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| 1 | Diagnosis and management of choledocholithiasis in the golden age of imaging, endoscopy and laparoscopy显示文摘Biliary lithiasis is an endemic condition in both Western and Eastern countries, in some studies affecting 20% of the general population. In up to 20% of cases, gallbladder stones are associated with common bile duct stones(CBDS), which are asymptomatic in up to one half of cases. Despite the wide variety of examinations and techniques available nowadays, two main open issues remain without a clear answer: how to cost-effectively diagnose CBDS and, when they are finally found, how to deal with them. CBDS diagnosis and management has radically changed over the last 30 years, following the dramatic diffusion of imaging, including endoscopic ultrasound(EUS) and magnetic resonance cholangiography(MRC), endoscopy and laparoscopy. Since accuracy, invasiveness, potential therapeutic use and costeffectiveness of imaging techniques used to identifyCBDS increase together in a parallel way, the concept of 'risk of carrying CBDS' has become pivotal to identifying the most appropriate management of a specific patient in order to avoid the risk of 'under-studying' by poor diagnostic work up or 'over-studying' by excessively invasive examinations. The risk of carrying CBDS is deduced by symptoms, liver/pancreas serology and ultrasound. 'Low risk' patients do not require further examination before laparoscopic cholecystectomy. Two main 'philosophical approaches' face each other for patients with an 'intermediate to high risk' of carrying CBDS: on one hand, the 'laparoscopy-first' approach, which mainly relies on intraoperative cholangiography for diagnosis and laparoscopic common bile duct exploration for treatment, and, on the other hand, the 'endoscopy-first' attitude, variously referring to MRC, EUS and/or endoscopic retrograde cholangiography for diagnosis and endoscopic sphincterotomy for management. Concerning CBDS diagnosis, intraoperative cholangiography, EUS and MRC are reported to have similar results. Regarding management, the recent literature seems to show better short and long term outcome of surgery in terms of retained stones and need for further procedures. Nevertheless, open surgery is invasive, whereas the laparoscopic common bile duct clearance is time consuming, technically demanding and involves dedicated instruments. Thus, although no consensus has been achieved and CBDS management seems more conditioned by the availability of instrumentation, personnel and skills than cost-effectiveness, endoscopic treatment is largely preferred worldwide. | Renato Costi Alessandro Gnocchi Francesco Di Mario Leopoldo Sarli | 2014 | World Journal of Gastroenterology2014,20,37: | 48 |
| 2 | Gastric cancer: Current status of lymph node dissection显示文摘D2 procedure has been accepted in Far East as the standard treatment for both early(EGC) and advanced gastric cancer(AGC) for many decades. Recently EGC has been successfully treated with endoscopy by endoscopic mucosal resection or endoscopic submucosal dissection, when restricted or extended Gotoda's criteria can be applied and D1+ surgery is offered only to patients not fitted for less invasive treatment. Furthermore, two randomised controlled trials(RCTs) have been demonstrating the non inferiority of minimally invasive technique as compared to standard open surgery for the treatment of early cases and recently the feasibility of adequate D1+ dissection has been demonstrated also for the robot assisted technique. In case of AGC the debate on the extent of nodal dissection has been open for many decades. While D2 gastrectomy was performed as the standard procedure in eastern countries, mostly based on observational and retrospective studies, in the west the Medical Research Council(MRC), Dutch and Italian RCTs have been conducted to show a survival benefit of D2 over D1 with evidence based medicine. Unfortunately both the MRC and the Dutch trials failed to show a survival benefit after the D2 procedure, mostly due to the significant increase of postoperative morbidity and mortality, which