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| 1 | 中国首次岸基GNSS-R海洋遥感实验显示文摘GNSS-Reflection技术是一种崭新的海洋遥感技术.它利用导航卫星的海面反射信号可获取海浪、潮汐及海面风场等重要信息,是海洋遥感的前沿领域.报道了中国岸基GNSS-R海洋遥感实验——CORE实验,研究了利用GPS卫星直达波与反射波信号反演海洋参数的方法,给出了有效波高的最新反演结果,并利用同步观测进行了对比验证. | 王鑫 孙强 张训械 吕达仁 邵连军 胡雄 Ruffini Giulio Dunne Stephen Francois Soulat | 2008 | 科学通报2008，53，5： | 25 |
| 2 | Long-term albumin infusion improves survival in patients with cirrhosis and ascites: An unblinded randomized trial显示文摘瞄准:在幸存上调查长期的白朊管理的效果,腹水的复发和另外的复杂并发症的发作。方法:为第一发作的腹水招收的 100 个连续病人被使随机化加人的白朊收到利尿剂第一年和 25 g 里的 25 g/wk 每二 wk 此后(组 1 ) 或利尿剂独自一个(组 2 ) 。没有肝移植,主要端点是幸存。第二等的端点是腹水的复发和另外的复杂并发症的出现。结果:中部的后续是 84 (2-120 ) 瞬间。对待白朊的病人有显著地更大的累积幸存率(Breslow test=7.05, P=0.0078 ) 并且腹水复发的更低的概率(51% 对 94% , P<0.0001 ) 。长期的白朊注入导致了 16 瞬间的幸存的吝啬的增加。结论:在第一发作的腹水以后的长期的白朊管理显著地改进病人的幸存并且减少腹水复发的风险。 | Roberto Giulio Romanelli Giorgio La Villa Giuseppe Barletta Francesco Vizzutti Fabio Lanini Umberto Arena Vieri Boddi Roberto Tarquini Pietro Pantaleo Paolo Gentilini Giacomo Laffi | 2006 | World Journal of Gastroenterology2006，12，9： | 22 |
| 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 | 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 |
| 5 | Diagnosis of pancreatic tumors by endoscopic ultrasound-guided fine-needle aspiration显示文摘AIM: To evaluate the diagnostic accuracy of endoscopic ultrasound-guided fi ne-needle aspiration (EUS-FNA) for pancreatic solid tumors larger or smaller than 3 cm, and cystic lesions. METHODS: From January/1997 to December/2006, 611 patients with pancreatic tumors were subjected to EUS-FNA. The fi nal diagnosis was obtained either by surgery (356 cases) or after a mean clinical follow-up of 11.8 mo in the remaining patients. RESULTS: There were 405 solid tumors, 189 cystic lesions and 17 mixed. Pancreatic specimens for cytological assessment were successfully obtained by EUS-FNA in 595 (97.4/) cases. There were 352 (57.6/) malignancies and 259 (42.4/) benign tumors. Among the malignancies, pancreatic adenocarcinomas accounted for 67/ of the lesions. Overall, the sensitivity, specifi city, positive and negative predictive values, and accuracy of EUS-FNA were, respectively, 78.4/, 99.2/, 99.3/, 77.2/ and 87.2/. Specif ically for solid tumors, the same parameters for neoplasms larger and smaller than 3 cm were, respectively, 78.8/ vs 82.4/, 100/ vs 98.4/, 100/ vs 99/, 54.8/ vs 74.1/ and 83.1/ vs 87.8/. For cystic lesions, the values were, respectively, 72.2/, 99.3/, 97.5/, 91/ and 92.2/. CONCLUSION: EUS-FNA can be used to sample pancreatic tumors in most patients. Even though the negative predictive value is inadequate for large solid tumors, the results are rather good for small solid tumors, especially concerning the sensitivity, negative predictive value and diagnostic accuracy. Among all pancreatic lesions, EUS-FNA for cystic lesions canreveal the best negative predictive value and diagnostic accuracy, both higher than 90/. | José Celso Ardengh César Vivian Lopes Luiz Felipe Pereira de Lima Juliano Rodrigues de Oliveira Filadélfi o Venco Giulio Cesare Santo José Luiz Pimenta Módena | 2007 | World Journal of Gastroenterology2007，13，22： | 17 |
| 6 | Ultrasound detection of abdominal lymphadenomegaly in subjects with hepatitis C virus infection and persistently normal transaminases:a predictive index of liver histology severity显示文摘UltrasounddetectionofabdominallymphadenomegalyinsubjectswithhepatitisCvirusinfectionandpersistentlynormaltransaminases:apredi... | Maurizio Soresi, Antonio Carroccio, Giulio Bonfissuto, Vincenzo Agate 1, Carmela Magliarisi, Federico Aragona 1, Massimo Levrero 2, Alberto Notarbartolo and Giuseppe Montalto Cattedra di Medicina Interna, 1Istituto di Anatomia Patologica, Univ | 1998 | World Journal of Gastroenterology1998，4，3： | 15 |
