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| 1 | How antibiotic resistances could change Helicobacter pylori treatment:A matter of geography?显示文摘Therapeutic management of Helicobacter pylori(H.pylori)remains an unsolved issue.Indeed,no therapeutic regimen is able to cure the infection in all treated patients,and in many the infection persists despite the administration of several consecutive standard therapies.Although antibiotic resistance reports describe alarming results,the outcome of therapeutic regimens does not seem to parallel this scenario in most cases,since a successful performance is often reached in more than 80%of cases.However,the phenomenon of increasing antibiotic resistance is being closely studied,and the results show controversial aspects even in the same geographic area.For the continents of Europe,America,Asia,Africa,and Oceania,minimal and maximal values of resistance to the main antibiotics(clarithromycin,amoxicillin,metronidazole,and levofloxacin)feature wide ranges in different countries.The real enigma is therefore linked to the several different therapeutic regimens,which show results that often do not parallel the in vitro findings even in the same areas.A first aspect to be emphasized is that some regimens are limited by their use in very small geographic districts.Moreover,not all therapeutic trials have considered bacterial and host factors affecting the therapeutic outcome.The additional use of probiotics may help to reduce adverse events,but their therapeutic impact is doubtful.In conclusion,the'ideal therapy',paradoxically,appears to be a'utopia',despite the unprecedented volume of studies in the field and the real breakthrough in medical practice made by the discovery and treatment of H.pylori.The ample discrepancies observed in the different areas do not encourage the development of therapeutic guidelines that could be valid worldwide.On these bases,one of the main challenges for the future might be identifying a successful solution to overcome antibiotic resistances.In this context,geography must be considered a relevant matter. | Enzo Ierardi Floriana Giorgio Giuseppe Losurdo Alfredo Di Leo Mariabeatrice Principi | 2013 | World Journal of Gastroenterology2013，19，45： | 23 |
| 2 | Intestinal microbiota: The explosive mixture at the origin of inflammatory bowel disease?显示文摘Inflammatory bowel diseases(IBDs), namely Crohn's disease and ulcerative colitis, are lifelong chronic disorders arising from interactions among genetic, immunological and environmental factors. Although the origin of IBDs is closely linked to immune response alterations, which governs most medical decision-making, recent findings suggest that gut microbiota may be involved in IBD pathogenesis. Epidemiologic evidence and several studies have shown that a dysregulation of gut microbiota(i.e., dysbiosis) may trigger the onset of intestinal disorders such as IBDs. Animal and human investigations focusing on the microbiota-IBD relationship have suggested an altered balance of the intestinal microbial population in the active phase of IBD. Rigorous microbiota typing could, therefore, soon become part of a complete phenotypic analysis of IBD patients. Moreover, individual susceptibility and environmental triggers such as nutrition, medications, age or smoking could modify bacterial strains in the bowel habitat. Pharmacological manipulation of bowel microbiota is somewhat controversial. The employment of antibiotics, probiotics, prebiotics and synbiotics has been widely addressed in theliterature worldwide, with the aim of obtaining positive results in a number of IBD patient settings, and determining the appropriate timing and modality of this intervention. Recently, novel treatments for IBDs, such as fecal microbiota transplantation, when accepted by patients, have shown promising results. Controlled studies are being designed. In the near future, new therapeutic strategies can be expected, with non-pathogenic or modified food organisms that can be genetically modified to exert anti-inflammatory properties. | Roberto Bringiotti Enzo Ierardi Rosa Lovero Giuseppe Losurdo Alfredo Di Leo Mariabeatrice Principi | 2014 | World Journal of Gastrointestinal Pathophysiology2014，5，4： | 20 |
