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| 1 | Portal vein thrombosis:Insight into physiopathology,diagnosis,and treatment显示文摘Portal vein thrombosis (PVT) is a relatively common complication in patients with liver cirrhosis, but might also occur in absence of an overt liver disease. Several causes, either local or systemic, might play an important role in PVT pathogenesis. Frequently, more than one risk factor could be identified; however, occasionally no single factor is discernable. Clinical examination, laboratory investigations, and imaging are helpful to provide a quick diagnosis, as prompt treatment might greatly affect a patient's outcome. In this review, we analyze the physiopathological mechanisms of PVT development, together with the hemodynamic and functional alterations related to this condition. Moreover, we describe the principal factors most frequently involved in PVT development and the recent knowledge concerning diagnostic and therapeutic procedures. Finally, we analyze the implications of PVT in the setting of liver transplantation and its possible influence on patients' future prognoses. | Francesca R Ponziani Maria A Zocco Chiara Campanale Emanuele Rinninella Annalisa Tortora Luca Di Maurizio Giuseppe Bombardieri Raimondo De Cristofaro Anna M De Gaetano Raffaele Landolfi Antonio Gasbarrini | 2010 | World Journal of Gastroenterology2010,16,2: | 75 |
| 2 | Microwave ablation of hepatocellular carcinoma显示文摘Although surgical resection is still the optimal treatment option for early-stage hepatocellular carcinoma(HCC) in patients with well compensated cirrhosis,thermal ablation techniques provide a valid nonsurgical treatment alternative,thanks to their minimal invasiveness,excellent tolerability and safety profile,proven efficacy in local disease control,virtually unlimited repeatability and cost-effectiveness.Different energy sources are currently employed in clinics as physical agents for percutaneous or intra-surgical thermal ablation of HCC nodules.Among them,radiofrequency(RF) currents are the most used,while microwave ablations(MWA) are becoming increasingly popular.Starting from the 90s',RF ablation(RFA) rapidly became the standard of care in ablation,especially in the treatment of small HCC nodules;however,RFA exhibits substantial performance limitations in the treatment of large lesions and/or tumors located near major heat sinks.MWA,first introduced in the Far Eastern clinical practice in the 80s',showing promising results but also severe limitations in the controllability of the emitted field and in the high amount of power employed for the ablation of large tumors,resulting in a poor coagulative performance and a relatively high complication rate,nowadays shows better results both in terms of treatment controllability and of overall coagulative performance,thanks to the improvement of technology.In this review we provide an extensive and detailed overview of the key physical and technical aspects of MWA and of the currently available systems,and we want to discuss the most relevant published data on MWA treatments of HCC nodules in regard to clinical results and to the type and rate of complications,both in absolute terms and in comparison with RFA. | Guido Poggi Nevio Tosoratti Benedetta Montagna Chiara Picchi | 2015 | World Journal of Hepatology2015,7,25: | 28 |
| 3 | Foveal avascular zone area and parafoveal vessel density measurements in different stages of diabetic retinopathy by optical coherence tomography angiography显示文摘AIM:To investigate foveal avascular zone(FAZ) and parafoveal vessel densities(PRVD) by means of optical coherence tomography angiography(OCTA) in diabetic patients with or without diabetic retinopathy(DR) and to assess the reproducibility of FAZ and PRVD measurements.METHODS:Sixty diabetic patients(60 eyes) with different stage of DR(graded according to the International Clinical Severity Scale for DR) and 20 healthy subjects underwent FAZ area and PRVD measurements using OCTA by two experienced examiners.FAZ area in all patients was also assessed using fluorescein angiography(FA).RESULTS:In subject with proliferative DR and with moderate-severe non proliferative DR,FAZ area was significantly increased compared to healthy controls(P=0.025 and P=0.050 respectively measured with OCTA and P=0.025 and P=0.048 respectively measured with FA).OCTA showed significantly less inter-observer variability compared to FA.Concordance correlation coefficient(CCC) for FAZ area measurements was 0.829(95%CI:0.736-0.891) P<0.001 with FA and 1.000(95%CI:0.999-1.000) P<0.001 with OCTA.CCC was 0.834(95%CI:0.746-0.893) P<0.001 and 0.890(95%CI:0.828-0.930) P<0.001 for parafoveal superficial and deep vessel density measurements,respectively.CONCLUSION:OCTA shows progressive increase of FAZ area and reduction of PRVD in both superficial and deep plexus at increasing DR severity.FAZ area and PRVD measurements using OCTA are highly reproducible. | Rodolfo Mastropasqua Lisa Toto Alessandra Mastropasqua Raffaella Aloia Chiara De Nicola Peter A Mattei Guido Di Marzio Marta Di Nicola Luca Di Antonio | 2017 | International Journal of Ophthalmology(English edition)2017,10,10: | 26 |
