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| 1 | Predictive factors for anastomotic leakage after laparoscopic colorectal surgery显示文摘Every colorectal surgeon during his or her career is faced with anastomotic leakage(AL); one of the most dreaded complications following any type of gastrointestinal anastomosis due to increased risk of morbidity, mortality, overall impact on functional and oncologic outcome and drainage on hospital resources. In order to understand and give an overview of the AL risk factors in laparoscopic colorectal surgery, we carried out a careful review of the existing literature on this topic and found several different definitions of AL which leads us to believe that the lack of a consensual, standard definition can partly explain the considerable variations in reported rates of AL in clinical studies. Colorectal leak rates have been found to vary depending on the anatomic location of the anastomosis with reported incidence rates ranging from 0 to 20%, while the laparoscopic approach to colorectal resections has not yet been associated with a significant reduction in AL incidence. As well, numerous risk factors, though identified, lack unanimous recognition amongst researchers. For example, the majority of papers describe the risk factors for left-sided anastomosis, the principal risk being male sex and lower anastomosis, while little data exists defining AL risk factors in a right colectomy. Also, gut microbioma is gaining an emerging role as potential risk factor for leakage. | Antonio Sciuto Giovanni Merola Giovanni D De Palma Maurizio Sodo Felice Pirozzi Umberto M Bracale Umberto Bracale | 2018 | World Journal of Gastroenterology2018，24，21： | 48 |
| 2 | What we should know about portal vein thrombosis in cirrhotic patients:A changing perspective显示文摘Portal vein thrombosis(PVT) is one of the most common complications occurring during the natural course of liver cirrhosis.Even though PVT is often asymptomatic,the worsening of liver function,an unexpected episode of gastrointestinal bleeding or ascitic decompensation may be landmarks of PVT development.Beyond these clinical manifestations,it is debated whether PVT really has an impact on liver cirrhosis natural history or rather represents only one of its consequences.Probably PVT development should not only be considered as a matter of impaired blood flow or pro-coagulation tendency.On one hand,PVT seems a consequence of the worsening in portal vein outflow due to the increased hepatic resistance in cirrhotic livers.On the other hand,vascular microthrombosis secondary to necroinflammation may cause liver ischemia and infarction,with loss of hepatic tissue(parenchymal extinction) which is replaced by fibrotic tissue.Therefore,PVT might also be considered as the overt manifestation of the liver fibrosing process evolution and anticoagulant therapy may thus have microscopic indirect effects also on the progression of liver disease.At present,a connection between PVT development and the progression of liver fibrosis/cirrhosis has not yet been demonstrated.Nevertheless,it is not clear if PVT development may worsen cirrhotic patients' outcome by itself.Some authors tried to assess liver transplant benefit in PVT cirrhotic patients but data are contrasting.In this review,we will try to answer these questions,providing a critical analysis of data reported in literature. | Francesca Romana Ponziani Maria Assunta Zocco Matteo Garcovich Francesca D'Aversa Davide Roccarina Antonio Gasbarrini | 2012 | World Journal of Gastroenterology2012，18，36： | 24 |
| 3 | 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 |
| 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 | Eubiotic properties of rifaximin: Disruption of the traditional concepts in gut microbiota modulation显示文摘Antibiotics are usually prescribed to cure infections but they also have significant modulatory effects on the gut microbiota. Several alterations of the intestinal bacterial community have been reported during antibiotic treatment, including the reduction of beneficial bacteria as well as of microbial alpha-diversity. Although after the discontinuation of antibiotic therapies it has been observed a trend towards the restoration of the original condition, the new steady state is different