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| 1 | Clinical features and prognosis of patients with extrahepatic metastases from hepatocellular carcinoma显示文摘AIM: To assess the clinical features and prognosis of 151 patients with extrahepatic metastases from primary hepatocellular carcinoma (HCC), and describe the treatment strategy for such patients. METHODS: After the diagnosis of HCC, all 995 consecutive HCC patients were followed up at regular intervals and 151 (15.2%) patients were found to have extrahepatic metastases at the initial diagnosis of primary HCC or developed such tumors during the follow-up period. We assessed their clinical features, prognosis, and treatment strategies. RESULTS: The most frequent site of extrahepatic metastases was the lungs (47%), followed by lymph nodes (45%), bones (37%), and adrenal glands (12%). The cumulative survival rates after the initial diagnosis of extrahepatic metastases at 6, 12, 24, and 36 mo were 44.1%, 21.7%, 14.2%, 7.1%, respectively. The median survival time was 4.9 mo (range, 0-37 mo). Fourteen patients (11%) died of extrahepatic HCC, others died of primary HCC or liver failure. CONCLUSION: The prognosis of HCC patients with extrahepatic metastases is poor. With regard to the cause of death, many patients would die of intrahepatic HCC and few of extrahepatic metastases. Although most of HCC patients with extrahepatic metastases should undergo treatment for the primary HCC mainly, treatment of extrahepatic metastases in selected HCC patients who have good hepatic reserve, intrahepatictumor stage (T0-T2), and are free of portal venous invasion may improve survival. | Kiminori Uka Hiroshi Aikata Shintaro Takaki Hiroo Shirakawa Soo Cheol Jeong Keitaro Yamashina Akira Hiramatsu Hideaki Kodama Shoichi Takahashi Kazuaki Chayama | 2007 | World Journal of Gastroenterology2007，13，3： | 44 |
| 2 | 1995-2005年青海省棘球蚴病流行病学调查分析显示文摘目的分析1995-2005年青海省人与动物棘球蚴病的流行病学调查结果。方法人群棘球蚴病感染情况以Bu-ELISA、EM18-ELISA和B超、X线进行检查和评价。动物棘球蚴病/棘球绦虫感染调查采用解剖学方法和寄生虫学方法。结果①女性人群的血清阳性率和患病率显著高于男性人群(14.41%和4.81%、10.22%和3.25%);随年龄增长,人群血清阳性率和患病率升高(见表5);以牧民、喇嘛的血清阳性率和患病率最高(17.73%和9.33%、18.56%和10.0%)。②青海省人与动物棘球蚴病/棘球绦虫的血清阳性率和感染/患病率以青南高原的果洛、玉树、黄南三州最高(见表1、7、8),祁连山地和河湟谷地的海南、海北两州次之,海东地区、西宁及柴达木盆地的海西州较低。③青海省是以囊型棘球蚴病/细粒棘球绦虫为主的囊型和泡型棘球蚴病的混合流行区,并在其南部发现存在石渠棘球绦虫的动物感染。结论青海省棘球绦虫的生活史循环链十分复杂,家养动物相互之间、野生动物相互之间、家养动物和野生动物之间均参与其中。 | 王虎 张静宵 Schantz P M Akira Ito P S craig 吴献洪 韩秀敏 | 2006 | 中国人兽共患病学报2006，22，12： | 37 |
| 3 | 四川省西部藏区家庭饲养牲畜人群包虫病风险因素的调查(英文)显示文摘目的 寻找四川省西部藏区家庭饲养牲畜人群包虫病的风险因素。方法 用问卷调查的方式收集有关包虫病风险因素的数据。以家庭饲养家畜的人群作为分析细粒棘球蚴病和泡球蚴病风险因素的研究对象。结果 本调查揭示了犬是这些地区泡球蚴病的最重要传染源。 19岁以下的人群大多患细粒棘球蚴病而非泡球蚴病 ,19~ 38岁的人群 ,尤其是妇女 ,增加感染泡球蚴病的风险 (女对男OR =2 438,CI =1 317~ 4 5 14,P <0 0 5 )。游牧、年龄大、耍犬及食物不防蝇等可增加患细粒棘球蚴病和泡球蚴病的机会。此外 ,饲养牦牛或绵羊的人群患两型包虫病的风险均增大 ,饮用不安全水源致使患泡球蚴病的可能性增加。结论 除年龄、性别、环境状况及卫生行为外 ,饲养牦牛或羊和耍犬也增加了患包虫病的风险。 | 王谦 邱加闽 Peter Schantz 何金戈 Akira lto 刘风洁 | 2001 | 中国寄生虫学与寄生虫病杂志2001，19，2： | 37 |
| 4 | Changes in growth factor and cytokine expression in biliary obstructed rat liver and their relationship with delayed liver regeneration after partial hepatectomy显示文摘瞄准:在部分肝切除术以后在肝新生上学习妨碍的黄疸的效果。方法: Hepatocyte 生长因素( HGF ),它的受体, 遇见c ,脉管的内皮生长因素( VEGF )和转变生长在肝织物和孤立的肝细胞的 factor-beta1 ( TGF-beta1 ) mRNA 表示被量的反向抄写的聚合酶链反应( RT-PCR )用 LightCycler 在胆汁的阻塞( BO )以后调查。为 desmin 和 alpha 光滑的肌肉肌动朊(alpha-SMA ) 染色的 Immunohistochemical 也被学习。标记的原子抗原(PCNA ) 索引的再生肝重量和增殖的房间,和生长因素表示然后与伴随物在 70% 肝切除术以后被评估在 BO 老鼠或假冒操作老鼠的内部胆汁的排水。结果:肝的 TGF-beta1 mRNA 层次显著地在 BO 以后增加了 14 天,并且进一步与胆汁郁积的持续时间增加了。同时, HGF 和 VEGF 趋于增加,但是不是重要的。在房间孤立, TGF-beta1 mRNA 主要在肝的星形的房间(HSC ) 被发现部分。Immunohistochemical 研究揭示了 HSC (desmin 积极的房间) 的一个增加的数字并且在 BO 以后在门区域激活 HSC (alpha-SMA-positive 房间) 。在一个肝切除术模型,肝新生在 BO 老鼠被推迟,作为与假冒操作老鼠相比。在肝切除术,和更早的 HGF mRNA 山峰沉醉于 BO 老鼠以后, TGF-beta1 mRNA 是显著地起来调整的直到 48 h。结论:BO 导致 HSC 增长和激活,导致 TGF-beta1 mRNA 的起来规定和在肝的 HGF mRNA 的抑制。这些改变的表示模式可以强烈与妨碍的黄疸在肝切除术以后涉及推迟的肝新生。 | Hironobu Makino Hiroaki Shimizu Hiroshi Ito Fumio Kimura Satoshi Ambiru Akira Togawa Masayuki Ohtsuka Hiroyuki Yoshidome Atsushi Kato Hideyuki Yoshitomi Shigeaki Sawada Masaru Miyazaki | 2006 | World Journal of Gastroenterology2006，12，13： | 32 |
