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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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    Hepatic expression and cellular distribution of the glucose transporter family

    Sumera KarimDavid H AdamsPatricia F Lalor
    6771-6781页
    查看更多>>摘要：Glucose and other carbohydrates are transported into cells using members of a family of integral membrane glucose transporter (GLUT) molecules.To date 14 members of this family,also called the solute carrier 2A proteins have been identified which are divided on the basis of transport characteristics and sequence similarities into several families (Classes 1 to 3).The expression of these different receptor subtypes varies between different species,tissues and cellular subtypes and each has differential sensitivities to stimuli such as insulin.The liver is a contributor to metabolic carbohydrate homeostasis and is a major site for synthesis,storage and redistribution of carbohydrates.Situations in which the balance of glucose homeostasis is upset such as diabetes or the metabolic syndrome can lead metabolic disturbances that drive chronic organ damage and failure,confirming the importance of understanding the molecular regulation of hepatic glucose homeostasis.There is a considerable literature describing the expression and function of receptors that regulate glucose uptake and release by hepatocytes,the most import cells in glucose regulation and glycogen storage.However there is less appreciation of the roles of GLUTs expressed by non parenchymal cell types within the liver,all of which require carbohydrate to function.A better understanding of the detailed cellular distribution of GLUTs in human liver tissue may shed light on mechanisms underlying disease pathogenesis.This review summarises the available literature on hepatocellular expression of GLUTs in health and disease and highlights areas where further investigation is required.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Utility of faecal calprotectin analysis in adult inflammatory bowel disease

    Lyn A SmithDaniel R Gaya
    6782-6789页
    查看更多>>摘要：The inflammatory bowel diseases (IBD),Crohn's disease and ulcerative colitis,are chronic relapsing,remitting disorders.Diagnosis,along with assessment of disease activity and prognosis present challenges to managing clinicians.Faecal biomarkers,such as faecal calprotectin,are a non-invasive method which can be used to aid these decisions.Calprotectin is a calcium and zinc binding protein found in the cytosol of human neutrophils and macrophages.It is released extracellularly in times of cell stress or damage and can be detected within faeces and thus can be used as a sensitive marker of intestinal inflammation.Faecal calprotectin has been shown to be useful in the diagnosis of IBD,correlates with mucosal disease activity and can help to predict response to treatment or relapse.With growing evidence supporting its use,over the last decade this faecal biomarker has significantly changed the way IBD is managed.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Have guidelines addressing physical activity been established in nonalcoholic fatty liver disease?

    Carmine FinelliGiovanni Tarantino
    6790-6800页
    查看更多>>摘要：The purpose of this review was to highlight,in relation to the currently accepted pathophysiology of non-alcoholic fatty liver disease (NAFLD),the known exercise habits of patients with NAFLD and to detail the benefits of lifestyle modification with exercise (and/or physical activity) on parameters of metabolic syndrome.More rigorous,controlled studies of longer duration and defined histopathological end-points comparing exercise alone and other treatment are needed before better,evidence-based physical activity modification guidelines can be established,since several questions remain unanswered.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Ileocecal valve dysfunction in small intestinal bacterial overgrowth: A pilot study

