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| 1 | Lipoprotein-associated phospholipase A2 prognostic role in atherosclerotic complications显示文摘Atherosclerosis manifests itself clinically at advanced stages when plaques undergo hemorrhage and/or rupture with superimposed thrombosis, thus abruptly stopping blood supply. Identification of markers of plaque destabilization at a pre-clinical stage is, therefore, a major goal of cardiovascular research. Promising results along this line were provided by studies investigating the lipoprotein-associated phospholipase A2(Lp-PLA2), a member of phospholipase A2 proteins family that plays a key role in the metabolism of pro-inflammatory phospholipids, as oxidized low-density lipoproteins, and in the generation of pro-atherogenic metabolites, including lysophosphatidylcholine and oxidized free fatty acids. We herein review the experimental and clinical studies supporting use of Lp-PLA2 activity for predicting cardiovascular events. To his end we considered not only Lp-PLA2 activity and mass, but also Lp-PLA2 gene variations and their association with incident coronary artery disease, stroke, and cardiovascular mortality. Based on these evidences the major scientific societies have included in their guidelines the measurement of Lp-PLA2 activity among the biomarkers that are useful in risk stratification of adult asymptomatic patients at intermediate cardiovascular risk. The results of two recently published major clinical trials with the LpPLA2 inhibitor darapladib, which seem to challenge the pathogenic role of Lp-PLA2, will also be discussed. | Giuseppe Maiolino Valeria Bisogni Giacomo Rossitto Gian Paolo Rossi | 2015 | World Journal of Cardiology2015，7，10： | 66 |
| 2 | Focus on peripherally inserted central catheters in critically ill patients显示文摘Venous access devices are of pivotal importance for an increasing number of critically ill patients in a variety of disease states and in a variety of clinical settings(emergency, intensive care, surgery) and for different purposes(fluids or drugs infusions, parenteral nutrition, antibiotic therapy, hemodynamic monitoring, procedures of dialysis/apheresis). However, healthcare professionals are commonly worried about the possible consequences that may result using a central venous access device(CVAD)(mainly, bloodstream infections and thrombosis), both peripherally inserted central catheters(PICCs) and centrally inserted central catheters(CICCs). This review aims to discuss indications, insertion techniques, and care of PICCs in critically ill patients. PICCs have many advantages over standard CICCs. First of all, their insertion is easy and safe-due to their placement into peripheral veins of the armand the advantage of a central location of catheter tip suitable for all osmolarity and p H solutions. Using the ultrasound-guidance for the PICC insertion, the risk of hemothorax and pneumothorax can be avoided, as wellas the possibility of primary malposition is very low. PICC placement is also appropriate to avoid post-procedural hemorrhage in patients with an abnormal coagulative state who need a CVAD. Some limits previously ascribed to PICCs(i.e., low flow rates, difficult central venous pressure monitoring, lack of safety for radio-diagnostic procedures, single-lumen) have delayed their start up in the intensive care units as common practice. Though, the recent development of power-injectable PICCs overcomes these technical limitations and PICCs have started to spread in critical care settings. Two important take-home messages may be drawn from this review. First, the incidence of complications varies depending on venous accesses and healthcare professionals should be aware of the different clinical performance as well as of the different risks associated with each type of CVAD(CICCs or PICCs). Second, an inappropriate CVAD choice and, particularly, an inadequate insertion technique are relevant-and often not recognized-potential risk factors for complications in critically ill patients. We strongly believe that all healthcare professionals involved in the choice, insertion or management of CVADs in critically ill patients should know all potential risk factors of complications. This knowledge may minimize complications and guarantee longevity to the CVAD optimizing the risk/benefit ratio of CVAD insertion and use. Proper management of CVADs in critical care saves lines and lives. Much evidence from the medical literature and from the clinical practice supports our belief that, compared to CICCs, the so-called power-injectable peripherally inserted central catheters are a good alternative choice in critical care. | Paolo Cotogni Mauro Pittiruti | 2014 | World Journal of Critical Care Medicine2014，3，4： | 52 |