| 3 | Laparoscopic resection vs laparoscopic radiofrequency ablation for the treatment of small hepatocellular carcinomas: A single-center analysis显示文摘AIM To compare survival and recurrence after laparoscopic liver resection(LLR) and laparoscopic radiofrequency ablation(LRFA) for the treatment of small hepatocellular carcinoma(HCC).METHODS Between June 1, 2005 and November 30, 2010, 46 patients(62.26 ± 8.55 years old; female/male: 12/34) treated for small HCC were enrolled following strict criteria. Patients with better liver function and larger tumors were referred for LLR(n = 24), while those with poorer liver function and multiple tumors were referred for LRFA(n = 22), and they were then followed for similar durations(44.74 ± 21.3 mo for LLR vs 40.27 ± 30.8 mo for LRFA). RESULTS The LLR and LRFA groups were homogeneous with regard to age, sex, etiology of liver cirrhosis, and AFP levels. The overall survival(OS) and disease-free survival(DFS) probability was 0.354 and 0.260, respectively. A significantly higher OS was observed in the LLR group(LLR: 0.442; LRFA: 0.261; P = 0.048), whereas no statistical difference was found for DFS(LLR: 0.206; LRFA: 0.286; P = 0.205). In the LRFA group was treated a greater number of nodules(LLR: 1.41 ± 0.77; LRFA: 2.72 ± 1.54; P < 0.001). Cox regression analysis found the number of intraoperative HCC nodules as the unique variable statistically significant for OS(hazard ratio: 2.225; P < 0.001). The rank-hazard plot showed a steeper increase of relative hazard for intraoperative nodules > 2.CONCLUSION Our preliminary results confirm the superiority of hepatic resection on thermoablation in the treatment of small HCC in selected patients, when both approaches are made laparoscopically. LLR showed better results compared to LRFA in terms of OS. These data need to be confirmed by further studies on a larger number of patients. | Marco Casaccia Gregorio Santori Giuliano Bottino Pietro Diviacco Enzo Andorno | 2017 | World Journal of Gastroenterology2017，23，4： | 20 |
| 4 | Efficacy of rituximab in gastric diffuse large B cell lymphoma patients显示文摘AIM:To evaluate retrospectively the efficacy of rituximab plus chemotherapy in gastric diffuse large B cell lymphoma(DLBCL).METHODS:Sixty patients(median age:58 years)with histologically confirmed gastric DLBCL treated at four Italian institutions between 2000 and 2007,were included in this analysis.Patients were selected by stage (Ⅰ-Ⅳ,Lugano staging system),European Cooperative Oncology Group performance status(0-2)and treatment strategies.Treatment strategies were chemotherapy alone(group A,n=30)[scheduled as cyclophosphamide,doxorubicin,vincristine and prednisone (CHOP)and CHOP-like],and chemotherapy combined with rituximab(group B,n=30).The primary end point of the study was complete response(CR)rate;the secondary end points were disease-free survival (DFS)at 5 years and overall survival(OS).RESULTS:Median follow-up was 62 mo(range:31102 mo).We observed a significant difference between the two groups(A vs B)in terms of CR[76.6%(23/30) vs 100%,P=0.04)and DFS at 5 years[73.3%(22/30) vs 100%,P=0.03).To date,19 group A(63.3%) patients are alive and 11 have died,while all group B patients are alive.No significant differences in toxicity were observed between the two groups.CONCLUSION:Rituximab in combination with chemotherapy improves CR rate,DFS and OS.Further prospective trials are needed to confirm our results. | Davide Leopardo Giuseppe Di Lorenzo Amalia De Renzo Piera Federico Serena Luponio Carlo Buonerba Elide Matano Gerardina Merola Martina Imbimbo Enzo Montesarchio Antonio Rea Maria Carmela Merola Sabino De Placido Giovannella Palmieri | 2010 | World Journal of Gastroenterology2010，16，20： | 19 |