from the previous one, as if antibiotics induced some kind of irreversible perturbation of the gut microbial community. The poorly absorbed antibiotic rifaximin seem to be different from the other antibiotics, because it exerts non-traditional effects additional to the bactericidal/bacteriostatic activity on the gut microbiota. Rifaximin is able to reduce bacterial virulence and translocation, has anti-inflammatory properties and has been demonstrated to positively modulate the gut microbial composition. Animal models, culture studies and metagenomic analyses have demonstrated an increase in Bifidobacterium, Faecalibacterium prausnitzii and Lactobacillus abundance after rifaximin treatment, probably consequent to the induction of bacterial resistance, with no major change in the overall gut microbiota composition. Antibiotics are therefore modulators of the symbiotic relationship between the host and the gut microbiota. Specific antibiotics, such as rifaximin, can also induce eubiotic changes in the intestinal ecosystem; this additional property may represent a therapeutic advantage in specific clinical settings. | Francesca Romana Ponziani Maria Assunta Zocco Francesca D’Aversa Maurizio Pompili Antonio Gasbarrini | 2017 | World Journal of Gastroenterology2017，23，25： | 17 |
| 6 | Effect of percutaneous endoscopic gastrostomy on gastroesophageal reflux in mechanically-ventilated patients显示文摘瞄准:在机械地通气的病人在胃的食道的倒流(GER ) 上调查经皮的内视镜的胃造口术(木钉) 的效果。方法:在未来的、使随机化的、控制研究有周期性或坚持的联系通风机的肺病(VAP ) 和 GER >
的 36 个病人 6% 被划分成木钉组(n = 16 ) 或非木钉组(n = 20 ) 。11 通气了没有倒流的病人(GER <
3%) 用作控制组。食道的 pH-metry 被执行由在基线“渡过”方法,在木钉以后的 2 和 7 d。病人们严格地被跟随在上面为胃的滋养的残余的半侧卧的位置和控制。结果:median (范围)的重要减少倒流从 7.8 在木钉组被观察( 6.2 - 15.6 )在到 2.7 的基线( 0 - 10.4 )在 d 上 7 post-gastrostomy ( P <
0.01 ),当倒流从 9 增加了时( 6.2 - 22 )到 10.8 ( 6.3 - 36.6 )( P <
0.01 )在非木钉组。在 GER (%) 和 nasogastric 试管的停留之间的重要关联被检测(r = 0.56, P <
0.01 ) 。结论:胃造口术什么时候与滋养的胃的残余的半侧卧的位置和缺席结合了,在通气病人减少胃的食道的倒流。 | Emmanuel E Douzinas Andreas Tsapalos Antonios Dimitrakopoulos Evanthia Diamanti-Kandarakis Alexandros D Rapidis Charis Roussos | 2006 | World Journal of Gastroenterology2006，12，1： | 15 |
| 7 | Role of blood AFP mRNA and tumor grade in the preoperative prognostic evaluation of patients with hepatoceiluiar carcinoma显示文摘AIM: To explore the potential prognostic role of preoperative tumor grade and blood AFP mRNA in a cohort of patients with hepatocellular carcinoma (HCC)eligible for radical therapies according to a well-defined treatment algorithm not including nodule size and number as absolute selection criteria.METHODS: Fifty patients with a diagnosis of HCC were prospectively enrolled in the study. Inclusion criteria were: (1) histological assessment of tumor grade by means of percutaneous biopsies; (2) determination of AFP mRNA status in the blood; (3) patient's eligibility for radical therapies.RESULTS: At preoperative evaluation, 54% of the study group had a well-differentiated HCC, 42% had AFP mRNA in the blood, 40% had a tumor larger than 5 cm and 56% had more than one nodule. Surgery (resection or liver transplantation) was performed in 29 patients,while 21 had percutaneous ablation procedures. After a median follow-up of 28 mo, 12-, 24-, and 36-mo survival rates were 78%, 58%, and 51%, respectively. Surgical therapy, performance status and three tumor-related variables (AFP mRNA, HCC grade and gross vascular invasion) resulted as significant survival predictors at univariate analysis. Nodule size and number did not perform as significant prognosticators. Multivariate study selected only surgical therapy and a biologically early HCC profile (AFP mRNA negative and well-differentiated tumor without gross vascular invasion) as independent survival variables.CONCLUSION: The preoperative determination of tumor grade and blood AFP mRNA status may potentially refine the prognostic evaluation of HCC patients and improve the selection process for radical therapies. | Umberto Cillo Alessandro Vitale Filippo Navaglia Daniela Basso Umberto Montin Marco Bassanello Francesco D'Amico Francesco Antonio Ciarleglio Alberto Brolese Giacomo Zanus Vito De Pascale Mario Plebani Davide Francesco D'Amico | 2005 | World Journal of Gastroenterology2005，11，44： | 12 |
