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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

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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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    Portal biliopathy

    Somnath ChattopadhyaySamiran Nundy
    6177-6182页
    查看更多>>摘要：Biliary ductal changes are a common radiological finding in patients with portal hypertension,however only a small percentage of patients (5％-30％) develop symptomatic bile duct obstruction.The exact pathogenesis is not clear,but an involvement of factors such as bile duct compression by venous collaterals,ischemia,and infection is accepted by most authors.Although endoscopic retrograde cholangiopancreatography was used to define and diagnose this condition,magnetic resonance cholangiopancreatography is currently the investigation of choice for diagnosing this condition.Treatment is indicated only for symptomatic cases.Portosystemic shunts are the treatment of choice for symptomatic portal biliopathy.In the majority of patients,the changes caused by biliopathy resolve after shunt surgery,however,15％-20％ patients require a subsequent bilio-enteric bypass or endoscopic management for persistent biliopathy.There is a role for endoscopic therapy in patients with bile duct stones,cholangitis or when portosystemic shunt surgery is not feasible.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Telaprevir/boceprevir era: From bench to bed and back

    Qiuwei PanMaikel P PeppelenboschHarry LA JanssenRobert J de Knegt...
    6183-6188页
    查看更多>>摘要：Hepatitis C virus (HCV) infects approximately 200 million people worldwide.Interferon-based therapies have dominated over the past two decades.However,the overall response rates remain suboptimal.Thanks to the tremendous effort from both academia and industry,two serine protease inhibitors telaprevir and boceprevir for treating chronic hepatitis C have finally reached the clinic.Although these compounds are only approved for combination use with interferon and ribavirin in genotype 1 HCV infected chronic patients,the management of HCV patients however is now evolving incredibly.Here,we overviewed a series of landmark studies,regarding the clinical development of telaprevir and boceprevir.We discussed the mechanism-of-action of telaprevir/boceprevir and their potential application in HCV-positive liver transplantation patients.We further emphasized some emerging concerns with perspective of further development in this field.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    MicroRNAs in biliary diseases

    Patricia Munoz-GarridoMaite García-Fernández de BarrenaElizabeth HijonaMiguel Carracedo...
    6189-6196页
    查看更多>>摘要：Cholangiopathies are a group of diseases primarily or secondarily affecting bile duct cells,and result in cholangiocyte proliferation,regression,and/or transformation.Their etiopathogenesis may be associated with a broad variety of causes of different nature,which includes genetic,neoplastic,immune-associated,infectious,vascular,and drug-induced alterations,or being idiopathic.miRNAs,small non-coding endogenous RNAs that post-transcriptionally regulate gene expression,have been associated with pathophysiological processes in different organs and cell types,and are postulated as potential targets for diagnosis and therapy.In the current manuscript,knowledge regarding the role of miRNAs in the development and/or progression of cholangiopathies has been reviewed and the most relevant findings in this promising field of hepatology have been highlighted.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Current endoscopic approach to indeterminate biliary strictures

    David W VictorStuart ShermanTarkan KarakanMouen A Khashab...
    6197-6205页
    查看更多>>摘要：Biliary strictures are considered indeterminate when basic work-up,including transabdominal imaging and endoscopic retrograde cholangiopancreatography with routine cytologic brushing,are non-diagnostic.Indeterminate biliary strictures can easily be mischaracterized which may dramatically affect patient's outcome.Early and accurate diagnosis of malignancy impacts not only a patient's candidacy for surgery,but also potential timely targeted chemotherapies.A significant portion of patients with indeterminate biliary strictures have benign disease and accurate diagnosis is,thus,paramount to avoid unnecessary surgery.Current sampling strategies have suboptimal accuracy for the diagnosis of malignancy.Emerging data on other diagnostic modalities,such as ancillary cytology techniques,single operator cholangioscopy,and endoscopic ultrasonography-guided fine needle aspiration,revealed promising results with much improved sensitivity.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Microscopic colitis