| 5 | Probiotic monotherapy and Helicobacter pylori eradication: A systematic review with pooled-data analysis显示文摘AIM To define probiotic monotherapy effect on Helicobacter pylori(H. pylori) status by performing a systematic review.METHODS Methods of analysis and inclusion criteria were based on PRISMA recommendations. Relevant publications were identified by searching Pub Med, MEDLINE, Science Direct, and EMBASE. The end-point was to estimate eradication rate and urea breath test delta value before and after probiotic monotherapy across all studies and, overall, with a pooled data analysis. Adverse events of probiotic therapy were evaluated. The data were expressed as proportions/percentages, and 95%CIs were calculated. For continuous variables, we evaluated the weighted mean difference. Odd ratios(ORs) were calculated according to the Peto method for the comparison of eradication rates between probiotics and placebo.RESULTS Eleven studies were selected. Probiotics eradicated H. pylori in 50 out of 403 cases. The mean weighted eradication rate was 14%(95%CI: 2%-25%, P =0.02). Lactobacilli eradicated the bacterium in 30 out of 235 patients, with a mean weighted rate of 16%(95%CI: 1%-31%). Saccharomyces boulardii achieved eradication in 6 out of 63 patients, with a pooled eradication rate of 12%(95%CI: 0%-29%). Multistrain combinations were effective in 14 out of 105 patients, with a pooled eradication rate of 14%(95%CI: 0%-43%). In the comparison of probiotics vs placebo, we found an OR of 7.91 in favor of probiotics(95%CI: 2.97-21.05, P < 0.001). Probiotics induced a mean reduction in delta values higher than placebo(8.61% with a 95%CI: 5.88-11.34, vs 0.19% for placebo, P < 0.001). Finally, no significant difference in adverse events was found between probiotics and placebo(OR = 1, 95%CI: 0.06-18.08).CONCLUSION Probiotics alone show a minimal effect on H. pylori clearance, thus suggesting a likely direct role. | Giuseppe Losurdo Rossella Cubisino Michele Barone Mariabeatrice Principi Gioacchino Leandro Enzo Ierardi Alfredo Di Leo | 2018 | World Journal of Gastroenterology2018，24，1： | 18 |
| 6 | Is there a real diagnostic impact of elastosonography and contrast-enhanced ultrasonography in the management of thyroid nodules?显示文摘Ultrasonography(US) and the new applications US elastography(USE) and contrast-enhanced US(CEUS) are used in the screening of thyroid nodules,for which fine-needle aspiration biopsy(FNAB) is the best single diagnostic test.The aim of the study was to compare the sensitivity,specificity,positive predictive value(PPV),and accuracy of the four examinations in nodules with cytological and histological diagnoses.The study used data from US,FNAB,USE(elasticity(ELX 2/1) index),and CEUS(Peak index and time to peak(TTP) index) evaluated in 73 thyroid nodules in 63 consecutive patients likely to undergo surgery.Cytological-histological correlation was available for 38 nodules.No correlation emerged between nodule size and cytological results.A significant(P=0.03) positive correlation between cumulative US findings and cytological results was found.In addition,significant correlations between cumulative US findings and cytology(P=0.02) and between cumulative US findings and histology(P<0.0001) were found.US showed the best specificity and PPV,and FNAB the best sensitivity.There was no significant difference in the ELX 2/1 index,Peak index,or TTP index among nodules subdivided according to cytological scores.No significant correlation was found between ELX 2/1 index,Peak index,and TTP index,on the one hand,and nodule size,US cumulative findings,cytology,and histology on the other hand.The sensitivity of the ELX 2/1 index was high,but its specificity was very low.The accuracy and PPV of USE were lower than those of the other procedures.Only the correlation between Peak index and cumulative US findings reached a value close to significance.Our ultimate aim is to minimise unnecessary thyroidectomy.US and FNAB continue to play a central diagnostic role.The use of a US score showed high specificity and PPV.The specificity of FNAB was low in this selected series because of the numbers of indeterminate cytological responses.USE and CEUS are innovative techniques that need to be standardized.The ELX 2/1 index,Peak index,and TTP index seem to be unrelated to histology.The best statistical data on USE and CEUS concerned their sensitivity and PPV,respectively.At present,USE and CEUS are too time-consuming and of limited utility in selecting patients for surgery. | Massimo GIUSTI Davide ORLANDI Giulia MELLE Barbara MASSA Enzo SILVESTRI Francesco MINUTO Gianni TURTULICI | 2013 | Journal of Zhejiang University-Science B(Biomedicine & Biotechnology)2013，14，3： | 17 |