| 8 | Is the pancreas affected in patients with septic shock?——a prospective study显示文摘BACKGROUND:Hyperamylasemia can be observed anecdotally during the course of severe sepsis or septic shock.This study aimed to investigate the possibility of pancreatic involvement in patients with septic shock using serum pancreatic enzyme determinations and imaging techniques in 21 consecutive patients with septic shock and 21 healthy subjects as controls. METHODS:The serum activity of pancreatic amylase and lipase was assayed initially in all subjects and 24 and 48 hours after the initial observation in the 21 patients with septic shock All patients also underwent radiological examination to detect pancreatic abnormalities. RESULTS:The serum activity of pancreatic amylase was significantly higher in the 21 patients with septic shock than in the 21 control subjects during the study period while the serum activity of lipase was similar to that of the control subjects.Amylase and lipase serum activity did not significantly changed throughout the study period in the 21 patients with septic shock.None of the patients with pancreatic hyperenzymemia had clinical signs or morphological alterations compatible with acute pancreatitis CONCLUSION:The presence of pancreatic hyperenzymemia in septic shock patients is not a biochemical manifestation of acute pancreatic damage,and the management of these patients should be dependent on the clinical situation and not merely the biochemical results. | Raffaele Pezzilli Alessandra Barassi Andrea Imbrogno Dario Fabbri Antonina Pigna Antonio M.Morselli-Labate Roberto Corinaldesi Gianvico Melzi d'Eril | 2011 | Hepatobiliary & Pancreatic Diseases International2011，10，2： | 11 |
| 9 | Role of Helicobacter pylori infection on nutrition and metabolism显示文摘Helicobacter pylori(H. pylori) is a gram-negative pathogen that is widespread all over the world, infecting more than 50% of the world's population. It is etiologically associated with non-atrophic and atrophic gastritis, peptic ulcer and shows a deep association with primary gastric B-cell lymphoma and gastric adenocarcinoma. Recently, the medical research focused on the modification of the gastric environment induced by H. pylori infection, possibly affecting the absorption of nutrients and drugs as well as the production of hormones strongly implicated in the regulation of appetite and growth. Interestingly, the absorption of iron and vitamin B12 is impaired by H. pylori infection, while infected subjects have lower basal and fasting serum levels of ghrelin and higher concentration of leptin compared to controls. Since leptin is an anorexigenic hormone, and ghrelin stimulates powerfully the release of growth hormone in humans, H. pylori infection may finally induce growth retardation if acquired very early in the childhood and in malnourished children. This review is focused on the nutritional effects of H. pylori infection, such as the reduced bioavailability or the malabsorbption of essential nutrients, and of gastrointestinal hormones, as well as on the relationship between H. pylori and the metabolic syndrome. | Francesco Franceschi Tortora Annalisa Di Rienzo Teresa D'Angelo Giovanna Gianluca Ianiro Scaldaferri Franco Gerardi Viviana Tesori Valentina Lopetuso Loris Riccardo Gasbarrini Antonio | 2014 | World Journal of Gastroenterology2014，20，36： | 11 |
| 10 | Attenuation of dextran sodium sulphate induced colitis in matrix metalloproteinase-9 deficient mice显示文摘AIM: To study whether matrix metalloproteinase-9 (MMP-9) is a key factor in epithelial damage in the dextran sodium sulphate (DSS) model of colitis in mice.METHODS: MMP-9-deficient and wild-type (wt) mice were given 5% DSS in drinking water for 5 d followed by recovery up to 7 d. On d 5 and 12 after induction of colitis, gelatinases, MMP-2 and MMP-9, were measured in homogenates of colonic tissue by zymography and Western blot, whereas tissue inhibitor of metalloproteinases (TIMPs) were measured by reverse zymography. The gelatinolytic activity was also determined in supernatants of polymorphonuclear leukocytes (PMN) isolated from mice blood. Moreover, intestinal epithelial cells were stimulated with TNF-α to study whether these cells were able to produce MMPs. Finally, colonic mucosal lesions were measured by microscopic examination. RESULTS: On d 5 of colitis, the