| 7 | First China ocean reflection experiment using coastal GNSS-R显示文摘It is a new way for oceanographic remote sensing using the GNSS-Reflection technique. Sea waves, tides and sea surface wind can be obtained by analyzing the direct and reflected GPS signals from sea surface. It has become an advanced field concerned by many researchers. In this paper the first China Ocean Reflection Experiment (CORE) with the coastal GNSS-R in the southeast is reported and the method to retrieve oceanographic parameters with the direct and reflected GPS signals is studied. The primary retrievals of Significant Wave Height (SWH) are presented and also compared with the meas-urements from Ultrasonic Wave Gauge (UWG) in situ. | WANG Xin SUN Qiang ZHANG XunXie LU DaRen SHAO LianJun HU Xiong RUFFINI Giulio DUNNE Stephen FRANCOIS Soulat | 2008 | Chinese Science Bulletin2008，53，7： | 15 |
| 8 | 多因素分析预测来曲唑提高非梗阻性无精子症和隐匿性无精子症患者精子密度研究显示文摘探讨来曲唑对提高睾酮/雌二醇比例(T/E2)〈10的非梗阻性无精子症或隐匿性无精子症患者的精子数量的有效性。46例不育症患者,排除染色体异常后随机分为两组:第1组22例患者,包括6例无精子症患者和16例隐匿性无精子症患者,接受来曲唑治疗,每天2.5毫克,连续治疗6个月;第2组24例患者包括5例无精子症患者和19例隐匿性无精子症患者,使用安慰剂。收集以下数据:精液常规分析、临床病史、阴囊超声检查、体重指数(BMI)、Y染色体微缺失筛查、染色体核型分析、囊性纤维化筛查,以及性激素检查卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇、雄激素和催乳素。所有患者在接受来曲唑或安慰剂前后都进行精液分析和性激素评估。采用Mann—Whitney己,检验进行统计学分析,精子浓度与FSH、T/E2的比例、双侧睾丸体积~IIBMI等参数的关系使用多变量分析评估,不良作用评估使用卡方检验进行分析。结果发现第1组患者精子浓度、活力、FSH、LH和T都显著增加,平均精子浓度从400ml。增加到1.29×10^6 ml^-1(P〈0.01),平均精子活力a级精子从2%增加至15%(P〈0.01),而第2组则没有明显变化。第一组中的雌二醇水平有显著下降,第2组无明显变化。第1组中有8名患者有副作用,第2组中没有患者出现副作用。来曲唑治疗后精子浓度与T/E2比值,FSH水平以及体重指数呈负相关,精子浓度和睾丸体积之间有直接相关性。 | Giorgio Cavallini Giulio Biagiotti Elisa Bolzon | 2013 | Asian Journal of Andrology2013，15，6： | 15 |
| 9 | Simultaneous intraductal papillary neoplasms of the bile duct and pancreas treated with chemoradiotherapy显示文摘Some authors have suggested that intraductal papillary mucinous neoplasms of the bile duct(IPMN-B) could be the the biliary counterpart of IPMN of the pancreas(IPMN-P) since they share several clinical-pathological features.These include prominent intraductal papil-lary proliferation pattern,a gastrointestinal phenotype,frequent mucin hyper-secretion and progression to mu-cinous carcinoma.To date there are just four reported cases of patients with synchronous IPMN-B and IPMN-P all of which were treated surgically.We hereby report the case of a 76-year-old woman who was incidentally diagnosed with both an asymptomatic 3 cm bulky uid lesion obstructing the bile duct lumen,diagnosed as a malignant IPMN-B,and synchronous multiple pancreatic cystic lesions(10-13 mm) communicating with an irreg-ular Wirsung,diagnosed as branch duct IPMN-P.Since surgery was ruled-out because of the patient's age and preferences,she underwent a conservative manage-ment regimen comprising both chemotherapy and radio-therapy.This was effective in decreasing the mass size and in resolving subsequent jaundice.This is also the f irst reported case of IPMN-B successfully treated with chemoradiotherapy.Clinicians should consider medical treatment as an option in this clinical scenario,in pa-tients who may be unf it for surgery. | Roberto Valente Gabriele Capurso Paola Pierantognetti Elsa Iannicelli Matteo Piciucchi Adriana Romiti Paolo Mercantini Alberto Larghi Giulia Francesca Federici Viola Barucca Maria Falchetto Osti Emilio Di Giulio Vincenzo Ziparo Gianfranco Delle Fave | 2012 | World Journal of Gastrointestinal Oncology2012，4，2： | 13 |