| 4 | Cardioprotection by remote ischemic conditioning: Mechanisms and clinical evidences显示文摘In remote ischemic conditioning(RIC), several cycles of ischemia and reperfusion render distant organ and tissues more resistant to the ischemia-reperfusion injury. The intermittent ischemia can be applied before the ischemic insult in the target site(remote ischemic preconditioning), during the ischemic insult(remote ischemic perconditioning) or at the onset of reperfusion(remote ischemic postconditioning). The mechanisms of RIC have not been completely defined yet; however, these mechanisms must be represented by the release of humoral mediators and/or the activation of a neural reflex. RIC has been discovered in the heart, and has been arising great enthusiasm in the cardiovascular field. Its efficacy has been evaluated in many clinical trials, which provided controversial results. Our incomplete comprehension of the mechanisms underlying the RIC could be impairing the design of clinical trials and the interpretation of their results. In the present review we summarize current knowledge about RIC pathophysiology and the data about its cardioprotective efficacy. | Alberto Aimo Chiara Borrelli Alberto Giannoni Luigi Emilio Pastormerlo Andrea Barison Gianluca Mirizzi Michele Emdin Claudio Passino | 2015 | World Journal of Cardiology2015,7,10: | 15 |
| 5 | Nonalcoholic fatty liver disease and aging: Epidemiology to management显示文摘Nonalcoholic fatty liver disease(NAFLD) is common in the elderly, in whom it carries a more substantial burden of hepatic(nonalcoholic steatohepatitis, cirrhosis and hepatocellular carcinoma) and extra-hepatic manifestations and complications(cardiovascular disease, extrahepatic neoplasms) than in younger age groups. Therefore, proper identification and management of this condition is a major task for clinical geriatricians and geriatric hepatologists. In this paper, the epidemiology and pathophysiology of this condition are reviewed, and a full discussion of the link between NAFLD and the aspects that are peculiar to elderly individuals is provided; these aspects include frailty, multimorbidity, polypharmacy and dementia. The proper treatment strategy will have to consider the peculiarities of geriatric patients, so a multidisciplinary approach is mandatory. Non-pharmacological treatment(diet and physical exercise) has to be tailored individually considering the physical limitations of most elderly people and the need for an adequate caloric supply. Similarly, the choice of drug treatment must carefully balance the benefits and risks in terms of adverse events and pharmacological interactions in the common context of both multiple health conditions and polypharmacy. In conclusion, further epidemiological and pathophysiological insight is warranted. More accurate understanding of the molecular mechanisms of geriatric NAFLD will help in identifying the most appropriate diagnostic and therapeutic approach for individual elderly patients. | Marco Bertolotti Amedeo Lonardo Chiara Mussi Enrica Baldelli Elisa Pellegrini Stefano Ballestri Dante Romagnoli Paola Loria | 2014 | World Journal of Gastroenterology2014,20,39: | 15 |
| 6 | Primary hepatic carcinoid:A case report and literature review显示文摘Carcinoids are tumors derived from neuroendocrine cells and often produce functional peptide hormones.Approximately 54.5% arise in the gastrointestinal tract and frequently metastasize to the liver.Primary hepatic carcinoid tumors(PHCT) are extremely rare;only 95 cases have been reported.A 65-year-old man came to our attention due to occasional ultrasound findings in absence of clinical manifestations.His previous medical history,since 2003,included an echotomography of the dishomogeneous parenchymal area but no focal lesions.A computed tomography scan performed in 2005 showed an enhanced pseudonodular-like lesion of about 2 cm.Cholangio-magnetic resonance