspected and extra-hepatic bile duct resection was performed.CT eleven months after surgery revealed enhanced inferior bile duct wall and a slightly enhanced tumor within it.Retrospective review of the CT images taken before first surgery showed enhanced inferior bile duct wall without intrabiliary tumor only on the delayed phase.The inferior bile duct tumor was suspected to have originally co-existed with the middle and superior bile duct tumor.Pancreaticoduodenectomy was performed subsequently.Histopathological examination revealed that the middle and superior bile duct tumor was a moderately differentiated tubular adenocarcinoma while the inferior bile duct tumor was a papillary adenocarcinoma.The two tumors were separated and had different histological findings and growth patterns,further suggesting that they were two primary cancers.
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    • NETL
    • NSTL
    • 万方数据
    • 维普