was referred to splenopancreatectomy. Only 15 years after the conclusion of its accrual, the Dutch trial could report a significant decrease of recur-rence after D2 procedure. Recently the long term survival analysis of the Italian RCT could demonstrate a benefit for patients with positive nodes treated with D2 gastrectomy without splenopancreatectomy. As nowadays also in western countries D2 procedure can be done safely with pancreas preserving technique and without preventive splenectomy, it has been suggested in several national guidelines as the recommended procedure for patients with AGC. | Maurizio Degiuli Giovanni De Manzoni Alberto Di Leo Domenico D'Ugo Erica Galasso Daniele Marrelli Roberto Petrioli Karol Polom Franco Roviello Francesco Santullo Mario Morino | 2016 | World Journal of Gastroenterology2016,22,10: | 29 |
| 3 | Evidence that chronic hypoxia causes reversible impairment on male fertility显示文摘瞄准:在人的精子发生的参数和他们的复原时间上评估长期的组织缺氧的效果。方法:六男健康的山缓慢艰辛地旅行 ers 的 Seminological 参数在海水平在 normoxia 被评估。在到高度的 26 天暴露以后(从 2 000 m 到 5 600 m,古代蒙古帝国旧都遗迹远征) 一样的参数再在回到海水平以后被评估。这些参数再次在 6 个月以后在 1 个月以后然后再被评估。结果:精子计数被发现在回到海水平以后立即更低(P = 0.0004 ) 并且再在一个月以后(P = 0.0008 ) 。正常层次在 6 个月以后被到达。精子的活动性(%) 不在回到海水平以后立即显示出减小(P = 0.0583 ) ,而在 1 个月以后这减小是重要的(P = 0.0066 ) 。在 6 个月以后,到 pre-hypoxic 暴露值有恢复。在回到海以后立即增加的反常或不成熟的精子(%) 铺平(P = 0.0067 ) 然后再在 1 个月以后(P = 0.0004 ) 。在 6 个月以后,到起始的值有完全的恢复。在精液的能动精子的全部的数字被发现在回到海水平以后立即更低(P = 0.0024 ) 然后再在 1 个月以后(P = 0.0021 ) 。在 6 个月以后,到 pre-hypoxic 暴露值有恢复。结论:在 6 个月在精子发生和男富饶的生理的机制显示氧供应的影响以后,长期的组织缺氧在以前的 normoxic 条件的恢复导致精子减少的一个状态和如此的 seminological 参数的正规化。 | Vittore Verratti Francesco Berardinelli Camillo Di Giulio Gerardo Bosco Marisa Cacchio Mario Pellicciotta Michele Nicolai Stefano Martinotti Raffaele Tenaglia | 2008 | Asian Journal of Andrology2008,10,4: | 21 |
| 4 | Pancreatic metastases from renal cell carcinoma:The state of the art显示文摘Pancreatic metastases are rare,with a reported incidence varying from 1.6%to 11%in autopsy studies of patients with advanced malignancy.In clinical series,the frequency of pancreatic metastases ranges from 2%to 5%of all pancreatic malignant tumors.However,the pancreas is an elective site for metastases from carcinoma of the kidney and this peculiarity has been reported by several studies.The epidemiology,clinical presentation,and treatment of pancreatic metastases from renal cell carcinoma are known from singleinstitution case reports and literature reviews.Thereis currently very limited experience with the surgical resection of isolated pancreatic metastasis,and the role of surgery in the management of these patients has not been clearly defined.In fact,for many years pancreatic resections were associated with high rates of morbidity and mortality,and metastatic disease to the pancreas was considered to be a terminal-stage condition.More recently,a significant reduction in the operative risk following major pancreatic surgery has been demonstrated,thus extending the indication for these operations to patients with metastatic disease. | Roberto Ballarin Mario Spaggiari Nicola Cautero Nicola De Ruvo Roberto Montalti Cristina Longo Anna Pecchi Patrizia Giacobazzi Giuseppina De Marco Giuseppe D’Amico Giorgio Enrico Gerunda Fabrizio Di Benedetto | 2011 | World Journal of Gastroenterology2011,17,43: | 21 |
| 5 | Serum uric acid as a prognostic marker in the setting of advanced vascular disease: a prospective study in the elderly显示文摘BackgroundMany 流行病学的研究分析在 hyperuricemia 和心血管的结果之间的关系。这观察未来的研究调查有在一张老人口的不利心血管的事件和死亡的尿酸(SUA ) 层次由百和 76 个老病人由先进动脉粥样硬化影响了的先进 atherosclerosis.MethodsTwo 影响了的浆液的协会(217 男性和 59 女性;71.2 ±7.8 年) 被包括。所有病人为心血管的疾病,癌症,肥胖和传统的风险因素的历史被估计。病人们为约 31 ± 被跟随;11 个月。主要事件在后续,定义同样心肌的梗塞,服的局部缺血,心肌或外部的 revascularization 和 death.ResultsMean SUA 期间被记录水平是 5.47 ±1.43 mg/dL;然后,我们进一步在二个组划分了人口,根据中部的价值(5.36 mg/dL ) 。在期间一中部列在后面在上面 31,月(5 ~ 49 个月) , 66 个心血管的事件, 9 个致命的心血管的事件和 14 癌症相关的死亡发生了。有增加的 SUA 水平的病人介绍了全部的心血管的事件的更高重要的发生(HR:1.867, P = 0.014, 95% CI:1.134-3.074 ) 。一样的病人显示出癌症相关的死亡的重要增加的风险(HR:4.335, P = 0.025, 95% CI:1.204-15.606 ).ConclusionsIncreased SUA 层次独立地并且显著地与心血管的事件的风险被联系,癌症在外部 vasculopathy 影响的主要老的病人的一张人口联系了死亡。 | Giuseppe Di Stolfo Sandra Mastroianno Domenico Rosario Potenza Giovanni De Luca Carmela d'Arienzo Michele Antonio Pacilli Mario Fanelli Aldo Russo Raffaele Fanelli | 2015 | Journal of Geriatric Cardiology2015,12,5: | 20 |