imaging identified the lesion as a possible cholangiocarcinoma.No positive findings were obtained with positron emission tomography.Histology suggested a secondary localization in the liver caused by a low-grade malignant neuroendocrine tumor.Immunohistochemistry was positive for anti chromogranin antibodies,Ki67 antibodies and synaptophysin.Octreoscan scintigraphy indicated intense activity in the lesion.Endoscopic investigations were performed to exclude the presence of extrahepatic neoplasms.Diagnosis of PHCT was established.The patient underwent left hepatectomy,followed by hormone therapy with sandostatine LAR.Two months after surgery he had a lymph nodal relapse along the celiac trunk and caudate lobe,which was histologically confirmed.The postoperative clinical course was uneventful,with a negative follow-up for hematochemical,clinical and radiological investigations at 18 mo post-surgery.Diagnosis of PHCT is based principally on the histopathological confi rmation of a carcinoid tumor and the exclusion of a non-hepatic primary tumor.Surgical resection is the recommended primary treatment for PHCT.Recurrence rate and survival rate in patients treated with resection were 18% and 74%,respectively. | Luigi Maria Fenoglio Sara Severini Domenico Ferrigno Giovanni Gollè Cristina Serraino Christian Bracco Elisabetta Castagna Chiara Brignone Fulvio Pomero Elena Migliore Ezio David Mauro Salizzoni | 2009 | World Journal of Gastroenterology2009,15,19: | 14 |
| 7 | Gene Duplication and the Evolution of Plant MADS-box Transcription Factors显示文摘Since the first MADS-box transcription factor genes were implicated in the establishment of floral organ identity in a couple of model plants,the size and scope of this gene family has begun to be appreciated in a much wider range of species.Over the course of millions of years the number of MADS-box genes in plants has increased to the point that the Arabidopsis genome contains more than 100.The understanding gained from studying the evolution,regulation and function of multiple MADS-box genes in an increasing set of species, makes this large plant transcription factor gene family an ideal subject to study the processes that lead to an increase in gene number and the selective birth,death and repurposing of its component members.Here we will use examples taken from the MADS-box gene family to review what is known about the factors that influence the loss and retention of genes duplicated in different ways and examine the varied fates of the retained genes and their associated biological outcomes. | Chiara A.Airoldi Brendan Davies | 2012 | Journal of Genetics and Genomics2012,39,4: | 14 |
| 8 | Age-related changes in the kinetics of human lenses:prevention of the cataract显示文摘The crystalline lens is a transparent,biconvex structure in the eye that,along with the cornea,helps to refract light to be focused on the retina and,by changing shape,it adjusts focal distance(accommodation).The three classes of structural proteins found in the lens areα,β,and γ crystallins.These proteins make up more than 90% of the total dry mass of the eye lens.Other components which can be found are sugars,lipids,water,several antioxidants and low weight molecules.When ageing changes occur in the lens,it causes a gradual reduction in transparency,presbyopia and an increase in the scattering and aberration of light waves as well as a degradation of the optical quality of the eye.The main changes that occur with aging are: 1) reduced diffusion of water from the outside to the inside of the lens and from its cortical to its nuclear zone; 2)crystalline change due to the accumulation of high molecular weight aggregates and insoluble proteins; 3)production of advanced glycation end products(AGEs),lipid accumulation,reduction of reduced glutathione content and destruction of ascorbic acid.Even if effective strategies in preventing cataract onset are not already known,good results have been reached in some cases with oral administration of antioxidant substances such as caffeine,pyruvic acid,epigallocatechin gallate(EGCG),α-lipoic acid and ascorbic acid.Furthermore,methionine sulfoxide reductase A(MSRA) over expression could protect lens cells both in presence and in absence of oxidative stress-induced damage.Nevertheless,promising results have been obtained by reducing ultraviolet-induced oxidative damage. | Nicola Pescosolido Andrea Barbato Rossella Giannotti Chiara Komaiha Fiammetta Lenarduzzi | 2016 | International Journal of Ophthalmology(English edition)2016,9,10: | 13 |
