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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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    Anemia after gastrectomy for early gastric cancer:Long-term follow-up observational study

    Chul-Hyun LimSang Woo KimWon Chul KimJin Soo Kim...
    6114-6119页
    查看更多>>摘要：AIM:To identify the incidence and etiology of anemia after gastrectomy in patients with long-term follow-up after gastrectomy for early gastric cancer.METHODS:The medical records of those patients with early gastric adenocarcinoma who underwent curative gastrectomy between January 2006 and October 2007 were reviewed.Patients with anemia in the preoperative workup,cancer recurrence,undergoing systemic chemotherapy,with other medical conditions that can cause anemia,or treated during follow up with red cell transfusions or supplements for anemia were excluded.Anemia was defined by World Health Organization criteria (Hb ＜ 12 g/dL in women and ＜13 g/dL in men).Iron deficiency was defined as serum ferritin ＜ 20 μg/dL.Vitamin B12 deficiency was defined as serum vitamin B12 ＜ 200 pg/mL.Iron deficiency anemia was defined as anemia with concomitant iron deficiency.Anemia from vitamin B12 deficiency was defined as megaloblastic anemia (mean cell volume ＞100 fL) with vitamin B12 deficiency.The profile of anemia over 48 mo of follow-up was analyzed.RESULTS:One hundred sixty-one patients with gastrectomy for early gastric cancer were analyzed.The incidence of anemia was 24.5％ at 3 mo after surgery and increased up to 37.1％ at 48 mo after surgery.The incidence of iron deficiency anemia increased during the follow up and became the major cause of anemia at 48 mo after surgery.Anemia of chronic disease and megaloblastic anemia were uncommon.The incidence of anemia in female patients was significantly higher than in male patients at 12 (40.0％ vs 22.0％,P =0.033),24 (45.0％ vs 25.0％,P =0.023),36 (55.0％vs 28.0％,P =0.004),and 48 mo (52.0％ vs 31.0％,P =0.022) after surgery.Patients with total gastrectomy showed significantly higher incidence of anemia than patients with subtotal gastrectomy at 48 mo after surgery (60.7％ vs 31.3％,P =0.008).The incidence of iron deficiency was significantly higher in female patients than in male patients at 6 (35.4％ vs 13.3％,P =0.002),12 (45.8％ vs 16.8％,P ＜ 0.001),18 (52.1％vs 22.3％,P ＜ 0.001),24 (60.4％ vs 20.9％,P ＜ 0.001),36 (62.5％ vs 29.2％,P ＜ 0.001),and 48 mo (66.7％vs 34.7％,P =0.001) after surgery.CONCLUSION:Anemia was frequent after gastrectomy for early gastric cancer,with iron deficiency being the major cause.Evaluation for anemia including iron status should be performed after gastrectomy and appropriate iron replacement should be considered.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Association of chronic viral hepatitis B with insulin resistance