| 6 | Performance of liver stiffness measurements by transient elastography in chronic hepatitis显示文摘AIM:To compare results of liver stiffness measurements by transient elastography(TE) obtained in our patients population with that used in a recently published meta-analysis.METHODS:This was a single center cross-sectional study.Consecutive patients with chronic viral hepatitis scheduled for liver biopsy at the outpatient ward of our Infectious Diseases Department were enrolled.TE was carried out by using FibroScan(Echosens,Paris,France).Liver biopsy was performed on the same day as TE,as day case procedure.Fibrosis was staged according to the Metavir scoring system.The diagnostic performance of TE was assessed by using receiver operating characteristic(ROC) curves and the area under the ROC curve analysis.RESULTS:Two hundred and fifty-two patients met the inclusion criteria.Six(2%) patients were excluded due to unreliable TE measurements.Thus,246(171 men and 75 women) patients were analyzed.One hundred and ninety-five(79.3%) patients had chronic hepatitis C,41(16.7%) had chronic hepatitis B,and 10(4.0%) were coinfected with human immunodeficiency virus.ROC curve analysis identified optimal cut-off value of TE as high as 6.9 kPa forF ≥ 2;7.9 kPa forF ≥ 3;9.6 kPa for F = 4 in all patients(n = 246),and as high as 6.9 kPa for F ≥ 2;7.3 kPa for F ≥ 3;9.3 kPa for F = 4 in patients with hepatitis C(n = 195).Cut-off values of TE obtained by maximizing only the specificity were as high as 6.9 kPa for F ≥ 2;9.6 kPa for F ≥ 3;12.2 kPa for F = 4 in all patients(n = 246),and as high as 7.0 kPa forF ≥ 2;9.3 kPa forF ≥ 3;12.3 kPa forF = 4 in patients with hepatitis C(n = 195).CONCLUSION:The cut-off values of TE obtained in this single center study are comparable to that obtained in a recently published meta-analysis that included up to 40 studies. | Giovanna Ferraioli Carmine Tinelli Barbara Dal Bello Mabel Zicchetti Raffaella Lissandrin Gaetano Filice Carlo Filice Elisabetta Above Giorgio Barbarini Enrico Brunetti Willy Calderon Marta Di Gregorio Roberto Gulminetti Paolo Lanzarini Serena Ludovisi Laura Maiocchi Antonello Malfitano Giuseppe Michelone Lorenzo Minoli Mario Mondelli Stefano Novati Savino FA Patruno Alessandro Perretti Gianluigi Poma Paolo Sacchi Domenico Zanaboni Marco Zaramella | 2013 | World Journal of Gastroenterology2013,19,1: | 18 |
| 7 | 冠状动脉内影像学临床应用专家共识(第一部分):对冠状动脉介入治疗的指导与优化显示文摘欧洲心血管介入协会(EAPCI)专家组系统总结了血管内超声(IVUS)和光学相干断层成像(OCT)这两种血管内影像学检查临床应用指征的现有证据,提供了关于IVUS和OCT指导经皮冠状动脉介入治疗(PCI)的应用价值,并明确了最可能从腔内影像学指导的介入治疗中获得临床收益的患者或病变类型,同时详细论述了PCI前如何使用IVUS或OCT优化支架尺寸(支架长度和直径)和手术策略的选择。此外,专家推荐对支架失败(支架内再狭窄或支架内血栓形成)的患者应常规进行冠状动脉内影像学检查,并首选OCT。最后,重点论述了IVUS和OCT在指导PCI和评估支架失败两个方面的优势和局限性,并对未来需要深入研究的领域进行了展望。 | Lorenz Raber Gary S Mintz Konstantinos C Koskinas Thomas W Johnson Niels R Holm Yoshinubo Onuma Maria D Radu Michael Joner Bo Yu Haibo Jia Nicolas Meneveau Jose M.de la Torre Hemandez Javier Escaned Jonathan Hill Francesco Prati Antonio Colombo Carlo di Mario Evelyn Regar Davide Capodanno William Wijns Robert A Byme Giulio Guagliumi | 2019 | 中华心血管病杂志2019,47,1: | 17 |
| 8 | 卒中相关性肺炎的诊断卒中肺炎共识小组的推荐意见显示文摘背景和目的下呼吸道感染常并发于卒中并对转归造成不利影响。对于并发于卒中的下呼吸道感染性疾病,目前尚无公认的专业术语或诊断金标准,这导致临床诊疗和研究受到影响。本共识旨在提出急性卒中并发下呼吸道感染的标准化术语和可操作性诊断标准。方法对多个文献数据库进行系统检索,经过证据回顾和2轮讨论,最后于2014年9月在英国曼彻斯特召开共识会议,经75%以上共识小组成员达成一致意见后形成共识。结果达成的共识如下:(1)推荐使用卒中相关性肺炎(stroke-associated pneumonia, SAP )作为卒中发病后7 d内发生的下呼吸道感染性疾病的专业术语。(2)提议对 SAP 使用经过改良的美国疾病控制预防中心(Centers for Disease Control and Prevention, CDC)诊断标准:①很可能的 SAP:符合 CDC 诊断标准,但复查或动态监测胸部 X 片仍缺乏典型改变;②确诊的 SAP:符合 CDC 诊断标准,且胸部 X 片有典型改变。(3)关于白细胞计数或 C反应蛋白在 SAP 诊断中的作用证据有限。(4)其他生物学标记物(如降钙素原)的证据不足。结论提议根据 CDC 诊断标准对 SAP 的术语和诊断制定可操作性的共识标准,需要在卒中患者中进行前瞻性研究来确定其信度、效度以及对医生行为(包括抗生素选择)和临床转归的影响。 | Craig J. Smith Amit K Kishore Andy Vail Angel Chamorro Javier Garau Stephen J. Hopkins Mario Di Napoli Lalit Kalra Peter Langhorne Joan Montaner Christine Roffe Anthony G. Rudd Pippa J. TyrreU Diederik van de Peek Mark Woodhead Andreas Meisel 范琳琳 宿英英 | 2016 | 国际脑血管病杂志2016,24,2: | 17 |