| 10 | Asthma and gastroesophageal reflux disease: Effect of long-term pantoprazole therapy显示文摘AIM: To define the prevalence of gastroesophageal reflux disease (GERD) in mild persistent asthma and to value the effect of pantoprazole therapy on asthmatic symptoms.METHODS: Seven of thirty-four asthmatic patients without GERD served as the non-GERD control group.Twenty-seven of thirty-four asthmatic patients had GERD (7/27 also had erosive esophagitis, sixteen of them presented GERD symptoms. An upper gastrointestinal endoscopy was performed in all the subjects to obtain five biopsy specimens from the lower 5 cm of the esophagus. Patients were considered to have GERD when they had a dilation of intercellular space (DIS)>0.74 μm at transmission electron microscopy.Patients with GERD were treated with pantoprazole,80 mg/day. Forced expiratory volume in one second (FEV1) was performed at entry and after 6 mo of treatment. Asthmatic symptoms were recorded. The required frequency of inhaling rapid acting 32-agonists was self-recorded in the patients' diaries.RESULTS: Seven symptomatic patients presented erosive esophagitis. Among the 18 asymptomatic patients, 11 presented DIS, while all symptomatic patients showed ultrastructural esophageal damage.Seven asymptomatic patients did not present DIS. At entry the mean of FEV1 was 1.91 L in symptomatic GERD patients and 1.88 L in asymptomatic GERD patients.After the treatment, 25 patients had a complete recovery of DIS and reflux symptoms. Twenty-three patients presented a regression of asthmatic symptoms with normalization of FEV1. Four patients reported a significant improvement of symptoms and their FEV1 was over 80%.CONCLUSION: GERD is a highly prevalent condition in asthma patients. Treatment with pantoprazole (80 mg/day)determines their improvement and complete regression. | Calabrese Carlo Fabbri Anna Areni Alessandra Scialpi Carlo Zahlane Desiree Di Febo Giulio | 2005 | World Journal of Gastroenterology2005，11，48： | 10 |
| 11 | Developmental pathways associated with cancer metastasis:Notch,Wnt,and Hedgehog显示文摘Master developmental pathways, such as Notch, Wnt, and Hedgehog, are signaling systems that control proliferation, cell death,motility, migration, and stemness. These systems are not only commonly activated in many solid tumors, where they drive or contribute to cancer initiation, but also in primary and metastatic tumor development. The reactivation of developmental pathways in cancer stroma favors the development of cancer stem cells and allows their maintenance, indicating these signaling pathways as particularly attractive targets for efficient anticancer therapies, especially in advanced primary tumors and metastatic cancers. Metastasis is the worst feature of cancer development. This feature results from a cascade of events emerging from the hijacking of epithelial-mesenchymal transition, angiogenesis, migration, and invasion by transforming cells and is associated with poor survival, drug resistance, and tumor relapse. In the present review, we summarize and discuss experimental data suggesting pivotal roles for developmental pathways in cancer development and metastasis, considering the therapeutic potential. Emerging targeted antimetastatic therapies based on Notch, Wnt, and Hedgehog pathways are also discussed. | Armel Herve Nwabo Kamdje Paul Takam Kamga Richard Tagne Simo Lorella Vecchio Paul Faustin Seke Etet Jean Marc Muller Giulio Bassi Erique Lukong Raghuveera Kumar Goel Jeremie Mbo Amvene Mauro Krampera | 2017 | Cancer Biology & Medicine2017，14，2： | 10 |
| 12 | A position statement on NAFLD/NASH based on the EASL 2009 special conference显示文摘 | Vlad Ratziu Stefano Bellentani Helena Cortez-Pinto Chris Day Giulio Marchesini | 2010 | Journal of Hepatology2010，，2： | 9 |