activity of MMP-9 was increased in homogenates of colonic tissues (0.24 ± 0.1 vs 21.3 ± 6.4, P < 0.05) and PMN from peripheral blood in wt (0.5 ± 0.1 vs 10.4 ± 0.7, P < 0.05), but not in MMP-9-deficient animals. The MMP-9 activity was also up-regulated by TNF-α in epithelial intestinal cells (2.5 ± 0.5 vs 14.7 ± 3.0, P < 0.05). Although colitis also led to increase of TIMP-1 activity, the MMP-9/TIMP-1 balance remained elevated. Finally, in the MMP-9-deficient colitic mice both the extent and severity of intestinal epithelialinjury were significantly attenuated when compared with wt mice. CONCLUSION: We conclude that DSS induced colitis is markedly attenuated in animals lacking MMP-9. This suggests that intestinal injury induced by DSS is modu-lated by MMP-9 and that inhibition of this gelatinase may reduce inflammation. | Alfredo Santana Carlos Medina Maria Cristina Paz-Cabrera Federico Díaz-Gonzalez Esther Farré Antonio Salas Marek W Radomski Enrique Quintero | 2006 | World Journal of Gastroenterology2006，12，40： | 9 |
| 11 | Endoscopic submucosal dissection training with pig models in a Western country显示文摘AIM:To test a strategy for endoscopic submucosal dissection(ESD) training in animal models designed to overcome the initial learning curve.METHODS:ESD was attempted in ex vivo and in vivo pig models.Thirty ESD procedures were attempted in the esophagus(n=9) or the stomach(n=21).The ex vivo model was used until initial competence was achieved.In the in vivo model,several ESD procedures were performed in up to 3 sessions.The following variables were analyzed:specimen size,complete and en bloc resection rate,time for circumferential incision,time for submucosal dissection,total ESD duration,and complications.RESULTS:Complete resection was achieved in 28 cases(en bloc 27);2 could not be completed(one perforation,one technical diff iculty).The mean ± SD time for circumferential incision was 36.2±16.8 min(range:8-87 min),and the mean±SD time for submucosal dissection was 45.1±35.7 min(range:9-196 min).The mean±SD size of the resected specimens was 45.2±17.8 mm.The mean±SD total resection time was signif icantly increased for the gastric cases performed in the f irst half of the study(n=13) than in the second half(n=8)(98.9±62.4 min vs 61.7±17.6 min,P=0.04),although the specimen size did not differ.CONCLUSION:Training in animal models could help endoscopists overcome the learning curve before starting ESD in humans. | Adolfo Parra-Blanco María Rosa Arnau David Nicolás-Pérez Antonio Z Gimeno-García Nicolás González Juan A Díaz-Acosta Alejandro Jiménez Enrique Quintero | 2010 | World Journal of Gastroenterology2010，16，23： | 9 |
| 12 | Gastric neuroendocrine tumor: A practical literature review显示文摘Gastric neuroendocrine tumors are gastric neoplasms originating from enterochromaffin type cells and are inserted in a larger group,named gastroenteropancreatic neuroendocrine tumors.They are considered rare and variable in terms of their clinical,morphological and functional characteristics and may be indolent or aggressive.They are classified into types I,II and III,according to their pathophysiology,behavior and treatment.Their diagnosis occurs,in most cases,incidentally during upper digestive endoscopies,presenting as simple gastric polyps.Most cases(type I and type II)are related to hypergastrinemia,can be multiple and are treated by endoscopic resection,whenever possible.The use of somatostatin analogs for tumor control may be one of the options for therapy,in addition to total or subtotal gastrectomy for selected cases.Adjuvant chemotherapy is only reserved for poorly differentiated neuroendocrine carcinomas.Although rare,gastric neuroendocrine tumors have an increasing incidence over the years,therefore deserving more comprehensive studies on its adequate treatment.The present study reviews and updates management recommendations for gastric neuroendocrine tumors. | Gabriel Antonio Roberto Carolina Magalhães Britto Rodrigues Renata D’Alpino Peixoto Riad Naim Younes | 2020 | World Journal of Gastrointestinal Oncology2020，12，8： | 8 |