| 9 | Comparison of magnetic resonance spectroscopy, proton density fat fraction and histological analysis in the quantification of liver steatosis in children and adolescents显示文摘AIM To establish a threshold value for liver fat content between healthy children and those with nonalcoholic fatty liver disease(NAFLD) by using magnetic resonance imaging(MRI), with liver biopsy serving as a reference standard. METHODS The study was approved by the local ethics committee, and written informed consent was obtained from all participants and their legal guardians before the study began. Twenty-seven children with NAFLD underwent liver biopsy to assess the presence of nonalcoholic steatohepatitis. The assessment of liver fat fraction was performed using MRI, with a high field magnet and 2D gradient-echo and multiple-echo T1-weighted sequence with low flip angle and single-voxel pointresolved 1H MR-Spectroscopy(1H-MRS), corrected for T1 and T2* decays. Receiver operating characteristic curve analysis was used to determine the best cutoff value. Lin coefficient test was used to evaluate thecorrelation between histology, MRS and MRI-PDFF. A Mann-Whitney U-test and multivariate analysis were performed to analyze the continuous variables. RESULTS According to MRS, the threshold value between healthy children and those with NAFLD is 6%; using MRI-PDFF, a cut-off value of 3.5% is suggested. The Lin analysis revealed a good fit between the histology and MRS as well as MRI-PDFF.CONCLUSION MRS is an accurate and precise method for detecting NAFLD in children. | Michele Di Martino Lucia Pacifico Mario Bezzi Rossella Di Miscio Beatrice Sacconi Claudio Chiesa Carlo Catalano | 2016 | World Journal of Gastroenterology2016,22,39: | 16 |
| 10 | Computed tomography findings of pneumatosis and portomesenteric venous gas in acute bowel ischemia显示文摘AIM:To use more representative sample size to evaluate whether computed tomography(CT)scan evidence of the concomitant presence of pneumatosis and portomesenteric venous gas is a predictor of transmural bowel necrosis.METHODS:Data from 208 patients who were referred for a diagnosis of bowel ischemia were retrospectively reviewed.Only patients who underwent a surgical intervention following a diagnosis of bowel ischemia who also had a post-operative histological confirmation of such a diagnosis were included.Patients were split into two groups according to the presence of histological evidence of transmural bowel ischemia(case group)or partial bowel ischemia(control group).CT images were reviewed for findings of ischemia,including mural thickening,pneumatosis,bowel distension,portomesenteric venous gas and arterial or venous thrombi.RESULTS:A total of 248 subjects who underwent surgery for bowel ischemia were identified.Among the208 subjects enrolled in our study,transmural bowel necrosis was identified in 121 subjects(case group),and partial bowel necrosis was identified in 87 subjects(control group).Based on CT findings,including mural thickening,bowel distension,pneumatosis,pneumatosis plus portomesenteric venous gas and presence of thrombi or emboli,there were no significant differences between the case and control groups.The concomitant presence of pneumatosis and porto-mesenteric venous gas showed an odds ratio of 1.95(95%CI:0.491-7.775,P=0.342)for the presence of transmural necrosis.The presence of pneumatosis plus porto-mesenteric venous gas exhibited good specificity(83%)but low sensitivity(17%)in the identification of transmural bowel infarction.Accordingly,the positive and negative predictive values were 60% and 17%,respectively.CONCLUSION:Although pneumatosis plus porto-mesenteric venous gas is associated with bowel ischemia,we have demonstrated that their co-occurrence cannot be used as diagnostic signs of transmural necrosis. | Marco Milone Matteo Nicola Dario Di Minno Mario Musella Paola Maietta Vittorio Iaccarino Giovanni Barone Francesco Milone | 2013 | World Journal of Gastroenterology2013,19,39: | 15 |