| 3 | Endoscopic ultrasound elastography for evaluation of lymph nodes and pancreatic masses:A multicenter study显示文摘AIM:To evaluate the ability of endoscopic ultrasound(EUS) elastography to distinguish benign from malignant pancreatic masses and lymph nodes.METHODS:A multicenter study was conducted and included 222 patients who underwent EUS examination with assessment of a pancreatic mass(n=121) or lymph node(n=101).The classification as benign or malignant,based on the real time elastography pattern,was compared with the classif ication based on the B-mode EUS images and with the fi nal diagnosis obtained by EUS-guided fi ne needle aspiration(EUS-FNA) and/or by surgical pathology.An interobserver study was performed.RESULTS:The sensitivity and specificity of EUS elastography to differentiate benign from malignant pancreatic lesions are 92.3% and 80.0%,respectively,compared to 92.3% and 68.9%,respectively,for the conventional B-mode images.The sensitivity and specificity of EUS elastography to differentiate benign from malignant lymph nodes was 91.8% and 82.5%,respectively,compared to 78.6% and 50.0%,respectively,for the B-mode images.The kappa coefficient was 0.785 for the pancreatic masses and 0.657 for the lymph nodes.CONCLUSION:EUS elastography is superior compared to conventional B-mode imaging and appears to be able to distinguish benign from malignant pancreatic masses and lymph nodes with a high sensitivity,specificity and accuracy.It might be reserved as a second line examination to help characterise pancreatic masses after negative EUS-FNA and might increase the yield of EUS-FNA for lymph nodes. | Marc Giovannini Botelberge Thomas Bories Erwan Pesenti Christian Caillol Fabrice Esterni Benjamin Monges Geneviève Arcidiacono Paolo Deprez Pierre Yeung Robert Schimdt Walter Schrader Hanz Szymanski Carl Dietrich Christoph Eisendrath Pierre Van Laethem Jean-Luc Devière Jacques Vilmann Peter Saftoiu Andrian | 2009 | World Journal of Gastroenterology2009，15，13： | 48 |
| 4 | Blood loss,predictors of bleeding,transfusion practice and strategies of blood cell salvaging during liver transplantation显示文摘Blood loss during liver transplantation (OLTx) is a common consequence of pre-existing abnormalities of the hemostatic system,portal hypertension with multiple collateral vessels,portal vein thrombosis,previous abdominal surgery,splenomegaly,and poor 'functional' recovery of the new liver.The intrinsic coagulopathic features of end stage cirrhosis along with surgical technical difficulties make transfusion-free liver transplantation a major challenge,and,despite the improvements in understanding of intraoperative coagulation profiles and strategies to control blood loss,the requirements for blood or blood products remains high.The impact of blood transfusion has been shown to be significant and independent of other well-known predictors of posttransplant-outcome.Negative effects on immunomodulation and an increased risk of postoperative complications and mortality have been repeatedly demonstrated.Isovolemic hemodilution,the extensive utilization of thromboelastogram and the use of autotransfusion devices are among the commonly adopted procedures to limit the amount of blood transfusion.The use of intraoperative blood salvage and autologous blood transfusion should still be considered an important method to reduce the need for allogenic blood and the associated complications.In this article we report on the common preoperative and intraoperative factors contributing to blood loss,intraoperative transfusion practices,anesthesiologic and surgical strategies to prevent blood loss,and on intraoperative blood salvaging techniques and autologous blood transfusion.Even though the advances in