| 5 | 四川西部藏区包虫病流行病学研究──Ⅰ.囊型包虫病与泡型包虫病人群感染特点与分布趋势显示文摘本文报告四川西部藏区两型包虫病(Hydatidosis,HD)人群感染特点与分布趋势。在石渠县与甘孜县的8个调查点,采用以B超与X光检查为主,辅以Dot-ELISA与Eml8blot血清学试验的方法对3999人的检查结果,人群平均感染率4.03%。其中细粒棘蚴病(CysticEchinococcosis,CE)2.13%,泡球蚴病(AlveolarEchinococcossi,AE)1.90%。女性感染率略高于男性,性别分布无明显差异。年龄分布显示中老年是高发人群。CE患者平均年龄38.8岁,AE为45.6岁。在不同经济类型地区,纯牧业乡的病情尤为严重,牧区>城区>农区的这种趋势极为明显。职业分布显示牧民是高危人群,HD感染率达7.01%—13.53%。AE患者亦以牧民最多,石渠县与甘孜县牧民AE感染率分别达6.06%、4.46%。此外,人群中文盲及受教育程度低者患者较多,随着文化水平提高人群感染率逐渐降低的趋势明显。 | 邱加闽 刘凤洁 Schantz Peter Akira Ito Carol Delker 何金戈 张奕 陈兴旺 | 2000 | 中国人兽共患病杂志2000，16，2： | 34 |
| 6 | Clinical features of gastroduodenal injury associated with long-term low-dose aspirin therapy显示文摘Low-dose aspirin(LDA) is clinically used for the prevention of cardiovascular and cerebrovascular events with the advent of an aging society.On the other hand,a very low dose of aspirin(10 mg daily) decreases the gastric mucosal prostaglandin levels and causes significant gastric mucosal damage.The incidence of LDAinduced gastrointestinal mucosal injury and bleeding has increased.It has been noticed that the incidence of LDA-induced gastrointestinal hemorrhage has increased more than that of non-aspirin non-steroidal anti-inflammatory drug(NSAID)-induced lesions.The pathogenesis related to inhibition of cyclooxygenase(COX)-1 includes reduced mucosal flow,reduced mucus and bicarbonate secretion,and impaired platelet aggregation.The pathogenesis related to inhibition of COX-2 involves reduced angiogenesis and increased leukocyte adherence.The pathogenic mechanisms related to direct epithelial damage are acid back diffusion and impaired platelet aggregation.The factors associated with an increased risk of upper gastrointestinal(GI) complications in subjects taking LDA are aspirin dose,history of ulcer or upper GI bleeding,age > 70 years,concomitant use of non-aspirin NSAIDs including COX-2-selective NSAIDs,and Helicobacter pylori(H.pylori) infection.Moreover,no significant differences have been found between ulcer and non-ulcer groups in the frequency and severity of symptoms such as nausea,acid regurgitation,heartburn,and bloating.It has been shown that the ratios of ulcers located in the body,fundus and cardia are significantly higher in bleeding patients than the ratio of gastroduodenal ulcers in patients taking LDA.Proton pump inhibitors reduce the risk of developing gastric and duodenal ulcers.In contrast to NSAIDinduced gastrointestinal ulcers,a well-tolerated histamine H2-receptor antagonist is reportedly effective in prevention of LDA-induced gastrointestinal ulcers.The eradication of H.pylori is equivalent to treatment with omeprazole in preventing recurrent bleeding.Continuous aspirin therapy for patients with gastrointestinal bleeding may increase the risk of recurrent bleeding but potentially reduces the mortality rates,as stopping aspirin therapy is associated with higher mortality rates.It is very important to prevent LDA-induced gastroduodenal ulcer complications including bleeding,and every effort should be exercised to prevent the bleeding complications. | Junichi Iwamoto Yoshifumi Saito Akira Honda Yasushi Matsuzaki | 2013 | World Journal of Gastroenterology2013，19，11： | 29 |