| 11 | Steps to consider in the approach and management of critically ill patient with spontaneous intracerebral hemorrhage显示文摘Spontaneous intracerebral hemorrhage is a type of stroke associated with poor outcomes. Mortality is elevated, especially in the acute phase. From a pathophysiological point of view the bleeding must traverse different stages dominated by the possibility of re-bleeding, edema, intracranial hypertension, inflammation and neurotoxicity due to blood degradation products, mainly hemoglobin and thrombin. Neurological deterioration and death are common in early hours, so it is a true neurologicalneurosurgical emergency. Time is brain so that action should be taken fast and accurately. The most significant prognostic factors are level of consciousness, location, volume and ventricular extension of the bleeding. Nihilism and early withdrawal of active therapy undoubtedly influence the final result. Although there are no proven therapeutic measures, treatment should be individualized and guided preferably by pathophysiology. The multidisciplinary teamwork is essential. Results of recently completed studies have birth to promising new strategies. For correct management it's important to establish an orderly and systematic strategy based on clinical stabilization, evaluation and establishment of prognosis, avoiding secondary insults and adoption of specific individualized therapies, including hemostatic therapy and intensive control of elevated blood pressure. Uncertainty continues regarding the role of surgery. | Daniel Agustin Godoy Gustavo Rene Pi?ero Patricia Koller Luca Masotti Mario Di Napoli | 2015 | World Journal of Critical Care Medicine2015,4,3: | 14 |
| 12 | Accuracy and responses of genomic selection on key traits in apple breeding显示文摘The application of genomic selection in fruit tree crops is expected to enhance breeding eficiency by increasing prediction accuracy,increasing selection intensity and decreasing generation interval.The objectives of this study were to assess the accuracy of prediction and selection response in commercial apple breeding programmes for key traits.The training population comprised 977 individuals derived from 20 pedigreed fllsib families.Historic phenotypic data were available on 10 traits related to productivity and fruit external appearance and genotypic data for 7829 SNPs obtained with an llumina 20K SNP array.From these data,a genome-wide prediction model was built and subsequently used to calculate genomic breeding values of five application fllsib families.The application families had genotypes at 364 SNPs from a dedicated 512 SNP array,and these genotypic data were extended to the high-density level by imputation.These five families were phenotyped for 1 year and their phenotypes were compared to the predicted breeding values.Accuracy of genomic prediction across the 10 traits reached a maximum value of 0.5 and had a median value of 0.19.The accuracies were strongly affected by the phenotypic distribution and heritability of traits.In the largest family,significant selection response was observed for traits with high heritability and symmetric phenotypic distribution.Traits that showed non-significant response often had reduced and skewed phenotypic variation or low heritability.Among the five application families the accuracies were uncorrelated to the degree of relatedness to the training population.The results underline the potential of genomic prediction to accelerate breeding progress in outbred fruit tree crops that still need to overcome long generation intervals and extensive phenotyping costs. | Hélène Muranty Michela Troggio Inès Ben Sadok Mehdi Al Rifaï Annemarie Auwerkerken Elisa Banchi Riccardo Velasco Piergiorgio Stevanato W.Eric van de Weg Mario Di Guardo Satish Kumar François Laurens Marco C.A.M.Bink | 2015 | Horticulture Research2015,2,1: | 14 |