| 9 | High-definition colonoscopy with i-Scan:Better diagnosis for small polyps and flat adenomas显示文摘AIM:To investigate if high-definition (HD) colonoscope with i-Scan gave a higher detection rate of mucosal lesions vs standard white-light instruments. METHODS:Data were collected from the computerized database of the endoscopy unit of our tertiary referral center. We retrospectively analyzed 1101 consecutive colonoscopies that were performed over 1 year with standard white-light (n = 849) or HD+ with i-Scan (n = 252) instruments by four endoscopists, in an outpatient setting. Colonoscopy records included patients' main details and family history for colorectal cancer, indication for colonoscopy (screening, diagnostic or surveillance), type of instrument used (standard white-light or HD+ plus i-Scan), name of endoscopist and bowel preparation. Records for each procedure included whether the cecum was reached or not and the reason for failure, complications during or immediately after the procedure, and number, size, location and characteristics of the lesions. Polyps or protrudinglesions were defined as sessile or pedunculated, and nonprotruding lesions were defined according to Paris classification. For each lesion, histological diagnosis was recorded. RESULTS:Eight hundred and forty-nine colonoscopies were carried with the standard white-light video colonoscope and 252 with the HD+ plus i-Scan video colonoscope. The four endoscopists did 264, 300, 276 and 261 procedures, respectively; 21.6%, 24.0%, 21.7% and 24.1% of them with the HD+ plus i-Scan technique. There were no significant differences between the four endoscopists in either the number of procedures done or the proportions of each imaging technique used. Both techniques detected one or more mucosal lesions in 522/1101 procedures (47.4%). The overall number of lesions recognized was 1266; 645 in the right colon and 621 in the left. A significantly higher number of colonoscopies recognized lesions in the HD+ plus i-Scan mode (171/252 = 67.9%) than with the standard white-light technique (408/849 = 48.1%) (P < 0.0001). HD+ with i-Scan colonoscopies identified more lesions than standard white-light imaging (459/252 and 807/849, P < 0.0001), in the right or left colon (mean ± SD, 1.62 ± 1.36 vs 1.33 ± 0.73, P < 0.003 and 1.55 ± 0.98 vs 1.17 ± 0.93, P = 0.033), more lesions < 10 mm (P < 0.0001) or nonprotruding (P < 0.022), and flat polyps (P = 0.04). The cumulative mean number of lesions per procedure detected by the four endoscopists was significantly higher with HD+ with i-Scan than with standard white-light imaging (1.82 ± 2.89vs 0.95 ± 1.35,P < 0.0001). CONCLUSION:HD imaging with i-Scan during the withdrawal phase of colonoscopy significantly increased the detection of colonic mucosal lesions, particularly small and nonprotruding polyps. | Pier Alberto Testoni Chiara Notaristefano Cristian Vailati Milena Di Leo Edi Viale | 2012 | World Journal of Gastroenterology2012,18,37: | 12 |
| 10 | untreatable hepatocellular 癌的自然历史: 回顾的队研究显示文摘 AIM:To investigate the clinical course of untreatable hepatocellular carcinoma(HCC) identified at any stage and to identify factors associated with mortality.METHODS:From January 1999 to December 2010,320 out of 825 consecutive patients with a diagnosis of HCC and not appropriate for curative or palliative treatments were followed and managed with supportive therapy.Cirrhosis was diagnosed by histological or clinical features and liver function was evaluated according to Child-Pugh score.The diagnosis of HCC was performed by Ultra-Sound guided biopsy or by multiphasic contrast-enhanced computed tomography or gadolinium-enhanced magnetic resonance imaging.Data were collected for each patient including all clinical,laboratory and imaging variables necessary for the outcome prediction staging systems considered.HCC staging was performed according Barcelona Clinic Liver Cancer(BCLC) and Cancer of the Liver Italian Program scores.Follow-up time was defined as the number of months from the diagnosis of HCC to death.Prognostic baseline variables were analyzed by multivariate Cox analysis to identify the independent predictors of survival.RESULTS:Seventy-five per cent of patients had hepatitis C.Ascites was present in 169 patients(53%),while hepatic encephalopathy was present in 49 patients(15%).The Child-Pugh score was class A in 105 patients(33%),class B in 142 patients(44%),and class C in 73 patients(23%).One hundred patients(31%) had macroscopic vascular invasion and/or extrahepatic spread of the tumor.A