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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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    Long-term treatment outcomes of clevudine in antiviral-naive patients with chronic hepatitis B

    Suk Bae KimIl Han SongYoung Min KimRan Noh...
    6943-6950页
    查看更多>>摘要：AIM:To evaluate the treatment outcomes of clevudine compared with entecavir in antiviral-naive patients with chronic hepatitis B (CHB).METHODS:We retrospectively analyzed the clinical data of CHB patients treated with clevudine 30 mg/d and compared their clinical outcomes with patients treated with entecavir 0.5 mg/d.The biochemical response,as assessed by serum alanine aminotransferase (ALT) activity,virologic response,as assessed by serum hepatitis B virus DNA (HBV DNA) titer,serologic response,as assessed by hepatitis B e antigen (HBeAg)status,and virologic breakthrough with genotypic mutations were assessed.RESULTS:Two-hundred and fifty-four patients [clevudine (n =118) vs entecavir (n =136)] were enrolled.In clevudine-treated patients,the cumulative rates of serum ALT normalization were 83.9％ at week 48 and 91.5％ at week 96 (80.9％ and 91.2％ in the entecavir group,respectively),the mean titer changes in serum HBV DNA were-6.03 and-6.55 log10 copies/mL (-6.35and-6.86 log10 copies/mL,respectively,in the entecavir group),and the cumulative non-detection rates of serum HBV DNA were 72.6％ and 83.1％ (74.4％ and 83.8％,respectively,in the entecavir group).These results were similar to those of entecavir-treated patients.The cumulative rates of HBeAg seroconversion were 21.8％ at week 48 and 25.0％ at week 96 in patients treated with clevudine,which was similar to patients treated with entecavir (22.8％ and 27.7％,respectively).The virologic breakthrough in the clevudine group occurred in 9 (7.6％) patients at weeks 48 and 15 (12.7％) patients at week 96,which primarily corresponded to genotypic mutations of rtM204I and/or rtL180M.There was no virologic breakthrough in the entecavir group.CONCLUSION:In antiviral-naive CHB patients,longterm treatment outcomes of clevudine were not inferior to those of entecavir,except for virologic breakthrough.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Effects of hexahydrocurcumin in combination with 5-fluorouracil on dimethylhydrazine-induced colon cancer in rats