| 13 | Liver transplantation:Fifty years of experience显示文摘Since 1963,when the first human liver transplantation(LT)was performed by Thomas Starzl,the world has witnessed 50 years of development in surgical techniques,immunosuppression,organ allocation,donor selection,and the indications and contraindications for LT.This has led to the mainstream,wellestablished procedure that has saved innumerable lives worldwide.Today,there are hundreds of liver transplant centres in over 80 countries.This review aims to describe the main aspects of LT regarding the progressive changes that have occurred over the years.We herein review historical aspects since the first experimental studies and the first attempts at human transplantation.We also provide an overview of immunosuppressive agents and their potential side effects,the evolution of the indications and contraindications of LT,the evolution of survival according to different time periods,and the evolution of methods of organ allocation. | Alice Tung Wan Song Vivian Iida Avelino-Silva Rafael Antonio Arruda Pecora Vincenzo Pugliese Luiz Augusto Carneiro D'Albuquerque Edson Abdala | 2014 | World Journal of Gastroenterology2014，20，18： | 8 |
| 14 | Peritoneal seeding from appendiceal carcinoma:A case report and review of the literature显示文摘Non-carcinoid appendiceal malignancies are rare entities,representing less than 0.5% of all gastrointestinal malignancies.Because of their rarity and particular biological behavior,a substantial number of patients affected by these neoplasms do not receive appropriate surgical resection.In this report,we describe a rare case of primary signetring cell carcinoma of the appendix with peritoneal seeding which occurred in a 40-year old man admitted at the Emergency Surgery Department with the clinical suspicion of acute appendicitis.After a surgical debulking and right hemicolectomy,the patient had systemic chemotherapy according to FOLFOX protocol.After completion of the latter,the patient underwent cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy.This report offers a brief review of the literature and suggests an algorithm for the management of non-carci-noid appendiceal tumors with peritoneal dissemination. | Valentina R Bertuzzo Federico Coccolini Antonio D Pinna | 2010 | World Journal of Gastrointestinal Surgery2010，2，8： | 6 |
| 15 | Transcranial direct current stimulation in psychiatric disorders显示文摘The interest in non-invasive brain stimulation techniques is increasing in recent years. Among these techniques, transcranial direct current stimulation(t DCS) has been the subject of great interest among researchers because of its easiness to use, low cost, benign profile of side effects and encouraging results of research in the field. This interest has generated several studies and randomized clinical trials, particularly in psychiatry. In this review, we provide a summary of the development of the technique and its mechanism of action as well as a review of the methodological aspects of randomized clinical trials in psychiatry, including studies in affective disorders, schizophrenia, obsessive compulsive disorder, child psychiatry and substance use disorder. Finally,we provide an overview of t DCS use in cognitive enhancement as well as a discussion regarding its clinical use and regulatory and ethical issues. Although many promising results regarding t DCS efficacy were described, the total number of studies is still low, highlighting the need of further studies aiming to replicate these findings in larger samples as to provide a definite picture regarding t DCS efficacy in psychiatry. | Gabriel Tortella Roberta Casati Luana V M Aparicio Antonio Mantovani Natasha Senco Giordano D’Urso Jerome Brunelin Fabiana Guarienti Priscila Mara Lorencini Selingardi Débora Muszkat Bernardo de Sampaio Pereira Junior Leandro Valiengo Adriano H Moffa Marcel Simis Lucas Borrione André R Brunoni | 2015 | World Journal of Psychiatry2015，5，1： | 6 |