| 7 | Usefulness of biodegradable stents constructed of poly-l-lactic acid monofilaments in patients with benign esophageal stenosis显示文摘AIM: To report 13 patients with benign esophageal stenosis treated with the biodegradable stent. METHODS: We developed a Ultraflex-type stent by knitting poly-l-lactic acid monofilaments. RESULTS: Two cases were esophageal stenosis caused by drinking of caustic liquid, 4 cases were due to surgical resection of esophageal cancers, and 7 cases were patients with esophageal cancer who received the preventive placement of biodegradable stents for post- endoscopic mucosal dissection (ESD) stenosis. The preventive placement was performed within 2 to 3 d after ESD. In 10 of the 13 cases, spontaneous migration of the stents occurred between 10 to 21 d after placement. In these cases, the migrated stents were excreted with the feces, and no obstructive complications were experienced. In 3 cases, the stents remained at the proper location on d 21 after placement. No symptoms of re-stenosis were observed within the follow-up period of 7 mo to 2 years. Further treatment with balloon dilatation or replacement of the biodegradable stent was not required. CONCLUSION: Biodegradable stents were useful for the treatment of benign esophageal stenosis, particularly for the prevention of post-ESD stenosis. | Yasuharu Saito Toyohiko Tanaka Akira Andoh Hideki Minematsu Kazunori Hata Tomoyuki Tsujikawa Norihisa Nitta Kiyoshi Murata Yoshihide Fujiyama | 2007 | World Journal of Gastroenterology2007，13，29： | 30 |
| 8 | Spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein显示文摘Preservation of the spleen at distal pancreatectomy has recently attracted considerable attention.Since our first successful trial,spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein for tumors of the pancreas and chronic pancreatitis has been performed more frequently.The technique for spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein are outlined.The splenic vein is identified behind the pancreas and within the thin connective tissue membrane.The connective tissue membrane is cut longitudinally above the splenic vein.An important issue is to remove the splenic vein from the body of the pancreas toward the spleen,since a different approach may be very difficult.The pancreas is preferably removed from the splenic artery toward the head of the pancreas itself.This procedure is much easier than removing the pancreas from the vein side.One patient had undergone distal gastrectomy for duodenal ulcer,with reconstruction by Billroth Ⅱ tehcnique.If distal pancreatectomy with splenectomy had been performed for the lesion of the distal pancreas at the time,the residual stomach would also have to be resected.The potential damage done to the patient by reconstruction of the gastrointestinal tract in combination with distal pancreatectomy and splenectomy would have been much greater than with distal pancreatectomy only with preservation of the spleen and residual stomach.Benign lesions as well as low-grade malignancy of the body and tail of the pancreas may be a possible indication for this procedure. | Wataru Kimura Toshiyuki Moriya Jinfeng Ma Yukinori Kamio Toshihiro Watanabe Mitsukiro Yano Hiroto Fujimoto Koji Tezuka Ichiro Hirai Akira Fuse | 2007 | World Journal of Gastroenterology2007，13，10： | 24 |
| 9 | Sutureless small incision extracapsular cataract extraction显示文摘 | Junsuke Akura MD Akira Momose MD 马静 张效房 | 2000 | 眼外伤职业眼病杂志2000，22，5： | 23 |