| 13 | Role of endoscopic ultrasonography in the loco-regional staging of patients with rectal cancer显示文摘The prognosis of rectal cancer(RC) is strictly related to both T and N stage of the disease at the time of diagnosis. RC staging is crucial for choosing the best multimodal therapy: patients with high risk locally advanced RC(LARC) undergo surgery after neoadjuvant chemotherapy and radiotherapy(NAT); those with low risk LARC are operated on after a preoperative short-course radiation therapy; finally, surgery alone is recommended only for early RC. Several imaging methods are used for staging patients with RC: computerized tomography, magnetic resonance imaging, positron emission tomography, and endoscopic ultrasound(EUS). EUS is highly accurate for the loco-regional staging of RC, since it is capable to evaluate precisely the mural infiltration of the tumor(T), especially in early RC. On the other hand, EUS is less accurate in restaging RC after NAT and before surgery. Finally, EUS is indicated for follow-up of patients operated on for RC, where there is a need for the surveillance of the anastomosis. The aim of this review is to highlight the impact of EUS on the management of patients with RC, evaluating its role in both preoperative staging and follow-up of patients after surgery. | Pietro Marone Mario de Bellis Valentina D'Angelo Paolo Delrio Valentina Passananti Elena Di Girolamo Giovanni Battista Rossi Daniela Rega Maura Claire Tracey Alfonso Mario Tempesta | 2015 | World Journal of Gastrointestinal Endoscopy2015,7,7: | 11 |
| 14 | 英国胃肠病学会关于胃癌风险患者的诊断和管理指南显示文摘胃癌预后较差,部分原因在于诊断较晚。胃癌的危险因素包括幽门螺杆菌(H.pylori,HP)感染和胃癌家族史,尤其是遗传性弥漫性胃癌和恶性贫血。胃癌发展的阶段包括慢性胃炎、胃黏膜萎缩(GA)、胃黏膜肠化生(GIM)和异型增生。胃癌早期发现和提高生存率的关键是在内镜检查前以非侵入性方式识别高危人群。然而,尽管生物标志物可能有助于检测慢性萎缩性胃炎,但尚无足够的证据支持其用于人群筛查。高质量内镜检查是胃癌早期发现的重要组成部分,图像增强内镜结合组织病理学活检是GA和GIM最佳的诊断方法,并能准确进行风险分层。按照悉尼标准从胃窦、角切迹、小弯和大弯进行活检,既能明确诊断,也能对胃癌进行风险分层。理想状态应当是在高质量内镜检查中对GA或GIM区域活检。英国属于低危地区,可根据需要接受常规诊断性胃镜检查,但没有足够证据支持筛查,对于广泛GA或GIM的患者,每3年检查内镜。对于胃异型增生和早期癌,只要满足标准,内镜下黏膜切除术或内镜黏膜下剥离术的治疗有效,成功率高,复发率低。 | Matthew Banks David Graham Marnix Jansen TakujiGotoda Sergio Coda Massimiliano di Pietro NoriyaUedo Pradeep Bhandari D Mark Pritchard Ernst J Kuipers Manuel Rodriguez-Justo Marco R Novelli KrishRagunath Neil Shepherd Mario Dinis-Ribeiro 乌雅罕(译) 张冬雪(译) 牛占岳(校) 刘鑫(校) 丁士刚(译/校) | 2020 | 中华胃肠内镜电子杂志2020,7,2: | 10 |
| 15 | Clinical significance of hepatitis B surface antigen mutants显示文摘Hepatitis B virus(HBV) infection is a major public health problem in many countries, with nearly 300 million people worldwide carrying HBV chronic infection and over 1 million deaths per year due to cirrhosis and liver cancer. Several hepatitis B surface antigen(HBs Ag) mutations have been described, most frequently due to a single amino acid substitution and seldom to a nucleotide deletion. The majority of mutations are located in the S region, but they have also been found in the pre-S1 and pre-S2 regions. Single amino acid substitutions in the major hydrophilic region of HBs Ag, called the 'a' determinant, have been associated with immune escape and the consequent failure of HBV vaccination and HBs Ag detection, whereas deletions in the pre-S1 or pre-S2 regions have been associated with the development of hepatocellular carcinoma. This review article will focus on the HBs Ag mutants and their biological and clinical implications. | Nicola Coppola Lorenzo Onorato Carmine Minichini Giovanni Di Caprio Mario Starace Caterina Sagnelli Evangelista Sagnelli | 2015 | World Journal of Hepatology2015,7,27: | 9 |
| 16 | T1-weighted dual-echo MRI for fat quantification in pediatric nonalcoholic fatty liver disease显示文摘AIM:To determine in obese children with nonalcoholic fatty liver disease (NAFLD) the accuracy of magnetic resonance imaging (MRI) in assessing liver fat concentration.METHODS:A case-control study was performed.Cases were 25 obese children with biopsy-proven NAFLD.Controls were 25 obese children matched for age and gender,without NAFLD at ultrasonography and with normal levels of aminotransferases and insulin.Hepatic fat fraction (HFF) by MRI was obtained using a modification of the Dixon method.RESULTS:HFF ranged from 2% to 44% [mean,19.0% (95% CI,15.1-27.4)] in children with NAFLD,while in the controls this value ranged from 0.08% to 4.69% [2.0% (1.3-2.5),P < 0.0001].HFF was highly correlated with histological steatosis (r=0.883,P < 0.0001) in the NAFLD children.According to the histological grade of steatosis,the mean HFF was 8.7% (95% CI,6.0-11.6) for mild,21.6% (15.3-27.0) for moderate,and 39.7% (34.4-45.0) for severe fatty liver infiltration.With a cutoff of 4.85%,HFF had a sensitivity of 95.8% for the diagnosis of histological steatosis ≥ 5%.All control children had HFF lower than 4.85%;thus,the specificity was 100%.After 12 mo,children with weight loss displayed a significant decrease in HFF.CONCLUSION:MRI is an accurate methodology for liver fat quantification in pediatric NAFLD. | Lucia Pacifico Michele Di Martino Carlo Catalano Valeria Panebianco Mario Bezzi Caterina Anania Claudio Chiesa | 2011 | World Journal of Gastroenterology2011,17,25: | 9 |