single lesion > 10 cm was observed in 34 patients(11%),while multinodular HCC was present in 189 patients(59%).Thirty nine patients(12%) were BCLC early(A) stage,55(17%) were BCLC intermediate(B) stage,124(39%) were BCLC advanced(C) stage,and 102(32%) were endstage BCLC(D).At the time of this analysis(July 2011),28(9%) patients were still alive.Six(2%) patients who were lost during follow-up were censored at the last visit.The overall median survival was 6.8 mo,and the 1-year survival was 32%.The 1-year survival according to BCLC classes was 100%,79%,12% and 0%,for BCLC A,B,C and D,respectively.There was a significant difference in survival between each BCLC class.The median survival of patients of BCLC stages A,B,C and D was 33,17.4,6.9,and 1.8 mo,respectively(P < 0.05 for comparison between stages).The median survival of Child-Pugh A,B and C classes were 9.8 mo(range 6.4-13),6.1(range 4.9-7.3),and 3.7(range 1.5-6),respectively(P < 0.05 for comparison between stages).By univariate analysis,the variables significantly associated to an increased liklihood of mortality were Eastern Cooperative Oncology Group performance status(PS),presence of ascites,low level of albumin,elevated level of bilirubin,international normalized ratio(INR) and Log-[(α fetoprotein(AFP)].At multivariate analysis,mortality was independently predicted by bad PS(P < 0.0001),high INR values(P = 0.0001) and elevated Log-(AFP) levels(P = 0.009).CONCLUSION:This study confirms the heterogeneous behavior of untreated HCC.BCLC staging remains an important prognostic guide and may be important in decision-making for palliative treatment. | Giuseppe Cabibbo Marcello Maida Chiara Genco Pietro Parisi Marco Peralta Michela Antonucci Giuseppe Brancatelli Calogero Cammà Antonio Craxì Vito Di Marco | 2012 | World Journal of Hepatology2012,4,9: | 11 |
| 11 | Hepatocellular carcinoma in viral and autoimmune liver diseases:Role of CD4+CD25+Foxp3+regulatory T cells in the immune microenvironment显示文摘More than 90%of cases of hepatocellular carcinoma(HCC)occurs in patients with cirrhosis,of which hepatitis B virus and hepatitis C virus are the leading causes,while the tumor less frequently arises in autoimmune liver diseases.Advances in understanding tumor immunity have led to a major shift in the treatment of HCC,with the emergence of immunotherapy where therapeutic agents are used to target immune cells rather than cancer cells.Regulatory T cells(Tregs)are the most abundant suppressive cells in the tumor microenvironment and their presence has been correlated with tumor progression,invasiveness,as well as metastasis.Tregs are characterized by the expression of the transcription factor Foxp3 and various mechanisms ranging from cell-to-cell contact to secretion of inhibitory molecules have been implicated in their function.Notably,Tregs amply express checkpoint molecules such as cytotoxic T lymphocyte-associated antigen 4 and programmed cell-death 1 receptor and therefore represent a direct target of immune checkpoint inhibitor(ICI)immunotherapy.Taking into consideration the critical role of Tregs in maintenance of immune homeostasis as well as avoidance of autoimmunity,it is plausible that targeting of Tregs by ICI immunotherapy results in the development of immune-related adverse events(irAEs).Since the use of ICI becomes common in oncology,with an increasing number of new ICI currently under clinical trials for cancer treatment,the occurrence of irAEs is expected to dramatically rise.Herein,we review the current literature focusing on the role of Tregs in HCC evolution taking into account their opposite etiological function in viral and autoimmune chronic liver disease,and we discuss their involvement in irAEs due to the new immunotherapies. | Alessandro Granito Luigi Muratori Claudine Lalanne Chiara Quarneti Silvia Ferri Marcello Guidi Marco Lenzi Paolo Muratori | 2021 | World Journal of Gastroenterology2021,27,22: | 11 |