    Gianluca IaniroGiovanni CammarotaLuca ValerioBrigida Eleonora Annicchiarico...
    6206-6215页
    查看更多>>摘要：Microscopic colitis may be defined as a clinical syndrome,of unknown etiology,consisting of chronic watery diarrhea,with no alterations in the large bowel at the endoscopic and radiologic evaluation.Therefore,a definitive diagnosis is only possible by histological analysis.The epidemiological impact of this disease has become increasingly clear in the last years,with most data coming from Western countries.Microscopic colitis includes two histological subtypes [collagenous colitis (CC) and lymphocytic colitis (LC)] with no differences in clinical presentation and management.Collagenous colitis is characterized by a thickening of the subepithelial collagen layer that is absent in LC.The main feature of LC is an increase of the density of intra-epitll lial lymphocytes in the surface epithelium.A number of pathogenetic theories have been proposed over the years,involving the role of luminal agents,autoimmunity,eosinophils,genetics (human leukocyte antigen),biliary acids,infections,alterations of pericryptal fibroblasts,and drug intake; drugs like ticlopidine,carbamazepine or ranitidine are especially associated with the development of LC,while CC is more frequently linked to cimetidine,non-steroidal antiinflammatory drugs and lansoprazole.Microscopic colitis typically presents as chronic or intermittent watery diarrhea,that may be accompanied by symptoms such as abdominal pain,weight loss and incontinence.Recent evidence has added new pharmacological options for the treatment of microscopic colitis:the role of steroidal therapy,especially oral budesonide,has gained relevance,as well as immunosuppressive agents such as azathioprine and 6-mercaptopurine.The use of anti-tumor necrosis factor-α agents,infliximab and adalimumab,constitutes a new,interesting tool for the treatment of microscopic colitis,but larger,adequately designed studies are needed to confirm existing data.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Management strategies of Barrett's esophagus

    Giovanni D De Palma
    6216-6225页
    查看更多>>摘要：Barrett's esophagus is a condition resulting from chronic gastro-esophageal reflux disease with a documented risk of esophageal adenocarcinoma.Current strategies for improved survival in patients with Barrett's adenocarcinoma focus on detection of dysplasia.This can be obtained by screening programs in high-risk cohorts of patients and/or endoscopic biopsy surveillance of patients with known Barrett's esophagus (BE).Several therapies have been developed in attempts to reverse BE and reduce cancer risk.Aggressive medical management of acid reflux,lifestyle modifications,antireflux surgery,and endoscopic treatments have been recommended for many patients with BE.Whether these interventions are cost-effective or reduce mortality from esophageal cancer remains controversial.Current treatment requires combinations of endoscopic mucosal resection techniques to eliminate visible lesions followed by ablation of residual metaplastic tissue.Esophagectomy is currently indicated in multifocal high-grade neoplasia or mucosal Barrett's carcinoma which cannot be managed by endoscopic approach.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Insights into erlotinib action in pancreatic cancer cells using a combined experimental and mathematical approach

    Falko LangeKatja RateitschakChristina KossowOlaf Wolkenhauer...
    6226-6234页
    查看更多>>摘要：AIM:To gain insights into the molecular action of erlotinib in pancreatic cancer (PC) cells.METHODS:Two PC cell lines,BxPC-3 and Capan-1,were treated with various concentrations of erlotinib,the specific mitogen-activated protein kinase kinase (MEK) inhibitor U0126,and protein kinase B (AKT) inhibitor XIV.DNA synthesis was measured by 5-bromo2'-deoxyuridine (BrdU) assays.Expression and phosphorylation of the epidermal growth factor receptor (EGFR) and downstream signaling molecules were quantified by Western blot analysis.The data were processed to calibrate a mathematical model,based on ordinary differential equations,describing the EGFRmediated signal transduction.RESULTS:Erlotinib significantly inhibited BrdU incorporation in BxPC-3 cells at a concentration of 1 μmol/L,whereas Capan-1 cells were much more resistant.In both cell lines,MEK inhibitor U0126 and erlotinib attenuated DNA synthesis in a cumulative manner,whereas the AKT pathway-specific inhibitor did not enhance the effects of erlotinib.While basal phosphorylation of EGFR and extracellular signal-regulated kinase (ERK) did not differ much between the two cell lines,BxPC-3 cells displayed a more than five-times higher basal phospho-AKT level than Capan-1 cells.Epidermal growth factor (EGF) at 10 ng/mL induced the phosphorylation of EGFR,AKT and ERK in both cell lines with similar kinetics.In BxPC-3 cells,higher levels of phospho-AKT and phospho-ERK (normalized to the total protein levels) were observed.Independent of the cell line,erlotinib efficiently inhibited phosphorylation of EGFR,AKT and ERK.The mathematical model successfully simulated the experimental findings and provided predictions regarding phosphoprotein levels that could be verified experimentally.CONCLUSION:Our data suggest basal AKT phosphorylation and the degree of EGF-induced activation of AKT and ERK as molecular determinants of erlotinib efficiency in PC cells.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Distribution of bleeding gastrointestinal angioectasias in a Western population