| 17 | Pharmacogenetics of the systemic treatment in advanced hepatocellular carcinoma显示文摘Hepatocellular carcinoma (HCC) accounts for the majority of primary liver cancers. To date, most patients with HCC are diagnosed at an advanced tumor stage, excluding them from potentially curative therapies (i.e., resection, liver transplantation, percutaneous ablation). Treatments with palliative intent include chemoembolization and systemic therapy. Among systemic treatments, the small-molecule multikinase inhibitor sorafenib has been the only systemic treatment available for advanced HCC over 10 years. More recently, other smallmolecule multikinase inhibitors (e.g., regorafenib, lenvatinib, cabozantinib) have been approved for HCC treatment. The promising immune checkpoint inhibitors (e.g., nivolumab, pembrolizumab) are still under investigation in Europe while in the US nivolumab has already been approved by FDA in sorafenib refractory or resistant patients. Other molecules, such as the selective CDK4/6inhibitors (e.g., palbociclib, ribociclib), are in earlier stages of clinical development, and the c- MET inhibitor tivantinib did not show positive results in a phase III study. However, even if the introduction of targeted agents has led to great advances in patient response and survival with an acceptable toxicity profile, a remarkable inter-individual heterogeneity in therapy outcome persists and constitutes a significant problem in disease management. Thus, the identification of biomarkers that predict which patients will benefit from a specific intervention could significantly affect decision-making and therapy planning. Germ-line variants have been suggested to play an important role in determining outcomes of HCC systemic therapy in terms of both toxicity and treatment efficacy. Particularly, a number of studies have focused on the role of genetic polymorphisms impacting the drug metabolic pathway and membrane translocation as well as the drug mechanism of action as predictive/prognostic markers of HCC treatment. The aim of this review is to summarize and critically discuss the pharmacogenetic literature evidences, with particular attention to sorafenib and regorafenib, which have been used longer than the others in HCC treatment. | Elena De Mattia Erika Cecchin Michela Guardascione Luisa Foltran Tania Di Raimo Francesco Angelini Mario D’Andrea Giuseppe Toffoli | 2019 | World Journal of Gastroenterology2019,25,29: | 8 |
| 18 | Adipose tissue and vascular inflammation in coronary artery disease显示文摘Obesity has become an important public health issue in Western and developing countries,with well known metabolic and cardiovascular complications.In the last decades,evidence have been growing about the active role of adipose tissue as an endocrine organ in determining these pathological consequences.As a consequence of the expansion of fat depots,in obese subjects,adipose tissue cells develope a phenotypic modification,which turns into a change of the secretory output.Adipocytokines produced by both adipocytes and adipose stromal cells are involved in the modulation of glucose and lipid handling,vascular biology and,moreover,participate to the systemic inflammatory response,which characterizes obesity and metabolic syndrome.This might represent an important pathophysiological link with atherosclerotic complications and cardiovascular events.A great number of adipocytokines have been described recently,linking inflammatory mileu and vascular pathology.The understanding of these pathways is crucial not only from a pathophysiological point of view,but also to a better cardiovascular disease risk stratification and to the identification of possible therapeutic targets.The aim of this paper is to review the role of Adipocytokines as a possible link between obesity and vascular disease. | Enrica Golia Giuseppe Limongelli Francesco Natale Fabio Fimiani Valeria Maddaloni Pina Elvira Russo Lucia Riegler Renatomaria Bianchi Mario Crisci Gaetano Di Palma Paolo Golino Maria Giovanna Russo Raffaele Calabrò Paolo Calabrò | 2014 | World Journal of Cardiology2014,6,7: | 8 |