| 7 | Optimizing proton pump inhibitors in Helicobacter pylori treatment:Old and new tricks to improve effectiveness显示文摘The survival and replication cycle of Helicobacter pylori(H.pylori)is strictly dependant on intragastric pH,since H.pylori enters replicative phase at an almost neutral pH(6-7),while at acid pH(3-6)it turns into its coccoid form,which is resistant to antibiotics.On these bases,it is crucial to increase intragastric pH by proton pump inhibitors(PPIs)when an antibiotic-based eradicating therapy needs to be administered.Therefore,several tricks need to be used to optimize eradication rate of different regimens.The administration of the highest dose as possible of PPI,by doubling or increasing the number of pills/day,has shown to be able to improve therapeutic outcome and has often proposed in rescue therapies,even if specific trials have not been performed.A pre-treatment with PPI before starting antibiotics does not seem to be effective,therefore it is discouraged.However,the choice of PPI molecule could have a certain weight,since second-generation substances(esomeprazole,rabeprazole)are likely more effective than those of first generation(omeprazole,lansoprazole).A possible explanation is due to their metabolism,which has been proven to be less dependent on cytochrome P450(CYP)2C19 genetic variables.Finally,vonoprazan,a competitive inhibitor of H+/K+-ATPase present on luminal membrane of gastric parietal cells has shown the highest efficacy,due to both its highest acid inhibition power and rapid pharmacologic effect.However current data come only from Eastern Asia,therefore its strong power needs to be confirmed outside this geographic area in Western countries as well as related to the local different antibiotic resistance rates. | Enzo Ierardi Giuseppe Losurdo Rosa Federica La Fortezza Mariabeatrice Principi Michele Barone Alfredo Di Leo | 2019 | World Journal of Gastroenterology2019，25，34： | 15 |
| 8 | Mechanisms of Helicobacter pylori antibiotic resistance:An updated appraisal显示文摘Helicobacter pylori(H. pylori) antibiotic resistance is the main factor affecting the efficacy of the current eradicating therapies. The aim of this editorial is to report on the recent information about the mechanisms accounting for the resistance to the different antibiotics currently utilized in H. pylori eradicating treatments. Different mechanisms of resistance to clarithromycin,metronidazole,quinolones,amoxicillin and tetracycline are accurately detailed(point mutations,redox intracellular potential,pump efflux systems,membrane permeability) on the basis of the most recent data available from the literature. The next hope for the future is that by improving the knowledge of resistance mechanisms,the elaboration of rational and efficacious associations for the treatment of the infection will be possible. Another auspicious progress might be the possibility of a cheap,feasible and reliable laboratory test to predict the outcome of a therapeutic scheme. | Vincenzo De Francesco Angelo Zullo Cesare Hassan Floriana Giorgio Rosa Rosania Enzo Ierardi | 2011 | World Journal of Gastrointestinal Pathophysiology2011，2，3： | 10 |
| 9 | 主要 clarithromycin 抵抗到 Helicobacter pylori : 这是为三倍的治疗失败的主要原因?显示文摘 Conventional triple therapies for Helicobacter pylori (H. pylori ) eradication have recently shown a disappointing reduction in effectiveness in many countries. The main reason for failure was found to be bacterial resistance to one of the most commonly used antibiotics, clarithromycin. An additional problem for conventional triple therapy is the high rate of resistance to metronidazole found in Europe, America and Asia. In Italy, in the last 15 years a 2-fold increase in resistance has occurred. A recent study of the whole of Italy included about 20 patients from each region at the first endoscopic diagnosis of H. pylori infection. The most surprising result was the patchy distribution of resistance, which was almost absent in two regions (one northern and one southern), although the highest prevalence was found in some regions of the South. In the paediatricpopulation we found a 25% prevalence of resistance in a sample