    Elizabeth BollingerDaniel RainesPatrick Saitta
    6235-6239页
    查看更多>>摘要：AIM:TO define which segments of the gastrointestinal tract are most likely to yield angioectasias for ablative therapy.METHODS:A retrospective chart review was performed for patients treated in the Louisiana State University Health Sciences Center Gastroenterology clinics between the dates of July 1,2007 and October 1,2010.The selection of cases for review was initiated by use of our electronic medical record to identify all patients with a diagnosis of angioectasia,angiodysplasia,or arteriovenous malformation.Of these cases,chart reviews identified patients who had a complete evaluation of their gastrointestinal tract as defined by at least one upper endoscopy,colonoscopy and small bowel capsule endoscopy within the past three years.Patients without evidence of overt gastrointestinal bleeding or iron deficiency anemia associated with intestinal angioectasias were classified as asymptomatic and excluded from this analysis.Thirty-five patients with confirmed,bleeding intestinal angioectasias who had undergone complete endoscopic evaluation of the gastrointestinal tract were included in the final analysis.RESULTS:A total of 127 cases were reviewed.Sixtysix were excluded during subsequent screening due to lack of complete small bowel evaluation and/or lack of documentation of overt bleeding or iron deficiency anemia.The 61 remaining cases were carefully examined with independent review of endoscopic images as well as complete capsule endoscopy videos.This analysis excluded 26 additional cases due to insufficient records/images for review,incomplete capsule examination,poor capsule visualization or lack of confirmation of typical angioectasias by the principal investigator on independent review.Thirty-five cases met criteria for final analysis.All study patients were age 50 years or older and 13 patients (37.1％) had chronic kidney disease stage 3 or higher.Twenty of 35 patients were taking aspirin (81 mg or 325 mg),clopidogrel,and/or warfarin,with 8/20 on combination therapy.The number and location of angioectasis was documented for each case.Lesions were then classified into the following segments of the gastrointestinal tract:esophagus,stomach,duodenum,jejunum,ileum,right colon and left colon.The location of lesions within the small bowel observed by capsule endoscopy was generally defined by percentage of total small bowel transit time with times of 0％-9％,10％-39％,and 40％-100％corresponding to the duodenum,jejunum and ileum,respectively.Independent review of complete capsule studies allowed for deviation from this guideline if capsule passage was delayed in one or more segments.In addition,the location and number of angioectasias observed in the small bowel was further modified or confirmed by subsequent device-assisted enteroscopy (DAE) performed in the 83％ of cases.In our study population,angioectasias were most commonly found in the jejunum (80％) followed by the duodenum (51％),stomach (22.8％),and right colon (11.4％).Only two patients were found to have angioectasias in the ileum (5.7％).Twenty-one patients (60％) had angioectasias in more than one location.CONCLUSION:Patients being considered for endoscopic ablation of symptomatic angioectasias should undergo push enteroscopy or anterograde DAE and reinspection of the right colon.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Understanding the health and social care needs of people living with IBD: A meta-synthesis of the evidence