| 13 | Preliminary study of letrozole use for improving spermatogenesis in non-obstructive azoospermia patients with normal serum FSH显示文摘我们调查了是否 letrozole (2.5 mg 天 −1) 在非妨碍的精子缺乏(NOA ) 改进精子计数病人。四个人在这研究被包括,并且他们在正常范围和没有精索静脉曲张或 chromosomal 错误以内有刺激 folliculo 荷尔蒙和其它荷尔蒙层次。这四个病人是管理 letrozole 3 个月了。精子计数,阴囊的体积, gonadotropin,睾丸激素(T) 和 estradiol (E2 ) 血层次以前被估计,在期间并且在治疗的暂停以后的 1 个星期。所有病人在他们的精液,增加的 gonadotropin 和 T 层次和更低的 E2 层次显示出精子(P< 0.05 在所有情况中) ,当 letrozole 被管理时。这建议 letrozole 治疗可能在一张 NOA 亚人口改进精子计数;然而,包括合适的控制,更多的研究被需要证实它的功效。 | Giorgio Cavallini Giovanni Beretta Giulio Biagiotti | 2011 | Asian Journal of Andrology2011，13，6： | 9 |
| 14 | Influence of Process Parameters and Sr Addition on the Microstructure and Casting Defects of LPDC A356 Alloy for Engine Blocks显示文摘The effects of Sr addition and pressure increase on the microstructure and casting defects of a low-pressure die cast(LPDC)Al Si7Mg0.3 alloy have been studied.Metallographic and image analysis techniques have been used to quantitatively examine the microstructural changes and the amount of porosity occurring at different Sr levels and pressure parameters.The results indicate that an increase in the filling pressure induces lower heat dissipation of the liquid close to the die/core surfaces,with the formation of slightly greater dendrite arms and coarser eutectic Si particles.On the other hand,the increase in the Sr level leads to finer microstructural scale and eutectic Si.The analysed variables,within the experimental conditions,do not affect the morphology of eutectic Si particles.Higher applied pressure and Sr content generate castings with lower amount of porosity.However,as the filling pressure increases the flow of metal inside the die cavity is more turbulent,leading to the formation of oxide films and cold shots.In the analysed range of experimental conditions,the design of experiment methodology and the analysis of variance have been used to develop statistical models that accurately predict the average size of secondary dendrite arm spacing and the amount of porosity in the low-pressure die cast Al Si7Mg0.3 alloy. | Giulio Timelli Daniele Caliari Jovid Rakhmonov | 2016 | Journal of Materials Science & Technology2016，32，6： | 8 |
| 15 | The Gut Microbiota and Atherosclerosis:The State of the Art and Novel Perspectives显示文摘The human gut microbiota is composed of more than 100 trillion microbes.Most communities are dominated by species belonging to the phyla Bacteroidetes,Firmicutes,Actinobacteria,Proteobacteria,and Verrucomicrobia.Microfl ora-derived short-chain fatty acids play a pivotal role in the framework of insulin resistance,obesity,and metabolic syndrome.They are an important energy source and are involved in several pathways,with proatherogenic and antiatherogenic effects.The increased gut microbiota lipopolysaccharide levels(defi ned as“metabolic endotoxemia”)induce a state of low-grade infl ammation and are involved in atherosclerotic disease through Toll-like receptor 4.Another important infl ammatory trigger in gut microbiota–mediated atherosclerotic promotion is trimethylamine N-oxide.On the other hand,protocatechuic acid was found to promote cholesterol effl ux from macrophages,showing an antiatherogenic effect.Further studies to clarify specifi c gut composition involved in cardiometabolic syndrome and atherogenesis are needed for greater use of targeted approaches. | Giulio La Rosa Luigi Marzio Biasucci | 2016 | Cardiovascular Innovations and Applications2016，，B09： | 7 |