| 12 | Clinical significance of lactate in acute cardiac patients显示文摘Lactate, as a metabolite of easy and quick assessment, has been studied over time in critically ill patients in order to evaluate its prognostic ability. The present review is focused on the prognostic role of lactate levels in acute cardiac patients(that is with acute coronary syndrome, cardiogenic shock, cardiac arrest, non including post cardiac surgery patients). In patients with STelevation myocardial infarction treated with mechanical revascularization, hyperlactatemia identified a subset of patients at higher risk for early death and in-hospital complications, being strictly related mainly to hemodynamic derangement. The prognostic impact of hyperlactatemia on mortality has been documented in patients with cardiogenic shock and in those with cardiac arrest even if there is no cut-off value of lactate to be associated with worse outcome or to guide resuscitation or hemodynamic management. Therapeutic hypothermia seems to affect per se lactate values which have been shown to progressively decrease during hypothermia. The mechanism(s) accounting for lactate levels during hypothemia seem to be multiple ranging from the metabolic effects of reduced temperatures to the hemodynamic effects of hypothermia(i.e., reduced need of vasopressor agents). Serial lactate measurements over time, or lactate clearance, have been reported to be clinically more reliable than lactate absolute value also in acute cardiac patients. Despite differences in study design, timing of lactate measurements and type of acute cardiac conditions(i.e., cardiogenic shock, cardiac arrest, refractory cardiac arrest), available evidence strongly suggests that higher lactate levels can be observed on admission in non-survivors and that higher lactate clearance is associated with better outcome. | Chiara Lazzeri Serafina Valente Marco Chiostri Gian Franco Gensini | 2015 | World Journal of Cardiology2015,7,8: | 10 |
| 13 | Seismic response of continuous span bridges through fiber-based finite element analysis显示文摘非线性的时间历史分析组成最精确的方法模仿受到地震刺激的强壮的层次的结构的反应,这广泛地被认出。这个分析方法基于位于原则下面的声音并且有能力撕生产结构的内在的无弹性的动态行为。尽管如此,有从结构的大规模测试的试验性的结果的比较仍然被需要,以便在这数字方法论保证信心的足够的层次。在当前的努力采用的纤维建模途径内在地说明几何非线性和材料无弹力,没有对塑料绞链机制的刻度的需要,在集中的粘性模型典型。分析精确性和建模简洁的产生联合,这样允许克服也许,复杂性的不充分有理由的感觉联系了到非线性的动态分析。基于纤维的建模途径在为加框的的结构的地震反应分析从因特网下载的一个有限元素节目的框架被采用。节目的 Thereliability 和精确性被数字地在四跨度上复制 pseudo-dynamictests 表明连续甲板水泥桥牌。建模假设被讨论,和他们非线性的时间历史分析的数字结果上的含意,它被发现在对试验性的结果的好同意。 | Chiara Casarotti Rui Pinho | 2006 | Earthquake Engineering and Engineering Vibration2006,5,1: | 9 |
| 14 | Alterations of seminal and hormonal parameters:An extrahepatic manifestation of HCV infection?显示文摘瞄准:在精液的参数和繁殖神经质的浆液层次上评估 HCV 感染和相对抗病毒的处理的可能的影响。方法:有 HCV 相关的长期的肝炎和 16 个健康男志愿者的十个男病人被学习。在所有使精液的参数遭到(nemaspermic 集中,进步活动性,形态学) 并且神经质的层次被决定。精液的参数和抑制素 B,刺激滤泡的荷尔蒙, luteinizing,总数和免费睾丸激素,雌二醇,在病人的 prolactine 在六和 12 个月以后被测量抗病毒联合(interferon+ribavirin ) 治疗。结果:在治疗前的病人比控制象更低的抑制素 B 和免费睾丸激素层次一样显示出显著地更低的 nemaspermic 活动性和形态学。在情况中的抑制素 B 层次被改进在五个应答者的六和 12 瞬间术后疗法(161.9+/-52.8 pg/mL 对 101.7+/-47.0 pg/mL 和 143.4+/-46.1 pg/mL 对 95.4+/-55.6 pg/mL,分别地) 。病人的神经质的模式显著地没改变术后疗法,与有起始的减小和全面随后的增长(19.7+/-6.4 pg/mL 对 13.6+/-5.0 pg/mL 对 17.3+/-5.7 pg/mL ) 的雌二醇层次的例外。然而,在 1 年的应答者,免费睾丸激素(14.2+/-2.54 pg/mL 对 17.1+/-2.58 pg/mL ) 的重要增长发生了。nemaspermic 形态学的一个缺陷发生了,当另外的精液的参数没在抗病毒的治疗期间显著地变化时。结论:有 HCV 感染的病人比控制显示出更坏的精子的参数,建议精子发生上的病毒的可能的否定影响,与在抗病毒的治疗期间的进一步温和的缺陷。然而,治疗能改进精子的功能,由增加的抑制素 B 层次建议了并且在应答者改进了神经质的模式。进一步的研究被需要证实这些初步的吸引人的结果。 | Marilena Durazzo Alberto Premoli Cataldo Di Bisceglie Angela Bertagna Emanuela Fagà Giampaolo Biroli Chiara Manieri Simona Bo Gianfranco Pagano | 2006 | World Journal of Gastroenterology2006,12,19: | 9 |
| 15 | Endoscopic ultrasound and magnetic resonance imaging for re-staging rectal cancer after radiotherapy显示文摘AIM:To compare the sensitivity and specificity of two imaging techniques,endoscopic ultrasound (EUS) and magnetic resonance imaging (MRI),in patients with rectal cancer after neoadjuvant chemoradiation therapy. And we compared EUS and MRI data with histological fi ndings from surgical specimens. METHODS:Thirty-nine consecutive patients (51.3% Male; mean age:68.2 ± 8.9 years) with histologically confirmed distal rectal cancer were examined for staging. All patients underwent EUS and MRI imaging before and after neoadjuvant chemoradiation therapy. RESULTS:After neoadjuvant chemoradiation,EUS and MRI correctly classified 46% (18/39) and 44% (17/39) of patients,respectively,in line with their histological T stage (P > 0.05). These proportions were higher for both techniques when nodal involvement was considered:69% (27/39) and 62% (24/39). When patients were sorted into T and N subgroups,the diagnostic accuracy of EUS was better than MRI for patients withT0-T2 (44% vs 33%,P > 0.05) and N0 disease (87% vs 52%,P = 0.013). However,MRI was more accurate than EUS in T and N staging for patients with more advanced disease after radiotherapy,though these differences did not reach statistical significance. CONCLUSION:EUS and MRI are accurate imaging techniques for staging rectal cancer. However,after neoadjuvant RT-CT,the role of both methods in the assessment of residual rectal tumors remains uncertain. | Gianni Mezzi Paolo Giorgio Arcidiacono Silvia Carrara Francesco Perri Maria Chiara Petrone Francesco De Cobelli Simone Gusmini Carlo Staudacher Alessandro Del Maschio Pier Alberto Testoni | 2009 | World Journal of Gastroenterology2009,15,44: | 9 |