of H. pylori positive children observed between 2002 and 2007, mirroring data obtained in southern European countries. Clarithromycin resistance assessment is currently based on phenotypic detection performed after culture the agar dilution method or E-test, and genotypic methods based on polymerase chain reaction (PCR). In a recent comparative study we found a 71.2% agreement between the two methods. Culture-free techniques are highly accurate in finding even minimal traces of genotypically resistant strains. Moreover, PCR-based tools are accurate in detecting a heteroresistant status, defined as the co-existence of some strains that are susceptible and some resistant to the same antibiotic in an individual patient. Three point mutations, namely A2143G , A2142G and A2142C , are responsible for 90% of cases of primary clarithromycin resistance in H. pylori strains isolated in Western countries, although we previously demonstrated that the presence of the A2143G mutation, but not A2142G or A2142C , significantly lowered the H. pylori eradication rate. Treatment failure has considerable cost/benefit implications because of 'waste' of National Health System and patient resources, in terms of drugs, further diagnostic tests and medical examination expenses. Therefore, in future it would be very useful to be able to test for clarithromycin resistance before starting conventional triple therapy. Hopefully, fast, effective noninvasive tests may soon be devised to determine this condition. | Floriana Giorgio Mariabeatrice Principi Vincenzo De Francesco Angelo Zullo Giuseppe Losurdo Alfredo Di Leo Enzo Ierardi | 2013 | World Journal of Gastrointestinal Pathophysiology2013，4，3： | 10 |
| 10 | 酒精对男性生殖功能有何影响?一个文献综述显示文摘酒精被广泛使用,而其对男性生殖功能的影响仍然存在争议。多年来,已经有许多研究调查了酒精对精子参数男性不育症的影响。本文综述了主要的临床前和临床证据。对实验动物进行的研究已经表明,富含乙醇的饮食会导致精子参数异常,导致很多改变,包括抑制生殖道,降低小鼠卵母细胞体外受精率。这些影响在停止酒精消费后是部分可逆的。大多数研究显示酒精对男性参数呈现负面影响。这已被报道与低睾酮症和低于正常和升高的促性腺激素水平有关,暗示着一个联合中枢的、酒精产生的睾丸损害效应。然而,饮洒似乎并没有对生育有太大的影响,无论是在体外授精过程中还是在基于人口的研究中。最后,遗传背景和其他因素,饮酒相关情况会影响睾丸损害的程度。总之,饮酒与精子参数的恶化有关,且这种恶化在停止饮酒后部分可逆。 | Sandro La Vignera Rosita A Condorelli Giancarlo Balercia Enzo Vicari Aldo E Calogero | 2013 | Asian Journal of Andrology2013，15，2： | 9 |
| 11 | Outcome of nonerosive gastro-esophageal reflux disease patients with pathological acid exposure显示文摘AIM: To assess the management and outcome of nonerosive gastro-esophageal reflux disease (NERD) patients who were identified retrospectively, after a 5-year follow-up.METHODS: We included patients with gastro-esophageal reflux disease (GERD) symptoms who had a negative endoscopy result and pathological 24-h esophageal pH-monitoring while off therapy. We interviewed them after an average period of 5 years (range 3.5-7 years) by means of a structured questionnaire to assess presence of GERD symptoms, related therapy, updated en-doscopic data and other features. We assessed predictors of esophagitis development by means of univariate and multivariate statistical analysis.RESULTS: 260 patients (137 women) were included. Predominant GERD symptoms were heartburn andregurgitation in 103/260 (40%). 70% received a maintenance treatment, which was proton pump inhibitor (PPI) in 55% of cases. An average number of 1.5 symptomatic relapses per patient/year of follow-up were observed. A progression to erosive gastro-esophageal reflux disease (ERD) was found in 58/193 (30.0%) of patients undergoing repeat endoscopy; 72% of these were Los Angeles grade A-B. CONCLUSION: This study shows that progression to ERD occurs in about 5% of NERD cases per year, despite therapy. Only two factors consistently and independently influence progression: smoking and absence of PPI therapy. | Fabio Pace Stefano Pallotta Gianpiero Manes Annalisa de Leone Patrizia Zentilin Luigi Russo Vincenzo Savarino Matteo Neri Enzo Grossi Rosario Cuomo | 2009 | World Journal of Gastroenterology2009，15，45： | 8 |