| 16 | Mechanisms of resistance to anti-epidermal growth factor receptor inhibitors in metastatic colorectal cancer显示文摘The prognosis of patients with metastatic colorectal cancer(m CRC) remain poor despite the impressive improvement of treatments observed over the last 20 years that led to an increase in median overall survival from 6 mo, with the only best supportive care, to approximately 30 mo with the introduction of active chemotherapy drugs and targeted agents. The monoclonal antibodies(mo Abs) cetuximab and panitumumab, directed against the epidermal growth factor receptor(EGFR), undoubtedly represent a major step forward in the treatment of m CRC, given the relevant efficacy in terms of progression-free survival, overall survival, response rate, and quality of life observed in several phase Ⅲ clinical trials among different lines of treatment. However, the anti-EGFR mo Abs were shown only to be effective in a subset of patients. For instance, KRAS and NRAS mutations have been identified as biomarkers of resistance to these drugs, improving the selection of patients who might derive a benefit from these treatments. Nevertheless, several other alterations might affect the response to these drugs, and unfortunately, even the responders eventually become resistant by developing secondary(or acquired) resistance in approximately 13-18 mo. Several studies highlighted that the landscape of responsible alterations of both primary and acquired resistance to anti-EGFR drugs biochemically converge into MEK-ERK and PIK3CA-AKT pathways. In this review, we describe the currently known mechanisms of primary and acquired resistance to anti-EGFR mo Abs together with the various strategies evaluated to prevent, overcame or revert them. | Vincenzo Sforza Erika Martinelli Fortunato Ciardiello Valentina Gambardella Stefania Napolitano Giulia Martini Carminia della Corte Claudia Cardone Marianna L Ferrara Alfonso Reginelli Giuseppina Liguori Giulio Belli Teresa Troiani | 2016 | World Journal of Gastroenterology2016，22，28： | 6 |
| 17 | Titanium elastic nailing in diaphyseal femoral fractures of children below six years of age显示文摘AIM To report the clinical and radiographic results of titanium elastic nail(TEN) in diaphyseal femoral fractures of children below age of six years.METHODS A retrospective analysis of 27 diaphyseal femoral fractures in children younger than six years treated with TEN between 2005 and 2015 was conducted. Patients were immobilized in a cast for 5 wk and the nails were removed from 6 to 12 wk after surgery. Twenty-four cases were clinically and radiographically re-evaluated using the Flynn's scoring criteria, focusing on: Limb length discrepancy, rotational deformity, angulation, hip and knee range of motion(ROM), functional status, complications, and parent's satisfaction.RESULTS Sixteen males and eight females with a mean age of 3.2 years at the time of treatment were re-evaluated at an average follow-up of 58.9 mo. No cases of delayed union were observed. The mean limb lengthening was 0.3 cm. Four cases experienced limb lengthening greater than 1 cm and always minor than 2 cm. Twelve point five percent of the cases showed an angulation < 10°. Complete functional recovery(hip and knee ROM, ability to run and jump on the operated limb) occurred in 95.7% of cases. Complications included two cases of superficial infection of the TEN entry point, one case of refracture following a new trauma, and one TEN mobilization. According to the Flynn's scoring criteria, excellent results were obtained in 79.2% of patients and satisfactory results in the remaining 20.8%, with an average parent's satisfaction level of 9.1/10.CONCLUSION TEN is as a safe, mini-invasive and surgeon-friendly technique and, considering specific inclusion criteria, it represents a useful and efficacy option for the treatment of diaphyseal femoral fractures even in patients younger than six years of age. | Fabrizio Donati Giuseppe Mazzitelli Marco Lillo Amerigo Menghi Carla Conti Antonio Valassina Emanuele Marzetti Giulio Maccauro | 2017 | World Journal of Orthopedics2017，8，2： | 5 |