| 16 | Percutaneous coronary intervention in nonagenarians: pros and cons显示文摘Percutaneous coronary intervention is a mainstay in the management of symptomatic or high-risk coronary artery disease. The bulk of clinical evidence and experience underlying this fact relies, however, on relatively young patients. Indeed, few data of very limited quality are available which adequately define the risk-benefit and cost-benefit profile of coronary angioplasty and stenting in very old subjects, such as those of 90 years of age or older (i.e., nonagenarians). The aim of this review is to provide a concise, yet practical, synthesis of the available evidence on percutaneous coronary revascularization in the very elderly. The main arguments elaborated upon are to what extent we can extrapolate findings from studies including younger patients to nonagenarians, whether we should provide higher priority to prognosis or quality of life in such patients, and whether we can afford to allocate vast resources to care for such subjects in an era of financial constraints. Our review of 18 studies and 1082 patients suggest that percutaneous coronary intervention is feasible and associated with acceptable short- and long-term results in this population, which is nonetheless fraught with a high mortality risk irrespective of the revascularization procedure. Accordingly, the pros and cons of percutaneous coronary intervention should be carefully weighed when considering this treatment in nonagenarians. | Giuseppe Biondi Zoccai Antonio Abbate Fabrizio D'Ascenzo Davide Presutti Mariangela Peruzzi Elena Cavarretta Antonino G.M. Marullo Marzia Lotrionte Giacomo Frati | 2013 | Journal of Geriatric Cardiology2013，10，1： | 6 |
| 17 | Magnetic resonance diffusion tensor imaging and fibertracking diffusion tensor tractography in the management of spinal astrocytomas显示文摘Some specially imaging of magnetic resonance imaging,the diffusion-weighted imaging(DWI),the diffusion tensor imaging and fractional anisotropy(FA),are useful to described,detect,and map the extent of spinal cord lesions.FA measurements may are used to predicting the outcome of patients who have spinal cord lesions.Fiber tracking enable to visualizing the integrity of white matter tracts surrounding some lesions,and this information could be used to formulating a differential diagnosis and planning biopsies or resection.In this article,we will describe the current uses for DWI and fiber tracking and speculate on others in which we believe these techniques will be useful in the future. | Alessandro Landi Valeria Palmarini Alessandro D'Elia Nicola Marotta Maurizio Salvati Antonio Santoro Roberto Delfini | 2016 | World Journal of Clinical Cases2016，4，1： | 6 |
| 18 | Perioperative blood transfusion decreases long-term survival in pediatric living donor liver transplantation显示文摘BACKGROUND The impact of perioperative blood transfusion on short-and long-term outcomes in pediatric living donor liver transplantation(PLDLT)must still be ascertained,mainly among young children.Clinical and surgical postoperative complications related to perioperative blood transfusion are well described up to three months after adult liver transplantation.AIM To determine whether transfusion is associated with early and late postoperative complications and mortality in small patients undergoing PLDLT.METHODS We evaluated the effects of perioperative transfusion on postoperative complications in recipients up to 20 kg of body weight,submitted to PLDLT.A total of 240 patients were retrospectively allocated into two groups according to postoperative complications:Minor complications(n=109)and major complications(n=131).Multiple logistic regression analysis identified the volume of perioperative packed red blood cells(RBC)transfusion as the only independent risk factor for major postoperative complications.The receiver operating characteristic curve was drawn to identify the optimal volume of the perioperative RBC transfusion related to the presence of major postoperative complications,defining a cutoff point of 27.5 mL/kg.Subsequently,patients were reallocated to a low-volume transfusion group(LTr;n=103,RBC≤27.5 mL/kg)and a high-volume transfusion group(HTr;n=137,RBC>27.5 mL/kg)so that the outcome could be analyzed.RESULTS High-volume transfusion was associated with an increased number of major complications and mortality during hospitalization up to a 10-year follow-up period.During a short-term period,the HTr showed an increase in major infectious,cardiovascular,respiratory,and bleeding complications,with a decrease in rejection complications compared to the LTr.Over a long-term period,the HTr showed an increase in major infectious,cardiovascular,respiratory,and minor neoplastic complications,with a decrease in rejection complications.Additionally,Cox