| 16 | Post-operative imaging in liver transplantation: State-of-the-art and future perspectives显示文摘Orthotopic liver transplantation(OLT)represents a major treatment for end-stage chronic liver disease,as well as selected cases of hepatocellular carcinoma and acute liver failure.The ever-increasing development of imaging modalities significantly contributed,over the last decades,to the management of recipients both in the pre-operative and post-operative period,thus impacting on graft and patients survival.When properly used,imaging modalities such as ultrasound,multidetector computed tomography,magnetic resonance imaging(MRI)and procedures of direct cholangiography are capable to provide rapid and reliable recognition and treatment of vascular and biliary complications occurring after OLT.Less defined is the role for imaging in assessing primary graft dysfunction(including rejection)or chronic allograft disease after OLT,e.g.,hepatitis C virus(HCV)recurrence.This paper:(1)describes specific characteristic of the above imaging modalities and the rationale for their use in clinical practice;(2)illustrates main imaging findings related to post-OLTcomplications in adult patients;and(3)reviews future perspectives emerging in the surveillance of recipients with HCV recurrence,with special emphasis on MRI. | Rossano Girometti Giuseppe Como Massimo Bazzocchi Chiara Zuiani | 2014 | World Journal of Gastroenterology2014,20,20: | 8 |
| 17 | Clinical significance of NOD2/CARD15 and Toll-like receptor 4 gene single nucleotide polymorphisms in inflammatory bowel disease显示文摘AIM: To evaluate the role of genetic factors in the pathogenesis of Crohn's disease (CD) and ulcerative colitis (UC), we investigated the single nucleotide poly- morphisms (SNPs) of NOD2/CARD15 (R702W, G908R and L1007fi nsC), and Toll-like receptor 4 (TLR4) genes (D299G and T399I) in a selected inflammatory bowel disease (IBD) population coming from Southern Italy. METHODS: Allele and genotype frequencies of NOD2/ CARD15 (R702W, G908R and L1007finsC) and TLR4 (D299G and T399I) SNPs were examined in 133 CD pa-tients, in 45 UC patients, and in 103 healthy controls. A genotype-phenotype correlation was performed. RESULTS: NOD2/CARD15 R702W mutation was sig-nificantly more frequent in CD (9.8%) than in controls (2.4%, P = 0.001) and in UC (2.3%, P = 0.03). No sig-nificant difference was found between UC patients and control group (P > 0.05). In CD and UC patients, no signifi cant association with G908R variant was found. L1007f insC SNP showed an association with CD (9.8%) compared with controls (2.9%, P = 0.002) and UC patients (2.3%, P = 0.01). Moreover, in CD patients, G908R and L1007finsC mutations were significantly associated with different phenotypes compared to CD wild-type patients. No association of IBD with the TLR4 SNPs was found in either cohort (allele frequencies: D299G-controls 3.9%, CD 3.7%, UC 3.4%, P > 0.05; T399I-controls 2.9%, CD 3.0%, UC 3.4%, P > 0.05). CONCLUSION: These findings confirm that, in our IBD patients selected from Southern Italy, the NOD2/ CARD15, but not TLR4 SNPs, are associated with in-creased risk of CD. | Luciana Rigoli Claudio Romano Rosario Alberto Caruso Maria A Lo Presti Chiara Di Bella Vincenzo Procopio Giuseppina Lo Giudice Maria Amorini Giuseppe Costantino Maria D Sergi Caterina Cuppari Giovanna Elisa Calabrò Romina Gallizzi Carmelo Damiano Salpietro Walter Fries | 2008 | World Journal of Gastroenterology2008,14,28: | 8 |
| 18 | Acute infectious osteomyelitis in children: new treatment strategies for an old enemy显示文摘Background Acute osteomyelitis still represents a significant clinical challenge,with an increasing incidence in paediatric population.A careful assessment and a rapid diagnosis with proper timing and choice of empirical antimicrobial therapy are necessary to avoid sequelae.The initial treatment should consist of empirical antibiotic therapy,to cover the major responsible pathogens in each age group.Data sources We made a literature search with PubMed and Cochrane database from 2000 to 2019 in English,French,and Spanish languages using the key words'osteomyelitis,children,clinical,diagnosis,and treatment'.Results The child's clinical features,age,and the microbiological profile of the geographic