| 10 | Mucosal cytokine network in inflammatory bowel disease显示文摘Inflammatory bowel disease (IBD), ulcerative colitis (UC) and Crohn's disease (CD) are characterized by ongoing mucosal inflammation in which dysfunction of the host immunologic response against dietary factors and commensal bacteria is involved. The chronic in-flammatory process leads to disruption of the epithelial barrier, and the formation of epithelial ulceration. This permits easy access for the luminal microbiota and dietary antigens to cells resident in the lamina pro-pria, and stimulates further pathological immune cell responses. Cytokines are essential mediators of the interactions between activated immune cells and non-immune cells, including epithelial and mesenchymal cells. The clinical efficacy of targeting TNF-α clearly indicates that cytokines are the therapeutic targets in IBD patients. In this manuscript, we focus on the bio-logical activities of recently-reported cytokines [Inter-leukin (IL)-17 cytokine family, IL-31 and IL-32], which might play a role through interaction with TNF-α in the pathophysiology of IBD. | Akira Andoh Yuhki Yagi Makoto Shioya Atsushi Nishida Tomoyuki Tsujikawa Yoshihide Fujiyama | 2008 | World Journal of Gastroenterology2008，14，33： | 21 |
| 11 | Efficacy of mosapride citrate with polyethylene glycol solution for colonoscopy preparation显示文摘AIM:To evaluate the efficacy and safety of adjunctive mosapride citrate for bowel preparation before colonoscopy. METHODS:We conducted a randomized,double-blind, placebo-controlled study with mosapride in addition to polyethylene glycol(PEG)-electrolyte solution.Of 250 patients undergoing colonoscopy,124 were randomized to receive 2 L PEG plus 15 mg of mosapride citrate (mosapride group),and 126 received 2 L PEG plus placebo(placebo group).Patients completed a questionnaire reporting the acceptability and tolerability of the bowel preparation process.The efficacy of bowel preparation was assessed by colonoscopists using a 5-point scale based on Aronchick's criteria.The primary end point was optimal bowel preparation rates(scores of excellent/good/fair vs poor/inadequate). RESULTS:A total of 249 patients were included in the analysis.In the mosapride group,optimal bowel preparation rates were significantly higher in the left colon compared with the placebo group(78.2%vs 65.6%,P<0.05),but not in the right colon(76.5%vs 66.4%,P=0.08).After excluding patients with severe constipation,there was a significant difference in bowel preparation in both the left and right colon(82.4%vs 66.7%,80.8%vs 67.5%,P<0.05,P<0.01).The incidence of adverse events was similar in both groups. Among the subgroup who had previous colonoscopy experience,a significantly higher number of patients in the mosapride group felt that the current preparation was easier compared with patients in the placebo group(34/72 patients vs 24/74 patients,P<0.05). CONCLUSION:Mosapride citrate may be an effective and safe adjunct to PEG-electrolyte solution that leads to improved quality of bowel preparation,especially in patients without severe constipation. | Masahiro Tajika Yasumasa Niwa Vikram Bhatia Hiroki Kawai Shinya Kondo Akira Sawaki Nobumasa Mizuno Kazuo Hara Susumu Hijioka Kazuya Matsumoto Yuji Kobayashi Akira Saeki Asana Akabane Koji Komori Kenji Yamao | 2012 | World Journal of Gastroenterology2012，18，20： | 21 |
| 12 | Case of clear-cell hepatocellular carcinoma that developed in the normal liver of a middle-aged woman显示文摘A 36-year-old woman was admitted to our department for close examination of a liver tumor that was found during a medical checkup. Abdominal US, CT and MRI showed a tumor in segment 7 (S7) of the liver. Although imaging suggested hepatocellular carcinoma, laboratory tests showed no abnormality in liver function, hepatitis virus markers were negative, and tumor markers including protein induced by vitamin K absence or antagonist Ⅱ (PIVKA-Ⅱ), α-fetoprotein (AFP), carbohydrate antigen 19-9 (CA19-9), and