    Larry S MillerAnil K VegesnaAiswerya Madanam SampathShital Prabhu...
    6801-6808页
    查看更多>>摘要：AIM:To explore whether patients with a defective ileocecal valve (ICV)/cecal distension reflex have small intestinal bacterial overgrowth.METHODS:Using a colonoscope,under conscious sedation,the ICV was intubated and the colonoscope was placed within the terminal ileum (TI).A manometry catheter with 4 pressure channels,spaced 1 cm apart,was passed through the biopsy channel of the colonoscope into the TI.The colonoscope was slowly withdrawn from the TI while the manometry catheter was advanced.The catheter was placed across the ICV so that at least one pressure port was within the TI,ICV and the cecum respectively.Pressures were continuously measured during air insufflation into the cecum,under direct endoscopic visualization,in 19 volunteers.Air was insufflated to a maximum of 40 mmHg to prevent barotrauma.All subjects underwent lactulose breath testing one month after the colonoscopy.The results of the breath tests were compared with the results of the pressures within the ICV during air insufflation.RESULTS:Nineteen subjects underwent colonoscopy with measurements of the ICV pressures after intubation of the ICV with a colonoscope.Initial baseline readings showed no statistical difference in the pressures of the TI and ICV,between subjects with positive lactulose breath tests and normal lactulose breath tests.The average peak ICV pressure during air insufflation into the cecum in subjects with normal lactulose breath tests was significantly higher than cecal pressures during air insufflation (49.33 ± 7.99 mmHg vs 16.40 ± 2.14 mmHg,P =0.0011).The average percentage difference of the area under the pressure curve of the ICV from the cecum during air insufflations in subjects with normal lactulose breath tests was significantly higher (280.72％ ± 43.29％ vs 100％ ± 0％,P =0.0006).The average peak ICV pressure during air insufflation into the cecum in subjects with positive lactulose breath tests was not significantly different than cecal pressures during air insufflation 21.23 ± 3.52 mmHg vs 16.10 ± 3.39 mmHg.The average percentage difference of the area under the pressure curve of the ICV from the cecum during air insufflation was not significantly different 101.08％ ± 7.96％ vs 100％ ±0％.The total symptom score for subjects with normal lactulose breath tests and subjects with positive lactulose breath tests was not statistically different (13.30 ±4.09 vs 24.14 ± 6.58).The ICV peak pressures during air insufflations were significantly higher in subjects with normal lactulose breath tests than in subjects with positive lactulose breath tests (P =0.005).The average percent difference of the area under the pressure curve in the ICV from cecum was significantly higher in subjects with normal lactulose breath tests than in subjects with positive lactulose breath tests (P =0.0012).Individuals with positive lactulose breath tests demonstrated symptom scores which were significantly higher for the following symptoms:not able to finish normal sized meal,feeling excessively full after meals,loss of appetite and bloating.CONCLUSION:Compared to normal,subjects with a positive lactulose breath test have a defective ICV cecal distension reflex.These subjects also more commonly have higher symptom scores.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Schizandra arisanensis extract attenuates cytokine-mediated cytotoxicity in insulin-secreting cells

    Yi-Shin HsuYao-Haur KuoHui-Ling ChengPeter R Flatt...
    6809-6818页
    查看更多>>摘要：AIM:To explore the bioactivity of an ethanolic extract of Schizandra arisanensis (SA-Et) and isolated constituents against interleukin-1β and interferon-γ-mediated β cell death and abolition of insulin secretion.METHODS:By employing BRIN-BD11 cells,the effects of SA-Et administration on cytokine-mediated cell death and abolition of insulin secretion were evaluated by a viability assay,cell cycle analysis,and insulin assay.The associated gene and protein expressions were also measured.In addition,the bioactivities of several peak compounds collected from the SA-Et were tested against cytokine-mediated β cell death.RESULTS:Our results revealed that SA-Et dose-dependently ameliorated cytokine-mediated β cell death and apoptosis.Instead of suppressing inducible nitric oxide synthase/nitric oxide cascade or p38MAPK activity,suppression of stress-activated protein kinase/c-Jun NH2-terminal kinase activity appeared to be the target for SA-Et against the cytokine mix.In addition,SA-Et provided some insulinotropic effects which re-activated the abolished insulin exocytosis in cytokine-treated BRIN-BD11 cells.Finally,schiarisanrin A and B isolated from the SA-Et showed a dose-dependent protective effect against cytokine-mediated β cell death.CONCLUSION:This is the first report on SA-Et ameliorating cytokine-mediated β cell death and dysfunction via anti-apoptotic and insulinotropic actions.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Moxibustion inhibits interleukin-12 and tumor necrosis factor alpha and modulates intestinal flora in rat with ulcerative colitis