    Khanitta SrimuangwongChainarong TocharusJiraporn TocharusApichart Suksamrarn...
    6951-6959页
    查看更多>>摘要：AIM:To investigate the effects of hexahydrocurcumin (HHC),and its combination with 5-fluorouracil (5-FU)on dimethylhydrazine (DMH)-induced colon cancer in METHODS:Male Wistar rats weighing 100-120 g were used as subject models.Aberrant crypt foci (ACF),early preneoplastic lesions of colon cancer,were induced by subcutaneous injection of DHM (40 mg/kg) twice a week for two weeks.After the first DMH injection,rats were treated daily with vehicle (n =12),curcumin (CUR) (50 mg/kg) (n =12),HHC (50 mg/kg) orally (n =12),and treated weekly with an intraperitoneal injection of 5-FU (50 mg/kg) (n =12),or a combination of 5-FU plus CUR (n =12) and HHC (n =12) at the same dosage(s) for 16 wk.The total number of ACF and large ACF were assessed.Cyclooxygenase (COX)-1 and COX-2 expression were detected by immunohistochemistry in colon tissues.The quantitative data of both COX-1 and COX-2 expression were presented as the percentage of number of positive-stained cells to the total number of cells counted.Apoptotic cells in colon tissues were also visualized using the dUTP-biotin nick end labeling method.Apoptotic index (AI) was determined as the percentage of labeled nuclei with respect to the total number of nuclei counted.RESULTS:The total number of ACF was highest in the DMH-vehicle group (1558.20 ± 17.37),however,the number of ACF was significantly reduced by all treatments,5-FU (1231.20 ± 25.62 vs 1558.20 ± 17.37,P ＜0.001),CUR (1284.20 ± 25.47 vs 1558.20 ± 17.37,P ＜0.001),HHC (1086.80 ± 53.47 vs 1558.20 ± 17.37,P ＜0.001),DMH-5-FU + CUR (880.20 ± 13.67 vs 1558.20± 17.37,P ＜ 0.001) and DMH-S-FU + HHC (665.80 ±16.64 vs 1558.20 ± 17.37,P ＜ 0.001).Interestingly,the total number of ACF in the combined treatment groups,the DMH-5-FU + CUR group (880.20 ± 13.67vs 1231.20 ± 25.62,P ＜ 0.001; 880.20 ± 13.67 vs 1284.20 ± 25.47,P ＜ 0.001) and the DMH-5-FU +HHCgroup (665.80 ± 16.64 vs 1231.20 ± 25.62,P ＜0.001; 665.80 ± 16.64 vs 1086.80 ± 53.47,P ＜ 0.001)were significantly reduced as compared to 5-FU or each treatment alone.Large ACF were also significantly reduced in all treatment groups,5-FU (111.00 ± 7.88 vs 262.20 ± 10.18,P ＜ 0.001),CUR (178.00 ± 7.33 vs 262.20 ± 10.18,P ＜ 0.001),HHC (186.60 ± 21.51 vs 262.20 ± 10.18,P ＜ 0.001),DMH-5-FU + CUR (122.00± 5.94 vs 262.20 ± 10.18,P ＜ 0.001) and DMH-5-FU+ HHC (119.00 ± 17.92 vs 262.20 ± 10.18,P ＜ 0.001)when compared to the vehicle group.Furthermore,in the DMH-5-FU + CUR and DMH-5-FU + HHC groups the formation of large ACF was significantly reduced when compared to CUR (122.00 ± 5.94 vs 178.00 ±7.33,P ＜ 0.005) or HHC treatment alone (119.00 ±17.92 vs 186.60 ± 21.51,P ＜ 0.001),however,this reduction was not statistically different to 5-FU monotherapy (122.00 ± 5.94 vs 111.00 ± 7.88,P =0.217;119.00 ± 17.92 vs 111.00 ± 7.88,P =0.619,respectively).The levels of COX-1 protein after all treatments were not different from normal rats.A marked increase in the expression of COX-2 protein was observed in the DMH-vehicle group.Over-expression of COX-2 was not significantly decreased by 5-FU treatment alone (95.79 ± 1.60 vs 100 ± 0.00,P =0.198).However,over-expression of COX-2 was significantly suppressed by CUR (77.52 ± 1.68 vs 100 ± 0.00,P ＜ 0.001),HHC (71.33 ± 3.01 vs 100 ± 0.00,P ＜ 0.001),5-FU ± CUR (76.25 ± 3.32 vs 100 ± 0.00,P ＜ 0.001) and 5-FU +HHC (68.48 ± 2.24 vs 100 ± 0.00,P ＜ 0.001) in the treated groups compared to the vehicle group.Moreover,CUR (77.52 ± 1.68 vs 95.79 ± 1.60,P ＜ 0.001),HHC (71.33 ± 3.01 vs 95.79 ± 1.60,P ＜ 0.001),5-FU + CUR treatments (76.25 ± 3.32 vs 95.79 ± 1.60,P ＜0.001) and 5-FU + HHC (68.48 ± 2.24 vs 95.79 ± 1.60,P ＜ 0.001) markedly decreased COX-2 protein expression more than 5-FU alone.Furthermore,the AI in all treated groups,5-FU (38.86 ± 4.73 vs 23.56 ± 2.12,P =0.038),CUR (41.78 ± 6.92 vs 23.56 ± 2.12,P ＜0.001),HHC (41.06 ± 4.81 vs 23.56 ± 2.12,P ＜ 0.001),5-FU + CUR (49.05 ± 6.75 vs 23.56 ± 2.12,P ＜ 0.001)and 5-FU + HHC (53.69 ± 8.59 vs 23.56 ± 2.12,P ＜0.001) significantly increased when compared to the DMH-vehicle group.However,the AI in the combination treatments,5-FU + CUR (49.05 ± 6.75 vs 41.78± 6.92,P =0.192; 49.05 ± 6.75 vs 38.86 ± 4.73,P =0.771) and 5-FU + HHC (53.69 ± 8.59 vs 41.06 ± 4.81,P =0.379; 53.69 ± 8.59 vs 38.86 ± 4.73,P =0.245)did not reach significant levels as compared with each treatment alone and 5-FU monotherapy,respectively.CONCLUSION:The combined effects of HHC with 5-FU exhibit a synergistic inhibition by decreasing ACF formation mediated by down-regulation of COX-2 expression.
      原文链接:
    • NETL
    • NSTL
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    • 维普