carcinoembryonic antigen (CEA) were all within normal ranges. Upon aspiration biopsy of the liver, the histopathological diagnosis was moderately differentiated hepatocellular carcinoma. Therefore, right hepatectomy was performed. Although a part of the tumor was necrotic, about 60% of the viable part showed a clear-cell variant. Consequently, it was diagnosed as clear-cell hepatocellular carcinoma. It was noted that the background liver tissue was normal. This case is worthy of reporting because development of clear-cell hepatocellular carcinoma in the normal liver of a middle-aged woman is rarely seen. | Atsushi Takahashi Hironobu Saito Yukiko Kanno Kazumichi Abe Junko Yokokawa Atsushi Irisawa Akira Kenjo Takuro Saito Mitsukazu Gotoh Hiromasa Ohira | 2008 | World Journal of Gastroenterology2008，14，1： | 20 |
| 13 | 青海省果洛州人与动物棘球蚴病调查显示文摘目的 通过对青海省果洛州人群与动物棘球蚴病的调查与分析,了解当地棘球蚴病在人群和动物中的流行与分布状况。方法 应用B超对人群进行患病率调查;囊液抗原间接血凝试验(IHA)法筛查人群棘球蚴抗体的阳性率;并分别用重组Em18(rEm18)、重组抗原B(rAgB)和Eg囊液抗原(EgcF),对随机选取的B超检查和IHA检测阳性者进行ELISA试验,与B超诊断结果进行符合率比较,评价泡型棘球蚴病(AE)、囊型棘球蚴病(CE)的分布情况;应用ELISA检测家犬和藏狐粪抗原阳性率;现场检查牛、羊胸腹腔,确定牛、羊感染率。结果 人群调查:①B超检查2826人,总患病率为9.45%。血清IHA法检查1113人,阳性率25.79%。女性人群的患病率和血清阳性率均显著高于男性;②血清囊液抗原IHA检测阳性者(108)与ELISA法检测EgcF,阳性符合率为66.94%:3种重组抗原检测,ELISA法与IHA法阳性符合率为75.00%。③B 超法诊断棘球蚴病(88人)与ELISA法检测,符合率EgcF为94.32%,rAgB为68.18%,rEm18为51-4%。EgcF阳性率符合率为69.44%:3种抗原检测与IHA检测总体阳性符合率为75.00%。61例CE患者中,血清ELISA法检测,EgcF阳性率为96.72%,rAgB为68.85%,rEm18为33.33%;26例AE患者中,EgcF和rEm18阳性率均为92-31%,rAgB为65.39%。动物调查:①高原鼠兔棘球蚴感染率21.74%。经cytb基因分析,证实有多房棘球绦虫(E.muhilocularis)和石渠棘球绦虫(Eshiquicus)感染。绵羊棘球蚴感染率82.61%,牦牛棘球蚴感染率78.52%。②野犬、藏狐、猞猁均有不同程度的棘球绦虫感染。结论 青海省果洛州人群与动物中存在棘球蚴病的高度流行。E.shiquicus种的幼虫和成虫分别在高原鼠兔和藏狐体内寄生已得到证实,提示果洛州为3种棘球蚴的混合流行区。 | 王虎 马俊英 韩秀敏 吴献洪 肖宁 Akira Ito Philips Craig | 2007 | 中国地方病学杂志2007，26，5： | 20 |
| 14 | Trastuzumab in combination with chemotherapy versus chemotherapy alone for treatment of HER2-positive advanced gastric or gastro-oesophageal junction cancer (ToGA): a phase 3, open-label, randomised controlled trial显示文摘 | Yung-Jue Bang Eric Van Cutsem Andrea Feyereislova Hyun C Chung Lin Shen Akira Sawaki Florian Lordick Atsushi Ohtsu Yasushi Omuro Taroh Satoh Giuseppe Aprile Evgeny Kulikov Julie Hill Michaela Lehle Josef Rüschoff Yoon-Koo Kang | 2010 | The Lancet2010，，9742： | 20 |
| 15 | Helicobacter pylori-infected animal models are extremely suitable for the investigation of gastric carcinogenesis显示文摘Although various animal models have been developed to clarify gastric carcinogenesis, apparent mechanism of gastric cancer was not clarified in recent years. Since the recognition of the pathogenicity of Helicobacter pylori (Hpylori), several animal models with Hpylori infection have been developed to confirm the association between Hpylori and gastric cancer. Nonhuman primate and rodent models were suitable for this study. Japanese monkey model revealed atrophic gastritis and p53mutation after long-term infection of Hpylori. Mongolian gerbil model showed the development of gastric carcinoma with H pylori infection alone, as well as with combination of chemical carcinogens, such as N-methylN-nitrosourea and N-methyl-N-nitro-N'-nitrosoguanidine.The histopathological changes of these animal models after Hpylori inoculation are closely similar to those in human beings with Hpylori infection. Eradication therapy attenuated the development of gastric cancer in Hpyloriinfected Mongolian gerbil. Although several features of animal models differ from those seen in human beings,these experimental models provide a starting point for further studies to clarify the mechanism of gastric carcinogenesis as a result of Hpylori infection and assist the planning of eradication therapy to prevent gastric carcinoma. | Masaaki Kodama Kazunari Murakami Ryugo Sato Tadayoshi Okimoto Akira Nishizono Toshio Fujioka | 2005 | World Journal of Gastroenterology2005，11，45： | 19 |