    Xiao-Mei WangYuan LuLu-Yi WuShu-Guang Yu...
    6819-6828页
    查看更多>>摘要：AIM:To investigate the effect of moxibustion on intestinal flora and release of interleukin-12 (IL-12) and tumor necrosis factor-α (TNF-α) from the colon in rat with ulcerative colitis (UC).METHODS:A rat model of UC was established by local stimulation of the intestine with supernatant from colonic contents harvested from human UC patients.A total of 40 male Sprague-Dawley rats were randomly divided into the following groups:normal (sham),model (UC),herb-partition moxibustion (HPM-treated),and positive control sulfasalazine (SA-treated).Rats treated with HPM received HPM at acupuncture points ST25 and RN6,once a day for 15 min,for a total of 8 d.Rats in the SA group were perfused with SA twice a day for 8 d.The colonic histopathology was observed by hematoxylin-eosin.The levels of intestinal flora,including Bifidobacterium,Lactobacillus,Escherichia coli (E.coli),and Bacteroides fragilis (B.fragilis),were tested by real-time quantitative polymerase chain reaction to detect bacterial 16S rRNA/DNA in order to determine DNA copy numbers of each specific species.Immunohistochemical assays were used to observe the expression of TNF-α and IL-12 in the rat colons.RESULTS:HPM treatment inhibited immunopathology in colonic tissues of UC rats; the general morphological score and the immunopathological score were significantly decreased in the HPM and SA groups compared with the model group [3.5 (2.0-4.0),3.0 (1.5-3.5) vs 6.0 (5.5-7.0),P ＜ 0.05 for the general morphological score,and 3.00 (2.00-3.50),3.00 (2.50-3.50) vs 5.00 (4.50-5.50),P ＜ 0.01 for the immunopathological score].As measured by DNA copy number,we found that Bilidobacterium and Lactobacillus,which are associated with a healthy colon,were significantly higher in the HPM and SA groups than in the model group (1.395± 1.339,1.461 ± 1.152 vs 0.045 ± 0.036,P ＜ 0.01 for Bifidobacterium,and 0.395 ± 0.325,0.851 ± 0.651 vs 0.0015 ± 0.0014,P ＜ 0.01 for Lactobacillus).On the other hand,E.coli and B.fragilis,which are associated with an inflamed colon,were significantly lower in the HPM and SA groups than in the model group (0.244 ± 0.107,0.628 ± 0.257 vS1.691 ± 0.683,P ＜0.01 for E.coli,and 0.351 ± 0.181,0.416 ± 0.329 vs 1.285 ± 1.039,P ＜ 0.01 for B.fragilis).The expression of TNF-α and IL-12 was decreased after HPM and SA treatment as compared to UC model alone (4970.81 ±959.78,6635.45 ± 1135.16 vs 12333.81 ± 680.79,P ＜ 0.01 for TNF-α,and 5528.75± 1245.72,7477.38±1259.16 vs 12550.29 ± 1973.30,P ＜ 0.01 for IL-12).CONCLUSION:HPM treatment can regulate intestinal flora and inhibit the expression of TNF-α and IL-12 in the colon tissues of UC rats,indicating that HPM can improve colonic immune response.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Minimally invasive treatment of pancreatic necrosis