    Endoscopic findings in patients with Schatzki rings:Evidence for an association with eosinophilic esophagitis

    Michaela MüllerAlexander J EckardtAnnette Fisseler-EckhoffSusanne Haas...
    6960-6966页
    查看更多>>摘要：AIM:To investigate endoscopic findings in patients with Schatzki rings (SRs) with a focus on evidence for eosinophilic esophagitis (EoE).METHODS:We consecutively approached all adult patients scheduled for elective outpatient upper endoscopy for a variety of indications at the German Diagnostic Clinic,Wiesbaden,Germany between July 2007 and July 2010.All patients with endoscopically diagnosed SRs,defined as thin,symmetrical,mucosal structures located at the esophagogastric junction,were prospectively registered.Additional endoscopic findings,clinical information and histopathological findings with a focus on esophageal eosinophilia (≥ 20 eosinophils/highpower field) were recorded.The criteria for active EoE were defined as:(1) eosinophilic tissue infiltration ≥20 eosinophils/hpf; (2) symptoms of esophageal dysfunction; and (3) exclusion of other causes of esophageal eosinophilia.Gastroesophageal reflux disease was excluded by proton pump inhibitor treatment prior to endoscopy.The presence of ≥ 20 eosinophils/hpf in esophageal biopsies in patients that did not fulfil the criteria of EoE was defined as esophageal hypereosinophilia.RESULTS:A SR was diagnosed in 171 (3.3％; 128males,43 females,mean age 66±12.9 years) of the 5163 patients that underwent upper gastrointestinalendoscopy.Twenty of the 116 patients (17％) from whom esophageal biopsies were obtained showed histological hypereosinophilia (≥ 20 eosinophils/hpf).Nine of these patients (8 males,1 female,mean age 49 ± 10 years) did not fulfill all diagnostic criteria of EoE,whereas in 11 (9％) patients with ≥ 20 eosinophils/hpf,a definite diagnosis of EoE was made.Three of the 11 patients (27％) with definite EoE had no suspicious endoscopic features of EoE.In contrast,in the 25 patients in whom EoE was suspected by endoscopic features,EoE was only confirmed in 7 (28％) patients.Patients with EoE were younger (mean age 41.5±6.5 vs 50.5± 11.5 years,P =0.012),were more likely to have a history of allergies (73％ vs 29％,P =0.007) and complained more often of dysphagia (91％ vs 34％,P=0.004) and food impaction (36％ vs 6％,P =0.007)than patients without EoE.Endoscopically,additional webs were found significantly more often in patients with EoE than in patients without EoE (36％ vs 11％,P =0.04).Furthermore,the SR had a tendency to be narrower in patients with EoE than in those without EoE (36％ vs 18％,P =0.22).The percentage of males (73％ vs 72％,P =1.0) and frequency of heartburn (27％ vs 27％,P =1.0) were not significantly different in both groups.The 9 patients with esophageal hypereosinophilia that did not fulfil the diagnostic criteria of EoE were younger (mean age 49 ± 10 years vs 58 ±6 years,P =0.0008) and were more likely to have a history of allergies (78％ vs 24％,P =0.003) than patients with ＜ 20 eosinophils/hpf.Predictors of EoE were younger age,presence of dysphagia or food impaction CONCLUSION:A significant proportion of patients with SRs also have EoE,which may not always be suspected according to other endoscopic features.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Sex-dimorphic adverse drug reactions to immune suppressive agents in inflammatory bowel disease