surgical technique and anesthetic management,as well as a better understanding of the risk factors,have resulted in a steady decrease in intraoperative bleeding,most patients still bleed extensively.Blood transfusion therapy is still a critical feature during OLTx and various studies have shown a large variability in the use of blood products among different centers and even among individual anesthesiologists within the same center.Unfortunately,despite the large number of OLTx performed each year,there is still paucity of large randomized,multicentre,and controlled studies which indicate how to prevent bleeding,the transfusion needs and thresholds,and the 'evidence based' perioperative strategies to reduce the amount of transfusion. | Feltracco Paolo Brezzi Marialuisa Barbieri Stefania Galligioni Helmut Milevoj Moira Carollo Cristiana Ori Carlo | 2013 | World Journal of Hepatology2013，5，1： | 37 |
| 5 | Attributable Causes of Breast Cancer and Ovarian Cancer in China:Reproductive Factors,Oral Contraceptives and Hormone Replacement Therapy显示文摘Objective:To provide an evidence-based,consistent assessment of the burden of breast cancer attributable to reproductive factors(RFs,including nulliparity,mean number of children,age at first birth and breastfeeding),use of oral contraceptives(OCs,restricted to the age group of 15-49 years),and hormone replacement therapy(HRT),as well as of the burden of ovarian cancer attributable to the mean number of children in China in 2005.Methods:We derived the prevalence of these risk factors and the relative risk of breast and ovarian cancer from national surveys or large-scale studies conducted in China.In the case of RFs,we compared the exposure distributions in 2001 and counterfactual exposure.Results:Exposure of RFs in 2001 was found to account for 6.74% of breast cancer,corresponding to 9,617 cases and 2,769 deaths,and for 2.78% of ovarian cancer(711 cases,294 deaths).The decrease in mean number of children alone was responsible for 1.47% of breast cancer and 2.78% of ovarian cancer.The prevalence of OC use was 1.74% and the population attributable fraction(PAF) of breast cancer was 0.71%,corresponding to 310 cases and 90 deaths.The PAF of breast cancer due to HRT was 0.31%,resulting in 297 cases and 85 deaths.Conclusion: RFs changes in China contributed to a sizable fraction of breast and ovarian cancer incidence and mortality, whereas HRT and OCs accounted for relatively low incidence of breast cancer in China. | Li Li Jia JI Jian-bing Wang Mayineur Niyazi You-lin Qiao Paolo Boffettas | 2012 | Chinese Journal of Cancer Research2012，24，1： | 38 |
| 6 | Irritable bowel syndrome: a disease still searching for pathogenesis, diagnosis and therapy显示文摘Irritable bowel syndrome(IBS) is the most frequently diagnosed functional gastrointestinal disorder in primary and secondary care. It is characterised by abdominal discomfort, pain and changes in bowel habits that can have a serious impact on the patient's quality of life. The pathophysiology of IBS is not yet completely clear. Genetic, immune, environmental, inflammatory, neurological and psychological factors, in addition to visceral hypersensitivity, can all play an important role, one that most likely involves the complex interactions between the gut and the brain(gut-brain axis). The diagnosis of IBS can only be made on the basis of the symptoms of the Rome Ⅲ criteria. Because the probability of organic disease in patients fulfilling the IBS criteria is very low, a careful medical history is critical and should pay particular attention to the possible comorbidities.Nevertheless, the severity of the patient's symptoms or concerns sometimes compels the physician to perform useless and/or expensive diagnostic tests, transforming IBS into a diagnosis of exclusion. The presence of alarming symptoms(fever, weight loss, rectal bleeding, significant changes in blood chemistry), the presence of palpable abdominal masses, any recent onset of symptoms in patient aged over 50 years, the presence of symptoms at night, and a familial history of celiac disease, colorectal cancer and/or inflammatory bowel diseases all warrant investigation. Treatment strategies are based on the nature and severity of the symptoms, the degree of functional impairment of the bowel habits, and the presence of psychosocial disorders. This review examines and discusses the pathophysiological aspects and the diagnostic and therapeutic approaches available for patients with symptoms possibly related to IBS, pointing out controversial issues and the strengths and weaknesses of the current knowledge. | Massimo Bellini Dario Gambaccini Cristina Stasi Maria Teresa Urbano Santino Marchi Paolo Usai-Satta | 2014 | World Journal of Gastroenterology2014，20，27： | 37 |