| 16 | Xanthogranulomatous cholecystitis:Difficulty in differentiating from gallbladder cancer显示文摘AIM: To compare cases of xanthogranulomatous cholecystitis(XGC) and advanced gallbladder cancer and discuss the differential diagnoses and surgical options.METHODS: From April 2000 to December 2013, 6 XGC patients received extended surgical resections. During the same period, 16 patients were proven to have gallbladder(GB) cancer, according to extended surgical resection. Subjects chosen for analysis in this study were restricted to cases of XGC with indistinct borders with the liver as it is often difficult to distinguish these patients from those with advanced GB cancer. We compared the clinical features and computed tomography findings between XGC and advanced GB cancer. The following clinical features were retrospectively assessed: age, gender, symptoms, and tumor markers. As albumin and the neutrophil/lymphocyte ratio(NLR) are prognostic in several cancers, we compared serum albumin levels and the NLR between the two groups. The computerized tomography findings were used to compare the two diseases, determine the coexistence of gallstones, the pattern of GB thickening(focal or diffuse), the presence of a hypoattenuated intramural nodule, and continuity of the mucosal line.RESULTS: Based on the preoperative image findings, we suspected GB carcinoma in all cases includingXGC in this series. In addition, by pathological examination, we found that the group of patients with XGC developed inflammatory disease after surgery. Patients with XGC tended to have abdominal pain(4/6, 67%). However, there was no significant difference in clinical symptoms, including fever, between the two groups. Serum albumin and NLR were also similar in the two groups. Serum tumor markers, such as carcinoembryonic antigen(CEA) and carbohydrate antigen 19-9(CA19-9), tended to increase in patients with GB cancer. However, no significant differences in tumor markers were identified. On the other hand, gallstones were more frequently observed in patients with XGC(5/6, 83%) than in patients with GB cancer(4/16, 33%)(P = 0.0116). A hypoattenuated intramural nodule was found in 3 patients with XGC(3/6, 50%), but in only 1 patient with GB cancer(1/16, 6%)(P = 0.0024). The GB thickness, continuous mucosal line, and bile duct dilatation showed no significant differences between XGC and GB cancer.CONCLUSION: Although XGC is often difficult to differentiate from GB carcinoma, it is possible to obtain an accurate diagnosis by careful intraoperative gross observation, and several intraoperative frozen sections. | Hideki Suzuki Satoshi Wada Kenichiro Araki Norio Kubo Akira Watanabe Mariko Tsukagoshi Hiroyuki Kuwano | 2015 | World Journal of Gastroenterology2015，21，35： | 18 |
| 17 | Maintenance for healed erosive esophagitis:PhaseⅢcomparison of vonoprazan with lansoprazole显示文摘AIM To compare vonoprazan 10 and 20 mg vs lansoprazole 15 mg as maintenance therapy in healed erosive esophagitis(EE).METHODS A total of 607 patients aged ≥ 20 years, with endoscopically-confirmed healed EE following 8 wk of treatment with vonoprazan 20 mg once daily, were randomized 1:1:1 to receive lansoprazole 15 mg(n = 201), vonoprazan 10 mg(n = 202), or vonoprazan 20 mg(n = 204), once daily. The primary endpoint of the study was the rate of endoscopically-confirmed EE recurrence during a 24-wk maintenance period. The secondary endpoint was the EE recurrence rate at Week 12 during maintenance treatment. Additional efficacy endpoints included the