| 12 | Soluble ST2:A new and promising activity marker in ulcerative colitis显示文摘AIM:To correlate circulating soluble ST2(sST2) levels with the severity of ulcerative colitis(UC) and serum levels of pro-inflammatory cytokines,and to demonstrate the predictive power of sST2 levels for differentiation between active and inactive UC.METHODS:We recruited 153 patients:82 with UC,26 with Crohn's disease(CD) and 43 disease controls [non-inflammatory bowel disease(IBD)].Subjects were excluded if they had diagnosis of asthma,autoimmune diseases or hypertension.The serum levels of sST2 and pro-inflammatory cytokines [pg/mL;median(25th-75th)] as well as clinical features,endoscopic and histological features,were subjected to analyses.The sST2 performance for discrimination between active and inactive UC,non-IBD and healthy controls(HC) was determined with regard to sensitivity and specificity,and Spearman's rank correlation coefficient(r).To validate the method,the area under the curve(AUC) of receiver-operator characteristic(ROC) was determined(AUC,95% CI) and the total ST2 content of the colonic mucosa in UC patients was correlated with circulating levels of sST2.RESULTS:The serum sST2 value was significantly higher in patients with active [235.80(90.65-367.90) pg/mL] rather than inactive UC [33.19(20.04-65.32) pg/mL],based on clinical,endoscopic and histopathological characteristics,as well as compared with non-IBD and HC(P < 0.001).The median level of sST2 in CD patients was 54.17(35.02-122.0) pg/mL,significantly higher than that of the HC group only(P < 0.01).The cutoff was set at 74.87 pg/mL to compare active with inactive UC in a multicenter cohort of patients.Values of sensitivity,specificity,and ability to correctly classify UC,according to activity,were 83.33%,83.33% and 83.33%,respectively.The AUC of the ROC curve to assess the ability of this molecule to discriminate between active vs inactive UC was 0.92(0.86-0.97,P < 0.0001).The serum levels of sST2 in patients with UC significantly correlated with endoscopic and histo-pathological scores(r = 0.76 and r = 0.67,P < 0.0001,respectively),and with the pro-inflammatory cytokine,tumor necrosis factor-α(r = 0.69 and r = 0.61,respectively,P < 0.0001).Interestingly,we found a direct correlation between total intestinal ST2 content and serum levels of sST2,adjusted to endoscopic activity score in patients with mild(r = 0.44,P = 0.004),moderate(r = 0.59,P = 0.002) and severe disease(r = 0.82,P = 0.002).Only patients with inactive UC showed no significant correlation(r = 0.45,P = 0.267).CONCLUSION:sST2 levels correlated with disease severity and inflammatory cytokines,are able to differentiate active from inactive UC and might have a role as a biomarker. | David Díaz-Jiménez Lucía E Núez Caroll J Beltrán Enzo Candia Cristóbal Suazo Manuel varez-Lobos María-Julieta González Marcela A Hermoso Rodrigo Quera | 2011 | World Journal of Gastroenterology2011，17，17： | 8 |
| 13 | Seminal vesicles and diabetic neuropathy: ultrasound evaluation in patients with couple infertility and different levels of glycaemic control显示文摘这研究的目的是与糖尿病 mellitus (DM ) 和糖尿病的神经病(DN ) 评估不肥沃的病人的精囊(SV ) 的超声特征并且在与 glycaemic 控制有关的超声特征调查可能的变化。完成这,有类型 2 DM 的 45 个不肥沃的病人和征兆的 DN 被选择。有没有 DM 的自发的 oligoasthenoteratozoospermia 的二十个健康的肥沃的人和 20 个病人代表了控制组。DM 病人任意地根据 glycaemic 控制水平被划分成三个组(A=glycosylated 血色素 < 7 %在 7 % 之间的 B=glycosylated 血色素;并且 10 %C=glycosylated 血色素 > 10 %) 。病人们经历了前列腺小囊的 transrectal ultrasonography 和精子分析。下列 SV 超声参数被记录:(i) 身体 antero 以后的直径(APD ) ;(ii ) 宫底 APD;(iii ) 正确、左的 SV 的顶骨厚度;并且(iv ) 在两 SV 以内的多不的区域的数字。我们然后计算了下列参数:(i) 宫底 / 身体(F/B ) 比率;(ii ) 在权利和左 SV 之间的顶骨厚度的差别;并且(iii )pre 射精并且 ejaculatory 以后 APD 差别。所有 DM 病人与控制相比有更高的 F/B 比率(P< 0.05 ) 。组 C 与另外的 DM 组相比有更高的 F/B 比率(P< 0.05 ) 。有的所有 DM 病人一更低 pre 射精并且与控制相比的身体 SV APD 的 ejaculatory 以后差别(P< 0.05 ) 。组 A 和 B 有一类似 pre 射精并且身体 SV APD 的 ejaculatory 以后差别,而这差别在组 C 是更低的(P< 0.05 ) 。在结论,有 DN 的不肥沃的 DM 病人显示出功能的弛缓暗示的古怪 SV 超声特征,并且低 glycaemic 控制与这些特征的更大的表示被联系。 | Sandro La Vignera Rosita A Condorelli Enzo Vicari Rosario D'Agata Aldo E Calogero | 2011 | Asian Journal of Andrology2011，13，6： | 8 |