| 7 | Early respiratory complications after liver transplantation显示文摘The poor clinical conditions associated with end-stage cirrhosis,pre-existing pulmonary abnormalities,and high comorbidity rates in patients with high Model for End-Stage Liver Disease scores are all well-recognized factors that increase the risk of pulmonary complications after orthotopic liver transplantation(OLT)surgery.Many intraoperative and postoperative events,such as fluid overload,massive transfusion of blood products,hemodynamic instability,unexpected coagulation abnormalities,renal dysfunction,and serious adverse effects of reperfusion syndrome,are other factors that predispose an individual to postoperative respiratory disorders.Despite advances in surgical techniques and anesthesiological management,the lung may still suffer throughout the perioperative period from various types of injury and ventilatory impairment,with different clinical outcomes.Pulmonary complications after OLT can be classified as infectious or non-infectious.Pleural effusion,atelectasis,pulmonary edema,respiratory distress syndrome,and pneumonia may contribute considerably to early morbidity and mortality in liver transplant patients.It is of paramount importance to accurately identify lung disorders because infectious pulmonary complications warrant speedy and aggressive treatment to prevent diffuse lung injury and the risk of evolution into multisystem organ failure.This review discusses the most common perioperative factors that predispose an individual to postoperative pulmonary complications and these complications’early clinical manifestations after OLT and influence on patient outcome. | Paolo Feltracco Cristiana Carollo Stefania Barbieri Tommaso Pettenuzzo Carlo Ori | 2013 | World Journal of Gastroenterology2013，19，48： | 32 |
| 8 | Mitochondrial metabolism and cancer显示文摘Glycolysis 长在癌症房间为精力生产和 anabolism 的生长被看作了主要新陈代谢的过程。尽管如此的一个看法为仍然在诊所被使用的强大的成像工具的发展是有帮助的,线粒体在 oncogenesis 起一个关键作用,现在是清楚的。除施加中央 bioenergetic 函数以外,线粒体确实为肿瘤同化提供积木,控制氧化还原作用和钙动态平衡,参予 transcriptional 规定,并且管理房间死亡。因此,线粒体为新奇 anticancer 代理人的发展组成有希望的目标。然而,肿瘤产生,进行,并且回答功能依靠未经触动的 mitochondrial 新陈代谢到在有主人免疫系统,和许多免疫学的亲密串音的上下文的治疗。这里,我们考察房间内在的癌症和线粒体影响都 oncogenesis 通过走的房间外来的机制,与指向为癌症治疗的 mitochondrial 新陈代谢的治疗学的潜力的一个焦点。 | Paolo Ettore Porporato Nicoletta Filigheddu José Manuel Bravo-San Pedro, Guido Kroemer, Lorenzo Galluzzi José Manuel Bravo-San Pedro, Guido Kroemer José Manuel Bravo-San Pedro, Guido Kroemer José Manuel Bravo-San Pedro, Guido Kroemer José Manuel Bravo-San Pedro, Guido Kroemer Guido Kroemer Guido Kroemer Lorenzo Galluzzi Lorenzo Galluzzi | 2018 | Cell Research2018，28，3： | 33 |
| 9 | Virus against virus:a potential treatment for 2019-nCov(SARS-CoV-2)and other RNA viruses显示文摘The novel coronavirus,2019-nCov(named as SARS-CoV-2 by ICTV Coronaviridae Study Group on February 12,2020),causes severe respiratory illness1 and has been spreading around the world rapidly.2 As of February 14,2020,there are over 64,000 confirmed cases with 1,384 deaths.This raises an urgent need for an effective treatment of the deadly disease.However,current antiviral drugs have limited effects on 2019-nCov(SARS-CoV-2). | Tuan M.Nguyen Yang Zhang Pier Paolo Pandolfi | 2020 | Cell Research2020，30，3： | 30 |
| 10 | 基于遥感与地理信息系统的SRM融雪径流模型在Alps山区流域的应用显示文摘融雪水在水资源利用中扮演着及其重要的角色 ,遥感技术的发展使得大面积监测雪盖成为可能 .选择Alps山意大利境内的Rienza流域 ,利用SRM模型模拟春季融雪径流 ,区别传统对SRM模型的描述、参数选择和应用的研究方式 ,研究环境因素对这些参数的影响尤其是对度 日因子的影响以及它们之间的内在关系 .重点讨论利用GIS和遥感数据获取SRM模型中的关键参数和因子 .结论显示SRM模型模拟春季融雪径流的关键是精确地输入模型参数 ;遥感数据在提取雪盖面积的过程中 ,消除地形影响是必要的 ;从SRM模型的应用状况分析 。 | 王建 马明国 Paolo Federicis | 2001 | 冰川冻土2001，23，4： | 25 |