    Zuzana ZelinkovaEvelien BultmanLauran VogelaarCheima Bouziane...
    6967-6973页
    查看更多>>摘要：AIM:To analyze sex differences in adverse drug reactions (ADR) to the immune suppressive medication in inflammatory bowel disease (IBD) patients.METHODS:All IBD patients attending the IBD outpatient dinic of a referral hospital were identified through the electronic diagnosis registration system.The electronic medical records of IBD patients were reviewed and the files of those patients who have used immune suppressive therapy for IBD,i.e.,thiopurines,methotrexate,cyclosporine,tacrolimus and anti-tumor necrosis factor agents (anti-TNF); infliximab (IFX),adalimumab (ADA) and/or certolizumab,were further analyzed.The reported ADR to immune suppressive drugs were noted.The general definition of ADR used in clinical practice comprised the occurrence of the ADR in the temporal relationship with its disappearance upon discontinuation of the medication.Patients for whom the required information on drug use and ADR was not available in the electronic medical record and patients with only one registered contact and no further followup at the outpatient clinic were excluded.The difference in the incidence and type of ADR between male and female IBD patients were analyzed statistically by x2 test.RESULTS:In total,1009 IBD patients were identified in the electronic diagnosis registration system.Out of these 1009 patients,843 patients were eligible for further analysis.There were 386 males (46％),mean age 42 years (range:16-87 years) with a mean duration of the disease of 14 years (range:0-54 years); 578 patients with Crohn's disease,244 with ulcerative colitis and 21 with unclassified colitis.Seventy percent (586 pts) of patients used any kind of immune suppressive agents at a certain point of the disease course,the majority of the patients (546 pts,65％) used thiopurines,176 pts (21％) methotrexate,46 pts (5％) cyclosporine and one patient tacrolimus.One third (240pts,28％) of patients were treated with anti-TNF,the majority of patients (227 pts,27％) used IFX,99 (12％)used ADA and five patients certolizumab.There were no differences between male and female patients in the use of immune suppressive agents.With regards to ADR,no differences between males and females were observed in the incidence of ADR to thiopurines,methotrexate and cyclosporine.Among 77 pts who developed ADR to one or more anti-TNF agents,significantly more females (54 pts,39％ of all anti-TNF treated women) than males (23 pts,23％ of all antiTNF treated men) experienced ADR to an anti-TNF agent [P =0.011; odds ratio (OR) 2.2,95％CI 1.2-3.8].The most frequent ADR to both anti-TNF agents,IFX and ADA,were allergic reactions (15％ of all IFX users and 7％ of all patients treated with ADA) and for both agents a significantly higher rate of allergic reactions in females compared with males was observed.As a result of ADR,36 patients (15％ of all patients using anti-TNF) stopped the treatment,with significantly higher stopping rate among females (27 females,19％vs 9 males,9％,P =0.024).CONCLUSION:Treatment with anti-TNF antibodies is accompanied by sexual dimorphic profile of ADR with female patients being more at risk for allergic reactions and subsequent discontinuation of the treatment.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Diagnosis of intestinal tuberculosis using a monoclonal antibody to Mycobacterium tuberculosis

    Yasushi IhamaAkira HokamaKenji HibiyaKazuto Kishimoto...
    6974-6980页
    查看更多>>摘要：AIM:To investigate the utility of immunohistochemical (IHC) staining with an antibody to Mycobacterium tuberculosis (M.tuberculosis) for the diagnosis of intestinal tuberculosis (TB).METHODS:We retrospectively identified 10 patients (4 males and 6 females; mean age =65.1 ± 13.6 years)with intestinal TB.Clinical characteristics,including age,gender,underlying disease,and symptoms were obtained.Chest radiograph and laboratory tests,including sputum Ziehl-Neelsen (ZN) staining,M.tuberculosis culture,and sputum polymerase chain reaction (PCR)for tubercle bacilli DNA,as well as Tuberculin skin test (TST) and QuantiFERON-TB gold test (QFT),were examined.Colonoscopic records recorded on the basis of Sato's classification were also reviewed,in addition to data from intestinal biopsies examined for histopathological findings,including hematoxylin and eosin staining,and ZN staining,as well as M.tuberculosis culture,and PCR for tubercle bacilli DNA.For the present study,archived formalin-fixed paraffin-embedded (FFPE) intestinal tissue samples were immunohistochemically stained using a commercially available species-specific monoclonal antibody to the 38-kDa antigen of the M.tuberculosis complex.These sections were also stained with the pan-macrophage marker CD68 antibody.RESULTS:From the clinical data,we found that no patients were immunocompromised,and that the main symptoms were diarrhea and weight loss.Three patients displayed active pulmonary TB,six patients (60％) had a positive TST,and 4 patients (40％) had a positive QFT.Colonoscopic findings revealed that all patients had type 1 findings (linear ulcers in a circumferential arrangement or linear ulcers arranged circumferentially with mucosa showing multiple nodules),all of which were located in the right hemicolon and/or terminal ileum.Seven patients (70％) had concomitant healed lesions in the ileocecal area.No acid-fast bacilli were detected with ZN staining of the intestinal tissue samples,and both M.tuberculosis culture and PCR for tubercle bacilli DNA were negative in all samples.The histopathological data revealed that tuberculous granulomas were present in 4 cases (40％).IHC staining in archived FFPE samples with anti-M.tuberculosis monoclonal antibody revealed positive findings in 4 patients (40％); the same patients in which granulomas were detected by hematoxylin and eosin staining.M.tuberculosis antigens were found to be mostly intracellular,granular in pattern,and primarily located in the CD68+ macrophages of the granulomas.CONCLUSION:IHC staining with a monoclonal antibody to M.tuberculosis may be an efficient and simple diagnostic tool in addition to classic examination methods for the diagnosis of intestinal TB.
      原文链接:
    • NETL
    • NSTL
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    • 维普