area should be evaluated for diagnosis and in the choice of antibiotic treatment.Latest data suggest the administration of intravenous antibiotics for a short period,with subsequent oral therapy,according to the improvement of clinical status and inflammatory markers.For children older than 3 months,the shift to oral medications is already possible after a short course of intravenous therapy,until recovery.The timing for the shift from cefazolin to cephalexin or cefuroxime,intravenous clindamycin to oral clindamycin,and intravenous ceftriaxone+oxacillin to oral equivalents will be decided according to the improvement of clinical status and inflammatory markers.We also present the approach to osteomyelitis due to difficult pathogens,such as Methicillin-resistant Staphylococcus aureus(MRSA)and Panton-Valentine leukocidin(PVL)-positive S.aureus infections.Conclusion In this review,we present the current approach to the clinical diagnosis and management of osteomyelitis in childhood,with an update on recent recommendations,as a useful instrument to understand the rationale of antibiotic therapy. | Sabrina Congedi Chiara Minotti Carlo Giaquinto Liviana Da Dalt Daniele Don | 2020 | World Journal of Pediatrics2020,16,5: | 8 |
| 19 | Effect of a counseling-supported treatment with the Mediterranean diet and physical activity on the severity of the non-alcoholic fatty liver disease显示文摘AIM To determine the clinical effectiveness of nutritional counseling on reduction of non-alcoholic fatty liver disease(NAFLD) severity, weight loss, metabolic and anthropometric indexes and liver enzymes.METHODS Forty-six adults with NAFLD received a 6-mo clinical and a dietary intervention(based on Mediterranean diet) carried out respectively by a gastroenterologist and a nutritionist with counseling license. The counseling process consisted of monthly meeting(about 45 min each). The effect of the treatment was evaluated monitoring liver enzymes, metabolic parameters, cardiovascular risk indexes, NAFLD severity [assessed by ultrasound(US)] and related indexes. All parameters were assessed at baseline. Biochemistry was also assessed at mid-and end-interventions and US was repeated at end-intervention.RESULTS The percentage of patients with steatosis grade equal or higher than 2 was reduced from 93% to 48% and steatosis regressed in 9 patients(20%). At the end of the treatment the end-point concerning the weight(i.e., a 7% weight reduction or achievement/maintenance of normal weight) was accomplished by 25 out of 46 patients(i.e., 54.3%). As far as the liver enzymes is concerned, all three liver enzymes significantly decrease during the treatment the normalization was particularly evident for the ALT enzyme(altered values reduced from 67% down to 11%). Several parameters, i.e., BMI, waist circumference, waist-to-hip ratio, AST, ALT, GGT, HDL, serum glucose, Tot-Chol/HDL, LDL/HDL, TG/HDL, AIP, HOMA, FLI, Kotronen index, VAI, NAFLD liver fat score and LAP, showed a significant improvement(P < 0.01) between baseline and end-treatment.CONCLUSION Outcomes of this study further strengthen the hypothesis that Med Diet and more active lifestyle can be considered a safe therapeutic approach for reducing risk and severity of NAFLD and related disease states. The proposed approach may be proposed as a valid and recommended approach for improving the clinical profile of NAFLD patients. | Chiara Gelli Mirko Tarocchi Ludovico Abenavoli Laura Di Renzo Andrea Galli Antonino De Lorenzo | 2017 | World Journal of Gastroenterology2017,23,17: | 8 |
| 20 | Viral manipulation of cellular protein conjugation pathways: The SUMO lesson显示文摘Small ubiquitin-like modifier(SUMO)ylation is a key posttranslational modification mechanism that controls the function of a plethora of proteins and biological processes. Given its central regulatory role, it is not surprising that it is widely exploited by viruses. A number of viral proteins are known to modify and/or be modified by the SUMOylation system to exert their function, to create a cellular environment more favorable for virus survival and propagation, and to prevent host antiviral responses. Since the SUMO pathway is a multi-step cascade, viral proteins engage with it at many levels, to advance and favor each stage of a typical infection cycle: replication, viral assembly and immune evasion. Here we review the current knowledge on the interplay between the host SUMO system and viral lifecycle. | Domenico Mattoscio Chiara V Segré Susanna Chiocca | 2013 | World Journal of Virology2013,2,2: | 8 |