    Jeong Gyu LeeSangyeoup LeeYun Jin KimByung Mann Cho...
    6120-6126页
    查看更多>>摘要：AIM:To investigate the relationship between chronic viral hepatitis B (CVHB) and insulin resistance (IR) in Korean adults.METHODS:A total of 7880 adults (3851 men,4029 women) who underwent a comprehensive medical examination were enrolled in this study.Subjects diagnosed with either diabetes mellitus,or any other disorder that could influence their insulin sensitivity,were rejected,Anthropometry,metabolic risk factors,hepatitis B surface antigen,hepatitis B surface antibody,hepatitis B core antibody,fasting plasma glucose and insulin were measured for all subjects.Homeostasis model assessment (HOMA),quantitative insulin check index (QUICKI),and Mffm index were used for determining insulin sensitivity.Each participant was categorized into a negative,recovery,or CVHB group.To compare variables between groups,a t-test and/or one-way analysis of variance were used.Partial correlation coefficients were computed to present the association between insulin resistance and other variables.Multiple logistic regression analysis was used to assess the independent association between CVHB and IR.RESULTS:The mean age of men and women were 48.9 and 48.6 years,respectively.Subjects in the CVHB group had significantly higher waist circumference [(86.0 ± 7.7 cm vs 87.3 ± 7.8 cm,P =0.004 in men),(78.3 ± 8.6 cm vs 80.5 ± 8.5 cm,P ＜ 0.001 in women)],cystatin C [(0.96 ± 0.15 mg/dL vs 1.02 ± 0.22 mg/dL,P ＜ 0.001 in men),(0.84 ± 0.15 mg/dL vs 0.90 ± 0.16 mg/dL,P ＜ 0.001 in women)],fasting insulin [(5.47 ± 3.38 μU/mL vs 6.12 ± 4.62 μU/mL,P＜ 0.001 in men),(4.57 ± 2.82 μU/mL vs 5.06 ± 3.10μU/mL,P ＜ 0.001 in women)] and HOMA index [(1.24± 0.86 vs 1.43 ± 1.24,P ＜ 0.001 in men),(1.02 ±0.76 vs 1.13 ± 0.87,P =0.033 in women)] compared to control group.The HOMA index revealed a positive correlation with body mass index (BMI) (r =0.378,P ＜ 0.001),waist circumference (r =0.356,P ＜ 0.001),percent body fat (r =0.296,P ＜ 0.001),systolic blood pressure (r =0.202,P ＜ 0.001),total cholesterol (r =0.134,P ＜ 0.001),triglycerides (r =0.292,P ＜ 0.001),cystatin C (r =0.069,P ＜ 0.001) and uric acid (r =0.142,P ＜ 0.001).The QUICKI index revealed a negative correlation with BMI (r =-0.254,P ＜ 0.001),waist circumference (r =0-0.243,P ＜ 0.001),percent body fat (r =-0.217,P ＜ 0.001),systolic blood pressure (r =-0.132,P ＜ 0.001),total cholesterol (r =-0.106,P ＜0.001),triglycerides (r =-0.205,P ＜ 0.001),cystatin C (r =-0.044,P ＜ 0.001) and uric acid (r =-0.096,P ＜0.001).For subjects identified with IR,the odds ratio of an accompanying diagnosis of chronic hepatitis B was 1.534 (95％ CI:1.158-2.031,HOMA index criteria)or 1.566 (95％ CI:1.124-2.182,QUICKI criteria) after adjustment for age,gender,BMI,and amount of alcohol consumption.CONCLUSION:Our study demonstrates that CVHB is associated with IR.CVHB may need to be monitored for occurrence of IR and diabetes mellitus.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Treatment of functional dyspepsia with sertraline:A double-blind randomized placebo-controlled pilot study

    Victoria PY TanTin K CheungWai M WongRoberta Pang...
    6127-6133页
    查看更多>>摘要：AIM:To evaluate sertraline,a selective serotonin reuptake inhibitor in the treatment of patients with functional dyspepsia.METHODS:Consecutive tertiaryhospital patients with a clinical diagnosis of functional dyspepsia (FD) according to the Rome Ⅱ criteria with a Hong Kong dyspepsia index (HKDI) of greater than 16 were recruited.Patients commenced enrolment prior to the inception of the Rome Ⅲ criteria for functional dyspepsia.All patients were ethnic Chinese,had a normal upper endoscopy and were Helicobacterpylori negative prior to enrolment.Study patients were randomized to receive sertraline 50 mg or placebo daily for 8 wk.HKDI symptom scores,quality of life,hospital anxiety and depression (HAD) scale and global symptom relief were evaluated before,during and after treatment.Adverse effects were monitored during and after treatment.RESULTS:A total of 193 patients were randomized in the intention to treat (ITT),and 150 patients were included in the per protocol (PP) analysis.In both the ITT and PP,there was no difference in the primary outcome of global dyspepsia symptoms between the sertraline and placebo groups at week 8.In the ITT analysis,98 and 95 patients were randomized to the sertraline and placebo groups respectively.A total of 43 patients withdrew from the study (22.3％) by week 8,with 23 of the 24 drop-outs in the sertraline group occurring prior to week 4 (95.8％).In contrast,in the placebo arm,11 of 19 patients dropped out by week 4 (57.9％).Utilizing the last response carried forward to account for the drop-outs,there were no differences between the sertraline and placebo groups at baseline in terms of the HKDI,HKDI 26.08 ± 6.19 vs 26.70 ±5.89,P =0.433; and at week 8,HKDI 22.41 ± 6.36 vs 23.25 ± 7.30,P =0.352 respectively.In the PP analysis,74 and 76 patients were randomized to the sertraline and placebo groups respectively.At baseline,there were no statistically significant differences between the sertraline and placebo groups,HKDI 25.83 ± 6.313 vs 27.19 ± 5.929 respectively,P =0.233; however by week 8,patients in the sertraline group demonstrated a statistically significant difference in their Hong Kong Dyspepsia Index compared to placebo,HKDI 20.53 ± 6.917 vs 23.34 ± 7.199,P =0.02,respectively).There was also no statistically significant difference in overall quality of life measures or the HAD scale related to treatment in either the HTT or PP analysis at week 8.CONCLUSION:This pilot study,the first to examine sertraline,a selective serotonin reuptake inhibitor,for the management of FD,did not find that it was superior to placebo.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Transcatheter arterial chemoembolization for gastrointestinal stromal tumors with liver metastases