    Karen KempJane GriffithsKarina Lovell
    6240-6249页
    查看更多>>摘要：AIM:To undertake a metasynthesis of qualitative studies to understand the health and social needs of people living with inflammatory bowel disease (IBD).METHODS:A systematic search strategy identified qualitative studies exploring the phenomenon of living with inflammatory bowel disease.Databases included MEDLINE,PsychInfo,EMBASE,CINAHL and the British Nursing Index via the OVID platform.Qualitative search filters were adapted from Hedges database (http:/ /www.urmc.rochester.edu/hslt/ miner/digital_library/tip_sheets/Cinahl eb fllters.pdf).Qualitative empirical studies exploring the health and social needs of people living with inflammatory bowel disease were selected.Study eligibility and data extraction were independently completed using the Critical Appraisal Skills Programme for qualitative studies.The studies were analysed and synthesised using metasynthesis methodology.The themes from the studies allowed for common translations into a new interpretation of the impact of living with inflammatory bowel disease.RESULTS:Of 1395 studies,six published studies and one unpublished thesis fulfilled the inclusion criteria.First iteration of synthesis identified 16 themes,2nd iteration synthesised these into three main 2nd order constructs:"detained by the disease"; "living in a world of disease" and "wrestling with life"."Detained by the disease" is the fear of incontinence,the behaviour the patients display due to the fear,and the impact this has on the individual,such as social isolation and missing out on life events.All of these serve to "pull" the patient back from normal living."Living in a world of disease" is the long term effects of living with a long term condition and the fear of these effects."Wrestling with life" is the continued fight to thrive,the "push" to continue normal living.CONCLUSION:The metasynthesis provides a comprehensive representation of living with IBD.The unmistakeable burden of incontinence is exposed and its ongoing effects are demonstrated.The combined overall impact of living with IBD is the tension these patients live with:"Pushed and pulled:a compromised life",people living with IBD experience a constant conflict throughout their lives,they push to be normal but IBD pulls them back.The impact of the fear of incontinence and behaviour of the individual as a result,requires further qualitative enquiry.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Helicobacter pylori eradication: Sequential therapy and Lactobacillus reuteri supplementation

    Cesare EfratiGiorgia NicoliniClaudio CannavielloNicole Piazza O'Sed...
    6250-6254页
    查看更多>>摘要：AIM:TO evaluate the role of sequential therapy and Lactobacillus reuteri (L.reuteri) supplementation,in the eradication treatment of He/icobacter pylori (H.pylori).METHODS:H.pylori infection was diagnosed in 90 adult dyspeptic patients.Patients were excluded if previously treated for H.pylori infection or if they were taking a proton pump inhibitor (PPI),H2-receptor antagonist or antibiotics.Patients were assigned to receive one of the following therapies:(1) 7-d triple therapy (PPI plus clarithromycin and amoxicillin or metronidazole) plus L.reuteri supplementation during antibiotic treatment; (2) 7-d triple therapy plus L.reuteri supplementation after antibiotic treatment;(3) sequential regimen (5-d PPI plus amoxicillin therapy followed by a 5-d PPI,clarithromycin and tinidazole) plus L.reuteri supplementation during antibiotic treatment; and (4) sequential regimen plus L.reuteri supplementation after antibiotic treatment.Successful eradication therapy was defined as a negative urea breath test at least 4 wk following treatment.RESULTS:Ninety adult dyspeptic patients were enrolled,and 83 (30 male,53 female; mean age 57 ± 13 years) completed the study.Nineteen patients were administered a 7-d triple treatment:11 with L.reuteri supplementation during and 8 after therapy.Sixty-four patients were administered a sequential regimen:32 with L.reuteri supplementation during and 32 after therapy.The eradication rate was significantly higher in the sequential group compared with the 7-d triple regimen (88％ vs 63％,P =0.01).No difference was found between two types of PPI.No difference in eradication rates was observed between patients submitted to L.reuteri supplementation during or after antibiotic treatment.Compliance with therapy was excellent in all patients.No difference in adverse effects was observed between the different antibiotic treatments and between patients submitted to L.reuteri supplementation during and after antibiotic treatment.There was a low incidence of adverse effects in all groups of patients with sequential therapy,probably due to the presence of the L.reuteri supplementation.CONCLUSION:The sequential treatment regimen achieved a significantly higher eradication rate of H.pylori compared with standard 7-d regimen.L.reuteri supplementation could reduce the frequency and the intensity of antibiotic-associated side-effects.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普