| 14 | Effect of corneal light scatter on vision: a review of the literature显示文摘The cornea is the transparent connective tissue window at the front of the eye.The physiological role of the cornea is to conduct external light into the eye,focus it,together with the lens,onto the retina,and to provide rigidity to the entire eyeball.Therefore,good vision requires maintenance of the transparency and proper refractive shape of the cornea.The surface structures irregularities can be associated with wavefront aberrations and scattering errors.Light scattering in the human cornea causes a reduction of visual quality.In fact,the cornea must be transparent and maintain a smooth and stable curvature since it contributes to the major part of the focusing power of the eye.In most cases,a simple examination of visual acuity cannot demonstrate the reduction of visual quality secondary light scattering.In fact,clinical techniques for examining the human cornea in vivo have greatly expanded over the last few decades.The measurement of corneal back scattering qualifies the degree of corneal transparency.The measurement of corneal forward-scattering quantifies the amount of visual impairment that is produced by the alteration of transparency.The aim of this study was to review scattering in the human cornea and methods of measuring it. | Leopoldo Spadea Giorgia Maraone Francesca Verboschi Enzo Maria Vingolo Daniele Tognetto | 2016 | International Journal of Ophthalmology(English edition)2016，9，3： | 7 |
| 15 | Italian survey on non-steroidal anti-inflammatory drugsand gastrointestinal bleeding in children显示文摘AIM: To investigate gastrointestinal complications associated with non-steroidal anti-inflammatory drug(NSAIDs) use in children.METHODS: A retrospective, multicenter study was conducted between January 2005 and January 2013, with the participation of 8 Italian pediatric gastroenterology centers. We collected all the cases of patients who refer to emergency room for suspected gastrointestinal bleeding following NSAIDs consumption, and underwent endoscopic evaluation. Previous medical history, associated risk factors, symptoms and signs at presentation, diagnostic procedures, severity of bleeding and management of gastrointestinal bleeding were collected. In addition, data regarding type of drug used, indication, dose, duration of treatment and prescriber(physician or selfmedication) were examined. RESULTS: Fifty-one patients, including 34 males, were enrolled(median age: 7.8 years). Ibuprofen was the most used NSAID [35/51 patients(68.6%)]. Pain was the most frequent indication for NSAIDs use [29/51 patients(56.9%)]. Seven patients had positive family history of Helicobacter pylori(H. pylori) infection or peptic ulcer, and 12 had associated comorbidities. Twenty-four(47%) out of 51 patients used medication inappropriately. Hematemesis was the most frequent symptom(33.3%). Upper gastrointestinal endoscopy revealed gastric lesions in 32/51(62%) patients, duodenal lesions in 17(33%) and esophageal lesions in 8(15%). In 10/51(19.6%) patients, a diagnosis of H. pylori gastritis was made. Forty-eight(94%) patients underwent medical therapy, with spontaneous bleeding resolution, while in 3/51(6%) patients, an endoscopic hemostasis was needed.CONCLUSION: The data collected in this study confirms that adverse events with the involvement of the gastrointestinal tract secondary to NSAID use are also common in | Sabrina Cardile Massimo Martinelli Arrigo Barabino Paolo Gandullia Salvatore Oliva Giovanni Di Nardo Luigi Dall'Oglio Francesca Rea Gian Luigi de'Angelis Barbara Bizzarri Graziella Guariso Enzo Masci Annamaria Staiano Erasmo Miele Claudio Romano | 2016 | World Journal of Gastroenterology2016，22，5： | 7 |
| 16 | Helicobacter pylori therapy:Present and future显示文摘Helicobacter pylori(H.pylori) plays a crucial role in the pathogenesis of chronic active gastritis,peptic ulcer and gastric mucosa-associated lymphoid tissue-lymphoma,and is also involved in carcinogenesis of the stomach.H.pylori treatment still remains a challenge for physicians,since no current first-line therapy is able to cure the infection in all treated patients.Several factors may help in the eradication of therapy failure.We reviewed both bacterial and host factors involved in therapeutic management of the H.pylori infection.In addition,we evaluated data on the most successful therapy regimens-sequential and concomitant therapies-currently available for H.pylori eradication. | Vincenzo De Francesco Enzo Ierardi Cesare Hassan Angelo Zullo | 2012 | World Journal of Gastrointestinal Pharmacology and Therapeutics2012，3，4： | 7 |