    Brian BelloJeffrey B Matthews
    6829-6835页
    查看更多>>摘要：AIM:To systematically review these minimally invasive approaches to infected pancreatic necrosis.METHODS:We used the MEDLINE database to investigate studies between 1996 and 2010 with greater than 10 patients that examined these techniques.Using a combination of Boolean operators,reports were retrieved addressing percutaneous therapy (341 studies),endoscopic necrosectomy (574 studies),laparoscopic necrosectomy via a transperitoneal approach (148 studies),and retroperitoneal necrosectomy (194 studies).Only cohorts with at least 10 or more patients were included.Non-English papers,letters,animal studies,duplicate series and reviews without original data were excluded,leaving a total of 27 studies for analysis.RESULTS:Twenty-seven studies with 947 patients total were examined (eight studies on percutaneous approach; ten studies on endoscopic necrosectomy;two studies on laparoscopic necrosectomy via a transperitoneal approach; five studies on retroperitoneal necrosectomy; and two studies on a combined percutaneous-retroperitoneal approach).Success rate,complications,mortality,and number of procedures were outcomes that were included in the review.We found that most published reports were retrospective in nature,and thus,susceptible to selection and publication bias.Few reports examined these techniques in a comparative,prospective manner.CONCLUSION:Each minimally invasive approach though was found to be safe and feasible in multiple reports.With these new techniques,treatment of infected pancreatic necrosis remains a challenge.We advocate a multidisciplinary approach to this complex problem with treatment individualized to each patient.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Dynamic magnetic resonance defecography in 10 asymptomatic volunteers

    Andreas G SchreyerChristian PaetzelAlois FürstLena M Dendl...
    6836-6842页
    查看更多>>摘要：AIM:Evaluation of the wide range of normal findings in asymptomatic women undergoing dynamic magnetic resonance (MR) defecography.METHODS:MR defecography of 10 healthy female volunteers (median age:31 years) without previous pregnancies or history of surgery were evaluated.The rectum was filled with 180 mL gadolinium ultrasound gel mixture.MR defecography was performed in the supine position.The pelvic floor was visualized with a dynamic T2-weighted sagittal plane where all relevant pelvic floor organs were acquired during defecation.The volunteers were instructed to relax and then to perform straining maneuvers to empty the rectum.The pubococcygeal line (PCGL) was used as the line of reference.The movement of pelvic floor organs was measured as the vertical distance to this reference line.Data were recorded in the resting position as well as during the defecation process with maximal straining.Examinations were performed and evaluated by two experienced abdominal radiologists without knowledge of patient history.RESULTS:Average position of the anorectal junction was located at-5.3 mm at rest and-29.9 mm during straining.The anorectal angle widened significantly from 93° at rest to 109° during defecation.A rectocele was diagnosed in eight out of 10 volunteers showing an average diameter of 25.9 mm.The bladder base was located at a position of +23 mm at rest and descended to-8.1 mm during defecation in relation to the PCGL.The bladder base moved below the PCGL in six out of 10 volunteers,which was formally defined as a cystocele.The uterocervical junction was located at an average level of +43.1 mm at rest and at +7.9 mm during straining.The uterocervical junction of three volunteers fell below the PCGL; described formally as uterocervical prolapse.CONCLUSION:Based on the range of standard values in asymptomatic volunteers,MR defecography values for pathological changes have to be re-evaluated.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Improved techniques for double-balloon-enteroscopy-assisted endoscopic retrograde cholangiopancreatography

