首页期刊导航|世界胃肠病学杂志（英文版）
期刊信息/Journal information
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。
正式出版
收录年代

    Prevention and treatment of hepatic encephalopathy:Focusing on gut microbiota

    Matteo GarcovichMaria Assunta ZoccoDavide RoccarinaFrancesca Romana Ponziani...
    6693-6700页
    查看更多>>摘要：The gut flora plays an important role in the pathogenesis of the complications of cirrhosis.Hepatic encephalopathy (HE) represents a broad continuum of neuropsychological dysfunction in patients with acute or chronic liver disease and/or porto-systemic shunting of blood flow and it manifests with progressive deterioration of the superior neurological functions.The pathophysiology of this disease is complex,as it involves overproduction and reduced metabolism of various neurotoxins,particularly ammonia.Management of HE is diversified and requires several steps:elimination of precipitating factors,removal of toxins,proper nutritional support,modulation of resident fecal flora and downregulation of systemic and gut-derived inflammation.This review will provide an overview of gut barrier function and the influence of gut-derived factors on HE,focusing on the role of gut microbiota in the pathogenesis of HE and the recent literature findings on its therapeutic manipulation.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    Glycogenotic hepatocellular carcinoma with glycogen-ground-glass hepatocytes: A heuristically highly relevant phenotype

    Peter Bannasch
    6701-6708页
    查看更多>>摘要：Glycogenotic hepatocellular carcinoma (HCC) with glycogen-ground-glass hepatocytes has recently been described as an allegedly "novel variant" of HCC,but neither the historical background nor the heuristic relevance of this observation were put in perspective.In the present contribution,the most important findings in animal models and human beings related to the emergence and further evolution of excessively glycogen storing (glycogenotic) hepatocytes with and without ground glass features during neoplastic development have been summarized.Glycogenotic HCCs with glycogen-ground-glass hepatocytes represent highly differentiated neoplasms which contain subpopulations of cells phenotypically resembling those of certain types of preneoplastic hepatic foci and benign hepatocellular neoplasms.It is questionable whether the occurrence of glycogen-ground-glass hepatocytes in a glycogenotic HCC justifies its classification as a specific entity.The typical appearance of ground-glass hepatocytes is due to a hypertrophy of the smooth endoplasmic reticulum,which is usually associated with an excessive storage of glycogen and frequently also with an expression of the hepatitis B surface antigen.Sequential studies in animal models and observations in humans indicate that glycogen-ground-glass hepatocytes are a facultative,integral part of a characteristic cellular sequence commencing with focal hepatic glycogenosis potentially progressing to benign and malignant neoplasms.During this process highly differentiated glycogenotic cells including ground-glass hepatocytes are gradually transformed via various intermediate stages into poorly differentiated glycogen-poor,basophilic (ribosome-rich) cancer cells.Histochemical,microbiochemical,and molecular biochemical studies on focal hepatic glycogenosis and advanced preneoplastic and neoplastic lesions in tissue sections and laser-dissected specimens in rat and mouse models have provided compelling evidence for an early insulinomimetic effect of oncogenic agents,which is followed by a fundamental metabolic switch from gluconeogenesis towards the pentose-phosphate pathway and the Warburg type of glycolysis during progression from preneoplastic hepatic glycogenosis to the highly proliferative malignant phenotype.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Targeting late SV40 factor: Is the achilles heel of hepatocarcinogenesis revealed?

    Amir Shlomal
    6709-6711页
    查看更多>>摘要：Hepatocellular carcinoma (HCC) is a dreadful cancer and a major cause of death among patients with chronic liver disease and cirrhosis.The apparent alterations in a diversity of intracellular pathways found in HCC has set the rational for developing moleculardirected drugs that simultaneously inhibit multiple pathways,such as the multi-kinase inhibitor Sorafenib.However,recently this concept has been challenged by showing that HCC is heavily dependent on a single oncogene designated late SV-40 factor (LSF),a transcription factor that is over-expressed in liver cancer cells and that its expression is strongly correlated with tumor grade and aggressiveness.Furthermore,using an intensive screening for drugs that inhibit LSF activity,Grant eta/have found a molecule designated factor quinolinone inhibitor 1 that can specifically block the ability of LSF to bind its target promoters,resulting in a massive death of HCC cells both in vitro and in vivo.The innovative findings of HCC representing "oncogene addiction" to LSF and the ability of a single molecule to block the activity of this oncogene resulting in tumor abolishment are encouraging and provide us with the hope that the "Achilles heel" of HCC has been found.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Thinking in three's: Changing surgical patient safety practices in the complex modern operating room