    -449 C＞G polymorphism of NFKB1 gene, coding nuclear factor-kappa-B, is associated with the susceptibility to ulcerative colitis

    Ranji HayashiTomomitsu TaharaTsukasa YamaakiTakashi Saito...
    6981-6986页
    查看更多>>摘要：AIM:To clarify the association between a polymorphism-449 C＞G (rs72696119) in 5'-UTR of NFKB1 with ulcerative colitis (UC).METHODS:The studied population comprised 639subjects,including patients with UC (UC cases,n =174) and subjects without UC (controls,n =465).We employed polymerase chain reaction-single strand conformation polymorphism to detect the gene polymorphism.RESULTS:The rs72696119 G allele frequencies in controls and UC cases were 33.4％ and 38.5％,respectively (P =0.10).Genotype frequency of the GG homozygote in UC cases was significantly higher than that in controls (P =0.017),and the GG homozygote was significantly associated with susceptibility to UC [odds ratio (OR),1.88; 95％CI,1.13-3.14].In male subjects,the GG homozygote was associated with an increased risk for UC (OR,3.10; 95％CI,1.47-6.54; P =0.0053),whereas this association was not found in female subjects.In addition,the GG homozygote was significantly associated with the risk of non-continuous disease (OR,2.06; 95％CI,1.12-3.79; P =0.029),not having total colitis (OR,2.40; 95％CI,1.09-3.80,P =0.040),disease which developed before 20 years of age (OR,2.80; 95％CI,1.07-7.32,P =0.041),no hospitalization (OR,2.28; 95％CI,1.29-4.05; P =0.0090) and with a maximum of 8 or less on the UCDAI score (OR,2.45;95％CI,1.23-4.93; P =0.022).CONCLUSION:Our results provide evidence that NFKB1 polymorphism rs72696119 was significantly associated with the development of UC.This polymorphism influences the susceptibility to and pathophysiological features of UC.
      原文链接:
    • NETL
    • NSTL
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    Treatment strategies using adefovir dipivoxil for individuals with lamivudine-resistant chronic hepatitis B

    Tae Jung YunJin Yong JungChang Ha KimSoon Ho Um...
    6987-6995页
    查看更多>>摘要：AIM:To investigate retrospectively the long-term efficacy of various treatment strategies using adefovir dipivoxil (adefovir) in patients with lamivudine-resistant chronic hepatitis B.METHODS:We included 154 consecutive patients in two treatment groups:the "add-on" group (n =79),in which adefovir was added to ongoing lamivudine treatment due to lamivudine resistance,and the "switch/combination" group (n =75),in which lamivudine was first switched to adefovir and then re-added later as needed.The "switch/combination" group was then divided into two subgroups depending on whether participants followed (group A,n =30) or violated (group B,n =45) a proposed treatment strategy that determined whether to add lamivudine based on the serum hepatitis B virus (HBV) DNA levels (＜ 60 IU/mL or not) after 6 mo of treatment (roadmap concept).RESULTS:The cumulative probability of virologic response (HBV DNA ＜ 60 IU/mL) was higher in group A than in the "add-on" group and in group B (P ＜ 0.001).In contrast,the cumulative probability of virologic breakthrough was lower in the "add-on" group than in group B (P =0.002).Furthermore,the risk of virologic breakthrough in the multivariate analysis was significantly lower in the "add-on" group than in group A (hazard ratio =0.096; 95％CI,0.015-0.629; P =0.015).CONCLUSION:The selective combination of adefovir with lamivudine based upon early treatment responses increased the odds of virologic breakthrough relative to the use of uniform combination therapy from the beginning of treatment.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Tenofovir rescue therapy for chronic hepatitis B patients after multiple treatment failures