hazard regression found that high-volume RBC transfusion increased the mortality risk by 3.031-fold compared to low-volume transfusion.The Kaplan-Meier survival curves of the studied groups were compared using log-rank tests and the analysis showed significantly decreased graft survival,but with no impact in patient survival related to major complications.On the other hand,there was a significant decrease in both graft and patient survival,with high-volume RBC transfusion.CONCLUSION Transfusion of RBC volume higher than 27.5 mL/kg during the perioperative period is associated with a significant increase in short-and long-term postoperative morbidity and mortality after PLDLT. | Karina Gordon Estela Regina Ramos Figueira Joel Avancini Rocha-Filho Luiz Antonio Mondadori Eduardo Henrique Giroud Joaquim Joao Seda-Neto Eduardo Antunes da Fonseca Renata Pereira Sustovitch Pugliese Agustin Moscoso Vintimilla Jose Otavio Costa Auler Jr Maria Jose Carvalho Carmona Luiz Augusto Carneiro D'Alburquerque | 2021 | World Journal of Gastroenterology2021，27，12： | 6 |
| 19 | Food allergy in irritable bowel syndrome:The case of non-celiac wheat sensitivity显示文摘Irritable bowel syndrome(IBS) is one of the most common gastrointestinal disorders, having a prevalence of 12%-30% in the general population. Most patientswith IBS attribute their symptoms to adverse food reactions. We review the role of diet in the pathogenesis of IBS and the importance of dietary factors in the management of these patients. The MEDLINE electronic database(1966 to Jan 2015) was searched using the following keywords: 'food', 'diet', 'food allergy', 'food hypersensitivity', 'food intolerance', 'IBS', 'epidemiology', 'pathogenesis', 'pathophysiology', 'diagnosis', 'treatment'. We found 153 eligible papers; 80 were excluded because: not written in English, exclusive biochemical and experimental research, case reports, reviews, and research otherwise not relevant to our specific interest. We selected 73 papers: 43 original papers, 26 reviews and 4 letters to the editor. These papers focused on IBS pathogenesis, the association between IBS and atopy, and between IBS and food allergy, the relationship between IBS and non-celiac wheat sensitivity, the role of diet in IBS. Pending further scientific evidence, a cautious approach is advisable but the concept of food allergy should be included as a possible cause of IBS, and a dietary approach may have a place in the routine clinical management of IBS. | Pasquale Mansueto Alberto D'Alcamo Aurelio Seidita Antonio Carroccio | 2015 | World Journal of Gastroenterology2015，21，23： | 5 |
| 20 | Differential colorectal carcinogenesis:Molecular basis and clinical relevance显示文摘Colorectal cancer(CCR) is one of the most frequent cancers in developed countries.It poses a major public health problem and there is renewed interest in understanding the basic principles of the molecular biology of colorectal cancer.It has been established that sporadic CCRs can arise from at least two different carcinogenic pathways.The traditional pathway,also called the suppressor or chromosomal instability pathway,follows the Fearon and Vogelstein model and shows mutation in classical oncogenes and tumour suppressor genes,such as K-ras,adenomatous polyposis coli,deleted in colorectal cancer,or p53.Alterations in the Wnt pathway are also very common in this type of tumour.The second main colorectal carcinogenesis pathway is the mutator pathway.This pathway is present in nearly 15% of all cases of sporadic colorectal cancer.It is characterized by the presence of mutations in the microsatellite sequences caused by a defect in the DNA mismatch repair genes,mostly in hMLH1 or hMSH2.These two pathways have clear molecular differences,which will be reviewed in this article,but they also present distinct histopathological features.More strikingly,their clinical behaviours are completely different,having the 'mutator' tumours a better outcome than the 'suppressor' tumours. | Alberto Morán Paloma Ortega Carmen de Juan Tamara Fernández-Marcelo Cristina Frías Andrés Sánchez-Pernaute Antonio José Torres Eduardo Díaz-Rubio Pilar Iniesta Manuel Benito | 2010 | World Journal of Gastrointestinal Oncology2010，2，3： | 5 |
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