    Verna C Gibbs
    6712-6719页
    查看更多>>摘要：The three surgical patient safety events,wrong site surgery,retained surgical items (RSI) and surgical fires are rare occurrences and thus their effects on the complex modern operating room (OR) are difficult to study.The likelihood of occurrence and the magnitude of risk for each of these surgical safety events are undefined.Many providers may never have a personal experience with one of these events and training and education on these topics are sparse.These circumstances lead to faulty thinking that a provider won't ever have an event or if one does occur the provider will intuitively know what to do.Surgeons are not preoccupied with failure and tend to usually consider good outcomes,which leads them to ignore or diminish the importance of implementing and following simple safety practices.These circumstances contribute to the persistent low level occurrence of these three events and to the difficulty in generating sufficient interest to resource solutions.Individual facilities rarely have the time or talent to understand these events and develop lasting solutions.More often than not,even the most well meaning internal review results in a new line to a policy and some rigorous enforcement mandate.This approach routinely fails and is another reason why these problems are so persistent.Vigilance actions alone have been unsuccessful so hospitals now have to take a systematic approach to implementing safer processes and providing the resources for surgeons and other stakeholders to optimize the OR environment.This article discusses standardized processes of care for mitigation of injury or outright prevention of wrong site surgery,RSI and surgical fires in an action-oriented framework illustrating the strategic elements important in each event and focusing on the responsibilities for each of the three major OR agents-anesthesiologists,surgeons and nurses.A Surgical Patient Safety Checklist is discussed that incorporates the necessary elements to bring these team members together and influence the emergence of a safer OR.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Modern treatment of gastric gastrointestinal stromal tumors

    Kevin K RogginMitchell C Posner
    6720-6728页
    查看更多>>摘要：Gastrointestinal stromal tumors (GIST) are rare mesenchymal smooth muscle sarcomas that can arise anywhere within the gastrointestinal tract.Sporadic mutations within the tyrosine kinase receptors of the interstitial cells of Cajal have been identified as the key molecular step in GIST carcinogenesis.Although many patients are asymptomatic,the most common associated symptoms include:abdominal pain,dyspepsia,gastric outlet obstruction,and anorexia.Rarely,GIST can perforate causing life-threatening hemoperitoneurn.Most are ultimately diagnosed on cross-sectional imaging studies (i.e.,computed tomography and/or magnetic resonance imaging in combination with upper endoscopy.Endoscopic ultrasonographic localization of these tumors within the smooth muscle layer and acquisition of neoplastic spindle cells harboring mutations in the c-KIT gene is pathognomonic.Curative treatment requires a complete gross resection of the tumor.Both open and minimally invasive operations have been shown to reduce recurrence rates and improve long-term survival.While there is considerable debate over whether GIST can be benign neoplasms,we believe that all GIST have malignant potential,but vary in their propensity to recur after resection and metastasize to distant organ sites.Prognostic factors include location,size (i.e.,＞ 5 cm),grade (＞ 5-10 mitoses per 50 high power fields and specific mutational events that are still being defined.Adjuvant therapy with tyrosine kinase inhibitors,such as imatinib mesylate,has been shown to reduce the risk of recurrence after one year of therapy.Treatment of locally-advanced or borderline resectable gastric GIST with neoadjuvant imatinib has been shown to induce regression in a minority of patients and stabilization in the majority of cases.This treatment strategy potentially reduces the need for more extensive surgical resections and increases the number of patients eligible for curative therapy.The modern surgical treatment of gastric GIST combines the novel use of targeted therapy and aggressive minimally invasive surgical procedures to provide effective treatment for this lethal,but rare gastrointestinal malignancy.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Adult to adult living related liver transplantation: Where do we currently stand?

    Erica M CarlisleGiuliano Testa
    6729-6736页
    查看更多>>摘要：Adult to adult living donor liver transplantation (AALDLT) was first preformed in the United States in 1997.The procedure was rapidly integrated into clinical practice,but in 2002,possibly due to the first widely publicized donor death,the number of living liver donors plummeted.The number of donors has since reached a steady plateau far below its initial peak.In this review we evaluate the current climate of AALDLT.Specifically,we focus on several issues key to the success of AALDLT:determining the optimal indications for AALDLT,balancing graft size and donor safety,assuring adequate outflow,minimizing biliary complications,and maintaining ethical practices.We conclude by offering suggestions for the future of AALDLT in United States transplantation centers.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Multidisciplinary approach for patients with esophageal cancer

    Victoria M VillaflorMarco E AllaixBruce MinskyFernando A Herbella...
    6737-6746页
    查看更多>>摘要：Patients with esophageal cancer have a poor prognosis because they often have no symptoms until their disease is advanced.There are no screening recommendations for patients unless they have Barrett's esophagitis or a significant family history of this disease.Often,esophageal cancer is not diagnosed until patients present with dysphagia,odynophagia,anemia or weight loss.When symptoms occur,the stage is often stage Ⅲ or greater.Treatment of patients with very early stage disease is fairly straight forward using only local treatment with surgical resection or endoscopic mucosal resection.The treatment of patients who have locally advanced esophageal cancer is more complex and controversial.Despite multiple trials,treatment recommendations are still unclear due to conflicting data.Sadly,much of our data is difficult to interpret due to many of the trials done have included very heterogeneous groups of patients both histologically as well as anatomically.Additionally,studies have been underpowered or stopped early due to poor accrual.In the United States,concurrent chemoradiotherapy prior to surgical resection has been accepted by many as standard of care in the locally advanced patient.Patients who have metastatic disease are treated palliatively.The aim of this article is to describe the multidisciplinary approach used by an established team at a single high volume center for esophageal cancer,and to review the literature which guides our treatment recommendations.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Laparoscopic rectal cancer surgery: Where do we stand?