| 18 | Percutaneous thrombin embolization of a pancreaticoduodenal artery pseudoaneurysm after failing of the endovascular treatment显示文摘Pancreatico-duodenal artery(PDA) pseudoaneurysms are rare vascular conditions with high mortality rates after rupture and they are frequently secondary to pan-creatitis, surgery, trauma or infection. Due to the high risk of rupture and bleeding, it is mandatory to treat all pseudoaneurysms, regardless of their size or symp-tomatology. First option of treatment is open surgical repair, but it has high mortality rate, especially in he-modynamically unstable patients. In the recent years, percutaneous ultrasonography(US)- or computed to-mography-guided thrombin injection was proposed as an alternative method for treating visceral aneurysms and pseudoaneurysms, but few reports described this therapy in case of peri-pancreatic pseudoaneurysms. We present a rare case of pseudoaneurysm of the PDA in a patient with no previous history of pancreatitis nor major surgery but with an occlusive lesion of the celiac axis. To the best of our knowledge this is the first reported case of PDA pseudoaneurysm successfully treated in emergency by single transabdominal US-guided injection of thrombin after failed attempts of percutaneous catheterization of the feeding vessel of the pseudoaneurysm. | Giulio Barbiero Michele Battistel Ana Susac Diego Miotto | 2014 | World Journal of Radiology2014，6，8： | 5 |
| 19 | Impaired coagulation,liver dysfunction and COVID-19:Discovering an intriguing relationship显示文摘Coronavirus disease 2019(COVID-19)is,at present,one of the most relevant global health problems.In the literature hepatic alterations have been described in COVID-19 patients,and they are mainly represented by worsening of underlying chronic liver disease leading to hepatic decompensation and liver failure with higher mortality.Several potential mechanisms used by severe acute respiratory syndrome coronavirus 2(SARS-Co V-2)to cause liver damage have been hypothesized.COVID-19 primary liver injury is less common than secondary liver injury.Most of the available data demonstrate how liver damage in SARSCo V-2 infection is likely due to systemic inflammation,and it is less likely mediated by a cytopathic effect directed on liver cells.Moreover,liver alterations could be caused by hypoxic injury and drugs(antibiotics and non-steroidal antiinflammatory drugs,remdesivir,tocilizumab,tofacitinib and dexamethasone).SARS-Co V-2 infection can induce multiple vascular district atherothrombosis by affecting simultaneously cerebral,coronary and peripheral vascular beds.Data in the literature highlight how the virus triggers an exaggerated immune response,which added to the cytopathic effect of the virus can induce endothelial damage and a prothrombotic dysregulation of hemostasis.This leads to a higher incidence of symptomatic and confirmed venous thrombosis and of pulmonary embolisms,especially in central,lobar or segmental pulmonary arteries,in COVID-19.There are currently fewer data for arterial thrombosis,while myocardial injury was identified in 7%-17%of patients hospitalized with SARS-Co V-2 infection and 22%-31%in the intensive care unit setting.Available data also revealed a higher occurrence of stroke and more serious forms of peripheral arterial disease in COVID-19 patients.Hemostasis dysregulation is observed during the COVID-19 course.Lower platelet count,mildly increased prothrombin time and increased Ddimer are typical laboratory features of patients with severe SARS-Co V-2 infection,described as“COVID-19 associated