    Yu Jin KimDong Hyun SinnGeum-Youn GwakMoon Seok Choi...
    6996-7002页
    查看更多>>摘要：AIM:To evaluate the efficacy and safety of tenofovir disoproxil fumarate (TDF) for chronic hepatitis B (CHB)patients after multiple failures.METHODS:A total of 29 CHB patients who had a suboptimal response or developed resistance to two or more previous nucleoside/nucleotide analogue (NA)treatments were included.Study subjects were treated with TDF alone (n =13) or in combination with lamivudine （LAM,n =12) or entecavir (ETV,n =4) for ≥ 6mo.Complete virologic response (CVR) was defined as an achievement of serum hepatitis B virus (HBV) DNA level ≤ 60 IU/mL by real-time polymerase chain reaction method during treatment.Safety assessment was based on serum creatinine and phosphorus level.Eleven patients had histories of LAM and adefovir dipivoxil (ADV) treatment and 18 patients were exposed to LAM,ADV,and ETV.Twenty-seven patients (93.1％) were hepatitis B e antigen (HBeAg) positive and the mean value of the baseline serum HBV DNA level was 5.5 log IU/mL ± 1.7 log IU/mL.The median treatment duration was 16 mo (range 7 to 29 mo).RESULTS:All the patients had been treated with LAM and developed genotypic and phenotypic resistance to it.Resistance to ADV was present in 7 patients and 10 subjects had a resistance to ETV.One patient had a resistance to both ADV and ETV.The cumulative probabilities of CVR at 12 and 24 mo of TDF containing treatment regimen calculated by the Kaplan Meier method were 86.2％ and 96.6％,respectively.Although one patient failed to achieve CVR,serum HBV DNA level decreased by 3.9 log IU/mL from the baseline and the last serum HBV DNA level during treatment was 85 IU/mL,achieving near CVR.No patients in this study showed viral breakthrough or primary non-response during the follow-up period.The cumulative probability of HBeAg clearance in the 27 HBeAg positive patients was 7.4％,12％,and 27％ at 6,12,and 18 mo of treatment,respectively.Treatment efficacy of TDF containing regimen was not statistically different according to the presence of specific HBV mutations.History of prior exposure to specific antiviral agents did not make a difference to treatment outcome.Treatment efficacy of TDF was not affected by combination therapy with LAM or ETV.No patient developed renal toxicity and no cases of hypophosphatemia associated with TDF therapy were observed.There were no other adverse events related to TDF therapy observed in the study subjects.CONCLUSION:TDF can be an effective and safe rescue therapy in CHB patients after multiple NA therapy failures.
      原文链接:
    • NETL
    • NSTL
    • 万方数据
    • 维普

    Interleukin-28 and hepatitis C virus genotype-4: Treatment-induced clearance and liver fibrosis