    Mukta K KraneAlessandro Fichera
    6747-6755页
    查看更多>>摘要：Large comparative studies and multiple prospective randomized control trials (RCTs) have reported equivalence in short and long-term outcomes between the open and laparoscopic approaches for the surgical treatment of colon cancer which has heralded widespread acceptance for laparoscopic resection of colon cancer.In contrast,laparoscopic total mesorectal excision (TME) for the treatment of rectal cancer has been welcomed with significantly less enthusiasm.While it is likely that patients with rectal cancer will experience the same benefits of early recovery and decreased postoperative pain from the laparoscopic approach,whether the same oncologic clearance,specifically an adequate TME can be obtained is of concern.The aim of the current study is to review the current level of evidence in the literature on laparoscopic rectal cancer surgery with regard to short-term and long-term oncologic outcomes.The data from 8 RCTs,3 metaanalyses,and 2 Cochrane Database of Systematic Reviews was reviewed.Current data suggests that laparoscopic rectal cancer resection may benefit patients with reduced blood loss,earlier retum of bowel function,and shorter hospital length of stay.Concerns that laparoscopic rectal cancer surgery compromises shortterm oncologic outcomes including number of lymph nodes retrieved and circumferential resection margin and jeopardizes long-term oncologic outcomes has not conclusively been refuted by the available literature.Laparoscopic rectal cancer resection is feasible but whether or not it compromises short-term or long-term results still needs to be further studied.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Minimally invasive approaches for the treatment of inflammatory bowel disease

    Marco ZoccaliAlessandro Fichera
    6756-6763页
    查看更多>>摘要：Despite significant improvements in medical management of inflammatory bowel disease,many of these patients still require surgery at some point in the course of their disease.Their young age and poor general conditions,worsened by the aggressive medical treatments,make minimally invasive approaches particularly enticing to this patient population.However,the typical inflammatory changes that characterize these diseases have hindered wide diffusion of laparoscopy in this setting,currently mostly pursued in high-volume referral centers,despite accumulating evidences in the literature supporting the benefits of minimally invasive surgery.The largest body of evidence currently available for terminal ileal Crohn's disease shows improved short term outcomes after laparoscopic surgery,with prolonged operative times.For Crohn's colitis,high quality evidence supporting laparoscopic surgery is lacking.Encouraging preliminary results have been obtained with the adoption of laparoscopic restorative total proctocolectomy for the treatment of ulcerative colitis.A consensus about patients' selection and the need for staging has not been reached yet.Despite the lack of conclusive evidence,a wave of enthusiasm is pushing towards less invasive strategies,to further minimize surgical trauma,with single incision laparoscopic surgery being the most realistic future development.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Impact of minimally invasive surgery on the treatment of benign esophageal disorders

    Brian BelloFernando A HerbellaMarco E AllaixMarco G Patti...
    6764-6770页
    查看更多>>摘要：Thanks to the development of minimally invasive surgery,the last 20 years have witnessed a change in the treatment algorithm of benign esophageal disorders.Today a laparoscopic operation is the treatment of choice for esophageal achalasia and for most patients with gastroesophageal reflux disease.Because the pathogenesis of achalasia is unknown,treatment is palliative and aims to improve esophageal emptying by decreasing the functional obstruction at the level of the gastro-esophageal junction.The refinement of minimally invasive techniques accompanied by large,multiple randomized control trials with long-term outcome has allowed the laparoscopic Heller myotomy and partial fundoplication to become the treatment of choice for achalasia compared to endoscopic procedures,including endoscopic botulinum toxin injection and pneumatic dilatation.Patients with suspected gastroesophageal reflux need to undergo a thorough preoperative workup.After establishing diagnosis,treatment for gastroesophageal reflux should be individualized to patient characteristics and a decision about an operation made jointly between surgeon and patient.The indications for surgery have changed in the last twenty years.In the past,surgery was often considered for patients who did not respond well to acid reducing medications.Today,the best candidate for surgery is the patient who has excellent control of symptoms with proton pump inhibitors.The minimally invasive approach to antireflux surgery has allowed surgeons to control reflux in a safe manner,with excellent long term outcomes.Like achalasia and gastroesophageal reflux,the treatment of patients with paraesophageal hernias has also seen a major evolution.The laparoscopic approach has been shown to be safe,and durable,with good relief of symptoms over the long-term.The most significant controversy with laparoscopic paraesophageal hernia repair is the optimal crural repair.This manuscript reviews the evolution of these techniques.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普