    Guang CaoJian LiLin ShenXu Zhu...
    6134-6140页
    查看更多>>摘要：AIM:To evaluate the efficacy and safety of transcatheter arterial chemoembolization (TACE) for gastrointestinal stromal tumor (GIST) with liver metastases after the failure of tyrosine kinase inhibitors (TKIs).METHODS:Patients with histologically confirmed CD117-positive GIST with liver metastases who were resistant and/or intolerant to prior imatinib and/or sunitinib and who received TACE for at least one treatment cycle or only best supportive care and TKI reintroduction were eligible for the study.The patients were divided into two groups:those in TACE group received TACE treatment containing 5-20 mL iodized oil and 40-80 mg doxorubicin hydrochloride and TKI reintroduction or best supportive care,those in control group only received TKI reintroduction or best supportive care.The primary end-point was overall survival and the secondary end-points were,progression-free survival (PFS),response rates,and safety.RESULTS:Sixty patients admitted between June 2008 and October 2011 were eligible for this study,including 22 in TACE group and 38 in control group.In the TACE group,12 (54.5％) achieved liver partial response,5 (22.7％) had stable disease,and 5 (22.7％) had liver progressive disease.Disease control rate of liver metastases was 77.3％ in the TACE group and 39.5％ in the control group.The median liver PFS in TACE group was 47.1 wk (95％ CI:23.9-70.3).The median PFS in TACE group was longer than in control group (30.0 wk,95％ CI:20.1-39.9 vs 12.9 wk,95％ CI:11.9-13.9) (P =0.0001).The median overall survival in TACE group was also longer than in control group (68.5 wk,95％ CI:57.4-79.6 vs 25.7 wk,95％ CI:23.2-28.2) (P =0.0001).TACE treatment significantly reduced the risk of death (hazard ratio:0.109).Patients without extrahepatic metastases treated with TACE had significantly better prognosis.Most of the adverse events were of grade 1 or 2 and tolerable.CONCLUSION:TACE is effective and well tolerated in GIST patients with liver metastases after TKI failure,and it may be an optional treatment for this disease.(C) 2012 Baishideng.All rights reserved.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Liver-protecting effects of omega-3 fish oil lipid emulsion in liver transplantation

    Xin-Hua ZhuYa-Fu WuYu-Dong QiuChun-Ping Jiang...
    6141-6147页
    查看更多>>摘要：AIM:To investigate the liver-protecting effect of parenteral nutrition (PN) support with omega-3 fatty acids in a randomized controlled clinical trial.METHODS:Sixty-six patients with the diagnosis of end-stage liver disease or hepatic cellular carcinoma were admitted to the Affiliated Drum Tower Hospital,Nanjing University,China for orthotopic liver transplantation.The patients were randomly divided into two groups:PN group (n =33) and polyunsaturated fatty acid (PUFA) group (n =33).All patients received isocaloric and isonitrogenous PN for seven days after surgery,and in PUFA group omega-3 fish oil lipid emulsion replaced part of the standard lipid emulsion.Liver function was tested on days 2 and 9 after surgery.Pathological examination was performed after reperfusion of the donor liver and on day 9.Clinical outcome was assessed based on the post-transplant investigations,including:(1) post-transplant mechanical ventilation; (2) total hospital stay; (3) infectious morbidities; (4) acute and chronic rejection; and (5) mortality (intensive care unit mortality,hospital mortality,28-d mortality,and survival at a one-year post-transplant surveillance period).RESULTS:On days 2 and 9 after operation,a significant decrease of alanine aminotransferase (299.16U/L ± 189.17 U/L vs 246.16 U/L ±175.21 U/L,P =0.024) and prothrombin time (5.64 s ± 2.06 s vs 2.54s ± 1.15 s,P =0.035) was seen in PUFA group compared with PN group.The pathological results showed that omega-3 fatty acid supplement improved the injury of hepatic cells.Compared with PN group,there was a significant decrease of post-transplant hospital stay in PUFA group (18.7 d ± 4.0 d vs 20.6 d ± 4.6d,P =0.041).Complications of infection occurred in 6 cases of PN group (2 cases of pneumonia,3 cases of intra-abdominal abscess and 1 case of urinary tract infection),and in 3 cases of PUFA group (2 cases of pneumonia and 1 case of intra-abdominal abscess).No acute or chronic rejection and hospital mortality were found in both groups.The one-year mortality in PN group was 9.1％ (3/33),one died of pulmonary infection,one died of severe intra-hepatic cholangitis and hepatic dysfunction and the other died of hepatic cell carcinoma recurrence.Only one patient in PUFA group (1/33,3.1％) died of biliary complication and hepatic dysfunction during follow-up.CONCLUSION:Post-transplant parenteral nutritional support combined with omega-3 fatty acids can significantly improve the liver injury,reduce the infectious morbidities,and shorten the post-transplant hospital stay.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Colorectal cancer lymph node staining by activated carbon nanoparticles suspension in vivo or methylene blue in vitro