incidence of heartburn and acid reflux, and the EE healing rate 4 wk after the initiation of maintenance treatment. Safety endpoints comprised adverse events(AEs), vital signs, electrocardiogram findings, clinical laboratory results, serum gastrin and pepsinogen Ⅰ/Ⅱ levels, and gastric mucosa histopathology results.RESULTS Rates of EE recurrence during the 24-wk maintenance period were 16.8%, 5.1%, and 2.0% with lansoprazole 15 mg, vonoprazan 10 mg, and vonoprazan 20 mg, respectively. Vonoprazan was shown to be non-inferior to lansoprazole 15 mg(P < 0.0001 for both doses). In a post-hoc analysis, EE recurrence at Week 24 was significantly reduced with vonoprazan at both the 10 mg and the 20 mg dose vs lansoprazole 15 mg(5.1% vs 16.8%, P = 0.0002, and 2.0% vs 16.8%, P < 0.0001, respectively); by contrast, the EE recurrence rate did not differ significantly between the two doses of vonoprazan(P = 0.1090). The safety profiles of vonoprazan 10 and 20 mg were similar to that of lansoprazole 15 mg in patients with healed EE. Treatment-related AEs were reported in 11.4%, 10.4%, and 10.3% of patients in the lansoprazole 15 mg, vonoprazan 10 mg, and vonoprazan 20 mg arms, respectively.CONCLUSION Our findings confirm the non-inferiority of vonoprazan 10 and 20 mg to lansoprazole 15 mg as maintenance therapy for patients with healed EE. | Kiyoshi Ashida Katsuhiko Iwakiri Naoki Hiramatsu Yuuichi Sakurai Tetsuharu Hori Kentarou Kudou Akira Nishimura Eiji Umegaki | 2018 | World Journal of Gastroenterology2018，24，14： | 18 |
| 18 | Vascular endothelial growth factor and angiopoietins regulate sinusoidal regeneration and remodeling after partial hepatectomy in rats显示文摘AIM: To study the regulatory mechanisms of sinusoidal regeneration after partial hepatectomy.METHODS: We investigated the expression of angiopoietin (Ang)-1, Ang-2, Tie-2, and vascular endothelial growth factor (VEGF) in regenerating liver tissue by quantitative reverse-transcription polymerase chain reaction (RT-PCR) using a LightCycler (Roche Diagnostics) and also immunohistochemical staining after 70% hepatectomy in rats. In the next step, we isolated liver cells (hepatocytes,sinusoidal endothelial cell (SEC), Kupffer cell, and hepatic stellate cells (HSC)) from regenerating liver tissue by in situ collagenase perfusion and counterflow elutriation,to determine potential cellular sources of these angiogenic factors after hepatectomy. Proliferation and apoptosis of SECs were also evaluated by proliferating cell nuclear antigen (PCNA) staining and the terminal deoxynucleotidyl transferase d-uridine triphosphate nick end labeling (TUNEL) assay, respectively.RESULTS: VEGF mRNA expression increased with a peak at 72 h after hepatectomy, decreasing thereafter.The expression of Ang-1 mRNA was present at detectable levels before hepatectomy and increased slowly with a peak at 96 h. Meanwhile, Ang-2 mRNA was hardly detected before hepatectomy, but was remarkably induced at 120 and 144 h. In isolated cells, VEGF mRNA expression was found mainly in the hepatocyte fraction.Meanwhile, mRNA for Ang-1 and Ang-2 was foundin the SEC and HSC fractions, but was more prominent in the latter. The PCNA labeling index of SECs increased slowly,reaching a peak at 72 h, whereas apoptotic SECs were detected between 120 h and 144 h.CONCLUSION: Ang-Tie system, together with VEGF,plays a critical role in regulating balance between SEC proliferation and apoptosis during sinusoidal regeneration after hepatectomy. However, the VEGF system plays a more important role in the early phase of sinusoidal regeneration than angiopoietin/Tie system. | Hiroaki Shimizu Noboru Mitsuhashi Masayuki Ohtsuka Hiroshi Ito Fumio Kimura Satoshi Ambiru Akira Togawa Hiroyuki Yoshidome Atsushi Kato Masaru Miyazaki | 2005 | World Journal of Gastroenterology2005，11，46： | 17 |