| 11 | Neoadjuvant chemotherapy for gastric cancer. Is it a must or a fake?显示文摘AIM To investigate the neoadjuvant chemotherapy(NAC) effect on the survival of patients with proper stomach cancer submitted to D2 gastrectomy.METHODS We proceeded to a review of the literature with Pub Med, Embase, ASCO and ESMO meeting abstracts as well as computerized use of the Cochrane Library for randomized controlled trials(RCTs) comparing NAC followed by surgery(NAC + S) with surgery alone(SA) for gastric cancer(GC). The primary outcome was the overall survival rate. Secondary outcomes were the site of the primary tumor, extension of node dissection according to Japanese Gastric Cancer Association(JGCA) performed in both arms, disease-specific(DSS) and disease-free survival(DFS) rates, clinical and pathological response rates and resectability rates after perioperative treatment. RESULTS We identified a total of 16 randomized controlled trials comparing NAC + S(n = 1089) with SA(n = 973) published in the period from January 1993-March 2017. Only 6 of these studies were well-designed, structured trials in which the type of lymph node(LN) dissection performed or at least suggested in the trial protocol was reported. Two out of three of the RCTs with D2 lymphadenectomy performed in almost all cases failed to show survival benefit in the NAC arm. Inthe third RCT, the survival rate was not even reported, and the primary end points were the clinical outcomes of surgery with and without NAC. In the remaining three RCTs, D2 lymph node dissection was performed in less than 50% of cases or only recommended in the 'Study Treatment' protocol without any description in the results of the procedure really perfomed. In one of the two studies, the benefit of NAC was evident only for esophagogastric junction(EGJ) cancers. In the second study, there was no overall survival benefit of NAC. In the last trial, which documented a survival benefit for the NAC arm, the chemotherapy effect was mostly evident for EGJ cancer, and more than one-fourth of patients did not have a proper stomach cancer. Additionally, several patients did not receive resectional surgery. Furthermore, the survival rates of international reference centers that provide adequate surgery for homogeneous stomach cancer patients' populations are even higher than the survival rates reported after NAC followed by incomplete surgery.CONCLUSION NAC for GC has been rapidly introduced in international western guidelines without an evidence-based medicinerelated demonstration of its efficacy for a homogeneous population of patients with only stomach tumors submitted to adequate surgery following JGCA guidelines with extended(D2) LN dissection. Additional larger sample-size multicentre RCTs comparing the newer NAC regimens including molecular therapies followed by adequate extended surgery with surgery alone are needed. | Rossella Reddavid Silvia Sofia Paolo Chiaro Fabio Colli Renza Trapani Laura Esposito Mario Solej Maurizio Degiuli | 2018 | World Journal of Gastroenterology2018，24，2： | 25 |
| 12 | MicroRNAs as possible biomarkers for diagnosis and prognosis of hepatitis b- and c-related-hepatocellularcarcinoma显示文摘Aim of the present review is to summarize the current knowledge about the potential relationship between mi RNAs and hepatitis B virus(HBV)-hepatitis C virus(HCV) related liver diseases. A systematic computerbased search of published articles, according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis Statement, was performed to identify relevant studies on usefulness of serum/plasma/urine mi RNAs, as noninvasive biomarkers for early detection of HBV and HCV-induced hepatocellular carcinoma(HCC) development, as well as for its prognostic evaluation. The used Medical Subject Headings terms and keywords were: 'HBV', 'HCV', 'hepatocellular carcinoma', 'micro RNAs', 'mi RNAs', 'diagnosis', 'prognosis', 'therapy', 'treatment'. Some serum/plasma mi RNAs, including mi R-21, mi R-122, mi-125a/b, mi R-199a/b, mi R-221, mi R-222, mi R-223, mi R-224 might serve as biomarkers for early diagnosis/prognosis of HCC, but, to date, not definitive results or well-defined panels of mi RNAs have been obtained. More well-designed studies, focusing on populations of different geographical areas and involving larger series of patients, should be carried out to improve our knowledge on the potential role of mi RNAs for HCC early detection and prognosis. | Sirio Fiorino Maria Letizia Bacchi-Reggiani Michela Visani Giorgia Acquaviva Adele Fornelli Michele Masetti Andrea Tura Fabio Grizzi Matteo Zanello Laura Mastrangelo Raffaele Lombardi Luca Di Tommaso Arrigo Bondi Sergio Sabbatani Andrea Domanico Carlo Fabbri Paolo Leandri Annalisa Pession Elio Jovine Dario de Biase | 2016 | World Journal of Gastroenterology2016，22，15： | 25 |