coagulopathy.”These alterations are correlated to poor outcomes.Moreover,patients with severe SARS-Co V-2 infection are characterized by high levels of von Willebrand factor with subsequent ADAMTS13 deficiency and impaired fibrinolysis.Platelet hyperreactivity,hypercoagulability and hypofibrinolysis during SARS-Co V-2 infection induce a pathological state named as“immuno-thromboinflammation.”Finally,liver dysfunction and coagulopathy are often observed at the same time in patients with COVID-19.The hypothesis that liver dysfunction could be mediated by microvascular thrombosis has been supported by postmortem findings and extensive vascular portal and sinusoidal thrombosis observation.Other evidence has shown a correlation between coagulation and liver damage in COVID-19,underlined by the transaminase association with coagulopathy,identified through laboratory markers such as prothrombin time,international normalized ratio,fibrinogen,D-dimer,fibrin/fibrinogen degradation products and platelet count.Other possible mechanisms like immunogenesis of COVID-19 damage or massive pericyte activation with consequent vessel wall fibrosis have been suggested. | Damiano D'Ardes Andrea Boccatonda Giulio Cocco Stefano Fabiani Ilaria Rossi Marco Bucci Maria Teresa Guagnano Cosima Schiavone Francesco Cipollone | 2022 | World Journal of Gastroenterology2022，28，11： | 5 |
| 20 | Electroconvulsive therapy in catatonic patients: Efficacy and predictors of response显示文摘Recent evidence favors the view of catatonia as an autonomous syndrome, frequently associated with mood disorders, but also observed in neurological, neurodevelop-mental, physical and toxic conditions. From our systematic literature review, electroconvulsive therapy(ECT) results effective in all forms of catatonia, even after pharmacotherapy with benzodiazepines has failed. Response rate ranges from 80% to 100% and results superior to those of any other therapy in psychiatry. ECT should be considered first-line treatment in patients with malignant catatonia, neuroleptic malignant syndrome, delirious mania or severe catatonic excitement, and in general in all catatonic patients that are refractory or partially responsive to benzodiazepines. Early intervention with ECT is encouraged to avoid undue deterioration of the patient's medical condition. Little is known about the long-term treatment outcomes following administration of ECT for catatonia. The presence of a concomitant chronic neurologic disease or extrapyramidal deficit seems to be related to ECT non-response. On the contrary, the presence of acute, severe and psychotic mood disorder is associated with good response. Severe psychotic features in responders may be related with a prominent GABAergic mediated deficit in orbitofrontal cortex, whereas non-responders may be characterized by a prevalent dopaminergic mediated extrapyramidal deficit. These observations are consistent with the hypothesis that ECT is more effective in 'top-down' variant of catatonia, in which the psychomotor syndrome may be sustained by a dysregulation of the orbitofrontal cortex, than in 'bottom-up' variant, in which an extrapyramidal dysregulation may be prevalent. Future research should focus on ECT response in different subtype of catatonia and on efficacy of maintenance ECT in long-term prevention of recurrent catatonia. Further research on mechanism of action of ECT in catatonia may also contribute to the development of other brain stimulation techniques. | Federica Luchini Pierpaolo Medda Michela Giorgi Mariani Mauro Mauri Cristina Toni Giulio Perugi | 2015 | World Journal of Psychiatry2015，5，2： | 5 |
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