    Moutaz DerbalaNasser RizkFatima SheblSaad Alkaabi...
    7003-7008页
    查看更多>>摘要：AIM:To investigate the association between interleukin-28B (IL28B) genotype and response to treatment and hepatic fibrosis in patients with hepatitis C virus (HCV) genotype 4.METHODS:Two hundred and one HCV-genotype 4 patients were included.All patients were treated with Peginterferon alph2a/Ribavirin for 48 wk.End of treatment response (ETR) was defined as loss of detectable serum HCV RNA at the end of treatment.Sustained viral response (SVR) was defined as loss of detectable serum HCV RNA at the end of 24 wk follow up.Genotyping of IL28B rs12979860 was performed using the TaqMan assay.We used logistic regression to estimate the adjusted odds ratio (aOR) and 95％CI.RESULTS:The study included 201 HCV-genotype 4 patients.The majority of patients were men (89.6％),with a median age of 47 years,inter-quartile range (40-51).Approximately 62.5％ of patients had ETR,and 49.6％ had SVR.Individuals who achieved SVR were more likely to be younger （x2 =4.91,P =0.027),and less likely to have fibrosis (x2=15.54,P ＜ 0.0001),or inflammation (x2 =7.58,P =0.006).The genotype distribution of rs12979860 was 36.2％,49.0％ and 14.8％ for genotypes CC,CT,and TT,respectively.In these participants,rs12979860 genotype distribution did not differ by gender (P =0.466),pretreatment viral load (P =0.600),inflammation (P =0.435),or fibrosis (P =0.291).The frequencies of IL28B rs12979860genotypes were TT (14.8％),CT (49.0％),and CC (36.2％).Compared to rs12979860 genotype TT,aORs (95％CI) for ETR and SVR were:CC genotype,[17.55(5.34-57.69) and 5.92 (2.09-16.76),respectively]; CT genotype,[5.15 (1.80-14.78) and 2.48 (0.94-6.52),respectively].In the current study,the patients who did not achieve ETR or SVR had a lower prevalence of rs12979860 CC (17.4％ and 23.3％,respectively) than individuals who had ETR or SVR (47.9％ and 47.2％,respectively).Individuals with rs12979860 CC genotype had approximately 6 times the odds of SVR compared to individuals with TT genotype (aOR =5.92; 95％C1:2.09-16.76).Similarly,patients with CT genotype had SVR more often than patients with TT genotype(aOR =2.48; 95％CI:0.94-6.52).Carrying at least one copy of the C allele (genotypes CT and CC) had almost 8 times the probability of ETR compared to those with genotype rs12979860 TT (aOR =7.87; 95％CI:2.84-21.82),and approximately 3 times the odds of SVR compared to those with genotype rs12979860 TT (aOR =3.46; 95％CI:1.37-8.74).In addition,data were consistent with a significant gene-dose relationship (aOR =4.05/allele; 95％CI:2.27-7.22).The association between rs12979860 genotype and SVR was similar among those who achieved and those who did not achieve SVR.CONCLUSION:In HCV-genotype 4 patients,rs12979860 is a sensitive predictor of viral clearance,independent of viral load,age,gender or fibrosis,with no similar relation to severity of fibrosis.
      原文链接:
    • NETL
    • NSTL
    • 万方数据

    Predictive factors of endoscopic submucosal dissection procedure time for gastric superficial neoplasia

    Zhong-Sheng LuYun-Sheng YangDan FengShu-Fang Wang...
    7009-7014页
    查看更多>>摘要：AIM:To identify the determinants of endoscopic submucosal dissection (ESD) operation time.METHODS:This investigation was conducted as a single-center,prospective study in which ESD was performed by the same endoscopist at the Chinese PLA General Hospital.A total of 173 patients underwent ESD operations performed by Dr.Lu from July 2007 to December 2011,and 183 lesions were enrolled.Patient gender,age,tumor location,gross type,tumor size,pathological type and adhesions were recorded prospectively.The order of treatment represented the experience of the operator.Univariate analysis and multivariate analysis were performed to evaluate the relationships between these factors and ESD procedure time.RESULTS:Univariate analysis showed the ESD time was closely related to the gender (P =0.0210),tumor size (P ＜ 0.0001),location (P ＜ 0.0001),gross type (P ＜ 0.0001) and adhesion (P =0.0010).The surgical proficiency level was associated with ESD time in unit area (P ＜ 0.0001).Multivariate analysis revealed that the ESD time was positively correlated with tumor size (P ＜ 0.0001),adhesion (P ＜ 0.0001) and location (P ＜0.0001),but negatively correlated with surgical proficiency level (P =0.0046).CONCLUSION:Large tumor size,adjacency to the cardia,and adhesion are predictors of a long ESD time,whereas high surgical proficiency level predicts a short ESD time.
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    • 万方数据
    • 维普