| 19 | Nano albumin bound-paclitaxel in pancreatic cancer: Current evidences and future directions显示文摘Pancreatic cancer(PDAC) is an aggressive and chemoresistant disease, representing the fourth cause of cancer related deaths in western countries. Majority of patients have unresectable, locally advanced or metastatic disease at time of diagnosis and the 5-year survival rate in these conditions is extremely low. For more than a decade gemcitabine has been the cornerstone of metastatic PDAC treatment, although survival benefit was very poor. PDAC cells are surrounded by an intense desmoplastic reaction that may create a barrier to the drugs penetration within the tumor. Recently PDAC stroma has been addressed as a potential therapeutic target. Nano albumin bound(Nab)-paclitaxel is an innovative molecule depleting tumor stroma, through interaction between albumin and secreted protein acidic and rich in cysteine. Addition of nab-paclitaxel to gemcitabine has showed activity and efficacy in metastatic PDAC first-line treatment improving survival and overall response rate vs gemcitabine alone in the MPACT phase Ⅲ study. This combination represents one of the standards of care in advanced PDAC therapy and is suitable to a broader spectrum of patients compared to other schedules. Nab-paclitaxel is under investigation as a backbone of chemotherapy in novel combinations with target agents or immunotherapy in locally advanced or metastatic PDAC. In this article, we provide an updated and critical overview about the role of nab-paclitaxel in PDAC treatment based on the latest advances in preclinical and clinical research. Furthermore, we focus on the use of nab-paclitaxel within the context of metastatic PDAC treatment landscape and we discuss about future implications in the light of current clinical ongoing trials. | Guido Giordano Massimo Pancione Nunzio Olivieri Pietro Parcesepe Marianna Velocci Tania Di Raimo Luigi Coppola Giuseppe Toffoli Mario Rosario D’Andrea | 2017 | World Journal of Gastroenterology2017,23,32: | 7 |
| 20 | Rhabdomyolysis after midazolam administration in a cirrhotic patient treated with atorvastatin显示文摘The administration of statins in patients with liver disease is not an absolute contraindication. Hepatotoxicity is a rare and often dose-related event and in the literature there are only a few described cases of fatal rhab-domyolysis in patients with chronic liver disease after statin administration. During treatment with 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors,the factors responsible for myopathy may either be related to the patient,or due to interactions with other medications that are metabolic substrates of the same isozymes and therefore able to increase blood statin concentration. The most important side effects consist of increased transaminase levels,abdominal pain or muscle weakness,increased serum levels of creatine kinase and rhabdomyolysis. In this article we report a case of fatal rhabdomyolysis with acute renal failure after gastric endoscopy,where midazolam was used as a sedation agent in a patient with chronic liver disease treated with a high dose of atorvastatin. Therefore,we suggest paying particular attention to the potential risks of associating atorvastatin and midazolam in patients with chronic liver disease who need to undergo gastric endoscopy. | Antonietta Gigante Gianluca Di Lazzaro Giraldi Maria Ludovica Gasperini Biagio Barbano Marta Liberatori Liborio Sardo Francesca Di Mario Antonella Giorgi Filippo Rossi-Fanelli Antonio Amoroso | 2014 | World Journal of Gastrointestinal Pharmacology and Therapeutics2014,5,3: | 6 |