    Hong-Ke CaiHai-Fei HeWei TianMei-Qi Zhou...
    6148-6154页
    查看更多>>摘要：AIM:To investigate whether activated carbon nanoparticles suspension (ACNS) or methylene blue (MB)can increase the detected number of lymph nodes in colorectal cancer.METHODS:Sixty-seven of 72 colorectal cancer patients treated at our hospital fulfilled the inclusion criteria of the study which was conducted from December 2010 to February 2012.Seven patients refused to participate.Eventually,60 patients were included,and randomly assigned to three groups (20 in each group):ACNS group (group A),MB group (group B) and non-stained conventional surgical group (group C).In group A,patients received subserosal injection of 1 mL ACNS in a 4-quadrant region around the mass.In group B,the main artery of specimen was identified and isolated after the specimen was removed,and 2 mL MB was slowly injected into the isolated,stretched and fixed vessel.In group C,no ACNS and MB were injected.All the mesentery lymph nodes were isolated and removed systematically by visually inspecting and palpating the adipose tissue.RESULTS:No difference was observed among the three groups in age,gender,tumor location,tumor diameter,T-stage,degree of differentiation,postoperative complications and peritoneal drainage retention time.The total number of detected lymph nodes was 535,476 and 223 in the three groups,respectively.The mean number of detected lymph nodes per patient was significantly higher in group A than in group C (26.8 ±8.4 vs 12.2-3.2,P ＜ 0.001).Similarly,there were significantly more lymph nodes detected in group B than in group C (23.8 ± 6.9 vS12.2 ± 3.2,P ＜ 0.001).However,there was no significant difference between group A and group B.There were 50,46 and 32 metastatic lymph nodes dissected in 13 patients of group A,10 patients of group B and 11 patients of group C,without significant differences among the three groups.Eleven of the 60 patients had insufficient number of detected lymph nodes (＜ 12).Only one patient with T4a rectal cancer had 10 lymph nodes detected in group B,the other 10 patients were all from group C.Based on the different diameter categories,the number of detected lymph nodes in groups A and B was significantly higher than in group C.However,there was no statistically significant difference between group A and group B.The metastatic lymph nodes were not significant different among the three groups.Similarly,tumor location,T stage and tumor differentiation did not affect the staining results.Body mass index was a minor influencing factor in the two different staining methods.The stained lymph nodes can easily be identified from the mesenteric adipose tissues,and the staining time for lymph nodes was not significantly different compared with unstained group.None of the patients in groups A and B had drug-related complications.CONCLUSION:Both activated carbon nanoparticles suspension in vivo and methylene blue in vitro can be used as tracers to increase the detected number of lymph nodes in colorectal cancer.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Inverted Meckel's diverticulum as a cause of occult lower gastrointestinal hemorrhage