| 13 | 贡嘎山地区不同海拔冷杉比叶质量和非结构性碳水化合物含量变化显示文摘以贡嘎山地区磨西山谷东北坡和康定山谷西南坡为样地,研究了高山林线和低海拔冷杉休眠期和生长旺盛期针叶比叶质量和组织非结构性碳水化合物含量.结果表明:生长在温暖湿润的磨西山谷东北坡的冷杉针叶比叶质量和组织非结构性碳水化合物含量均高于炎热干燥的康定山谷西南坡;高山林线冷杉比叶质量大于低海拔冷杉;高山林线冷杉组织非结构性碳水化合物含量总体高于低海拔冷杉,且生长期比休眠期更为显著.研究结果不支持'碳供应不足导致高山林线形成'的假说. | 李蟠 孙玉芳 王三根 王小丹 蔡小虎 朱万泽 Cherubini Paolo 李迈和 | 2008 | 应用生态学报2008，19，1： | 24 |
| 14 | 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 |
| 15 | Incidence of gallstone disease in Italy:Results from a multicenter,population-based Italian study (the MICOL project)显示文摘AIM:To evaluate gallstone incidence and risk factors in a large population-based study. METHODS: Gallstone incidence and risk factors, were evaluated by structured questionnaire and physical examination, respectively, in 9611 of 11 109 (86.5%) subjects who were gallstone-free at the cross-sectional study. RESULTS: Six centers throughout Italy enrolled 9611 subjects (5477 males, 4134 females, aged 30-79 years), 9517 of whom were included into analysis: 424 subjects (4.4%) had gallstones and 61 (0.6%) had been cholecystectomized yielding a cumulative incidence of 0.67% per year (0.66% in males, 0.81% in females). Increasing age, a high body mass index (BMI), a history of diabetes, peptic ulcer and angina, and low cholesterol and high triglyceride levels were identifi ed as risk factors in men while, in females, the only risk factors were increasing age and a high BMI.Increasing age and pain in the right hypocondrium in men and increasing age in females were identifi ed as predictors of gallstones. Pain in the epigastrium/ right hypocondrium was the only symptom related to gallstones; furthermore, some characteristics of pain (forcing to rest, not relieved by bowel movements) were significantly associated with gallstones. No correlation was found between gallstone characteristics and clinical manifestations, while increasing age in men and increasing age and BMI in females were predictors of pain. CONCLUSION:Increasing age and BMI represent true risk factors for gallstone disease (GD); pain in the right hypocondrium and/or epigastrium is confi rmed as the only symptom related to gallstones. | Davide Festi Ada Dormi Simona Capodicasa Tommaso Staniscia Adolfo F Attili Paola Loria Paolo Pazzi Giuseppe Mazzella Claudia Sama Enrico Roda Antonio Colecchia | 2008 | World Journal of Gastroenterology2008，14，34： | 23 |
| 16 | Low-volume plus ascorbic acid vs high-volume plus simethicone bowel preparation before colonoscopy显示文摘AIM:To investigate the effectiveness of low-volumeplus ascorbic acid [polyethylene glycol plus ascorbicacid(PEG + Asc) ] and high-volume plus simethicone[polyethylene glycol plus simethicone(PEG + Sim) ]bowel preparations.METHODS:A total of one hundred and forty-fourout patients(76 males) ,aged from 20 to 84 years(me-dian age 59.5 years) ,who attended our Department,were divided into two groups,age and sex matched,and underwent colonoscopy. Two questionnaires,onefor patients reporting acceptability and the other forendoscopists evaluating bowel cleansing effectivenes saccording to validated scales,were completed. Indications,timing of examination and endoscopical findings were recorded. Biopsy forceps were used as a measuring tool in order to determine polyp endoscopic sizeestimation. Difficulty in completing the preparation wasrated in a 5-point Likert scale(1 = easy to 5 = un-able) . Adverse experiences(fullness,cramps,nausea,vomiting,ab dominal pain,headache and insomnia) ,number of evacuations and types of activities performed during preparation(walking or resting in bed) were also investigated.RESULTS:Seventy-two patients were selected for eachgroup. The two groups were age and sex matched aswell as being comparable in terms of medical historyand drug therapies taken. Fourteen patients droppedout from the trial because they did not complete the