    Takashi OsoegawaYasuaki MotomuraKazuya AkahoshiNaomi Higuchi...
    6843-6849页
    查看更多>>摘要：AIM:To investigate the clinical outcome of double balloon enteroscopy (DBE)-assisted endoscopic retrograde cholangiopancreatography (DB-ERCP) in patients with altered gastrointestinal anatomy.METHODS:Between September 2006 and April 2011,47 procedures of DB-ERCP were performed in 28 patients with a Roux-en-Y total gastrectomy (n =11),Billroth Ⅱ gastrectomy (n =15),or Roux-en-Y anastomosis with hepaticojejunostomy (n =2).DB-ERCP was performed using a short-type DBE combined with several technical innovations such as using an endoscope attachment,marking by submucosal tattooing,selectively applying contrast medium,and CO2 insufflations.RESULTS:The papilla of Vater or hepaticojejunostomy site was reached in its entirety with a 96％ success rate (45/47 procedures).There were no significant differences in the success rate of reaching the blind end with a DBE among Roux-en-Y total gastrectomy (96％),Billroth Ⅱ reconstruction (94％),or pancreatoduodenectomy (100％),respectively (P =0.91).The total successful rate of cannulation and contrast enhancement of the target bile duct in patients whom the blind end was reached with a DBE was 40/45procedures (89％).Again,there were no significant differences in the success rate of cannulation and contrast enhancement of the target bile duct with a DBE among Roux-en-Y total gastrectomy (88 ％),Billroth l reconstruction (89％),or pancreatoduodenectomy (100％),respectively (P =0.67).Treatment was achieved in all 40 procedures (100％) in patients whom the contrast enhancement of the bile duct was successful.Common endoscopic treatments were endoscopic biliary drainage (24 procedures) and extraction of stones (14 procedures).Biliary drainage was done by placement of plastic stents.Stones extraction was done by lithotomy with the mechanical lithotripter followed by extraction with a basket or by the balloon pull-through method.Endoscopic sphincterotomy was performed in 14 procedures with a needle precutting knife using a guidewire.The mean total duration of the procedure was 93.6 ± 6.8 min and the mean time required to reach the papilla was 30.5 ± 3.7 min.The mean time required to reach the papilla tended to be shorter in Billroth Ⅱ reconstruction (20.9 ± 5.8 min) than that in Roux-en-Y total gastrectomy (37.1 ± 4.9 min) but there was no significant difference (P =0.09).A major complication occurred in one patient (3.5％);perforation of the long limb in a patient with Billroth Ⅱ anastomosis.CONCLUSION:Short-type DBE combined with several technical innovations enabled us to perform ERCP in most patients with altered gastrointestinal anatomy,
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Is laparoscopy equal to laparotomy in detecting and treating small bowel injuries in a porcine model?

    Cheng-Xiang ShanChong NiMing QiuDao-Zhen Jiang...
    6850-6855页
    查看更多>>摘要：AIM:To evaluate the safety and effectiveness of laparoscopy compared with laparotomy for diagnosing and treating small bowel injuries (SBIs) in a porcine model.METHODS:Twenty-eight female pigs were anesthetized and laid in the left recumbent position.The SBI model was established by shooting at the right lower quadrant of the abdomen.The pigs were then randomized into either the laparotomy group or the laparoscopy group.All pigs underwent routine exploratory laparotomy or laparoscopy to evaluate the abdominal injuries,particularly the types,sites,and numbers of SBIs.Traditional open surgery or therapeutic laparoscopy was then performed.All pigs were kept alive within the observational period (postoperative 72 h).The postoperative recovery of each pig was carefully observed.RESULTS:The vital signs of all pigs were stable within 1-2 h after shooting and none of the pigs died from gunshot wounds or SBIs immediately.The SBI model was successfully established in all pigs and definitively diagnosed with single or multiple SBIs either by exploratory laparotomy or laparoscopy.Compared with exploratory laparotomy,laparoscopy took a significantly longer time for diagnosis (41.27 ± 12.04 min vs 27.64± 13.32 min,P =0.02),but the time for therapeutic laparoscopy was similar to that of open surgery.The length of incision was significantly reduced in the laparoscopy group compared with the laparotomy group (5.27 ± 1.86 cm vs 15.73 ± 1.06 cm,P ＜ 0.01).In the final post-mortem examination 72 h after surgery,both laparotomy and laparoscopy offered a definitive diagnosis with no missed injuries.Postoperative complications occurred in four cases (three following laparotomy and one following laparoscopy,P =0.326).The average recovery period for bowel function,vital appearance,and food re-intake after laparoscopy was 10.36 ± 4.72 h,14.91±3.14 h,and 15.00 ± 7.11 h,respectively.All of these were significantly shorter than after laparotomy (21.27 ± 10.17 h,P =0.004; 27.82 ± 9.61 h,P ＜ 0.001;and 24.55 ± 9.72 h,respectively,P =0.016).CONCLUSION:Compared with laparotomy,laparoscopy offers equivalent efficacy for diagnosing and treating SBIs,and reduces postoperative complications as well as recovery period.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普