    Omar M RashidJoseph K KuMasayuki NagahashiAkimitsu Yamada...
    6155-6159页
    查看更多>>摘要：Meckel's diverticulum is a common asymptomatic congenital gastrointestinal anomaly,but rarely it can present with hemorrhage.Over the last few years inverted Meckel's diverticulum has been reported in the literature with increasing frequency as an occult source of lower gastrointestinal hemorrhage.Here,we report a case of a 54-year-old male,who was referred for surgical evaluation with persistent anemia and occult blood per rectum after a work up which failed to localize the source over 12 mo,including upper and capsule endoscopy,colonoscopy,enteroclysis,Meckel scan,and tagged nuclear red blood cell scan.An abdominal computed tomography scan showed a possible mid-ileal intussusception and intraluminal mass.During the abdominal exploration,inverted Meckel's diverticulum was diagnosed and resected.We review the literature,discuss the forms in which the disease presents,the diagnostic modalities utilized,pathological findings,and treatment.Although less than 40 cases have been reported in the English literature from 1978 to 2005,19 cases have been reported in the last 6 years alone (2006-2012) due to improved diagnostic modalities.Successful diagnosis and treatment of this disease requires a high index of clinical suspicion,which is becoming increasingly relevant to general gastroenterologists.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Enterolithiasis-associated ileus in Crohn's disease

    Alexander PerathonerPamela KoglerChristian DeneckeJohann Pratschke...
    6160-6163页
    查看更多>>摘要：Stasis of the flow of the intestinal contents,ingested material and unfavorable composition of the chylus can lead to the formation of enteroliths inside the bowel.Enterolithiasis represents a rare disorder of the gastrointestinal tract that can be associated with intermittent abdominal pain or more serious complications such as bleeding or obstruction.Enterolithiasis in Crohn' s disease represents an extremely rare condition and usually occurs only in patients with a long symptomatic history of Crohn's disease.We report an unusual case of enterolithiasis-related intestinal obstruction in a young male patient with Crohn's disease (A2L3B1 Montreal Classification for Crohn's disease 2005) undergoing emergency laparotomy and ileocoecal resection.In addition,we present an overview of the relevant characteristics of enterolithiasis on the basis of the corresponding literature.
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    • NETL
    • NSTL
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    • 维普

    An aortoduodenal fistula as a complication of immunoglobulin G4-related disease

    Momir SaracIvan MarjanovicMihailo BezmarevicUros Zoranovic...
    6164-6167页
    查看更多>>摘要：Most primary aortoduodenal fistulas occur in the presence of an aortic aneurysm,which can be part of immunoglobulin G4 (IgG4)-related sclerosing disease.We present a case who underwent endovascular grafting of an aortoduodenal fistula associated with a high serum IgG4 level.A 56-year-old male underwent urgent endovascular reconstruction of an aortoduodenal fistula.The patient received antibiotics and other supportive therapy,and the postoperative course was uneventful,however,elevated levels of serum IgG,IgG4 and C-reactive protein were noted,which normalized alter the introduction of steroid therapy.Control computed tomography angiography showed no endoleaks.The primary aortoduodenal fistula may have been associated with IgG4-related sclerosing disease as a possible complication of IgG4-related inflammatory aortic aneurysm.Endovascular grafting of a primary aortoduodenal fistula is an effective and minimally invasive alternative to standard surgical repair.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Should anticoagulants be administered for portal vein thrombosis associated with acute pancreatitis?

    Won-Seok ParkHyeong-Il KimByung-Jun JeonSeong-Hun Kim...
    6168-6171页
    查看更多>>摘要：Venous complications in patients with acute pancreatitis typically occur as a form of splenic,portal,or superior mesenteric vein thrombosis and have been detected more frequently in recent reports.Although a well-organized protocol for the treatment of venous thrombosis has not been established,anticoagulation therapy is commonly recommended.A 73-year-old man was diagnosed with acute progressive portal vein thrombosis associated with acute pancreatitis.After one month of anticoagulation therapy,the patient developed severe hematemesis.With endoscopy and an abdominal computed tomography scan,hemorrhages in the pancreatic pseudocyst,which was ruptured into the duodenal bulb,were confirmed.After conservative treatment,the patient was stabilized.While the rupture of a pseudocyst into the surrounding viscera is a well-known phenomenon,spontaneous rupture into the duodenum is rare.Moreover,no reports of upper gastrointestinal bleeding caused by pseudocyst rupture in patients under anticoagulation therapy for venous thrombosis associated with acute pancreatitis have been published.Herein,we report a unique case of massive upper gastrointestinal bleeding due to pancreatic pseudocyst rupture into the duodenum,which developed during anticoagulation therapy for portal vein thrombosis associated with acute pancreatitis.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普