preparation procedure. Ratings of global bowel cleansing examinations were considered to be adequate in91% of PEG + Asc and 88% of PEG + Sim patients.Residual Stool Score indicated similar levels of amountand consistency of residual stool;there was a significant difference in the percentage of bowel wall visuali-zation in favour of PEG + Sim patients. In the PEG +Sim group,12 adenomas ≤ 10 mm diameter(5/left co-lon + 7/right colon) vs 9(8/left colon + 1/right colon) in the PEG + Asc group were diagnosed. Visualization of small lesions seems to be one of the primary advantages of the PEG + Sim preparation.CONCLUSION:PEG + Asc is a good alternative solution as a bowel preparation but more improvements arenecessary in order to achieve the target of a perfect preparation. | Stefano Pontone Rita Angelini Monica Standoli Gregorio Patrizi Franco Culasso Paolo Pontone Adriano Redler | 2011 | World Journal of Gastroenterology2011，17，42： | 22 |
| 17 | Combined chemo-radiotherapy in locally advanced nasopharyngeal carcinomas显示文摘AIM:To provide efficacy and safety data about the combined use of radiotherapy and chemo-radiotherapy in nasopharyngeal carcinoma(NPC).METHODS:We reviewed data of 40 patients with locally advanced NPC treated with induction chemotherapy followed by concomitant chemo-radiotherapy(CCRT)(22/40 patients)or CCRT alone(18/40)from March 2006 to March 2012.Patients underwent fiberoscopy with biopsy of the primitive tumor,and computed tomography scan of head,neck,chest and abdomen with and without contrast.Cisplatin was used both as induction and as concomitant chemotherapy,while 3D conformal radiation therapy was delivered to the nasopharynx and relevant anatomic regions(total dose,70 Gy).The treatment was performed using 6 MV photons of the linear accelerator administered in 2 Gy daily fraction for five days weekly.This retrospective analysis was approved by the review boards of the participating institutions.Patients gave their consent to treatment and to anonymous analysis of clinical data.RESULTS:Thirty-three patients were males and 7 were females.Median follow-up time was 58 mo(range,1-92 mo).In the sub-group of twenty patients with a follow-up time longer than 36 mo,the 3-year survival and disease free survival rates were 85%and 75%,respectively.Overall response rate both in patients treated with induction chemotherapy followed by CCRT and in those treated with CCRT alone was 100%.Grade 3 neutropenia was the most frequent acute side-effect and it occurred in 20 patients.Grade 2 mucositis was seen in 29 patients,while grade 2 xerostomia was seen in 30 patients.Overall toxicity was manageable and it did not cause any significant treatment delay.In the whole sample population,long term toxicity included grade 2 xerostomia in 22 patients,grade 1 dysgeusia in 17 patients and grade 1 subcutaneous fibrosis in 30 patients.CONCLUSION:Both CCRT and induction chemotherapy followed by CCRT showed excellent activity in locally advanced NPC.The role of adjuvant chemotherapy remains to be defined. | Francesco Perri Giuseppina Della Vittoria Scarpati Carlo Buonerba Giuseppe Di Lorenzo Francesco Longo Paolo Muto Concetta Schiavone Fabio Sandomenico Francesco Caponigro | 2013 | World Journal of Clinical Oncology2013，4，2： | 22 |
| 18 | Total mesorectal excision for mid and low rectal cancer: laparoscopic vs robotic surgery显示文摘AIM: To compare the short- and long-term outcomes of laparoscopic and robotic surgery for middle and low rectal cancer.METHODS: This is a retrospective study on a prospectively collected database containing 111 patients who underwent minimally invasive rectal resection with total mesorectal excision(TME) with curative intent between January 2008 and December 2014(robot, n = 53; laparoscopy, n = 58). The patients all had a diagnosis of middle and low rectal adenocarcinoma with stage?