| 19 | Pneumatosis cystoides intestinalis following alpha-glucosidase inhibitor treatment:A case report and review of the literature显示文摘A 69-year-old man was diagnosed as having myasthenia gravis (MG) in September 2004,and treated with thymectomy and prednisolone. He was then diagnosed as having steroid-induced diabetes mellitus,and received sulfonylurea (SU) therapy in May 2005. An alpha-glucosidase inhibitor (αGI) was added in March 2006,resulting in good glycemic control. He experienced symptoms of abdominal distention,increased flatus,and constipation in October 2007,and was admitted into our hospital in late November with hematochezia. Plain abdominal radiography revealed small linear radiolucent clusters in the wall of the colon. Computed tomography (CT) showed intramural air in the sigmoid colon. Colonoscopy revealed multiple smooth surfaced hemispherical protrusions in the sigmoid colon. The diagnosis of pneumatosis cystoides intestinalis (PCI) was made on the basis of these findings. As the αGI voglibose was suspected as the cause of this patient's PCI,treatment was conservative,ceasing voglibose,with fasting and fluid supplementation. The patient progressed well,and was discharged 2 wk later. Recently,several reports of PCI associated with αGI therapy have been published,predominantly in Japan where αGIs are commonly used. If the use of αGIs becomes more widespread,we can expect more reports of this condition on a global scale. The possibility of PCI should be considered in diabetic patients complaining of gastrointestinal symptoms,and the gastrointestinal tract should be thoroughly investigated in these patients. | Tatsuhiro Tsujimoto Erika Shioyama Kei Moriya Hideto Kawaratani Yasuyo Shirai Masahisa Toyohara Akira Mitoro Jun-ichi Yamao Hisao Fujii Hiroshi Fukui | 2008 | World Journal of Gastroenterology2008，14，39： | 16 |
| 20 | Helicobacter pylori infection and liver diseases: Epidemiology and insights into pathogenesis显示文摘Both Helicobacter pylori(H. pylori) infection and liver diseases, including nonalcoholic fatty liver disease(NAFLD), viral hepatitis, and hepatocellular carcinoma(HCC), have high prevalences worldwide, and the relationship between H. pylori infection and liver disease has been discussed for many years. Although positive correlations between H. pylori and NAFLD have been identified in some clinical and experimental studies, nega-tive correlations have also been obtained in high-quality clinical studies. Associations between H. pylori and the pathogenesis of chronic viral hepatitis, mainly disease progression with fibrosis, have also been suggested in some clinical studies. Concerning HCC, a possible role for H. pylori in hepatocarcinogenesis has been identified since H. pylori genes have frequently been detected in resected HCC specimens. However, no study hasrevealed the direct involvement of H. pylori in promoting the development of HCC. Although findings regarding the correlations between H. pylori and liver disease pathogenesis have been accumulating, the existing data do not completely lead to an unequivocal conclusion. Further high-quality clinical and experimental analyses are necessary to evaluate the efficacy of H. pylori eradication in ameliorating the histopathological changes observed in each liver disease. | Kazuya Okushin Takeya Tsutsumi Kazuhiko Ikeuchi Akira Kado Kenichiro Enooku Hidetaka Fujinaga Kyoji Moriya Hiroshi Yotsuyanagi Kazuhiko Koike | 2018 | World Journal of Gastroenterology2018，24，32： | 15 |
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