| 17 | 伴随自主神经病变的二型糖尿病人中雄附腺炎症的发病率显示文摘雄附腺炎(MAGI)在二型糖尿病人(DM2)当中可能被漏诊。近期文献报道TDM2中MAGI的发病率是43%。以往的研究证明糖尿病患者的自主神经病变与精子囊泡的特有超声波有关。本项研究意在评估二类DM2患者(是否具有自主神经病变)的MAGI发病率并测定各自的超声特征。共60例DM2患者(平均年龄42.0±6.0岁)根据是否具有自主神经病变分为二组(A组具有可能的神经病变症状共28人,B组无神经病变症状共32人)。结果发现A组较B组有更高的MAGI发病率及精囊炎的超声频率。此外,A组患者精液中的淋巴细胞聚焦浓度显著高于B组。 | Rosita A Condorelli Enzo Vicari Aldo E Calogero Sandro La Vignera | 2014 | Asian Journal of Andrology2014，16，5： | 6 |
| 18 | Furazolidone therapy for Helicobacter pylori:Is it effective and safe?显示文摘Some aspects related with the use of furazolidone as a rescue therapy for Helicobacter pylori(H pylori) infection should be remarked,especially regarding its potential oncologic risk.The inclusion of furazolidone in a treatment regimen for H pylori infection is,at least,controversial,and it does not appear to be safe. | Vincenzo De Francesco Enzo Ierardi Cesare Hassan Angelo Zullo | 2009 | World Journal of Gastroenterology2009，15，15： | 6 |
| 19 | Artifi cial neural networks in the recognition of the presence of thyroid disease in patients with atrophic body gastritis显示文摘AIM: To investigate the role of artifi cial neural networks in predicting the presence of thyroid disease in atrophic body gastritis patients. METHODS: A dataset of 29 input variables of 253 atrophic body gastritis patients was applied to artifi cial neural networks (ANNs) using a data optimisation procedure (standard ANNs,T&T-IS protocol,TWIST protocol). The target variable was the presence of thyroid disease. RESULTS: Standard ANNs obtained a mean accuracy of 64.4% with a sensitivity of 69% and a specifi city of 59.8% in recognizing atrophic body gastritis patients with thyroid disease. The optimization procedures (T&T-IS and TWIST protocol) improved the performance of the recognition task yielding a mean accuracy,sensitivity and specifi city of 74.7% and 75.8%,78.8% and 81.8%,and 70.5% and 69.9%,respectively. The increase of sensitivity of the TWIST protocol was statistically signifi cant compared to T&T-IS. CONCLUSION: This study suggests that artificial neural networks may be taken into consideration as a potential clinical decision-support tool for identifying ABG patients at risk for harbouring an unknown thyroid disease and thus requiring diagnostic work-up of their thyroid status. | Edith Lahner Marco Intraligi Massimo Buscema Marco Centanni Lucy Vannella Enzo Grossi Bruno Annibale | 2008 | World Journal of Gastroenterology2008，14，4： | 6 |
| 20 | Management of liver cirrhosis between primary care and specialists显示文摘This article discusses a practical, evidence-based approach to the diagnosis and management of liver cirrhosis by focusing on etiology, severity, presence of complications, and potential home-managed treatments. Relevant literature from 1985 to 2010 (PubMed) was reviewed. The search criteria were peer-reviewed full papers published in English using the following MESH headings alone or in combination: 'ascites', 'liver fibrosis', 'cirrhosis', 'chronic hepatitis', 'chronic liver disease', 'decompensated cirrhosis', 'hepatic encephalopathy', 'hypertransaminasemia', 'liver transplantation' and 'portal hypertension'. Forty-nine papers were selected based on the highest quality of evidence for each section and type (original, randomized controlled trial, guideline, and review article), with respect to specialist setting (Gastroenterology, Hepatology, and Internal Medicine) and primary care. Liver cirrhosis from any cause represents an emerging health issue due to the increasing prevalence of the disease and its complications worldwide. Primary care physicians play a key role in early identification of risk factors, in the management of patients for improving quality and length of life, and for preventing complications. Specialists, by contrast, should guide specific treatments, especially in the case of complications and for selecting patient candidates for liver transplantation. An integrated approach between specialists and primary care physicians is essential for providing better outcomes and appropriate home care for patients with liver cirrhosis. | Ignazio Grattagliano Enzo Ubaldi Leonilde Bonfrate Piero Portincasa | 2011 | World Journal of Gastroenterology2011，17，18： | 5 |
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