Ⅰ-Ⅲ disease. The median follow-up period was 37.4 mo. Perioperative results, morbidity a pathological data were evaluated and compared. The 3-year overall survival and disease-free survival rates were calculated and compared.RESULTS: Patients were comparable in terms of preoperative and demographic parameters. The median surgery time was 192 min for laparoscopic TME(L-TME) and 342 min for robotic TME(R-TME)(P < 0.001). There were no differences found in the rates of conversion to open surgery and morbidity. Thepatients who underwent laparoscopic surgery stayed in the hospital two days longer than the robotic group patients(8 d for L-TME and 6 d for R-TME, P < 0.001). The pathologic evaluation showed a higher number of harvested lymph nodes in the robotic group(18 for R-TME, 11 for L-TME, P < 0.001) and a shorter distal resection margin for laparoscopic patients(1.5 cm for L-TME, 2.5 cm for R-TME, P < 0.001). The three-year overall survival and disease-free survival rates were similar between groups.CONCLUSION: Both L-TME and R-TME achieved acceptable clinical and oncologic outcomes. The robotic technique showed some advantages in rectal surgery that should be validated by further studies. | Francesco Feroci Andrea Vannucchi Paolo Pietro Bianchi Stefano Cantafio Alessia Garzi Giampaolo Formisano Marco Scatizzi | 2016 | World Journal of Gastroenterology2016，22，13： | 22 |
| 19 | Alcohol and hepatocellular carcinoma:A review and a point of view显示文摘It is well recognized that one cause of chronic liver disease and hepatocellular carcinoma(HCC)is alcohol consumption.Research in Italy and the United States concludes that the most common cause of HCC(responsible for 32%to 45%of HCC)is alcohol.It has recently been shown that a significant relationship between alcohol intake,metabolic changes,and hepatitis virus infection does exist.Alcohol may be a factor in the development of HCC via direct(genotoxic)and indirect mechanisms(cirrhosis).There is only one way of diagnosing HCC,which is early identification through surveillance,when curative treatments become possible.After stopping alcohol intake the risk of liver cancer decreases by 6%to 7%a year,and an estimated time period of 23 years is also needed.Therefore,surveillance is also important in former drinkers and,in our opinion,independently from the presence of compensated cirrhosis.In cases of very early stage(VES)and early stage with portal hypertension,liver transplantation is the optimal option;and in cases of associated disease,percutaneous ethanol injections,radiofrequency and microwave ablation are the ideal treatments.Despite the possibility of detecting microvascular invasion with HR,several studies and some randomized controlled trials revealed that overall survival and DSF rates in patients with VES HCC are much the same after ablation and HR.Therefore,ablation can be regarded as a firstline choice for patients with VES HCC.It is important to emphasize that the choice of treatment should be weighed carefully in the context of a multidisciplinary cancer team. | Gianni Testino Silvia Leone Paolo Borro | 2014 | World Journal of Gastroenterology2014，20，43： | 21 |
| 20 | Cystic tumors of the liver:A practical approach显示文摘Biliary cyst tumors(cystadenoma and cystadeno-carcinoma) are an indication for liver resection. They account for only 5% of all solitary cystic lesions of the liver,but differential diagnosis with multiloculated or complicated biliary cysts,atypical hemangiomas,hamartomas and lymphangiomas may be difficult. The most frequent challenge is to differentiate biliary cyst tumors from hemorrhagic cysts. Computerized tomography(CT) and magnetic resonance imaging(MRI) are often not diagnostic and in these cases fine needle aspiration(FNA) is used to confirm the presence of atypical biliary cells. FNA,however,lacks adequate sensitivity and specificity and should always be used in conjunction with imaging. Pre-operative differentiation of cystadenoma from cystadenocarcinoma is impossible and surgery must be performed if a biliary cyst tumor is suspected. When multiple cystic lesions are observed throughout the liver parenchyma,it is important to exclude liver metastasis,of which colonic cancer is the most common primary site. Multiple biliary hamartomas(von Meyenburg complex) can appear as a mixture of solid and cystic lesions and can be confused with cystic metastasis. Strong and uniform T2 hyperintensity on MRI is usually diagnostic,but occasionally a percutaneous biopsy may be required. | Paolo Del Poggio Marco Buonocore | 2008 | World Journal of Gastroenterology2008，14，23： | 20 |
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